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Background: Assessing children's early development can help health and social policymakers to improve children's well-being. This study aims to develop an early childhood composite index for measuring early childhood care and education among Iranian children considering each child's geographical area, socioeconomic status and gender. Methods: In this cross-sectional secondary study, the data come from Iran's Multiple Indicator Demographic and Health Survey 2010. Of the 9,345 eligible children whose information had been collected, 3,532 fulfilled the inclusion criterion of being 3 or 4 years old at the time of the interview. We examined a composite index and three subscales of early childhood development including "Quality of Care", "Early Childhood Care and Education", and "Overall Developmental Status". Factor analysis and latent class analysis were used for analyzing the data. Results: The results indicate that of the children in the sample, 47.3% were in the "low early child development" class, 6% were in the "middle early child development" class, and 46.7% were in the "high early child development" class. The means of the three subscales and the composite index were significantly different across geographical areas (P < 0.01) and between the socioeconomic classes (P < 0.0001), with children from poorer families having lower scores. The composite index was significantly higher for girls (M = 11.28, SD = 3.96) than boys (M = 10.99, SD = 3.87, P = 0.029). Conclusions: The study presents significant differences in childhood development based on geographical divisions, quartile classes and gender. We suggest that future research is needed to explore the robustness of findings in this study over time and diversity between and within various Iranian populations. [ABSTRACT FROM AUTHOR]

Background: To study correlates which are related to retention time of a cohort study of the opioid-dependent patients participating in the Methadone Maintenance Treatment (MMT) program offered by a major addiction treatment clinic in Tehran, Iran between April 2007 and March 2011. Methods: Several parametric Survival models assuming Weibull, Log-normal and Log-logistic distributions were compared to search for association between covariates and risk of relapse and dropping out of treatment among 198 patient participants. Results: According to Akaike Information Criterion (AIC), Log-normal model had the best fitting. Estimates of this model indicated that increase in average methadone dosage was associated with longer retention time. Correlates associated with shorter retention time were suffering from mental disorders, using stimulant drugs, being polysubstance dependents and having prior treatments. Conclusions: Findings of this study provide support for giving more attention to patients who are poly-substance or stimulant-drug dependents, have non-substance psychiatric comorbidity and the ones with addiction treatment history. Independent of patient characteristics, retention improved as the dose of methadone increased. [ABSTRACT FROM AUTHOR]

Objective: Inventory Drug-Taking Situations (IDTS) is a universal instrument used to determine high-risk situations resulting in drug abuse. The aim of this study was to translate this questionnaire to Farsi, and to assess its validity and reliability by applying it to Iranian drug users. Methods: As a psychometric study, 300 drug users participated in a treatment program in National Center of Addiction Studies filled in a version of Inventory of Drug Taking Situations. We assessed face and content validity, internal consistency, and reliability based on the completed questionnaires, using test-retest method and confirmatory factor analysis. Results: Internal consistency analysis confirmed that all subscales of IDTS were reliable (Cronbach alpha was ranging from 0.7 to 0.81). Analyses indicated that each of the subscales was unifactorial; however, unpleasant emotions had a second eigenvalue that was nearly large enough to be a second factor. Confirmatory factor analysis was used to test the fit of the data to the original version of IDTS. Based on goodness of fit indices, we found that all factors were fitted (X2/df=1.43, GFI=0.98, RMSEA=0.038). The test-retest reliability was satisfactory(r>0.6). Conclusion: The Farsi version of Inventory of Drug Taking Situations was shown to be a valid and reliable instrument to apply in clinical and research settings in Iran. [ABSTRACT FROM AUTHOR]

Background: The determinants of the intention to stop childbearing tend to differ over time and contexts. This allows the issue of families' childbearing intentions to continually remain on the research agenda. As societal context and temporal variability will matter for second childbearing intentions, this study aimed at uncovering the reasons behind the intentions to stop childbearing from one-child mothers' perspective., Method: A qualitative descriptive study in Isfahan City, Iran, was used to scrutinize reasons behind the unwillingness to have a second pregnancy. A purposeful sampling with maximum variation was used to select one-child mothers. Until reaching saturation, 48 semistructured interviews were conducted. A thematic analysis was used to analyse the qualitative data., Results: Five themes and 19 subthemes emerged from the data analysis as structural attributes (economic, social and political conditions), parental attributes (parental (dis)agreements, childrearing troubles, having impatience and being at the inappropriate age for childbearing), husband attributes (having the intention to stop parenting, financially and emotionally nonsupportive and being busy by working), maternal attributes (health-related problems, adverse experience during former pregnancy, being employed, self-compassion, the fear of parity progression and being pessimistic) and child attributes (having a naughty child and having the physical or mental distress of the first child)., Conclusion: Overall, findings highlight the multifaceted nature of factors influencing second childbearing intentions. Structural reasons at macro level, intrafamily relationship, mothers' self-related factors and challenges of raising the first child all play distinct roles in discouraging mothers from a second child intention. Understanding these key reasons can help policymakers, researchers and individuals alike to comprehend the complexities involved in family planning and fertility decisions., (© 2024 John Wiley & Sons Ltd.)

Background: Determining cardiovascular disease (CVD) research priorities is essential given the high burden of these diseases, limited financial resources, and competing priorities. This study aimed to determine the research priorities in CVD field in Iran using standard indigenous methods., Materials and Methods: An extensive search was done in relevant international and national studies. Then, an indigenous standard multistage approach based on multicriteria decision analysis steps was adapted to local situation and implemented. This process included forming a working group of experts in priority setting methodology, identifying the context and prioritization framework, discussing the methodology with the National Network of CVD Research (NCVDR) members who ultimately determined the priority research topics, weighted topics criteria, ranked topics, and reviewed all determined research priorities for final report., Results: Thirteen cardiovascular research priorities were determined by the NCVDR members. The first five priorities based on their scores include studies in hypertension, prevention and control of ischemic heart disease (IHD) and its risk factors, burden of IHD, Registration of CVDs, and COVID-19 and CVDs., Conclusion: Cardiovascular research priorities were determined using a standard indigenous approach by national experts who are the NCVDR members. These priorities can be used by researchers and health decision makers., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Research in Medical Sciences.)

Objective: Pesticides have been used as the main part of the national cutaneous leishmaniasis control program for serveral years in Iran. However, the cost-effectiveness of this strategy has not been yet analyzed. The aim of this study is to to analyze the cost-effectiveness and cost-utility of using pesticides as the main strategy to prevent rural CL in Isfahan., Methods: This is an economic evaluation study performed from a health system perspective to estimate the cost-effectiveness and cost-utility of the control strategy with and without pesticides. The outcome measures are incidence rate of cutaneous leishmaniasis and the disability-adjusted life years (DALYs). The cost-effectiveness and cost-utility have been analyzed by calculating incremental cost-effectiveness ratio (ICER). Data of cost and incidence rate obtained from the health centers of Isfahan University of Medical Sciences and Vice-Chancellery for Health. The disability weight was obtained from the literature. A one-way sensitivity analysis was applied with a 20% increase and decrease in costs., Findings: The total cost of control program in 2013 and 2014 were US$578,453 (ppp) and US$14,978.2 (ppp), respectively. The incidence rate of cutaneous leishmaniasis was estimated at 1396 and 1277 (per 100,000 population in hyperendemic areas where pesticides have been used) in 2013 and 2014, respectively. DALY lost due to disease was estimated to be 8.024 and 7.342 in 2013 and 2014, correspondingly. Both the cost-effectiveness and the cost-utility analyses resulted in negative ICERs, lying in the rejection area of the ICER plane., Conclusion: The use of pesticides to prevent cutaneous leishmaniasis (rural sicker) in Isfahan province has not proved to offer a reduction in the incidence rate of cutaneous leishmaniasis as well as reduction in DALYs lost. However, due to data availability limitation, the time frame for this study was limited. A prospective design with longitudinal data is recommended to be used by future research. Other alternatives to raise population awareness about different aspects of disease should be also considered for evaluation., Competing Interests: There are no conflicts of interest.