Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 435 44 Li-Yuan Sun Dept. of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea. Eun-Whan Lee Dept. of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea. Aqeela Zahra Dept. of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea. Jae-Hyun Park Dept. of Social and Preventive Medicine, Samsung Biomedical Research Institute, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea. 2015 10 14 Background: In order to decrease the burden of cardiovascular disease (CVD), social determinants for CVD risk factors have been extensively studied in developed countries. However, few studies about them have been performed in low-middle-income countries. This study describes factors related to CVD risk factors in low-middle-income countries at a national level. Methods: Data were assembled from international databases for 47 low-middle-income countries and were collected from various sources including WHO, World Bank, and previous studies. Coefficient estimates between male and female CVD risk factor prevalence and each independent variable were calculated via linear regression. Results: Statistically significant inverse associations were observed between adult literacy rate and systolic blood pressure, blood glucose. Pump price for gasoline was negatively associated with blood glucose also. Associations for female unemployment, adult literacy rate, paved roads and urban population, alcohol and western diet were positively associated with CVD risk factors. Unemployment, urban population and alcohol were positively associated with CVD risk factors in males. Conclusion: The effectiveness of intervention program for the prevention of cardiovascular disease in populations in developing countries should be explored, and more attention should be given to women. https://ijph.tums.ac.ir/index.php/ijph/article/view/3610 https://ijph.tums.ac.ir/index.php/ijph/article/download/3610/3285

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 445 57 Jian Jin School of Economics, Hebei University, Baoding, P.R.China. Jianxiang Wang New Campus Administrative Office, Hebei University, Baoding, P.R.China. Xiaoyi Ma School of Economics, Hebei University, Baoding, P.R.China. Yuding Wang School of Economics, Hebei University, Baoding, P.R.China. Renyong Li University of Oulu, FIN 90014 Oulun yliopisto, Finland. 2015 10 14 Background: The Chinese government is trying to achieve the goal of “universal access to basic health care services”. However, the inequality of the distribution of health care resources across the country is the biggest obstacle. This paper aims to explore these inequalities and the extent to which the method of analysis influences the perception. Methods: The indicators of health care resource distribution studied consisted of the number of health care institutions, the number of beds in health care institutions and the number of medical personnel. Data were obtained from the China Statistical Yearbook 2014. The extent of equality was assessed using the Lorenz Curve and Gini Coefficient Method. Results: Health care resource distribution in China demonstrates inequalities. The demographic Gini Coefficients based on the Lorenz Curves for the distribution of health care institutions, beds in health care institutions and medical  personnel are 0.190, 0.070 and 0.070 respectively, while the corresponding Coefficients based on geographical areas are 0.616, 0.639 and 0.650. Conclusion: The equality of China’s demographically assessed distribution of health care resources is greater than that of its geographically measured distribution. Coefficients expressed by population imply there is ready access to healthcare in all regions, whilst the Coefficients by geographical area apparently indicate inequality. This is the result of the sparsity of population. https://ijph.tums.ac.ir/index.php/ijph/article/view/3608 https://ijph.tums.ac.ir/index.php/ijph/article/download/3608/3283

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 458 69 Sadegh Seifpanahi Dept. of Speech & Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Shohreh Jalaie Biostatistics Division, School of Rehabilitation Sciences, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Nikoo School of Rehabilitation Sciences, Hamedan University of Medical Sciences, Hamedan, Iran. Davood Sobhani-Rad Dept. of Speech Pathology, Paramedical Science Faculty, Mashhad University of Medical Sciences, Mashhad, Iran. 2015 10 14 Background: In this systematic review, the aim is to investigate different VHI-30 versions between languages regarding their validity, reliability and their translation process. Methods: Articles were extracted systematically from some of the prime databases including Cochrane, googlescholar, MEDLINE (via PubMed gate), Sciencedirect, Web of science, and their reference lists by Voice Handicap Index keyword with only title limitation and time of publication (from 1997 to 2014). However the other limitations (e.g. excluding non-English, other versions of VHI ones, and so on) applied manually after studying the papers. In order to appraise the methodology of the papers, three authors did it by 12-item diagnostic test checklist in "Critical Appraisal Skills Programme" or (CASP) site. After applying all of the screenings, the papers that had the study eligibility criteria such as; translation, validity, and reliability processes, included in this review. Results: The remained non-repeated articles were 12 from different languages. All of them reported validity, reliability and translation method, which presented in details in this review. Conclusion: Mainly the preferred method for translation in the gathered papers was " Brislin‘s classic back-translation model (1970), although the procedure was not performed completely but it was more prominent than other translation procedures. High test-retest reliability, internal consistency and moderate construct validity between different languages in regards to all 3 VHI-30 domains confirm the applicability of translated VHI-30 version across languages. https://ijph.tums.ac.ir/index.php/ijph/article/view/3606 https://ijph.tums.ac.ir/index.php/ijph/article/download/3606/3281

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 470 8 Chia-Ying Kuo School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan AND Office of Medical Affairs, Shuang Ho Hospital, Taipei Medical University, Taiwan. Hung-Yi Chiou School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan. Jia-Wei Lin Division of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taiwan AND College of Medicine, Taipei Medical University, Taipei, Taiwan. Shin-Han Tsai School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan AND College of Medicine, Taipei Medical University, Taipei, Taiwan AND Dept. of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, Taiwan. Yung-Hsiao Chiang Division of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan. Chien-Min Lin Division of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taiwan. Wen-Ta Chiu School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan. 2015 10 14 Background: A motor vehicle seat belt use law for the driver and front-seat passenger was implemented in Taiwan on June 1, 2001. The purpose of this study was to determine the effect of motor vehicle seat belt use on the severity of traumatic brain injuries because of motor vehicle accidents. Methods: Data were collected from 27 major teaching hospitals four years before June 1, 2001 and until May 31, 2013. A total of 822 brain-injured patients with a mean age of 37.4 (± 13.4) years were included; 251 were injured prior to implementation of the law and 571 after. The Glasgow coma scale was adapted to rate the severity of traumatic brain injury on admission. The Glasgow outcome scale was used to categorize the outcome on discharge. Results: After the seat belt law was implemented, traumatic brain injuries were less severe (P<0.001) and the rates of loss of consciousness, neurologic deficit, intracranial hematoma, craniotomy, and poor physical condition at discharge were all significantly lower (all P< 0.05). Male gender, longer hospital stays, not wearing a seat belt, and injury before the law was enacted were all associated with poorer physical condition at the time of discharge (all P <0.01). Conclusion: Among occupants who survived a motor vehicle accident but had traumatic brain injuries, those who had worn seat belts had a better prognosis. Seat belts remain one of the best methods to reduce both the severity of injuries and the number of fatalities. https://ijph.tums.ac.ir/index.php/ijph/article/view/3604 https://ijph.tums.ac.ir/index.php/ijph/article/download/3604/3279

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 479 85 Donnapa Hongthong Boromarajonani College of Nursing, Phayao, Phayao, Thailand. Ratana Somrongthong College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand. Paul Ward Flinders University, Adelaide, Australia. 2015 10 14 Background: The population prevalence of older people has been growing worldwide. Quality of Life (QoL) among older people is a significant public health concern. Hence, this study aimed to assess level of QoL and factors influencing QoL among rural Thai older people. Methods: The study was undertaken in Phayao Province where is one of the top ten provinces with the highest index of Thai aging. A district in this province was purposively selected to be the study area and the quota-sampling technique was used for sample collection, totally 400 older people participated according to Taro Yamane. The WHOQoL-Old was employed to interview elderly QoL. Multivariate linear regression was performed to determine the factors influencing QoL among the older people. Results: Over two-thirds of older people (68.5%) had QoL at fair level. The vast majority (96%) had high scores for Activity Daily Living (ADL). Approximately one-fifth (20.5%) reported current smoking and 31.7% reported ever drinking during previous year. Following univariate analysis, nine factors – gender, age, education, working, income, present illness, drinking, ADL, and participating in elderly club were identified as being significantly associated with QoL (P <0.05). Multivariate analysis revealed four factors predictive of QoL among elderly: ADL, income, alcohol drinking, and present illness (P < 0.01). Conclusion: Physical function, health status and financial were the predictor of QoL among elderly. Noticeably, drinking was one predictive factor of QoL but only among moderate drinkers. Hence, healthy life style should be considered as key areas in attempts to promote QoL among elderly people. https://ijph.tums.ac.ir/index.php/ijph/article/view/3602 https://ijph.tums.ac.ir/index.php/ijph/article/download/3602/3277

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 486 94 María Morales-Suárez-Varela Unit of Public Health, Hygiene, and Environmental care, Dept. of Preventive Medicine, University of Valencia, Valencia, Spain AND Center for Public Health Research (CSISP-FISABIO), Valencia, Spain. Candelaria Ruso Julve Unit of Public Health, Hygiene, and Environmental care, Dept. of Preventive Medicine, University of Valencia, Valencia, Spain. Agustín Llopis González Unit of Public Health, Hygiene, and Environmental care, Dept. of Preventive Medicine, University of Valencia, Valencia, Spain AND Center for Public Health Research (CSISP-FISABIO), Valencia, Spain. 2015 10 14 Background: The infant-juvenile period is one of high vulnerability during the lifestyles chosen become determining factors for future health status. This study aimed to evaluate lifestyle, specifically eating habits and physical activity, in 5-15-year-olds in Spain and their health status (anthropometry). Methods: This cross-sectional population study with two time points (2006 and 2013) was conducted by compiling data from the Spanish National Health Survey. We used the minor survey, specifically the data from the Health Determinants module, which included 5-15-year-olds. Compiled information was obtained from parents or guardians. Results: The overall overweight and obesity prevalence in Spain (2013) in 5- to 15-year-olds is 24.3%. A drop of 8.2% in meat consumption was found, while overall intake was high. Daily intake of plant-based food (fruit, vegetables, pulses) was low, especially vegetables (32.9%). Increased sedentary lifestyle was observed, probably because the use of communication technologies has increased in recent years (P<0.001). Moreover, watching TV rose to 19.3% for 1 hour/day watching TV on weekdays and to 23.5% at weekends. Conclusion: When comparing the two time points (2006 and 2013), we observed that lifestyle, eating habits and physical activity strongly associated with the Spanish infant-juvenile population’s anthropometry. Mediterranean  diet patterns seem to be abandoned and physical activity is practiced less, which will have a negative impact on future quality of life. https://ijph.tums.ac.ir/index.php/ijph/article/view/3600 https://ijph.tums.ac.ir/index.php/ijph/article/download/3600/3275

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 495 500 Huijie Li Dept. of Epidemiology and Biostatistics, Shandong University, Jinan, P.R. China. Yunping Zhou Zibo Center for Disease Control and Prevention, Zibo, P.R. China. Suyun Li Dept. of Epidemiology and Biostatistics, Shandong University, Jinan, P.R. China. Qiang Wang Dept. of Epidemiology and Biostatistics, Shandong University, Jinan, P.R. China. Lulu Pan Dept. of Epidemiology and Biostatistics, Shandong University, Jinan, P.R. China. Xiaorong Yang Dept. of Epidemiology and Biostatistics, Shandong University, Jinan, P.R. China. Nan Zhang Dept. of Epidemiology and Biostatistics, Shandong University, Jinan, P.R. China. Fan Jiang Dept. of Epidemiology and Biostatistics, Shandong University, Jinan, P.R. China. Mingkui Han Dept. of Epidemiology and Biostatistics, Shandong University, Jinan, P.R. China. Chongqi Jia Dept. of Epidemiology and Biostatistics, Shandong University, Jinan, P.R. China. 2015 10 14 Background: A recent study indicates that the incidence of smoking cessation varies with age. Although nicotine dependence (ND) has been regarded as one of the most significant barriers of successful smoking cessation, few researches have focused on the relationship between nicotine dependence and age. Methods: A cross-sectional study (conducted in 2013) with 596 Chinese rural male current smokers was performed to study the relationship between ND and age. The ND level was assessed using the Fagerström Test for Nicotine Dependence (FTND) scale. The univariate two-degree fractional polynomials (FPs) regression was used to explore the relation of ND to age. Results: The mean of FTND scores in the middle-aged group (45-64 yr old) was higher than that in the younger (<45 yr old) and older groups (≥65 yr old). The FPs regression showed an inverse U-shaped relationship between ND and age. Conclusion: The middle-aged current smokers had higher degree of ND than the younger and the older groups, which showed an inverse U-shaped relationship between ND and age. This finding needs to be confirmed by further researches. https://ijph.tums.ac.ir/index.php/ijph/article/view/3598 https://ijph.tums.ac.ir/index.php/ijph/article/download/3598/3273

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 501 11 Keyhan Ashrafi Dept. of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Farshid Saadat Dept. of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Sandra O'Neill School of Biotechnology, Faculty of Science and Health, Dublin City University, Glasnevin, Dublin, Ireland. Behnaz Rahmati Dept. of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Hadid Amin Tahmasbi Dept. of Microbiology, Faculty of Science, Azad University of Lahijan, Iran. John Pius Dalton School of Biological Sciences, Queen's University Belfast, Medical Biology Centre, Belfast, Northern Irland. Abolhassan Nadim Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences. Iran. Mohsen Asadinezhad Dept. of Biochemistry and Biophysics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Sayed Mahmood Rezvani Dept. of Communicable Diseases Control, Guilan province Health Center, Rasht, Iran. 2015 10 14 Background: The largest global outbreaks of liver fluke disease (Fascioliasis) in humans, caused by species of the genus Fasciola, have occurred in Guilan Province of Iran, affecting more than 15000 people. Although, different aspects of fascioliasis have been the subject of various researches during last two decades, nevertheless no community-based study has been performed in endemic regions of Guilan. The aim of present study was to obtain the basic information needed to develop future control strategies. Methods: Fecal and blood samples were collected from 1,984 volunteers in the Bandar-Anzali district, the region where previous epidemics occurred. Fecal samples were examined by Kato-Katz and formalin-ether methods for the presence of Fasciola eggs. Sera samples were analyzed by ELISA to detect anti-cathepsin L antibodies. Results: Twenty-seven (1.36%) individuals were seropositive, 9 (0.45%) individuals were egg positive (mean egg count  50.7 (±30.36) eggs per gram of faeces) and 30 individuals (1.51%) were positive using both methods. No statistical association was observed between infection and age, gender, location, occupation, educational status and dietary habits. The prevalence of intestinal parasites is also included. Conclusion: Human fascioliasis is hypoendemic in this region and recommends a passive case-finding approach, effective primary prevention measures, health education through mass media and effective veterinary public health measures for control of human disease. https://ijph.tums.ac.ir/index.php/ijph/article/view/3596 https://ijph.tums.ac.ir/index.php/ijph/article/download/3596/3271

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 512 21 Ali Akbari Sari Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Ali Kazemi Karyani Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Seyed Moayed Alavian Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran. Mohamad Arab Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Fateme Rostami Gholmohamadi Vice Chancellery of Treatment, Qazvin University of Medical Sciences, Qazvin, Iran. Satar Rezaei Dept. of Public Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2015 10 14 Background: According to importance of cirrhosis of the liver and the lack of information about the economic burden of the disease, we performed this study to estimate the economic burden of liver Cirrhosis in Iran in 2011. Methods: The cost-of-illness method, based on the human capital theory, has been used. Both direct and indirect costs have been estimated using a prevalence approach and bottom-up method. The inpatient and outpatient records were investigated for obtaining the medical costs. Also, a questionnaire was used for collection the other data such as transportation costs, out of pocket payment and times of inpatients, etc. Costs consisted of expenditures which happened during March 2011 to February 2012 and the perspective of the study was Iranian society. Results: The total cost of the disease was 2014.5 billion Rials (USD164.32 million). Direct and indirect costs were 1384.16 and 630.4 billion Rials (86.7% and 11.3% of the total cost), respectively. Cost due to premature death was USD 38.66 million, included 23.52% of the total cost and 75% of indirect cost. Conclusion: Liver Cirrhosis impose enormous economic burden on Iranian society. Policymakers should therefore take this into consideration and according to available health resources provide services and facilities for the prevention and treatment of the disease https://ijph.tums.ac.ir/index.php/ijph/article/view/3594 https://ijph.tums.ac.ir/index.php/ijph/article/download/3594/3269

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 522 34 Kamran Yazdani Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Saharnaz Nedjat Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran. Masoud Karimlou Dept. of Statistics and Computer, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Hojjat Zeraati Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Kazem Mohammad Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Akbar Fotouhi Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: Few studies use modern approaches to develop a quality of life (QOL) questionnaire with acceptable construct validity, especially in Iran. Our main objective was to construct a new validated and uni-dimensional questionnaire, based on WHOQOL-100, using the Rasch analysis. Methods: In a population-based, cross-sectional study in 2007, 500 Tehran residents aged≥18 were randomly sampled. The Persian version of WHOQOL-100 was used to measure the participants' QOL. After using targeting and person fit analysis, we performed category/threshold ordering, item fit, and differential item functioning analyses, in succession. We used outfit or infit statistics>1.5 and <0.5 for detecting underfit and overfit items/persons, respectively. We also deleted items with disordered category and/or threshold. Person Separation Index and test reliability were also calculated in the datasets. Results: Male to female ratio was 0.98 and the mean age (SD) of participants was 35.1 (12.8) years. Initial analyses showed significant differences in quality of life between age groups (P=0.002), educational levels (P=0.001), and current health status groups (P<0.001). We eliminated 67 persons for under-fitting, 38 items for category and/or threshold disordering, 6 items for under-fitting, and 26 items for item bias. Test reliability for the final 30-item scale was 0.89. Conclusion: We prepared a shortened version of the WHOQOL-100 that is single construct, uni-dimensional and free of item bias or any disordering, according to the Rasch model. https://ijph.tums.ac.ir/index.php/ijph/article/view/3592 https://ijph.tums.ac.ir/index.php/ijph/article/download/3592/3267

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 535 42 Masoumeh Mohajer Rahbari Dept. of Reproductive Health, Student Research Committee, Shahroud University of Medical Sciences, Shahroud, Iran. Mohammad Shariati Dept. of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran. Afsaneh Keramat Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran. Masoud Yunesian Institute for Environmental Research, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Eslami Dept. of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran. Seyed Abbas Mousavi Golestan Research Center of Psychiatry, Golestan University of Medical Sciences, Gorgan, Iran. Ali Montazeri Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran. 2015 10 14 Background: Although the validity of content of program is mostly conducted with qualitative methods, this study used both qualitative and quantitative methods for the validation of content of post marriage training program provided for newly married couples. Content validity is a preliminary step of obtaining authorization required to install the program in country's health care system. Methods: This mixed methodological content validation study carried out in four steps with forming three expert panels. Altogether 24 expert panelists were involved in 3 qualitative and quantitative panels; 6 in the first item development one; 12 in the reduction kind, 4 of them were common with the first panel, and 10 executive experts in the last one organized to evaluate psychometric properties of CVR and CVI and Face validity of 57 educational objectives. Results: The raw data of post marriage program had been written by professional experts of Ministry of Health, using qualitative expert panel, the content was more developed by generating 3 topics and refining one topic and its respective content. In the second panel, totally six other objectives were deleted, three for being out of agreement cut of point and three on experts' consensus. The validity of all items was above 0.8 and their content validity indices (0.8-1) were completely appropriate in quantitative assessment. Conclusion: This study provided a good evidence for validation and accreditation of national post marriage program planned for newly married couples in health centers of the country in the near future. https://ijph.tums.ac.ir/index.php/ijph/article/view/3590 https://ijph.tums.ac.ir/index.php/ijph/article/download/3590/3265

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 543 50 Asieh Ashouri Dept. of Epidemiology and Biostatistics, Faculty of Health, Tehran University of Medical Sciences, Tehran, Iran AND Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran. Amirali Hamidieh Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mahmood Mahmoodi Dept. of Epidemiology and Biostatistics, Faculty of Health, Tehran University of Medical Sciences, Tehran, Iran. Kazem Mohammad Dept. of Epidemiology and Biostatistics, Faculty of Health, Tehran University of Medical Sciences, Tehran, Iran. Molouk Hadjibabaie Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran. Hojjat Zeraati Dept. of Epidemiology and Biostatistics, Faculty of Health, Tehran University of Medical Sciences, Tehran, Iran. Akram Karimi Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ardeshir Ghavamzadeh Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: Cox proportional hazard model is a popular choice in modeling the survival data, but sometimes proportionality assumption is not satisfied. One of the tools for handling the non-proportional effects is the multiplicative-additive model named “Cox-Aalen model”. Recently these flexible regression models developed for competing risks setting. The aim of this paper is showing the application of the multiplicative-additive model in competing risks setting on real bone marrow transplantation (BMT) data when the proportionality assumption is violated. Methods: The data was from a retrospective study on class III thalassemia patients who undergo hematopoietic stem cell transplantation (HSCT) in BMT ward of Shariatei Hospital, Tehran, Iran. The neutrophil engraftment time as the early outcome of HSCT on37 patients who received mesenchymal stem cell infusion (MSC group) compared with 50 patients who did not. We fit the standard proportional models and flexible Cox-Aalen model in the sub distribution hazards. Results: By day 30 after transplantation, the cumulative incidence of neutrophil recovery was 97% (95%CI: 89%- 100%) and 76%(95%CI: 64%-88%) in MSC and control group, respectively. Based on the Cox-Aalen model for cumulative incidence function, the MSC infusion had a significant delay effect on neutrophil engraftment (P=.044). In patients who did not neutrophil recovery immediately after HSCT, those who received MSC had faster recovery. Conclusion: Cox-Aalen model provides more accurate statistical description for time-varying covariate effects. There is a positive effect of MSCs on the neutrophil recovery, however further study on the advantages and disadvantages of MSCs are needed https://ijph.tums.ac.ir/index.php/ijph/article/view/3587 https://ijph.tums.ac.ir/index.php/ijph/article/download/3587/3262

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 551 60 Hamed Alaghemandan Dept. of Health Management in Disaster and Emergency, Engineering Research Institution of Natural Disaster Management, Shakhes Pajouh, Isfahan, Iran. Mohsen Ghaffari Darab Dept. of Business Management, Mobarakeh Branch, Islamic Azad University, Mobarakeh, Isfahan, Iran AND Dept. of Health Services Management, Isfahan University of Medical Sciences, Isfahan, Iran. Elahe Khorasani Dept. of Health Services Management, Isfahan University of Medical Sciences, Isfahan, Iran AND Dept. of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ehsan Namazi Shefa Drug Rehabilitation Center, Isfahan, Iran. Mohammad Hossein Maniyan Shefa Drug Rehabilitation Center, Isfahan, Iran. Maryam Barati Dept. of Health Services Management, Isfahan University of Medical Sciences, Isfahan, Iran. 2015 10 14 Background: : Addiction is one of the most serious social damages and due to its progressive nature in all aspects,  adversely affects people’s physical and psychological health. Hence, this paper investigates the characteristics of drug addicts in a drug rehabilitation center in the city of Isfahan. Methods: In this cross-sectional study conducted in 2012, the population consisted of all addicts that referred to Shefa Drug Rehabilitation Center. A sample of 201 individuals was selected randomly. Two questionnaires were drawn up to collect data; the first questionnaire examined demographic characteristics and the second was the 71-item Minnesota Multiphase Personality Inventory short form. Chi-square test, Fisher’s exact test and Kruskal-Wallis test were used in SPSS20 to analyze the data. Results: Overall, 98% of participants were men, 65.7% were married, and 13.3% were unemployed. Depression and  hypomania were respectively the most and the least prevalent disorders among individuals with high-risk psychological profiles of clinical scales respectively. Psychopathic deviation and schizophrenia were seen among the unemployed more than the employed ones. Conclusion: Considering the fact that depression was the most common personality disorder among the addicts participating, it is recommended that this disorder be given priority in investigations in the treatment programs of these patients.  In addition, the scales of disorder, schizophrenia, mental infirmity, mental deviation, and paranoia had a significant relationship to aggression, delirium and hallucination, which must be taken into consideration in the treatment of such patients. https://ijph.tums.ac.ir/index.php/ijph/article/view/3585 https://ijph.tums.ac.ir/index.php/ijph/article/download/3585/3260

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 561 9 Mina Mazaheri Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Shekoufeh Nikneshan Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Hamed Daghaghzadeh Integrative Functional Gastroenterology Research Center, Dept. of Gasteroenterology, Isfahan University of Medical Sciences, Isfahan, Iran. Hamid Afshar Psychosomatic Research Center, Dept. of Psychiatry, Isfahan University of Medical Science, Isfahan, Iran. 2015 10 14 Background: Personality traits and emotion regulation processes play an important role in human health. The purpose of this study was to investigate the role of positive personality traits (psychological hardiness and interpersonal forgiveness) in emotion regulation of patients with Irritable Bowel Syndrome. Methods: The research was a cross-sectional study. Statistical population included all of IBS patients referred to the Subspecialty Center of Psychiatry in Isfahan in 2013. Overall, 123 subjects (100 women, 83.3%, and 30 men, 16.7%) were selected by census method, according to criteria of research and during a particular period. To collect data, the Difficulties in Emotion Regulation Scale )DERS), Lang and Goulet Hardiness Scale (LGHS) and Interpersonal forgiveness Inventory (IFI) were used. Data was analyzed using Pearson,s correlation coefficient and Multivariate and Binary Logistic regression analyses. Results: Mean age of patients was 33.82±10.45 years and 83.3% (100) of them were female. Regression analyses showed  that both personality traits of hardiness and forgiveness were as protective factors for emotional dysregulation with OR, 95% CI: 0.93 and 0.96 sequentially, with adjusting demographic variables (age, gender, and education level and disease duration). Conclusion: Patients who are more hardy and forgiving toward others, are likely more successful at adaptive emotion regulation. It emphasizes the positive and beneficial role of the personality traits in regulating of emotional problems of IBS patients. Hence, these variables should be considered as effective factors in the treatment process of the patients. https://ijph.tums.ac.ir/index.php/ijph/article/view/3583 https://ijph.tums.ac.ir/index.php/ijph/article/download/3583/3258

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 570 9 Leila Doshmangir Dept. of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran AND Iranian Center of Exellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran. Parinaz Doshmangir Dept. of Health Education and Promotion, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran. Nazanin Abolhassani Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Esmaeil Moshiri Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Semnan University of Medical Sciences and Health Services, Semnan, Iran. Mehdi Jafari Dept. of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran AND Research Center for Health Services Management, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran. 2015 10 14 Background: This study aimed to explore the effects of national targeted subsidies policy on health behavior of Iranian households. Methods: In this qualitative study, data were collected between January 2012 and December 2013 through face-toface interviews (23 experts in national and provincial levels of health system and 18 household heads) and through a comprehensive and purposive document analysis. The data was analyzed using a thematic analysis method (inductivedeductive) and assisted by Atlas-ti software. Results: Rising health care costs, removing some food subsidies and the increase in price of most goods and services due to the implementation of economic policy of targeted subsidies have led to significant changes in the demand for health services, changes in the consumption trends of goods and services affecting health as well as changes in the health habits of households. Conclusion: Targeted subsidies and the cash subsidy policy have some negative effects on population health behavior especially among poor people. Hence, maintaining or increasing the cash subsidy is not an efficient allocation of resources toward health care system. So, it is necessary to identify appropriate strategies and policies and apply interventions in order to moderate negative effects and enhance positive effects resulted from implementing this economic  reform on population health behavior. https://ijph.tums.ac.ir/index.php/ijph/article/view/3581 https://ijph.tums.ac.ir/index.php/ijph/article/download/3581/3256

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 580 2 Mateusz Cybulski Dept. of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Poland. Elzbieta Krajewska-Kulak Dept. of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Poland. Jacek Jamiolkowski Dept. of Public Health, Faculty of Health Sciences, Medical University of Bialystok, Poland. 2015 10 14 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/3579 https://ijph.tums.ac.ir/index.php/ijph/article/download/3579/3254

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 583 5 Jun Tu Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan, China. Ke-Jian Liu Dept. of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. Long-Ju Ran Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan, China. Xing-Ping Pan Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan, China. 2015 10 14 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/3577 https://ijph.tums.ac.ir/index.php/ijph/article/download/3577/3252

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 586 7 Rashid Menhas Dept. of Sociology, Pir Mehr Ali Shah Arid Agriculture University Rawalpindi, Pakistan. Shumaila Umer Dept. of Sociology, Sardar Bahadur Khan Women University Quetta, Pakistan. 2015 10 14 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/3575 https://ijph.tums.ac.ir/index.php/ijph/article/download/3575/3250

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 588 9 Ning Li School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, China. Bin Li Traditional Chinese Medicine Hospital, Xi'an, China. Juanhua Dou Xi'an Health School, Xi'an, China. Xueliang Wang Dept. of Public Health, College of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China. 2015 10 14 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/3573 https://ijph.tums.ac.ir/index.php/ijph/article/download/3573/3248

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 590 2 Pelin Özmen 2'nd Army Command Health and Veterinary Department Manager. Malatya/Turkey. Soykan Şahin Turkish Fleet Command Heath Department Manager, Gölcük /Turkey. Mehmet Çetin Dept. of Military Health Services Gulhane Military Medical Academy Ankara/ Turkey. Yusuf Ziya Türk Dept. of Military Health Services Gulhane Military Medical Academy Ankara/ Turkey. 2015 10 14 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/3571 https://ijph.tums.ac.ir/index.php/ijph/article/download/3571/3246

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 593 5 Mohammadreza Yasinzadeh Dept. of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran. Seyed Hashem Pour Shafiee Dept. of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran. Mojtaba Chardoli Dept. of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran. Hamed-Basir Ghafouri Dept. of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran. Seyed Behzad Jazayeri Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran. Vafa Rahimi-Movaghar Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/3569 https://ijph.tums.ac.ir/index.php/ijph/article/download/3569/3244

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 596 7 Tahereh Naseri Boori Abadi Dept. of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Abbas Sheikhtaheri Dept. of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. 2015 10 14 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/3567 https://ijph.tums.ac.ir/index.php/ijph/article/download/3567/3242

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 598 9 Zahra Yazdanpanahi Dept. of Midwifery, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. Maryam Shahamatmanesh Dept. of Law, Farabi Faculty, Tehran University, Tehran, Iran. Amirhossein Babaei Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran. Mahboubeh Hajifoghaha Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 10 14 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/3566 https://ijph.tums.ac.ir/index.php/ijph/article/download/3566/3241

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 44 4 2015 04 15 600 1 Elahe Moravej-Salehi Dept. of Oral Medicine, Dental Branch, Islamic Azad University, Tehran, Iran. Elham Moravej-Salehi Dept. of Restorative Dentistry, School of Dentistry, Shahed University, Tehran, Iran. Farnaz Hajifattahi Dept. of Oral Medicine, Dental Branch, Islamic Azad University, Tehran, Iran. 2015 10 14 No Abstract https://ijph.tums.ac.ir/index.php/ijph/article/view/3564 https://ijph.tums.ac.ir/index.php/ijph/article/download/3564/3239