Psychometric properties of the Social Cognitive Theory questionnaire for physical activity in a sample of Iranian adolescent girl students

This research examined the validity and reliability of a researcher-developed questionnaire based on Social Cognitive Theory [SCT] to assess the physical activity behaviour of Iranian adolescent girls [SCT-PAIAGS]. Psychometric properties of the SCT-PAIAGS were assessed by determining its face validity, content and construct validity as well as its reliability. In order to evaluate factor structure, cross-sectional research was conducted on 400 high-school girls in Tehran. Content validity index, content validity ratio and impact score for the SCT-PAIAGS varied between 0.97-1, 0.91-1 and 4.6-4.9 respectively. Confirmatory factor analysis approved a six-factor structure comprising self-efficacy, self-regulation, family support, friend support, outcome expectancy and self-efficacy to overcoming impediments. Factor loadings, t-values and fit indices showed that the SCT model was fitted to the data. Cronbach's alpha-coefficient ranged from 0.78 to 0.85 and intraclass correlation coefficient from 0.73 to 0.90

Psychometric properties of the Persian version of the sexual and reproductive health needs assessment questionnaire

No tools to assess women's general sexual and reproductive health needs have been validated in the Iranian context. This study in Sari in Mazandaran province of the Islamic Republic of Iran was conducted to evaluate the psychometric properties of a Persian version of the Sexual and Reproductive Health Needs Assessment Questionnaire [first developed for the International Organization for Migration and United Nations Population Fund]. The Persian version of the questionnaire was found to have adequate face and content validity [quantitative and qualitative] for assessing sexual and reproductive health needs among women [content validity index = 0.88]. The test-retest reliability showed that, except for the domain of sexually transmitted infections, all domains of the questionnaire had an acceptable reliability [intra-class correlation coefficients > 0.5]. This questionnaire is a valid tool for assessing the sexual and reproductive health needs of Iranian women and planning/designing strategies to meet them

[Adolescent's perspectives on the factors that influence caries development: a qualitative study]

Oral and dental diseases limit an individual's activities at the school, work place and home, leading to a loss of millions of work and school hours all over the world. The period of adolescence is critical as regards shaping of healthy behaviors related to oral and dental diseases. The purpose of this study was to explore and describe school pupils' viewpoints on factors influencing development of dental caries. A qualitative study with a content analysis approach was conducted to collect the perspectives of 18 Iranian students in 8 guidance schools selected by purposive sampling. Structured and semi-structured interviews were held to collect data. An informed consent was obtained and the interviews were recorded and transcribed. The data was analyzed through an inductive approach of content analysis. In order to support the validity and rigor of the data, different criteria such as acceptability, confirmability and transferability were utilized. Data analysis could identify four major factors influencing dental caries development: "family interactions in dental health", "role of school in caring for teeth", "role of dentists in caring for teeth" and "effect of education in caring for teeth". The factors influencing caring for teeth and mouth had a greater significance. The students' experiences, as observed in this study, can help in developing mutual trust between students and dentists, delivering better services in schools by relevant organizations, and designing more effective oral health interventions, with due consideration of vital role of the parents

[Effect of the mental and physical disorders status of Tehran's public transportation system bus drivers on the occurrence of crashes]

In many studies, chronic diseases are associated with incidence of driving accident. The main objective of the present study is investigation the effect of physical and mental disorders status of bus drivers on the occurrence of crashes. This research is a cross-sectional and descriptive-analytical study that was performed on 665 bus drivers' public transportation system in Tehran. The samples were selected randomly and to the proportion of working population in nine bus systems or areas. In order to investigate physical [disease] and mental [family problems] disorders demographic information and health status questionnaires were used. The relationships between variables analyzed through Univariate analysis of variance [UNIANOVA] and Kendall's tau-b tests by SPSS 16 of software. The results showed 68.7% of drivers with mental disorders [with family problems] in both groups from healthy and unhealthy [physical diseases] drivers' had average 3.2 crashes in the last three years. Furthermore the tests of Univariate analysis of variance [UNIANOVA] [F = 0.43, p <0.05] and Kendall's tau-b [r = 0.112, p <0.01] showed significant and positive correlation between family problems and the number of self-reported crashes over the previous three years. Because of the increased risk of crashes among drivers suffering from mental problems, it is assumed that the removal of economic problems and the use of psychological consultations will reduce family problems including poor emotional relationships of family members which play an important role in increasing attention and concentration of the drivers while driving and consequently reducing traffic crashes.

[Investigating of the effect of familiarzation play on the injective procedural anxiety in B-Thalassemic pre-school children]

During Thalassemia, children should be under frequent blood injections to maintain their lives. The use of intra-vein cutters is one of the most prevalent and painful procedures, and children specially young children usually call it the most stressful aspect of their disease, hospitalization and even their outpatient visit. The present research is an investigation of the influence of familiarization play on the anxiety in the case of injection procedures for children before school age. The present study is a clinical experiment. The research sample consists of 60 Thalassemia children of 3-7 years old, possessing files in Thalassemia sections in Gilan Province. The participants were randomly divided into two groups [experimental group and one control group]. In the experimental group, a familiarization play was carried out for 10-15 minutes prior to the injection procedure. The instruments used in the research include: Demographic Information Questionnaire, the Scale of facial self report of anxiety, and the Questionnaire of child clinical fear self report. The analysis of the data was carried out through SPSS and the statistic test: chi-square, t-test, Mann-whiney and Wilcoxon sign. The data indicated that there was not a significant difference between the average scores of anxiety in the two groups prior to the treatment [P>0.05]. However, after the treatment, the statistic test Mann-whiney and Wilcoxon sign showed a significant difference between the experimental group and the control group in term of the average scores anxiety [P<0.05]. According to the research results, the treatment of familiarization play is influential on anxiety decrease resulted from the injection procedures in children. Therefore it is suggested that child nurses use the method of familiarization play in order to comfort of children with acute and chronic diseases who are frequently under treatment measures

Application of artificial neural network in predicting the survival rate of gastric cancer patients

The aim of this study was to predict the survival rate of Iranian gastric cancer patients using the Cox proportional hazard and artificial neural network models as well as comparing the ability of these approaches in predicting the survival of these patients. In this historical cohort study, the data gathered from 436 registered gastric cancer patients who have had surgery between 2002 and 2007 at the Taleghani Hospital [a referral center for gastrointestinal cancers], Tehran, Iran, to predict the survival time using Cox proportional hazard and artificial neural network techniques. The estimated one-year, two-year, three-year, four-year and five-year survival rates of the patients were 77.9%, 53.1%, 40.8%, 32.0%, and 17.4%, respectively. The Cox regression analysis revealed that the age at diagnosis, high-risk behaviors, extent of wall penetration, distant metastasis and tumor stage were significantly associated with the survival rate of the patients. The true prediction of neural network was 83.1%, and for Cox regression model, 75.0%. The present study shows that neural network model is a more powerful statistical tool in predicting the survival rate of the gastric cancer patients compared to Cox proportional hazard regression model. Therefore, this model recommended for the predicting the survival rate of these patients

[Relationship between DNMT1 gene's SNPs and colorectal cancer at Taleghani hospital in Tehran]

The relation between Single Nucleotide Polymorphisms [SNPs] and a number of diseases has triggered many researches. Investigating the possible relations between SNPs present in DNMT1 gene from man's chromosome 19 and colorectal cancer. This was a case/control study in which 100 patients with colorectal cancer, referred to Research Center of Gastroenterology and Liver Diseases of Shaheed Beheshti Medical University during 2008, were chosen as case group. The control group included an equal number of patients who visited the medical center for a variety of reasons. Genetic test was carried out on all patients to determine the type of 6 SNPs of DNMT1 gene from man's chromosome 19. Data were statistically analyzed by SPSS software using chi-square test and logistic regression. All SNPs investigated showed significant relations with colorectal cancer indicating that in all cases the chance of getting colorectal cancer in people with genotype 1 and 2 was much higher than those with genotype 0. by exploring people's SNPs, it is feasible to predict the risk of catching colorectal cancer and thus establishing proper preventive measures

Oral health status and its determinants in a sample of Iranian adolescents in Qazvin [2010]

There is a vital need to assess the changes in oral health trend and also the preventive strategies in different locations, systematically. This could help to plan for promoting oral health in Iran. To describe the dental caries status in a sample of Iranian adolescents aged from 14 to 18 years old in Qazvin and to identify the related factors affecting the oral health in this group. In this cross-sectional study, a total of 380 adolescents were randomly selected from high schools in Qazvin. The adolescents agreed to participate and completed a questionnaire. Oral health status was assessed in terms of number of teeth, decayed teeth [DT], filled teeth [FT], and decayed, missing or filled teeth [DMFT]. A multivariate regression analysis was used to assess the statistical association between the DMFT as dependent variable and those of other variables. Of total participants, 190 were females [50%]. The mean age of the adolescents was 15.10 [SD=1.03] years. The mean DMFT was 2.62 [SD=1.89] for all subjects. There was a significant difference between the boys and girls regarding the DMFT as boys had higher DMFT scores than girls. The multivariate regression analyses revealed a significant associations between the high DMFT scores and other variables including: higher age, lower parental education, higher family income, lower frequency of dental brushing and flossing, no history of visiting a dentist, and bad perception of own oral health. Although the dental caries is rather low in this group but it has a major impact on Iranian adolescent's daily living

[Change-point in poisson distribution with application in Iranian mortality data]

Changing the pattern of mortality gives important perspective of health determinants. The aim of this study is to detect location and time of mortality pattern change in country using statistical change point method during 1971-2009 Years. We assume for years before and after K0, Y1 has a Poisson distribution with meansand lamda[0] and lamda[1] respectively. We used several methods for estimation change point in real data by assume Poisson model. Using two simulated and real data analysis showed that the change point has been occurred in year 1993 and this confirmed by all methods. Our findings have shown that the change pattern of mortality trend in Iran is related to improvement of health indicators and decreasing mortality rate in Iran

Trend analysis of gastric cancer and colorectal cancer mortality in Iran, 1995-2003

Cancer is the third most common cause of death in Iran. Gastric cancer [GC] and colorectal cancer [CRC] are two important causes of mortality due to cancer. With regards to cancer mortality, data are important to monitor the effects of screening program, earlier diagnosis, demographic data and other prognostic factors. The aim of this study was to evaluate the mortality rates and trends from GC and CRC in Iranian population during a period of almost a decade, i.e. from 1995 to 2003. National death Statistic Reported by the Ministry of Health and Medical Education [MOH and ME] from 1995 to 2003, stratified by age group, sex, and cause of death are included in this study. CRC and GC were expressed as the annual mortality rates/100,000, general and/or per gender, and age group. The general mortality rate of CRC slightly increased during the years under study from 0.44 to 2.54 and CRC mortality was higher for older age and male. The general mortality rates of GC showed a sharp increasing from 1.68 to 9.67. In addition to this, GC mortality rate was higher for male than female. Our study indicated remarkable increasing trends in GC and CRC mortality. So developing for a gastric cancer for both primary prevention and early detection programs and manage the delays of diagnosis is recommended to decrease the trend of GC mortality. For CRC, since the rate of CRC screening is very low in Iran, it is recommended that in Iran screening be started as a public program in order to control the mortality and burden of CRC in the future

[Investigation of influential factors affecting survival rate of patients with colorectal cancer using copula function]

Competing risk data is one of the multivarite survival data. Competing risk data can be modelled using copula function. In this study we propose a bayesian modelling approach of competing risk data using the copula function. We used the data from colorectal cancer registyrarty in Tehran. After constructing likelihood function using Clayton copula by choosing appropriate prior distribution for parameters, we obtained the posterior distribution of parameters using the Metropolis-Hastings algorithms and Slice sampling. The results of univariate analysis showed that sex, histology of tumor, extent of wall penetration, lymph node metastasis, distant metastasis and pathological stage of tumor were significantly associated with colon cancer and sex, histology of tumor, lymph node metastasis, distant metastasis and pathological stage of tumor were were significantly related to rectal cancer. In the multivariate analysis, age at diagnosis, tumor grade and distant metastasis were significant prognostic factors for colon cancer and tumor grade and size of the tumor were significant prognostic factors of rectal cancerAs we showed some variables may have different impacts on colon and rectum cancers, consequently, further studies are needed to be conducted considering risk factors of these cancers separately

Comparison of maternity care quality in teaching and non-teaching hospitals in Khorram Abad, Islamic Republic of Iran

The objective of this study was to compare the quality of maternity care in 2 types of government-run hospital in the town of Khorram Abad, Islamic Republic of Iran in 2009: a university-linked teaching and asocial security organization non-teaching hospital. A sample of 264 women hospitalized in the delivery and postpartum wards was selected. Data collection was done using interviews with mothers and observation checklists based on Iranian government criteria. The quality of maternity care in the non-teaching hospital was higher than the teaching hospital in terms of facilities, processes of maternal and newborn care and outcomes [mother's satisfaction]. In the teaching hospital, the quality of the physical space, the educational level and training of health care personnel and monitoring and evaluation of care quality needed improvement. In both hospitals, meeting women's expectations about the degree of privacy could lead to an increase in the quality of maternity services

[Survival analysis of the patients with acute myocardial infarction by use of penalized splines]

Cardiovascular diseases are one of the most common causes of death and also major health problems in the world. The classical methods such as Cox regression are used in most medical studies on survival distribution, while this model assumes a linear relationship between log hazard ratio and risk factors which is not useful in many cases. The present study was performed to use the method of penalized splines to analyze the survival rate of the patients who had acute myocardial infraction. This research was a prospective descriptive-analytical study of longitudinal type which included 650 patients with acute myocardial infarction. Patients were followed for one year from the moment of diagnosis of MI, for survival analysis. The collected data were recorded in a check-list for every patient. Two different multivariate methods, proportional hazard regression and Cox model with penalized splines were used. Data analysis was carried out using R version 2.12 software and significant levels were considered 0.05. The mortality rate of the patients in a period of one year was 10.3% [67patients]. History of smoking, hypertension, diabetes, hyperlipidemia, arrhythmia and heart block were detected in 48%, 33.4%, 17.7%, 15.3%, 30% and 10.3% of the patient respectively. Based on Cox model with penalized splines the factors affecting survival rate were age, ejection fraction and use of streptokinase. Knowledge of the survival rate and factors affecting survival in the patients with acute MI can be used to provide the patients with valuable services, and to take measures to control and reduce mortality rate which can lead to increased life expectancy of these patients

[Assessment of factors affecting self-care behavior among women with type 2 diabetes in Khoy City diabetes clinic using the extended theory of reasoned action]

Many studies show that the only way to control diabetes and prevent its debilitating complications is continuous self-care. This study aimed to determine factors affecting self-care behavior of diabetic women in Khoy City, Iran based the extended theory of reasoned action [ETRA]. A sample of 352 women with type 2 diabetes referring to a Diabetes Clinic in Khoy City in West Azarbaijan Province, Iran participated in the study. Appropriate instruments were designed to measure the relevant variables [diabetes knowledge, personal beliefs, subjective norm, self-efficacy and behavioral intention, and self-care behavior] based on ETRA. Reliability and validity of the instruments were determined prior to the study. Statistical analysis of the data was done using the SPSS-version 16 software. Based on the data obtained, the proposed model could predict and explain 41% and 26.2% of the variance of behavioral intention and self-care, respectively, in women with type-2 diabetes. The data also indicated that among the constructs of the model perceived self-efficacy was the strongest predictor for intention for self-care behavior. This construct affected both directly and indirectly self-care behavior. The next strongest predictors were attitudes, social pressures, social norms, and intervals between visiting patients by the treating team. The proposed model can predict self-care behavior very well. Thus, it may form the basis for educational interventions aiming at promoting self-care and, ultimately, controlling diabetes

[Elder abuse by family members: an exploration in the lived experiences of older people]

Elder abuse by family members particularly where family provides care to an aging relative has been addressed as a serious problem by most societies. Considering the importance and prevalence of the issue, exploring lived experiences of elders in this regards is necessary to have a better understanding of elder abuse phenomenon. The study aimed to explore experiences and perceptions of elders regarding their abuse by family members. A qualitative study using hermeneutic phenomenological approach was employed to conduct the study. Unstructured interviews were undertaken with fourteen elderly community dwellers of Tehran city. In-depth interviews were taped and transcribed verbatim and analyzed using van Manen method. Four themes were identified including: 'being deprived of human rights and dignities', 'smashed up integrity', 'silent suffering' and 'painful ending'. The lived experience of the older adults evidenced elder abuse as a deprivation from the human rights and dignity which could result in negative physical, psychological, and socio- economical consequences, decreased quality of life and tough ending which they bear it in silence. The findings reveal significant concepts in providing care to elders and could contribute in increasing capabilities of healthcare workers specially nurses to assess, intervene and prevent it appropriately

[To evaluate the prognostic factors in using Bayesian interval censoring analysis on survival rate of gastric cancer in Iran]

The Cox proportional-hazards regression and other parametric models model have achieved widespread use in the analysis of time-to-event data with censoring and covariates. However employing Bayesian method has not been widely used or discussed. The aim of this study was to evaluate the prognostic factors in using Bayesian interval censoring analysis. This cohort study was based on 178 patients with gastric cancer from January 2003 to December 2007 admitted to Taleghani teaching hospital in Tehran. Known prognostic risk factors were entered into the analysis using Bayesian Weibull and Exponential models. The term DIC was employed to find best model. The results were showed survival rate depended on age of diagnosis and tumor size. Those patients who had early diagnosis and/or had smaller tumor size were in lower risk of death. The age of diagnosis and tumor size of patients are important prognostic factors related to survival of patients with gastric cancer. Based on DIC, Bayesian analysis of the Weilbull model performed better than the Exponential model. As a result, if this cancer has been diagnosed early, the relative risk of death would reduce

[Comparison of artificial neural network and parametric regression models in survival prediction of patients with gastric cancer]

Using parametric models is common approach in survival analysis. In the recent years, artificial neural network [ANN] models have increasingly used in survival prediction. The aim of this study was to predict of survival rate of patients with gastric cancer by using a parametric regression and ANN models and compare these methods. We used the data of 436 gastric cancer patients from a cancer registry in Tehran between 2002-2007. All patients had a confirmed diagnosis. Data were randomly divided into two groups: training and testing [or validation] set. For analysis of data we used a parametric model [exponential, Weibull, normal, lognormal, logistic and log-logistic models] and a three layer ANN model. In order to compare of the prediction of two models, we used the area under receiver operating characteristic [AUROC] curve, classification table and concordance index. The prediction accuracy of the ANN and the parametric [Weibull] models were 79.45% and 73.97% respectively. The AUROC for the ANN and the Weibull models were 0.815 and 0.748 respectively. The ANN had a better predictions than the Weibull model. Thus it is suggested to use of the ANN model survival prediction in field of cancer

[Comparison the role of BMI, pathologic stage and hereditary related factors on survival between colon and rectal cancers: frailty competing risks model]

Cholera is always being considered as a public health threat in poor and developing countries. However outbreaks of cholera are not very common in central area of Iran; in 2008 district health authority reported a cluster of diarrhea cases. We investigated this cluster to identify the etiological agent, source of transmission and propose control measures. We analyzed the data of total of 1219 patients with colorectal cancer who registered between 1 January 2002 to 1 October 2007. Data were analyzed using univariate and multivariate Accelerated Failure Time [AFT] parametric survival model with frailty, utilizing STATA statistical software. In the univariate analysis for age at diagnosis, gender, marital status, race and education level, the survival of patients with colon cancer were approximately between half to one fourth and for BMI, alcohol history, Inflammatory Bowel Disease [IBD], familial history of cancer and the pathologic stage of tumor, the survival of patients with colon cancer were significantly [between 0.12 to 0.56 times] shorter than those patients with rectal cancer. In the multivariate analysis, for age at diagnosis [45-65 years], there was significant difference between colon and rectum cancer. But for BMI, alcohol history, IBD and pathologic stage there were not significant differences. The adjusted survival and 1, 2, 3, 4 and 5 year survival of patients with rectal cancer were better than those with colon cancer. Site-specific evaluation of colon and rectum could give a better perspective of factors affecting these cancers. It may help to design of clinical trials, better diagnosis of diseases and optimal administration of specific treatments

[Implementation of participatory-educational program based on Precede model for self-esteem and psychological well-being enhancement of university students]

Students are susceptible to mental health and psychological problems in different situations. The purpose of this study was to use a participatory-educational intervention for enhancement of self-esteem and psychological well-being of the students of Gonabad and Birjand medical sciences universities. This experimental study was based on Precede model in which 154 university students were randomly selected for the case and control groups. The data were collected by GHQ>-28, Rosenberg's self-esteem scale, enabling, predisposing and reinforcement factors questionnaires. The skill training program was used based on focus group discussion method in the sub-group of 12 participants. Then planned and implemented program was evaluated in the groups. The data were analysed using SPSS software. The results showed that there are significant differences between predisposing, enabling and reinforcement factors, self-esteem and psychological well-being variables before and after intervention. Moreover, after intervention, differences in psychological well-being [P<0.0001], self-esteem [P<0.001], predisposing factors [P<0.01], enabling and reinforcement factors [P<0.02] in case a and control groups, were significant. The study showed that skill training based on Precede Model can enhance self-esteem and psychological well-being and leads to empowerment and participation

[Modification of reasoned action theory and comparison with the original version by path analysis for substance abuse prevention among adolescents]

Objective of present study was assessing the competence of self efficacy to development of theory of Reasoned Action [TRA] and comparison with original version by path analysis for substance abuse prevention among adolescents. In this analytic study, 433 randomly selected adolescents [range of age 15-19] from Tehran participated in study. The study design was based on the theory of Reasoned Action and other self efficacy methods. Validity and reliability of the study questionnaire was assessed. Then the collected data were analyzed by using path analysis method The results indicated that the reasoned action developed by self efficacy, has a better fitness [RMSEA=0.043-df / chi[2]=1.77-P-value=0.1829] compare to the original [RMSEA=0.128-df / chi[2]=7.96-P-value=0.00479] in path analysis. In this study self efficacy become effective construct for fitness of model and powerful predictors for intention [beta=0.35] and behavior [beta=0.20]. The model covered 36% of intention variance and 28% of behavior variance. The reasoned action was developed by self efficacy and increased its prediction