The Role of Age, Period, and Cohort Effects on Smoking among the Students of Tehran University of Medical Science

The aim of the study is to determine age, period, and cohort effects on trends in student’s cigarette smoking in Tehran University of medical science from 2006 to 2009. We analyzed data from subjects aged 18 to 23 years from Aids Researches Center with Cooperation Environment Researches Center and Accessory collegian. Intrinsic Estimator was used for analysis, that is a new method for resolving linear dependency between age, period, and cohort in linear regression models. In the present study, age effects exhibited increased for both sexes. Also, aging proportion of smoking increased. For both sexes log coefficients were negative at young ages. Period effects for females showed declines but for males there was no significant difference. Cohort effects for females were small and gradual declines were shown for male cohorts. Proportion of smoking at young cohorts was less than old cohorts and log coefficients were negative.There was an increasing trend on age effect .Although a reduction period effect was observed from 2006 to 2009 in females that can be due to utilizing smoking policies in previous years but such a trend was not showed for males. Cohort effect was observed for males and smoking proportion at young cohorts was less than old cohorts

HIV, hepatitis C virus, and hepatitis B virus co-infections among injecting drug users in Tehran, Iran

SummaryObjectivesTo assess the prevalence of HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and co-infections among injecting drug users (IDUs) in Tehran.MethodsA sample of 899 IDUs (861 male and 38 female) was recruited in Tehran from treatment and harm reduction facilities and from drug user hangouts in public areas in equal proportions. ELISA testing for HIV, HCV antibody (HCV-Ab), hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (HBcAb) was carried out. Positive HIV tests were rechecked by Western blot.ResultsThe prevalence of HIV was 10.7%, HCV infection was 34.5%, and past or current HBV infection was 50.7%. Infection with all three viruses was seen in 6.5% (95% confidence interval 4.9–8.2) of participants. HIV/HCV, HIV/HBV, and HBV/HCV co-infections were seen in 8.7%, 7.8%, and 21.0% of participants, respectively. The rate of HCV infection among HIV-positive cases was significantly higher than in HIV-negative IDUs (80.6% vs. 28.7%, p<0.0001). There was no significant association between these infections and co-infections with gender and source of sampling.ConclusionIn general, co-infection with these three blood-borne viruses is common among IDUs. Since co-infection increases the morbidity and mortality of all infections, the observed level of co-infection in the high number of IDUs in Iran necessitates a serious comprehensive response

Mental health services for youth in the Eastern Mediterranean Region: Challenges and opportunities (Editorial)

The Global Burden of Disease study shows that the burden from mental and substance use disorders, measured in Disability Adjusted Life Years (DALYs), has steadily risen in the Eastern Mediterranean Region (EMR) over the last three decades and is higher than the global average for almost all EMR countries). Even more alarming is the finding that depression, self-harm, anxiety and conduct disorders constitute four of the top 10 causes of DALYs among girls and boys aged 15-19 years and suicide is a leading cause of adolescent mortality

Blended smartphone intervention for patients in opioid maintenance treatment in Iran: protocol for a randomized controlled trial

Background The pattern of substance use in Iran is characterized by a high prevalence of opioid use and opioid use disorder (OUD). Although opioid maintenance therapy (OMT) has been introduced in Iran, approximately 50% of people with opioid use disorder remain unreached. Moreover, psychosocial treatment of OUD and common mental health symptoms during OMT is limited. Digital interventions have been shown to improve psychological distress, depression, anxiety, and post-traumatic stress disorder symptoms. In addition, providing psychoeducation and risk reduction counseling to prevent communicable diseases like HIV and infectious hepatitis is common via the Internet. However, despite these promising advances, no smartphone intervention in OMT has been investigated for the treatment of OUD and common comorbid mental health symptoms. Objective We examine the effectiveness of adding a blended smartphone intervention based on community reinforcement approach, motivational interviewing- and cognitive behavioral therapy compared to OMT as usual that aims to improve OMT outcomes and addresses common mental health symptoms in OMT patients in Iran. Method Adults with opioid dependence entering 8 treatment centers in Tehran, Iran will be randomly assigned to receive either OMT plus a smartphone intervention or OMT as usual. The primary outcomes will be the percentage of negative urine tests for illicit, non-prescribed use of opioids (opium, heroin, tramadol) and treatment retention. Secondary outcomes will include the longest period of abstinence from the illicit, non-prescribed use of opioids (opium, heroin, and tramadol) confirmed by urine samples, changes in communicable disease risk-taking behaviors, changes in stress and common mental health symptoms, and client satisfaction. Data analysis will follow the intention-to-treat principle and employ (generalized) linear mixed models. Discussion This study will provide substantial knowledge for designing effective blended interventions for OUD. Moreover, it will investigate if treatment retention and OMT-related outcomes and common mental health symptoms can be improved by adding a smartphone intervention to OMT. Trial Registration https://en.irct.ir/trial/53578

A Scientometric Study of Iranian Scientific Productions in the Field of ‎Substance Use and Addiction Research in the Years 2008 to 2012‎

Background: We aimed to evaluate the current status of scientific production in the field of substance use and addiction in Iran, to determine its trend and pattern during a 5 years period (2008-2012). Methods: Using relevant keywords, we searched three international databases (Web of Science, Medline, and Scopus) and two local databases (SID and Iranmedex) to locate the papers published in the field of addiction by Iranian researchers during 2008-2012. Findings: The results indicated a significant increase in the number of studies published in the field during the 5 years study period, with more than half of the papers published in the last 2 years. Results also indicated that over half (53.5%) of the papers were published in Persian-language Iranian Journals, but the rate of increase in the number of papers published in English was slightly higher than that of Persian ones. Opioid substances were found to be the topic of approximately 75% of the papers. Studies on key topics, including national surveys, evaluation of current programs, addiction in women and children, and so forth, were found to be highly lacking. Conclusion: Results suggested a significant growth in the scientific production of Iran in the field of substance use and addiction. However, considering the significance of substance use and dependence in the country, and compared to the scientific production of developed countries, the amount of research conducted in the field of addiction in Iran is still limited

The change in attitude and knowledge of health care personnel and general population following trainings provided during integration of mental health in Primary Health Care in Iran: a systematic review

<p>Abstract</p> <p>Background</p> <p>Mental health has been integrated in the primary health care program in small cities and villages of Iran in a national level since the late 1980s. We performed a systematic review of literature to investigate the effect of education on change in attitude and knowledge of mental health care providers and the population covered in the program during the recent two decades in Iran.</p> <p>Methods</p> <p>Electronic bibliographic databases including Pubmed, PsycINFO and EMBase as well as the main Iranian databases (Scientific Information Database, IranMedex, IranPsych, and IranDoc) were searched. Additionally, hand searching, personal contacts and tracking of reference lists were performed. All of the studies which compared the attitude and knowledge of the related population before and after an educational intervention were recruited.</p> <p>Results</p> <p>Six articles met the inclusion criteria and entered the review. All of these studies showed an improvement in the attitude and knowledge of the studied population. Although the studies were different in many respects, a meta-analysis on the two more similar studies showed a significant effect of training on long term improvement of the knowledge and attitude of the population.</p> <p>Conclusion</p> <p>A short term training improved knowledge and attitude of the population and health personnel immediately after the intervention. There is also evidence for a long term change in the attitude and knowledge of general population after short term training.</p

Inclusion of gaming disorder in the diagnostic classifications and promotion of public health response

There are ongoing controversies regarding the upcoming ICD-11 concept of gaming disorder. Recently, Aarseth et al. have put this diagnostic entity into scrutiny. Although we, a group of Iranian researchers and clinicians, acknowledge some of Aarseth et al.’s concerns, believe that the inclusion of gaming disorder in the upcoming ICD-11 would facilitate necessary steps to raise public awareness, enhance development of proper diagnostic approaches and treatment interventions, and improve health and non-health policies

A Six-Year Follow-up of People Who Use Cannabis in Iran – A Case Series

Background: Frequent cannabis use is associated with adverse health-related outcomes. This study followed up individuals who used cannabis to assess their use and adverse event status. Methods: The eligible individuals, recruited in the Iranian Mental Health Survey (IranMHS), were contacted via telephone calls six years after the index interview. The frequency of cannabis use and the occurrence of selected adverse events were recorded. The baseline status was extracted from the index survey. If any individual was inaccessible, his/her vital status was assessed.  Findings: Of the 50 eligible individuals (all male), two had died. Moreover, from among 25 reached participants, 19 reported abstinence from cannabis in the past year, and 18 reported at least one adverse event in the past six years. Violence and imprisonment were the most common events reported.  Conclusion: Six years after the index interview, most of the participants abstained from cannabis. Besides, adverse events were common, emphasizing the need for further investigations on larger samples of cannabis users

Validity of self-reported substance use : research setting versus primary health care setting

Funding Information: This study has been supported by the Vice Chancellery for Research & Technology of Rafsanjan University of Medical Sciences. The context of this article are the views of the authors and the funder had no role in design of the study and collection, analysis, and interpretation of data, decision to publish and writing the manuscript. Acknowledgments The Rafsanjan University of Medical Sciences provided funding for this study. Also we thank the people who participated in the study.Peer reviewedPublisher PD