Association of knowledge and attitudes with practices of misuse of tranquilizers: a cohort study in Spain

Tranquilizer misuse represents a growing international public health problem with heavy social and economic consequences. We aimed to identify the psychosocial determinants of this misuse practice, focusing on modifiable factors including knowledge and attitudes towards these medicationsThis study was supported by a grant from the Regional Ministry of Education, Universities and Vocational Training, Santiago de Compostela, Spain, (ED431C 2018/20)S

Effects of a School-Based Interventional Program on Smoking Refusal Self-efficacy in Adolescent Females

smoking. Self-efficacy can be assumed as the best predictor of smoking behavior in adolescents. Aim: The present study aimed to investigate the effects of a school-based interventional program on smoking refusal self-efficacy in adolescent females. Method: This randomized controlled trial was conducted on 53 adolescent females in 2017. The participants were randomly divided into two groups of intervention (n=27) and control (n=26). The intervention group was provided with a smoking prevention program implemented five sessions a week in their school classrooms. On the other hand, the control group received the routine interventions. A researcher-made Smoking Refusal Self-Efficacy Questionnaire was completed before and one month after the intervention. Statistical analysis was performed in SPSS software (version 20.0) using Fisher’s exact test, t-test, and Mann-Whitney U test. Results: According to the results, 9 (34.6%) and 7 (25.9%) individuals in the control and intervention groups had smoking fathers, respectively. The two study groups were homogeneous in terms of smoking refusal self-efficacy before the intervention. Following the intervention, the mean self-efficacy scores in the intervention and control groups were estimated as 111.55±13.1 and 93.53±25.02, respectively. There was a significant difference between the two groups regarding this variable after the intervention (P=0.02). Implications for Practice: The school-based interventional program for smoking prevention in accordance with social skills training could effectively increase the level of smoking refusal self-efficacy in adolescent females

Developing and Examining the Psychometrics of Single-word Quick Repetition Test for Speech Sound Production in Persian-speaking Children

Objectives: The present study aimed to develop and validate a quick repetition test using familiar and culture-based words for assessing Persian-speaking children with Speech Sound Disorders (SSDs). Methods: The study sample was divided into two groups, including 419 participants without any clinical signs of speech impairment and 36 cases with SSD. The psychometric properties of the single word quick repetition test, including reliability (inter-rater and test-retest reliability) and validity (construct, discriminant, convergent, clinical and concurrent validity) were examined. Moreover, the descriptive data for children without SSD were reported. Results: The obtained test-retest and inter-rater reliability data were satisfactory with Intraclass correlation coefficient (ICC): >0.7. There was a positive correlation between the results of the quick repetition test and phonetic test, indicating the scale's acceptable convergence validity. Using inflated beta-binomial regression, statistically significant improvement in test score was found with age (discriminant validity). Comparing the correct responses of the control and case groups (clinical validity) revealed a significant difference in responses between the study groups. Results of Bland–Altman plot suggested an acceptable agreement between quick repetition test and phonetic test (construct validity). Discussion: The Persian quick repetition test is a valid and reliable instrument facilitating the screening of speech sound abilities in 3-8-year-olds. Moreover, this test's conciseness makes it easily applicable in clinical practice and epidemiologic investigations. Establishing descriptive data from a large sample facilitated comparing children's speech ability to the speech development standards

Prevalence and Risk Factors of Voice Disorders in University Teaching Faculty Members: A Pilot Study

Voice disorder is a multifactorial impairment. Several studies have shown that there is a direct relationship between voice problems and voice-related jobs. Therefore, professional voice users, including teachers, are at high risk of voice disorders, which threatens the employment positions. Also, the investigation of voice impairments among faculty members seems essential. The purpose of this study is to assess the prevalence of voice disorders in faculty members, its impact on the physical, emotional, and functional status of this job group, with and without voice disorders, and the correlation of voice disorders with some risk factors. Methods The participants of this study were 114 university teaching faculty members of Mashhad University of Medical Sciences, with a mean age of 43.95±0.98 years. The current cross-sectional descriptive-analytical study used a demographic questionnaire and Voice Handicap Index (VHI) as the data collection instruments. In the present study, based on VHI test results, participants with a total VHI score greater than 14.5 are considered to have voice disorders. Results The prevalence of voice disorders among university teaching faculty members was 27.19%. There was a significant correlation between allergy and voice disorders (P= 0.04). Significant differences were also found between the two study groups in terms of the total score of the VHI and its subscales (P <0.001). Conclusions Considering the 27.19% prevalence of voice disorders among university teaching faculty members and its effect on the total VHI score, our results confirm that education, prevention, and treatment programs are critical to lessen the frequency of voice disorders related to teaching. However, it has been found that this job group with voice disorders is four times more likely to have allergies than those without voice disorder, which indicates the importance of controlling this problem

Factors Associated with The Incidence of Coronary Heart Disease in The Mashad: A Cohort Study

Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally, and specifically in Iran. Accurate assessments of Coronary heart disease (CHD) incidence is very necessary for public health. In current study we aimed to investigate the incidence of CHD and importance of several classical, modifiable and un-modifiable risk factors for CHD among an urban population in eastern Iran after 6 years of follow-up. Methods The population of MASHAD cohort study were followed up for 6 years, every 3 years in two step by phone and who reported symptoms of CVD were asked to attend for a cardiac examination, to estimate the incidence of CHD with 95% confidence interval (95% CI) as well multiple logistic regression analysis was performed to assess the association of several baseline characteristics with incidence of CHD event. Evaluation of goodness-of-fit was done using ROC analysis. CHD cases divided into four different classes which include: stable angina, unstable angina pectoris, myocardial infarction and sudden cardiac death. Results In the six years\u27 follow-up of Mashhad study, the incidence rate of all CHD event in men and women in 100,000 people-years with 95% confidence intervals were 1920 (810-3030) and 1160 (730-1590), respectively. The areas under ROC curve (AUC), based on multivariate predictors of CHD outcome, was 0.7825. Conclusion Our findings indicated that the incidence rate of coronary heart diseases in MASHAD cohort study increases with age as well as our final model designed, was able to predict approximately 78% of CHD events in Iranian population

Prediction of neonatal and maternal index based on development and population indicators: a global ecological study

Introduction: Although worldwide maternal and neonatal mortalities have decreased,&nbsp;but Achieving sustainable development goals remains an unfinished agenda and global challenge. This study aimed to predict neonatal and maternal index based on development and demographic indicators.Methods: In this ecologic study, the dependent variables were Maternal mortality ratio (MMR), Neonatal mortality rate (NMR), and Under 5 Mortality Rate (U5MR) and the independent variables were Gender gap index (GGI) and its four components, human development, life expectancy, total fertility rate, and population growth. Data conducted using international secondary data published data bases of health metrics from 2016 to 2018 in 149 countries from WHO (World Health Organization), World Economic Forum, UNICEF (United Nations Children's Fund), and UNDP (United Nations Development Programme). Data analysis was performed using correlation model in Stata version 14.1 software.Results: In this study, economic participation and total fertility rate are positively and educational attainment, Human Capital Index and life expectancy are negatively associated with MMR. Human Capital Index, Educational attainment, and Life expectancy are negatively associated with NMR. Economic participation and total fertility rate are positively and educational attainment, Human Capital Index and life expectancy are negatively associated with U5MR.&nbsp;Discussion: To reduce the maternal and neonatal mortality rate, it is important to pay attention to indirect causes such as equal conditions for men and women to demographic and population indices such as economic participation, educational attainment, Human Capital Index and life expectancy

The maternal near miss incidence ratio with WHO Approach in Iran: A systematic review and meta-analysis

Background: Maternal near miss (MNM) is one of the important criteria for checking the quality of care in maternal health. This systematic review and meta-analysis study was conducted in 2017 to evaluate the incidence ratio of MNM using the World Health Organization approach in Iran. Materials and Methods: This study was designed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for systematic reviews, and Web of Science and PubMed databases were searched systematically, which, respectively, yielded 171 and 137 papers published before June 9, 2017. To include papers written in Persian by Iranian scholars, Google Scholar database was searched and 542 papers were retrieved. Finally, 12 papers which had covered the topic more appropriately were included in the study. Random-effects meta-analysis was used to pool the incidence ratio. Heterogeneity was explored using formal tests and subgroup analyses, then the study quality was also explored. Results: The pooling of overall potentially life-threatening conditions ratio was I2 (97.60%, p < 0.001, ratio = 2.50/1000 live births [LBs] [95% CI: 2.00-3.00]), which is divided into two indicators: severe complication ratio (2.40/1000 LBs) and critical intervention ratio (2.54/1000 LBs). The pooling of overall life-threatening conditions ratio was I2 (95.10%, p < 0.001, ratio = 0.86/1000 LBs [95% CI: 0.64-1.07]). Conclusions: The incidence ratio of MNM needs more attention in Iran. Therefore, it is necessary to identify the factors related to MNM and then implement suitable strategies to reduce the risk factors of the maternal morbidity and improve the quality of maternal care in facilities

The association of mode of delivery and dyspareunia: a systematic review and meta-analysis

This meta-analysis aimed to examine the association between the mode of delivery and dyspareunia worldwide. Epidemiologic studies evaluating the link between the mode of delivery and dyspareunia (published up to July 2019) were included in this research. These studies were selected by searching several databases such as MEDLINE, ClinicalTraial.gov, PubMed, Web of Science, Scopus and Google Scholar and considering the list of selected articles extracted from references. Then, meta-analyses, subgroup analyses and meta-regressions of the studies were conducted to evaluate the association between the mode of delivery and dyspareunia. In this study, 23 out of 1099 articles were identified and used in the final analysis. Dyspareunia differed according to the mode of delivery although this difference was not statistically significant. In terms of the mode of delivery, a difference was found between instrumental vaginal delivery and caesarean section, but it was not significant. It seems that more studies with a larger sample size should be considered to determine the difference

Providing an imputation algorithm for missing values of longitudinal data using Cuckoo search algorithm: A case study on cervical dystonia

Background: Missing values in data are found in a large number of studies in the field of medical sciences, especially longitudinal ones, in which repeated measurements are taken from each person during the study. In this regard, several statistical endeavors have been performed on the concepts, issues, and theoretical methods during the past few decades. Methods: Herein, we focused on the missing data related to patients excluded from longitudinal studies. To this end, two statistical parameters of similarity and correlation coefficient were employed. In addition, metaheuristic algorithms were applied to achieve an optimal solution. The selected metaheuristic algorithm, which has a great search functionality, was the Cuckoo search algorithm. Results: Profiles of subjects with cervical dystonia (CD) were used to evaluate the proposed model after applying missingness. It was concluded that the algorithm used in this study had a higher accuracy (98.48%), compared with similar approaches. Conclusion: Concomitant use of similar parameters and correlation coefficients led to a significant increase in accuracy of missing data imputation

Using quadratic inference functions to determine the factors associated with obesity: findings from the STEPS Survey in Iran

Purpose: The last study that had a representative sample of the Iranian population and examined the association between sociodemographic and lifestyle factors with obesity used data from the 1999 to 2000 National Health Survey in Iran. Concern about the increased prevalence of obesity has heightened interest in the association between varieties of these factors with obesity among Iranian households. Methods: Data (20,917 adults) were taken from the 2009 STEPwise approach to Surveillance survey in Iran that was conducted under the supervision of World Health Organization. Using quadratic inference function, we evaluated the relation of age, sex, physical activity, serving of fruit and vegetable, employment status, smoking, and place of residence with obesity. Results: Using 20–30 years as the reference group, the obesity odds ratios (ORs) were 2.48, 3.79, 3.52, and 3.15 for ages 30–40, 40–50, 50–60, and 60+ years, respectively. Obesity OR for female was 2.63, compared with male. Obesity ORs for smokers and ex-smokers were 0.64 and 1.18, respectively, compared with nonsmokers. Among Iranian adult, obesity ORs for the moderate and vigorous physical activity were 0.99 and 0.90, respectively, compared with low level. The estimated odds of obesity were 46% higher for rural adults. Obesity ORs for public and private employed were 0.79 and 0.76, respectively, compared with unemployed. Conclusions: Our results may provide better insights of the factors associated with obesity and can be used as a basis to reinforce health programs to prevent obesity in Iran