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Physical disability is one of the factors influencing the sexual and reproductive health (SRH) of people. Women with a severe disability receive fewer Pap smear tests, regular mammography examinations, and sex education. This study was carried out to identify the SRH needs of women with spinal cord injuries (SCI) in Tehran (Iran) in 2019. This descriptive cross-sectional study was conducted using the SRHNA-SCI validation tool. The study included married Iranian women between the ages of 18 and 55 years, who had SCI. and were registered with the Welfare Organization of Tehran. A total of 78 questionnaires were collected for statistical analysis. The mean age of the participants was 41.73 ± 8.42 years and they were mainly high school graduates with diplomas (35.9%), housewives (85.9%), and patients with thoracic injuries (61.5%). The SRH needs of women with SCI were the need for improving the quality of services (98.87 ± 2.34%), social needs (98.66 ± 3.03%), the need for services of the Welfare Organization (98.04 ± 6.28%), personal needs (98.03 ± 4.59%), sexual needs (96.58 ± 7.66%), and educational needs (96.83 ± 5.32%), respectively. The provision of low-quality SRH services is seemingly the most important preventive factor, while the absence of family and community support is the factor influencing the promotion of the SRH of women with SCI. Therefore, the attainment of this goal is contingent on the cooperation and interaction of different organizations such as the Ministry of Health, the municipality, the insurance organization, the Welfare Organization, and non-governmental organizations. [ABSTRACT FROM AUTHOR]

Background: Exposure of nontarget organs such as the thyroid gland (as a normal and high radiosensitive tissue) to radiation during radiotherapy for patients with head-and-neck cancers remains unavoidable. Hypothyroidism is the most common radiation side effect on the thyroid gland. In this study, we used the parameters of thyroid gland (triiodothyronine [T3], thyroxine [T4], and thyroid-stimulating hormone [TSH]) measurements before and after radiotherapy for patients with head-and-neck cancers. Materials and Methods: In the first step, descriptive statistics for predictors and response variables were performed. In the next step of data analysis, a multivariate linear mixed-effects model was fitted simultaneously for three response variables in order to study the trend of thyroid gland parameters. Results: The results indicated that there was a significant decreasing trend in TSH from 1.74 at baseline to 0.65 at the end of the study, and there was a significant increasing trend in T4 from 8.63 at baseline to 9.38 at the end of the study. Conclusions: There were significant changes in thyroid gland parameters after radiotherapy treatment for patients with head-and-neck cancers. Thus, preventative strategies are needed to reduce this complication. The patients with head-and-neck cancers who received radiotherapy treatment should be evaluated regularly and repeatedly during the radiotherapy treatment period. [ABSTRACT FROM AUTHOR]

This simulation study aims at investigating the performance of maximum likelihood and weighted least-square estimation approaches in growth curve models with categorical data. The goodness-of-fit indices were compared with a number of scenarios (different trajectories, sample sizes, replications, and number of categories). The results show that when the number of categories and replications are small, using weighted least-square estimating methods leads to better goodness-of-fit indices. However, when the number of categories and replications are large, both maximum likelihood and weighted least squares in estimating methods will result in similar fit indices. [ABSTRACT FROM AUTHOR]

Aim: For the purpose of cost modeling, the semi-parametric single-index two-part model was utilized in the paper. Furthermore, as functional gastrointestinal diseases which are well-known as common causes of illness among the society people in terms of both the number of patients and prevalence in a specific time interval, this research estimated the average cost of functional gastrointestinal diseases. Background: Health care policy-makers seek for real and accurate estimations of society's future medical costs. However, data dealt with in hygienic studies have characteristics which make their analysis complicated; distribution of cost data is highly skewed since many patients pay great costs. In addition, medical costs of many persons are zero in a specific time interval. Indeed, medical costs data are often right skewed, including remarkable number of zeros, and may be distributed non-homogeneously. Patients and methods: In modeling these costs by the semi-parametric single-index two-part model, parameters were determined by method of least squares; a result of this method was compared with the results yielded from two-part parametric model. Results: Average costs of functional gastrointestinal diseases and their standard deviation in semi-parametric and parametric methods were yielded as $72.69±108.96 (R2=0.38) and $75.93±122.29 (R2=0.33) respectively. Conclusion: Based on R2 index, the semi-parametric model is recognized as the best model. Totally, the two-part parametric regression model is a simple and available model which can be easily interpreted; on the other hand, though the single-index two-part semi-parametric model cannot be easily interpreted, it has considerable flexibility. The study goals can be indeed used as the main factor for choosing one of these two models. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to compare alternatives methods for analysis of zero inflated count data and compare them with simple count models that are used by researchers frequently for such zero inflated data. Background: Analysis of viral load and risk factors could predict likelihood of achieving sustain virological response (SVR). This information is useful to protect a person from acquiring Hepatitis C virus (HCV) infection. The distribution of viral load contains a large proportion of excess zeros (HCV-RNA under 100), that can lead to over-dispersion. Patients and methods: This data belonged to a longitudinal study conducted between 2005 and 2010. The response variable was the viral load of each HCV patient 6 months after the end of treatment. Poisson regression (PR), negative binomial regression (NB), zero inflated Poisson regression (ZIP) and zero inflated negative binomial regression (ZINB) models were carried out to the data respectively. Log likelihood, Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to compare performance of the models. Results: According to all criterions, ZINB was the best model for analyzing this data. Age, having risk factors genotype 3 and protocol of treatment were being significant. Conclusion: Zero inflated negative binomial regression models fit the viral load data better than the Poisson, negative binomial and zero inflated Poisson models. [ABSTRACT FROM AUTHOR]

Parents and school staff play important roles in promoting children's oral health. Our study goals were to investigate whether an intervention targeting parents and school staff can improve the oral-health behavior and oral-health status of schoolchildren. Three-hundred and ninety-two schoolchildren in six schools in Tehran participated in a group randomized trial from September 2010 to March 2011. Schools were randomly allocated into three groups: comprehensive, student, and control. Intervention in the comprehensive group consisted of strategies to encourage children, their parents, and school staff to increase the frequency of toothbrushing and flossing. In the student group, the intervention targeted only children. The control group received no intervention. The primary outcome was change in oral-health behaviors (brushing and flossing), while the secondary outcomes were changes in oral hygiene and Community Periodontal indices and in Health Belief Model components. Multilevel modeling was employed for data analyses. Students who were in the comprehensive intervention group brushed and flossed significantly more frequently compared with those in the student intervention group. Although students' gingival health improved significantly in the comprehensive intervention group, such significant improvement was not seen in the student group. In conclusion, promising results are seen when the oral-health education targets both school and home settings. [ABSTRACT FROM AUTHOR]

In many areas of medical research, especially in studies that involve paired organs, a bivariate ordered categorical response should be analyzed. Using a bivariate continuous distribution as the latent variable is an interesting strategy for analyzing these data sets. In this context, the bivariate standard normal distribution, which leads to the bivariate cumulative probit regression model, is the most common choice. In this paper, we introduce another latent variable regression model for modeling bivariate ordered categorical responses. This model may be an appropriate alternative for the bivariate cumulative probit regression model, when postulating a symmetric form for marginal or joint distribution of response data does not appear to be a valid assumption. We also develop the necessary numerical procedure to obtain the maximum likelihood estimates of the model parameters. To illustrate the proposed model, we analyze data from an epidemiologic study to identify some of the most important risk indicators of periodontal disease among students 15–19 years in Tehran, Iran. [ABSTRACT FROM AUTHOR]

Background and purpose: Vaso-cardiac diseases are among the most Prevalent causes of death in the world. According to the studies it is expected that they become the main cause of death until 2020. Materials and methods: The aim of this research is preparing the geographical maps of the relative death rate out of Vaso-cardiac diseases in cities of the Mazandaran province in 2008 Method: In this research, we have analyzed data related to the registered death rate of Mazandaran province's cities in 2008 caused by Vaso-cardiac diseases, using statistical winbas software. Results: The highest estimated risk among females related to Juibar town and lowest to Noshahr the highest and lowest risk among males related to Tonekabon and Mahmud Abad respectively. Conclusion: The relative death rate prevalence caused by vasco-cardiac diseases is not symmetric in the whole Mazandaran province, in general. This rate is higher in western areas; but is nearly the same among males and females. [ABSTRACT FROM AUTHOR]

Background and purpose: To analyze the data in which the correlation between observations are to be considered, a general method is using marginal model with repeated measures, yet there is another method called conditional model with random clusters. According to the binary responses, the aim of the present study is to compare the efficiency of these two models in studying the risk factors affecting hypertension in Mazandaran province. Materials and methods: This cross-sectional study is part of research studying the risk factors of the non-infectious diseases in Mazandaran province in 2007 with a sample size of 1000 cases. First, stratified sampling was employed and then random cluster sampling was used in each stratum. In all cases, blood pressure was measured three times through standard methods. The obtained data were analyzed using χ² test and fitting marginal and conditional logistic models. Results: Of the total of 1000 (500 male and 500 female) cases, 38 percent had high blood pressure. In both models four variables of age, physical activity, body-mass-index, and the consumption of fruits and vegetables were identified as factors affecting hypertension. In addition, gender and fasting blood sugar were statistically significant only in marginal logistic model. Using goodness-of-fit criteria, values of all the statistics for conditional logistic model with random effects of individuals were lower in comparison with the marginal logistic model with repeated measures. Conclusion: It can be concluded that although one cannot decisively select a model as the most appropriate one, conditional logistic model fits were somewhat better than the marginal logistic model with repeated measures, so it can be used to analyze such data. [ABSTRACT FROM AUTHOR]

Introduction: Cancer diagnosis is an extremely stressful experience that has a profound impact on a patient's life. Cancer related perceived stress and complications may lead to the experience of positive psychological changes and post-traumatic growth (PTG). Since there is lack of qualitative research assessing the experience of PTG in Iranian women with breast cancer, this study aims to investigate experiences relating to PTG of Iranian women. Methods: A qualitative phenomenological approach was selected to explore the experiences of Iranian women with PTG. Data were gathered using semi-structured, in-depth interviews with 18 eligible patients, which were then transcribed and analyzed using Van Manen's thematic analysis approach. Data gathering and analyses were conducted simultaneously. In addition, MAXQDA software was used for data management. Results: In this study, the participants were 18 Iranian women between the ages of 31 and 65 years. Four prominent themes were extracted from the participant's statements that demonstrated the Iranian women's experiences with breast cancer-induced psychological growth and maturity: 1) appreciate of life, 2) stability, 3) spiritual prosperity, and 4) effective interaction. Conclusion: Health care professionals are strongly recommended to design robust and timely intervention programs to improving PTG among breast cancer survivors and reduce their perceived distress resulting from cancer diagnosis. [ABSTRACT FROM AUTHOR]