Testing the Equivalence of Survival Functions of HIV/AIDS Data

For establishing equivalence of survival functions of HIV/ AIDS data, log-rank test, the confidence interval procedure and Cox model procedure which are based on proportionality assumption were employed. Since proportionality assumption may not hold in some cases, attempt is made to develop a general procedure for testing the equivalence of survival time by a simple modification of Cox model

A New Scale for Measuring the Socio-economic Status in Health Studies Conducted in Tehran

Introduction: One of the most important determinants in health studies is health-related socio-economic status. The precise determination of health-related socio-economic classes is contingent upon updating the data and taking new cultural, social, and health factors. The objective of this study is to provide a practical method for determining the index and health-related socio-economic classes of the subjects under study. Materials and Methods: A questionnaire containing 68 items was developed as a tool to assess the socio-economic status index related to health. Data were collected from six hundred and four married individuals who were randomly recruited from the city of Tehran. To identify the prognostic variables of the model, linear regression method was used. Predicted values of the index were obtained using the model. Then, boundary lines were proposed to determine the five socio-economic classes using the K-means cluster method. Results: Education, employment, internet access at home, use of supplementary health insurance, and time spent in virtual reality (cyberspace) were among the significant variables. Conclusion: The socio-economic class determination table at the end of the manuscript presents a step-by-step method for calculating the index and determining the desired class with respect to gender

Reliability of functional connectivity in resting-state functional MRI

     Functional MRI is a noninvasive method in brain imaging. Localization, classification, prediction and connectivity are the most common issues. Functional connectivity is a branch of fMRI that focuses on connectivity between voxels and ROIs. There are several methods for investigating functional connectivity such as correlation analysis. In any field, it is very important that results of any research have reliability according to the experiment. Any methods and measurement instruments need to be reliable. Without reliability, results are meaningless and our research is not trustworthy. Brain imaging can be used as a valuable tool for pre-surgical planning, so the results should be highly reproducible. Test-retest reliability can be explored using the intra-class correlation coefficient (ICC). I2C2 is an extent of ICC to verify the reliability in high-dimensional data as imaging studies. 13 subjects of test-retest resting-state fMRI are used to investigate reliability. I2C2 of four ROIs are also computed (Caudate, Cingulate, Cuneus and Precentral regions). Functional connectivity is found to have moderate reliability ranging 0.6244 to 0.6941. 95% confidence interval of I2C2 is calculated by nonparametric bootstrap in which CI of Caudate region I2C2 has the shortest length.

The Effect of a Peer-Group Support Intervention Program on the Tensions of Mothers with Premature Neonates Admitted to the Intensive Care Units in Babol, Iran

Abstract Introduction: Admission of premature neonates to the neonates intensive care unit (NICU) encounters mothers with tension, which affects mother-neonate relationship. The current study aimed at investigating the impact of peer support on the tension of mothers of premature infants admitted to NICUs of the selected hospitals in Babol, Iran. Methods: The current before-and-after, two-group, quasi-experimental study, was conducted on 40 mothers with neonates who recently admitted to NICU in order to participate in peer-group support program. The amount of tension in the study participants was measured, before and after the intervention and the results were compared with those of the control group, using parental tension scale: NICU. Results: The average tension in the intervention and control groups before and after the intervention, and comparison of measures between the groups were125.2 (23.10), 135.2 (19.88), 33.35 (8.19), and 49.40 (18.63), respectively. There was a significant difference between the mean score of tension before and after the intervention in both the study groups. There was no significant difference in tension scores between the two groups, before and after the intervention. Conclusions: Hospitals should meet the requirements o

On the estimation of survival time and contributory risk factors in the elderly participants in the Tehran lipid and glucose study. A 10-year follow-up

ABSTRACT       In the increasing population of the elderly in Iran, so far no prospective health studies have been undertaken.  This study was conducted to identify the risk factors of survival time of the elderly of ages above 60 years. Material and Methods: Individuals above 60 years old were recruited in the primary phase of the Tehran Lipid and Glucose Study (TLGS) during 1998-2001. They were followed up for 10 years and their vital status were registered (1998-2008).  Age and sex mortality rates for age groups (60-69, 70-79, 80+) were calculated and by using Cox proportional hazard model the hazard rates were estimated. Results: Out of 929 males, 154 (17%) and out of 869 women 85(10%) died during the follow-up years. Cox model showed that diabetes on an average reduces 4.4 years and 2.5 years and smoking reduces 5 and 6.6 years of males' and females' survival time, respectively. BMI>33Kg/m2 and dis-lipoproteinemia reduce 4.5 years and 4 years of women's life span.  Tehranian native men on an average live 3 years shorter than other male residents. In addition, hypertension and history of MI, stroke or sudden death of father, brother or son reduce 3.3 years and 4.1 years of men's life time. Conclusion: The elderly population is in need of a healthy ageing to be gained from prevention and intervention. Identification of life time reducing risk factors of elderly helps the policymakers to develop some protocols to increase the life span of the population.

Auditing Palliative Care Provided by Nurses for Chronic Pain Management in the Elderly

AbstractIntroduction: Pain is the most common mental pressure in the elderly and its abstract nature makes it a challenging subject to study. Conformity of palliative care management was examined with standards.Methods: Through a descriptive audit study, 210 elderly patients with chronic pain, who were candidates for palliative and curative care, were examined. A researcher-designed checklist of standard health care for pain management and McGill pain questionnaire were used for data gathering. Data analyses were performed using descriptive statistics and estimating conformity of the pain management measures with standards of SPSS (18).Results: Checking records of painkillers (60%) and reporting the patient’s pain to the physician (74.8%) were the most efficient palliative and curative measures, respectively. Surveying pain (41.9%) and introducing oneself to the patient (42.4%) were the least efficient healthcare services. In addition, palliative measures (24.73%) and drug-intervention measures (30.93%) had little conformity with the pain management standards.Conclusions: Pain management care provided for the elderly has a long way to meet standards. This notable difference can be rooted in the abstract nature of pain and lack of knowledge of the medical team about palliative and curative measures for pain managemen

Evaluation and comparing rectum and bladder's clinical complications in pelvis radiotherapy in order to treat prostate cancer by using custom block and MLC for three- dimensional conformal radiotherapy

       Ionization radiation caused to incidence of complications in the exposed organs. In prostate radiotherapy, rectum and bladder have been radiated unwantedly and indicated some complications during and after treatment. The purpose of present study is to consider and to compare clinical complications of rectum and bladder in custom block and MLC for 3- D conformal radiotherapy, in order to determine if both treatments differ with respect to creating radiation protection, subsequently in the incidence of complications. In this respect, 72 patients with prostate cancer classified into two arms, above 60 years without the history of previous radiotherapy, hormone therapy and surgery, were selected randomly in October 2014. In one arm, patients were treated with block 3- D conformal radiotherapy, and in second arm with MLC outbound technique for 3- D radiotherapy. Rectal and bladder clinical complications were recorded before, during (at the end of 10 treatment sessions), 3 and 6 months after treatment then compared based on tables (RTOG/ LENT).Obtained results showed that patients had a significant difference in such complications as urinary frequency after 10 treatment sessions, 3 months after treatment (p<0.02 and p<0.04, respectively)   Also, patients had a significant difference in regard to dysuria at the end of treatment (p<0.02). In both arms, patients had a significant difference in constipation after 30 sessions also at the end of treatment (p<0.02, p<0.02, respectively).In comparing different grades of complications based on RTOG/ LENT tables, it was not observed a significant difference between patients' complications in both arms

Effect of Reflexology on the Side Effects of Chemotherapy in Cancer Patients: An Integrative Review

Background: The global cancer incidence and the number of survivors are increasing. Therefore, it is necessary to pay more attention to the side effects of treatment. Aim: The aim of this study was to assess the effect of reflexology on the side effects of chemotherapy in cancer patients. Method: For finding the related articles, the researchers searched several databases including PubMed & ProQuest and valid websites including ScienceDirect, Google Scholar, Scientific Information Database, and Magiran. The key terms of “reflexology, cancer, and chemotherapy” individually and combined together were searched in Parisian and English, and the studies performed from 2009 to 2018 were extracted. Due to the lack of sufficient studies carried out into the outcome of reflexology on chemotherapy, both Persian and English articles were used. Results: A total of 57 studies were extracted from the databases and valid websites; five of which met the inclusion criteria. All selected studies were clinical trials. Implications for Practice: Reflexology can be used as a non-pharmacologic nursing intervention to alleviate the side effects of chemotherapy and improve the quality of life of cancer patients

An integrative review of multistage clinical trials

Introduction: Clinical trials have long been vital to advancing how to prevent, diagnose, and treat diseases. However, traditional clinical trials can be difficult and slow. With application to precision medicine, new concepts in clinical trial design increase the speed and flexibility of clinical trials, increasing the likelihood that a trial will benefit the most people who participate.   Methods: In today's world, with the change in lifestyle, we are facing the spread of various diseases. and doctors make many treatment decisions in different stages of the disease.   In practice, these multiple treatment decisions are how doctors treat, but statistically, this is a dynamic treatment regimen (DTR ). Effective DTRs can be developed and studied in clinical trials called sequential multiple Assignment randomized trials (SMART).   Results: A total of 29 studies were extracted from reliable databases and websites, and we reviewed research related to SMART.   Discussion: In this research, we first introduced SMART and then compared SMART and several RCT plans. By doing these comparisons, we showed more the unique features of SMART in the family of RCT designs and we also examined the researches related to the topic of SMART.   Conclusion: Considering that most experiments are done in one step and ignore the intermediate events and focus on the final event. Introducing SMART plans and the concept of DTRs is important for researchers and clinical colleagues, as treatment guidelines must encompass entire treatment regimens to be useful to clinicians and patients.       &nbsp