Predicting cutaneous leishmaniasis using SARIMA and Markov switching models in Isfahan, Iran: A time-series study

Objective: To determine the potential effect of environment variables on cutaneous leishmaniasis occurrence using time-series models and compare the predictive ability of seasonal autoregressive integrated moving average (SARIMA) models and Markov switching model (MSM). Methods: This descriptive study employed yearly and monthly data of 49 364 parasitologically-confirmed cases of cutaneous leishmaniasis in Isfahan province, located in the center of Iran from January 2000 to December 2019. The data were provided by the leishmaniasis national surveillance system, the meteorological organization of Isfahan province, and Iranian Space Agency for vegetation information. The SARIMA and MSM models were implemented to examine the environmental factors of cutaneous leishmaniasis epidemics. Results: The minimum relative humidity, maximum relative humidity, minimum wind speed, and maximum wind speed were significantly associated with cutaneous leishmaniasis epidemics in different lags (P<0.05). Comparing SARIMA and MSM, Akaikes information criterion (AIC), and mean absolute percentage error (MAPE) in MSM were much smaller than SARIMA models (MSM: AIC=0.95, MAPE=3.5%; SARIMA: AIC=158.93, MAPE:11.45%). Conclusions: SARIMA and MSM can be a useful tool for predicting cutaneous leishmaniasis in Isfahan province. Since cutaneous leishmaniasis falls into one of two states of epidemic and non-epidemic, the use of MSM (dynamic) is recommended, which can provide more information compared to models that use a single distribution for all observations (Box-Jenkins SARIMA model).

A review of methods to estimate the visibility factor for bias correction in network scale-up studies / 한국역학회지

Network scale-up is an indirect size estimation method, in which participants are questioned on sensitive behaviors of their social network members. Therefore, the visibility of the behavior affects the replies and estimates. Many attempts to estimate visibility have been made. The aims of this study were to review the main methods used to address visibility and to provide a summary of reported visibility factors (VFs) across populations. We systematically searched relevant databases and Google. In total, 15 studies and reports that calculated VFs were found. VF calculation studies have been applied in 9 countries, mostly in East Asia and Eastern Europe. The methods applied were expert opinion, comparison of NSU with another method, the game of contacts, social respect, and the coming-out rate. The VF has been calculated for heavy drug users, people who inject drugs (PWID), female sex workers (FSWs) and their clients, male who have sex with male (MSM), alcohol and methamphetamine users, and those who have experienced extra-/pre-marital sex and abortion. The VF varied from 1.4% in Japan to 52.0% in China for MSM; from 34.0% in Ukraine to 111.0% in China for FSWs; and from 12.0% among Iranian students to 57.0% in Ukraine for PWID. Our review revealed that VF estimates were heterogeneous, and were not available for most settings, in particular the Middle East and North Africa region, except Iran. More concrete methodologies to estimate the VF are required.

A review of methods to estimate the visibility factor for bias correction in network scale-up studies / 한국역학회지

Network scale-up is an indirect size estimation method, in which participants are questioned on sensitive behaviors of their social network members. Therefore, the visibility of the behavior affects the replies and estimates. Many attempts to estimate visibility have been made. The aims of this study were to review the main methods used to address visibility and to provide a summary of reported visibility factors (VFs) across populations. We systematically searched relevant databases and Google. In total, 15 studies and reports that calculated VFs were found. VF calculation studies have been applied in 9 countries, mostly in East Asia and Eastern Europe. The methods applied were expert opinion, comparison of NSU with another method, the game of contacts, social respect, and the coming-out rate. The VF has been calculated for heavy drug users, people who inject drugs (PWID), female sex workers (FSWs) and their clients, male who have sex with male (MSM), alcohol and methamphetamine users, and those who have experienced extra-/pre-marital sex and abortion. The VF varied from 1.4% in Japan to 52.0% in China for MSM; from 34.0% in Ukraine to 111.0% in China for FSWs; and from 12.0% among Iranian students to 57.0% in Ukraine for PWID. Our review revealed that VF estimates were heterogeneous, and were not available for most settings, in particular the Middle East and North Africa region, except Iran. More concrete methodologies to estimate the VF are required.

A review of methods to estimate the visibility factor for bias correction in network scale-up studies / 한국역학회지

Network scale-up is an indirect size estimation method, in which participants are questioned on sensitive behaviors of their social network members. Therefore, the visibility of the behavior affects the replies and estimates. Many attempts to estimate visibility have been made. The aims of this study were to review the main methods used to address visibility and to provide a summary of reported visibility factors (VFs) across populations. We systematically searched relevant databases and Google. In total, 15 studies and reports that calculated VFs were found. VF calculation studies have been applied in 9 countries, mostly in East Asia and Eastern Europe. The methods applied were expert opinion, comparison of NSU with another method, the game of contacts, social respect, and the coming-out rate. The VF has been calculated for heavy drug users, people who inject drugs (PWID), female sex workers (FSWs) and their clients, male who have sex with male (MSM), alcohol and methamphetamine users, and those who have experienced extra-/pre-marital sex and abortion. The VF varied from 1.4% in Japan to 52.0% in China for MSM; from 34.0% in Ukraine to 111.0% in China for FSWs; and from 12.0% among Iranian students to 57.0% in Ukraine for PWID. Our review revealed that VF estimates were heterogeneous, and were not available for most settings, in particular the Middle East and North Africa region, except Iran. More concrete methodologies to estimate the VF are required.

Normative data of grip and pinch strengths in healthy adults of Iranian population

Measuring and comparing grip and pinch strengths with their normative data is a valid method to detect intensity of the numerous damages of hand. This research was carried out with the aim of establishing normative data of grip strength and three types of pinch strengths [Tip, Key and Palmar] in healthy Iranian adults. In this cross-sectional study, the study population was formed of 1008 people [526 men and 482 women] from healthy Fars race adults of over 20 years old in five cities of Iran. American Society of Hand Therapists [ASHT] recommendations were followed to establish normative data of grip and pinch strengths. Normative data of grip and pinch strengths were developed based on sex, 12 different age groups and dominant and non-dominant hands. Jamar dynamometer and Seahan pinch gauge were used to measure grip and pinch strengths, respectively. Normative data of grip and pinch strengths were provided. Grip and pinch strengths of men were significantly stronger than women. The maximum grip strength of men was obtained in the group of 20-24 years and among women it was in the age group 35-39 years. Regardless of gender, grip and pinch strengths were declined with aging. Normative data of grip and pinch strengths were developed for Iranian population

Prevalence of child abuse in 15-17 year old students

Child abuse is a common phenomenon accompanies with unfavorable short and long term personal and social consequences. With changes in environment which child taken care, negative long term consequences could decreased. This study designed to determine the prevalence of all types of maltreatments in 15-17 year-old students in Kerman. In this cross sectional -descriptive study, a sample of 360 students [184 boys/196 girls] selected by cluster method from all boy and girls high school students of educational area one and two of Kerman and was evaluated. Maltreatment assessment instrument was a 48-questions standard self-report questionnaire which previously recorded. Data were analyzed by descriptive statistical tests. The average of child abuse among samples was 27.6%. The students have experienced physical, neglect and emotional abuse, 9.67%, 23.6% and 17.9% respectively in their history. Despite the lower frequency of child abuse types in comparison with other studies, it seems the early diagnosis and protective educational interventions could have critical roles in diminishing the prevalence and harmful consequences of child abuse

relationship between students' bonding to school and multiple health risk behaviors among high school students in South-East of Iran

Background: School is the first social institution which affects adolescents' lives, and it determines their opportunities, life quality and behavior. Thus, the aim of this study was to determine the relationship between students' bonds with their school and multiple health risk behaviors amongst high school students in Kerman City, Iran

Methods: In this cross-sectional study, high school students of all levels participated during November and December 2001 in Kerman. The research sample included 1024 students [588 females and 436 males] aged 15 to 19 years. A CTC [Communities That Care Youth Survey] questionnaire was designed based ona standard questionnaire in order to collect a profile of students' risk behaviors. A multi-stage cluster sampling method was used to collect the data

Results: In the final multivariate logistic regression, two variables including; age, [ORa=1.15, P=0.02] and male gender [ORa=2.14, P=0.001] had a significant positive association with multiple health risk behaviors [MHRB]. School commitment [ORa=0.38, P=0.001] and school rewards for involvement [ORa=0.80, P=0.21], had a significant negative association with MHRB

Conclusion: Our results quantified the pivotal role of schools in shaping the risky behavior of students. It seems that school may minimize the risky behaviors by creating a strong link, and improving the effective communications with students

Survey of critical thinking and clinical decision making in nursing student of Kerman University

The ability to think critically is an essential element in nursing education and more specifically in nurses' clinical decision making [CDM]. Critical thinking [CT] and CDM ability as well as their relationship were examined among nursing students of Kerman University. Study was designed in four towns: Kerman, Bam, Jiroft, and Zarand, settled in Kerman province. This research was a cross-sectional descriptive correlation study. 300 nursing students with different level of education were asked to fill two questionnaires including: [1] California Critical Thinking Skills Test [CCTST] and [2] Lauri and Salantera [2002] CDM instrument. Statistical Analysis Used: Data were analyzed with SPSS12 and descriptive and inferential statistics. Nursing students yielded a low score [mean = 5/40 from 20] of CT and a mild score [mean = 12.8 from 20] of CDM. We found positively correlation between male and CT and CDM score with mean score of the nursing student. Also CDM score in male was more than female but not significant, and Jirofts CDM nursing student was significantly better than other city. Although students that answers evaluation question in CCTST better can gave better CDM score but there isn't relationship between CT and CDM of nursing student. The finding showed that mean score of nursing student CT was low. Reason can be either due to the defects of nursing education program, teaching, and learning strategies.

[ epidemiological model [Markov Chain] of cardiovascular disease in Iran]

To propose a model to estimate the incidence of acute cardiac disease and its complications in Iran. The Markov Chain Model used to consider all probable outcomes of acute cardiac events in individuals over 40 years old in Iran. We estimated the model parameters using systematic reviews and experts opinions. The conceptual framework was validated and finalized by the expert panel. Annual ischemic heart disease mortality in population over 40 years old is 14 per 1000 and the ischemic patients who need outpatient care are around 2, 935, 000 individuals. The number of beds estimated to be necessary in emergency wards and intensive cardiac care units for whole country are estimated 23520 and 14280 respectively. The estimation number of beds needed to service patients who have undergone a surgical intervention is 8540. The number of cardiac specialist for only outpatients' services is 2240 for whole country. This model may help health policy makers to make evidence based decisions for improving medical education and better treatment as well as estimating the trend of cardiovascular diseases in Iran

[Staff nurses knowledge of aging process and their attitude toward elder people]

Nowadays, nurses are an essential part of the health care team involved in the care of older people. The aim of this study was to determine the knowledge about aging process and attitude toward older people among staff nurses of hospitals affiliated to the Kerman University of Medical Sciences in 2006. In this descriptive analytical study, all of the nurses, working in Kerman University of medical sciences hospitals were selected to participate in the study. Data collection instrument was an investigator-made questionnaire that its validity and reliability was established. Data were analyzed using SPSS software version 11.5. Findings showed that the mean [ +/- SD] duration of working experience of the participants' was 11.19 [ +/- 5.58]. Also, 70.2% reported having no previous experience of living with older people. The participant acquired 54% and 88.72% of the score of the knowledge and attitude, respectively. In overall, nurses had positive attitude toward older people. There wasn't found statistically significant relationship between knowledge and attitude scores. The findings of thi study support the findings of the previous studies showing that there is knowledge deficit among staff nurses regarding aging process and normal changes of aging. Such knowledge deficit may be rectified through formal and continuing education, thereby, increase nurses' understanding of aged people needs. Otherwise, older people in long-term care centers would be in danger of being victims of inaccurate nursing cares

[Nurses' performance in training patients from the point of view of patients discharging from medical- surgical wards of hospitals affiliated to Kerman university of medical sciences]

Training Patients is one of the fundamental principles of nursing profession. Nurses have to do this training task in order to provide patient's satisfaction, speed up patient's recovery and reduce rate of readmission. To determine training performance of nurses working in Kerman University of Medical Sciences from the point of view patients discharging from Medical - Surgical wards in 2006. In this descriptive analytic study, the sample size base on a pilot study was determined 396 patients and subjects were selected consecutivly. A researcher - made questionnaire was used to collect data. The questionnaire included two parts of demographic features and evaluating training performance of nurses in 6 domains. Data were analyzed by using central and distributional indices and Mann - Withny U, kruskal Wallis, Freedman tests and Spearman coefficient correlation. According to the results, the majority of samples were males [62/1%], married [66/4], over 50 years of age [30/55%], illiterate [30.55%] and with no history of previous hospitalization [40/7%]. In regard to the performance of nurses in training patients, the results showed that in the domains of disease nature 19%, disease complications 23%, medicines 43%, physical activity 32.07%, nutrition 42.8% and other items 41.3% had received complete or relative training. considering nurses' total training performance score based on demographic features of patients, significant differences were observed in terms of sex, hospital and educational level]P < 0/05]. That is, nurses' training performance score was higher from the point of view of female patients, patients with higher educational levels and patients in hospital C comparing to male patients, patients with lower educational levels and patients in hospitals other than hospital C. The obtained percentages for nurses' performance in training patients show their poor performance in this regard. Therefore, improving nurses' knowledge about the importance of training patients is highly recommended

Qualitative study of Ph.D. student scholarship systems in developing and developed countries

From two centuries ago, scholarship systems in many countries have supportedpostgraduate students to continue their studies abroad. Nonetheless, due to the fundamentalrevolution in the concepts of scientific development in last decades, scholarship systems havemodified their missions particularly in developed countries. To express some practical guidelines to improve the scholarship system in Iran, thisstudy compared scholarship systems in developed and developing countries in terms of their rulesand regulations. The main questions were about the objectives of scholarship systems, theselection methods of eligible students, and how they encourage students to come back their homecountries. This was a qualitative study; data were collected by exploring written documents,websites, and interviewing 40 PhD students from 16 countries who were studying in UKuniversities. Obtaining certificate to get higher academic position was the main objective ofdeveloping country students; however, scholarship systems in developed countries were aimed topush students to understand others' cultures and scientific styles, and address research questionsduring their studies. In addition, there were well established collaborations between developedcountries and their organization in supporting students. These types of collaborations were notseen developing countries. By looking at the advantages of scholarship systems in developed countries, it issuggested that we need to amend the objectives of scholarship system in Iran and formulate a newplan to optimize the method in selecting students, decreasing brain drain, and activating privatesection and NGOs

[ trend of alterations in the quality of educational performance in faculty members of Kerman university of medical sciences]

Faculty members are one of the major parts of universities whose performance has a key role in outcomes of educational systems. With continuous evaluation of faculty members, part of which done by students, real performance of faculty members with all its shortcomingsand positive points would be determined and consequently it helps improving the quality ofeducational activities.To determine the process of alterations in the quality of educational performance infaculty members of Kerman University of Medical Sciences. This correlation study was done on all faculty members of Kerman University ofMedical Sciences during 2001-2006 who had been evaluated 8 times through gettingstudents' opinion. Data related to the quality of educational performance were gathered through the obtained scores in students' evaluation and data related to research activities were gathered through research activity scores assigned for annual promotion of faculty members. According to the obtained results, during the study period, the average annual increase in educational performance was 0.06 that is statistically significant [p=0.0001], but alteration in research activities during the studied period was not significant. There was no significant relation between educational performance and research activity and also demographic features of subjects such as academic rank, educational degree and job experience, while educational degree and academic rank showed significant relations with research activity score [p= 0.001, p= 0.003 respectively].The present study shows an improvement in educational performance during the recent years that is probably due to continuous evaluations. Lack of significant relation between the quality of educational performance and research activity requires planning programs for bridging these two domains

[Durations of studies of iranian Ph.D students graduated from UK and Irland Universities between 1995 and 2001]

Iran experienced a big jump in higher education in 1990s. In compatible with this jump, the number of Ph. D. student was increased considerably, particularly those who were sponsored to study abroad. It is incredibly important to explore the issues around the study of these students, which its findings can be used for further planning. To assess the education duration of Iranian Ph. D. students graduates from universities in UK and Irland between 1995 and 2001. Also, to compare the durations of studies of student in medical fields with that in other students. The data of Iranian ph.D students were collected from the Deputy of Science in the Embassy of Iran in UK. In order to minimize the selection bias introducted by sensored data, only the information of students who started their studies before 1997 was analyzed. Around 30% of students were sponsored by the Health Ministry of Iran to study in medical fields. In average, the durations of studies in students of medical fields was not statistically different with the durations in other students [42.5 months versus 42 months respectively, p=0.23]. Less than 15% of students finished their studies within 3 years; however, it was around 10% greater in students of medical fields. The diversity of the durations of studies was greater in medical field students. The correlation coefficients between the duration of studies and age, the number of children, and English score of students in the beginning of their courses were 0.1, 0.02 and -0.17, respectively; the last two coefficients were not statistically significant. In addition, the students in large cities and in small towns finished their courses more or less with the same length. Most of students could not finish their studies within three years which is the duration of scholarship in Iran; therefore, it is suggested that the system revises its regulations. In addition, it is suggested that the scholarship system chooses younger students, because age had a positive association with the length of study

[Evaluation of holding procedure of elementary teaching methodology workshops based on the views of the faculty of Kerman University of Medical Sciences participating in the workshops]

Teaching Methodology workshop aimed at development of education, therefore, it must offer best developed methods of teaching. To determine the quality of the teaching methodology workshops held in Kerman University of Medical Sciences based on the views of the participators. The views of all 171 faculty members participated in six teaching methodology workshops were evaluated using the questionnaire approved by The Ministry of Health and Medical Education. The questionnaire consisted of two sections: demographic features and statements on the views based on a 5 Likert scale [from strongly agree to strongly disagree]. Its validity was 0.9, measured by the views of experts. 67.3 percent of the participators were male and assistant professors 62.6%. 69.5% of the participants were strongly agreed or agreed upon the statements. The most agreement was on "sequential planning of aims" [84%], then "giving introductory information in the beginning" [81%], "sequential outline" [82%], respectively. The least agreement was found on "the facilities". [40.4%], "enough time allocated to individual and group discussion" [47.4%]. A significant difference was observed between the views based on different workshop sessions [P<0.05] so that evaluation results of the 5[th] and 6[th] workshop were better than the 1[st] and 2[nd] results. The success of a workshops depends on planning and facilities to some extent. The teaching methodology workshop holding to improve teaching abilities, should have acceptable characteristics to be efficient. According to the findings, the planning of the workshops was appropriate but facilities have to be improved. Designating more discussion and using more appropriate educational methods is also necessary

[Evaluation of the efficacy of [the best prescription workshops] held for general physicians liable to continuous education in Kerman Medical Sciences University]

Background: Continuous medical education has been accepted throughout the world as one of the most efficient strategies for up-to dating physicians' knowledge and information

Objective: The aim of the present study was to evaluate the efficacy of three held workshops on The best prescription

Methods: Sample consisted of 82 general physicians participating in three held workshops on The best prescription. Data collection was done by a questionnaire consisting of two parts of demographic features and the assessment of prescription. The questionnaire administered before and after the workshops

Results: From all participants, 49% were female and 44% of subjects had been graduated from Kerman and 9.7% from Rafsanjan Medical Schools. Mean score before workshop was 5.95 +/- 1.4 with the minimum of zero and maximum of 9 and it increased to 7.62 +/- 1.95 with the minimum of zero and maximum of 10 after workshop. In whole there was a significant difference between the mean scores before and after the workshop [P<0.001], but in some respects there was no significant difference [P>0.05]

Conclusion: According to the findings, the held workshops on the best prescription have been efficient in increasing participants' level of information. Therefore continuous medical educational programs along with improving their quality is highly necessary