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Introduction: Motorcyclists have the highest proportion of casualty toll caused by street accidents in Iran, and they endanger themselves and others by those risky behaviors. Health and safety education will not be sufficient without knowing the causes of such behaviors. Since no studies have been carried out based on accurate statistical methods on bounded response variables for motorcyclists' high-risk behaviors in Iran, this study aimed to predict MRBQ by ADHD and the underlying predictors using the Beta Regression as an alternative strategy. Methods: The present sectional study included 311 Motorcyclists randomly selected using a cluster sampling method in Bukan city to evaluating the relationship between the limited response MRBQ with ADHD and its subscales. We used an innovative beta regression method for the analysis and carried out unadjusted and adjusted modeling. Results: Direct and significant relationships were observed between MRBQ score and ADHD score and its subscales, including (DSS score) (coefficients ranged over 0.01 to 0.6, All P

Background: In 2015, the Iranian Urban Family Physician Program (UFPP) was implemented in urban health centers. In the present study, we aimed to evaluate the trend of health indicators across a ten-year period in an Iranian population and to measure the possible effects of this intervention on health indicators.Methods: An interrupted time series analysis (ITSA) was performed on a ten-years (from 2009 to 2018) of annual data set covering all healthcare indicators associated to the UFPP in Bonab County, Iran. The time of intervention was at the 7th data point in 2015. Health indicators were divided into two groups including process indicators (Modern Contraceptives Use (MCU), Prenatal and Postpartum care visits, Clinical Breast Examinations (CBE), brucellosis and tuberculosis (TB) incidence), and outcome indicators (Total fertility rate (TFR), Maternal Mortality Rate (MMR), Stillbirth Rate (SBR), Infant mortality Rate (IMR), Neonatal Mortality Rate (NMR), 1-59 months old Mortality Rate, Low Birth Weight (LBW), crud birth rate (CBR) and the rates of Infants fed by Formula milk.Results: The ratio of some process indicators, including the MCU (b = -5.13. 95% Confidence Interval (CI): -8.01 to -2.26), incidence of tuberculosis (b = .016. 95% CI: -1.01 to 1.34) and brucellosis (b = 3.04. 95% CI: -3.4 to 9.50) had a decreasing trend from 2008 to 2018. However, the CBE (b = 0.60. 95% CI: -4.97 to 6.18), prenatal care visits, (b= -4.25. 95% CI: -10.4 to 1.5) postpartum care visits (b = -22.83. 95% CI: -31.44 to -14.21), and first time care visits during pregnancy (b = -5.59. 95% CI: -14.52 to 3.32) were found with increasing trends. In contrast, the rate of at least six-time care visits during pregnancy was found to be in a decreasing trend (b = -10.32. 95% CI: -16.82 to -3.82). A series of outcome indicators including MMR (b = 24.78. 95% CI: 2.88 to 46.61), TFR (b= 0.07. 95% CI: 0.01 to 0.13), 1-59 Month old Mortality Rate (b = -.16. 95% CI: -.45 to .12), LBW (b = .33. 95% CI: -.08 to .40), Formula-fed infant rate (b = .48. 95% CI: -.007 to .97), Delivery rate in high-risk groups (b = 1.85. 95% CI: 1.22 to 2.49) and CS (b = -3.43. 95% CI: -5.73 to -1.12) had increasing trends from 2008 to 2018. In contrast, SBR (b = -.04. 95% CI: -.21 to .12), NMR (b = -.77. 95% CI: -2.91 to 1.36), IMR (b = -1.05. 95% CI: -2.99 to .89) and CBR (b = -.97. 95% CI: -1.85 to -.09) were in decreasing trends. Conclusion: The UFPP was found with positive impacts on some process, proximal and distal outcome indicators, but its positive impacts on the trends of some critical indicators, including MMR, NMR and IMR remained questionable. Our findings may shed light on the role of some other factors like social determinants of health in the programs like the UFPP.

Background: Breast cancer (BC) was the fifth cause of mortality worldwide in 2015 and second cause of mortality in Iran in 2012. This study aimed to explore factors associated with survival of patients with BC using parametric survival models. Materials and Methods: Data of 1154 patients that diagnosed with BC recorded in the East Azerbaijan population-based cancer registry database between March 2007 and March 2016. The parametric survival model with an accelerated failure time (AFT) approach was used to assess the association between sex, age, grade, and morphology with time to death. Results: A total of 217 (18.8%) individuals experienced death due to BC by the end of the study. Among the fitted parametric survival models including exponential, Weibull, log logistic, and log-normal models, the log-normal model was the best model with the Akaike information criterion = 1441.47 and Bayesian information criterion = 1486.93 where patients with higher ages (time ratio [TR] =0.693; 95% confidence interval [CI] = [0.531, 0.904]) and higher grades (TR = 0.350; 95% CI = [0.201, 0.608]) had significantly lower survival while the lobular carcinoma type of morphology (TR = 1.975; 95% CI = [1.049, 3.720]) had significantly higher survival. Conclusion: Log-normal model showed to be an optimal tool to model the survival of patients with BC in the current study. Age, grade, and morphology showed significant association with time to death in patients with BC using AFT model. This finding could be recommended for planning and health policymaking in patients with BC. However, the impact of the models used for analysis on the significance and magnitude of estimated effects should be acknowledged.

Attention Deficiency and Hyperactivity Disorder (ADHD), as a predictor of injuries in motorcyclists, affects the risky behavior. Since there was no pre-established conceptual model, this study aimed at exploring a conceptual model. Following this model, the Structural Equation Modeling (SEM) was utilized to find the predictors of Motorcycle Riding Behavior (MRB), as well as the mediators and moderators of ADHD-MRB relationship. In the current cross-sectional study, 340 motorcyclists in Bukan city, Iran, were recruited through a randomized cluster sampling. A simple conceptual model was explored and utilizing the goodness of fit indices in SEM, an optimal model was chosen. Then, utilizing 3-step hierarchical regressions and SEMs, the relationship between ADHD and MRB was assessed by modeling the possible mediators/moderators such as answering the cell phone and using the helmet. The results of hierarchical regression showed that answering the cell phone had both moderating and mediating effects on the relationship between ADHD (and the ASS subscale) with MRB. The final SEM, by introducing the mediating role of underlying variables, had a good fit on data (Normed Chi2 = 0.90), wherein ADHD score (and the subscales) predicted the MRB score directly/indirectly (P