Publications by authors named "Seyed Abbas Motevalian"

40 Publications

Is driver education contributing towards road safety? a systematic review of systematic reviews.

J Inj Violence Res 2021 Jan 18;13(1). Epub 2021 Jan 18.

Department of Social Sciences, University of Nicosia, Cyprus.

Background: There is a vast amount of literature on the effects of driver education. However, the evidence has become somewhat fragmented, making it challenging to understand driver education's effectiveness for improving road safety. The current study aimed to provide the efficacy of pre-LDE and post-LDE interventions aimed at improving the safety of drivers (includes crashes, injuries, or secondary outcomes).

Methods: The following online databases were searched up to the 21st of February 2020: Web of Science (WOS), Scopus, PubMed, Cochrane library, and other relevant databases. Systematic reviews (SR) and meta-analyses were selected to investigate the efficacy of driving education in reducing crashes, injuries, or secondary outcomes. Two investigators independently conducted the data extraction and used the assessment of multiple systematic reviews (AMSTAR) tool to conduct a quality assessment of each SR identified.

Results: Out of the 229 potential articles, seven SRs were eligible for the current overview of systematic reviews and meta-analyses. This overview showed that pre-and post-license education by people of all ages led to improvements in secondary outcomes, such as performance, self-perceived driving abilities, behind-the-wheel driving performance, and even a small decrease in traffic offenses. However, education was not effective in reducing crashes or injuries, either at the individual or community level.

Conclusions: There was no evidence that driver education is an effective approach to reducing crashes or injuries. This negative result might be due to ineffective teaching methods. To improve road safety, it appears necessary to change the method or content of driving education since the current approaches to driving education do not reduce traffic crashes or injuries.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5249/jivr.v13i1.1592DOI Listing
January 2021

Adding extended-release methylphenidate to psychological intervention for treatment of methamphetamine dependence: A double-blind randomized controlled trial.

Med J Islam Repub Iran 2020 14;34:137. Epub 2020 Oct 14.

Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine (SATiM), Tehran University of Medical Sciences, Tehran, Iran.

Iran has been faced with an emerging epidemic of methamphetamine (MA) use during recent years. No effective pharmacotherapy has been identified for MA treatment; and psychological interventions are the only available effective treatment. The aim of this study is to investigate the efficacy and safety of extended-release methylphenidate (ER-MTP) for the treatment of methamphetamine dependence. Sixty-two people with methamphetamine dependence, according to DSM-IV-TR, were randomly assigned to either fixed-dose extended-release methylphenidate (ER-MTP) (60 mg per day) or placebo for 12 weeks. All participants received twice-weekly cognitive behavioral treatment for stimulant dependence. Recent drug use and craving level were measured using weekly rapid urine test and craving visual analogue scale, respectively. The severity of addiction was measured using the Addiction Severity Index at baseline and study completion. Assessment of MA withdrawal was conducted using Amphetamine Withdrawal Questionnaire and Amphetamine Selective Severity Assessment at baseline, day 3, week 1, week 4 and week 12. Depression and high-risk behaviors assessed with the Beck Depression Inventory and the high-risk behavior questionnaire at baseline, weeks 4 and 12 of the study. SPSS software version 22 was used for data analysis and p<0.05 was considered significant. Percent of weekly MA negative urine tests was not significantly different between groups during the course of the study (p=0.766). Two groups showed similar retention rates. Changes in MA craving, withdrawal, addiction severity, depression and high-risk behaviors were not significantly different between groups. No serious adverse event was observed. Our finding did not show the superiority of fixed-schedule ER-MTP over placebo when added to an intensive biweekly outpatient psychosocial treatment. Further studies using individually tailored flexible-dose regimes might provide new insights regarding the safety and efficacy of psychostimulant maintenance treatment for MA dependence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.34171/mjiri.34.137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787037PMC
October 2020

Developing and validating a measurement tool to self-report pedestrian safety-related behavior: The Pedestrian Behavior Questionnaire (PBQ).

Bull Emerg Trauma 2020 Oct;8(4):229-235

Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

Objective: Pedestrians are road users vulnerable to traffic injuries and fatalities. This study aimed to develop and validate a pedestrian behavior questionnaire to be used in Iran.

Methods: In this cross-sectional study, the initial questionnaire was designed based on the evaluation of previous studies conducted world-wide or in Iran. The initial pack included 127 items. After the assuring the face validity of the questionnaire, 27 experts' opinions in the field of traffic was obtained for assessing/ improving the content validity. To test the reliability of the questionnaire, the test-retest method and internal consistency assessment were used. To evaluate the structural validity, the Exploratory Factor Analysis (EFA) using the principal component and the Varimax rotation was applied.

Results: After completing the face validity and after summarizing the experts' suggestions, 12 questions were deleted. By calculating the content validity ratio and coefficient, 20 and 17 were removed. Also, the average content validity coefficient regarding relevancy, clarity and overall average were 0.86, 0.88, and 0.87, respectively. The Cronbach's alpha coefficient was 0.84. In the last stage and according to the results of the factor analysis, five factors violations, distraction, positive behaviors (group1), positive behaviors (group2) and Aggressive behaviors) were identified from the 29-items questionnaire, which explained 98% of the total variance.

Conclusion: Considering the necessity of using a verified and validated tool for planning and evaluating effective interventions for pedestrians is inevitable. The tool designed in the study was found to be valid and reliable for use to measure pedestrian's behavior and planning to modify high-risk behaviors and enhance safe pedestrian behaviors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.30476/beat.2020.86488DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783302PMC
October 2020

A systematic review and meta-analysis on the prevalence of Escherichia coli and extended-spectrum β-lactamase-producing Escherichia coli in pregnant women.

Arch Gynecol Obstet 2021 02 2;303(2):363-379. Epub 2021 Jan 2.

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

Propose: The aim of the present study was to determine the prevalence of E. coli and extended-spectrum β-lactamase-producing (ESBL) E. coli in pregnant women in a systematic review and meta-analysis study.

Methods: We searched important databases, including Medline (PubMed), Embase, Scopus, Web of sciences, Cochrane library, Ovid, and CINHAL to retrieve all articles reporting the prevalence of ESBL E. coli in pregnant women that published from January 1990 to June 2020.

Results: The pooled prevalence of E. coli in pregnant women with and without symptoms of UTI after combining 82 studies with a sample size of 33,118 was 29% (29%; %95 CI 23, 36%). The prevalence based on urine, Feacal, and vagina samples was 26% (% 95 CI 19-34%), 77% (% 95 CI 22-98%), and 32% (% 95 CI 17-48%), respectively. Also, 19 studies with a sample size of 9,200 reported ESBL E. coli prevalence in pregnant women. After combining the results of these studies, the pooled prevalence of ESBL E. coli in pregnant women was 34% (34%; %95 CI 24, 43%). The pooled prevalence of E. coli in pregnant women with HIV was 9%(9%; %95 CI 7, 11%).

Conclusion: According to the results of this study, the prevalence of E. coli and ESBL E. coli is high in pregnant women. Also, the overuse of antibiotics was higher in European and Asian pregnant women than other continents.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00404-020-05903-wDOI Listing
February 2021

Patterns of high-risk behaviors associated with HIV among male prisoners: A latent class analysis.

Med J Islam Repub Iran 2020 29;34:109. Epub 2020 Aug 29.

Research Center for Addiction and High-Risk Behaviors (ReCARB), Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.

Acquired Immunodeficiency Syndrome (AIDS) is one of the most important health challenges worldwide. Moreover, the prevalence of the Human Immunodeficiency Virus (HIV) infection differs among Iranian prisoners and the general population. The present study aimed to identify the patterns of HIV-related high-risk behaviors in male prisoners. In this cross-sectional study, 2832 inmates were examined for HIV-related high-risk behaviors. The required data were collected using a questionnaire on high-risk behaviors, including a history of heterosexual and homosexual intercourse, and a history of drug use disorders. A Latent Class Analysis (LCA) was performed to analyze the obtained data in WinLTA software. Five latent classes were defined for the male prisoners, as follows: low-risk (20%), moderate-risk (23%), Injection Drug Use (IDU) (8%), heterosexual intercourse/methamphetamine use (38%), and high-risk (11%). The LCA results revealed that high-risk sexual behaviors, IDU, and sharing injection equipment in prisons significantly influence the classification. The obtained data suggested that a history of imprisonment was not frequent in class 2 (OR=1.0033, %95CI:0.9936-1.01) and class 4 members (OR=1.0053, %95CI:0.9929-1.0179). However, it was more prevalent in class 3 (OR=1.0164, %95CI:1.0068-1.0262), and 5 (OR=1.0211, %95CI:1.0129-1.0293). Heterosexual contact had the highest prevalence (75%) in this regard. The results showed that the lowest prevalence of high-risk behaviors was associated with morphine use (0.3%). Among illicit drugs, methamphetamine was the most prevalent drug (42%) in the studied subjects. The present study indicated a high prevalence of high-risk sexual behaviors and methamphetamine use in the investigated participants. We observed the co-occurrence of HIV-related high-risk behaviors in male prisoners. Thus, providing safe sex education for prisoners is highly recommended. It is also necessary to pursue care programs about IDU as a key risk factor for HIV transmission in prisons.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.34171/mjiri.34.109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7722948PMC
August 2020

Investigating the relationship between extended spectrum β-lactamase producing in the environment and food chains with the presence of this infection in people suspected of septicemia: Using the fuzzy set qualitative comparative analysis.

J Environ Health Sci Eng 2020 Dec 25;18(2):1509-1520. Epub 2020 Oct 25.

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

Propose: Among antibiotic resistance cases, resistance to β-lactam antibiotics is a major concern for the treatment of microbial infections. Furthermore, the prevalence of extended-spectrum β-lactamases (ESBL) in environment, food, and human resources of Iran has increased over the past few years. This study aimed to predict the relationship between the prevalence of ESBL in the environment and the food chains with the presence of this infection in people suspected of septicemia using fuzzy set qualitative comparative analysis model.

Methods: In this analytical cross sectional study samples were collected from the environment (hospital sewage, downstream and upstream urban sewage, and slaughterhouse sewage), food (chicken), and human chains (people suspected of septicemia) in Tehran province, Iran. This study was conducted from September to February 2019 and the prevalence of ESBL was calculated in each resource. Then, the relationship between the prevalence of ESBL in the environment and food chains and its prevalence in the human chain was predicted using the fuzzy set qualitative comparative analysis.

Results: The results showed the prevalence of ESBL in those suspected of septicemia in September, October, November, December, January and February was 58.1%, 60%, 33.3%, 100%, 43%, and 57.8%, respectively. Also, the results of the fuzzy set qualitative comparative analysis indicated hospital wastewater and chicken contamination with ESBL were the main causes of contamination with ESBL in people suspected of septicemia.

Conclusions: According to the results of this study, if there is a contamination of hospital wastewater and chickens in an area, it can be claimed that people suspected of septicemia are infected with ESBL , and the percentage of this contamination can be high. On the other hand, controlling ESBL in hospital wastewater (environmental chain) and chickens (food chain) can prevent contamination in people with suspected septicemia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40201-020-00567-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721934PMC
December 2020

Ethical considerations and interdisciplinary approach to research on COVID-19 pandemic: The response of Iran University of Medical Sciences.

Med J Islam Repub Iran 2020 29;34:87. Epub 2020 Jul 29.

Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran.

Research ethics committees are comprised of policymakers, supervisors, and decision-makers and aim at increasing adherence to professional ethics standards in conducting health-related research. The existential philosophy of these committees is to preserve the patients' health, maintain and promote public trust in health care providers, protect the rights of both patients and health care providers, and promote organizational ethics. However, this task can be complex and challenging during a public health emergency. Research ethics committees set the standard of research in the emergency situations through defining which research has the potential to promote the quality of response to a public health emergency. This study aims at collecting and classifying the valuable experiences of the research ethics committee members and reviewers during the early days of the COVID-19 epidemic in Iran University of Medical Sciences, one of the major universities in Tehran. It provides a basic understanding of the key concepts and challenges in reviewing and approving research by research ethics committees and the recommendations to overcome these challenging issues. To accelerate the review process of COVID-19 research proposals, the scientific, methodological and ethical review panel was integrated as a large committee called 'IUMS Corona Research Team'. The first meeting was held on March 7, two weeks after the official announcement of the first case of the disease and is continued once a week. A total of 130 projects have been discussed and evaluated in this committee, among which 83 proposals were approved after modification. An interdisciplinary approach supports a flexible and effective scientific and ethical review of research leading to more protection of research subjects as well as promotion in the treatment and management of the pandemic ahead.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.34171/mjiri.34.87DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711043PMC
July 2020

Signal transduction pathway mutations in gastrointestinal (GI) cancers: a systematic review and meta-analysis.

Sci Rep 2020 10 30;10(1):18713. Epub 2020 Oct 30.

Gastrointestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, Iran.

The present study was conducted to evaluate the prevalence of the signaling pathways mutation rate in the Gastrointestinal (GI) tract cancers in a systematic review and meta-analysis study. The study was performed based on the PRISMA criteria. Random models by confidence interval (CI: 95%) were used to calculate the pooled estimate of prevalence via Metaprop command. The pooled prevalence indices of signal transduction pathway mutations in gastric cancer, liver cancer, colorectal cancer, and pancreatic cancer were 5% (95% CI: 3-8%), 12% (95% CI: 8-18%), 17% (95% CI: 14-20%), and 20% (95% CI: 5-41%), respectively. Also, the mutation rates for Wnt pathway and MAPK pathway were calculated to be 23% (95% CI, 14-33%) and 20% (95% CI, 17-24%), respectively. Moreover, the most popular genes were APC (in Wnt pathway), KRAS (in MAPK pathway) and PIK3CA (in PI3K pathway) in the colorectal cancer, pancreatic cancer, and gastric cancer while they were beta-catenin and CTNNB1 in liver cancer. The most altered pathway was Wnt pathway followed by the MAPK pathway. In addition, pancreatic cancer was found to be higher under the pressure of mutation compared with others based on pooled prevalence analysis. Finally, APC mutations in colorectal cancer, KRAS in gastric cancer, and pancreatic cancer were mostly associated gene alterations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-020-73770-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599243PMC
October 2020

COVID-19 Population Survey of Iran (COPSIR) study protocol: Repeated survey on knowledge, risk perception, preventive behaviors, psychological problems, essential needs, and public trust during COVID-19 epidemic.

Med J Islam Repub Iran 2020 25;34:52. Epub 2020 May 25.

Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran.

The worldwide emergence and rapid expansion of COVID-19 emphasizes the need to assess the knowledge gap and to predict the disease-related behaviors and reactions during this epidemic. COVID19 Population Survey of Iran (COPSIR) is a repeated cross sectional survey that will be conducted in 8 waves. In each wave, 515 Iranian adults aged 18 years or older will be randomly selected and interviewed by phone. The study waves will be performed at approximately weekly intervals. The survey tool is adapted from COSMO (COVID-19 Snapshot MOnitoring) study. This study will provide information on trends of knowledge, risk perception, preventive behaviors, psychological problems, essential needs, and public trust among Iranian adults during COVID-19 epidemic. The key findings of each wave will be immediately reported to the National Headquarters for Coronavirus Control to set better policies for disease control and prevention. Moreover, if a message is extracted from the results of this study that needs to be communicated to the public, it will be done through the mass media.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.34171/mjiri.34.52DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7481858PMC
May 2020

Developing the Persian Version of Sensory Gating Inventory and Assessing Its Validity and Reliability.

Basic Clin Neurosci 2019 Nov-Dec;10(6):597-607. Epub 2019 Sep 1.

Head & Neck Research Center, Department of Ear, Nose, and Throat Diseases, Iran University of Medical Sciences, Tehran, Iran.

Introduction: Sensory Gating Inventory (SGI) measures behavioral aspects of Sensory Gating (SG), which filters irrelevant sensory inputs into the higher cortex. It modifies sensitivity to sensory stimuli. Abnormal SG leads to overloading of information in the brain and its subsequent dysfunction. Electrophysiological techniques cannot assess the behavioral aspects of SG. We aimed to design the Persian version of SGI with high validity and reliability.

Methods: After a forward and then backward translation of the original SGI, we assessed the content validity and construct validity of the Persian version. A total of 405 participants filled the Persian version of SGI. To assess test-retest reliability, 100 participants filled the inventory again 7-10 days later. The content validity ratio and index, as well as confirmatory factor analysis, were computed, too. Finally, the Cronbach's alpha, Cohen's kappa, and intraclass correlation coefficients were calculated.

Results: The content validity ratios of all items of the inventory were more than 60%, which means that they were necessary according to the experts' opinions. Confirmatory factor analysis confirmed the fitness of the 4-factor structure of the original Inventory. The test-retest reliability using the intraclass correlation coefficient and Cronbach's alpha coefficients were also high for the four subscales. The Cohen's kappa coefficients revealed moderate to substantial level of agreement between the first and second scores for all items.

Conclusion: The Persian version of SGI has good and acceptable psychometric properties. It can be used as a valid and reliable tool for studying behavioral aspects of SG in Persian speaking population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.32598/BCN.9.10.360DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253804PMC
September 2019

Prevalence of Hookah Smoking among University Students in Iran: A Meta-Analysis of Observational Studies.

Iran J Public Health 2020 Jan;49(1):1-13

Research Center for Addiction & Risky Behaviors (ReCARB), Psychiatric Department, Iran University of Medical Sciences, Tehran, Iran.

Background: The rise in popularity of waterpipe smoking among younger people cause increase its deleterious effects on health in recent years. The aim of this study was to estimate the pooled prevalence of water-pipe smoking in university students in Iran.

Methods: We performed the literature search from 1946 to January 21, 2019, in several international and national databases such as Medline/PubMed, Web of Science, Scopus, Google Scholar, Magiran, Iranmedex, and IranPsych. To investigate the between-study heterogeneity we used the chi-squared test and I index. We used a random-effects model to estimate the pooled prevalence of water-pipe smoking. The potential source of heterogeneity was assessed by subgroup analysis and meta-regression.

Results: According to the eligibility criteria, we included 37 relevant studies in our meta-analysis. The pooled prevalence of lifetime water-pipe smoking was 25% (95% CI: 22-29) and in male and female subgroups was 37% (95%CI: 30-45), 17% (95%CI: 15-19) respectively. The pooled prevalence of water-pipe smoking in last year was 21% (95%CI: 16-25) and in last month was 8% (95%CI: 5-11). Results of meta-regression analysis showed that there was not any significant association between suspected variables and the prevalence of water-pipe smoking.

Conclusion: The higher prevalence rate of water pipe smoking among university students indicates the emergency need for planning preventive program.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152648PMC
January 2020

Epidemiology of Hepatitis B in Iran from 2000 to 2016: A Systematic Review and Meta-Regression Analysis.

Arch Iran Med 2020 03 1;23(3):189-196. Epub 2020 Mar 1.

Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Hepatitis B infection is the major risk factor for liver cancer in Iran. There is no comprehensive population-based study on the prevalence of hepatitis B by regional distribution. Moreover, systematic reviews of hepatitis B prevalence lack knowledge of some regions. We aimed to estimate the prevalence of hepatitis B and its temporal trends over 17 years by sex, age and geographical distribution.

Methods: We used the Iranian Blood Donors data in addition to systematic reviews on population-based studies at national and provincial levels and statistical methods (A two-stage spatio-temporal model and crosswalk approach) to address the missing points of hepatitis B prevalence among the general population. The direct age-standardized approach was applied using Iran's national population in 2016.

Results: At national level, age-standardized hepatitis B prevalence in Iran decreased from 3.02% (95% uncertainty interval; 2.26 to 3.96) in 2000 to 1.09% (95% uncertainty interval; 0.85 to 1.37) in 2016, with a total -64.84% change. Hepatitis B prevalence was more than 1.3 times greater in males than females in 2016. Overall, the prevalence of hepatitis B increased with increasing age. At provincial level, in 2016, the province with the highest prevalence had a nearly 11-time greater rate compared to the lowest prevalence. The declining annual percent change (APC) of the prevalence trend varied between -11.53% to -0.5% at provincial level from 2000 to 2016. Only one province did not witness a downward trend in which the APC was 0.5% (95% UI:0.47-0.54).

Conclusion: The downward trend in prevalence of hepatitis B infection indicates the effectiveness of strategies and preventive measures adapted in Iran. Nevertheless, we need to eradicate this infection. In this regard, re-evaluating preventive measures, especially in high-risk age groups of the population, is recommended.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2020

Evaluation of Timeliness, Simplicity, Acceptability, and Flexibility in Child Mortality Surveillance System for Children Aged 1-59 Months in Iran.

Int J Prev Med 2019 28;10:205. Epub 2019 Nov 28.

Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences (IUMS), Tehran, Iran.

Background: Child mortality surveillance system (CMSS) for children aged 1-59 months is a critical issue in the prevention of mortality. This surveillance system like other health programs needs to be evaluated. Therefore, this study aims to evaluate CMSS in Iran.

Methods: This evaluation was performed from March 2015 to March 2016 based on selected criteria for assessing the public health surveillance system proposed by the Centers for Disease Control and Prevention. Selected criteria examined in this study included timeliness, simplicity, acceptability, and flexibility. These criteria were evaluated in two ways. First, it included the use of a researcher-made questionnaire. The questionnaires were completed by 100 experts on CMSS. Second, to perform a more exact evaluation of these criteria, 24 of these experts were selected for the focus group.

Results: In this study, the response rate was 91% (42% hospital-based and 49% primary care-based). In the timeliness section, 49% of the experts believed that approvals of the child mortality committees have not been sent within the designated time frame; hardware, software, and questionnaires were reported as effective factors in this respect. The structural and administrative problems were effective in simplicity domain and the experts of mortality registration and mood of relatives were effective in acceptability domain. The flexibility of the system was high and appropriate.

Conclusions: The findings of the present study reveal that CMSS has some limitations and problems in the timeliness, simplicity, and acceptability criteria, which can be resolved. But this program has an appropriate situation in terms of flexibility.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijpvm.IJPVM_452_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6921285PMC
November 2019

Effects of zinc, vitamin D, and their co-supplementation on mood, serum cortisol, and brain-derived neurotrophic factor in patients with obesity and mild to moderate depressive symptoms: A phase II, 12-wk, 2 × 2 factorial design, double-blind, randomized, placebo-controlled trial.

Nutrition 2020 03 15;71:110601. Epub 2019 Oct 15.

Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran; Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Objective: The aim of this study was to investigate the effects of zinc, vitamin D, and their co-supplementation versus placebo on changes in the Beck Depression Inventory II (BDI-II) score, serum cortisol level, and brain-derived neurotrophic factor (BDNF) in obese/overweight patients with depressive symptoms.

Method: This 2 × 2 factorial, double-blind, randomized, placebo-controlled trial with obese/overweight patients with depressive symptoms was conducted in the Endocrinology and Metabolism Research Center (EMRC), Vali-Asr, Emam Khomeini Hospital between July 2016 and February 2017. The intervention period was 12 wk. There were 140 randomized participants who were obese or overweight (mean ± SD, 38.35± 6.70 y of age; mean ± SD body mass index, 30.1 ± 3.78 kg/m) with BDI ≥ 10. Participants were randomly assigned to one of four groups in a 1:1:1:1 ratio: 2000 IU/d vitamin D + zinc placebo; 30 mg/d zinc gluconate + vitamin D placebo; 2000 IU/d vitamin D + 30 mg/d zinc gluconate; or vitamin D placebo + zinc placebo for 12 wk.

Results: We analyzed 125 participants, and a significant decrease in BDI-II was found among those who received zinc, vitamin D, or joint zinc-vitamin D supplements compared with the placebo group (P < 0.001). Zinc was significantly more effective than vitamin D on decreasing the depression score. Supplementation with zinc, vitamin D, or a combination of the two had no significant effects on serum cortisol (P = 0.974) or BDNF (P = 0.076). Fifteen patients discontinued participation owing to pregnancy (n = 1), severe anemia (n = 1), and unspecified unwillingness to continue (n = 13).

Conclusion: Supplementation with zinc, vitamin D, or in combination for 12 wk yielded significant beneficial effects on the BDI-II score in obese or overweight patients with BDI-II ≥10.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nut.2019.110601DOI Listing
March 2020

Developing a Comprehensive Evidence-Based Service Package for Toddlers with Autism in a Low Resource Setting: Early Detection, Early Intervention, and Care Coordination.

Iran J Psychiatry 2019 Apr;14(2):120-129

Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran.

The number of children with autism, who have many unmet needs, is increasing dramatically. However, the existing evidence shows that early identification and intervention are effective in reducing the later costs and burdens of autism spectrum disorder (ASD). Thus, the present study aimed to develop evidence-based services for children with autism in Iran to reduce its impacts on the affected children and their families and to decrease its burden on the society. A 3-step study was conducted based on a modification of the Replicating Effective Programs (REP) framework (step 1: need assessment and situation analysis; step 2: identifying current evidence-based services; step 3: designing the first draft of the package and its core elements). Each step was conducted by a specific methodology. By considering the obtained data, it was found that a package of services with 4 core components to respond to the perceived needs in Iran was needed: (1) early detection of at-risk children; (2) care coordination and facilitation of access to current services; (3) implementation of an evidence-based early intervention program; and (4) training interventionists using an effective educational framework based on evidence-based material. REP framework was used in the present study, which has been shown to be effective in adapting and implementing health care services. By considering the preconditions of REP, a comprehensive package of services, with 4 components was designed for toddlers with autism in Iran. The next step will be to study this package using a multicenter hybrid effectiveness-implementation randomized control trial.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702275PMC
April 2019

Current Status of Health and Social Services for Children with Autism in Iran: Parents' Perspectives.

Iran J Psychiatry 2019 Jan;14(1):76-83

Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran.

The present study is a part of a larger study that aimed at developing a comprehensive model of service delivery for individuals with autism in Iran based on the local needs and characteristics. In this study, the status of the services provided to those with autism in Iran was investigated based on the perspectives of parents of children with autism. A semi-structured interview was used to qualitatively investigate the status of the services with regards to autism in Iran based on the perspectives of parents of children with autism. This study revealed several barriers, including shortness of eligible professionals, difficulty in access to care for families, high costs, and lack of formal and informal supports, in providing services to those with autism in Iran. Early detection and diagnosis are of prime importance. We also need to train our specialists to diagnose autism based on the standard protocols and tests. In sum, we need a comprehensive program that involves different sectors in charge of health and education in Iran.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505045PMC
January 2019

Province-Level Prevalence of Psychiatric Disorders: Application of Small-Area Methodology to the Iranian Mental Health Survey (IranMHS).

Iran J Psychiatry 2019 Jan;14(1):16-32

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

National surveys revealed a high prevalence of psychiatric disorders in Iran. Province-level estimates are needed to manage the resources and focus on preventive efforts more efficiently. The objective of this study was to provide province-level estimates of psychiatric disorders. In this study, Iranian Mental Health Survey (IranMHS) data (n = 7886) was used to produce province-level prevalence estimates of any psychiatric disorders among 15-64 year old males and females. Psychiatric disorders were diagnosed based on structured diagnostic interview of the Persian version of Composite International Diagnostic Interview (CIDI, version, 2.1). The Hierarchical Bayesian (HB) random effect model was used to calculate the estimates. The mental health status of half of the participants was also measured using a 28-item general health questionnaire (GHQ). A wide variation in the prevalence of psychiatric disorders was found among 31 provinces of Iran. The direct estimates ranged from 3.6% to 62.6%, while the HB estimates ranged from 12.6% to 36.5%. The provincial prevalence among men ranged from 11.9% to 34.5%, while it ranged from 18.4% to 38.8% among women. The Pearson correlation coefficient between HB estimates and GHQ scores was 0.73. The Bayesian small area estimation provides estimation with improved precision at local levels. Detecting high-priority communities with small-area approach could lead to a better distribution of limited facilities and more effective mental health interventions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6505053PMC
January 2019

Meta-analysis of the correlation between personality characteristics and risky driving behaviors.

J Inj Violence Res 2019 Jul 28;11(2):107-122. Epub 2019 Apr 28.

Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran. Email:

Background: A systematic review and meta-analysis was performed to determine the relationships risky driving behaviors (RDBs) have with the big five personality factors, sensation seeking and driving anger.

Methods: The PubMed, EMBASE, Web of Science, Scopus, Psychinfo, and the Cochrane Library databases were systematically searched. All original studies were retrieved that assessed the relationships RDBs had with the big five personality factors, sensation seeking, and driving anger. Heterogeneity between studies was examined using the Cochran Q statistic and I2 tests. After applying Fisher's r-to-z transformation, the correlation coefficients (r) were summarized from each study and 95% confidence intervals (CIs) were estimated.

Results: Overall, 22 studies were included in the meta-analysis, which included 11211 participants. The results showed that RDBs had a significant negative relationship with agreeableness (r -0.27; 95% CI, -0.36, -0.19; P less than 0.0001), but significant positive relationships with neuroticism (r 0.16; 95% CI, 0.03, 0.29; P=0.584), sensation seeking (r 0.28; 95% CI: 0.23, 0.33; P less than 0.0001) and driving anger (r 0.39; 95% CI: 0.14, 0.64; P=0.002). Conversely, RDBs were not significantly related to extraversion (r -0.01; 95% CI, -0.08, 0.05; P=0.705), conscientiousness (r -0.05; 95% CI, -0.21, 0.12; P=0.584), or openness (r -0.06; 95% CI, -0.12, 0.00; P=0.065).

Conclusions: Therefore, it appears that individuals most likely to engage in risky driving behaviors would be low in agreeableness, but high in neuroticism, sensation seeking and driving anger.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5249/jivr.v11i2.1172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646834PMC
July 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.addbeh.2018.11.043DOI Listing
May 2019

Setting research priorities to achieve long-term health targets in Iran.

J Glob Health 2018 Dec;8(2):020702

Engineering Seismology Department, International Institute of Earthquake Engineering and Seismology (IIEES), Tehran, Iran.

Background: In 2015, it was estimated that the burden of disease in Iran comprised of 19 million disability-adjusted life years (DALYs), 74% of which were due to non-communicable diseases (NCDs). The observed leading causes of death were cardiovascular diseases (41.9%), neoplasms (14.9%), and road traffic injuries (7.4%). Even so, the health research investment in Iran continues to remain limited. This study aims to identify national health research priorities in Iran for the next five years to assist the efficient use of resources towards achieving the long-term health targets.

Methods: Adapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 48 prominent Iranian academic leaders in the areas related to Iran's long-term health targets, a group of research funders and policy makers, and 68 stakeholders from the wider society. 128 proposed research questions were scored independently using a set of five criteria: feasibility, impact on health, impact on economy, capacity building, and equity.

Findings: The top-10 priorities were focused on the research questions relating to: health insurance system reforms to improve equity; integration of NCDs prevention strategy into primary health care; cost-effective population-level interventions for NCDs and road traffic injury prevention; tailoring medical qualifications; epidemiological assessment of NCDs by geographic areas; equality in the distribution of health resources and services; current and future common health problems in Iran's elderly and strategies to reduce their economic burden; the status of antibiotic resistance in Iran and strategies to promote rational use of antibiotics; the health impacts of water crisis; and research to replace the physician-centered health system with a team-based one.

Conclusions: These findings highlight consensus amongst various prominent Iranian researchers and stakeholders over the research priorities that require investment to generate information and knowledge relevant to the national health targets and policies. The exercise should assist in addressing the knowledge gaps to support both the National General Health Policies by 2025 and the health targets of the United Nations' Sustainable Development Goals by 2030.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7189/jogh.08.020702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188089PMC
December 2018

Epidemiological study of hospitalized road traffic injuries in Iran 2011.

Med J Islam Repub Iran 2018 17;32:50. Epub 2018 Jun 17.

Shahid Beheshti University of Medical Sciences, Tehran, Iran.

In Iran, Road Traffic Injuries (RTIs) is the second-leading cause of deaths, and the first leading cause of disabilityadjusted life year, and has one of the highest rates of death (32.1 per 100 000 population) all over the world. This study's aim was to investigate the epidemiological pattern and underlying components of hospitalized RTIs in 31 provinces of Iran in 2011. This study conducted on all hospitalized RTIs during one-year period (March 21, 2011 to March 21, 2012). Data extracted from a hospital-based traffic injury registration system. According to a national law passed in 2005, all hospital expenses of traffic injuries should be covered by ministry of health based on governmental tariffs. The medical costs of eligible patients will be paid to the hospitals only if the patient data are sent to the above mentioned database. Statistical analysis was performed using SPSS v.16 (SPSS Inc., Chicago, USA), and spatial maps are provided using GIS 10.2. Descriptive statistics and t-test were used to compare means. World (WHO 2000-2025) standard population used to calculate age-adjusted incidence rate. All statistical tests were performed at the 5% level of statistical significance. There were 322,064 injured cases recorded in the registration system during the study period. The national age-adjusted incidence rate of RTIs was 405 per 100,000 population. The highest incidence rates were in the age group of 15-29 years (643 per 100,000 population), followed by 30-44 year age groups (401 per 100,000 population). The incidence rate in men was 3.36 times more than women. Motorcyclist were the most frequent type of road users (39.2%) who involved in RTIs, followed by passengers (28.9%) and pedestrians (20.0%). Head injuries were among the most affected part of the body which occurred in 27.2% of the patients. The proportion of urban crashes was 60.7%. The results of this study indicated that the majority of RTI occurred on motorcyclists and head injuries was the most commonly affected body part. Therefore, in order to reduce motorcycle accidents and avoiding head injury among them, stricter law enforcement is urgently needed for helmet use and promotion of safety behaviors among motorcycle riders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14196/mjiri.32.50DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6108239PMC
June 2018

The association between polymorphism of the BDNF gene and cigarette smoking in the Iranian population.

J Gene Med 2018 10 12;20(10-11):e3052. Epub 2018 Sep 12.

Department of Medical Genetics and Molecular Biology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Background: Cigarette smoking remains a serious public health problem. Environmental and genetic factors both play critical roles in the process of cigarette smoking. We aimed to investigate the associations between single nucleotide polymorphisms (SNP) in the BDNF gene and cigarette smoking in the Iranian population.

Methods: We conducted a case-control study. In total, 932 case and control subjects aged > 15 years were recruited in the present study in a simple random manner, including 523 lifetime cigarette smokers, 466 cigarette smokers within a 12-month period, 409 never cigarette smokers in their lifetime and 466 never cigarette smokers within a 12-month period. The rs6265 SNP genotypes were determined by a polymerase chain reaction followed by restriction fragment length polymorphism. To examine the association of smoking with the BDNF gene polymorphism, odds ratios (OR) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression adjusting for age and sex.

Results: In total, 932 participants (758 males and 174 females) were selected. Using a chi-squared test, we found that rs6265 with OR = 1.41 and 95% CI = 1.07-1.87 (p = 0.009) and OR = 1.41 and 95% CI = 1.08-1.85 (p = 0.008) in the BNDF was associated with an increased odds of lifetime cigarette smoking and cigarette smoking within a 12-month period, respectively. Also, the allele "A" of rs6265 in BDNF had a significant elevating effect for cigarette smoking in a recessive model (p < 0.05).

Conclusions: These results suggest that polymorphisms of BDNF play an important role in lifetime cigarette smoking and cigarette smoking within a 12-month period of susceptibility in the Iranian population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jgm.3052DOI Listing
October 2018

Major anxiety disorders in Iran: prevalence, sociodemographic correlates and service utilization.

BMC Psychiatry 2018 08 20;18(1):261. Epub 2018 Aug 20.

Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.

Background: It has been shown in the past two decades that anxiety disorders are the most common mental disorders in general population across the world. This study sought to assess the prevalence of major anxiety disorders, their sociodemographic correlates and mental health service utilization as part of the Iranian Mental Health Survey (IranMHS).

Methods: A national household face-to-face survey was carried out on a representative sample of Iranian adults from January to June 2011 using Composite International Diagnostic Interview (CIDI 2.1). A total of 7886 subjects between 15 and 64 years who can understand Persian language were included. The 12-month prevalence of anxiety disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), their socio-demographic correlates, health service use and days out of role were measured in this study.

Results: The 12-month prevalence of anxiety disorders (not including specific phobias) was 15.6%. The prevalence was 12.0% in males and 19.4% in females. The three most prevalent anxiety disorders were generalized anxiety disorder (5.2%), obsessive-compulsive disorder (5.1%) and social phobia (3.2%), respectively. Factors found to be significantly associated with anxiety disorders were: female gender (OR = 1.16, 95% CI: 1.09-1.23), middle (OR = 1.23, 95%CI: 1.01-1.50) or low (OR = 1.66, 95%CI: 1.31-2.10) socioeconomic status, unemployment (OR = 1.98, 95%CI: 1.49-2.62), and urban residence (OR = 1.31, 95%CI: 1.10-1.57). Comorbidity with non-anxiety disorders significantly increased service utilization. In all subgroups, service utilization was higher among females while the number of days out of role was higher among males.

Conclusions: Anxiety disorders are common conditions with a higher prevalence among the female gender, unemployed individuals, and people with low socioeconomic conditions living in urban areas. Comorbidity of anxiety disorders with other psychological disorders aggravates the disability and significantly increases the number of days out of role.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12888-018-1828-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6102821PMC
August 2018

An ad hoc method for dual adjusting for measurement errors and nonresponse bias for estimating prevalence in survey data: Application to Iranian mental health survey on any illicit drug use.

Stat Methods Med Res 2018 10 23;27(10):3062-3076. Epub 2017 Feb 23.

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

Purpose The prevalence estimates of binary variables in sample surveys are often subject to two systematic errors: measurement error and nonresponse bias. A multiple-bias analysis is essential to adjust for both biases. Methods In this paper, we linked the latent class log-linear and proxy pattern-mixture models to adjust jointly for measurement errors and nonresponse bias with missing not at random mechanism. These methods were employed to estimate the prevalence of any illicit drug use based on Iranian Mental Health Survey data. Results After jointly adjusting for measurement errors and nonresponse bias in this data, the prevalence (95% confidence interval) estimate of any illicit drug use changed from 3.41 (3.00, 3.81)% to 27.03 (9.02, 38.76)%, 27.42 (9.04, 38.91)%, and 27.18 (9.03, 38.82)% under "missing at random," "missing not at random," and an intermediate mode, respectively. Conclusions Under certain assumptions, a combination of the latent class log-linear and binary-outcome proxy pattern-mixture models can be used to jointly adjust for both measurement errors and nonresponse bias in the prevalence estimation of binary variables in surveys.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0962280217690939DOI Listing
October 2018

The relative efficiency of Iranian's rural traffic police: a three-stage DEA model.

BMC Public Health 2017 10 13;17(1):806. Epub 2017 Oct 13.

Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Background: Road traffic Injuries (RTIs) as a health problem imposes governments to implement different interventions. Target achievement in this issue required effective and efficient measures. Efficiency evaluation of traffic police as one of the responsible administrators is necessary for resource management. Therefore, this study conducted to measure Iran's rural traffic police efficiency.

Methods: This was an ecological study. To obtain pure efficiency score, three-stage DEA model was conducted with seven inputs and three output variables. At the first stage, crude efficiency score was measured with BCC-O model. Next, to extract the effects of socioeconomic, demographic, traffic count and road infrastructure as the environmental variables and statistical noise, the Stochastic Frontier Analysis (SFA) model was applied and the output values were modified according to similar environment and statistical noise conditions. Then, the pure efficiency score was measured using modified outputs and BCC-O model.

Results: In total, the efficiency score of 198 police stations from 24 provinces of 31 provinces were measured. The annual means (standard deviation) of damage, injury and fatal accidents were 247.7 (258.4), 184.9 (176.9), and 28.7 (19.5), respectively. Input averages were 5.9 (3.0) patrol teams, 0.5% (0.2) manpower proportions, 7.5 (2.9) patrol cars, 0.5 (1.3) motorcycles, 77,279.1 (46,794.7) penalties, 90.9 (2.8) cultural and educational activity score, 0.7 (2.4) speed cameras. The SFA model showed non-significant differences between police station performances and the most differences attributed to the environmental and random error. One-way main road, by road, traffic count and the number of household owning motorcycle had significant positive relations with inefficiency score. The length of freeway/highway and literacy rate variables had negative relations, significantly. Pure efficiency score was with mean of 0.95 and SD of 0.09.

Conclusions: Iran's traffic police has potential opportunity to reduce RTIs. Adjusting police performance with environmental conditions is necessary. Capability of DEA method in setting quantitative targets for every station induces motivation for managers to reduce RTIs. Repetition of this study is recommended, annually.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-017-4780-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640958PMC
October 2017

Exploring Measures to Control Road Traffic Injuries in Iran: Key Informants Points of View.

Iran J Public Health 2017 May;46(5):671-676

Dept. of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Injuries and fatalities from road traffic Injuries are global public health concerns, and a major problem in the Iran. This study aimed to explore strategies to control road traffic Injuries (RTI) in Iran.

Methods: We conducted a qualitative study to explore possible ways to reduce the occurrence of road traffic Injuries in Iran in 2016. Interviewees were purposively sampled from various sectors due to multidisciplinary nature of RTIs. Participants were mainly representatives from the police, Ministry of Road, Municipal, emergency services and Ministry of Health. Besides, public health authorities, researchers, and university professors were interviewed. We conducted in-depth interviews using generic guides. Data was analyzed using MAXQDA 10 software. Through content analysis, we interpreted core themes relevant to the accomplishment of our study objectives.

Results: Themes that emerged from our study include; road traffic management, governance, education, improving accident database, enforcement, driving license restrictions, and construction of pedestrian overpass.

Conclusion: This study revealed key informants' views regarding available and affordable solutions to reduce RTIs in Iran. Many applicable strategies are identified in the control of RTIs in Iran. Although some solutions such as highway construction and/or expanding rail transportation have been suggested as effective measures for reducing accident, but they are costly and may not be fully applied in developing countries like Iran.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442280PMC
May 2017

Economical Burden of Burn Injuries in a Developing Country.

J Burn Care Res 2017 Nov/Dec;38(6):e900-e905

From the *Faculty of Medicine and †Faculty of Health School, Iran University of Medical Sciences, Tehran, Iran.

Burn injuries have economical impacts on patients in several ways. Understanding the charges of burn treatment is very important for patients, families, governmental authorities, and insurance companies. During the protocol of their treatment, they may be admitted several times for treatment of acute burn and then for reconstructive treatments of burn's complications. Calculating the hospital burn charges can serve as an objective criteria for authorities to plan for a sufficient budget for acute burn treatment, for additional management for chronic complications, and as a guide for planning preventive and public educational programs. The authors used data of their burn registry program. During more than 3 years, the authors had 912 patients with multiple admissions for burns. All of hospital costs during several admissions were recorded. Men were 71% and women were 29% of the patients. Burns caused by flame were the most frequent (50.1%) followed by scald (34.0%). Mean hospital stay was 14.1 days (range, 0-64 days). Patients with TBSA equal to or less than 10% were 38.8%, TBSA between 11 and 22% were 29.1%, and TBSA more than 23% were 32.1%. Those who were admitted for 30 days or less were 34.1%, those between 31 and 131 days were 32.7%, and those with more than 132 days of admission were 33.2%. Mean hospital cost for all patients during the 3 years was about $2766 (range, from $143 to $33,566; median = 1586.93; SE = 93.84). The patients were admitted for treatment of acute burns and later admitted for reconstruction of the burn sequels. Total number of admissions was up to six times (median = 2). About 66.27% of the total charges were the cost of first admission, 19.39% the cost of second admission, 7.34% the cost of third admission, 3.56% for fourth admission, 2.3% for fifth admission, and 1.15% for last or sixth admission. The authors conducted a multiple linear regression test. Male sex, TBSA, length of stay, and number of admissions were significantly related to total treatment charges. But "age" did not influence the charges. Mean total cost of several burn admissions in one patient was around $2766. TBSA, length of stay, male sex, and number of admissions were significantly related to the hospital costs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/BCR.0000000000000515DOI Listing
July 2018

Trends in gastrointestinal cancer incidence in Iran, 2001-2010: a joinpoint analysis.

Epidemiol Health 2016 5;38:e2016056. Epub 2016 Dec 5.

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

Objectives: The main purpose of this study was to evaluate changes in the time trends of stomach, colorectal, and esophageal cancer during the past decade in Iran.

Methods: Cancer incidence data for the years 2001 to 2010 were obtained from the cancer registration of the Ministry of Health. All incidence rates were directly age-standardized to the world standard population. In order to identified significant changes in time trends, we performed a joinpoint analysis. The annual percent change (APC) for each segment of the trends was then calculated.

Results: The incidence of stomach cancer increased from 4.18 and 2.41 per 100,000 population in men and women, respectively, in 2001 to 17.06 (APC, 16.7%) and 8.85 (APC, 16.2%) per 100,000 population in 2010 for men and women, respectively. The corresponding values for colorectal cancer were 2.12 and 2.00 per 100,000 population for men and women, respectively, in 2001 and 11.28 (APC, 20.0%) and 10.33 (APC, 20.0%) per 100,000 in 2010. For esophageal cancer, the corresponding increase was from 3.25 and 2.10 per 100,000 population in 2001 to 5.57 (APC, 12.0%) and 5.62 (APC, 11.2%) per 100,000 population among men and women, respectively. The incidence increased most rapidly for stomach cancer in men and women aged 80 years and older (APC, 23.7% for men; APC, 18.6% for women), for colorectal cancer in men aged 60 to 69 years (APC, 24.2%) and in women aged 50 to 59 years (APC, 25.1%), and for esophageal cancer in men and women aged 80 years and older (APC, 17.5% for men; APC,15.3% for women) over the period of the study.

Conclusions: The incidence of gastrointestinal cancer significantly increased during the past decade. Therefore, monitoring the trends of cancer incidence can assist efforts for cancer prevention and control.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4178/epih.e2016056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309725PMC
February 2017

The epidemiology of geriatric burns in Iran: A national burn registry-based study.

Burns 2016 Aug 25;42(5):1128-1132. Epub 2016 Apr 25.

Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Defining the epidemiology and outcome of geriatric burn patients is critical for specialized burn centers, health-care workers, and governments. Better resource use and effective guidelines are some of the advantages of studies focusing on this aspect. The outcome of these patients serves as an objective criterion for quality control, research, and preventive programs. We used data from the burn registry program in our country. For 2 years, >28,700 burn patients were recorded, 1721 of whom were admitted. Among them, 187 patients were ≥55 years old. Sixty-nine percent of patients were male and 31% female, with a male to female ratio of 2.22:1. The mean±standard deviation (SD) of age was 63.4±8.1. The cause of burns was flame (58.2%) and scalds (20.3%). Most of the burns were sustained at home. The mean duration of hospital stay was 19.5 days (range 3-59 days). The mean (SD) of the total body surface area (TBSA) was 20.3% (8.4%). The median hospital stay (length of stay (LOS)) was 11 days (SD=14). The increase in TBSA was related to a longer LOS (p<0.02). Burn wound infection developed in 44.3% of patients. The presence of inhalation injury was significantly related to mortality (p<0.001). Among the patients, 9% recovered completely, 74.9% recovered partially (requiring further treatment), 1% underwent amputation, and 12.8% died. The lack of insurance coverage did not affect the survival of our geriatric burn patients. However, being alone or single, ignition of clothing, cause of burn, comorbid illnesses, complications following the burn, TBSA, age, and sepsis were positively correlated with mortality. The mean cost of treatment for each patient was about $7450.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.burns.2016.03.011DOI Listing
August 2016

Prevalence of Spinal Cord Injury in Iran: A 3-Source Capture-Recapture Study.

Neuroepidemiology 2015 18;45(1):28-33. Epub 2015 Jul 18.

Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Epidemiologic data of spinal cord injured (SCI) patients are necessary for prevention policymaking and improvement of social and healthcare support to patients. This study was designed to estimate the prevalence of traumatic and non-traumatic SCI in Iran in a three-source capture-recapture study.

Methods: Three organizations, which provide supports to SCI patients were identified. Demographic data of patients in each organization was obtained. Datasets were formed and matching data were found. Matched data were incorporated into STATA 12 for log linear analyses. Results of sensitivity analyses were used to estimate total number of SCI patients in Iran. Veterans of Iraq-Iran conflict were added as separate data source to final results.

Results: The prevalence of traumatic and non-traumatic SCI patients is 296.87 (95% confidence intervals (CI): 292.04-302.48) per million in Tehran and Alborz provinces. The prevalence of SCI in Iran is an estimated 318.45 (95% CI: 312.98-324.54) per million.

Conclusion: The prevalence of SCI in Iran is among the lowest figures reported in the literature. The supporting organizations in Iran do not have details about the cause, level and severity of SCI patients. A national study to register SCI patients' data is needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000435785DOI Listing
May 2016