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1.
BMC Psychiatry ; 24(1): 75, 2024 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-38279091

RESUMO

BACKGROUND AND PURPOSE: Mental health disorders are a growing concern worldwide, with a significant impact on public health. Understanding attitudes toward seeking professional psychological help is essential in addressing these issues. In the Iranian context, there is a need for a reliable tool to measure these attitudes. This study aims to assess the validity and reliability of the Persian Adaptation of the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF). MATERIALS AND METHODS: A cross-sectional study was conducted in May 2023, utilizing a convenience sampling method with 1050 participants aged 10 to 65 years in Iran.The ATSPPH-SF questionnaire, consisting of 10 items and 2 subscales, was employed. The questionnaire underwent translation and cultural adaptation, and its validity was assessed through qualitative face and content validities. Confirmatory factor analysis (CFA) was used to evaluate construct validity. Reliability was assessed using McDonald's omega coefficient and Cronbach's alpha coefficient. Data collection was conducted through an online survey. RESULTS: The CFA results indicated a two-factor structure for the ATSPPH-SF, with one factor representing openness to seeking treatment for emotional problems and the other factor reflecting the value and need for seeking treatment. The model demonstrated acceptable fit indices. Both McDonald's omega coefficient and Cronbach's alpha coefficient suggested good internal consistency for the scale. The mean total score for the ATSPPH-SF was 21.37 (SD = 5.52), indicating the reliability and validity of the scale for the Iranian population. CONCLUSION: This study confirms the suitability of the short-form ATSPPH-SF with 10 items and 2 subscales as a valid and reliable tool for assessing attitudes toward seeking professional psychological help in the Iranian population. With no prior appropriate instrument available, this scale fills a crucial gap. It can be employed to measure attitudes among various demographic groups, aiding in the design of targeted interventions to enhance mental health literacy and reduce the stigma associated with seeking professional psychological help in Iran.


Assuntos
Psicometria , Humanos , Psicometria/métodos , Estudos Transversais , Irã (Geográfico) , Reprodutibilidade dos Testes , Inquéritos e Questionários
2.
Iran J Public Health ; 51(2): 438-449, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35866121

RESUMO

Background: We investigated the impact of cancer incidence on CHE in Iran by considering spatial variation across provinces as well as temporal trends. Methods: Data from Household Income-Expenditure Survey were merged with cancer incidence rates during 2011-2016. We developed a Bayesian hierarchical model to explore the spatial and temporal patterns of CHE and its associated factors at provincial level. We used a Besag-York-Mollie2 prior and a random walk prior for spatial and temporal random effects respectively. All statistical analysis was carried out in R software. Results: All-type cancer incidence (OR per SD (95% CrI) = 1.16 (1.02, 1.32)), unemployment rate (1.08 (1.01, 1.15)) and income equity (0.88 (0.81, 0.97)) have important association with CHE. Percentage of urbanization and percentage of poverty were not statistically significant. Conclusion: The results suggest the development of new policies to protect cancer patients against financial hardship, narrow the gap in income inequality and solve the problem of high unemployment rate to reduce the level of CHE at provincial level.

3.
BMC Public Health ; 21(1): 2323, 2021 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-34969389

RESUMO

BACKGROUND: The thermal strain can be measured using subjective methods without the use of sensitive equipment. The purpose of the present study was the development and validation of an observational - perceptual heat strain risk assessment (OPHSRA) method. METHODS: This cross-sectional study, in 2019, was performed. At first, an observational-perceptual questionnaire was designed using effective items in producing heat strain. Then, the reliability and validity of the questionnaire were examined. Later, 201 male workers were asked to perform the routine tasks for 90 min under various climatic conditions after resting in a cool room. At the end of the activity, the tympanic temperature of the subjects was accurately measured. Also, the designed questionnaire was completed by researchers and participants. Then, the effect coefficients of the items were calculated and used for developing the novel index. At final, the index validity was investigated. RESULTS: The values of the content validity ratio (CVR), content validity index (CVI), and Cronbach's coefficient alpha (α) of the designed questionnaire with 16 questions were equal to 0.793, 0.913, and 0.910, respectively. The results indicated that environmental, job, administrative, and clothing items assessed by the questionnaire with the coefficients of 0.860, 0.658, 0.783, and 0.566 had significant effects on the thermal strain, respectively. These coefficients were exploited to develop the index. The result revealed that the OPHSRA index justified 69% of the variations of the tympanic temperature (R2 = 0.69). CONCLUSION: The novel index developed by the questionnaire had an acceptable validity. Therefore, this index can be used for estimating the risk of thermal strain in a variety of thermal conditions.


Assuntos
Temperatura Alta , Estudos Transversais , Humanos , Masculino , Reprodutibilidade dos Testes , Medição de Risco/métodos , Inquéritos e Questionários
4.
J Environ Health Sci Eng ; 18(2): 469-481, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33312576

RESUMO

BACKGROUND: Agricultural soils pollution with heavy metal (loid) s (HMs) can create significant ecological and health problems. The aims of present study were to characterize HMs pollution profile of dry farmland soils in rural areas of Kurdistan province in Iran and evaluate potential associated ecological and health risks. METHODS: Different indices of Geo-accumulation index (IGeo), Individual contamination factor (ICF), Nemerow composite pollution index (NCPI) and Potential Ecological Risk Index (PERI) were employed to assess the bio-accumulation of the HMs and evaluate associated ecological risks. Human health risks estimated with total hazard index (THI) and total carcinogenic risk (TCR) indices based on ingestion, inhalation and dermal exposure pathways for children and adults. RESULTS: As, Cd, Cr, Ni and Pb exceeded the soil standards. The spatial maps of the IGeo showed that As pollution was at severe level in eastern part of the study region. According to the ICF results, the studied soils were extremely contaminated with As, Cd, Cr, Ni and Zn. Furthermore, based on the pollution indices, some of sampling sites were critically polluted by abovementioned HMs. For children and adults groups, the THI values in 13 and 97% of sampling sites were more than 1 and the TCR in 7 and 14% of sampling sites were more than 10-4, respectively. The farmland soil pollution of the study area by As and Cr were found to be quite serious and dangerous. CONCLUSION: The findings of this study suggest that further attention should be paid by decision-makers to control the HMs pollution in the agricultural soils of the study area.

5.
Environ Health Prev Med ; 25(1): 63, 2020 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-33115400

RESUMO

BACKGROUND: Need to a simple, available, accurate, comprehensive, and valid indicator is felt to assess thermal effects. Therefore, the present study was aimed to develop and validate the environmental heat strain risk assessment (EHSRA) index using structural equation modeling (SEM) based on empirical relations. METHODS: This cross-sectional study was performed on 201 male workers in environments with various climatic conditions. The heart rate and tympanic temperature of the individuals were monitored at times of 30, 60, and 90 min after beginning the work. At these times, values of dry temperature, wet temperature, globe temperature, and air velocity were also measured and metabolism rate and clothing thermal insulation value were estimated. At the end, a theoretical model was depicted in AMOS software and obtained coefficients were applied to develop a novel index. The scores of this indicator were categorized into four risk levels via ROC curves and validate using linear regression analysis. RESULTS: Indirect effect coefficients of the globe temperature, dry temperature, wet temperature, air velocity, metabolism, and clothing thermal insulation variables on the tympanic temperature were computed by 0.77, 0.75, 0.69, 0.24, 0.49, and 0.39, respectively. These coefficients were applied to develop the index. Optimal cut-off points of boundaries between risk levels included 12.02, 15.88, and 17.56. The results showed that the EHSRA index justified 75% of the variations of the tympanic temperature (R2 = 0.75). CONCLUSIONS: The novel index possesses appropriate validity. It was suggested that this indicator is applied and validated in various environments in the next studies.


Assuntos
Saúde Ambiental/métodos , Resposta ao Choque Térmico , Temperatura Alta/efeitos adversos , Adulto , Humanos , Irã (Geográfico) , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Adulto Jovem
6.
Ethiop J Health Sci ; 30(3): 409-416, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32874084

RESUMO

BACKGROUND: Diagnostic services are highly critical in the success of treatment processes, overly costly nonetheless. Accordingly, hospitals generally seek the private partnership in the provision of such services. This study intends to explore the incentives owned by both public and private sector in their joint provision of diagnostic services under the public-private partnership agreement. METHOD: A qualitative, exploratory study was employed in Tehran hospitals from October 2017 to March 2018. Around 25 face-to-face, semi-structured interviews were conducted with the purposively recruited hospital managers, heads of diagnostic services and managers of private companies. Interviews were transcribed and analyzed using conventional content analysis, assisted by "MAXQDA-12". RESULTS: Three main categories and nine sub-categories represented the incentives of public sector, and four main categories and seven sub-categories signified those of private sector. The incentives of public sector included the status-quo remediation, upstream requirements, and personal reasons. As such, the individual, social and economic incentives and legal constraints were driving the behavior of the private sector. CONCLUSIONS: Financial problem and gain were the most noted incentives by the partners. Attention to the either side's incentives and aims is likely to ensure the durability and effectiveness of such partnerships in the health sector.


Assuntos
Pessoal Administrativo/psicologia , Serviços de Diagnóstico/economia , Parcerias Público-Privadas/economia , Reembolso de Incentivo , Adulto , Serviços de Diagnóstico/organização & administração , Feminino , Administração Hospitalar/economia , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Motivação , Setor Privado/economia , Setor Privado/organização & administração , Setor Público/economia , Setor Público/organização & administração , Parcerias Público-Privadas/organização & administração , Pesquisa Qualitativa
7.
BMC Public Health ; 20(1): 837, 2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32493326

RESUMO

BACKGROUND: There is not a comprehensive heat stress index to screen the people susceptible to heat disorders and illnesses in hot workplaces. The present study was aimed to develop a personal heat strain risk assessment (PHSRA) index in workplaces and validate it. METHODS: This cross-sectional study was carried out on 201 Iranian male employees under various thermal conditions. At first, the demographical data of participants were gathered. After that, the heart rate and tympanic temperature of the subjects were carefully measured at times of 30, 60, and 90 min of starting the work. Environmental factors were measured simultaneously. The metabolism rate and insulation value of clothes were also estimated. At the end, a novel index of the heat strain was developed using structural equation modeling in AMOS and validated using linear regression analysis in SPSS. RESULTS: Indirect effect coefficients of personal factors including age, body mass index, maximum aerobic capacity, and body surface area were equal to 0.031, 0.145, - 0.064, and 0.106, respectively. The coefficients of main factors including dry temperature, wet temperature, globe temperature, wind speed, metabolism, and clothing thermal insulation were obtained as 0.739, 0.688, 0.765, 0.245, 0.482, and 0.383, respectively. These coefficients and normalized values of the factors were used to develop a novel index. The total score of the index was categorized into four levels by optimal cut-off points of 12.93, 16.48, and 18.87. Based on the results of regression analysis, this index justifies 77% of the tympanic temperature as a dependent variable (R2 = 0.77). CONCLUSIONS: In general, the results indicated that the novel index developed by the personal and main factors had proper validity in the prediction of thermal strain.


Assuntos
Indicadores Básicos de Saúde , Transtornos de Estresse por Calor/diagnóstico , Doenças Profissionais/diagnóstico , Medição de Risco/métodos , Avaliação de Sintomas/métodos , Adulto , Temperatura Corporal , Estudos Transversais , Frequência Cardíaca , Temperatura Alta , Humanos , Irã (Geográfico) , Análise de Classes Latentes , Modelos Lineares , Masculino , Valores de Referência , Reprodutibilidade dos Testes , Vento , Local de Trabalho , Adulto Jovem
8.
Epidemiol Health ; 41: e2019014, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31010280

RESUMO

OBJECTIVES: The emergence of multidrug-resistant tuberculosis (MDR-TB) is a major challenge for the global control of tuberculosis (TB). The aim of this study was to determine the risk factors associated with MDR-TB in Sudan. METHODS: This case-control study was conducted from May 2017 to February 2019. Patients newly diagnosed with MDR-TB were selected as cases, and controls were selected from TB patients who responded to first-line anti-TB drugs. A questionnaire was designed and used to collect data from study participants. Logistic regression was used to evaluate associations between risk factors and MDR-TB infection. The best multivariate model was selected based on the likelihood ratio test. RESULTS: A total of 430 cases and 860 controls were selected for this study. A history of previous TB treatment (adjusted odds ratio [aOR], 54.85; 95% confidence interval [CI], 30.48 to 98.69) was strongly associated with MDR-TB infection. We identified interruption of TB treatment (aOR, 7.62; 95% CI, 3.16 to 18.34), contact with MDR-TB patients (aOR, 5.40; 95% CI, 2.69 to 10.74), lower body weight (aOR, 0.89; 95% CI, 0.87 to 0.91), and water pipe smoking (aOR, 3.23; 95% CI, 1.73 to 6.04) as factors associated with MDR-TB infection. CONCLUSIONS: Previous TB treatment and interruption of TB treatment were found to be the main predictors of MDR-TB. Additionally, this study found that contact with MDR-TB patients and water pipe smoking were associated with MDR-TB infection in Sudan. More efforts are required to decrease the rate of treatment interruption, to strengthen patients' adherence to treatment, and to reduce contact with MDR-TB patients.


Assuntos
Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Adolescente , Adulto , Idoso , Antituberculosos/uso terapêutico , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Sudão/epidemiologia , Inquéritos e Questionários , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Adulto Jovem
9.
Int J Health Plann Manage ; 34(1): e397-e410, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30289584

RESUMO

BACKGROUND: Low-income and middle-income countries have a lot of problems in providing the financial, human, and capital resources for advanced medical imaging technologies (AMITs). Proper distribution of such expensive equipment might increase access to these services and enhance the quality and efficiency of health care. The present study aimed to identify the factors affecting the diffusion of AMITs including CT and MRI in Iran. METHODS: This is a qualitative research conducted in 2017. A number of purposively chosen policy makers and managers from Ministry of Health, medical universities, hospitals, health insurance, and vendor companies were approached for face-to-face and semistructured interviews. Data analysis was done using thematic analysis method. RESULTS: Three categories of influential factors were identified, including contextual, stakeholder related, and situational factors. With regards to the stakeholders, the ministry and physicians played the most important role in the diffusion process of the AMITs. Health insurance organizations and vendor companies played a minor role in distribution of the equipment. Application of political pressure by the authorities on the Ministry of Health to issue licenses for the acquisition of AMITs was taken as the most important factor and the greatest challenge in the diffusion of devices. CONCLUSION: The results sought to assist health system authorities to manage diffusion of AMITs effectively and assign an equitable access to the expensive resources. The diffusion management together with utilization management could largely improve efficiency and cost containment. Medical technology diffusion management de facto needs policy instruments in both supply and demand sides.


Assuntos
Difusão de Inovações , Imageamento por Ressonância Magnética/instrumentação , Tomografia Computadorizada por Raios X/instrumentação , Política de Saúde , Entrevistas como Assunto , Irã (Geográfico) , Papel do Médico , Política , Pesquisa Qualitativa , Participação dos Interessados
10.
J Occup Health ; 60(1): 46-54, 2018 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-29046509

RESUMO

OBJECTIVES: Prolonged sitting with a flexed back and neck is recognized as being associated with an increased risk of neck and back pain disorders among overhead crane operators. The aim of this study was to compare back and head postures over a full shift of work between operators who experience back and neck pain, and healthy operators. METHODS: In a first phase, the prevalence of musculoskeletal symptoms was assessed using the Nordic questionnaire among 120 crane operators. Based on first phase results, 17 operators with back/neck disorders were matched with 15 healthy operators based on age and selected to participate in the second phase of the study. Postures and movements were continuously measured over an 8 h shift using inclinometers. RESULTS: The highest 12-month prevalence of musculoskeletal disorders was found in the lower back, neck and knees. Case and control groups differed significantly in back and head flexion angles at the 50th percentiles APDF (p < 0.05). There was also a significant difference in the time spent working in an extreme posture of the back and head between groups (p < 0.05). CONCLUSIONS: This is the first study to document work postures assumed during a full work shift and to compare postures between symptomatic and healthy overhead crane operators. Physical exposure in case group operators was characterized by more awkward and extreme postures in the back and head. The results of this study demonstrate that effective prevention strategies directed towards musculoskeletal disorders are required that address awkward work postures for overhead crane operators.


Assuntos
Indústria Manufatureira/instrumentação , Doenças Musculoesqueléticas/etiologia , Doenças Profissionais/etiologia , Exposição Ocupacional/análise , Postura/fisiologia , Adulto , Dorso , Biometria , Estudos de Casos e Controles , Desenho de Equipamento , Ergonomia , Feminino , Cabeça , Humanos , Masculino
11.
Electron Physician ; 8(6): 2551-6, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27504172

RESUMO

INTRODUCTION: Over the last few decades, total fertility rate (TFR) has followed a downward trend in Iran. The consequences of this trend from the perspectives of some are negative. Considering the macro-population policies in recent years, this study aimed to examine the effect of some macro socio-economic variables, including divorce, marriage, urbanization, and unemployment rate on TFR in Iran from 2002 to 2012. METHODS: This time series research was conducted in 2015 using the databases of the National Organization for Civil Registration (NOCR) and the Statistical Center of Iran. The study population was the related data of provinces in the selected variables. The main methods used in the research were the common unit root test, Pedroni Cointegration test, redundant fixed effects tests, correlated random effects-Hausman test, and panel least squares of fixed effects. In order to determine the suitable model for estimating panel data, likelihood ratio and Huasman tests were done using Eviews software, and the fixed effects regression model was chosen as the dominant model. RESULTS: The results indicated that the divorce rate had a negative and significant effect on TFR (p < 0.05). A positive and significant relationship between marriage rate and TFR variables also was observed (p < 0.05). Urbanization rate (p = 0.24) and unemployment rate (p = 0.36) had no significant relationship with TFR. According to F statistic, significance of the overall model also was confirmed (p < 0.001). CONCLUSION: Due to the lower effect of the studied factors on the reduction of TFR, it seems that variables other than the ones studied, as well as cultural factors and values, might be fundamental factors for this change in the country.

12.
Glob J Health Sci ; 8(5): 166-74, 2015 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-26652076

RESUMO

BACKGROUND & OBJECTIVE: Because of social progress, population growth, industrialization, and the requirements of some jobs, a significant percentage of employees are working in shifts. Shift work is considered a threat to health that could have unfavorable effects on various aspects of human life. This study investigated the relationship between shift work and the personality traits of nurses and their coping strategies in a selection of non-governmental hospitals in Tehran in 2014. METHODS: This applied cross-sectional descriptive research employed the Standard Shift work Index and Eysenck Personality Questionnaire (EPQ) which, after confirmation of its validity and reliability (Cronbach's alpha 0.73), were distributed among 305 nurses from 6 non-governmental hospitals in Tehran selected through cluster random sampling. Data was analyzed in two statistical levels: descriptive and inferential. RESULTS: Results revealed that 43.6% of the nurses participating in the study were introverted and 56.4% were extroverted. There are significant relationships between age and physical health (P=0.008), sex and physical health (P=0.015), educational level and physical health (P=0.014), sex and cognitive, somatic anxiety (P=0.006), age and social-family status (P=0.001), marital status and social-family status (P=0.001), having a second job and social-family status (P=0.001), educational level and sleep and fatigue (P=0.002), work experience and coping strategies (P=0.044), and sleep and fatigue and personality traits (P=0.032). CONCLUSION: Complying with the standards of working hours for nurses and avoiding overtime when scheduling, especially for nurses with more work experience, can prevent the severe complications of shift work, enhance health, and ultimately enhance the quality of care. By improving the physical, psychological, and social health of nurses, the quality of patient care can be expected to improve, too.


Assuntos
Adaptação Psicológica , Recursos Humanos de Enfermagem Hospitalar/psicologia , Personalidade , Admissão e Escalonamento de Pessoal , Adulto , Fatores Etários , Estudos Transversais , Fadiga/epidemiologia , Feminino , Nível de Saúde , Humanos , Satisfação no Emprego , Masculino , Reprodutibilidade dos Testes , Fatores Sexuais , Sono , Fatores Socioeconômicos
13.
Glob J Health Sci ; 8(4): 127-35, 2015 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-26573052

RESUMO

BACKGROUND AND OBJECTIVES: More than 8% of Iran's populations are elderly. The greatest challenge in this generation is improvement of health and QoL.The main goal of this study was QoL for elderly residents in nursing homes over 65 years in Golestan Province - Iran. METHODS: This research was an analytical cross study. The population society includes the elderly over 65 years in Golestan Province - Iran. The sample size was calculated based on the correlation of 193 elderly men and women. Therefore, if the correlation is 2.0 or greater is statistically significant at 80% and 0.95 confidence. The needed data collected from two questionnaires Consumer product Safety Commission (CPSC) to assess the QOL of nursing homes and the SF-36 for health QOL the elderly indicators through interviews and observation. The reliability of the CPSC questionnaire was estimated using Cronbach's alpha with a coefficient of 0.838. The SF-36 questionnaire was validated with Cronbach's alpha with a coefficient of 0.95. To analyze data, ANOVA one-way test was used that after investigating homogenization of variances with Levin statistic, if homogenization reported P is rejected, the independent T-test was used to interpret it. RESULTS: Among QOL dimensions only General Health (GH) status showed a significant association with supporting organizations covering status (P = 0.01). The relationship between QOL with marital status in both genders was observed that the General Health (GH) (P = 0.001), Physical Functioning (PF) P = (0.007) Mobility Restricts (MR) P = (0.002), Emotional Problems (EP) (P = 0.001), vitality (V) (P = 0.001), Mental Health (MH) (P = 0.001) were significantly related. CONCLUSIONS: There was a significant relationship between the Physical Functioning (PF) mean and the mean of other QOL indicators in two groups of male and female (P = 0.007), also the safety of nursing homes just related respectively with residence variable (P = 0.01) and their employment (P = 0.031).


Assuntos
Casas de Saúde , Qualidade de Vida , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Feminino , Avaliação Geriátrica , Humanos , Irã (Geográfico) , Masculino , Inquéritos e Questionários
14.
Glob J Health Sci ; 8(7): 68-76, 2015 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-26925904

RESUMO

BACKGROUND & OBJECTIVES: The objective of this study was to evaluate the elderly quality of life of people covered by the healthcare centers in Tehran and its influencing demographic and background factors. METHOD: This is a cross-sectional study of quality of life of the elderly population covered by healthcare centers and bases in Tehran, as well as the influential background and demographic factors. Sampling was performed using simple random stratified sampling proportionate to the size of strata. Data were collected using the Iranian version of the standard questionnaire Short Form Health Survey (SF-36). RESULTS: According to the findings, 240 (60%) of the cases were men and 160 (40%) were women. Regarding age distribution, 76.3% fell in the 60-69 age range and 87.2% were illiterate. 18% of the elderly stated that they have financial problems and 19.5% did not express any financial problems. While studying the relationship between financial status and health status with the mean scores of quality of life, statistically significant differences were observed in all domains (p=0.032<0.001). The mean quality of life was lower in women compared to men. CONCLUSIONS: The findings of the present study indicate that the health-related quality of life in the elderly population is influenced by their health status and demographic and background variables.


Assuntos
Serviços de Saúde para Idosos/normas , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Demografia , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários
15.
Int J Prev Med ; 5(4): 414-23, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24829728

RESUMO

BACKGROUND: Despite significant reduction in global disease prevalence, leprosy still has a high rate of disability while its determinants are unfair and many of them are amendable. The objective of this study was to measure inequality of disability in leprosy in Iran. METHODS: This was a cross-sectional study (2006-2007) on all living people affected by leprosy registered in W. Azerbaijan province health center, Western North of Iran. The outcome of the study was the socio-economic inequality considering presence or absence of grade 2 disability (G2D) based on the WHO classifications. An extended concentration index decomposition approach was used for analysis. RESULTS: Among 452 cases, 65.3% were male and 67% were affected by the multi bacillary type. Overall G2D was 65.3%. The estimated Concentration Index was -0.0782, showing presence of pro-poor socio-economic inequality of G2D, while extended CI estimation (ѵ = 5) was -0.163. Achievement index with coefficient (ѵ = 5) revealed that G2D mean was 16% more than classic mean in the poorest group. The result of decomposition of the existing inequality revealed that, some of the determinants such as receiving mono-therapy, education, urbanization, and bacillus calmette guerin (BCG) vaccination had shared contribution (67.4%, 61.8%, 59.2%, and 57.5% respectively). CONCLUSIONS: This study provided new perspective for the health system to leprosy control considering the significant gap between rich and poor (inequality) regarding G2D disability, and its effective elements in socio-economic strata. Some effective actions can be considered to reduce the scale of existing inequality.

16.
Int J Prev Med ; 4(11): 1304-11, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24404366

RESUMO

BACKGROUND: Notwithstanding the importance of smoking stages evaluation in adolescents, there is not an appropriate instrument for its measurement. This study aims to introduce an appropriate instrument for measurement of smoking stages in adolescents and to examine its validity using latent class analysis (LCA) model. METHODS: We designed an algorithm to measure the smoking stages. The relevancy and clarity of the algorithm was examined by experts and lay experts. We assessed the reliability of our algorithm using test-retest method. Moreover, using the LCA, we studied the validity of the stages measured by the designed algorithm in 4903 students (ages 14-19), who were randomly selected from grade 10 high school students in Tabriz (North-West of Iran). RESULTS: The algorithm content validity indicates high relevancy and clarity percentages. Intra-class correlation of 0.929 was found in the assessment of the reliability of smoking stages (9 stages) in 154 students within a two-week interval. The LCA model revealed nine interpretable classes (G(2) = 0.051, df = 1, P = 0.821) for the measurement of smoking stages. Examination of the smoking cessation stages in a sample of 218 students in the cessation stage demonstrated that the results for five classes could be interpreted (G(2) = 0.001, df = 1, P = 0.975). CONCLUSIONS: The results suggested that this algorithm is clear, valid, and reliable.

17.
Int J Prev Med ; 3(3): 181-90, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22448311

RESUMO

BACKGROUND: Population-based estimates of traffic accidents (TAs) are not readily available for developing countries. This study examined the contribution of socioeconomic status (SES) to the risk of TA among Iranian adults. METHODS: A total of 64,200people aged ≥18years were identified from 2008 Urban Health Equity Assessment and Response Tool (Urban HEART) survey. 22,128 households were interviewed to estimate the overall annual incidence, severity and socioeconomic determinants of TAs for males and females in Iranian capital over the preceding year. Wealth index and house value index were constructed for economic measurement. Weighted estimates were computed adjusting for complex survey design. Logistic regression models were used to examine individual and SES measures as potential determinants of TAs in adults. RESULTS: The overall incidence of traffic accident was 17.3(95% CI 16.0, 18.7) per 1000 per year. TA rate in men and women was 22.6(95% CI 20.6, 24.8) and 11.8(95% CI 10.4, 13.2), respectively. The overall TA mortality rate was 26.6(95% CI 13.4, 39.8) per 100,000 person-years, which was almost three times higher in men than that for women (40.4 vs. 12.1 per 100,000person-years). Lower economic level was associated with increased incidence and mortality of TA. Association between SES and incidence, and severity and mortality of TA were identified. CONCLUSION: TAs occur more in lower socioeconomic layers of the society. This should be taken seriously into consideration by policy makers, so that preventive programs aimed at behavioral modifications in the society are promoted to decrease the health and economic burden imposed by TAs.

18.
J Res Med Sci ; 15(5): 270-8, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21526095

RESUMO

BACKGROUND: Few studies that have investigated hypertension have considered a state of oxidative stress that can contribute to the development of atherosclerosis and other hypertension induced organ damage. The aim of this study was to investigate whether pre-hypertension and hypertension status is associated with activities of erythrocyte antioxidant enzymes in a random sample of cardiovascular disease-free women. METHODS: In this case-control study, 53 pre-hypertensive women, 32 hypertensive women and 75 healthy controls were included. General information was gathered using questionnaires and face-to-face interviews. Blood pressure and anthropometric measurements were measured for each subject. Venous blood samples were drawn from subjects and plasma was separated. Activities of erythrocyte antioxidant enzymes were also evaluated by measuring activities of copper zinc-superoxide dismutase (CuZn-SOD), glutathione peroxidase (GPX) and catalase (CAT) in selected subjects. RESULTS: Fifty-three (33.1%) and 32 (20%) participants were pre-hypertensive and hypertensive, respectively. The hypertensive and pre-hypertensive women had lower CuZn-SOD (p < 0.001) and GPX (p < 0.01) activities compared to normotensives. Furthermore, hypertensive women had lower CAT activity compared to pre-hypertensive and normotensive women (p < 0.001). Moreover, significant differences were also observed between hypertensive and pre-hypertensive women in erythrocyte CAT activity (p < 0.01). CONCLUSIONS: The present findings show that activities of erythrocyte antioxidant enzymes decrease in pre-hypertensive and hypertensive women, which may eventually lead to atherosclerosis and other high blood pressure related health problems.

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