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Network scale-up is an indirect size estimation method, in which participants are questioned on sensitive behaviors of their social network members. Therefore, the visibility of the behavior affects the replies and estimates. Many attempts to estimate visibility have been made. The aims of this study were to review the main methods used to address visibility and to provide a summary of reported visibility factors (VFs) across populations. We systematically searched relevant databases and Google. In total, 15 studies and reports that calculated VFs were found. VF calculation studies have been applied in 9 countries, mostly in East Asia and Eastern Europe. The methods applied were expert opinion, comparison of NSU with another method, the game of contacts, social respect, and the coming-out rate. The VF has been calculated for heavy drug users, people who inject drugs (PWID), female sex workers (FSWs) and their clients, male who have sex with male (MSM), alcohol and methamphetamine users, and those who have experienced extra-/pre-marital sex and abortion. The VF varied from 1.4% in Japan to 52.0% in China for MSM; from 34.0% in Ukraine to 111.0% in China for FSWs; and from 12.0% among Iranian students to 57.0% in Ukraine for PWID. Our review revealed that VF estimates were heterogeneous, and were not available for most settings, in particular the Middle East and North Africa region, except Iran. More concrete methodologies to estimate the VF are required.

Background: The aim of this study was to estimate the incidence of reactions caused by blood donations in Iran as well as exploring three potential scenarios of the worst, moderate, and the best situations for adverse reactions among Iranian blood donations by specifying the under-reporting rate. Methods: There are two different designs; first, the ecological study was coducted to estimate the blood donation adverse effects by using the data registered in the donor vigilance part of Iranian Blood Transfusion Organization (IBTO). Second, the cross-sectional study was conducted to estimate under-reporting in the data. For the cross-sectional study, 2408 donors were selected randomly in three cities. Results: In general, based on the estimations of this study, adverse reactions to blood donation in Iran is 2%(CI 95%, 1.4-2.6%). Local and systemic reactions estimated are 1.7%(CI 95%, 1.2-2.2) and 0.3%(0.1-0.5), respectively. Based on the national report, in general, adverse reactions to blood donation in Iran is 0.5(CI 95% 0.4-0.6). Local and systemic reactions estimated are 0.38%(CI 95% 0.28-0.48) and 0.03%(0.0.02-0.04), respectively. Conclusion: Adverse reactions may vary from region to region in Iran, but in total, there is a lot of under-reporting in the incidence of adverse reactions to blood donation in Iran, most of which are related to local reactions. [ABSTRACT FROM AUTHOR]

Introduction: Social media platforms provide easy access to an unprecedented volume of information which could influence the awareness and perception of people during public health crises. The current study aims to explore the trends and content of the posts on Instagram. Material and Methods: We performed a retrospective content analysis of available public messages posted on Instagram. We collected data between 23 January 2020 and 25 March 2020. The inclusion criteria included an Instagram post with a hashtag related to Coronavirus (i.e. # “Corona” and # “Coronavirus”, in the Persian language). Persian hashtags were used for retrieving posts. All posts were categorized into seven categories. We performed descriptive statistics with Microsoft Excel 2019 and SPSS version 26. Results: A total of 4280 posts were extracted, out of which 1281 were categorized into seven main categories including News (n=205, 26.7%), Criticism (n=136, 17.7%), Education (n=112, 14.6%), Coronavirus’s impact on the healthcare system (n=100, 13%), Combating Coronavirus (n=98, 12.8%), Coronavirus’s impact on society (n=89, 11.6%), Joke (n=28, 3.6%). Conclusion: Our findings revealed that the trend of posts on social media was influenced by factors such as the nature of the information sources as well as social and political occasions. This study provides insight into health dissemination on social media for future responses to public health crises. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the quality of life (QoL) and its association with HIV-related stigma among people living with HIV (PLHIV) in Kerman province, southeast Iran. A convenience sample of 104 PLHIV was recruited. Data on QoL were collected using the HIV/AIDS-Targeted QoL instrument. Internal and external stigma were measured using an instrument developed by UNAIDS. The average QoL score was 52.5 (SD =13.9). In multivariable model, PLHIV who experienced higher external stigma score (B = −1.9; 95% confidence interval [CI]: −2.6 to −1.1) and higher internal stigma score (B = −1.1; 95% CI: −1.5 to −0.6) had lower level of QoL. The low level of QoL among PLHIV in Iran indicates the need for initiatives to increase QoL among this population. Our data suggest that QoL in PLHIV could be improved by interventions aimed at reducing stigma in both community and health care settings. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) is a common mental disorder following traumatic events. The present study was conducted to understand the prevalence of PTSD after the earthquake in Iran and Pakistan. The review includes all articles published from inception to March 2019. The pooled prevalence for overall PTSD was 55.6% (95% CI: 49.9–61.3). It was 60.2% (95% CI: 54.1–66.3) and 49.2% (95% CI: 39.4–59) for Iranian and Pakistani survivors, respectively. Women experienced higher incidence of PTSD than men. The variation of PTSD based on the clinical interview was lower than the self-report approach. The interval time between the earthquakes and the assessment showed that the prevalence of PTSD decreased over time. The prevalence of PTSD in Iran and Pakistan was higher than the global average, and the rate of the disorder in Iran was higher than in Pakistan. Sex, method of assessment, and time lag between the occurrence of disaster and assessment of PTSD affect the prevalence. [ABSTRACT FROM AUTHOR]

Job-related stress may affect smoking initiation, progression, and intensity, therefore, it is important to have a better understanding of these associations to design targeted and effective workplace cessation programs. In this study, we aimed to synthesize existing literature concerning the relationship between job-related stress and tobacco use among adult workers (18 years and older). We searched articles indexed in six major databases (Scopus, PubMed, Embase, Web of Science, EBSCO, and Ovid) between 1997 and March 2020. We included cross-sectional and cohort studies published in English that examined self-reported smoking status or change in smoking status as exposure variables, and job-related status as the outcome variable consistent with the Demand Control Support and Effort-Reward Imbalance models. We searched the databases using combinations of keywords including "occupational stress," or "job stress" or "work stress" or "job strain" and "smoking" or "tobacco use" or "tobacco consumption" or "cigarettes." Of 906 identified articles, 19 (n = 240,787 participants) were included in this review. Findings showed no clear association between job-related stress and smoking status (smoking vs nonsmoking) and smoking cessation. However, the findings suggest an association between job-related stress and changing smoking habits, toward heavier smoking. Our findings indicate that job-related stress may lead to increased smoking intensity. [ABSTRACT FROM AUTHOR]

Background: We examined and estimated the trend of breast cancer incidence in Kerman, the largest province in Iran. Method: Having compiling the data of new cases from three sources (cancer registry, pathology, radiotherapy) in this longitudinal study, the number of untouched cases was estimated using log-linear model. We estimated the annual age-standardized rate (ASR) per 100,000 women in 2001-2015. We utilized joint point regression method to estimate the trend of breast cancer incidence during the examined years. Results: The ASR of breast cancer increased from 25 in 2001-2005 to 37 in 2011- 2015, showing that the annual average percentage increased by 5.9% (95% Confidence Interval: 3.5, 8.4, P<0.001). Moreover, during this period, the completeness of the cancer registry increased from 16% in the first five years to 70% in the last five years. Conclusion: Our findings revealed that the coverage of the cancer registry increased significantly. It seems that part of the increasing trend of the reported cancer incidence was attributed to the enhancement of the cancer registry scheme, but our findings suggested that the real incidence of breast cancer had a growing trend. [ABSTRACT FROM AUTHOR]

Background: This study aimed to measure internal and external HIV stigma and their associated factors among people living with HIV in the southeast of Iran. Methods: Using convenience sampling and a standard questionnaire, we recruited 104 HIVpositive patients (40% women) in 2018-2019 from two public clinics in Kerman, Iran. The internal stigma scale ranged from 0-22 and the external stigma scale ranged from 0-11 in which a higher score indicates higher stigma. Results: The mean internal stigma score was 10.7 (SD: 5.2), and that of the external stigma score was 3.1 (SD: 2.9). In multivariable regression analysis, women (Adjusted (Adj). ᵦ=-3.3; p=0.08), and married people (Adj. ᵦ=-5.5; p=<0.001) experienced less internal stigma. In contrast, those who were a member of support group of PLHIV (Adj. ᵦ=2.8; p=0.04), and those infected by sexual contact (Adj. ᵦ=2.1; P=0.006) experienced a higher internal stigma. Moreover, married people (Adj. ᵦ=-1.4; p=0.01), those with high school or higher education (Adj. ᵦ=-1.7; p=0.002), and those with other transmission routes (Adj. ᵦ=-1.4; P=0.01) experienced lower external stigma. Conclusions: People living with HIV feel considerable internal and external stigma. Addressing HIV stigma should be tailored based on gender, education, marriage, peer groups, and risk groups as these factors have different effects on stigma experiences. [ABSTRACT FROM AUTHOR]

Out-of-pocket (OOP) costs are a major part of the expenditures for healthcare services. In most cases, patient financial protection plans cover only direct medical costs and not other expenses by patients. This cross-sectional study was conducted on 800 patients referring medical centers of Kerman to analyse all aspects of OOP, especially after the Health Transformation Plan in Iran. Using the probability proportional to the size of the medical center, samples from each ward in each medical center were determined in accordance with the previous year's patient number. Randomly selected medical records of the last 2 weeks of patients discharged were collected, information was extracted, and telephone interviews were conducted. The mean total OOP costs of a one-time hospitalization in all medical centers in Kerman was equal to 7 561 977 Iranian rials. Assuming a 5% threshold, 37% of patients in public centers were faced with catastrophic health expenditures for a one-time hospitalization. Based on the results of the regression model, reduction of length of stay, elimination of the need for the presence of next of kin, and provision of healthcare services out of hospitals can greatly reduce OOP expenditures. Although direct medical costs are of special importance, and it is very necessary to protect patients against such costs, patients usually incur a variety of costs when receiving inpatient services. Inattention to direct nonmedical costs and indirect costs due to patients' and their next of kin's absenteeism may cause households to face catastrophic expenditures. [ABSTRACT FROM AUTHOR]

Background: Mobile-based social media play an important role in the dissemination of information during public health emergencies. Objectives: This study aimed to analyze the contents and trends of public messages posted on Telegram during Coronavirus Disease 2019 (COVID-19) pandemic. Methods: A content analysis of the 1781 messages, posted in a public Telegram channel with more than one million subscribers performed over 9-weeks. The messages were categorized into seven categories. Results: In total, 39% (n=703) of all messages were related to COVID-19. With the official confirmation of the case of COVID-19 in Iran, the number of COVID-related massages started to rise. Overall, the most frequent messages were of joke and humor (n=292, 41.5%), followed by educational messages (n=140, 19.9%). Conclusion: Our study showed that the most popular messages during first weeks of COVID pandemic were satirical, indicating that people may not had taken the risks of this pandemic seriously. It is crucial for health organizations to develop strategies for dissemination of reliable health information through social media. [ABSTRACT FROM AUTHOR]

Phenylketonuria is a disease caused by congenital defects in phenylalanine metabolism that leads to irreversible nerve cell damage. However, its detection in the early days of life can reduce its severity. Thus, many countries have started disease screening programs for neonates. The present study aimed to determine the worldwide prevalence of classic phenylketonuria using the data of neonatal screening studies. The PubMed, Web of Sciences, Sciences Direct, ProQuest, and Scopus databases were searched for related articles. Article quality was evaluated using the Joanna Briggs Institute Critical Appraisal Evaluation Checklist. A random effect was used to calculate the pooled prevalence, and a phenylketonuria prevalence per 100,000 neonates was reported. A total of 53 studies with 119,152,905 participants conducted in 1964- 2017 were included in this systematic review. The highest prevalence (38.13) was reported in Turkey, while the lowest (0.3) in Thailand. A total of 46 studies were entered into the meta-analysis for pooled prevalence estimation. The overall worldwide prevalence of the disease is 6.002 per 100,000 neonates (95% confidence interval, 5.07-6.93). The metaregression test showed high heterogeneity in the worldwide disease prevalence (I2=99%). Heterogeneity in the worldwide prevalence of phenylketonuria is high, possibly due to differences in factors affecting the disease, such as consanguineous marriages and genetic reserves in different countries, study performance, diagnostic tests, cutoff points, and sample size. [ABSTRACT FROM AUTHOR]

Background: Network Scale Up (NSU) is applied in many settings to estimate the size of hidden populations. The visibility of alcohol consumption - as a hidden behavior - in Iran has not been yet set. Our aim is to estimate the visibility factor (VF) of alcohol consumption in Iran which is an Islamic country in the Middle East. Methods: Ninety persons who had a history of alcohol consumption were recruited. Relationships in network were aligned in three main subgroups: immediate family, extended family, and non-family. According to the game of contact methodology, participants answered questions about total and aware number of persons they know in each relationship category. VF was calculated by dividing total number of people aware about the respondent's alcohol consumption by total number of respondent's social network. The 95% confidence intervals (CIs) were computed through bootstrapping. Findings: The mean and standard deviation (SD) of participants' age was 32.9 ± 10.2, the sex ratio was 3. Overall VF (95% CI) was 40% (33% to 47%). VF was estimated at 44% and 23% among men and women's network, respectively. The immediate family was the highest informed group, followed by non-family and extended family members. Conclusion: The visibility of alcohol consumption in Iran was not high. This is due to religious and legal prohibitions around it. [ABSTRACT FROM AUTHOR]

Background: The rate of viral infections in donated bloods is one of the main indicators of blood safety which has to be monitored precisely. This paper provides a thorough study of blood safety indicators in the last 15 years in Iran. Methods: The data of the transfusion organization in Iran from years 2003 to 2017 were used. The study focuses on the analysis of the frequency of viral hepatitis B and C (HBV and HCV) as well as human immunodeficiency virus (HIV) in blood donations. Results: Of 27,442,124 donated bloods, the relative frequencies were 4, 302, and 81 for HIV, HBV and HCV, respectively. This study also shows that the corresponding frequencies were significantly lower in recent years (2.5, 53, and 26 per 100,000 samples in 2017). Conclusion: The presented study indicates an overall low infection rate and provides evidence for the effectiveness of modern safety measures in improving the level of blood safety in Iran. [ABSTRACT FROM AUTHOR]

Background: Two main issues that challenge model building are number of Events Per Variable and multicollinearity among exploratory variables. Our aim is to review statistical methods that tackle these issues with emphasize on penalized Lasso regression model. The present study aimed to explain problems of traditional regressions due to small sample size and multi-colinearity in trauma and influenza data and to introduce Lasso regression as the most modern shrinkage method. Methods: Two data sets, corresponded to Events Per Variable of 1.5 and 3.4, were used. The outcomes of these two data sets were hospitalization due to trauma and hospitalization of patients suffering influenza respectively. In total, four models were developed: classic Cox and logistic regression models, as well as their penalized lasso form. The tuning parameters were selected through 10-fold cross validation. Results: Traditional Cox model was not able to detect significance of any of variables. Lasso Cox model revealed significance of respiratory rate, focused assessment with sonography in trauma, difference between blood sugar on admission and 3 h after admission, and international normalized ratio. In the second data set, while lasso logistic selected four variables as being significant, classic logistic was able to identify only the importance of one variable. Conclusion: The AIC for lasso models was lower than that for traditional regression models. Lasso method has practical appeal when Events Per Variable is low and multicollinearity exists in the data. [ABSTRACT FROM AUTHOR]

Background: Heavy vehicle drivers spend a great deal of time away from their families. This issue and other difficulties around their job may increase risky behaviors among them. The current study aims to investigate the prevalence of opium drugs, stimulants, cannabis, and alcohol use 12 hours before driving among heavy vehicle drivers. Methods: In this cross-sectional study, we selected two sites that were in charge of medical examination of drivers and recruited 363 drivers of heavy vehicles (trucks, trailers, and buses). We asked drivers about total number of drivers they knew and number of drivers who experienced use of different types of drugs. The data were analyzed using Network Scale Up Method (NSUM). Findings: Mean of age and job experience was 43.28 ± 10.04 years and 16.07 ± 9.67 years, respectively. The highest and lowest prevalence of drug use related to opium-based drugs at 12.8% to 14.0% and simulants at 1.97% to 2.84%, respectively. The prevalence of alcohol use 12 hours before driving was 4%. Conclusion: 12-hour before driving prevalence of opium-based drugs among drivers was high. This might put them in higher risk of road accidents. There is a need to design appropriate educational programs for them. [ABSTRACT FROM AUTHOR]

Background: Abortion is a sensitive issue surrounded by social, cultural and religious stigmata. Therefore, estimation of its prevalence involves methodological challenges. The aim of this manuscript is to estimate the abortion prevalence, stratified by type, using a direct and two indirect methods. Materials and Methods: This cross-sectional study was done in 2016, we recruited 1020 women aging 18-49 years. Three methods were applied to estimate the abortion prevalence: direct question, network scale-up (NSU), and single sample count (SSC). In the direct method, to guarantee anonymity, data were collected by means of a self-administered questionnaire. In other methods, data were collected through gender-matched street-based interviews. Results: The annual rate of abortion estimated by direct and NSU methods were 2 respectively 9 (10 intentional, 4 therapeutic and 15 spontaneous) and 23 (9 intentional, 3 therapeutic, and 11 spontaneous) per 1000 women aging 18- 49 years. The annual rate of intentional abortion estimated based on SSC method was higher (15 per 1000) women than other methods. Conclusion: The present estimates are higher than previously reported ones. The results of three methods more or less supported each other confirming the internal validity of our estimates. [ABSTRACT FROM AUTHOR]

Background: Alcohol use and drug injection are prevalent among homeless youths. The aim of this study was to identify the associated factors of alcohol consumption and drug injection among homeless youths aged 18-29 years. Methods: Data on 202 homeless youths (111 males and 91 females) were collected using a standardized questionnaire and face-to-face interview. Lasso logistic regression was applied to determine the impact of associated factors on alcohol consumption and drug injection. Findings: The mean age of the participants was 26.30 ± 3.19 years. Also, the prevalence of alcohol consumption and drug injection was 33.0% [95% confidence interval (CI): 30-36] and 4.0% (95% CI: 0-8), respectively; 6 people (3.0%) consumed alcohol and injected drugs at the same time. Correlates of alcohol consumption and drug injection were male sex [odds ratio (OR)Alc = 5.7], age (ORAlc = 0.96 and ORDI = 0.98), bachelor or higher education level (ORAlc = 1.34), non-Iranian nationality (ORAlc = 0.05 and ORDI = 0.18), food score (ORDI = 0.92), smoking (ORAlc = 2.05), substance use (ORAlc = 1.12), opposite sex relationship (ORAlc = 1.6), homosexual relationship (ORAlc = 3.56 and ORDI = 2.69), and mental disorder (ORAlc = 0.99). Conclusion: Based on our findings, it seems that the homeless youth are more desired to use alcohol and drug injection, whereas the prevalence of alcohol consumption and drug injection in homeless youth was higher than general youth population in Iran. Therefore, some suitable solutions are needed to prevent the homelessness. Also, the effective variables that were identified in this study for alcohol use and drug injection can help design and implement beneficial interventions. [ABSTRACT FROM AUTHOR]

Background: Due to the unpredictable nature of disasters, it is crucial to anticipate, define and divide tasks as preparedness activities to respond efficiently. This is because the organizations involved in, becoming aware of their own tasks and other organizations' tasks. The aim of this study is to explore disparities in the viewpoints of members of Kerman University of medical sciences and Red Crescent in emergent tasks after Bam Earthquake in Iran. Materials and Methods: During January and February 2017 a total of 30 members from Kerman Red Crescent and Kerman University of Medical Sciences were recruited through snowball sampling with exploratory interviews and Self-administered questionnaire. The content validity of the questions was tested through obtaining opinion of expert which was acceptable (CVR=0.6, CVI=0.8). Results: The results of our study showed that there was no predefined agreement about emergent tasks over response phase to the Bam earthquake; buried corpses, and management of received national and international aids from other organizations. Also, involved organizations were not aware the specific tasks of other organizations. Conclusion: During the disaster response phase in Bam earthquake, there was no agreement about the responsible of organizations for undertaking emergent tasks. This disparity was a barrier for effective response for involved organization. [ABSTRACT FROM AUTHOR]

Background: Network Scale Up (NSU) is a promising tool for size estimation of sensitive issues. In this study we investigated the important methodological considerations to employ this method for estimating behaviors, such as abortion, which happens in a particular age-gender group. Methods: We recruited 1250 males and 1250 females aged 18 to 50. Abortion rate was calculated through direct question and NSU methodology. The NSU was applied on three sub-samples (male, female and aggregate). Integrating replies to 25 reference groups, we estimated the network size (C) of respondents and its age-gender structure. To calculate the part of network that is subject to abortion, we compared two approaches: proportional and data based. The Visibility Factor (VF) was calculated through 222 females who had abortion. Direct estimate was considered as gold standard. Results: Using C’s derived from proportional method, the Relative Bias (RB) in the male and female samples was 33% and 84%. Applying the data-based C’s, the RB in the gender-specific and aggregate samples was 5% and 2%. Conclusion: The proportional method overestimates the prevalence. The data-based method to calculate the C is superior. The determination of the age-sex distribution of the network and the specific VF is essential. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aimed at investigating the burden of injuries, including spinal cord injuries and limb amputation, caused by the Bam earthquake. Materials and Methods: The data related to morbidity of spinal cord injuries were collected from records provided by State Welfare Organization of Iran. Then, morbidity and mortality data for amputation and also mortality of spinal cord injuries were obtained from a previous study using the network scale-up method. Then, we followed the World Health Organization guidelines to assess the burden of this disease, and then years of life lost (YLL) and years of life lost due to disability (YLD) were calculated. Results: The disability-adjusted life years (DALYs) caused by the spinal cord injury were 15,435 years. YLL due to premature mortality was 13,134 and YLD was 2301 years and the number of DALY caused by limb amputation was equal to 2184, all of which were due to YLD. Conclusions: According to the results of the present study, spinal cord injuries and amputations resulting from the earthquake impose many burdens on society. This provides outcomes and evidence for policymaking and planning in the field of health care for policymakers. [ABSTRACT FROM AUTHOR]

This paper aims to determine novice and experienced users’ search performance and satisfaction with the interfaces of the Web of Science and Scopus. This is a descriptive-analytical study. Snowball sampling was used. Given queries were searched by 15 experienced and 15 novice users and their search performance was recorded using Camtasia. Their satisfaction was determined by the QUIS questionnaire. The experienced users were more satisfied with both databases than the novices but the difference was not significant. The results imply that even a limited amount of search experience provides search performance benefits in using databases to locate information. If a user interface is designed in a proper manner and considering users’ needs, users get better results. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed at investigating the effect of Iranian traditional remedy prepared from Apium graveolens and Trachyspermum copticom (AT) on the severity and frequency of symptoms in patients with functional dyspepsia (FD). Material and Methods: In total, 150 FD patients were included in this randomized double-blind trial, based on the ROME III diagnostic criteria, and they were divided into three intervention groups namely, AT, Placebo and omeprazole. Then, severity and frequency of symptoms during this eight-week trial were measured. Obtained information was analyzed using Chi-square test and repeated measures test. Result: In general, the severity and frequency of symptoms after the 4th week significantly decreased in the AT group as compared to the omeprazole and placebo groups, and continued to reduce by the end of the eighth week. General reduction of symptom severity and frequency in the omeprazole group was significantly different from the placebo group by the end of the 4th and 8th weeks. With respect to each individual symptom, AT markedly improved symptoms, such as burning, pain, early satiation, fullness, bloating, belching and nausea, as compared to placebo-treated group. Moreover, AT significantly improved symptoms, like vomiting, and nausea, except for pain, as compared to omeprazoletreated subjects. Conclusion: According to the results, AT, as Iranian traditional remedy, was more effective than omeprazole and placebo in reducing the symptoms in FD patients. [ABSTRACT FROM AUTHOR]

Objectives: Abortion is a sensitive issue; many cultures disapprove of it, which leads to underreporting. This study sought to estimate the rate of abortion visibility in the city of Kerman, Iran--that is, the percentage of acquaintances who knew about a particular abortion. For estimating the visibility rate, it is crucial to use the network scale-up method, which is a new, indirect method of estimating sensitive behaviours more accurately. Materials and methods: This cross-sectional study was conducted in Kerman, Iran using various methods to ensure the cooperation of clinicians and women. A total of 222 women who had had an abortion within the previous year (74 elective, 74 medical and 74 spontaneous abortions) were recruited. Participants were asked how many of their acquaintances were aware of their abortion. Abortion visibility was estimated by abortion type. 95% CIs were calculated by a bootstrap procedure. A zero-inflated negative binomial regression analysis was conducted to assess the variables related to visibility. Results: The visibility (95% CI) of elective, medical and spontaneous abortion was 8% (6% to 10%), 60% (54% to 66%) and 50% (43% to 57%), respectively. Women and consanguineal family were more likely to be aware of the abortion than men and affinal family. Non-family members had a low probability of knowing about the abortion, except in elective cases. Abortion type, marital status, sex of the acquaintance and closeness of the relationship were the most important determinants of abortion visibility in the final multifactorial model. Conclusions: This study shows the visibility rate to be low, but it does differ among social network members and by the type of abortion in question. This difference might be explained through social and cultural norms as well as stigma surrounding abortion. The low visibility rate might explain the low estimates of abortion rates found in other studies. [ABSTRACT FROM AUTHOR]

Background: Network Scale-up (NSU) method is an indirect method for the estimation of hidden behaviors. In NSU, respondents are asked about the number of members they know from a subpopulation of interest (e.g., injecting drug user) and assume that the prevalence of risky behavior in the networks of a random sample of respondents is similar to that of the population. However, first, we need to identify the total number of people each respondent knows [the social network size (C)]; Moreover, certain risky behaviors happen in particular age and gender groups. Our aim was to determine the size and age-gender distribution of female networks. Methods: This cross-sectional study was conducted in the city of Kerman, Iran. A total sample of 1275 women was recruited using multistage sampling. In this study, 25 first names were selected as reference groups. Participants were asked how many people they know with the selected names. The respondent's answers were categorized into eight separate age-gender subgroups and C was estimated for each subgroup. Findings: The results of this study showed that, on average, each Kermanian woman knows about 234 people and about two-thirds of them are female (82 males and 152 females); moreover, participants were more likely to communicate with their peers. The majority of males (88%) known by Kermanian women were in young and middle age groups; in contrast the female young and middle age groups, who are at reproductive age, form only 45% of the female part of their networks. Conclusion: We have seen that the age-gender distribution of the networks is not the same as that of the general population. Our figures can be applied in NSU studies focusing on risky behaviors of particular age and gender groups. [ABSTRACT FROM AUTHOR]

HIV-1 Circulating Recombinant Form 35_AD (CRF35_AD) has an important position in the epidemiological profile of Afghanistan and Iran. Despite the presence of this clade in Afghanistan and Iran for over a decade, our understanding of its origin and dissemination patterns is limited. In this study, we performed a Bayesian phylogeographic analysis to reconstruct the spatio-temporal dispersion pattern of this clade using eligible CRF35_AD gag and pol sequences available in the Los Alamos HIV database (432 sequences available from Iran, 16 sequences available from Afghanistan, and a single CRF35_AD-like pol sequence available from USA). Bayesian Markov Chain Monte Carlo algorithm was implemented in BEAST v1.8.1. Between-country dispersion rates were tested with Bayesian stochastic search variable selection method and were considered significant where Bayes factor values were greater than three. The findings suggested that CRF35_AD sequences were genetically similar to parental sequences from Kenya and Uganda, and to a set of subtype A1 sequences available from Afghan refugees living in Pakistan. Our results also showed that across all phylogenies, Afghan and Iranian CRF35_AD sequences formed a monophyletic cluster (posterior clade credibility> 0.7). The divergence date of this cluster was estimated to be between 1990 and 1992. Within this cluster, a bidirectional dispersion of the virus was observed across Afghanistan and Iran. We could not clearly identify if Afghanistan or Iran first established or received this epidemic, as the root location of this cluster could not be robustly estimated. Three CRF35_AD sequences from Afghan refugees living in Pakistan nested among Afghan and Iranian CRF35_AD branches. However, the CRF35_AD-like sequence available from USA diverged independently from Kenyan subtype A1 sequences, suggesting it not to be a true CRF35_AD lineage. Potential factors contributing to viral exchange between Afghanistan and Iran could be injection drug networks and mass migration of Afghan refugees and labours to Iran, which calls for extensive preventive efforts. [ABSTRACT FROM AUTHOR]

Background: Controlling and preventive measures considerably reduced malaria incidence in Iran over the past few years, which confined the endemic areas to some regions in the southeastern Iran. The National Malaria Elimination Programme commenced in 2010. With regard to the presumption that the elimination programme interventions have accelerated the declining trend of malaria incidence across the endemic areas of Iran, the present study attempted to assess the effectiveness of the elimination programme by reviewing malaria incidence status, over a 14-year period, and comparing the trend of malaria incidence across malaria-endemic areas between the control and pre-elimination phase, and the elimination phase. Methods: A retrospective analysis of malaria surveillance data was conducted in a 14-year period (2001-2014), using multilevel Poisson regression. The epidemiological malaria maps and indicators also were developed and compared between the control and pre-elimination phase, and the elimination phase. Results: The mean of malaria incidence was 2.2 (1.7-2.7) for the entire study period. This rate was 3.4 (2.6-4.1) in the control and pre-elimination phase, and 0.41 (0.25-0.57) for the elimination phase. During the malaria elimination phase, the decline of annual malaria incidence had significantly accelerated and autochthonous cases had the greatest difference in malaria incidence decline (compared to the control and pre-elimination phase), whereas, falciparum cases had the lowest difference in malaria incidence decline, followed by non-Iranian and imported cases. Furthermore, there was a decline in Iranians to non-Iranians ratio and an increase in the ratios of over 15 to under 15, as well as male to female, in the elimination phase in comparison to the control and pre-elimination phase. Conclusions: It seems that the decline of malaria transmission, which has been initiated over the past few years, has accelerated as a result of the elimination programme, and Iran is approaching the goals set regarding the elimination of this disease. [ABSTRACT FROM AUTHOR]

Functional disability refers to conditions in which a person is not able to fulfill the daily chores and activities on his/her own or requires assistive devices to perform them. The objective of this study was to investigate the functional disability of the elderly in Kerman, Southeastern Iran and its relationship with handgrip strength. This cross-sectional study was conducted on 110 elderly participants (58 man and 52 woman) living in nursing homes in Kerman in 2014. Data were collected using functional disability standard questionnaire and Jamar Dynamometer so as to measure grip strengths of the elderly. Moreover, data were analyzed by statistical tests at a significance level of 0.05 using SPSS software. The measured grip strength of women was significantly lower than that of men (P< 0.05). The grip power of the women in the age group of 60-70 yrs was approximately equal with the grip power of men in the age group of 90-100. With age increase, grip strength would decline in both genders. Furthermore, there was a strong and direct correlation between functional ability and handgrip strength. In addition, there was a significant relationship between the increase in functional disability of the elderly and decline in their grip strength. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease is asymptomatic until its last stages and though it is increasing globally, we are faced with paucity of a population-based model to assess this disease, particularly in developing countries. Therefore, the aim of this study was to estimate the prevalence and trends of CKD according to a new estimation method. Methods: Using multiplier method, we estimated the numbers of different stages of CKD based on the number of patients with end stage renal failure from 2006 to 2016. The required multipliers were extracted from a simulation of the disease in Kerman following a dynamic model. The 95% uncertainty interval was computed using Monte-Carlo technique with 10,000 iterations. Results: The prevalence of CKDA (GFR<=90mL/min/1.73m2) and CKDB (GFR less than 60mL/min/1.73m2) patients were estimated to be 7.6% (95% uncertainty interval (UI), 5.7-9.1%) and 1.1% (95% UI, 0.8-1.3%), respectively in 2011. The method revealed that the prevalence may rise up to 25.7% (95% UI, 18.2-32.5%) and 3.7% (95% UI, 2.7-4.5%) for CKDA and CKDB, respectively in 2016, indicating approximately 3.3 times increase for both figures. Conclusion: This study predicted an increase in the prevalence of CKD in the future. This may be due to the increasing life expectancy of the population, the increase in the prevalence of non- communicable diseases such as hypertension and diabetes, or patients' survival due to receiving better support. Therefore, the policymakers should be concerned and well informed about this increase. [ABSTRACT FROM AUTHOR]

Low Back pain (LBP) is the most common type of musculoskeletal disorder (MSDs) in transfer tasks such as nursing personnel. Financial and economic costs expended for these disorders affect not only the individual, but the organization and society as well. The aim of this study was to evaluate associated factors in the incidence of LBP among nursing personnel according to risk assessment methods related to the patient's transfer. The present analytical study was conducted on 243 nurses in Kerman, Iran in 2014. The instruments for gathering data were Nordic Musculoskeletal Questionnaire (NMQ), MAPO and PTAI checklists. The data was analysed using SPSS.16 software. The prevalence of LBP among nursing personnel was 69.55%. Based on MAPO index, 48.2% of wards had moderate level of risk. In addition, the results of PTAI index also showed that 76.5% of the studied subjects were at the second risk level (moderate risk) of LBP. Work experience, work shifts and the final score of PTAI index were factors that affected prevalence of LBP the most. In this regard, we recommend the modification of factors such as guidance in work posture, use of patient transfer equipment and guidance in their use, work arrangement, mental strain of patient transfer, physical load of patient transfer and Frequency of manual patient transfer. [ABSTRACT FROM AUTHOR]

This This paper aims at determining the influence of contextual factors on information seeking behavior. This survey investigates search tactics used and users' perceptions of the search results on the Web by postgraduate students at Kerman University of Medical Sciences. This study was conducted through a mixed method. Thirty postgraduate students voluntarily participated. The study was carried out in the first semester of the academic year 2012-2013. The data was gathered using two questionnaires and log files recorded with Camtasia Studio software. The findings indicated that more than half of the participants (53.3 percent) used Google, short queries were more used than long queries, advanced search options were used rarely (23 percent), and the participants view few search result pages. According to the results, the contextual factors significantly influenced the search time, search tactics (including querying and navigating) and users' perceptions of the search results (including ease of use, usefulness, satisfaction and relevance judgment). Navigating tactic was primarily used by the participants. Among different aspects of users' perceptions of the search results, ease of use and relevance judgments were significantly different based on the contextual factors, whereas scanning, extracting, and confidence were less affected by the contextual factors. The findings suggest practical implications for information retrieval systems designers to design systems with better user interface in order to meet the needs of users with different knowledge and skills. Doing this, it leads in promotion of search process and improvement of search results quality. [ABSTRACT FROM AUTHOR]

Background: Since 2000, Iran has been delivering training and treatment services, including methadone therapy, to human immunodeficiency virus (HIV) positive patients through triangular clinics. This study aims to evaluate the effectiveness of these activities at the HIV Triangulation Centre in the city of Kerman, Iran, through clients' views. Methods: Participants were recruited using a convenience sample and assessed through in-depth interviews, and observations. Data were analyzed using a thematic analysis, matrix based method. Findings: The results found problems in training and counseling which was described by the staff to be due to the effects of the economic difficulties of the clients, not being of the same sex as the consultant, and lack of utilization of a variety of training methods by the clients. Furthermore, the absorption of clients was perceived as being affected by the appearance of the center, gossip around the center, limited working hours, and interpersonal relations between clients and staff. The clients also criticized the building of the center as it failed to maintain anonymity of the patients. The need for supplementary services, such as dentistry, was perceived by many clients. Conclusion: The application of appropriate strategies such as providing adequate training and removing the obstacles of absorption should be taken into account to increase the utility and coverage of the triangular clinic. These interventions could be a range of activities, such as relocating the center to a more decent place and encouraging the staff to appear in a professional white coat to help gain the trust of clients. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to generate a valid and adapted version of the Personal Impact Health Assessment Questionnaire (PI HAQ) compatible with Iranian culture. Patients and methods: Between October 2006 and February 2007, data obtained from 100 patients with rheumatoid arthritis (RA) (80 females, 20 males; mean age 51 years; range 20 to 78 years) in a referral rheumatologic clinic in Kerman, Iran were included in this cross-sectional study. The study had five phases; (i) translation and back translation; (ii) cultural adaptation seeking advice of expert rheumatologists in the country; (iii) assessment of face validity by deep interview technique with 20 patients; (iv) assessment of reliability and internal consistency of questionnaire and (v) assessment of content and construct validity using factorial analysis. The results of the PI HAQ were also compared with Short-Form Health Survey (SF-36) and Visual Analog Scale (VAS). Results: The Persian version of the PI HAQ had small changes in three items compatible with Iranian culture in terms of the ability of cutting meat, taking a tub bath and using a toilet. The correlation coefficient in test and re-test was high (r=0.86, p-value <0.001). Cronbach's alpha was 0.94. The correlation coefficient between the VAS and PI HAQ scores was significantly high (r=0.93, p?0.001). The factorial analysis showed that the main hidden variable explained over 50% of to total variance (Eigenvalue=50.6%). Conclusion: It seems that the adapted version of the questionnaire is a valid and reliable tool to assess the quality of life of Iranian RA patients. [ABSTRACT FROM AUTHOR]

Introduction: Iran, similar to other countries, had faced H1N1 flu outbreak in 2009. In order to assess its transmission dynamic, we estimated its force of infection (β) and basic reproductive number (R0). Methods: Within a middle size primary school in Iran, we actively followed students and detected flu-like syndrome among students and their families in the first three months of academic year; October through December 2009. We estimated the probability of disease transmission within families (β) fitting random effects Poisson regression model. Moreover, R0 within the school was computed based on the number of detected cases. Results: In 452 students, 204 influenza-like syndromes were detected. The estimated β within families was 0.10; increasing one infectious member within each family was associated with 30% increase in this number. The estimated R0 for the first month was 1.21 (95% C.I.: 0.99, 1.47); corresponding numbers for the first two and first three months were 1.28 (95% C.I.: 1.05, 1.54) and 1.32 (95% C.I.: 1.11, 1.59), respectively. Conclusion: It seems that the dynamic transmission of H1N1 virus was more or less comparable with that in other seasonal species. Our findings showed that the virus mainly circulated among students within schools. In addition, it seems that the transmission rate within families was relatively high. [ABSTRACT FROM AUTHOR]