Psychometric properties of the king spiritual intelligence questionnaire (KSIQ) in physical veterans of Iran-Iraq warfare

Aims: The study's purpose was to determine reliability and validity of the King spiritual intelligence questionnaires in veterans of Iran-Iraq Warfare. Methods: In this cross sectional study, 300 veterans of the Iran-Iraq war completed the King spiritual intelligence questionnaires. Principal components analysis (PCA) with varimax rotation was used to assess domain structure of the King spiritual intelligence questionnaires. Internal and external consistency reliability was assessed with Cronbach's alpha and intra-class correlation coefficient (ICC). Results: Internal consistency of King spiritual intelligence questions estimated with Cronbach's alpha, 0.872 and intra-class correlation coefficient (ICC).872 (CI 95%: 0.84 -0.89). The construct validity of the questionnaire was calculated using exploratory factor analysis that showed 3 factors with Eigen values of greater than one, which explained in total 44.7% of the variance. (1, 8 items, α= 0.87; 2, 5. items; α = 0.89; 3, 2 items, α= 0.51). Conclusion: The Persian version of King spiritual intelligence questionnaire demonstrated suitable validity and reliability among the Veterans of Iran-Iraq Warfare. With the consideration of the proper psychometric characteristics, this questionnaire can be used to further research spiritual intelligence in this population

Assessment of seasonal and climatic effects on the incidence and species composition of malaria by using GIS methods

Malaria is highly dependent on climate and environmental factors. This thesis incorporates environmental and climatic factors into mathematical and geographic information system (GIS) models in order to assess the feasibility of an early warning system in a strongly seasonally transmitted region in Iran. It also measures Plasmodium spp interactions through meta­ analysis, modelling, and further analysis of a large epidemiological dataset. The first part of the thesis assesses the feasibility of malaria prediction models based on ground climate and remote sensing data. Predicted values were typically extrapolated from the previous month’s data; adding ground climate data can improve these predictions by around ten percent. Predictive variables for these models are readily available in the field, so an improvement of even a few percent makes them feasible. However, more ground climate data are needed for prediction at finer than district spatial scales. The second part of the thesis measures interactions between malaria species. A systematic literature review and meta-analysis assessed the heterogeneity of interaction terms between malaria species. Mathematical models assessed the effects of within-population heterogeneity in infection risks. Finally, data from a large epidemiological study in a highly malaria- endemic area (Garki, West Africa) were analysed cross-sectionally and longitudinally. Random-effect meta-analysis produced a summary OR between P. falciparum and P. vivax of less than one (0.6, 95% Cl 0.46-0.8). The very 2 wide range of ORs seen between studies (0.02 to 10.9) could be explained partly by species prevalence and the temporal span of studies. Mathematical models indicated that within-population heterogeneity in infection risks may, by itself, explain ORs as great as ten or more. Longitudinal analysis of the Garki data produced lower ORs than those from cross-sectional analysis. P. falciparum had suppressive effects on the other species. In addition, Plasmodium spp interactions highly depend on subject age and the temporal and spatial distribution of species. In conclusion, heterogeneity in infection risks, due to heterogeneity either in acquired immunity or in exposure risk, is the most important factor on interactions between Plasmodium spp. Finally, it seems that species-specific models would improve the predictions due to the different impacts of climate on the transmission of species and the interaction between the

Prevalence and intensity of catastrophic health care expenditures in Iran from 2008 to 2015: a study on Iranian household income and expenditure survey.

BACKGROUND: Households exposure to catastrophic health expenditure is a valuable measure to monitor financial protection in health sector payments. The present study had two aims: first, to estimate the prevalence and intensity of catastrophic health expenditures (CHE) in Iran. Second, to investigate main factors that influence the probability of CHE. METHODS: CHE is defined as an occasion in which a household's out-of-pocket (OOP) spending exceeds 40% of the total income that remains after subtraction of living expenses. This study used the data from eight national repeated cross-sectional surveys on households' income and expenditure. The proportion of households facing CHE, as a prevalence measure, was estimated for rural and urban areas. The intensity of CHE was also calculated using overshoot and mean positive overshoot (MPO) measures. The factors affecting the CHE were also analyzed using logistic random effects regression model. We also used ArcMap 10.1 to display visually disparities across the country. RESULTS: An increasing number of Iranians has been subject to catastrophic health care costs over the study period in both rural and urban areas (CHE = 2.57% in 2008 and 3.25% in 2015). In the same period, the overshoot of CHE and the mean positive overshoot ranged from 0.26% to 0.65% and from 12.26% to 20.86%, respectively. The average absolute monetary value of OOP spending per month has been low in rural areas over the years, but the prevalence of CHE has been higher than urban areas. Generally put, rural settlement, higher income, receiving inpatient and outpatient services, and existence of elderly people in the household led to increase in CHE prevalence (p < 0.05). Interestingly, provinces with more limited geographical and cultural accessibility had the lowest CHE. CONCLUSIONS: According to the findings, Iran's healthcare system has failed to realize the aim of five-year national development plan regarding CHE prevalence (1% CHE prevalence according to the plan). Therefore, revision of financial health care protection policies focusing on pre-payments seems mandatory. For instance, these policies should extend the interventions that target low-income populations particularly in rural areas, provide more coverage for catastrophic medical services in basic benefit packages, and develop supplementary health insurance

Correlation of invalidation with symptom severity and health status in fibromyalgia

Objective. Invalidation is a new construct in health psychology, especially in diseases with inherently invisible symptoms such as FM. It can potentially affect both the quality of life and disease severity in patients with FM. This study aimed to investigate the correlation of illness invalidation with health status and symptom severity in FM. Methods. A total of 112 consecutive patients with FM referred to the rheumatology clinic were enrolled. Invalidation was measured by the Illness Invalidation Inventory (3*I). To measure patient status and progress of FM, the Revised Fibromyalgia Impact Questionnaire (FIQR) was used and patients' quality of life was assessed by the 12-item Short Form Health Survey (SF-12). Multiple linear regression analyses were performed and Spearman's correlations were calculated. Results. All the patients were female and aged between 18 and 61 years. No significant differences in discounting and lack of understanding between various sources of invalidation were found. The strongest correlation was observed between FIQR symptom score and discounting by work (r = 0.519, P < 0.05). Multiple linear regression analyses revealed that only discounting from the spouse significantly predicted FIQR total scores of FM patients P = 0.03 (CI 0.28, 10.64). Conclusion. Discounting correlated more strongly with SF-12 subscales and FIQR domains than did lack of understanding. The current study revealed that active negative social responses and the source of invalidation are important in predicting symptom severity and quality of life in FM. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved

What the policy and stewardship landscape of a national health research system looks like in a developing country like Iran: a qualitative study

BACKGROUND: The health research system (HRS) is an important national priority that requires a systematic and functional approach. Evaluating the HRS of Iran as a developing country and identifying its challenges reveals the stewardship-related role in how the whole system is operating well. This study aims to assess the HRS in terms of stewardship functions and highlight the enhancement points. METHODS: This study was carried out between March 2020 and April 2021 using a systematic review and meta-synthesis of evidence to examine the Iranian HRS stewardship challenges and interview 32 stakeholders, using a critical case sampling and snowballing approach which included both semi-structured and in-depth interviews. The interviewees were selected based on criteria covering policy-makers, managers, research bodies and nongovernmental organizations (NGOs) in health research-related fields like higher education, research, technology, innovation and science. All data were analysed using content analysis to determine eight main groups of findings under three levels: macro, meso, and micro. RESULTS: Analysis of the findings identified eight main themes. The most critical challenges were the lack of an integrated leadership model and a shared vision among different HRS stakeholders. Their scope and activities were often contradictory, and their role was not clarified in a predetermined big picture. The other challenges were legislation, priority-setting, monitoring and evaluation, networking, and using evidence as a decision support base. CONCLUSIONS: Stewardship functions are not appropriately performed and are considered the root causes of many other HRS challenges in Iran. Formulating a clear shared vision and a work scope for HRS actors is critical, along with integrating all efforts towards a unified strategy that assists in addressing many challenges of HRS, including developing strategic plans and future-oriented and systematic research, and evaluating performance. Policy-makers and senior managers need to embrace and use evidence, and effective networking and communication mechanisms among stakeholders need to be enhanced. An effective HRS can be achieved by redesigning the processes, regulations and rules to promote transparency and accountability within a well-organized and systematic framework

Effects of aflatoxin B1 on growth performance, health indices, phagocytic activity and histopathological alteration in Fenneropenaeus indicus

Mycotoxins contamination of feedstuff for aquatic animals is common in regions with humid tropical conditions. In this study Indian white shrimp, Fenneropenaeus indicus, (11.79 ± 1.76 g) were fed with diets containing 0, 20, 50, 100, 200, 400, 800 and 1600 ppb levels of aflatoxin B1 (AFLB1) for 8 weeks. Final weight, aflatoxin B1 residue (2-week intervals), Total Hemocyte Count (THC), Total Plasma Protein (TPP), Phagocytic Activity (PA), Survival rate (4-week intervals) were determined. Histopathological alterations in hepatopancreas, midgut and muscle tissues were studied at the end of 4 and 8 weeks. Shrimps fed with the 1600, 800 and 400 ppb concentrations of AFLB1 exhibited slow growth, and more reddish discoloration disseminated over the body at 4th week. Growth parameters, survival rate and health indices (THC, TPP) of F. indicus, are affected by the different doses of AFLB1 in diets. At the end of 8th week, doses of AFLB1 in the diets showed negative correlation to final weight, survival rate, THC and TPP (r = - 0.312, -0.603, -0.237 and - 0.649 at P<0.001, respectively). Moreover, significant histopathological alterations in the hepatopancreas, midgut and muscle tissues of exposed shrimps to different levels of AFLB1 were observed and these alterations are obviously indicated by changes in the health indexes (THC and TPP)

Medical student and academic staff perceptions of role models: an analytical cross-sectional study

BACKGROUND: This study explored the associations between the perceptions of students and the perceptions of academic staff about the characteristics of clinical lecturers at the Department of Internal Medicine at Kerman University of Medical Sciences (KUMS). It also assessed what characteristics constitute a 'role model' from the point of view of students and staff. METHODS: Staff and students were questioned about the characteristics of their colleagues and lecturers, respectively. They were asked about 15 characteristics under four headings: personality, teaching skill, group working and overall performance as a role model. Associations between lecturers' characteristics were explored using Pearson correlation and characteristics were allocated into groups by partition cluster method. In addition, predictors of being a valuable lecturer were assessed using logistic regression analysis. RESULTS: Based on staff responses, the strongest association observed was between honesty and being respectful (r = 0.93, p < 0.0001). Based on student responses, the strongest association observed was between being professional and honesty (r = 0.98, p < 0.0001). None of the correlations between student and staff perceptions were significant for any characteristic. Two groups were recognized among the characteristics. group one contained those characteristics which were related to the lecturer's activity; while the second group contained characteristics that were related to the personality or teaching performance of the lecturer. The predictors of lecturer as 'role model' (i.e., perceptions of students) consisted mostly of characteristics from the first group, while the predictors of a 'role model' by fellow academic staff consisted of characteristics that were in both groups. CONCLUSION: These findings showed considerable differences between the perceptions of students about their lecturers when compared with perceptions of staff about their colleagues. Students were more concerned with the personality of their lecturers, while staff also considered their ideas and behaviors. This suggests that a more comprehensive assessment of a lecturer's performance could be obtained by taking into account feedback from both students and colleagues