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Eftekharian K, Eftekhar Ardebili H, Shojamoradi MH, Samimi S. Bone metabolic disorder and its contributing factors in patients with chronic kidney disease; a three-year cohort study. J Renal Inj Prev 2021. [DOI: 10.34172/jrip.2022.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: The prevalence of bone mineral disorder is best known in end-stage renal disease (ESRD) patients, but less data is available for the earlier stages. Objectives: We aimed to compare the prevalence of bone metabolic disorder at all stages of chronic kidney disease (CKD) and assess its contribution to CKD progression and patients’ outcome. Patients and Methods: In a retrospective cohort study, CKD patients who were under treatment for three years were selected from a nephrology clinic in Tehran, Iran. Patients’ demographic and laboratory data, as well as the outcome of their treatment were gathered and analyzed. Results: In 473 patients with an average age of 61.5, 60.1% were at stage III, 35.8% were at stage IV, and 4.1% were at stage V of CKD. There was a significant relationship between CKD stage and serum phosphate, calcium-phosphate product, and systolic blood pressure (SBP). Furthermore, the patients’ outcome was significantly related to advanced stages of CKD, higher first phosphate level, diabetes mellitus in medical history, and higher stages of SBP. By multiple Cox regression analysis, after adjustment for glomerular filtration rate (GFR), the first serum phosphate level, and the calcium-phosphate product did not contribute to the undesirable outcome. Conclusion: Although bone metabolic disorder is more frequently seen in advanced stages of chronic kidney disease, these changes can be seen even in earlier stages of the disease. The influence of phosphate abnormality in the patients’ outcome should be studied more in earlier stages for better control.
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Affiliation(s)
- Kourosh Eftekharian
- Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Department of Health Education and Promotion, School of Public Health, Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sahar Samimi
- Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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2
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Joveini H, Rohban A, Eftekhar Ardebili H, Dehdari T, Maheri M, Hashemian M. The effects of an education program on hookah smoking cessation in university students: an application of the Health Action Process Approach (HAPA). Journal of Substance Use 2019. [DOI: 10.1080/14659891.2019.1664655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hamid Joveini
- Department of Health Education and Promotion, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Alireza Rohban
- Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Dehdari
- Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mina Maheri
- Department of Public Health, School of Health, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Masoumeh Hashemian
- Department of Health Education and Promotion, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
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3
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Khalili N, Karvandian K, Eftekhar Ardebili H, Eftekhar N, Nabavian O. Predictive Factors of Preoperative Anxiety in the Anesthesia Clinic: A Survey of 231 Surgical Candidates. AACC 2019. [DOI: 10.18502/aacc.v5i4.1452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Despite the growing advancements of surgical and anesthetic techniques resulting in decreased morbidity and mortality, the period before surgery remains stressful for most patients. Considering the adverse effect of preoperative anxiety on anesthesia and surgery outcomes, we conducted this study to evaluate the level of anxiety in the anesthesia clinic among Iranian patients undergoing surgery and also to determine its associated factors.
Methods: This was a cross-sectional study performed on 231 patients admitted to the anesthesia clinic of Imam Khomeini hospital, Tehran, Iran. Data were collected by using a three-part questionnaire consisting of demographic data, clinical findings and the translated version of Spielberger state-trait anxiety inventory (STAI). Chi-square test and binary logistic regression model were performed for univariate and multivariate analysis, respectively. A p-value< 0.05 was considered statistically significant.
Results: The mean (SD) score for state and trait anxiety were 39.8 (13.4) and 36.5 (12.2), respectively. A significant association was seen between state anxiety and age, gender, occupation, level of education, marital status, patients’ awareness of type of anesthesia and patients’ awareness of anesthesia adverse events (p< 0.05). The most predictive factors for state anxiety were age, patients’ awareness of anesthesia adverse events and female gender, and for trait anxiety these factors were age, place of residence and female gender.
Conclusion: Screening for anxiety and identifying individuals vulnerable to preoperative anxiety (e.g. younger patients, females…) can help reduce undesirable surgery outcomes and their economic burden on the healthcare system.
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Jamshidi E, Eftekhar Ardebili H, Yousefi-Nooraie R, Raeisi A, Malekafzali Ardakani H, Sadeghi R, Hanafi-Bojd AA, Majdzadeh R. A social network analysis on immigrants and refugees access to services in the malaria elimination context. Malar J 2019; 18:1. [PMID: 30602373 PMCID: PMC6317246 DOI: 10.1186/s12936-018-2635-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 12/21/2018] [Indexed: 11/30/2022] Open
Abstract
Background There has been significant progress in eliminating malaria in Iran. The aim of this study is to investigate the structure of inter-organizational collaboration networks in the field of unauthorized immigrants and refugees access to services in order to eliminate malaria. Methods This study employed social network analysis, in which nodes represented stakeholders associated with providing access of immigrants and refugees to services in the field of malaria elimination, and ties indicated the level of collaboration. This study adopted socio-centric analysis and the whole network was studied. In this regard, 12 districts of the malaria-endemic area in Iran were selected. Participants included 360 individuals (30 representatives of the organization/group in each district). The data were gathered by interview, using the levels of collaboration scale. UCINET 6 was used for data analysis. The indices of density, centralization, reciprocity, and clustering were investigated for each twelve network and at each level of collaboration. Results The average density of the networks was 0.22 (SD: 0.04). In districts with a high incidence of imported malaria, the values of network density and centralization were high and the networks comprised of a larger connected component (less isolated clusters). There were significant correlations between density of network (r = 0.66, P = 0.02), degree centralization (r = 0.65, P = 0.02), betweenness centralization (r = 0.76, P = 0.004), and imported malaria cases. In general, the degree centrality and betweenness centrality of the organizations of health, district governor, and foreign immigrants’ affairs were higher. In all networks, 60% of the relationships were bilateral. At a higher level of collaboration, the centralization declined and reciprocity increased. The average of betweenness centralization index was 22.76 (SD = 3.88). Conclusions Higher values of network indices in border districts and districts with more cases of imported malaria, in terms of density and centralization measures, can propose the hypothesis that higher preparedness against the issue and centralization of power can enable a better top-down outbreak management, which needs further investigations. Higher centrality of governmental organizations indicates the need for involving private, non-governmental organizations and representatives of immigrant and refugee groups. Recognition of the existing network structure can help the authorities increase access to malaria prevention, diagnosis, and treatment services among immigrants and refugees. Electronic supplementary material The online version of this article (10.1186/s12936-018-2635-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ensiyeh Jamshidi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Raeisi
- Department of Medical Entomology and Vector Control, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Malekafzali Ardakani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ali Hanafi-Bojd
- Department of Medical Entomology and Vector Control, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran, Iran. .,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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5
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Rahmani F, Saghazadeh A, Rahmani M, Teixeira AL, Rezaei N, Aghamollaii V, Ardebili HE. Plasma levels of brain-derived neurotrophic factor in patients with Parkinson disease: A systematic review and meta-analysis. Brain Res 2018; 1704:127-136. [PMID: 30296429 DOI: 10.1016/j.brainres.2018.10.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is an abundant neurotrophin in the adult brain. Serum BDNF levels might be used as a proxy for its central expression. Considering conflicting reports, we aimed to answer "How do serum/CSF levels of BDNF change in patients with PD?". METHODS We conducted a comprehensive search in MEDLINE, EMBASE and SCOPUS databases including 12 eligible studies. Five studies compared BDNF in serum of PD patients versus healthy controls (HC) and 3 studies provided BDNF levels in sera of non-depressed and depressed PD patients (NDPD and DPD). Review Manager and Software version 3.0 were used for meta-analysis and meta-regressions. Mean difference (MD) was used for measurement of effect size. RESULTS PD patients had reduced serum BDNF levels compared to HC (MD = -2.99 ng/mL). Serum BDNF was highest in DPD patients compared to HC (MD = -4.83 ng/mL), with no difference between DPD and NDPD patients in serum BDNF levels. Among co-variates that were eligible for meta-regression, age, sex, and Hoehn and Yahr (H&Y) motor stage had significant positive associations with the effect size in the difference of serum BDNF between patients and HC. CONCLUSIONS PD patients had reduced serum BDNF levels compared to HC, regardless of presence of co-morbid depression. PD is at least equally effective in reducing serum BDNF levels as depression. Motor progression predicts serum BDNF downregulation in PD. Acute exercise improves motor function and depressive symptoms in PD probably via BDNF upregulation. The paradoxical rise in serum BDNF in advance PD is probably compensatory in nature.
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Affiliation(s)
- Farzaneh Rahmani
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Amene Saghazadeh
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Rahmani
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Antonio L Teixeira
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA; Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Nima Rezaei
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Boston, USA; Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Vajiheh Aghamollaii
- Department of Neurology, Roozbeh Hospital, Tehran University of Medical Sciences, Roozbeh Hospital, Tehran, Iran.
| | - Hassan Eftekhar Ardebili
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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6
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Joveini H, Dehdari T, Ardebili HE, Mahmoudi M, Firouzian AA, Rohban A. Factors Associated with Hookah Smoking among University Students. Electron Physician 2016; 8:3403-3408. [PMID: 28163855 PMCID: PMC5279973 DOI: 10.19082/3403] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 10/22/2016] [Indexed: 11/20/2022] Open
Abstract
Background These days, hookah smoking has gained popularity among people in many communities, especially among youths and students, and more attention to this issue seems necessary. The purpose of this study was to determine the factors affecting hookah smoking among Sabzevar Azad University students. Methods This cross-sectional study was conducted on university students in Sabzevar, Iran in 2014. The questionnaire was developed and its validity and reliability were assessed. Three hundred six male students of Sabzevar Azad University were selected by simple random sampling and questionnaires were filled out by them. The collected data were analyzed by SPSS software and the Chi-Square and Independent-samples t-test. Results The results showed that 47.7% of the participants had a history of smoking hookah. The main factors affecting hookah smoking from participants’ point of view were: filling leisure time, availability of hookah, positive social appearance, friends’ invitation and relief from anxieties. Chi-Square tests showed that there was no significant relationship between fathers’ level of education (p=0.41), mothers’ level of education (p=0.46), fathers’ job (p=0.18), mothers’ job (p=0.53) and students’ current grade (p=0.41) with hookah smoking. The study showed significant relationship between present hookah smoking and awareness about complications of the hookah (p=0.01). Conclusion Interventions to reduce and quit hookah smoking among students should include several items, such as teaching problem-solving skills to fill leisure time properly and to deal with the temptation of hookah smoking, as well as teaching refusal skills at the invitation of friends for hookah.
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Affiliation(s)
- Hamid Joveini
- Ph.D. Candidate in Health Education and Promotion, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Taherh Dehdari
- Assistant Professor of Health Education, Department of Health Education and Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Professor, Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Mahmoudi
- Professor, Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran Iran
| | - Ali Asghar Firouzian
- M.Sc. in Nursing, Educator, Esfarayan University of Medical Sciences, Esfarayen, Iran
| | - Alireza Rohban
- M.Sc. in Rehabilitation Management, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
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7
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Pishgar F, Soleyman-Jahi S, Pishgar F, Eftekhar Ardebili H, Jamal A, Arab A. Level of happiness and its determining factors in pregnant women: a cross-sectional study. J Reprod Infant Psychol 2016. [DOI: 10.1080/02646838.2016.1222071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Omranikhoo H, Pourreza A, Ardebili HE, Heydari H, Forushani AR. Avoidable Mortality Differences between Rural and Urban Residents During 2004-2011: A Case Study in Iran. Int J Health Policy Manag 2013; 1:287-93. [PMID: 24596886 DOI: 10.15171/ijhpm.2013.58] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 10/26/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Avoidable mortality as an indicator for assessing the health system performance has caught the attention of researchers for a long time. In this study we aimed to compare the health system performance using this indicator in rural and urban areas of one of Iran's southern provinces. METHODS All deaths (29916) which happened during 2004-2011 in Bushehr province were assessed. Nolte and McKee's avoidable deaths model was used to distinguish avoidable and unavoidable conditions. Accordingly, all deaths were classified into four categories including three avoidable death categories and one unavoidable death category. STATA software was used to conduct Poisson Regression Test and age-standardized death rate. RESULTS Findings showed that avoidable mortality rates declined in both urban and rural areas at 3.33% per year, but decline rates were influenced by Ischemic Heart Disease (IHD) and preventable death categories to treatable death category. Annual decline rate for IHD category in rural and urban areas was nearly the same as 8%, but in preventable death category, rural areas experienced more decreases than urban ones (7% vs 5% respectively). However, decline rate in treatable mortality neither in urban and nor in rural areas was statistically significant. CONCLUSION Despite the annual decline in the rate of avoidable deaths, policy making initiatives especially screening and inter-sectoral measures targeting cause of deaths such as colon and breast cancers, hypertension, lung cancer and traffic accidents, can still further decrease avoidable deaths in both areas.
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Affiliation(s)
- Habib Omranikhoo
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ; Department of Health Promotion, School of Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Abolghasem Pourreza
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Department of Health Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Heydari
- Institute for Trade Studies and Research, Ministry of Industry, Mine and Trade, Tehran, Iran
| | - Abbas Rahimi Forushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Mortazavi SS, Shati M, Ardebili HE, Mohammad K, Beni RD, Keshteli AH. Comparing the Effects of Group and Home-based Physical Activity on Mental Health in the Elderly. Int J Prev Med 2013; 4:1282-9. [PMID: 24404363 PMCID: PMC3883253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 07/16/2012] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The present study focuses on comparing the effects of home-based (HB) and group-based (GB) physical activity on mental health in a sample of older adults in Shahr-e-kord. METHODS In this quasi-experimental study, a twice-weekly physical activity program for 2 months was provided either individually at home or in a group format for 181 people who were divided into two groups (HB and GB). The outcome, mental health, was measured with the 28-item General Health Questionnaire (GHQ-28). RESULTS Mental health status improved after participation in the physical activity program. The decrease in GHQ-28 total score in GB group, 3 months after intervention, was 3.61 ± 2.28 (P < 0.001). In HB group, this reduction was 1.20 ± 2.32 during the same period (P < 0.001). The difference of these "before-after differences" between the two groups in the GHQ-28 and all its subscales was statistically significant (P < 0.001). Also, the effects of GB physical activity on mental health compared with HB physical activity, adjusted for related baseline variables, were significant. CONCLUSIONS These findings reveal the probable effects of GB rather than HB physical activity on mental health among the elderly.
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Affiliation(s)
- Seyede Salehe Mortazavi
- Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Shati
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences and Health Center for Community-Based Participatory Research, Tehran, Iran
| | - Kazem Mohammad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Dorali Beni
- General Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - AH Keshteli
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences and Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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10
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Mortazavi SS, Mohammad K, Ardebili HE, Beni RD, Mahmoodi M, Keshteli AH. Mental disorder prevention and physical activity in Iranian elderly. Int J Prev Med 2012; 3:S64-72. [PMID: 22826772 PMCID: PMC3399311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 07/25/2011] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES Mental disorders such as depression, anxiety and dementia are common in elderly. However, physical activity is suggested to be effective in preventing such aging-related disorders. The aim of this study was to investigate the role of physical activity on mental health in later life. METHODS Four hundred elderly people were randomly divided into the intervention and control groups. The intervention consisted of exercise twice a week for two months. Mental health status before, just after, and three months after the study was assessed with the 28-item General Health Questionnaire (GHQ-28). RESULTS The mean of the GHQ-28 total scale decreased in the case group and this change remained significant after three months (before: 8 ± 5.5, after three months: 5.6 ± 4.6, p < .001). GHQ subscales including somatization, anxiety, social dysfunction, and depression decreased significantly in the case group just after and three months after the intervention. CONCLUSIONS Physical activity significantly prevents mental disorder in older adults. Although it has effects on anxiety, social dysfunction, and depression, the greatest influence is on improving the somatization symptoms.
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Affiliation(s)
- Seyede Salehe Mortazavi
- Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Correspondence to: Seyede Salehe Mortazavi, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kazem Mohammad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences and Health Center for Community-Based Participatory Research, Tehran, Iran
| | - Reza Dorali Beni
- General Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Mahmoodi
- Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ammar Hassanzadeh Keshteli
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences and Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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11
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Didarloo A, Shojaeizadeh D, Ardebili HE, Niknami S, Hajizadeh E, Alizadeh M. Factors Influencing Physical Activity Behavior among Iranian Women with Type 2 Diabetes Using the Extended Theory of Reasoned Action. Diabetes Metab J 2011; 35:513-22. [PMID: 22111043 PMCID: PMC3221027 DOI: 10.4093/dmj.2011.35.5.513] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Accepted: 04/25/2011] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Findings of most studies indicate that the only way to control diabetes and prevent its debilitating effects is through the continuous performance of self-care behaviors. Physical activity is a non-pharmacological method of diabetes treatment and because of its positive effects on diabetic patients, it is being increasingly considered by researchers and practitioners. This study aimed at determining factors influencing physical activity among diabetic women in Iran, using the extended theory of reasoned action in Iran. METHODS A sample of 352 women with type 2 diabetes, referring to a Diabetes Clinic in Khoy, Iran, participated in the study. Appropriate instruments were designed to measure the desired variables (knowledge of diabetes, personal beliefs, subjective norms, perceived self-efficacy, behavioral intention and physical activity behavior). The reliability and validity of the instruments were examined and approved. Statistical analyses of the study were conducted by inferential statistical techniques (independent t-test, correlations and regressions) using the SPSS package. RESULTS The findings of this investigation indicated that among the constructs of the model, self efficacy was the strongest predictor of intentions among women with type 2 diabetes and both directly and indirectly affected physical activity. In addition to self efficacy, diabetic patients' physical activity also was influenced by other variables of the model and sociodemographic factors. CONCLUSION Our findings suggest that the high ability of the theory of reasoned action extended by self-efficacy in forecasting and explaining physical activity can be a base for educational intervention. Educational interventions based on the proposed model are necessary for improving diabetics' physical activity behavior and controlling disease.
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Affiliation(s)
- Alireza Didarloo
- Department of Health and Social Medicine, Urmia University of Medical Sciences, School of Medicine, Urmia, Iran
| | - Davoud Shojaeizadeh
- Department of Health Education, Tehran University of Medical Sciences, School of Public Health, Tehran, Iran
| | - Hassan Eftekhar Ardebili
- Department of Health Education, Tehran University of Medical Sciences, School of Public Health, Tehran, Iran
| | - Shamsaddin Niknami
- Department of Health Education, Tarbiat Modares University, School of Medical Sciences, Tehran, Iran
| | - Ebrahim Hajizadeh
- Department of Biostatistics, Tarbiat Modares University, School of Medical Sciences, Tehran, Iran
| | - Mohammad Alizadeh
- Department of Nutrition and Biochemistry, Urmia University of Medical Sciences, School of Medicine, Urmia, Iran
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12
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Ostovar R, Rashidian A, Pourreza A, Rashidi BH, Hantooshzadeh S, Ardebili HE, Mahmoudi M. Developing criteria for cesarean section using the RAND appropriateness method. BMC Pregnancy Childbirth 2010; 10:52. [PMID: 20840776 PMCID: PMC2949786 DOI: 10.1186/1471-2393-10-52] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 09/14/2010] [Indexed: 12/03/2022] Open
Abstract
Background Cesarean section rates are increasing worldwide, and a rapid increase has been observed in Iran. Disagreement exists between clinicians about when to use cesarean section. We aimed to identify the appropriateness criteria for the use of cesarean section in Iran. Method A consensus development study using a modified version of the RAND Appropriateness Method (RAM). We generated scenarios from valid clinical guidelines and expert opinions. A panel of experts participated in consensus development: first round via mail (12 members), second round face-to-face (9 members). We followed the RAM recommendations for the development of the scenario lists, rating scales, and statistical analyses. Results 294 scenarios relevant to cesarean section were identified. 191 scenarios were considered appropriate, of which 125 scenarios were agreed upon. The panel found cesarean inappropriate for 21% of scenarios, and 'equivocal' for 14% of scenarios. Conclusion RAM is useful for identifying stakeholder views in settings with limited resources. The participants' views on appropriateness of certain indications differed with available evidence. A large number of scenarios without agreement may partly explain why it has been difficult to curb the growth in cesarean section rate.
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Affiliation(s)
- Rahim Ostovar
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Iran
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Eftekhar B, Mohammad K, Ardebili HE, Ghodsi M, Ketabchi E. Comparison of artificial neural network and logistic regression models for prediction of mortality in head trauma based on initial clinical data. BMC Med Inform Decis Mak 2005; 5:3. [PMID: 15713231 PMCID: PMC551612 DOI: 10.1186/1472-6947-5-3] [Citation(s) in RCA: 143] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2004] [Accepted: 02/15/2005] [Indexed: 12/03/2022] Open
Abstract
Background In recent years, outcome prediction models using artificial neural network and multivariable logistic regression analysis have been developed in many areas of health care research. Both these methods have advantages and disadvantages. In this study we have compared the performance of artificial neural network and multivariable logistic regression models, in prediction of outcomes in head trauma and studied the reproducibility of the findings. Methods 1000 Logistic regression and ANN models based on initial clinical data related to the GCS, tracheal intubation status, age, systolic blood pressure, respiratory rate, pulse rate, injury severity score and the outcome of 1271 mainly head injured patients were compared in this study. For each of one thousand pairs of ANN and logistic models, the area under the receiver operating characteristic (ROC) curves, Hosmer-Lemeshow (HL) statistics and accuracy rate were calculated and compared using paired T-tests. Results ANN significantly outperformed logistic models in both fields of discrimination and calibration but under performed in accuracy. In 77.8% of cases the area under the ROC curves and in 56.4% of cases the HL statistics for the neural network model were superior to that for the logistic model. In 68% of cases the accuracy of the logistic model was superior to the neural network model. Conclusions ANN significantly outperformed the logistic models in both fields of discrimination and calibration but lagged behind in accuracy. This study clearly showed that any single comparison between these two models might not reliably represent the true end results. External validation of the designed models, using larger databases with different rates of outcomes is necessary to get an accurate measure of performance outside the development population.
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Affiliation(s)
- Behzad Eftekhar
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
| | - Kazem Mohammad
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Tehran University, Tehran, Iran
| | | | - Mohammad Ghodsi
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
| | - Ebrahim Ketabchi
- Department of Neurosurgery, Sina Hospital, Tehran University, Tehran, Iran
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Ardebili HE, Kamali P, Pouranssari Z, Komarizadeh A. Prenatal care and maternal age, education and reproductive behaviour. Iran J Public Health 1987; 16:57-64. [PMID: 12283709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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15
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Islam MS, Naieni KH, Ardebili HE, Foroushani AR, Mirani A. ROLE OF SOCIO-DEMOGRAPHIC AND CULTURAL FACTORS IN KNOWLEDGE, ATTITUDE AND PRACTICE OF USERS ABOUT FAMILY PLANNING METHODS AND SERVICES, RENDERING FROM RURAL PRIMARY HEALTH CARE CENTRE OF BANGLADESH. ACTA ACUST UNITED AC 1970. [DOI: 10.32413/pjph.v7i1.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: The socio-demographic and cultural factors closely related with Knowledge, Attitude and Practice (KAP) of users at rural setting. Unfortunately studies on KAP of women about Family planning services from rural setting are almost absent. This study was designed to determine the responsible factors role on KAP of users for receiving family planning services from rural setting of Bangladesh. Methods: Qualitative descriptive analytical study was employed to follow a structured questionnaire format. A total 420 users were interviewed from two unions. Relevant literatures were reviewed to enhance our understanding of the issue in question. The questionnaires were pretest before finalization and it's has both open and close-ended questions. Results: The knowledge of users (87%) was mostly universal, while community women were more advanced than men. The unmet need for contraception's remains about 16% and 40% of mothers to have unintended births. Of all users, Pill was most known methods (68%), although IUCD (18%) and condom (14%) methods were common at community. Side effect (69%) and husband disapproval (31%) was barrier of practice of FPMs, although space for child bear (37%), health problems (30%), financial problems (25%) and education (8%) were push factors to users. Approximately 40% respondents travelled more than 4 kilometer to getting services. Factors were found to be significantly associated with KAP of users were: education (X2=29.73; p<0.001), occupation (X2=16.67; p<0.001) income (X2=17.61; p<0.011) family size (X2=25.44; p<0.022) distance(X2=18.75; p<0.013) cultural beliefs (X2=23.84; p<0.001, and accessibility (X2=23.67; p<0.00). Poor practice (44%) associated with schooling of users. Conclusion: Regular yard meeting with users' community and services allied persons may be arranged at community levels for upgrading the existing KAP. Stakeholders' from different ages, genders, and socioeconomic groups have to be engaged to promote evidence-based services. Extensive education and communication programs are needed to address family planning methods and services.
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