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Statement of the Problem: Dental caries is the most common chronic disease among children. Determinants of children’s oral health behavior should be better understood and known. Purpose: This study aimed to investigate the predictive factors of oral health behavior among preschool children based on the theory of planned behavior (TPB). Materials and Method: This cross-sectional study included 833 mother-child pairs referring to twenty health centers in Tabriz, North-West Iran, from August 2014 to November 2015. The participants were selected by multi-stage stratified random sampling. Data were collected through self-administered questionnaires completed by the participating mothers. The questionnaire consisted of demographic characteristics, oral health behavior, and TPB structures (attitude, subjective norms, perceived behavioral control, and intention). Results: The mean±standard deviation (SD) of children’s age was 4.6±1.1 years (ranging 3–6), and 52% were boys. 20.3% of mothers had university degrees. The mean (SD) score of children’s oral health behavior was 5.8 (±1.9) out of 8. Muliple regression analysis revealed a positive relationship between all TPB structures and children’s oral health behavior F(11,821)=41.8, R=0.6, (p< 0.001). Furthermore, the TPB structures explained 35% and 29% of the variance in children’s oral health behavior and maternal intention towards it, respectively. Conclusion: Based on the current finding, TBP is the important predictor of children’s oral health behavior. Effective promotion interventions could be designed based on this predictor to help improving the children’s oral hygiene behavior.

Additional file of The psychosocial barriers to medication adherence of patients with type 2 diabetes: a qualitative study

Shadi Ghasemi,1 Behzad Mahaki,2 Emanuela Dreassi,3 Saeedeh Aghamohammadi4 1Student Research Committee, Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran; 2Department of Biostatistics, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Department of Statistics, Computer Science, Applications (DiSIA), University of Florence, Florence, Italy; 4Iranian Ministry of Health and Medical Education, Tehran, IranCorrespondence: Behzad Mahaki Tel +98 09128077960Email behzad.mahaki@gmail.comPurpose: Lung cancer is considered as a common cause of cancer mortality. The disease represents the second and third causes of deaths from cancer among Iranian women and men, respectively. The present study aimed to evaluate the spatial variations in relative risk of lung cancer mortality in Iran and its relation to common risk factors between men and women and specific risk factors among women.Methods: In this ecological study, the lung cancer mortality data were analyzed in Iran during 2011– 2014. Besag, York, and Mollie’s (BYM) model and shared component model (SCM) were used to compare the spatial variations of the relative risk of lung cancer mortality by applying OpenBUGS version 3.2.3 and R version 3.6.1.Results: The median age for death due to lung cancer in Iran is 74 years. During 2011– 2014, the age-standardized lung cancer mortality rates among men and women were 12 and 5 per 100,000 individuals, respectively. In addition, almost similar spatial patterns were observed for both men and women. Further, risk factors, which are shared between men and women, were considered as the main cause of variation of lung cancer mortality relative risk in the regions under study for both men and women. The highest impact of the women-specific risk factors was estimated in northeastern and southwestern of the country while the lowest was related to Gilan province in northern part of Iran.Conclusion: Based on the spatial pattern, lung cancer risk factors are at relatively high levels in most parts of Iran, especially in the northwest of the country. Regarding the women, the high-risk regions were considerably extended. Further, the highest concentration of the specific risk factors among women was observed in the eastern, central, and southwestern parts. The smoking effect, and the second-smoking effect and environmental pollutions could play more significant roles for men and women, respectively.Keywords: ecological study, age-standardized mortality rate, BYM model, shared component model

Background: The reduction in fertility and increase in the number of single-child families in Iran will result in an increased risk of population aging. One of the factors affecting fertility is women's empowerment. This study aimed to evaluate the relationship between women's empowerment and fertility in single-child and multi-child families. Materials and Methods: This case-control study was conducted among 350 women (120 who had only 1 child as case group and 230 who had 2 or more children as control group) of 15–49 years of age in Isfahan, Iran, in 2016. For data collection, a 2-part questionnaire was designed. Data were analyzed using independent t-test, Chi-square test, and logistic regression analysis. Results: The difference between average scores of women's empowerment in the case group 54.08 (9.88) and control group 51.47 (8.57) was significant (p = 0.002). Simple logistic regression analysis showed that under diploma education, compared to postgraduate education, (OR = 0.21, p = 0.001) and being a housewife, compared to being employed, (OR = 0.45, p = 0.004) decreased the odds of having only 1 child. Multiple logistic regression results showed that the relationship between women's empowerment and fertility was not significant (p = 0.265). Conclusions: Although women in single-child families were more empowered, this was not the main reason for their preference to have only 1 child. In fact, educated and employed women postpone marriage and childbearing and limit fertility to only 1 child despite their desire.

Background: Among the proposals for joint disease mapping, the shared component model has become more popular. Another advance to strengthen inference of disease data is the extension of purely spatial models to include time aspect. We aim to combine the idea of multivariate shared components with spatio-temporal modelling in a joint disease mapping model and apply it for incidence rates of seven prevalent cancers in Iran which together account for approximately 50% of all cancers. Methods: In the proposed model, each component is shared by different subsets of diseases, spatial and temporal trends are considered for each component, and the relative weight of these trends for each component for each relevant disease can be estimated. Results: For esophagus and stomach cancers the Northern provinces was the area of high risk. For colorectal cancer Gilan, Semnan, Fars, Isfahan, Yazd and East-Azerbaijan were the highest risk provinces. For bladder and lung cancer, the northwest were the highest risk area. For prostate and breast cancers, Isfahan, Yazd, Fars, Tehran, Semnan, Mazandaran and Khorasane-Razavi were the highest risk part. The smoking component, shared by esophagus, stomach, bladder and lung, had more effect in Gilan, Mazandaran, Chaharmahal and Bakhtiari, Kohgilouyeh and Boyerahmad, Ardebil and Tehran provinces, in turn. For overweight and obesity component, shared by esophagus, colorectal, prostate and breast cancers the largest effect was found for Tehran, Khorasane-Razavi, Semnan, Yazd, Isfahan, Fars, Mazandaran and Gilan, in turn. For low physical activity component, shared by colorectal and breast cancers North-Khorasan, Ardebil, Golestan, Ilam, Khorasane-Razavi and South-Khorasan had the largest effects, in turn. The smoking component is significantly more important for stomach than for esophagus, bladder and lung. The overweight and obesity had significantly more effect for colorectal than of esophagus cancer. Conclusions: The presented model is a valuable model to model geographical and temporal variation among diseases and has some interesting potential features and benefits over other joint models.