Spatio-temporal Distribution of Suicide Risk in Iran: A Bayesian Hierarchical Analysis of Repeated Cross-sectional Data / 예방의학회지

Objectives@#We aimed to estimate the space-time distribution of the risk of suicide mortality in Iran from 2006 to 2016. @*Methods@#In this repeated cross-sectional study, the age-standardized risk of suicide mortality from 2006 to 2016 was determined. To estimate the cumulative and temporal risk, the Besag, York, and Mollié and Bernardinelli models were used. @*Results@#The relative risk of suicide mortality was greater than 1 in 43.0% of Iran’s provinces (posterior probability >0.8; range, 0.46 to 3.93). The spatio-temporal model indicated a high risk of suicide in 36.7% of Iran’s provinces. In addition, significant upward temporal trends in suicide risk were observed in the provinces of Tehran, Fars, Kermanshah, and Gilan. A significantly decreasing pattern of risk was observed for men (β, -0.013; 95% credible interval [CrI], -0.010 to -0.007), and a stable pattern of risk was observed for women (β, -0.001; 95% CrI, -0.010 to 0.007). A decreasing pattern of suicide risk was observed for those aged 15-29 years (β, -0.006; 95% CrI, -0.010 to -0.0001) and 30-49 years (β, -0.001; 95% CrI, -0.018 to -0.002). The risk was stable for those aged >50 years. @*Conclusions@#The highest risk of suicide mortality was observed in Iran’s northwestern provinces and among Kurdish women. Although a low risk of suicide mortality was observed in the provinces of Tehran, Fars, and Gilan, the risk in these provinces is increasing rapidly compared to other regions.

Effect of maternal smoking during pregnancy on Tourette syndrome and chronic tic disorders among offspring: a systematic review and meta-analysis

Current studies have controversial reports about the effect of maternal smoking during pregnancy (MSDP) on the risk of psychiatric disorders among offspring. The purpose of this systematic review and meta-analysis was to assess the effect of MSDP on the risk of Tourette syndrome (TS) and chronic tic disorders (CTD) among offspring. A systematic search using PubMed, Scopus, and Web of Science was conducted up to July 2019 to retrieve potential studies in English. Fixed and random-effects meta-analyses was performed to estimate pooled relative risk (RR) with 95% confidence interval (CI) according to heterogeneity. The methodological quality of the included studies was evaluated using the Newcastle-Ottawa Scale. Heterogeneity among studies was explored using the I2 statistic. Of the 641 studies from the initial search, 7 were included in the quantitative synthesis (3 cohort and 4 case control studies). Overall, MSDP increased the risk of TS and CTD among the offspring by 35% (pooled RR, 1.35; 95% CI, 1.17–1.56; I2 =45.8%; P-value=0.08). The results of this meta-analysis revealed that there is a significant association between MSDP and the risk of TS and CTD in offspring, and MSDP may be considered a potential risk factor for TS and CTD.

Changes in spirometric parameters after protective interventions among workers at a chlorine production plant in Iran / 한국역학회지

OBJECTIVES@#This study was conducted to assess changes in spirometric parameters after protective interventions among workers at a chlorine production plant in Semnan, Iran during 2012-2016. @*METHODS@#This quasi-experimental study included 100 workers at a chlorine production plant in Semnan during 2012-2016. Spirometric parameters (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1/FVC, peak expiratory flow [PEF], and PEF occurring in the middle 50% of the patient’s exhaled volume [PEF 25-75%]) were measured in all workers before the initial intervention in 2012. Protective interventions were then implemented for 4 consecutive years and the parameters were measured annually. A multivariable linear regression model was used to assess the factors affecting spirometric parameters before and after the protective interventions in SPSS version 24. @*RESULTS@#The mean values of all spirometric parameters significantly increased after the protective interventions (p<0.05). Multivariable linear regression showed that age (β=-0.40), body mass index (BMI) (β=0.71; 95% confidence interval [CI], 0.11 to 1.31), and type of mask (β=-7.88; 95% CI, -15.96 to -0.46) had significant effects on the mean difference in FVC. Similarly, age (β=-0.35; 95% CI, -0.70 to -0.01), BMI (β=0.80; 95% CI, 0.20 to 1.41) and type of mask (β=-8.88; 95% CI, -16.98 to -0.79) had significant associations with the mean difference in FEV1. The type of mask (β=-12.81; 95% CI, -25.01 to -0.60) had a significant effect on the mean difference in PEF. @*CONCLUSIONS@#All spirometric parameters significantly increased in workers after protective interventions were implemented. Therefore, protective interventions to prevent respiratory disorders in workers exposed to chlorine gas are suggested.

Determination of maternal risk factors of preterm delivery: adjusted for sparse data bias; results from a population-based case-control study in Iran

OBJECTIVE: To determine the maternal risk factors associated with preterm delivery in Iran.METHODS: A population-based case-control study was conducted including 48 women having preterm delivery (case group) and 100 women having term delivery (control group) between March 2007 and March 2012 in the maternity hospitals of the Selseleh County, Lorestan province, Iran. Information regarding maternal risk factors was collected by structured interview and reviewing the medical records. The maternal risk factors associated with preterm delivery were identified using univariate and multivariable logistic regression analysis after adjusting the sparse data bias. The area under the receiver operating characteristic (ROC) curves was estimated to evaluate the discrimination power of the statistical models.RESULTS: Multivariable analysis demonstrated that multiparty (odds ratio [OR], 14.23; 95% confidence interval [CI], 1.60–127.05), history of gestational diabetes (OR, 0.10; 95% CI, 0.01–0.99), thyroid dysfunction (OR, 97.32; 95% CI, 5.78–1,637.80), urinary tract infection (OR, 16.60; 95% CI, 3.20–85.92), and taking care during pregnancy (OR, 0.12; 95% CI, 0.03–0.50) had significant impact on preterm delivery after adjusting the potential confounders. The area under the ROC curve for the aforementioned maternal risk factors was 0.86 (95% CI, 0.80–0.92).CONCLUSION: Our study provides evidence for the associations between multiparty, history of gestational diabetes, thyroid dysfunction, urinary tract infection, as well as taking care during pregnancy, and preterm delivery.

Association between the incidence and mortality rates for corpus uteri cancer and human development index (HDI): a global ecological study

OBJECTIVE: The aim of this study was to determine the association between the incidence of and mortality due to corpus uteri cancer (CUC) and the human development index (HDI) across the world.METHODS: This was an ecological study. The incidence and mortality rates of CUC along with HDI data were extracted from the Global Cancer Data in 2018. Subsequently, correlation coefficient and linear regression model were used to determine the association between the incidence and mortality rates of CUC and the HDI. STATA-14 was used for data analysis.RESULTS: There was a positive and significant correlation between the incidence (r=0.693; P<0.001) and mortality (r=0.284; P<0.001) rates of uterine cancer and the HDI. A positive and significant correlation was also observed between the incidence rate and the gross national income per 1,000 capita (r=0.440; P<0.001), mean years of schooling (MYS) (r=0.740; P<0.001), life expectancy at birth (LEB) (r=0.590; P<0.001), and expected years of schooling (r=0.650; P<0.001). The results of the linear regression model showed a significant statistical association between MYS and the incidence of CUC (β=1.10; 95% confidence interval [CI], 0.60–1.70) and LEB and mortality due to uteri cancer (β=0.40; 95% CI, 0.10–0.90).CONCLUSION: The results of this study suggest a significant statistical association between the incidence and mortality rates of CUC and the HDI.

The effect of antenatal magnesium sulfate on intraventricular hemorrhage in premature infants: a systematic review and meta-analysis

Objective@#The aim of this systematic review and meta-analysis study was to determine the pooled estimate of the effect of antenatal magnesium sulfate (MgSO4) on intraventricular hemorrhage (IVH) in premature infants. @*Methods@#Two review authors independently searched all randomized clinical trials from international databases, including Medline (PubMed), Web of Sciences, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Research Registers of ongoing trials (ClinicalTrials.gov), from January 1989 to August 2017. Two independent review authors were responsible for data collection. After extracting the necessary information from the evaluated articles, metaanalysis of the data was performed using Stata version 14. Also, sources of heterogeneity among studies were determined by Meta regression. @*Results@#In this study, among 126 articles that were extracted from primary studies, 7 papers that evaluated the effect of MgSO4 on IVH were eligible for inclusion in the meta-analysis. The results of the meta-analysis showed that pooled relative risk (95% confidence interval [CI]) was 0.80 (95% CI, 0.63 to 1.03) for the effect of MgSO4 on IVH. @*Conclusion@#Results of this study showed that although MgSO4 had a protective effect on IVH in premature infants, this effect was not statistically significant. Further studies are needed to determine the best dosage, timing, and gestational age to achieve the optimum effect of MgSO4 on IVH.Systematic Review Registration International Prospective Register of Systematic Reviews (PROSPERO) Identifier: CRD42019119610

Changes in spirometric parameters after protective interventions among workers at a chlorine production plant in Iran / 한국역학회지

OBJECTIVES@#This study was conducted to assess changes in spirometric parameters after protective interventions among workers at a chlorine production plant in Semnan, Iran during 2012-2016. @*METHODS@#This quasi-experimental study included 100 workers at a chlorine production plant in Semnan during 2012-2016. Spirometric parameters (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1], FEV1/FVC, peak expiratory flow [PEF], and PEF occurring in the middle 50% of the patient’s exhaled volume [PEF 25-75%]) were measured in all workers before the initial intervention in 2012. Protective interventions were then implemented for 4 consecutive years and the parameters were measured annually. A multivariable linear regression model was used to assess the factors affecting spirometric parameters before and after the protective interventions in SPSS version 24. @*RESULTS@#The mean values of all spirometric parameters significantly increased after the protective interventions (p<0.05). Multivariable linear regression showed that age (β=-0.40), body mass index (BMI) (β=0.71; 95% confidence interval [CI], 0.11 to 1.31), and type of mask (β=-7.88; 95% CI, -15.96 to -0.46) had significant effects on the mean difference in FVC. Similarly, age (β=-0.35; 95% CI, -0.70 to -0.01), BMI (β=0.80; 95% CI, 0.20 to 1.41) and type of mask (β=-8.88; 95% CI, -16.98 to -0.79) had significant associations with the mean difference in FEV1. The type of mask (β=-12.81; 95% CI, -25.01 to -0.60) had a significant effect on the mean difference in PEF. @*CONCLUSIONS@#All spirometric parameters significantly increased in workers after protective interventions were implemented. Therefore, protective interventions to prevent respiratory disorders in workers exposed to chlorine gas are suggested.

The effect of antenatal magnesium sulfate on intraventricular hemorrhage in premature infants: a systematic review and meta-analysis

Objective@#The aim of this systematic review and meta-analysis study was to determine the pooled estimate of the effect of antenatal magnesium sulfate (MgSO4) on intraventricular hemorrhage (IVH) in premature infants. @*Methods@#Two review authors independently searched all randomized clinical trials from international databases, including Medline (PubMed), Web of Sciences, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Research Registers of ongoing trials (ClinicalTrials.gov), from January 1989 to August 2017. Two independent review authors were responsible for data collection. After extracting the necessary information from the evaluated articles, metaanalysis of the data was performed using Stata version 14. Also, sources of heterogeneity among studies were determined by Meta regression. @*Results@#In this study, among 126 articles that were extracted from primary studies, 7 papers that evaluated the effect of MgSO4 on IVH were eligible for inclusion in the meta-analysis. The results of the meta-analysis showed that pooled relative risk (95% confidence interval [CI]) was 0.80 (95% CI, 0.63 to 1.03) for the effect of MgSO4 on IVH. @*Conclusion@#Results of this study showed that although MgSO4 had a protective effect on IVH in premature infants, this effect was not statistically significant. Further studies are needed to determine the best dosage, timing, and gestational age to achieve the optimum effect of MgSO4 on IVH.Systematic Review Registration International Prospective Register of Systematic Reviews (PROSPERO) Identifier: CRD42019119610

Prevalence of HIV, Hepatitis B and C Virus Co-infections among Iranian High-Risk Groups: A Systematic Review and Meta- Analysis

@#Co-infection with hepatitis B and C among HIV infected patients are prevalent among high-risk populations. This meta-analysis aimed to estimate the prevalence of HIV, HCV and HBV co-infections among high-risk populations in Iran. We systematically searched the national and international electronic databases until 2016. The primary outcome was the prevalence of HIV, HBV, HCV and HIV co-infections in different high-risk populations in Iran. All English and Persian studies conducted on Iranian high-risk groups were included in the study. The review was reported based on PRISMA guidelines and data were analysed at 95% confidence level using random effect models.Overall, 916 relevant papers were recognised and 14 articles were included in the metaanalysis. The pooled estimates of HBV/HCV, HCV/HIV, HBV/HIV and HBV/HCV/HIV were 1.3% (95%CI: 0.5–2.1), 16.3% (95%CI: 1.1–31.6), 0.5% (95%CI: 0–1.4) and 0.5% (95%CI: 0.2–0.8), respectively. Based on subgroup analysis, there was a higher proportion of all co-infections from the years 2010–2016 as compared to that of the years 2003–2009. Our results highlighted that HCV/HIV co-infection in Iranian high-risk groups including injection drug users (IDUs) and prisoners is common. In addition, the increasing trend of coinfections should be considered alarming for policymakers.

Prevalence of obesity and overweight in Iranian children aged less than 5 years: a systematic review and meta-analysis / 소아과

PURPOSE: The present study aimed to determine the prevalence of childhood obesity and overweight in Iranian children under 5 years of age using a systematic review and meta-analysis. METHODS: We searched MEDLINE (PubMed), Web of Science, Google Scholar, Scopus, CINHAL, and the Iranian databases, including Scientific Information Database (www.sid.ir), Iranian Research Institute for Information Science and Technology (Irandoc.ac.ir), Iranmedex (www.iranmedex.com), and Magiran (www.magiran.com), for all articles published between January 1989 and August 2017. Sources of heterogeneity were determined using subgroup analysis and meta-regression. RESULTS: Six articles were ultimately included in the meta-analysis to estimate the pooled prevalence, based on which the prevalence of obesity and overweight were estimated to be 8% (95% confidence interval [CI], 6%–10%) and 9% (95% CI, 7%–11%), respectively. The results of the subgroup analysis showed that the prevalence of obesity in boys and girls was 9% (95% CI, 6%–13%) and 7% (95% CI, 4–10%), respectively, and the prevalence of overweight in boys and girls was 10% (95% CI, 5%–15%) and 9% (95% CI, 5%–13%), respectively. CONCLUSION: Despite high heterogeneity among the results of the articles included in the meta-analysis, the prevalence of obesity and overweight is higher in Iranian children under 5 years of age. Therefore, parents and the health system must pay more attention to the lifestyle, nutritional habits, and physical activity of these children.

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.

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.

Prevalence of underweight and wasting in Iranian children aged below 5 years: a systematic review and meta-analysis / 소아과

PURPOSE: Wasting and underweight are the 2 main indicators of children’s undernutrition. We aimed to estimate the prevalence of undernutrition at the national level in Iran. METHODS: We performed a search for original articles published in international and Iranian databases including MEDLINE, Web of Science, Google Scholar, Scopus, CINHAL (Cumulative Index to Nursing and Allied Health Literature), Scientific Information Database, Irandoc, Iranmedex, and Magiran during January 1989–August 2017. Seven keywords, in English and Persian, including malnutrition, protein energy malnutrition, growth disorders, underweight wasting, weight loss, children below 5 years old, and children, were used to search the databases. RESULTS: Finally, 17 articles were included in the meta-analysis, based on which the prevalence of underweight and wasting in Iranian children were estimated to be 11% and 5%, respectively. The prevalence rates of underweight among children in the central, western, southern, and northern parts of Iran and at the national level were 24%, 5%, 20%, 17%, and 6%, respectively. The prevalence rates of wasting in the central, western, southern, and northern parts of Iran and at the national level were 9%, 4%, 11%, 5%, and 4%, respectively. CONCLUSION: Although the prevalence of underweight and wasting in Iran was low, some parts of the country showed high prevalence. The main reason behind this difference in the prevalence of malnutrition may be due to the level of development in different regions.

Application of the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) to patients with endometriosis

OBJECTIVE: Endometriosis, a common hormone-dependent chronic inflammatory disease causes various symptoms including pelvic pain, which affect the physical and psychological quality of life in women of reproductive age. The present study aimed to assess the quality of life of Iranian women with endometriosis using the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) questionnaire. METHODS: This cross-sectional study performed in Tehran between October 2014 and July 2016 included 70 Iranian women with endometriosis. The Iranian version of the WHOQOL-BREF questionnaire was used to measure quality of life in these women. The Pearson's correlation coefficient, the paired and the independent t-tests, and a linear regression model were used to statistically analyze the data using the SPSS software version 16.0. RESULTS: The total mean score of the WHOQOL-BREF questionnaire was 80.58. The highest and the lowest mean scores were observed in the environmental (28.15) and the physical health domains (10.59), respectively. A multiple linear regression model (backward method) showed that insurance coverage was associated with the total WHOQOL-BREF score, whereas age, insurance coverage, and income level were associated with domains 1 through 4, respectively (P < 0.05). CONCLUSION: Endometriosis affects various aspects of the quality of life of Iranian women who therefore require holistic management focused on both, the physical and psychological aspects of treatment.

Letter to the Editor: Postpartum modern contraceptive use in northern Ethiopia: prevalence and associated factors - methodological issues in this cross-sectional study / 한국역학회지

No abstract available.

Geographic distribution of the incidence of colorectal cancer in Iran: a population-based study / 한국역학회지

OBJECTIVES: Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer death in the world. The aim of this study was to investigate the provincial distribution of the incidence of CRC across Iran.METHODS: This epidemiologic study used data from the National Cancer Registry of Iran and the Center for Disease Control and Prevention of the Ministry of Health and Medical Education of Iran. The average annual age-standardized rate (ASR) for the incidence of CRC was calculated for each province.RESULTS: We found that adenocarcinoma (not otherwise specified) was the most common histological subtype of CRC in males and females, accounting for 81.91 and 81.95% of CRC cases, respectively. Signet ring cell carcinoma was the least prevalent subtype of CRC in males and females and accounted for 1.5 and 0.94% of CRC cases, respectively. In patients aged 45 years or older, there was a steady upward trend in the incidence of CRC, and the highest ASR of CRC incidence among both males and females was in the age group of 80-84 years, with an ASR of 144.69 per 100,000 person-years for males and 119.18 per 100,000 person-years for females. The highest incidence rates of CRC in Iran were found in the central, northern, and western provinces. Provinces in the southeast of Iran had the lowest incidence rates of CRC.CONCLUSIONS: Wide geographical variation was found in the incidence of CRC across the 31 provinces of Iran. These variations must be considered for prevention and control programs for CRC, as well as for resource allocation purposes.

Geographic distribution of the incidence of colorectal cancer in Iran: a population-based study / 한국역학회지

OBJECTIVES: Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer death in the world. The aim of this study was to investigate the provincial distribution of the incidence of CRC across Iran. METHODS: This epidemiologic study used data from the National Cancer Registry of Iran and the Center for Disease Control and Prevention of the Ministry of Health and Medical Education of Iran. The average annual age-standardized rate (ASR) for the incidence of CRC was calculated for each province. RESULTS: We found that adenocarcinoma (not otherwise specified) was the most common histological subtype of CRC in males and females, accounting for 81.91 and 81.95% of CRC cases, respectively. Signet ring cell carcinoma was the least prevalent subtype of CRC in males and females and accounted for 1.5 and 0.94% of CRC cases, respectively. In patients aged 45 years or older, there was a steady upward trend in the incidence of CRC, and the highest ASR of CRC incidence among both males and females was in the age group of 80-84 years, with an ASR of 144.69 per 100,000 person-years for males and 119.18 per 100,000 person-years for females. The highest incidence rates of CRC in Iran were found in the central, northern, and western provinces. Provinces in the southeast of Iran had the lowest incidence rates of CRC. CONCLUSIONS: Wide geographical variation was found in the incidence of CRC across the 31 provinces of Iran. These variations must be considered for prevention and control programs for CRC, as well as for resource allocation purposes.

Letter to the Editor: Postpartum modern contraceptive use in northern Ethiopia: prevalence and associated factors - methodological issues in this cross-sectional study / 한국역학회지

No abstract available.

Avoidable Burden of Risk Factors for Serious Road Traffic Crashes in Iran: A Modeling Study / 예방의학회지

OBJECTIVES: The aim of this study was to model the avoidable burden of the risk factors of road traffic crashes in Iran and to prioritize interventions to reduce that burden. METHODS: The prevalence and the effect size of the risk factors were obtained from data documented by the traffic police of Iran in 2013. The effect size was estimated using an ordinal regression model. The potential impact fraction index was applied to calculate the avoidable burden in order to prioritize interventions. This index was calculated for theoretical, plausible, and feasible minimum risk level scenarios. The joint effects of the risk factors were then estimated for all the scenarios. RESULTS: The highest avoidable burdens in the theoretical, plausible, and feasible minimum risk level scenarios for the non-use of child restraints on urban roads were 52.25, 28.63, and 46.67, respectively. In contrast, the value of this index for speeding was 76.24, 37.00, and 62.23, respectively, for rural roads. CONCLUSIONS: On the basis of the different scenarios considered in this research, we suggest focusing on future interventions to decrease the prevalence of speeding, the non-use of child restraints, the use of cell phones while driving, and helmet disuse, and the laws related to these items should be considered seriously.

Application of the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) to patients with cataract / 한국역학회지

OBJECTIVES: Cataract is a prevalent disease in the elderly, and negatively influences patients' quality of life. This study was conducted to study the application of the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF) to patients with cataract. METHODS: In this cross-sectional study, 300 patients with cataract were studied in Neyshabur, Iran from July to October 2014. The Iranian version of the WHOQOL-BREF questionnaire was used to measure their quality of life. Cronbach's alpha coefficient, Pearson's correlation coefficient, the paired t-test, the independent t-test, and a linear regression model were used to analyze the data in SPSS version 16.0 (SPSS Inc., Chicago, IL, USA). RESULTS: The mean age of the participants was 68.11±11.98 years, and most were female (53%). The overall observed Cronbach's alpha coefficient for the WHOQOL-BREF was 0.889, ranging from 0.714 to 0.810 in its four domains. The total mean score of the respondents on the WHOQOL-BREF was 13.19. The highest and lowest mean scores were observed in the social relationship domain (14.11) and the physical health domain (12.29), respectively. A backward multiple linear regression model found that duration of disease and marital status were associated with total WHOQOL scores, while age, duration of disease, marital status, and income level were associated with domains one through four, respectively (p<0.05). CONCLUSIONS: The reliability analysis conducted in this study indicated that the WHOQOL-BREF scale exhibited an acceptable degree of internal consistency in the measurement of the quality of life of patients with cataract. It was also found that the patients with cataract who were surveyed reported a relatively moderate quality of life.