Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study / 한국역학회지

OBJECTIVES@#Cigarette smoking is an established, strong, and modifiable risk factor for coronary heart disease (CHD). However, little research has investigated CHD risk in former smokers who continue to be exposed to others’ cigarette smoke (former & secondhand smokers). @*METHODS@#In the Tehran Lipid and Glucose Study, a prospective population-based cohort (n=20,069) was followed up for a median period of 14.6 years. A subset of 8,050 participants of 30 years of age and older was analyzed, with first CHD events as the study outcome. Participants were categorized as never, former, current, secondhand, and former & secondhand smokers. Data on smoking intensity (cigarette/d) were also collected. A Cox proportional hazards regression model was applied to estimate the risk of CHD, taking into account the main potential confounders. @*RESULTS@#The mean age of participants was 46.10 ±11.38 years, and they experienced 1,118 first CHD events (with most CHD cases in former smokers) during the follow-up period. The risk of CHD was highest in current smokers, followed in order by former & secondhand, former, and secondhand smokers (hazard ratio [HR], 1.99; 95% confidence interval [CI], 1.65 to 2.39; HR, 1.55; 95% CI, 1.15 to 2.08; HR, 1.39; 95% CI, 1.12 to 1.72; HR, 1.27; 95% CI, 1.07 to 1.51, respectively), compared to never smokers. The risk of CHD increased with smoking intensity, which has been proposed as a preferable measure of smoking, indicating a dose-response pattern. @*CONCLUSIONS@#The elevated risk of CHD in former & secondhand smokers was a noteworthy finding, with possible implications for health policy; however, further research is needed.

Modification of the effect of ambient air temperature on cardiovascular and respiratory mortality by air pollution in Ahvaz, Iran / 한국역학회지

OBJECTIVES@#This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide). @*METHODS@#Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value. @*RESULTS@#We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality. @*CONCLUSIONS@#A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.

How to improve the human brucellosis surveillance system in Kurdistan Province, Iran: reduce the delay in the diagnosis time / 한국역학회지

OBJECTIVES@#Spatial information makes a crucial contribution to enhancing and monitoring the brucellosis surveillance system by facilitating the timely diagnosis and treatment of brucellosis. @*METHODS@#An exponential scan statistic model was used to formalize the spatial distribution of the adjusted delay in the diagnosis time of brucellosis (time between onset and diagnosis of the disease) in Kurdistan Province, Iran. Logistic regression analysis was used to compare variables of interest between the clustered and non-clustered areas. @*RESULTS@#The spatial distribution of clusters of human brucellosis cases with delayed diagnoses was not random in Kurdistan Province. The mean survival time (i.e., time between symptom onset and diagnosis) was 4.02 months for the short spatial cluster, which was centered around the city of Baneh, and was 4.21 months for spatiotemporal clusters centered around the cities of Baneh and Qorveh. Similarly, the mean survival time for the long spatial and spatiotemporal clusters was 6.56 months and 15.69 months, respectively. The spatial distribution of the cases inside and outside of clusters differed in terms of livestock vaccination, residence, sex, and occupational variables. @*CONCLUSIONS@#The cluster pattern of brucellosis cases with delayed diagnoses indicated poor performance of the surveillance system in Kurdistan Province. Accordingly, targeted and multi-faceted approaches should be implemented to improve the brucellosis surveillance system and to reduce the number of lost days caused by delays in the diagnosis of brucellosis, which can lead to long-term and serious complications in patients.

Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study / 한국역학회지

OBJECTIVES@#Cigarette smoking is an established, strong, and modifiable risk factor for coronary heart disease (CHD). However, little research has investigated CHD risk in former smokers who continue to be exposed to others’ cigarette smoke (former & secondhand smokers). @*METHODS@#In the Tehran Lipid and Glucose Study, a prospective population-based cohort (n=20,069) was followed up for a median period of 14.6 years. A subset of 8,050 participants of 30 years of age and older was analyzed, with first CHD events as the study outcome. Participants were categorized as never, former, current, secondhand, and former & secondhand smokers. Data on smoking intensity (cigarette/d) were also collected. A Cox proportional hazards regression model was applied to estimate the risk of CHD, taking into account the main potential confounders. @*RESULTS@#The mean age of participants was 46.10 ±11.38 years, and they experienced 1,118 first CHD events (with most CHD cases in former smokers) during the follow-up period. The risk of CHD was highest in current smokers, followed in order by former & secondhand, former, and secondhand smokers (hazard ratio [HR], 1.99; 95% confidence interval [CI], 1.65 to 2.39; HR, 1.55; 95% CI, 1.15 to 2.08; HR, 1.39; 95% CI, 1.12 to 1.72; HR, 1.27; 95% CI, 1.07 to 1.51, respectively), compared to never smokers. The risk of CHD increased with smoking intensity, which has been proposed as a preferable measure of smoking, indicating a dose-response pattern. @*CONCLUSIONS@#The elevated risk of CHD in former & secondhand smokers was a noteworthy finding, with possible implications for health policy; however, further research is needed.

Modification of the effect of ambient air temperature on cardiovascular and respiratory mortality by air pollution in Ahvaz, Iran / 한국역학회지

OBJECTIVES@#This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide). @*METHODS@#Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value. @*RESULTS@#We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality. @*CONCLUSIONS@#A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.

How to improve the human brucellosis surveillance system in Kurdistan Province, Iran: reduce the delay in the diagnosis time / 한국역학회지

OBJECTIVES@#Spatial information makes a crucial contribution to enhancing and monitoring the brucellosis surveillance system by facilitating the timely diagnosis and treatment of brucellosis. @*METHODS@#An exponential scan statistic model was used to formalize the spatial distribution of the adjusted delay in the diagnosis time of brucellosis (time between onset and diagnosis of the disease) in Kurdistan Province, Iran. Logistic regression analysis was used to compare variables of interest between the clustered and non-clustered areas. @*RESULTS@#The spatial distribution of clusters of human brucellosis cases with delayed diagnoses was not random in Kurdistan Province. The mean survival time (i.e., time between symptom onset and diagnosis) was 4.02 months for the short spatial cluster, which was centered around the city of Baneh, and was 4.21 months for spatiotemporal clusters centered around the cities of Baneh and Qorveh. Similarly, the mean survival time for the long spatial and spatiotemporal clusters was 6.56 months and 15.69 months, respectively. The spatial distribution of the cases inside and outside of clusters differed in terms of livestock vaccination, residence, sex, and occupational variables. @*CONCLUSIONS@#The cluster pattern of brucellosis cases with delayed diagnoses indicated poor performance of the surveillance system in Kurdistan Province. Accordingly, targeted and multi-faceted approaches should be implemented to improve the brucellosis surveillance system and to reduce the number of lost days caused by delays in the diagnosis of brucellosis, which can lead to long-term and serious complications in patients.

Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis / 한국역학회지

OBJECTIVES: We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models.METHODS: Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45–84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis.RESULTS: The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02).CONCLUSIONS: Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.

Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis / 한국역학회지

OBJECTIVES: We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models. METHODS: Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45–84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis. RESULTS: The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02). CONCLUSIONS: Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.

Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis / 한국역학회지

OBJECTIVES@#We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models.@*METHODS@#Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45–84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis.@*RESULTS@#The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02).@*CONCLUSIONS@#Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.

The association between physical activity and atrial fibrillation applying the Heaviside function in survival analysis: the Multi-Ethnic Study of Atherosclerosis / 한국역학회지

OBJECTIVES: Although the effect of physical activity (PA) on the incidence of atrial fibrillation (AF) has been studied, contradictory results have been reported. Such discrepancies may reflect the different effects of various types of PA upon AF, as well as gender interactions. Therefore, we aimed to evaluate the associations of PA types (total, moderate/vigorous, and intentional), as well as walking pace, with AF risk in men and women.METHODS: Using the Multi-Ethnic Study of Atherosclerosis Typical Week Physical Activity Survey, 3 PA measures and walking pace were calculated among 6,487 men and women aged 45-84 years. The incidence of AF over approximately 11 years of follow-up was ascertained. The association of each PA measure and walking pace with AF incidence was estimated using multivariable Cox proportional hazard models. An extended Cox model with Heaviside functions (hv) of time was used to estimate the effects of time-varying covariates.RESULTS: During 11 years of follow-up (49,557 person-years), 242 new AF cases occurred. The incidence rate of AF was 48.83 per 10,000 person-years. The proportional hazard (PH) assumption for total PA among women was not met; hence, we used the hv to calculate the hazard ratio. Total PA in women in the hv2 analysis was negatively associated with AF in all 3 models, although for hv1 no significant association was observed. The PH assumption for walking pace among men was not met, and none of the hv showed a statistically significant association between walking pace and AF in men.CONCLUSIONS: These results suggest that PA is inversely associated with AF in women.

The association between physical activity and atrial fibrillation applying the Heaviside function in survival analysis: the Multi-Ethnic Study of Atherosclerosis / 한국역학회지

OBJECTIVES: Although the effect of physical activity (PA) on the incidence of atrial fibrillation (AF) has been studied, contradictory results have been reported. Such discrepancies may reflect the different effects of various types of PA upon AF, as well as gender interactions. Therefore, we aimed to evaluate the associations of PA types (total, moderate/vigorous, and intentional), as well as walking pace, with AF risk in men and women. METHODS: Using the Multi-Ethnic Study of Atherosclerosis Typical Week Physical Activity Survey, 3 PA measures and walking pace were calculated among 6,487 men and women aged 45-84 years. The incidence of AF over approximately 11 years of follow-up was ascertained. The association of each PA measure and walking pace with AF incidence was estimated using multivariable Cox proportional hazard models. An extended Cox model with Heaviside functions (hv) of time was used to estimate the effects of time-varying covariates. RESULTS: During 11 years of follow-up (49,557 person-years), 242 new AF cases occurred. The incidence rate of AF was 48.83 per 10,000 person-years. The proportional hazard (PH) assumption for total PA among women was not met; hence, we used the hv to calculate the hazard ratio. Total PA in women in the hv2 analysis was negatively associated with AF in all 3 models, although for hv1 no significant association was observed. The PH assumption for walking pace among men was not met, and none of the hv showed a statistically significant association between walking pace and AF in men. CONCLUSIONS: These results suggest that PA is inversely associated with AF in women.

Urbanization and noncommunicable disease [NCD] risk factors: WHO STEPwise Iranian NCD risk factors surveillance in 2011

This study was conducted to examine the relationship between urbanization and risk factors of noncommunicable diseases [NCDs] according to the World Health Organization stepwise approach to surveillance of NCDs. This study is part of a NCD risk factor surveillance of 10 069 individuals in all provinces of the Islamic Republic of Iran, aged over 20 years, during 2011. By utilizing 2011 census data, urbanization levels were determined in all provinces and logistics regression was used to examine the relationship between urbanization and risk factors. Among males, urbanization had a positive correlation with low physical activity [OR=1.7; 95% CI: 1.42-2.09], low fruit and vegetable consumption [OR=1.8; 95% CI: 1.09-2.96], and high BMI [OR=1.4; 95% CI: 1.20-1.70]. Among females there was a positive and significant correlation with low physical activity [OR=1.2; 95% CI: 1.08-1.49], low fruit and vegetable consumption [OR=1.22; 95% CI: 0.78-1.91] and high BMI [OR=1.3; 95% CI: 1.14-1.53]. Thus, urbanization has a significant correlation with increases in NCD factors in the Islamic Republic of Iran

Determining the factors associated with cardiovascular disease Recurrence: Tehran lipid and glucose study

Background: several studies have emphasized the importance of cardiovascular disease [CVD] prevention. However, there is a dearth of data on the prevention of cardiovascular disease recurrence. The present study was the 1st in Iran to evaluate factors associated with CVD recurrence

Methods: this prospective cohort study was conducted on 483 subjects [> 30 years old] with a history of CVD who participated in the Tehran Lipid and Glucose Study and were followed up for 12 years [1999-2012]. The relationships between the most important established risk factors for CVD and CVD recurrence were evaluated

Results: totally, 258 [53.4%] men and 225[46.5%] women at a mean age of 59.2 +/- 10.7 years were recruited in the study. Our results showed that over the 12-year follow-up, the incidence of a recurrent event [per 100 person-years] was 48.5. Further, after controlling the possible confounding factors, the following variables had a significant relationship with CVD recurrence: age [HR = 1.02; p value = 0. 001], male sex [HR = 1.4; p value = 0.012], smoking [HR = 1.7; p value = 0.004], and increased fasting blood sugar [HR = 2.1; p value = 0.001]

Conclusion: we found that the established variables in the development of CVD [i.e., age, sex, and smoking] played an important role in the risk of CVD recurrence

Prediction of the thromboembolic syndrome: an application of artificial neural networks in gene expression data analysis

The aim of this study was to propose a method for improving the power of recognition and classification of thromboembolic syndrome based on the analysis of gene expression data using artificial neural networks

The studied method was performed on a dataset which contained data about 117 patients admitted to a hospital in Durham in 2009. Of all the studied patients, 66 patients were suffering from thromboembolic syndrome and 51 people were enrolled in the study as the control group

The gene expression level of 22277 was measured for all the samples and was entered into the model as the main variable. Due to the high number of variables, principal components analysis and auto-encoder neural network methods were used in order to reduce the dimension of data

The results showed that when using auto-encoder networks, the classification accuracy was 93.12. When using the PCA method to reduce the size of the data, the obtained accuracy was 78.26, and hence a significant difference in the accuracy of classification was observed. If auto-encoder network method is used, the sensitivity and specificity will be 92.58 and 93.68 and when PCA method is used, they will be 0.77 and 0.78 respectively. The results suggested that auto-encoder networks, compared with the PCA method, had a higher level of accuracy for the classification of thromboembolic syndrome status

Using support vector machines in predicting and classifying factors affecting preterm delivery

Various statistical methods have been proposed in terms of predicting the outcomes of facing special factors. In the classical approaches, making the probability distribution or known probability density functions is ordinarily necessary to predict the desired outcome. However, most of the times enough information about the probability distribution of studied variables is not available to the researcher in practice. In such circumstances, we need that the predictors function well without knowing the probability distribution or probability density. It means that with the minimum assumptions, we obtain predictors with high precision. Support vector machine [SVM] is a good statistical method of prediction. The aim of this study is to compare two statistical methods, SVM and logistic regression. To that end, the data on premature infants born at Tehran Milad Hospital is collected and used

Biomarker profiling [Erbb2, P53, and PR] for Stage I of breast cancer

Breast cancer [BC] accounts for one of the major health problems around the world. Since the diagnosis process can have great effect on therapy outcomes, we studied the biomarkers specific to breast tumors stage I based on examining different Iranian patients. Cases from different stages were examined to discover their highly expressed proteins. In addition, pathologic evaluations were performed as the diagnosis procedure. Considering positive percentage of over-expressed protein in different stages in the population, it is guessed that over-expression of ErBb2 and PR are positively correlated, while P53 is in negative correlation with them. Therefore, these molecules can probably account for stage I biological marker. This study suggests that alterations in over-expression of specific biomarkers in different stages may be associated to the stage classification, and can help achieve more effective therapies of this malignancy

Biclustering algorithm for embryonic tumor gene expression dataset: LAS algorithm

An important step in considering of gene expression data is obtained groups of genes that have similarity patterns. Biclustering methods was recently introduced for discovering subsets of genes that have coherent values across a subset of conditions. The LAS algorithm relies on a heuristic randomized search to find biclusters. In this paper, we introduce biclustering LAS algorithm and then apply this procedure for real value gene expression data. In this study after normalized data, LAS performed. 31 biclusters were discovered that 26 of them were for positive gene expression values and others were for negative. Biological validity for LAS procedure in biological process, in molecular function and in cellular component were 77.96%, 62.28% and 74.39% respictively. The result of biological validation of LAS algorithm in this study had shown LAS algorithm effectively convenient in discovering good biclusters

Long-term exposure to low frequency electro-magnetic fields of 50- and 217-Hz leads to learning and memory deficits in mice

Electromagnetic field [EMF] radiation affects cellular and brain chemistry and function, resulting in deleterious effects such as free radicals formation, impaired DNA repair, reduced melatonin and blood brain barrier protection, and defects on learning and memory and other higher brain functions. In this paper the effects of low frequency EMF of 50- and 217 Hz, ranges often associated with common electronic devices such as televisions and cell phones were examined on learning and memory in adult male mice. Five groups [n=10 mice/group] of mice [1 control and 4 experimental] were initially trained for the passive avoidance [PA] test. They were then placed in devices creating EMF radiation with varying intensities [0.5 to 2 milli-Tesla, mT] and frequencies [50- and 217-Hz] for 2-weeks [16 hrs/day]. Control mice received no radiation. Learning and memory was tested by the PA test and evaluated based on the following parameters: mean step through latency [STL], number of crossing [Cr#] and time in dark compartment [TDC]. Results showed significant deficiencies in learning and memory in the EM-exposed mice compared to controls: mean STL decreased significantly [p<0.001] in the 50 Hz group [1 and 1.5 mT intensities]. In the 217 Hz group, STL also decreased in the 0.5 and 2 mT groups [p< 0.05]. There was a notable increase in mean Cr# for both groups and TDC for 50 Hz group. Results confirm that long-term exposure to EMF radiation of 50 and 217 Hz, imparts significant harmful changes on memory and learning, reiterating the need for preventive measures against such exposures

Gene sets involved in prostate cancer based on differential expression

Prostate cancer is the second most common cancer in men. In spite of on-going researches in this filed, the specific causes of prostate cancer are so far unknown. In this study, we used two methods of Gene Set Analysis to improve the biological interpretation of the observed expression patterns in prostate cancer. The Gene Set Analysis is a computational method to discover gene sets whose expression is associated with a phenotype of interest. In addition, we used these methods to search gene sets defined by KEGG and BioCarta. Although, our results showed that most of the gene sets were associated with prostate cancer in the Category and Hotelling's T[2] methods, the power of the Hotelling's T[2] was more than Category method in either KEGG or BioCarta gene sets. The concordance between the results of Pubmed articles and KEGG gene sets was more than the results of Pubmed articles and BioCarta gene sets

Using of ordinal coefficient alpha in the evaluation of spiritual coping questionnaires reliability

Spirituality is known as a factor affecting adjustment to stress conditions in adolescence period. To assess the spiritual coping, a questionnaire in Likert scale is applied. In this study, the ordinal alpha coefficient was used to test the reliability of questionnaire. The data of spirituality coping scale in a semi-structured interview included 103 items developed in 5-point Likert scale. After validation and factor analysis to identify factors, a multiple-choice questionnaire with 39 items was designed. The reliability of this questionnaire was investigated on a sample consisting of 120 adolescents living in boarding centers, Tehran Province. FACTOR and SPSS softwares were used to measure the ordinal alpha and Cronbach's alpha, respectively. The factor analysis revealed the spiritual coping in 3 factors: [purposefulness of life], [connection with God] and [looking for spiritual protection]. The reliability coefficients of factors by ordinal alpha were 0.834, 0.913 and 0.984, respectively, which were higher in comparison with Cronbach's alpha. The reliability coefficient of 39-item-questionnaire by ordinal alpha was 0.992. If the data is normally distributed, Cronbach's alpha can be used to calculate the reliability of the data with ordinal scale. Otherwise, ordinal alpha is a more accurate coefficient for testing the reliability. Spiritual coping questionnaire measures the different dimensions of Spiritual coping in institutionalized adolescences and also has higher reliability