Predictors of pre-hospital vs. hospital mortality due to road traffic injuries in an Iranian population: results from Tabriz integrated road traffic injury registry.

BACKGROUND: Road Traffic Injuries (RTIs) is considered as one of the main health challenges and causes of mortality, worldwide and especially in Iran. Predicting the place where RTIs-related death takes place is vital in decreasing this type of mortality. The purpose of the present study was to identify the predictors of RTI fatalities with respect to the place of death (hospital vs. pre-hospital) during the recent decade in East Azerbaijan Province, Iran. METHODS: Overall, 7347 RTI fatalities were retrieved from the road traffic injuries registry which is supported by the Forensic Medicine Organization in East Azerbaijan. Among these cases, 2758(37.5%)) were hospital deaths. The registered variables of these cases were analysed using bivariate and multiple logistic regression (STATA version 15). RESULTS: Out of 7347 deaths, 5862 (79.8%) were men and the rest were women 1485 (20.2%).The mean age was 40.3 (SD = 20.8). Of the total number of cases, 2758 (37.5%) died in hospital death and the rest 4589 (62.5) were pre-hospital death. According to the results of the present study, inter-city RTI (OR = 1.7, CI 95% = (1.5-2)) and RTIs inside the city of Tabriz (OR = 1.4, CI 95% = (1.2-1.6)) increases the chance of hospitals death. In addition, having a heavy counterpart vehicle compared to no counterpart vehicle decreased the chances of hospitals death (OR = 0.46, CI 95% = (0.39-0.55)) while motorcycle or bike counterpart vehicle compared to no counterpart vehicle increased the chances of hospital death (OR = 2.26, CI 95% = (1.59-3.22)). Also the users of the motorcycle or bike vehicle compared to the pedestrians increased the chances of hospital death (OR = 1.43, CI 95% = (1.19-1.71)) while any the other vehicle users compared to the pedestrians have significantly lower chances for hospital death. Other factors that increased hospitals death were transferring injured people by ambulance (OR = 1.3, CI 95% = (1.1-1.6)) and being elderly (OR = 1.5, CI 95% = (1.2-1.7)). Moreover, it was found that the annual trend of change in hospital death is strongly affected by the above-identified factors. CONCLUSIONS: The effective predictors in hospital death were RTI location, type of counterpart vehicle, used vehicles and lighting condition. The identified factors related to the location of deaths by RTI can be divided into the RTI severity-related factors as well as factors related to the services quality and speed of delivery. According to the present results, through professional training of people in the field and providing immediate assistance in RTIs pre-hospital mortality can be significantly prevented.

Development and psychometric testing of a Gastric Cancer Behavioural Risk Assessment Inventory (GC-BRAI)

Background: Gastric cancer (GC) is one of the most common cancers worldwide. There is no disease-specific tool for GC risk assessment in research and practice settings within the Iranian sociocultural context.Aims: To develop and assess the psychometric properties of the Gastric Cancer Behavioral Risk Assessment Inventory (GC-BRAI) in GC patients in Northwest Islamic Republic of Iran.Methods: Face-to-face interviews were performed on a convenient sample of 175 GC patients and a purposive sample of 350 matched non-GC patients as a control group. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to appraise the structure validity of GC-BRAI and examine its possible latent constructs.Results: The designed instrument with its 5 latent factors indicated acceptable internal consistency (0.72), reliability (0.99) and fit indices (χ2/degrees of freedom = 2.24, root mean square error of approximation = 0.049, adjusted goodness of fit index = 0.91 and root mean square residual = 0.085). The identified components were specific nutritional behaviours, typical daily diet, routine heartburn-causing behaviours or foods in diet, daily use of rice and smoked foods, and tobacco smoking/alcohol consumption, which all indicated a significant association (P= 0.0001) with high-risk of GC.Conclusions: GC-BRAI can be considered a feasible tool to measure individual GC risk and a reliable data collection instrument in tailor-made risk reduction interventional programmes.

Relationship between happiness and tobacco smoking among high school students / 한국역학회지

OBJECTIVES: Recent research has described negative relationship between happiness and habitual smoking among adolescents. No study of this relationship has been conducted among Iranian adolescents. The aim of the present study was to characterize the relationship between happiness and cigarette or hookah smoking among a sample of high school students. METHODS: A sample of 1,161 10th-grade students in Tabriz (northwest Iran) was selected by multi-stage proportional cluster sampling. Participants completed a self-administered multiple-choice questionnaire including information on cigarette smoking, hookah smoking, happiness score, substance abuse, self-injury, general risk-taking behavior, attitudes towards smoking, socioeconomic information, and demographic characteristics. An ordinal logistic regression model was used for data analysis. RESULTS: It was found that 5.9 and 5.0% of students were regular cigarette smokers and regular hookah smokers, respectively. After controlling for potential confounders, higher happiness scores were found to protect students against more advanced stages of cigarette smoking (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99; p=0.013). However, no significant relationship was found between happiness scores and hookah smoking status (OR, 1.01; 95% CI, 0.97 to 1.02; p=0.523). CONCLUSIONS: Happiness scores were associated with less advanced stages of habitual cigarette smoking among high school students. Our findings underscore the necessity of conducting longitudinal or interventional studies aiming to determine the effects of enhancing happiness on preventing the transition through the stages of cigarette and hookah smoking.

Relationship between happiness and tobacco smoking among high school students / 한국역학회지

OBJECTIVES@#Recent research has described negative relationship between happiness and habitual smoking among adolescents. No study of this relationship has been conducted among Iranian adolescents. The aim of the present study was to characterize the relationship between happiness and cigarette or hookah smoking among a sample of high school students.@*METHODS@#A sample of 1,161 10th-grade students in Tabriz (northwest Iran) was selected by multi-stage proportional cluster sampling. Participants completed a self-administered multiple-choice questionnaire including information on cigarette smoking, hookah smoking, happiness score, substance abuse, self-injury, general risk-taking behavior, attitudes towards smoking, socioeconomic information, and demographic characteristics. An ordinal logistic regression model was used for data analysis.@*RESULTS@#It was found that 5.9 and 5.0% of students were regular cigarette smokers and regular hookah smokers, respectively. After controlling for potential confounders, higher happiness scores were found to protect students against more advanced stages of cigarette smoking (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99; p=0.013). However, no significant relationship was found between happiness scores and hookah smoking status (OR, 1.01; 95% CI, 0.97 to 1.02; p=0.523).@*CONCLUSIONS@#Happiness scores were associated with less advanced stages of habitual cigarette smoking among high school students. Our findings underscore the necessity of conducting longitudinal or interventional studies aiming to determine the effects of enhancing happiness on preventing the transition through the stages of cigarette and hookah smoking.

Relationship between happiness and tobacco smoking among high school students / 한국역학회지

OBJECTIVES: Recent research has described negative relationship between happiness and habitual smoking among adolescents. No study of this relationship has been conducted among Iranian adolescents. The aim of the present study was to characterize the relationship between happiness and cigarette or hookah smoking among a sample of high school students.METHODS: A sample of 1,161 10th-grade students in Tabriz (northwest Iran) was selected by multi-stage proportional cluster sampling. Participants completed a self-administered multiple-choice questionnaire including information on cigarette smoking, hookah smoking, happiness score, substance abuse, self-injury, general risk-taking behavior, attitudes towards smoking, socioeconomic information, and demographic characteristics. An ordinal logistic regression model was used for data analysis.RESULTS: It was found that 5.9 and 5.0% of students were regular cigarette smokers and regular hookah smokers, respectively. After controlling for potential confounders, higher happiness scores were found to protect students against more advanced stages of cigarette smoking (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99; p=0.013). However, no significant relationship was found between happiness scores and hookah smoking status (OR, 1.01; 95% CI, 0.97 to 1.02; p=0.523).CONCLUSIONS: Happiness scores were associated with less advanced stages of habitual cigarette smoking among high school students. Our findings underscore the necessity of conducting longitudinal or interventional studies aiming to determine the effects of enhancing happiness on preventing the transition through the stages of cigarette and hookah smoking.

Absence of association between vitamin D deficiency and incident metabolic syndrome: Tehran Lipid and Glucose Study.

BACKGROUND: Links between vitamin D status and metabolic syndrome have been reported in cross-sectional studies; however, few prospective studies regarding this association exist. We performed this study to assess prospective association between vitamin D status and incident metabolic syndrome in a large population-based cohort. METHOD: This was a nested case-control study within the Tehran Lipid and Glucose Study (TLGS) which followed representative Tehranian adults. A total of 324 matched pairs aged 20 or older were selected. Cases and controls were free of metabolic syndrome according to definition of Joint Interim Statement (JIS) at baseline and followed for a mean duration of 6.8 years. Each case was matched individually by sex, age, duration of follow-up, and month of entry to the study with a randomly selected control. Prespecified cut points were used to characterize varying degrees of 25-hydroxyvitamin D [25(OH)D] deficiency (<20, 20-29.9, and ≥30 ng/mL). Conditional logistic regression was used to investigate the association between 25(OH)D concentration and the incident metabolic syndrome. RESULTS: The mean age of participants was 40.8±11.7, and 50% were women. The median [interquartile range (IQR) 25-75] of serum 25(OH) D was 16 ng/mL (10-25 ng/mL) and there was no difference between cases (16 ng/mL; IQR 10-25 ng/mL) and controls (16 ng/mL; IQR 10-26 ng/mL). The odds ratio of serum 25(OH)D <20 ng/mL for developing metabolic syndrome was 0.97 [95% confidence interval (CI) 0.6-1.52] compared with serum 25(OH)D ≥30 ng/mL. Adjustment for potential confounders did not change the results. CONCLUSIONS: Our study does not provide evidence that there is association between different serum vitamin D levels and incidence of metabolic syndrome.

Associations between vitamin D and cardiovascular outcomes; Tehran Lipid and Glucose Study.

BACKGROUND: Vitamin D status seems to have an association with cardiometabolic risk factors and its deficiency may negatively affect the cardiovascular outcomes. The aim of this study was to determine the possible association between vitamin D status and cardiovascular outcomes. METHOD: We performed a nested case control study within the Tehran Lipid and Glucose Study (TLGS), which followed a representative sample of Tehranian adults. A total of 251 matched pairs, aged>30 years, were selected. Cases were TLGS individuals that were free of cardiovascular disease (CVD) at the beginning of study and developed CVD during assessments of 5.7 year follow up. Each case was matched by age, sex and the month of entry to study with a randomly selected control (risk-set sampling). Prespecified cut points were used to characterize varying degrees of 25-OH D deficiency (<10, between 10 and 14.9, and ≥ 15 ng/ml). Conditional logistic regression was used to investigate the association between 25-OH-D concentration and the incident cardiovascular outcomes. RESULTS: The mean age of participants was 56.84 ± 11.17 years and 244 (48.6%) were women. The median (IQ: 25-75) of serum 25-OH-D was 14.1 ng/ml (9.6-29 ng/ml) and 306 (61%) of participants had serum 25-OH-D<15 g/ml. Median serum 25-OH-D was lower in cases (12.5 vs. 18.1, P<0.001). After adjustment for potential confounders, the odds ratio of serum 25-OH-D<10 ng/ml for having CVD outcomes was 2.90 compared with 25-OH-D ≥ 15 (95% confidence interval (CI): 1.67-5.12, P<0.001). CONCLUSION: Our results indicate that serum 25-OH-D concentration has an independent association with cardiovascular outcomes in adult Tehranians.

Trends of obesity and abdominal obesity in Tehranian adults: a cohort study.

BACKGROUND: Considering the increasing trend of obesity reported in current data, this study was conducted to examine trends of obesity and abdominal obesity among Tehranian adults during a median follow-up of 6.6 years. METHODS: Height and weight of 4,402 adults, aged 20 years and over, participants of the Tehran Lipid and Glucose Study (TLGS), were measured in 1999-2001(phase I) and again in 2002-2005(phase II) and 2006-2008 (phase III). Criteria used for obesity and abdominal obesity defined body mass index (BMI) >or= 30 and waist circumference >or= 94/80 cm for men/women respectively. Subjects were divided into 10-year groups and the prevalence of obesity was compared across sex and age groups. RESULTS: The prevalence of obesity was 15.8, 18.6 and 21% in men and 31.5, 37.7 and 38.6% in women in phases I, II and III respectively (p < 0.001). The prevalence of abdominal obesity in men was 36.5, 57.2 and 63.3% and in women was 76.7, 83.8 and 83.6% in the three periods mentioned (p < 0.001). Men aged between 20-29 years had highest increase rates of obesity and abdominal obesity in phase III in comparison with phase I (with a respective rates of 2.2- and 3.3-fold). In both sexes, an increased trend was observed between phases I and II, whereas between phases II and III, this trend was observed in men, but not in women. CONCLUSION: This study demonstrates alarming rises in the prevalences of both obesity and abdominal obesity in both sexes especially in young men, calling for urgent action to educate people in lifestyle modifications.