مجله اپیدمیولوژی ایران
سال هفدهم شماره 1 (پیاپی 61، بهار 1400)

The incidence of colorectal cancer has increased significantly in Iran in recent decades. The pattern of occurrence varies in different populations. A study was conducted to perform a spatial analysis of colorectal cancer and some of its risk factors in Iran using GIS. 

The data of this descriptive-analytic study included colorectal cancer incidence as a dependent variable and physical activity, Body Mass Index and smoking as independent variables recorded by the Cancer Department, Center for Non-Communicable Diseases Management, the Ministry of Health and Medical Education and the care system for non-communicable disease risk factors according to province and gender in 2009. Data was analyzed using the ArcGIS 10.3 software and spatial correlation analysis, hot spots analysis, and geographic weighted regression model. 

The spatial relationship between the disease and some of its risk factors was confirmed by the model of geographical weight regression, according to which the northern and central provinces had the highest risk of colorectal cancer compared to other regions of the country. 

The results of this study showed that spatial analysis could be useful in identifying disease patterns, prioritizing the factors affecting it, and controlling the disease through strategic planning and interventions.

Quality of life is a valuable indicator for measuring peoplechr('39')s health. The purpose of this study was to determine the predictors of quality of life in the staff of Shahid Beheshti University of Medical Sciences, Tehran, Iran using the path analysis model. 

This cross-sectional study was performed on subjects participating in the Health Cohort Study of Shahid Beheshti University of Medical Sciences, Tehran, Iran in 2018. A demographic information form and standard quality of life, general health, physical activity and burnout scales were used for data collection. The SPSS version 24 and Amos version 24 were used for data analysis. 

A total of 770 individuals were selected for the study, of whom 345 (44.8%) were male. The mean age ± standard deviation of the participants was 42.6±8.4. Analysis of the quality of life pathway of the participants showed an appropriate model (RMSEA= 0.014, CFI=0.999, NFI = 0.991, TLI = 0.994, CMIN/DF = 1.146). In addition, general health (0.560) and physical activity (0.078) had a direct correlation and occupational burnout (-0.178) and age (-0.082) had an inverse correlation with quality of life. 

The results of this study suggest that factors such as general health, physical activity, and burnout have an impact on the participants. Therefore, it is necessary to consider the factors affecting the quality of life.

Environmental conditions in different geographical areas provide a basis for the spread of some diseases. Cutaneous leishmaniasis is a serious threat to public health and is one of the arthropod-borne diseases. The prevalence and distribution of this disease is affected by environmental and climatic factors. The aim of this study was to model the Spatio-temporal variations in the incidence rate of this disease based on environmental and ecological criteria. 

The northeast of Iran was selected as the study area. The data used in this study included vegetation, surface temperature, precipitation, evapotranspiration, soil moisture, digital elevation model and sunny hours. The artificial neural network method was used to model the spatio-temporal changes of cutaneous leishmaniasis. 

Spatial variations in the incidence of the disease had a north-south trend and decreased from north to south. In addition, two foci were identified in the medium altitude areas in North and South Khorasan provinces. Temporal variations in the incidence of disease in the study period showed that the incidence rate decreased in the two identified foci from 2011 to 2016. 

The modeling results showed that the estimated regression coefficient was 0.92 for neural network based on all three types of data (training, validation, test) indicating good quality of constructed neural network.  In addition, sensitivity analysis results showed that sunny hours and soil moisture were the most important factors in the model function.

Fair financial protection against health expenditures is one of the most critical goals of health systems. This study was conducted to investigate the most appropriate threshold for measuring the exposure to catastrophic health expenditure (CHE) in Iran. 

The present study was conducted using 2018 national household income and expenditure data of the Iran statistics center. The occurrence and intensity of the householdschr('39') exposure to CHE at different thresholds and for economic quintiles was measured using two World Health Organization (WHO) and World Bank (WB) methodologies. The most appropriate threshold for each methodology was also determined using the Kappa statistics adaptation estimation. 

The occurrence of households’ exposure to CHE was 3.02% and 8.51% in urban households and 4.66% and 9.22% in rural households, respectively. According to asset quintiles, the highest occurrence was in the first quintile and the lowest in the fifth quintile. In addition, the results of adaptation estimation based on Kappa statistics showed that a threshold of 40% in the WHO methodology and 25% in the WB methodology were the most appropriate thresholds. 

The results showed a relatively high rate of exposure to CHE. CHE occurrence was also more in poorer households, and common thresholds were the most appropriate thresholds for estimating CHE.

Human resources, especially youth work force, are considered as the main capital for every society. Maintaining the quantity and quality of human resources is essential for every policymaking. The present study was conducted to estimate the Years of Life Lost (YLL) due to early death amongst the working age population (i.e. 15-64 years) of two provinces with very different levels of socio-economic development in Iran. For this purpose, premature mortality was compared between Yazd and Sistan & Baluchistan provinces in 2016. 

This cross-sectional study used secondary data. The target statistical population of the study was all deaths registered in the age groups 15 to 64 years in the provinces of Yazd and Sistan & Baluchistan during March 2016 to March 2017. The mentioned provinces reflect completely different and unequal development at the national level: Yazd is amongst one of the highly developed regions of Iran, while Sistan & Baluchistan is as one of underdeveloped provinces. The data were obtained from health departments of Yazd and Sistan & Baluchistan provinces’ medical universities. The YLL was calculated according to the standard procedure provided by the World Health Organization. 

Our findings showed that the lost human capital due to early death was about two times higher in Sistan & Baluchistan compared to Yazd. The main causes of death were unintentional injuries in the younger working age group (15-44 years) and cardiovascular disease and cancers in the older working age group (45-64 years).  

Causes of death were different in Yazd and Sistan & Baluchistan provinces according to the regional level of development. Therefore, health policies have to be implemented as regional policies. In general, the results showed that as the epidemiologic transition passes, the cause of death changes from causes that are less related to medical conditions and more related to social situations. Consequently, it is required to consider social policymaking when designing health policies.

Accurate assessment of patientschr('39') death depression requires a specific tool that is appropriate to the culture of each community. Therefore, the aim of this study was to evaluate the psychometric properties of the Death Depression Scale in women with breast cancer. 

In this methodological study, 246 breast cancer patients presenting to Qazvin Provincial Hospital completed the 17-item Templar Death Depression Scale. Psychometric properties of this scale were evaluated by exploratory and confirmatory factor analysis. Reliability was also assessed using Cronbachchr('39')s alpha, omega and composite reliability. 

Exploratory factor analysis showed that six items in the Persian version did not acquire the required loading factor, and were omitted. The remaining eleven items as a single factor accounted for 66.91% of the variance of this concept. In confirmatory factor analysis, 11 items had appropriate fit indices (χ2 = 97.664, p <.001, χ2 / df = 2.504, GFI = .932, CFI = .972, IFI = .973, TLI = .961, SRMR = .030, and RMSEA = .079). A Cronbachchr('39')s alpha coefficient of 0.95, Omega coefficient of 0.95, and composite reliability coefficient of 0.96 indicated the acceptable reliability of the 11-item version. 

The results of this study showed that the 11-item Death Depression Scale was valid and reliable in Iranian patients with breast cancer. Given the appropriate psychometric parameters, this scale can be used to assess death depression in future studies.

One of the most important issues in public health is violence, which affects people around the world. Therefore, a qualitative study was conducted to explain the consequences of student violence. 

This study was part of a qualitative exploratory sequential study conducted in Ruodsar in 2017. This study was carried out using conventional qualitative content analysis method. The data were collected through 50 individual in-depth interviews using purposive sampling. Data analysis was done using the Landman and Grahaim method. 

Data analysis in the first phase of research resulted in the extraction of 98 initial codes, two subcategories and one main category. At the end of this stage, the consequences of adult violence according to the findings were as follows: "The harmful consequences of violence are conceptual, dynamic, and multidimensional. The harmful consequences of violence point to changes that occur within the violent person or the people around them after the violence, which are divided to interpersonal and intrapersonal consequences. 

The present study revealed some new dimensions of the concept of harmful consequences of violence, especially in student girls. This definition is based on the Iranian context and culture. Violence prevention requires attention to these dimensions at different interpersonal and the intrapersonal levels.

Physical activity is one of the most important components of life. The aim of this study was to evaluate the physical activity level of primary school students in Bushehr in 1398. 

In this cross-sectional descriptive-analytical study, the research population included all elementary school students in Bushehr. Four hundred and six students were selected using multi-stage random sampling. The Physical Activity Questionnaire for Children, which is a valid and reliable scale, was used to collect the data. Independent t test, one-way analysis of variance, Pearson correlation coefficient and multiple linear regression model were used for data analysis. Data was analyzed using the SPSS software version 20. 

The mean score of physical activity was 3.27±0.84. There was a significant relationship between demographic factors (parents’ education level, participant’s education level and BMI) and physical activity. Students whose parents had higher levels of education were more likely to engage in physical activity and people who were obese had less physical activity. 

The studentschr('39') physical activity was moderate. Given that there is a direct link between physical inactivity and increased prevalence of overweight and obesity, it is important to pay attention to the lifestyle of people, especially children and adolescents who are in the learning age. Therefore, more attention should be paid to improving the level of physical activity in students through education and building a culture.

The commercial layer chicken farming is one of the most important sectors of the poultry industry. This study was conducted to evaluate the status of biosecurity of commercial layer chicken farms in 9 Iranian provinces with the highest layer chicken population. 

In this cross-sectional study, 202 commercial layer chicken farms were selected from nine Iranian provinces in 2019 using stratified random sampling. Then, the required data were collected using a questionnaire by presenting to the farms in person. The results are expressed as mean, standard variation, sum and adoption rate index. 

The results showed that the adoption level of total biosecurity measures was 68.18% in the commercial layer chicken farms in Iran. This figure was 72.11%, 75% and 60.82% for conceptual, structural and operational biosecurity measures, respectively. Among conceptual biosecurity measures, the lowest adoption level (29.20%) was for distance to the nearest garden and agriculture land. Among structural biosecurity measures, the lowest adoption level (28.96%) was for a hand disinfection spot before shed. Among the operational biosecurity measures, the lowest adoption level was for water filtrations (31.18%) and microbial testing of water (33.91%). 

This study investigated the biosecurity status of commercial layer chicken farms in nine Iranian provinces with the highest layer chicken population and revealed some weaknesses in the implementation of these measures at conceptual, structural and operational levels.