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@#Introduction: Breast cancer is the most common cancer and it is the second leading cause of cancer mortality for women after lung cancer in Iran. Given the high prevalence of breast cancer, it is of crucial importance to determine reproductive risk factors of breast cancer. Methods: A total of 139 female patients suffering from breast cancer (the case group) and 279 healthy females (the control group) who were age-matched participated in the study over the period from March 2018 to March 2019. Demographic and reproductive variables, including the number of pregnancies, breastfeeding, history of oral contraceptive use, abortion history, age at first menstruation and age at first childbirth, were all recorded via survey. Conditional Logistic regression was employed to calculate OR (CI: 95%). Results: The mean age of breast cancer patients was 50.8 ± 8.31. First degree family history of breast cancer, History of oral contraceptive use and delaying first pregnancy drastically increased the chance of breast cancer whereas breastfeeding and menstruation after the age of 14 reduced the chance of breast cancer. Conclusion: The findings of this study reveal that the age at first birth, use of oral contraceptives, first degree family history of breast cancer and lack of breastfeeding have a significant relationship with breast cancer. Thus, women who have experienced such factors are susceptible to breast cancer and need to be prioritized for preventive treatments and screening.
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Background: Infertility, one of life's great stressors, may adversely affect marital satisfaction. No studies have in- vestigated the relationship between perceived stress and marital satisfaction at the dyadic level. The current study assessed the actor and partner effects of perceived stress on marital satisfaction in husband-wife dyads using an innovative dyadic analysis approach, the Actor-Partner Interdependence Model [APIM]
Materials and Methods: In this cross-sectional study, we recruited a total of 141 infertile couples. Marital satisfaction and stress were assessed using the ENRICH Marital Satisfaction Scale [EMS Scale] and Perceived Stress Scale-4 Item [PSS-4], respectively. Dyadic data have been analysed by the APIM approach, with distinguishable dyads. In this approach, actor effect is the impact of a person?s perceived stress on his/her own marital satisfaction. Partner effect is the impact of a person's perceived stress on the partner?s marital satisfaction
Results: Both men and women's perceived stress exhibited an actor effect on their marital satisfaction [beta=-0.312, P<0.001, beta=-0.405, P<0.001, respectively]. Women's perceived stress had a negative relationship to the marital satis- faction of their partner [beta=-0.174, P=0.040]. Although the partner effect of men's perceived stress on woman's marital satisfaction was not significant [beta=-0.138, P=0.096], women whose husbands had higher levels of stress were more likely to have poorer marital satisfaction. Both actor and partner effects of perceived stress on marital satisfaction were similar among men and their wives
Conclusion: The findings of this study have highlighted that marital satisfaction in patients with infertility was in- fluenced by not only their own perceived stress, but also their spouses' perceived stresses. Therefore, psychological interventions that target a reduction in perceived stress and enhancement of marital satisfaction in the context of infer- tility should treat the couple as a unit
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Background: Abnormalities in birth weight and gestational age cause several adverse maternal and infant out- comes. Our study aims to determine the potential factors that affect birth weight and gestational age, and their association
Materials and Methods: We conducted this cross-sectional study of 4415 pregnant women in Tehran, Iran, from July 6-21, 2015. Joint multilevel multiple logistic regression was used in the analysis with demographic and obstetrical variables at the first level, and the hospitals at the second level
Results: We observed the following prevalence rates: preterm [5.5%], term [94%], and postterm [0.5%]. Low birth weight [LBW] had a prevalence rate of 4.8%, whereas the prevalence rate for normal weight was 92.4, and 2.8% for macrosomia. Compared to term, older mother's age [odds ratio [OR]=1.04, 95% confidence interval [CI]: 1.02-1.07], preeclampsia [OR=4.14, 95% CI: 2.71-6.31], multiple pregnancy [OR=18.04, 95% CI: 9.75- 33.38], and use of assisted reproductive technology [ART] [OR=2.47, 95% CI: 1.64-33.73] were associated with preterm birth. Better socioeconomic status [SES] was responsible for decreased odds for postterm birth com- pared to term birth [OR=0.53, 95% CI: 0.37-0.74]. Cases with higher maternal body mass index [BMI] were 1.02 times more likely for macrosomia [95% CI: 1.01-1.04], and male infant sex [OR=1.78, 95% CI: 1.21-2.60]. LBW was related to multiparity [OR=0.59, 95% CI: 0.42-0.82], multiple pregnancy [OR=17.35, 95% CI: 9.73-30.94], and preeclampsia [OR=3.36, 95% CI: 2.15-5.24]
Conclusion: Maternal age, SES, preeclampsia, multiple pregnancy, ART, higher maternal BMI, parity, and male infant sex were determined to be predictive variables for birth weight and gestational age after taking into consideration their association by using a joint multilevel multiple logistic regression model
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Background: Many infertile couples experience psychological distress and suffer from impaired quality of life. Gen- erally, when couples are dealing with uncontrolled events such as infertility, it is important to manage it well and to use the suitable coping style; so this can represent an example of attribution style. The purpose of this study is to investigate the quality of life, relationship beliefs and attribution style in infertile couples
Materials and Methods: This cross-sectional study consisted of 50 infertile couples, who were at least 18 years of age and could read and write in Persian. Participants provided demographic and general characteristics and completed the quality of life [SF-12], relationship belief inventory [RBI] and attribution style [ASQ] forms. Data was analyzed by the paired t test, Pearson correlation tests and multiple linear regression analysis, using SPSS version 22 statistical software
Results: Overall, 50 infertile couples participated in our study. The males had a significantly higher score for quality of life compared to the females [P=0.019]. In RBI subscales except "Disagreement is Destructive" all others signifi- cantly higher in wives than husbands. All subscales of RBI had a negative correlation with the quality of life. The quality of life had a significant correlation with positive internal [r=0.213, P=0.033]. The adjusted regression model showed that the quality of life for males was higher than in females [beta=-3.098, P=0.024]
Conclusion: The current data indicate that in infertile couples, the husbands have a higher quality of life in comparison to their wives. Also, all subscales of relationship beliefs have a negative correlation with the quality of life, but in at- tribution style, just internal attribution style for positive events is associated with the quality of life. In general, there is a correlation between relationship beliefs and the quality of life in infertile couples
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OBJECTIVES: Over the past few decades, the prevalence of cesarean sections (CS) have risen dramatically worldwide, particularly in Iran. The aim of this study was to determine the prevalence of CS in Tehran, and to examine the associated risk factors. METHODS: A cross-sectional study of 4,308 pregnant women with singleton live-births in Tehran, Iran, between July 6–21, 2015 was performed. Multilevel logistic regression analysis was performed using demographic and obstetrical variables at the first level, and hospitals as a variable at the second level. RESULTS: The incidence of CS was 72.0%. Multivariate analysis showed a significant relationship between CS and the mother's age, socioeconomic status, body mass index, parity, type of pregnancy, preeclampsia, infant height, and baby's head circumference. The intra-class correlation using the second level variable, the hospital was 0.292, indicating approximately 29.2% of the total variation in the response variable accounted for by the hospital. CONCLUSION: The incidence of CS was substantially higher than other countries. Therefore, educational and psychological interventions are necessary to reduce CS rates amongst pregnant Iranian women.
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Female , Humans , Infant , Pregnancy , Body Mass Index , Cesarean Section , Cross-Sectional Studies , Head , Incidence , Iran , Logistic Models , Multivariate Analysis , Parity , Pre-Eclampsia , Pregnant Women , Prevalence , Risk Factors , Social ClassABSTRACT
Background: The hospital anxiety and depression scale [HADS] is a common screening tool designed to measure the level of anxiety and depression in different factor structures and has been extensively used in non-psychiatric populations and individuals experiencing fertility problems
Objective: The aims of this study were to evaluate the factor structure, item analyses, and internal consistency of HADS in Iranian infertile patients
Materials and Methods: This cross-sectional study included 651 infertile patients [248 men and 403 women] referred to a referral infertility Center in Tehran, Iran between January 2014 and January 2015. Confirmatory factor analysis was used to determine the underlying factor structure of the HADS among one, two, and three factor models. Several goodness of fit indices were utilized such as comparative, normed and goodness of fit indices, Akaike information criterion, and the root mean squared error of approximation. In addition to HADS, the Satisfaction with Life Scale questionnaires as well as demographic and clinical information were administered to all patients
Results: The goodness of fit indices through CFAs exposed that three and one factor model provided the best and worst fit to the total, male and female datasets compared to the other factor structure models for the infertile patients. The Cronbach's alpha for anxiety and depression subscales were 0.866 and 0.753 respectively. The HADS subscales significantly correlated with SWLS, indicating an acceptable convergent validity
Conclusion: The HADS was found to be a three-factor structure screening instrument in the field of infertility
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Background: Infertility and its treatment can have a considerable effect on a person's quality of life [QoL]. The Fertility QoL [FertiQoL] questionnaire is currently the most frequently used instrument to measure QoL in people with fertility problems. This study aims to examine the reliability and validity of the FertiQoL in infertile Iranian women
Materials and Methods: This cross-sectional study included 155 women with fertility problems in a referral fertility clinic in Tehran, Iran from January to March 2014. A battery of instruments was used: FertiQoL, Satisfaction with Life Scale [SWLS], Hospital Anxiety and Depression Scale [HADS], and a demographic questionnaire. Construct validity of the scale was evaluated using confirmatory factor analysis [CFA]. We assessed internal consistency with Cronbach's alpha and convergent validity was examined by correlating the FertiQoL with SWLS and HADS
Results: The results of the CFA generally supported the four-factor model of Core FertiQoL and two-factor model of Treatment FertiQoL. Both FertiQoL modules and their subscales revealed acceptable internal consistency that ranged from 0.643 to 0.911. However, the FertiQoL might be improved if Q15 and T2 items were removed from the scale. These items had low loadings on the Relational and Environment factors which decreased their internal consistency. The FertiQoL and their subscales significantly correlated with both SWLS and HADS, which confirmed convergent validity
Conclusion: The Persian version of the FertiQoL is a valid, reliable instrument to measure QoL in infertile women and seems to perform as well as the original English Version
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Adult , Adolescent , Female , Humans , Middle Aged , Young Adult , Infertility, Female/psychology , Quality of Life , Surveys and Questionnaires , Cross-Sectional StudiesABSTRACT
OBJECTIVES: Preterm birth (PTB) is a leading cause of neonatal death and the second biggest cause of death in children under five years of age. The objective of this study was to determine the prevalence of PTB and its associated factors using logistic regression and decision tree classification methods. METHODS: This cross-sectional study was conducted on 4,415 pregnant women in Tehran, Iran, from July 6–21, 2015. Data were collected by a researcher-developed questionnaire through interviews with mothers and review of their medical records. To evaluate the accuracy of the logistic regression and decision tree methods, several indices such as sensitivity, specificity, and the area under the curve were used. RESULTS: The PTB rate was 5.5% in this study. The logistic regression outperformed the decision tree for the classification of PTB based on risk factors. Logistic regression showed that multiple pregnancies, mothers with preeclampsia, and those who conceived with assisted reproductive technology had an increased risk for PTB (p < 0.05). CONCLUSION: Identifying and training mothers at risk as well as improving prenatal care may reduce the PTB rate. We also recommend that statisticians utilize the logistic regression model for the classification of risk groups for PTB.
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Child , Female , Humans , Infant , Pregnancy , Cause of Death , Classification , Cross-Sectional Studies , Decision Trees , Iran , Logistic Models , Medical Records , Methods , Mothers , Perinatal Death , Pre-Eclampsia , Pregnancy, Multiple , Pregnant Women , Premature Birth , Prenatal Care , Prevalence , Reproductive Techniques, Assisted , Risk Factors , Sensitivity and SpecificityABSTRACT
OBJECTIVES: Kidney transplantation is the best renal replacement therapy for patients with end-stage renal disease. Several studies have attempted to identify predisposing factors of graft rejection; however, the results have been inconsistent. We aimed to identify prognostic factors associated with kidney transplant rejection using the artificial neural network (ANN) approach and to compare the results with those obtained by logistic regression (LR). METHODS: The study used information regarding 378 patients who had undergone kidney transplantation from a retrospective study conducted in Hamadan, Western Iran, from 1994 to 2011. ANN was used to identify potential important risk factors for chronic nonreversible graft rejection. RESULTS: Recipients' age, creatinine level, cold ischemic time, and hemoglobin level at discharge were identified as the most important prognostic factors by ANN. The ANN model showed higher total accuracy (0.75 vs. 0.55 for LR), and the area under the ROC curve (0.88 vs. 0.75 for LR) was better than that obtained with LR. CONCLUSIONS: The results of this study indicate that the ANN model outperformed LR in the prediction of kidney transplantation failure. Therefore, this approach is a promising classifier for predicting graft failure to improve patients' survival and quality of life, and it should be further investigated for the prediction of other clinical outcomes.
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Humans , Causality , Cold Ischemia , Creatinine , Data Mining , Graft Rejection , Iran , Kidney Failure, Chronic , Kidney Transplantation , Kidney , Logistic Models , Quality of Life , Renal Replacement Therapy , Retrospective Studies , Risk Factors , ROC Curve , TransplantsABSTRACT
STUDY DESIGN: A cross-sectional, descriptive study. PURPOSE: This study aimed to investigate the relationship between kyphosis and lordosis measured by using a flexible ruler and musculoskeletal pain in students of Hamadan University of Medical Sciences. OVERVIEW OF LITERATURE: The spine supports the body during different activities by maintaining appropriate body alignment and posture. Normal alignment of the spine depends on its structural, muscular, bony, and articular performance. METHODS: Two hundred forty-one students participated in this study. A single examiner evaluated the angles of lumbar lordosis and thoracic kyphosis by using a flexible ruler. To determine the severity and frequency of pain in low-back and inter-scapular regions, a tailor-made questionnaire with visual analog scale was used. Finally, using the Kendall correlation coefficient, the data were statistically analyzed. RESULTS: The mean value of lumbar lordosis was 34.46degrees+/-12.61degrees in female students and 22.46degrees+/-9.9degrees in male students. The mean value of lumbar lordosis significantly differed between female and male students (p<0.001). However, there was no difference in the level of the thoracic curve (p=0.288). Relationship between kyphosis measured by using a flexible ruler and inter-scapular pain in male and female students was not significant (p=0.946). However, the relationship between lumbar lordosis and low back pain was statistically significant (p=0.006). Also, no significant relationship was observed between abnormal kyphosis and frequency of inter-scapular pain, and between lumbar lordosis and low back pain. CONCLUSIONS: Lumbar lordosis contributes to low back pain. The causes of musculoskeletal pain could be muscle imbalance and muscle and ligament strain.