Publications by authors named "Mohsen Dehghani"

52 Publications

The Relationship Between Ruminating the Catastrophic Consequences of Bodily Changes and Positive Reappraisal and Practical Problem-Solving Strategies in Individuals With Illness Anxiety Disorder.

Basic Clin Neurosci 2020 Sep-Oct;11(5):639-648. Epub 2020 Sep 1.

Interdisciplinary Program in Neuroscience, Bilkent University, Ankara, Turkey.

Introduction: Cognitive emotion regulation is suggested to contribute to Illness Anxiety Disorder (IAD). Reappraisal and suppression are essential ER strategies with controversial data about their roles in IAD. Relevant studies are mostly limited to exploring these two strategies in individuals without such disorder. Therefore, we aimed to study the role of emotion regulation in the psychopathology of IAD by evaluating other ER strategies in illness-anxious individuals. Furthermore, we investigated the relationship between IAD and emotion regulation by targeting the role of interpretation bias for health-related information.

Methods: The study participants were 60 university students. They underwent a semi-structured clinical interview to assess the presence or absence of IAD symptoms (n=30/group). They completed a battery of questionnaires measuring IAD, emotion regulation, and interpretation bias.

Results: The illness-anxious group applied significantly less reappraisal and refocus on planning and more rumination, catastrophizing, and acceptance strategies, compared to the controls. Besides, interpretation bias was positively correlated with rumination and catastrophizing; while its association with reappraisal and planning was negative.

Conclusion: Both functional (e.g. reappraisal & planning) and dysfunctional strategies (e.g. rumination & catastrophizing) contributed to the psychopathology of IAD. The biased interpretation of bodily information could make individuals prone to ruminate about the catastrophic consequences of bodily changes; such conditions interrupt fostering more positive reappraisal or practical problem-solving strategies.
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http://dx.doi.org/10.32598/bcn.9.10.240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878061PMC
September 2020

Time course of attentional bias to painful facial expressions and the moderating role of attentional control: an eye-tracking study.

Br J Pain 2021 Feb 31;15(1):5-15. Epub 2019 Jul 31.

Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.

Introduction: This study investigated the time course of attention to pain and examined the moderating effect of attentional control in the relationship between pain catastrophizing and attentional bias in chronic pain patients.

Methods: A total of 28 patients with chronic pain and 29 pain-free individuals observed pictures of pain, happy and neutral facial expressions while their gaze behaviour was recorded. Pain intensity and duration, anxiety, depression, stress, attentional control and pain catastrophizing were assessed by questionnaires.

Results: In all subjects, the pattern of attention for pain faces was characterized by initial vigilance, followed by avoidance. No significant difference was found between the two groups in terms of orientation towards the stimuli, the duration of first fixation, the average duration of fixation or number of fixations on the pain stimuli. Attentional control moderated the relationship between catastrophizing and overall dwell time for happy faces in pain patients, indicating that those with high attentional control and high catastrophizing focused more on happy faces, whereas the reverse was true for those with low attentional control.

Conclusion: This study supported the vigilance-avoidance pattern of attention to painful facial expressions and a moderation effect of attentional control in the association between pain catastrophizing and attentional bias to happy faces among pain patients.
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http://dx.doi.org/10.1177/2049463719866877DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882769PMC
February 2021

Emotional working memory updating in individuals with borderline personality features.

J Behav Ther Exp Psychiatry 2021 Jun 5;71:101636. Epub 2021 Jan 5.

Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.

Background And Objectives: Individuals with features of borderline personality disorder (BPD) are highly sensitive to social rejection. Working memory (WM) may play a critical role in processing emotional interpersonal information in BPD. Yet, little is known about how emotional WM operations are related to sensitivity to rejection cues and BPD features. Therefore, this study examined relationships among emotional WM operations, rejection sensitivity, and BPD features.

Methods: Participants with BPD features (n = 39 with non-suicidal self-injury history; n = 47 without non-suicidal self-injury history) and healthy participants (n = 46) completed an emotional two-back task before and after a social exclusion induction (the Cyberball game).

Results: Results showed that participants with BPD features were slower at discarding faces expressing anger and pain from WM compared to healthy individuals before the social exclusion induction. Participants with BPD features and a history of self-injury were also slower at entering happy faces into WM compared to the other participants. Moreover, across participants, slower WM discarding of angry and pain faces was associated with higher levels of rejection sensitivity. Finally, no group differences emerged with respect to WM entering and discarding operations for emotional faces in response to social exclusion.

Limitations: This study was conducted in a sample of undergraduate students and did not consider comorbidity with other forms of psychopathology.

Conclusions: These findings cast light on how emotional WM difficulties may be involved in how individuals with BPD process emotional interpersonal information.
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http://dx.doi.org/10.1016/j.jbtep.2021.101636DOI Listing
June 2021

Calcium intake, calcium supplementation and cardiovascular disease and mortality in the British population: EPIC-norfolk prospective cohort study and meta-analysis.

Eur J Epidemiol 2020 Dec 31. Epub 2020 Dec 31.

Ageing Clinical and Experimental Research (ACER) Team, University of Aberdeen, Aberdeen, UK.

The role of dietary calcium in cardiovascular disease prevention is unclear. We aimed to determine the association between calcium intake and incident cardiovascular disease and mortality. Data were extracted from the European Prospective Investigation of Cancer, Norfolk (EPIC-Norfolk). Multivariable Cox regressions analysed associations between calcium intake (dietary and supplemental) and cardiovascular disease (myocardial infarction, stroke, heart failure, aortic stenosis, peripheral vascular disease) and mortality (cardiovascular and all-cause). The results of this study were pooled with those from published prospective cohort studies in a meta-analsyis, stratifying by average calcium intake using a 700 mg/day threshold. A total of 17,968 participants aged 40-79 years were followed up for a median of 20.36 years (20.32-20.38). Compared to the first quintile of calcium intake (< 770 mg/day), intakes between 771 and 926 mg/day (second quintile) and 1074-1254 mg/day (fourth quintile) were associated with reduced all-cause mortality (HR 0.91 (0.83-0.99) and 0.85 (0.77-0.93), respectively) and cardiovascular mortality [HR 0.95 (0.87-1.04) and 0.93 (0.83-1.04)]. Compared to the first quintile of calcium intake, second, third, fourth, but not fifth quintiles were associated with fewer incident strokes: respective HR 0.84 (0.72-0.97), 0.83 (0.71-0.97), 0.78 (0.66-0.92) and 0.95 (0.78-1.15). The meta-analysis results suggest that high levels of calcium intake were associated with decreased all-cause mortality, but not cardiovascular mortality, regardless of average calcium intake. Calcium supplementation was associated with cardiovascular and all-cause mortality amongst women, but not men. Moderate dietary calcium intake may protect against cardiovascular and all-cause mortality and incident stroke. Calcium supplementation may reduce mortality in women.
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http://dx.doi.org/10.1007/s10654-020-00710-8DOI Listing
December 2020

Interpretations of partners' responses to pain behaviours: Perspectives of patients and partners.

Br J Health Psychol 2020 Nov 12. Epub 2020 Nov 12.

Department of Health Psychology, University Medical Center Groningen, University of Groningen, The Netherlands.

Objectives: Partner's responses to pain behaviours play a pivotal role in the patient's adjustment. This study aims to further our knowledge regarding patients' and partners' interpretation of partners' responses to pain behaviours, and the possible discrepancies between patients' and partners' perceptions. Further, this study examines patients' preferred responses to pain behaviours and possible discrepancies between received and preferred responses to pain behaviours.

Design: A qualitative research design based on a semi-structured in-depth interview.

Methods: Patients with chronic low back pain and their partners (n = 54) were recruited through purposive sampling and interviewed. Data were analysed based on an inductive analytic approach.

Results: Patients as well as partners indicated a number of different interpretations of partners' responses to pain behaviours, including invalidation, relieving pain, validation, encouragement, caregiving exhaustion, and expressing resentment. Patients and partners revealed similarities in the interpretation of response categories that they associated with validation, invalidation, and expressing resentment. Discrepancies between patients and partners indicated that partners interpreted some responses as caused by caregiving exhaustion while patients did not. Patients perceived partner responses that included the active involvement of the partner (e.g., encouraging pain talk) more positively than responses that showed less active involvement of the partner.

Conclusion: Patients and partners are likely to make various interpretations of a certain partner response to pain behaviours. Our findings underscore that patients' interpretation about a certain behaviour might determine whether that behaviour is rated as desirable or aversive.
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http://dx.doi.org/10.1111/bjhp.12490DOI Listing
November 2020

Elevated Blood-Based Brain Biomarker Levels in Patients with Epileptic Seizures: A Systematic Review and Meta-analysis.

ACS Chem Neurosci 2020 12 4;11(24):4048-4059. Epub 2020 Nov 4.

Hearing Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran.

Recently, growing attention has been paid to the changes of brain biomarkers following the epilepsy. However, establishing specific epilepsy-related biomarkers has been impeded due to contradictory findings. This study systematically reviewed the evidence on brain biomarkers in epilepsy and determined reliable biomarkers in epileptic patients. A comprehensive systematic search of online databases was performed to find eligible studies up to August 2019. The quality of studies methodologically was assessed using the Newcastle-Ottawa Scale score. Among the several biomarkers, S100 calcium binding protein B (S100B) and neuron specific enolase (NSE) have been qualified for meta-analysis of the association between epilepsy and the brain biomarkers. Inverse-variance weights method was used to calculate pooled standardized mean difference (SMD) estimate with 95% CI, and random effects meta-analysis was conducted taking into account conceptual heterogeneity. Sensitivity analysis and publication bias assessment was performed using Stata. Of 29 studies that were qualified for further analysis, only 22 studies were eligible to quantify by meta-analysis. Significant increase of serum S100B levels (SMD = 0.80; 95% CI 0.18 to 1.42) but not NSE (SMD = 0.45; 95% CI -0.09 to 1.00) has been found in epileptic patients compared with healthy controls. Subgroup meta-analysis by age demonstrated that S100B could be found in pediatric (SMD = 1.15; 95% CI 0.03 to 2.27) not adult patients (SMD = 0.43; 95% CI -0.12 to 0.98). Findings of this meta-analysis indicate that serum level of S100B is significantly increased in epileptic patients, suggesting the elevation and release of the brain biomarkers from brain to blood following epileptic seizures.
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http://dx.doi.org/10.1021/acschemneuro.0c00492DOI Listing
December 2020

Optimized dose of synthetic analogues of Monophosphoryl lipid A as an effective alternative for formulating recombinant human papillomavirus vaccine.

Biologicals 2020 Nov 25;68:60-64. Epub 2020 Aug 25.

Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran. Electronic address:

Adjuvants are a crucial component of recombinant vaccines such as the human papillomavirus (HPV) vaccine. Monophosphoryl lipid A (MPL) extracted from Salmonella Minnesota lipopolysaccharide is used as an adjuvant for the HPV vaccine. Due to the limitations in accessibility and reproducibility of MPL, investigating synthetic analogues of MPL (synMPL) is urgently needed to overcome these limitations. In this study, female BALB/c mice were vaccinated by HPV vaccine formulated with synMPL and aluminum hydroxide gel in which the concentration of synMPL ranged from 0 to 100 μg/dose. Anti-HPV L1 VLP antibody was measured for each group through Indirect ELISA and compared with Cervarix and Gardasil vaccines as approved anti-HPV vaccines. SynMPL showed a concentration-dependent increase up to 50 μg/dose in the immunogenicity of the vaccine. Therefore, synMPL at concentration of 50 μg/dose was selected as optimum concentration. The GMT profiling of synMPL-formulated vaccine (named Papilloguard) and Cervarix was not statistically different (Mann-Whitney test). The Gardasil vaccine showed 10-fold lower GMT for anti-HPV 18 L1 VLP antibody but anti-HPV 16 L1 VLP antibody was similar to Cervarix and Papilloguard. The current findings suggest that the synMPL in combination with aluminum hydroxide could be used as a potential adjuvant candidate for human vaccine.
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http://dx.doi.org/10.1016/j.biologicals.2020.08.007DOI Listing
November 2020

Why do Patients Engage in Pain Behaviors? A Qualitative Study Examining the Perspective of Patients and Partners.

Clin J Pain 2020 10;36(10):750-756

Department of Health Psychology, University of Groningen, University Medical Center Groningen, The Netherlands.

Objectives: Patients' pain behavior plays an important role in the interaction between patients and their partners, as acknowledged in operant models of pain. However, despite the considerable research attention to pain behaviors, the underlying motives of such behaviors are still unclear. The current study explores the motives to engage in pain behaviors and the possible discrepancies between individuals experiencing pain and partners' perceptions of those motives.

Methods: A qualitative study was performed, comprising semistructured interviews with 27 patients with chronic low back pain and their partners. They were recruited through purposive sampling at 2 pain clinics located in Tehran, Iran.

Results: Patients and partners mentioned a variety of motives for pain behaviors, including protecting oneself against more pain, regulating negative emotions, informing others about the pain severity, seeking validation or intimacy, gaining advantages from pain, and expressing anger. Patients and partners revealed the most similarities in motives such as protecting oneself against more pain and informing others about the pain severity. However, partners rarely acknowledged patients' motives for seeking validation and they were more likely to mention negative motives (eg, expressing anger).

Discussion: In conclusion, partners are more likely to attribute negative motives to the patient's pain behaviors, which may lead to their hostility toward patients. The findings of this study provide new insights into motives of pain behaviors from the perspective of patients and partners, which can inform couple-based interventions in terms of effective pain communication.
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http://dx.doi.org/10.1097/AJP.0000000000000868DOI Listing
October 2020

Attentional control moderates the relationship between pain catastrophizing and selective attention to pain faces on the antisaccade task.

Sci Rep 2020 07 30;10(1):12885. Epub 2020 Jul 30.

Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.

Cognitive models of chronic pain emphasize the critical role of pain catastrophizing in attentional bias to pain-related stimuli. The aim of this study was (a) to investigate the relationship between pain catastrophizing and the ability to inhibit selective attention to pain-related faces (attentional bias); and (b) to determine whether attentional control moderated this relationship. One hundred and ten pain-free participants completed the anti-saccade task with dynamic facial expressions, specifically painful, angry, happy, and neutral facial expressions and questionnaires including a measure of pain catastrophizing. As predicted, participants with high pain catastrophizing had significantly higher error rates for antisaccade trials with pain faces relative to other facial expressions, indicating a difficulty disinhibiting attention towards painful faces. In moderation analyses, data showed that attentional control moderated the relationship between attentional bias to pain faces and pain catastrophizing. Post-hoc analyses demonstrated that it was shifting attention (not focusing) that accounted for this effect. Only for those with high self-reported ability to shift attention was there a significant relationship between catastrophizing and attentional bias to pain. These findings confirm that attentional control is necessary for an association between attentional bias and catastrophizing to be observed, which may explain the lack of relationships between attentional bias and individual characteristics, such as catastrophizing, in prior research.
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http://dx.doi.org/10.1038/s41598-020-69910-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7393078PMC
July 2020

Pain Catastrophizing Thoughts Explain the Link Between Perceived Caregiver Responses and Pain Behaviors of Patients With Chronic Musculoskeletal Pain.

Front Psychol 2020 3;11:1386. Epub 2020 Jul 3.

Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.

Purpose: Caregivers' responses to pain behaviors of patients with chronic pain have an essential role in how patients perceive their pain condition. The current study investigated the mediating role of pain catastrophizing on the link between perceived caregiver responses and patient pain behaviors.

Materials And Methods: The sample of this cross-sectional study consisted of 200 patients with chronic pain (mean of age = 44.6; 71.5% were female). Participants responded to measures assessing their perception of their caregiver responses to their pain, their pain catastrophizing thoughts, and their pain behaviors.

Results: The mediation analyses showed that perceived distracting responses were negatively related to pain catastrophizing level in patients, which in turn was positively associated with expressing pain behaviors. Besides, perceived caregiver negative responses were positively associated with catastrophizing thoughts, which in turn was positively related to expressing pain behaviors.

Conclusion: Patients' perceptions regarding how their caregiver responds to their pain condition can be related to their thoughts about their pain and how they react to their pain situation. Investigating the external sources that might have an impact on patients' reactions to their pain, especially when those external sources are caregivers who, in most situations, are with the patients for a prolonged duration, is essential.
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http://dx.doi.org/10.3389/fpsyg.2020.01386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7349588PMC
July 2020

Evaluation of targetable biomarkers for chimeric antigen receptor T-cell (CAR-T) in the treatment of pancreatic cancer: a systematic review and meta-analysis of preclinical studies.

Int Rev Immunol 2020 16;39(5):223-232. Epub 2020 Jun 16.

Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.

One of the cutting edge techniques for treating cancer is the use of the patient's immune system to prevail cancerous disease. The versatility of the chimeric antigen receptor (CAR) T-cell approach in conjugation with promising treatments in haematological cancer has led to countless cases of research literature for the treatment of solid cancer. A systematic search of online databases as well as gray literature and reference lists of retrieved studies were carried out up to March 2019 to identify experimental animal studies that investigated the antigens targeted by CAR T-cell for pancreatic cancer treatment. Studies were evaluated for methodological quality using the SYstematic Review Center for Laboratory Animal Experimentation bias risk tool (SYRCLE's ROB tool). Pooled cytotoxicity ratio/percentage and 95% confidence intervals were calculated using the inverse-variance method while random-effects meta-analysis was used, taking into account conceptual heterogeneity. Heterogeneity was assessed with the Cochran statistic and quantified with the statistic using Stata 13.0. Of the 485 identified studies, 56 were reviewed in-depth with 16 preclinical animal studies eligible for inclusion in the systematic review and 11 studies included in our meta-analysis. CAR immunotherapy significantly increased the cytotoxicity assay (percentage: 65%; 95% CI: 46%, 82%). There were no evidence for significant heterogeneity across studies [ = 0.38 ( statistics), 2 = 7.14%] and for publication bias. The quality assessment of included studies revealed that the evidence was moderate to low quality and none of studies was judged as having a low risk of bias across all domains. CAR T-cell therapy is effective for pancreatic cancer treatment in preclinical animal studies. Further high-quality studies are needed to confirm our finding and a standard approach of this type of studies is necessary according to our assessment.
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http://dx.doi.org/10.1080/08830185.2020.1776274DOI Listing
June 2020

Association of antibiotics therapy during pregnancy with spontaneous miscarriage: a systematic review and meta-analysis.

Arch Gynecol Obstet 2020 07 14;302(1):5-22. Epub 2020 May 14.

Endocrinology Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.

Purpose: This systematic review and meta-analysis of observational studies were conducted to assess the association between antibiotics use during pregnancy and spontaneous miscarriage.

Methods: A systematic search of online databases as well as reference lists of retrieved studies were performed up to September 2018 to identify observational studies that investigated the association between antibiotics use and spontaneous miscarriage. The retrieved studies were assessed for methodological quality. Pooled relative risk (RR) and 95% confidence intervals were calculated using DerSimonian and Laird method. Random-effects meta-analysis was used to account for conceptual heterogeneity. Sensitivity analysis was performed to assess the robustness of pooled estimates using Stata software.

Results: Of 1435 retrieved studies, 89 were reviewed in depth and 12 (8 prospective cohort and 4 population-based case-control studies) met the criteria for inclusion in a systematic review with 1,084,792 participants and 7015 cases of spontaneous miscarriage. Finally, 11 studies were included in the meta-analysis (one study was not included in the meta-analysis owing to methodological issues and low-quality score). Overall percentage of miscarriage in women who received antibiotics was 2.6%. After adjusting for important potential confounders, use of macrolides (RR: 1.42; 95% CI 1.04, 1.93), quinolones (RR: 2.48; 95% CI 1.46, 4.20), and tetracyclines (RR: 2.57; 95% CI 1.95, 3.38) during pregnancy were significantly associated with spontaneous miscarriage. In macrolides class, a significant positive association was found between clarithromycin and spontaneous miscarriage (RR: 1.98; 95% CI 1.46, 2.70). Sensitivity analysis demonstrated the consistency of the results, indicating that the meta-analysis model was robust.

Conclusion: Findings support a significant positive association between use of macrolides (especially clarithromycin), quinolones, and tetracyclines during pregnancy and spontaneous miscarriage, although it should be interpreted with caution in the context of limitations of the available data.

Review Registration: International register for systematic reviews; PROSPEROCRD42018093465.
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http://dx.doi.org/10.1007/s00404-020-05569-4DOI Listing
July 2020

Development and Validation of Fear of Relapse Scale for Relapsing-Remitting Multiple Sclerosis: Understanding Stressors in Patients.

Front Psychiatry 2020 20;11:226. Epub 2020 Mar 20.

Department of Psychology, Shahid Beheshti University, Tehran, Iran.

Chronic diseases are associated with patients' long-term stress and development of fear to things related to the source of stress. Better management of a patients' condition requires investigation of the underlying mechanisms that contribute to the process of development of chronic stress. Multiple Sclerosis (MS) is a debilitating chronic disease in most cases diagnosed after a relapse and characterized by the periodic occurrence of relapses in most patients. Due to the unpredictable course of the disease and relapses, patients with Relapsing-Remitting MS (RRMS) may deal with the stress of anticipation of relapse and its unpredictable consequences. The role of relapses and related stress on patients' quality of life has not been previously investigated. This study is the first effort to develop a self-report measure of Fear of Relapse (FoR) in patients with RRMS. Thirty-one items were extracted from in-depth clinical interviews with 33 RRMS patients to develop the preliminary version of the scale. Subsequently, 168 RRMS patients completed the questionnaire, the Intolerance of Uncertainty Scale (IUS) and Depression, Anxiety, and Stress Scale (DASS). Fifty-one patients completed the scale one more time a month later. Factor analysis revealed three components, and five items failed to load on any of them. To test the FoR's independence from similar measures, responses to 26 items were pooled once with DASS items and once with IUS items, and each time were subjected to confirmatory factor analysis (two-component solution). Despite significant correlations between FoR, DASS, and IUS Independent loadings of items belonging to FoR and DASS, and FoR and IUS revealed independence and unique contribution of FoR to the evaluation of patients. Cronbach's alpha for the 26-item version was 0.92. Test-retest reliability for total score was equal to 0.74. These findings provide preliminary evidence of the validity and reliability of the measure. This scale can help researchers and clinicians to have a more comprehensive understanding of patients' experience with the uncertain nature of MS, which is necessary for future efforts to address this stressor by targeting the underlying mechanism.
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http://dx.doi.org/10.3389/fpsyt.2020.00226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7100001PMC
March 2020

Factor structure and invariance of the pain catastrophizing scale in patients with chronic pain and their spouses.

Rehabil Psychol 2021 Feb 6;66(1):50-56. Epub 2020 Apr 6.

Department of Occupational Science and Occupational Therapy.

Purpose: This study was designed to investigate the equivalency and factor structure of the patients and significant others' version of pain catastrophizing scales in patients with chronic pain and their spouses who are not in pain.

Method: Participants were 142 married couples in which 1 spouse reported chronic musculoskeletal pain. Confirmatory factor analyses were used to compare 4 models of pain catastrophizing, and to examine the invariance of the factor structure of the PCS-Patient version and the PCS-Significant other version in patients with chronic pain and their spouses.

Results: The results indicated that the 2-factor oblique model provided an adequate fit to the data of both patients with chronic pain and their spouses who are not in pain. Moreover, it was found that when gender was controlled, the hypothesized factor structures of the PCS-patient version and the PCS-Significant other version were invariant. Indeed, it was revealed that the PCS-Patient version and the PCS-Significant other version measure the same factors in couples in which 1 of them have a chronic pain condition.

Conclusions: The findings of the current study showed that the 2-factor oblique model is the best fit in both samples (i.e., patients with chronic pain and their spouses). Therefore, it can be suggested that these versions can be used among patients and their spouses and the findings regarding them can be compared. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/rep0000322DOI Listing
February 2021

The Association of Food Intake and Physical Activity with Body Composition, Muscle Strength, and Muscle Function in Postmenopausal Women.

Methods Mol Biol 2020 ;2138:363-371

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

Sarcopenia is defined as an age-related reduction in muscle mass and performance. Some of the most important risk factors include advanced age, malnutrition, and sedentary lifestyle. The aim of this study was to investigate the association of food intake and physical activity with body composition, muscle strength, and muscle function in a cross-sectional study of postmenopausal women. This analysis gave a positive association between physical activity and handgrip strength, calorie intake and muscle function, protein intake and fat-free mass percentage, and total fat intake and fat mass percentage. In addition, there were negative associations found between carbohydrate intake and muscle function, as well as total fat intake and fat-free mass percentage. This chapter presents a protocol for the study setup along with measurements of physical activity, handgrip strength, nutrient intake, and fat-free mass percentage.
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http://dx.doi.org/10.1007/978-1-0716-0471-7_26DOI Listing
March 2021

Effect of Vitamin D Supplementation on Muscle Strength, Muscle Function, and Body Composition in Vitamin D-Deficient Middle-Aged Women.

Methods Mol Biol 2020 ;2138:351-361

Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Sarcopenia is the loss of muscle strength and muscle mass with aging and is one of the major risk factors for metabolic diseases. Cross-sectional studies have shown that vitamin D is associated with sarcopenia in both men and women. We investigated the effect of vitamin D supplementation over 12 weeks on muscle strength, muscle function, and body composition in middle-aged women in randomized double-blind placebo-controlled trial format. This revealed a significant difference in serum 25-hydroxyvitamin D levels between the intervention and placebo groups. In addition, handgrip strength was improved, and the timed get up and go (TGUG) test and body fat content were decreased. This chapter presents a protocol for trial setup involving measurement of vitamin D levels, handgrip strength, the TGUT test, and body composition as readouts.
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http://dx.doi.org/10.1007/978-1-0716-0471-7_25DOI Listing
March 2021

Efficacy of complete rings (MyoRing) in treatment of Keratoconus: a systematic review and meta-analysis.

Int Ophthalmol 2019 Dec 1;39(12):2929-2946. Epub 2019 Jun 1.

Department of Epidemiology, School of Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.

Purpose: We aimed to systematically review the existing evidence and determine the efficacy of MyoRing as a novel method for treatment of keratoconus using meta-analysis.

Methods: Online electronic search of Medline, ISI Web of Science, Embase, Scopus, and Cochrane Library databases was performed with reference lists of relevant articles for pre-post trials published through August 2017. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere, cylinder, spherical equivalent (SE), maximum, minimum, and mean keratometry were considered as the visual acuity outcomes. Weighted mean difference (WMD) with 95% confidence interval was used as pooled estimation of intervention efficacy using random-effects meta-analysis. Heterogeneity was measured with the Cochran Q statistic and quantified with the I statistic using Stata software.

Results: Of the 47 potentially related studies, 21 eligible studies were included in the meta-analysis. The mean of uncorrected distance visual acuity (UDVA) based on LogMAR in patients with keratoconus had a significant change 3 months after implantation/embedding of the complete ring (WMD =  - 0.73 (CI = - 0.88 to - 0.58), I = 79.9%, p < 0.001). Results support a statistically significance improvement in CDVA, SE, sphere, cylinder, and maximum keratometry after surgical intervention. Range of reported safety index, stability, and efficacy index by included studies was 1.7-2.7, 74-100%, and 0.9-1.96, respectively.

Conclusions: MyoRing is an appropriate treatment option for keratoconus. Findings of this meta-analysis demonstrated that main visual outcomes have been improved 3, 6, and 12 months after the implantation of the complete ring (MyoRing).
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http://dx.doi.org/10.1007/s10792-019-01121-9DOI Listing
December 2019

Early maladaptive schemas and borderline personality disorder features in a nonclinical sample: A network analysis.

Clin Psychol Psychother 2019 May 5;26(3):388-398. Epub 2019 Mar 5.

Department of Experimental, Clinical and Health Psychology, Ghent University, Ghent, Belgium.

Borderline personality disorder (BPD) is a challenging problem. Early maladaptive schemas (EMSs) are considered as important vulnerability factors for the development and maintenance of BPD. Literature suggests a complex relationship between BPD and EMSs. The current study employed network analysis to model the complex associations between central BPD features (i.e., affective instability, identity problems, negative relations, and self-harm) and EMSs in 706 undergraduate students. The severity of BPD symptoms was assessed using the Personality Assessment Inventory-Borderline subscale; the Young Schema Questionnaire-Short Form was used to assess EMSs. Results suggest that specific EMSs show unique associations with different BPD features. Interestingly, affective instability showed no unique associations with EMSs. Identity problems were uniquely associated with abandonment, insufficient self-control, dependence/incompetence, and vulnerability to harm/illness schemas. Negative relations in BPD showed unique connections with mistrust/abuse and abandonment. Finally, BPD self-harm was connected to emotional deprivation and failure. These findings indicate potential pathways between EMSs and specific BPD features that could improve our understanding of BPD theoretically and clinically.
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http://dx.doi.org/10.1002/cpp.2360DOI Listing
May 2019

Association between tobacco smoking and opioid use: A meta-analysis.

Addict Behav 2019 05 4;92:225-235. Epub 2018 Dec 4.

Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Non-Communicable Disease Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Tobacco smoking has been shown to be a major risk factor for opioid use and opioid use disorders in several observational studies; however, the results are inconsistent. Thus, this systematic review and meta-analysis of observational studies was conducted to investigate the association between smoking behavior and opioid use and opioid use disorders.

Methods: A systematic literature search of relevant keywords was done in Medline, Embase, Scopus, Web of Science, and Google Scholar up to October 2017. The reference lists of retrieved articles were also examined for inclusion. While random effects meta-analysis was used, pooled odds ratio (OR) and 95% confidence intervals were calculated using Der-Simonian and Laird method, taking into account conceptual heterogeneity. Subgroup analyses were performed using participants and studies' characteristics to assess the sources of heterogeneity.

Results: Ten eligible observational studies (6 cohorts and 4 population-based cross sectional studies), with 175,063 participants, were identified. The pooled OR of opioid use disorders was 8.23 (95% CI: 3.07-22.09) for current smokers compared to nonsmokers; pooled OR for opioid use was 2.51 (95% CI: 1.91-3.28). Opioid use or opioid use disorders were positively associated with earlier age at onset of smoking (pooled OR = 1.66; 95% CI: 1.28-2.16).

Conclusions: The results of this meta-analysis confirmed that tobacco smoking is associated with opioid use and opioid use disorders development. This conclusion has an important public health message for areas with high smoking prevalence and high opioid use and opioid use disorders incidence.
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http://dx.doi.org/10.1016/j.addbeh.2018.11.043DOI Listing
May 2019

Liver Transplantation Status in Iran: A Multi-center Report on the Main Transplant Indicators and Survival Rates.

Arch Iran Med 2018 07 1;21(7):275-282. Epub 2018 Jul 1.

Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Iran's experience with liver transplantation (LT) began more than two decades ago. The purpose of this article is to present the status of LT in Iran, review specific characteristics of the programs, their outcomes, and their growth to become one of the largest LT programs in the world.

Methods: A questionnaire, asking for data on the number of transplants performed and specifics of the recipients and type of donors with focus on indications and outcomes was sent to LT programs.

Results: During a period of 23 years, 4,485 LTs were performed at 6 centers in the country. Of these, 4106 were from deceased donors and 379 were from living donors. There were 3553 adults and 932 pediatric recipients. Hepatitis B and biliary atresia were the most common etiologies in adult and pediatric patients, respectively. Overall survival rates at 1, 5, and 10 years were 85%, 77%, and 71% for adults and 76%, 67% and 56% for pediatric patients, respectively.

Conclusion: Approval of the brain death law in Iran and coordinated efforts by the transplant centers to build comprehensive LT programs has resulted in the ability to procure more than 700 deceased donors per year with acceptable long-term survival.
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July 2018

The Process of Adjusting to Divorce After Leaving Violent Marriages: A Case Study of Iranian Women.

J Interpers Violence 2018 Jul 1:886260518787210. Epub 2018 Jul 1.

1 Kansas State University, Manhattan, USA.

Despite growing international attention to Intimate Partner Violence (IPV), there is little systemic information available regarding the process of adjusting to divorce after leaving violent marriages among Iranian women. Despite the strong religious discouragement and social stigma associated with divorce in Iran, divorce has always been recognized as a possible outcome of marriage. This qualitative study was conducted to understand the process that nine Iranian women who left violent marriages went through after divorce. The data came from two interviews with each participant and interviewer's notes that were taken during the interview. The data were analyzed using phenomenology and themes related to adjusting to divorce after experiencing IPV were identified. The process of adjusting to divorce seemed to occur in phases, that is, "initial experience after divorce," "searching for stability/challenges/resources," and "the process of developing new identity but still not being at peace." Each phase consists of subthemes and boundaries between these phases were fluid and adjustment was an ongoing process. This process was a journey for these Iranian IPV victims, which was dependent on their financial situation, emotional support, having a child or not, and their psychological health. These findings can help Iranian women who are in the process of adjustment to divorce to make sense of their experience. Also, findings provide a framework for researchers and clinicians in their work with female survivors of violent marriages. By testing these findings, researchers will be able to develop a theory regarding healing and disentanglement process. Clinicians need to understand the role of internalized stigma and how they can help their clients who are seeking to adjust after leaving violent marriages in Iran to reduce internalized stigma of divorce and challenge some of negative cultural beliefs against divorced women. Implications and suggestions for future research and clinicians are provided.
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http://dx.doi.org/10.1177/0886260518787210DOI Listing
July 2018

Chronic Pain and Selective Attention to Pain Arousing Daily Activity Pictures: Evidence From an Eye Tracking Study.

Basic Clin Neurosci 2017 Nov-Dec;8(6):467-478

Department of Psychology, Faculty of Economics, Administrative, and Social Sciences, Bilkent University, Ankara, Turkey.

Introduction: According to the pain research literature, attentional bias for pain is the mechanism responsible for the development and maintenance of fear of pain in patients with chronic pain. However, there is still some debate about the exact mechanism and the role of faster engagement versus difficulty in disengagement in the development of attentional bias.

Methods: To investigate attentional bias in patients with chronic pain, we used an eye-tracker with the pictures of pain-provoking activities and compared the results with an age- and gender-matched group of pain-free participants. In addition, other measures of pain-related cognition and pain severity ratings were included to assess their contribution to the attentional bias toward pain-related information.

Results: Calculating the frequency of the first fixations showed that both groups fixated initially on pain-provoking pictures compared to neutral one. Calculating the speed of fixations showed that control participants were faster in fixating on neutral stimuli, but patients with pain were faster in fixating on pain-provoking pictures, indicating a relative vigilance for the pain-related stimuli among them. These patients reported that the intensity of pain in the previous week was positively correlated with the speed of their fixation on the painful stimuli.

Conclusion: Although these results did not provide unequivocal support for the vigilance-avoidance hypothesis, they are generally consistent with the results of studies using eye tracking technology. Furthermore, our findings put a question over characterization of attentional biases in patients with chronic pain by simply relating that to difficulty in disengaging from pain-related stimuli.
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http://dx.doi.org/10.29252/nirp.bcn.8.6.467DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010654PMC
June 2018

Attentional Bias to Threat-Related Information Among Individuals With Dental Complaints: The Role of Pain Expectancy.

Front Psychol 2018 23;9:786. Epub 2018 May 23.

Psychology Department, Bilkent University, Ankara, Turkey.

Expecting pain can be perceived as a threat may involve recruitment of cognitive strategies (such as attentional avoidance) which might help the person to reduce distress. The ecological validity of the paradigms aiming to study the attentional biases toward or away from threatening stimuli by manipulating the perception of threat in experimental settings has been questioned. Therefore, the current study aims to investigate the attentional bias toward or away from the threat when a confrontation with a real threatening and painful condition would be expected (i.e., dental treatment). One hundred and twenty-seven patients referred to three dentistry clinics for a dental treatment (experiment participants) and 30 individuals with no dental complaints (control participants) completed this study. Patients were randomly allocated to a high pain expectancy (HPE: = 65) or a low pain expectancy (LPE: = 62) expectancy condition. All participants completed questionnaires of distress, fear of pain, and fear of dental pain. Furthermore, they participated in a dot-probe task that assessed their attention to painful faces, dental pictures, and happy faces. In addition, before the treatment, participants reported their anticipated pain intensity and after the treatment, they reported the pain intensity that they perceived during the treatment using two separate visual analog scales. Patients in the HPE group showed a bias away from dental pictures compared to LPE and control group participants. HPE group patients also reported greater pain intensity during the treatment compared to LPE patients. Greater attentional bias away from dental pictures among HPE patients was associated with higher levels of fear of pain, fear of dental pain, and stress. Avoidance of highly salient threatening images can be seen as an unhelpful emotion-regulation strategy that individuals use to manage their fears. However, in this study, avoidance was associated with poorer outcomes.
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http://dx.doi.org/10.3389/fpsyg.2018.00786DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5974166PMC
May 2018

Association of sugar sweetened beverages consumption with non-alcoholic fatty liver disease: a systematic review and meta-analysis.

Eur J Nutr 2019 Aug 14;58(5):1759-1769. Epub 2018 May 14.

Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Purpose: The relationship between consumption of sugar sweetened beverages (SSB) and NAFLD has been reported in several epidemiological studies, but the results are inconsistent. The present systematic review and meta-analysis of observational studies was carried out to assess the relationship between sugar sweetened beverages consumption and NAFLD.

Methods: Online databases were searched systematically through December, 2016 for studies investigating association between SSB consumption and NAFLD but limited to observational studies in human. Pooled odds ratio (OR) and 95% confidence intervals were calculated using Der-Simonian and Laird method while random effects meta-analysis was used, taking into account conceptual heterogeneity. Heterogeneity was assessed with the Cochran Q statistic and quantified with the I statistic.

Results: Of the 1015 identified articles, 42 were reviewed in depth and six studies (four cross-sectional, one case-control, and one cohort) met the criteria for inclusion in our systematic review with 6326 participants and 1361 cases of NAFLD in both men and women. Finally, four cross-sectional studies were included in the meta-analysis. Higher intake of SSBs (highest compared to lowest categories) was significantly associated with NAFLD, with a 40% increased Odds of NAFLD after adjusting for important potential confounders (pooled odds ratio 1.40; 95% CI 1.07, 1.82). There was no evidence for significant heterogeneity across studies [P = 0.226 (Q statistics), I = 31.0%]. A significant positive association between SSB consumption and NAFLD was observed consistently in a sensitivity analysis [range of summary ORs 1.39-1.49]. There was no evidence of publication bias for the association between SSB and NAFLD.

Conclusions: This meta-analysis supports a positive significant association between higher consumption of SSB and NAFLD in both men and women. These findings strengthen the evidence that intake of SSBs should be limited to reduce fatty liver disease.
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http://dx.doi.org/10.1007/s00394-018-1711-4DOI Listing
August 2019

Reproductive biology of Sodhiana iranica (Brachyura: Gecarcinucidae) from Southern Iran.

Rev Biol Trop 2017 Mar;65(1):365-73

Freshwater crab, Sodhiana iranica, is an endemic gecarcinucid crab that has been recently reported from Southern Iran. This research examined some reproductive aspects of S. iranica from Eelood freshwater spring, Southern Iran. Crabs were haphazardly sampled from April 2012 to April 2013, on a bimonthly basis. Measurements of Gonado-Somatic Index (GSI), Hepato-Somatic Index (HSI), oocyte diameter, and other aspects such as carapace width (CW) and total body weight (TW) were made in the captured specimens. Results showed a single seasonal reproductive cycle. Maturation and spawning occurred from December 2012 to April 2013 during the study period. The peaks of HSI were observed in April 2012 and February 2013. The oocyte diameter showed its most significant increase between August 2012 and February 2013. Considering the single seasonal breeding of S. iranica, a correct management, during the reproductive cycle, is necessary to support a healthy stock of this crab.
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http://dx.doi.org/10.15517/rbt.v65i1.23242DOI Listing
March 2017

The effect of gluten-free diet among celiac patients aged 3-12 years old on BMI during 2006 to 2014 at Nemazee Teaching hospital.

Rev Gastroenterol Peru 2017 Oct-Dec;37(4):323-328

Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences. Ahvaz, Iran; Research Center for Infectious Diseases of Digestive System, Ahvaz Jundishapur University of Medical Sciences. Ahvaz, Iran.

Introduction: Celiac disease (CD) is increasingly diagnosed and weight changes are common after adoption of a glutenfree diet (GFD) and there is concern that patients might gain further weight on a GFD.

Objectives: This study examined to evaluate the impact of a GFD on the body mass index (BMI), whether favorable or unfavorable.

Materials And Methods: In this retrospective study, we reviewed electronic records of 44 patients with serologic study and intestinal biopsy confirmed CD who was visited in Nemazee hospital, Shiraz. All patients were put on GFD for 2 years and followed closely by pediatric gastroenterologist. BMIs were categories to four group underweight, normal weight, overweight and obese. Initial BMI and follow-up BMI was comparing together and also compared with general population.

Result: At diagnosis, 27.27% of subjects were underweight, 63.64% normal and 9.09% were obese. On a GFD, 66.66% of underweight patients gained weight and became normal weight and 25% of normal weight and 75% of obese patients had increase weight; and the rest of the patients, BMI remained stable. The follow-up BMIs were statistically higher than initial BMIs (mean 17.17 vs. 15.62, p <0.0001).

Conclusion: Individuals with celiac disease have lower BMI than the regional population at diagnosis. On the GFD, BMI is increased significantly in all categories.
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September 2018

Corrigendum to "Incorporating Family Function into Chronic Pain Disability: The Role of Catastrophizing".

Pain Res Manag 2017 25;2017:3808520. Epub 2017 Oct 25.

Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Ghent, Belgium.

[This corrects the article DOI: 10.1155/2016/6838596.].
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http://dx.doi.org/10.1155/2017/3808520DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676477PMC
October 2017

Pain in the Context of Family: A Study on Factors Contributing to Marital Satisfaction among Couples Suffering from Chronic Pain.

Iran J Public Health 2017 Jul;46(7):964-972

Family Research Institute, Shahid Beheshti University, Tehran, Iran.

Background: Chronic pain is associated with increased stress in families and has its own impact on the relationship between members of the family. Among couples, if one of them suffers from chronic pain, this may influence marital satisfaction in both of them and given the importance of marital satisfaction in the prediction of successful treatment outcome, it is important to investigate pain and personality-related factors contributing to inter-individuals variation in marital satisfaction.

Methods: Participants in this study were recruited from Atieh Hospital and Rasa Pain Clinic, Tehran, Iran in the year 2013. Chronic pain patients and their spouses were asked to complete a battery of questionnaires including measures on pain cognition and marital satisfaction. Using correlation and regression analysis factors with the highest level of contribution to marital satisfaction were investigated.

Results: Spouses' level of rumination about patients' pain has been found to be positively correlated with marital satisfaction in patients. In addition, patients' depression has been found to be the best predictor of level of marital satisfaction in patients. In addition, patients' level of depression, disability and perceived helplessness has been found to be the best predictors of marital satisfaction in their spouses.

Conclusion: To improve marital satisfaction among chronic pain patients, their support-seeking needs should be satisfied through involvement of their spouses in the process of treatment. To improve marital satisfaction among patients' spouses, we should help patients regain their ability, improve their mood, and make patients believe that they have access to the support of their caregivers.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563879PMC
July 2017

Modeling the Burden of Cardiovascular Diseases in Iran from 2005 to 2025: The Impact of Demographic Changes.

Iran J Public Health 2017 Apr;46(4):506-516

Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran.

Background: Estimating the burden of non-communicable diseases particularly cardiovascular disease (CVD) is essential for health management and policymaking. In this paper, we used a regression model to estimate the future impact of demographic changes on the burden of CVD in Iran during the next two decades.

Methods: Disability-adjusted life years (DALY) were used to estimate the future burden of CVD in Iran. A regression model was used to estimate DALY caused by CVD in the Iranian population aged 30-100 yr, stratified by age group and sex. The predicted population of Iranians aged ≥ 30 yr was entered into the model and DALY were calculated over 2005-2025. To assess the areas of uncertainty in the model, we did sensitivity analysis and Monte Carlo Simulation.

Results: In the year 2005, there were 847309 DALYs caused by CVD in Iranian adults aged ≥ 30 yr. This figure will nearly be 1728836 DALYs in 2025. In other words, just because of the aging, DALY related to CVD will increase more than two-fold in 2025 compared with 2005. The burden of CVD was higher in men (443235) than in women (404235) in 2005; but in 2025, the difference will be less (867639 vs. 861319).

Conclusion: The burden of CVD will increase steeply in Iran over 2005-2025, mainly because of the aging population. Therefore, more attention is needed to deal with the impact of CVD in the following decades in Iran.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439040PMC
April 2017

Family physicians' attitude and interest toward participation in urban family physician program and related factors.

J Family Med Prim Care 2016 Oct-Dec;5(4):840-846

Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

Introduction: Every family physician has a key role in achieving the goals of the family physician program (FPP). Low satisfaction of physicians in certain areas of Iran and their low maintenance level in the program is quite challenging. The aims of the present study were; (1) to assess the attitude of rural/rural-urban family physicians about FPP and (2) to investigate their interest toward participation in urban FPP and (3) to explore the influencing factors.

Methods: This cross-sectional study was performed on 137 family physicians who were working in rural/rural-urban FPP in Mashhad University of Medical Sciences (Iran). A self-designed valid and reliable questionnaire including demographic data and thirty questions on the participants' attitudes toward the FPP in Likert scale were used. Data were analyzed by multiple logistic regression models using SPSS software.

Results: 49.3% of physicians were interested in continuing their cooperation in the urban-FPP. The mean total attitude score was 62.18 out of 100. The highest agreement and positive attitude of physicians were related to achievements of the program goals dimension. Multiple analyses showed that gender (odds ratio [OR] =5.5; male vs. female) and employment status (OR = 16.7 and 10.9 for permanent employment and by contract compared to legal obligation, respectively) were significantly associated with physicians' willingness toward participation in the urban-FPP.

Conclusion: About half of the studied physicians were interested toward participation in the urban-FPP; Male physicians more than females and permanent employees more than others were willing and interested to participate in the urban-FPP.
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http://dx.doi.org/10.4103/2249-4863.201171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353825PMC
March 2017