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Background and Objective: Mortality rate and causes of death is one of the main components in health planning at each society. This study was done to show the pattern of mortality trends in Iran during 1970-2009. Materials and Methods: In this cross-sectional descriptive study related data to 9740656 deaths registered in National Organization Civil Registration were surveyed and analyzed during 1970-2009. SPSS software and statistical descriptive methods were applied to evaluate the data. Results: 60.4% of all registered death was in rural areas. 61.1% were male. Crude death rate according the current statistics decreased from 13 per 1000 in 1970-75 to 5 per 1000 in 2005-09. Life expectancy with 28.6% increased from 55.2 years in 1970-75 to 71 years in 2005-09. Conclusion: This study showed that all mortality indicators in Iran were lower than other part of the world. There was a general decreasing in infant mortality rate in last three decade. Also the death registry system has been improved during study years.

Introduction: Cox regression model is one of the statistical methods in survival analysis.Proportionality of hazard rate is an assumption of this model. In the recent decades, artificial neuralnetwork (ANN) model has increasingly used in survival prediction. This study aimed to predict thesurvival probability of Gastric cancer patients using Cox regression and ANN models.Materials and Methods: In this historical-cohort study, information of total of 436 gastric cancerpatients with adenocarcinomas pathology who underwent surgery at the Taleghani hospital of Tehranbetween 2002 and 2007 were included. Data were divided to training and testing (or validation) groups,randomly. The Cox regression model (semi-parametric model) and a three layer ANN model were usedfor analyzing of database. Furthermore, the area under receiver operating characteristic curve (AUROC)and classification accuracy were used to compare these models.Results: Prediction accuracy of ANN and Cox regression models were 81.51% and 72.60%,respectively. In addition, AUROC of ANN and Cox regression models were 0.826 and 0.754,respectively.Conclusions: ANN was better than Cox regression model in terms of AUROC and accuracy ofprediction. Therefore, ANN model is recommended for prediction of survival probability. These findingare very important in health research, particularly in allocation of medical resources for patients whopredicted as high-risks.

Introduction: Gastric cancer is one of the most common cancers in the world. The classical methodssuch as Cox regression and parametric models are used in most medical researches that their aims is thesurvival distribution survey, although the Bayes models have some advantages in compared with theclassical models. The present study was performed to analyze the survival rate of patients who had gastriccancer and were under treatment in the gastroenterology ward of Taleghani hospital, in Tehran usingBayes models. Weibull distribution was used for modeling in the study .Material and Methods: This study was a cohort study and performed in the gastroenterology ward ofTaleghani hospital by using gastric cancer patient's data from January 2003 to December 2007.178patients were enrolled to the study and their information was collected through telephone contacts. Thesurvival rate of patients were analyzed using Bayes Weibull models by considering variables such as ageof diagnosis, gender, tumor size, metastasis of other lymph. For determining of the risk factors on thesurvival of patients, was used Weibull model in the case that interval censoring. Data analysis was carriedout using Winbugs software and significant levels were considered 0.05 .Results: The results showed survival rate are dependent on the age of diagnosis and tumor size. Thosepatients who had early diagnosis, the rate of survival was greater. In addition, he patients who had smallertumor size, their survival rate was greater .Conclusion: Considering to classical models are based on normal approximation and applicable for bigsamples, Bayes methods are emphasized for small to medium samples. The results of this study showedthat the Bayesian Weibull model is a suitable model. This study also showed that age of diagnosis andtumor size of patients is important factors in regard to the survival rate of these patients. As a result, ifgastric cancer is diagnosed early, the relative risk of death would reduce.

Background and aims: Construction is one of the most dangerous industries in the worldwide. Workplace safety is a complicated phenomena and behavioral safety in the construction industry is even more so. The Aim of this study was the development of a new model for understanding the factors influencing unsafe behavior in construction industry. Methods: In the current quantitative study, a three-stage Structural Equation Model (SEM) was conducted on two main construction workplaces in Iran. In the first stage, the measurement model was tested by confirmatory factor analysis. Then, a modified structural model was extracted for the workplace 1. Finally, the modified model was evaluated in the workplace 2. LISREL 8.8 was used for data analysis process. Results: Goodness-of-fit indices indicated the modified structural model in the workplace 1 was confirmed in the workplace 2 (GFI=0.93 SRMR=0.04 RMSEA=0.06 CFI=0.97 NFI=0.98 χ2/df=1.98). Client safety climate had the highest correlation (SPC=0.87, t-value=16.21) with overall safety climate. Attitudes and beliefs had the greatest correlation (SPC=0.87, t-value=13.34) with overall individual factors. The physical condition had the highest correlation (SPC=0.77, t-value=7.69) with the overall safety performance. Conclusion: For implementing of the effective interventions in the construction industry, we must use an integrated and good-fit model to understanding factors influencing unsafe behavior. The current model can help us to understanding the factors influencing unsafe behavior in construction projects.

Background: There is evidence that a significant proportion of people living with HIV (PLWH) still practice unsafe sex and this remains a challenge for HIV prevention. Since some manuals can have positive effects on condom use among the high risk population, this qualitative study explored perceptions of Iranian PLWH regarding such manuals. Methods: In-depth, semi-structured interviews were held with a purposively selected group of PLWH recruited from three HIV care clinics in Tehran, Iran. Overall, 34 individuals including 26 HIV positive patients (22 males and 4 females) were interviewed. In addition, 5 healthcare workers and 3 wives of HIV-patients were also interviewed. All interviews were recorded and typed, and the codes were extracted after reviewing them several times. Data was analyzed using the content analysis approach. Findings: Participants pointed to the internal and external stimuli. Conscience was the most important internal stimulus. The most influential external stimuli included mass media, consulting with health care providers, communication with friends, and training. Conclusion: Although external stimuli such as the media can have a significant role in the adoption of safe behaviors and preventing sexual transmission of AIDS, focusing on internal stimuli may also be of high importance. Keywords: HIV/AIDS, Condom, Cues to action, Media

Introduction: Colorectal cancer is the most common cancer of digestive system and also fourth cause fordeath of cancer around the world. Different studies indicate that survival of patients suffering fromcolorectal cancer has recently developed in some areas of the world. However, it is not clear which factorsinvolve in this improvement. This study aims at investigating some clinical and pathologic factors inprognosis of these patients with colon and rectum cancers separately.Material and Methods: Data recorded from 1194 patients with colorectal cancer in Cancer RecordCenter of Research Center for Gastroenterology and Liver Disease, Shahid Beheshti University of MedicalSciences (Tehran, Iran) was used in this study. Data analysis was performed using competing risks model.Software used for data analysis was STATA, 11 version, and significance level was regarded as 0.05.Results: Body mass index, alcohol consumption, tumor site, inflammatory bowel disease, metastasis tolymph nodes and metastasis to other organs had significant effect on death of colon cancer, while bodymass index, metastasis to other organs and kind of the first treatment had significant effect (P

Background and aims: The construction industry continues to rank among the most dangerous industries worldwide. The aim of this study was to investigate the factors influencing unsafe behavior in the construction industry from the perspective of experienced workers, supervisors and managers. Methods: Triangulation approach was used for data generation in this grounded theory study. Sixty nine participants from a variety of work groups took part in focus group interviews, individual interviews, field observations, and focus group discussions. Thematic analysis was conducted to emerge and identify the contributing factors. Results: The thematic analysis identified six main categories as influencing factors of unsafe behaviors, namely: (1) Social (2) Organizational (3) Contractor (4) Supervision and system safety (5) Unsafe condition and (6) Individual characteristics. Conclusion: Our findings indicated the significant role of social and organization factors as the precondition of unsafe conditions and behaviors. These results can be used to improve safe behaviors on construction sites. Keyword: Unsafe behavior Conceptual model Grounded theory Construction industry

Background and aims:Traffic safety has been influenced by mobile phone induced distractionwhile driving and related car crashes. The effects of audio-verbal tasks on driving performances likebreak reaction time, hazard detection time and deviation from lane have been studied by manyresearchers. But driver’s audio-verbal performance in has not received more attention. The effect ofdriving task on conversation task and vice versa can be determined by evaluating conversationperformance and can explain how drivers prioritize two tasks.Methods: In this experimental study remembering of negative and positive words by 52 young (23t0 35 years old) male participants while driving a simulator was examined.Results:Results revealed that Short-Term Memory (STM) performance is influenced by difficultylevel of audio task and road type. The Wilcoxon test for nonparametric paired data showed thatmean rank for remembered words in two-way roads is greater than one way roads and thisdifference is statistically significant. Also this test has performed for considering the effect ofword’s semantic content on STM performance and showed that there is no statistically significantdifference between remembered positive words and negative ones. Negative and significantcorrelation found between age and driving experience with remembering wordsConclusion:These findings shows that driver’s STM performance while driving is related to limitedcapacity of short-term memory in one hand and is influenced by driving circumstances like speedand road type on the other hand. More studies have suggested determining the effect of semanticcontent of auditory task on STM performance while driving.

Introduction: Chemotherapy after surgery is one of the adjuvant therapy components in breast cancerpatients. In the current study, Taxane-based and Anthracycline-based regimes were compared toCyclophosphamide, Methotrexate and 5-Fluorouracil (CMF) chemotherapy after modified radicalmastectomy (MRM) surgery in terms of disease-free survival (DFS).Materials and Methods: Sixty-two patients with confirmed breast cancer that underwent MRMsurgery at no metastasis stage (M0) enrolled. These patients were received one of the three types ofadjuvant chemotherapies that mentioned above and the relapse/metastasis in 8-year follow-up wasrecorded. In addition, some paraclinical and demographical factors were recorded and the efficacy of thedifferent chemotherapy regimes was compared using log-logistic survival model.Results: The mean age (SD) of patients was 49 (1.31). More than 40% of patients had tumors withgrade 3. The median time of follow-up was 20.0 months and the rate of 5-year DFS was 48%. Survivalanalysis indicated that type of chemotherapy (OR(Taxane/CMF) =3.676; OR (Anthracycline/CMF) =3.185),histological grade (OR=2.528), tumor size (OR=5.598) and number of lymph nodes (OR=1.112) affectthe DFS.Conclusion: The results of the current study indicated that the efficacy of Taxane-based andAnthracycline-based is more than CMF. This study also showed that early detection of tumor was animportant factor for a successful treatment in terms of DFS, and so, it declares the roll of screening andpublic education.

Background: Cervical cancer is a preventable disease with a regular screening program. Many studies have reported a large number of barriers that women had for the first time, but this study decided to find other barriers for the second time pap smear. Methods: In this qualitative research, data were gathered through in-depth interviews and expressed through conventional content analysis in the form of constant comparison. The participants were 15 women with family profile at 30 health care centers who lived in the south of Tehran and had done Pap smear for one time but didn’t do it for the second time. Results: Three main themes emerged from the analysis of the interviews: negative experiences of the first Pap test were as follows: results of the first time test, readiness for performing the test, getting the test itself, and the site of the first Pap test. Personal barriers to getting the second Pap test were: inattention to time, physical barriers to the second Pap test, and inhibitory beliefs. Perceived social barriers to getting the second Pap test with two sub-themes included social supports and abstract norms. Conclusion: This study provided other barriers about Pap smear including lack of the spouse’s support, the role of health care providers and physicians in screening program for early diagnosis in women.