مجله اپیدمیولوژی ایران
سال نهم شماره 3 (پیاپی 31، پاییز 1392)

To assess inequity of childhood health care package provision according to the distance of health houses from the town and the provincial capital in Markazi province (Iran). We used 4 measures of childhood health care provision by family medicine program in randomly selected health houses in Markazi province. The measures included were monitoring of the childhood health by the GP (General Practitioner)، childhood disease management according to the Iranian MOHME guidelines، good knowledge of the GP about the content of the guidelines and good knowledge of the GP about the 1-59 month death registration system. These measures were estimated by a predefined، interviewer administered questionnaire. The distance of each selected health house was determined in each district health center. To assess the inequity of the measures we estimated concentration index and its 95% confidence interval using covariance method. P Values of greater than 0. 05 were considered as statistically insignificant. About 46 health house were randomly selected. All of the estimated concentration indices about the childhood care measures were less than 0. 1 and their differences with zero score were insignificant (p value> 0. 05). according to the data of our study it seems there is no inequity between different health houses in accordance of their distance from district center and provincial capital. It seems necessary to measure other health indices to assess the inequity of the whole of the health care providing system.

Although the population of elderly is increasing in Iran، few studies carried out on this group. The aim of this study was to identify life expectancy and contributory risk factors for the Tehranian elderly of ages above 60 years. Individuals above 60 years old whom were recruited in the primary phase of the Tehran Lipid and Glucose Study (TLGS) during 1998-2001 were followed up for 12 years and their vital status were registered (1998-2011). Age and sex mortality rates for age groups (60-69، 70-79، 80+) were calculated and by using Cox proportional hazard model the mean of survival time and hazard rates with respect to risk factors were estimated. Life expectancy for females and males after crossing 60 years of age reaches to 81 and 80 years، respectively; without any statistically significant differences between these two groups. Cox model showed that diabetes، BMI>33Kg/m2 and non ischmecic heart disease reduced survival time in women significantly. While diabetes، smoking، hypertension، ischemic heart disease، history of MI، stroke or sudden death of father، brother or son، lack of physical activity and antihypertensive medications are among the hazardous risk factors for men. Among the variables studied، only three (ABC) of them were found as risk factors of women''s life، while for men seven risk factors were identified. It seems that more studies are needed to determine the risk factors for women.

Suicide has been recognized as a public health concern in all communities. Several factors are contributing to its incidence in developed and developing countries. Purpose of this study is to investigate seasonal patterns of suicide in Ilam province western Iran. Data were recruited from a systematic registry of Ilam province between available from 2001–2009. Overall، 3873 suicides were recorded. According to month and season of suicide، data were analyzed using chi-square test and logistic regression. Among suicide attempters، a peak of suicide occurrence was observed in summer، especially in August. In general، 16% of suicides were completed. The risk of death (OR) due to suicide was significantly greater in winter and March compared to other seasons and months، respectively. Suicide occurrence varies by month and season and seasonal-related factors such as psychological، environmental and social aspects should be considered for any prevention programs and strategies.

Randomized controlled trials are the most reliable type of study to be able to compare different interventions in scientific research. The introduction of bias into the design and conduct of randomized controlled trials can seriously affect the accuracy of the results and led to the results be invalid. The aim of this study was to assess the bias in randomized controlled trials published in Iranian nursing and midwifery journals. We searched all published articles in eight professional nursing and midwifery Iranian journals in 2010. Risk of bias in RCTs was assessed using of Cochrane group risk of bias standard tool by two reviewers independently. After reviewing the eight journals، 68 randomized controlled trials were retrieved. The majority of studies had unclear or high risk of bias. Random sequence generation in 22%، concealment allocation in 4. 5%، blinding in 22%، incomplete outcome data in the 35. 3%، selective outcome reporting in 51. 5%، and other bias in 36. 7% of the studies were in low risk of bias. A large proportion of the studies had high or unclear risk of bias. It was considerable that none reporting bias led to uncertainty reader from study quality. Bias might significantly affect the internal validity of the studies results; therefore in interpretation of the findings of these studies caution should be taken.

Previous studies and reports show that majority of motorcyclists do not use helmet in Iran. The aim of study was to evaluate the performance of motorcycle helmet use based on health belief model in Markazi province in Iran. This cross- sectional study was carried out on 384 subjects selected based on convenience sampling. Participants completed a designed questionnaire on attitudes and behaviors relevant to bicycle helmet use. The mean age of participants was 28. 9 ± 8. 5 years and 42% of drivers were single. There were significant association between performance with perceived severity، benefits، barriers، and motorcyclists’ action (P<0. 05). The barriers of using helmet reported by participants were sweating، hearing disturbance، expensiveness، heaviness، and visual limitation، respectively. In time of study، only 16. 2% of motorcyclists used helmet. Based on our health belief model، 61. 4% of participants believed that education and information are the best method، 22. 7% believed that not users of helmet should pay a penalty، and 15. 9% believed that confine of motorcycle could be effective actions to encourage them to use helmet. According to the results، the helmet use practice was poor and should be increased Meanwhile، the perceived severity should increase especially in young people. The community - based health education programs accompanied with police harsh treatment is necessary.

There have been several reports showing that the rate of anabolic-androgenic steroids abuse has increased in athlete and non-athlete adolescents. Therefore، the objective of this study was to assess، attitude and awareness of side-effects of these drugs in male bodybuilders. 227 bodybuilders completed a tridimensional questionnaire that investigated demographic information، prevalence of anabolic-androgenic steroids (AAS) and attitude towards steroids abuse. Forty percent of participants (40. 1%) of bodybuilders had used anabolic-androgenic steroids at least one time. The main reasons for taking this medication were strength، muscle mass، speed and endurance، respectively and 7. 73% did not know the reason of using it. 32. 6% of bodybuilders believed that anabolic steroids increased muscle size without exercise and without proper exercise and nutrition. The mean score of awareness and attitude of athletes who used these drugs were significantly higher than the athletes who did notuse (P=0. 001). Athletes with Championship history were more aware regard to adverse effects of steroids than athletes with no history of championship. The findings of this indicating that that abusing AAS seems to be increased and become a public health concern that implies the need to implement educational programs by health care professionals and sport specialists.

Asthma and allergic diseases remain among the most important health problem in different societies that affect childhood life. These diseases mostly seem to be occurred in children with family history positive. In this study، we aimed to evaluate the association between family history and the prevalence of allergic diseases in children in Gonabad.

A cross-sectional study was conducted in the city of Gonabad in 2011 year. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire were completed by 1627 students whom were selected by using multi-level sampling across city. The Chi-Square test was used for comparison of qualitative variables between two groups and Odds ratios (ORs) and 95% confidence intervals (CI) were calculated.

Of the total (1627) participated students، 876 (53. 8%) were boys and 751 (46. 2%) were girls. Mean age of children was 14. 5±1. 8. Almost forty percent of children had at least one allergic symptom at sometime in their life and 48/1% had family history and 35/1% did not have family history (P<0. 001). However، lifetime and 12-month prevalence of rhinitis symptoms، 12-month prevalence of rhino conjunctivitis and lifetime hay fever and eczema was significantly higher in students with positive family history than those with negative family history (P<0. 05).

Our study shows that the prevalence of most allergic disorders was higher in children with positive family history. It seems that heredity plays a major role in the occurrence of allergic diseases in children.

Nowadays، human values for example quality of life has important place to be considered as health index along with other measurements like morbidity and mortality indexes. This study intended to compare the quality of life for residents living in apartment’s flats more than 15 years with residents living in non-apartment housing in Shiraz. The World Health Organization Quality of Life (WHOQOL_BREF) standard questionnaire was completed by participants. This population was chosen by a multi-stage sampling method in Shiraz city. Type of living accommodation، physical، psychological، social، and environmental health factors were adjusted in the linear model. The mean score of health aspects in people who lived in apartment vs non apartment living were: physical 13. 57 and 16. 41، psychological 10. 71and 14. 87، social 8. 57and 13. 84 and in environmental 13. 59 and 10. 18 respectively، however after adjustment for gender، education، marital status، age، job، family size، income، type of disease (chronic، acute، chronic- acute)، possession of house and area of house، changed to 14. 41 for physical and 15. 61، psychological 12. 6 and 14. 47، social 8. 74 and 13. 72 and environmental 15. 42 and 9. 23 (P<0. 0001). The results of this study show that the health of apartment-living residents even after adjustment of some other influencing factors، in major of domains was less than non apartment-living residents which indicating this issue should be considered in urban-living health.