Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models / 예방의학회지

OBJECTIVES@#The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models.@*METHODS@#This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The Besag-York-Mollié (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis.@*RESULTS@#The Moran index was statistically significant for all the variables studied (p < 0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively.@*CONCLUSIONS@#Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in atrisk areas.

Comparing the performance of data mining algorithms in predicting Coronary Artery diseases

Introduction: Cardiovascular diseases are the first leading cause of death worldwide. World health organization has estimated that the morality rate due to heart diseases will mount to 23 million cases by 2030. Hence, the use of data mining algorithms will be useful in predicting coronary artery disease. The objective of the present study was to compare the accuracy of the CAD predictions made by ANN and SVM techniques

Methods: The present study was conducted via descriptive-analytical method. The research sample included all CAD patients hospitalized in three hospitals affiliated to AJA University of Medical Sciences from March 2016 to March 2017. Totally, 1324 records with 26 characteristics affecting the disease were extracted and after normalizing, and cleaning of the data, they were entered in SPSS statistics V23.0 and IBM Excel 2013; then, R3.3.2 data mining software was used to format data

Results: SVM model with lower MAPE [112.03] and higher Hosmer-lemeshow statistic [16.71], sensitivity [92.23] and specificity [74.42] yielded better fitness of data and provides more accurate prediction than ANN model. On the other hand, since the area under the ROC curve in SVM algorithm was more than that in ANN, it could be concluded that this model had higher accuracy

Conclusion: According to the results, SVM algorithm presented higher accuracy and better performance than ANN model and showed higher sensitivity and accuracy. It is suggested that in future studies, the results of the present study be compared with the findings resulted from applying other data mining algorithms

Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models / 예방의학회지

OBJECTIVES: The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models. METHODS: This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The Besag-York-Mollié (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis. RESULTS: The Moran index was statistically significant for all the variables studied (p < 0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively. CONCLUSIONS: Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in atrisk areas.

Factors that influence the occurrence of multiple pregnancies after intracytoplasmic injection cycles with two or three fresh embryo transfers

Background: Multiple pregnancies are an important complication of assisted reproductive technology [ART]. The present study aims to indentify the risk factors for multiple pregnancies independent of the number of transferred embryos

Materials and Methods: This retrospective study reviewed the medical records of patients who underwent intracy topi asm ic sperm injection [ICSI] cycles in Royan Institute between October 2011 and January 2012. We entered 12 factors that affected the number of gestational sacs into the poisson regression [PR] model. Factors were obtained from two study populations-cycles with double embryo transfer [DET] and cycles that transferred three embryos [TET]. We sought to determine the factors that influenced the number of gestational sacs. These factors were entered into multivariable logistic regression [MLR] to identify risk factors for multiple pregnancies

Results: A total of 1000 patients referred to Royan Institute for ART during the study period. We included 606 eligible patients in this study. PR analysis demonstrated that the quality of transferred embryos and woman's age had a significant effect on the number of observed sacs in patients who underwent ICSI with DET. There was no significant predictive variable for multiple pregnancies according to MLR analysis. Our findings demonstrated that both regression models [PR and MLR] had the same outputs. A significant relation existed between age and fertilization rate with multiple pregnancies in patients who underwent ICSI with TET

Conclusion: Single embryo transfer [SET] should be considered with the remaining embryos cryopreserved to prevent multiple pregnancies in women younger than 35 years of age who undergo ICSI cycles with high fertilization rates and good or excellent quality embryos. However, further prospective studies are necessary to evaluate whether SET in women with these risk factors can significantly decrease multiple pregnancies and improve cycle outcomes

Effective factors for risk of death in patients with cirrhosis using competing risks model

Background: Including multivariate survival data can be pointed competing risks data. There are various methods to analyze such data such as semi-parametric methods of cause-specific hazard function, and cumulative incidence function. The aim of this study was to deploy competing risks model to analyze the determinants of patients with liver cirrhosis

Materials and Methods: During the one-year study period [June 2008-June 2009] we used the recorded information of patients with cirrhosis who were scheduled for liver transplantation and were followed up for at least 7 years in Imam Khomeini Hospital. In order to determine the effective factors for the time of death and transplantation of the patients, the cumulative incidence function regression method and data analysis were performed using R statistical software. The error level of 0,05 was considered for all tests

Results: 305 patients with cirrhosis including 180 men and 125 women were studied. The mean age+/- SD of the patients was 39.8+/-14.54 years. At the end of the study, 82 patients died and 40 patients underwent liver transplantation. 7-year survival for the dead patients and for those who received liver transplantation was 18,3 and 21.2 months, respectively

Conclusion: To investigate the effective factors for the time of death and transplantation of patients with cirrhosis, cumulative incidence function seems desirable. After fitting the multivariate regression model of cumulative incidence function, age, serum albumin, and encephalopathy had a significant effect on the time of the patients death. So planning and policy making in prioritizing patients to receive liver transplantation can be made on the basis of their age. Also serum albumin and encephalopathy as two other effective factors can contribute to the prioritization. In this study, among the various causes of cirrhosis, hepatitis B [23%] and cryptogenesis [22.6%], were the most important factors

Investigating the different stages in the progress of cirrhosis using the markov model

Background: Multistate Markov models are frequently used for analyzing data obtained from longitudinal studies and they are typically appropriate in the study of chronic diseases such as liver cirrhosis. Ascites is the most common major complication of liver cirrhosis. This study was done to examine the importance of ascites complications in the survival analysis of patients with cirrhosis

Materials and Methods: In this longitudinal study, 305 patients with liver cirrhosis who had enrolled in a waiting list for liver transplantation in Imam Khomeini Hospital from May 2008 to May 2009 and had been followed up for at least 7 years, were investigated. To analyze the data and estimation of transition intensities, a 4-state Markov model [state 1: liver cirrhosis [without ascites], state 2: ascites complication, state 3: liver transplantation, and state 4: death] was defined. Finally, data analysis was performed using R statistical software

Results: Of the 305 patients studied, 180 [59%] were male. The mean [+/-standard deviation] age of the patients was 43/14 [ +/- 8/39] years. There were 127 patients with ascites during that period. Estimated transition intensities from liver cirrhosis and ascites state to death state were 0.0419 and 0.1731 per year, respectively, and from ascites state to liver transplantation state was 0.2936 per year. 7-year survival probabilities from cirrhosis and ascites state to death state were estimated 48% and 64%, respectively. Estimated mean sojourn times in cirrhosis and ascites state were 4.0166 and 1.912 years. Serum albumin, bilirubin, and prothrombin levels as well as age, and encephalopathy had a significant effect on the transition intensity from liver cirrhosis state to ascites state [p<0.001]

Conclusion: The result of this study indicates that transition from ascites state to liver transplantation or death state occurs faster than transition from liver cirrhosis state. Especially, accompaniment of ascites and encephalopathy increases the transition intensity to death state

The effect of age, and serum bilirubin and prothrombin levels on the survival of patients is important. As ascites complication has an important role in the prognosis of the survival of patients with cirrhotic, it is suggested that ascites would be considered as an effective factor in prioritization of waiting lists for liver transplantation

Psychometric Properties of the Persian Version of the Fatigue Impact Scale [FIS-P] in Patients with Multiple Sclerosis

Objectives: This study was designed to evaluate the psychometric features of the Persian version of the Fatigue Impact Scale [FIS-P] tool when used in Iranian MS patients.

Methods: 140 MS patients and the equivalent number of healthy controls completed the following assessments: FIS-P, Fatigue Severity Scale [FSS], SF-36 questionnaire and the Mini-Mental State Examination [MMSE].

Results: A significant inverse correlation between FIS and the quality of life [SF-36 assessment tool], as well as a positive and significant correlation with the FSS were noted. The Intraclass Correlation Coefficient [ICC] values for the inter-rater reliability for the physical, cognitive, and social sections and the whole questionnaire were 0.89, 0.86, 0.95 and 0.98, respectively. The FIS Persian version was shown to possess a high reliability [with a Cronbach's alpha of 0.953]. Likewise, the ICC values for the testretest reliability were 0.86, 0.87, 0.92 and 0.93 for the physical, cognitive, social subscales and the whole questionnaire, respectively. This suggested a high reliability for the FIS-P.

Discussion: With a proper validity and reliability, the Persian-version of FIS retains the capability for being used in the assessment of fatigue and evaluation of the treatment and rehabilitation effects on fatigue-related symptoms among Persian-speaking patients with MS

Malaria epidemiology in Sistan and Balouchestan province during April 2008-March 2011, Iran

Sistan and Balouchestan province is one of areas in Iran that have the highest malaria incidence. We have tried to investigate the epidemiology of malaria in this province. In this study, we evaluated epidemiological data of all malaria cases from April 2008 to March 2011 in this province. In our study plasmodium vivax was the most type of malaria. Malaria incidence was more in men and rural than female and urban. 22.7% of all cases were foreigners. Malaria incidence has had two picks. Malaria control interventions should be focused on high risk group and based on incidence peak

Relationship between quality of life and hypertonia in young adults with spastic cerebral palsy

Background: The complications associated with spastic cerebral palsy can affect the physical ability and quality of life of individuals suffering from this motor disorder. The aim of this study was to assess the relationship between quality of life and hypertonia in adults with spastic cerebral palsy

Methods: In an analytical cross sectional study, 70 subjects with the diagnosis of spastic cerebral palsy from three Ra'ad Rehabilitation Goodwill complexes in Tehran and Karaj cities took part in this study through convenient sampling. The severity of spasticity and contracture of the knee flexors were measured by Modified Tardieu Scale. Also the quality of life was assessed through World Health Organization quality of life-BREF questionnaire. To analyze data, Pearson and spearman correlation coefficient were used

Results: Participants of this study were 42.9% male, 57.1% female with mean age 26.24 +/- 5 years. No correlation existed between quality of life with knee flexor muscles spasticity. However, psychological and environmental domains showed low correlations with knee extension range [respectively r=0.26 and r=0.28; p< 0.05]

Conclusion: The influences of the mechanical component of hypertonia [contracture] on the quality of life are more prominent than neural factors such as spasticity

Performance ratio analysis: a national study on Iranian hospitals affiliated to ministry of health and medical education

This study was designed to present and compare Iranian hospitals' performance applying ratio analysis technique. This cross-sectional survey was conducted to present an instant image of 139 Iranian hospitals' performance status applying ratio analysis as one of the non parametric technical efficiency assessment methods in 2008. Data was collected using nine dimensional questionnaires supported by world wide web to achieve main hospital ratios. Final analysis was performed applying classic statistics and relevant statistical tests on significant level of 0.05. Four hospital performance indicators were estimated in the studied hospitals as follows: Bed turnover rate [BTR] was fluctuated from 64.5 to 114.8 times for hospitals located in rich and poor areas respectively. Moreover Bed Interval Rate [BIT] was calculated 1.36 versus 2.4 in the poor and rich areas. Average length of stay [ALS] was computed 1.82 for the poor regions but 3.27 for the rich ones furthermore, a positive statistical significant correlation was seen between ALS and the hospital size [P=0.001, r=0.28]. Average bed occupancy rate [BOR] was 57.8% and its variation was from 31.4% to 64.5% depending on the hospital size so that there was a positive statistical significant relationship between the hospital size and BOR [P=0.006, r=0.32]. Regarding that BOR, ALS, BTR and BIT along with mortality rates are mentioned as the most considerable performance indicators, applying analytic frameworks more than considering single and raw indicators are severely recommended

phase 2 study of "[TOX] preoperative chemotherapy" response rate and side effects in [locally advanced operable gastric adenocarcinoma] patients with docetaxel, oxaliplatin and capecitabine

Early stage gastric cancer diagnosis has ensued different approaches in resection strategies. In order to increase the proportion of cases which have undergone radical resection or have reduced the recurrence rate, different pre-operative treatments have introduced. Here, we have verified an active preoperative chemotherapeutic regimen in locally advanced gastric cancer patients. Forty nine patients who have found eligible to enter this phase 2 trial have treated with oxaliplatin 100 mg/m[2] IV, docetaxel 50 mg/m[2] IV, plus capecitabine 625 mg/m[2] PO [TOX]. Clinical staging has been following the first 2 cycles of induction chemotherapy. Patients that have further undergone radical surgery, have evaluated for pathological response rate. Anemia [10.2%], nausea [10.2%] and vomiting [6.1%] were the most frequent grade 3 or 4 adverse effects. Regarding the pathologic staging, 6 patients [12.2%] had complete response [95% CI 3% to 21.4%], 18 of them [36.7%] had partial response [95% CI 23.2% to 50.2%], then 3 patients [6.1%] had stable disease [95% CI 0%-12.8%]. Among the patients who had surgery, 22% had pathologic complete response. Preoperative chemotherapeutic regimen of TOX seems to be an active and safe neoadjuvant therapy in non metastatic gastric cancer. It should further be considered with concurrent radiotherapy

Test-retest reliability of Motricity index strength assessments for lower extremity in post stroke hemiparesis

The Motricity Index was used to measure strength in upper and lower extremities after stroke. The weighted score based on the ordinal 6 point scale of Medical Research Council was used to measure maximal isometric muscle strength. There is dearth of articles dealing with the reliability of this method. Therefore, the aim of this study was to determine the test retest reliability of Motricity Index strength assessments for paretic lower limb in 20 chronic stroke patients with one week interval. In a cross sectional study, intrarater reliability of lower extremity Motricity Index strength assessments with one week interval were measured. The SPSS 18 was used for analysis of data. Two-way random-consistency model of ICC was used for assessment of test-retest reliability. The ICC values showed high reliability of strength measurement of Motricity Index [ICC=0.93]. The Motricity Index can be a reliable instrument for measuring the strength of involved lower extremity when assessment is done by one rater following chronic stroke

Evaluation of T-SPOT[registered] serology test for the diagnosis of pulmonary tuberculosis

Tuberculosis is a chronic contagious infectious disease which is fatal within 5 years in more than half of cases if not diagnosed. Since the fight against tuberculosis is based on early diagnosis and complete treatment of all TB patients, useful biochemical methods are emphasized to find a more rapid diagnostic method. This study aims to evaluate the impact of diagnostic value of T-SPOT[registered] serology in patients suspected or diagnosed with tuberculosis admitted in Bou-Ali Hospital of Zahedan, Iran. The descriptive-analytic study conducted on 60 patients, 30 of whom had AFB sputum smear positive pulmonary tuberculosis, and 30 patients had AFB sputum smear negative pulmonary tuberculosis. The results were stated as sensitivity, specificity, positive and negative predictive value and likelihood ratio using conventional epidemiological table. In 23 out of 30 patients with AFB sputum smear positive pulmonary tuberculosis, T-SPOT[registered] serology became positive and in 12 out of 30 patients with AFB sputum smear negative pulmonary, T-SPOT[registered] serology became positive. According to the epidemiological table in this study, sensitivity, specificity, positive and negative predictive value and likelihood ratio of this test were determined respectively 76%, 40%, 56%, 63% and 1.25%. According to the results, this test is not able to distinguish active pulmonary tuberculosis from latent infection. Moreover, considering high contact of regional people with TB patients and pulmonary involvement of people due to factors other than TB, the test value with this likelihood ratio is low.

[Development of picture verb test for 36-54 month-old normal Persian-speaking children and determination of its validity and reliability]

Verb is one of the most important aspects of a sentence, and verb deficit is a noticeable part of developmental language disorders. In Iran, there is no standard test for evaluating this aspect of language in children. This study aimed to develop and evaluate a picture verb test for 36- 54 month-old normal Persian-speaking children, and assess its ability to differentiate between children. A list of verbs that could be depicted was collected and content validity was assessed by seven speech therapist. 55 verbs were selected. Then, three pictures were prepared for each verb and one of those pictures was chosen by the same seven specialists. 106 children aged 36-54 months participated in this study. They were divided into three groups [36-42, 42-48, and 48-54 months]. Reliability of this test was assessed by Spearman's correlation and internal consistency. Correlation between children's scores and their age was calculated. Content validity index of all verbs were 1. Spearman's correlation of 0.89 and internal consistency of 0.60 was obtained. By deletion of item method, the Kuder-Richardson score was enhanced to 0.71. There was a significant correlation between children's ability to respond and their age [r=0.76, p < 0.001]. This test is a suitable tool for assessment of verbs in 36-54 month-old Persian-speaking children and can differentiate between three groups under study

Association between spasticity and the level of motor function with quality of life in community dwelling Iranian young adults with spastic cerebral palsy

Consequences of cerebral palsy in adulthood can affect physical, psychological capabilities and quality of life. The purpose of this study was to investigate the relationship between quality of life with spasticity and level of motor function in Iranian young adults with spastic cerebral palsy who were community dweller. In an analytical cross sectional study, 77 participants with spastic cerebral palsy [44 women¡ 33 men] with age range of 20 to 40 years; [mean age 26.19 +/- 5 yr] took part in this study. They were enrolled from three Raad Rehabilitation Goodwill complexes in Tehran and Karaj cities. All subjects were recruited through convenient sampling. Severity of Spasticity for knee flexors was measured with Modified Tardieu Scale. In addition, the level of motor function, and quality of life were assessed respectively through Gross Motor Function Classification System and World Health Organization Quality of life questionnaire [WHOQOL- BREF]. To analyze data, Pearson and spearman correlation coefficient was used. No correlation found between quality of life with knee flexor muscles spasticity and level of motor function [p> 0.05]. Quality of life as a multi dimensional concept has been impacted by many factors such as physical status, environmental issues and culture. Possibly, severity of spasticity and level of function have a less pronounced effect on quality of life in community dwelling adults with cerebral palsy

Relation between Voice Handicap Index [VHI] and disease severity in Iranian patients with Parkinson's disease

One third of patients with Parkinson's disease [PD] have mentioned "dysphonia" as their most debilitating communication deficit. Patient-based measurements, such as Voice Handicap Index [VHI] add necessary supplementary information to clinical and physiological assessment. There are a few studies about relation between VHI and disease severity in PD, although none of them showed any significant correlation. The goal of this study was to find correlation between these variables in Iranian PD patients. This cross-sectional, analytical and non-interventional study was done on 23 PD patients who reported a voice disorder related to their disease. They were selected from attendants of movement disorders clinic of Hazrat Rasool Akram Hospital. The relationship between disease severity [according to Hoehn and Yahr/H and Y and Unified Parkinson's Disease Rating Scale-part3 /UPDRS-III] and VHI questionnaire [and its 3 domains] was investigated based on patients' sex, UPDRS-III score H and Y and VHI. Total VHI and its 3 domains had no relationship with disease severity [H and Y] in all patients and by sex separation. However, there was a positive correlation between VHI and disease severity [UPDRS-III] [r=0.485]. There was also a relation between physical and functional domains of VHI and UPDRS [r[P]=0.530, r[F]=0.479] while no relationship observed regarding sex differences. 9 out of 18 UPDRS-III items had strong relationship with VHI [total and 3subscales]. Iranian PD patients feel handicap according to voice disorder caused by PD. Patient satisfaction of voice decreases with the disease severity and progression. A larger sample size is necessary to find relationship in genders. VHI is an important issue could be offered to be used in PD beside other assessments

[Application of random effect model for determining factors affecting FTT in less than 2 years children in east of Tehran]

Failure To Thrive [FTT] is the delay or suspension in child growth; not dealing with this disorder may lead to more serious consequences like increased death rate, appearance of other relevant diseases, reduced learning, and mental, emotional, or physical disabilities. Given the serious symptoms of failure to thrive in children's future, this paper tries to identify and investigate factors affected in FTT. The study population included children below 2 years old visiting the Health Center of East Tehran from which 1660 infants using two-stage cluster sampling method were selected according to the input criteria [not suffering from any particular disease at birth, and having regular visit to health centers]. After gathering data from the first two years of the infants' lives, factors associated with FTT using SAS software and Random Effect Regression Model were analyzed. Mean age [ +/- SD] of mothers at birth time was 27.3 +/- 5.46 years and 46% [764] of the mothers had an education lower than high school diploma but there was no significant relationship between mothers' education and FTT [p = 0.290]. Mean weight [ +/- SD] of children at birth was 3202 +/- 463.03 g and 5.1% [85] of them were born with underweight [2500g] and 68.1% [1130] of the children were affected by FTT at least in one period. Factors associated with diarrhea, infection, teething, nourishment, weaning, and other diseases had significant role in causing FTT [p < 0.05], out of which the cause of diarrhea was the most likely factor. In addition, the model's random section became significant [p < 0.05]. Given the abundance and graveness of the symptoms of this disorder in child's future and the high likelihood of occurrence of this disorder among infants below 2 years, a strong need is felt to deal with this impairment. Given the significance of the random effect, the known causes alone are not enough for prediction of FTT among infants and genetic and environmental factors play a role in occurrence of FTT as well

Forecasting number of work-related injuries time series with Box-Jenkins Models for registered insured in SSIO between 2000 and 2010 in Iran

Controlling occurrence of accidents in work place has been an interesting subject in all countries worldwide. Financial consequences of these accidents and their economic losses imposed on the involved companies is only one of the insignificant aspects of such damages and when the non-economic but intangible losses to the society are taken into consideration ,these economic damages will be marginalized. Purpose of this research is fitting the box-Jenkins model to time series of total number of accidents in work place and estimation of series1 missing values during fitting of this model. This longitudinal [time series] study, intends to model, estimate and forecast time series of total number of work place accidents for the insured people between 2000 and 2010 in Iran. Spline non-parametric regression methods to find the best interpolation and estimation of the series' missing value as well as box-Jenkins prediction method to find the best prediction on series have been used. Results: Smoothing spline method using some adjusts for seasonal time series in order to estimate missing values, shows better performance on the series. Then, suitable box-Jenkins model, SARIMA [0,1,1] x [0,1,1][12], was fitted to the series. Goodness of fit criterion of model, AIC, for prediction of the time series was equal to 1050.833. Estimation of the missing data in time series with regard to characteristics such as long period of missing data and exposure of values in tandem without any reliable middle points, is an appropriate method in order to leave situation of such gaps in the data. Looking at the goodness of fit of the model can be said that the error estimation and prediction model is rather low and hence, the model is well fitted to the series, Therefore, box-Jenkins model will be reliable for fitting to similar data

Geographical mapping and Bayesian spatial modeling of malaria incidence in Sistan and Baluchistan province, Iran

OBJECTIVE@#To present the geographical map of malaria and identify some of the important environmental factors of this disease in Sistan and Baluchistan province, Iran.@*METHODS@#We used the registered malaria data to compute the standard incidence rates (SIRs) of malaria in different areas of Sistan and Baluchistan province for a nine-year period (from 2001 to 2009). Statistical analyses consisted of two different parts: geographical mapping of malaria incidence rates, and modeling the environmental factors. The empirical Bayesian estimates of malaria SIRs were utilized for geographical mapping of malaria and a Poisson random effects model was used for assessing the effect of environmental factors on malaria SIRs.@*RESULTS@#In general, 64,926 new cases of malaria were registered in Sistan and Baluchistan Province from 2001 to 2009. Among them, 42,695 patients (65.8%) were male and 22,231 patients (34.2%) were female. Modeling the environmental factors showed that malaria incidence rates had positive relationship with humidity, elevation, average minimum temperature and average maximum temperature, while rainfall had negative effect on malaria SIRs in this province.@*CONCLUSIONS@#The results of the present study reveals that malaria is still a serious health problem in Sistan and Baluchistan province, Iran. Geographical map and related environmental factors of malaria can help the health policy makers to intervene in high risk areas more efficiently and allocate the resources in a proper manner.

Psychometric properties of the Persian version of the world health organization's quality of life questionnaire [WHOQOL-100]

In recent decades there has been increasing focus on developing and localizing quality of life [QOL] instruments in different societies In this study, we aim to translate WHO'S Quality of Life WHOQOL-100 questionnaire into the Persian language and assess the validity and reliability of the translated version. We used a forward-backward procedure to translate the questionnaire. A pilot sample of 60 university students was recruited to assess the repeatability and construct validity of the instrument. To assess the construct validity, 60 university students filled out both the WHOQOL-100 and WHOQOL-BREF questionnaires. Then, 500 healthy and 500 disabled individuals were randomly selected using a multistage sampling technique. The internal consistency of the Persian version of the WHOQOL-100 was evaluated using Cronbach's alpha in the sample. In addition, a multiple linear regression model was utilized for assessing the discriminant validity of this instrument, adjusting for different confounders. Test-retest analysis of data from the pilot sample showed that the Persian version of the WHOQOL-100 has acceptable repeatability [ICCs for all six domains were higher than 0.7]. In addition, computation of the correlation between the domains of WHOQOL-100 and WHOQOL-BREF showed satisfactory construct validity. Analyzing the data from 500 healthy and 500 disabled persons revealed that all domains of WHOQOL-100 met the minimum level of acceptable internal consistency. Multiple regression results showed acceptable discriminant validity for all domains of the Persian version, except for the spiritual domain. In general, the Persian version of the WHOQOL-100 had satisfactory reliability and validity for assessing QOL of Iranian people. However, we recommend further research for challenging the problem of the spiritual domain