| 1. |
- Bakker, Marian K., et al.
(författare)
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Analysis of Mortality among Neonates and Children with Spina Bifida : An International Registry-Based Study, 2001-2012
- 2019
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Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 33:6, s. 436-448
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Tidskriftsartikel (refereegranskat)abstract
- Background: Medical advancements have resulted in better survival and life expectancy among those with spina bifida, but a significantly increased risk of perinatal and postnatal mortality for individuals with spina bifida remains. Objectives: To examine stillbirth and infant and child mortality among those affected by spina bifida using data from multiple countries. Methods: We conducted an observational study, using data from 24 population- and hospital-based surveillance registries in 18 countries contributing as members of the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR). Cases of spina bifida that resulted in livebirths or stillbirths from 20 weeks' gestation or elective termination of pregnancy for fetal anomaly (ETOPFA) were included. Among liveborn spina bifida cases, we calculated mortality at different ages as number of deaths among liveborn cases divided by total number of liveborn cases with spina bifida. As a secondary outcome measure, we estimated the prevalence of spina bifida per 10 000 total births. The 95% confidence interval for the prevalence estimate was estimated using the Poisson approximation of binomial distribution. Results: Between years 2001 and 2012, the overall first-week mortality proportion was 6.9% (95% CI 6.3, 7.7) and was lower in programmes operating in countries with policies that allowed ETOPFA compared with their counterparts (5.9% vs. 8.4%). The majority of first-week mortality occurred on the first day of life. In programmes where information on long-term mortality was available through linkage to administrative databases, survival at 5 years of age was 90%-96% in Europe, and 86%-96% in North America. Conclusions: Our multi-country study showed a high proportion of stillbirth and infant and child deaths among those with spina bifida. Effective folic acid interventions could prevent many cases of spina bifida, thereby preventing associated childhood morbidity and mortality.
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| 2. |
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| 3. |
- Bell, Jane C., et al.
(författare)
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Survival of infants born with esophageal atresia among 24 international birth defects surveillance programs
- 2021
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Ingår i: Birth Defects Research. - : Wiley. - 2472-1727. ; 113:12, s. 945-957
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Tidskriftsartikel (refereegranskat)abstract
- Background: Esophageal atresia (EA) affects around 2.3–2.6 per 10,000 births world-wide. Infants born with this condition require surgical correction soon after birth. Most survival studies of infants with EA are locally or regionally based. We aimed to describe survival across multiple world regions. Methods: We included infants diagnosed with EA between 1980 and 2015 from 24 birth defects surveillance programs that are members of the International Clearinghouse for Birth Defects Surveillance and Research. We calculated survival as the proportion of liveborn infants alive at 1 month, 1- and 5-years, among all infants with EA, those with isolated EA, those with EA and additional anomalies or EA and a chromosomal anomaly or genetic syndrome. We also investigated trends in survival over the decades, 1980s–2010s. Results: We included 6,466 liveborn infants with EA. Survival was 89.4% (95% CI 88.1–90.5) at 1-month, 84.5% (95% CI 83.0–85.9) at 1-year and 82.7% (95% CI 81.2–84.2) at 5-years. One-month survival for infants with isolated EA (97.1%) was higher than for infants with additional anomalies (89.7%) or infants with chromosomal or genetic syndrome diagnoses (57.3%) with little change at 1- and 5-years. Survival at 1 month improved from the 1980s to the 2010s, by 6.5% for infants with isolated EA and by 21.5% for infants with EA and additional anomalies. Conclusions: Almost all infants with isolated EA survived to 5 years. Mortality was higher for infants with EA and an additional anomaly, including chromosomal or genetic syndromes. Survival improved from the 1980s, particularly for those with additional anomalies.
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| 4. |
- Esmaily, Hamideh M, et al.
(författare)
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Does an outcome-based approach to continuing medical education improve physicians' competences in rational prescribing?
- 2009
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Ingår i: Medical teacher. - : Informa UK Limited. - 0142-159X .- 1466-187X. ; 31:11, s. E500-E506
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Tidskriftsartikel (refereegranskat)abstract
- Background: Continuing medical education (CME) is compulsory in Iran, and traditionally it is lecture-based, which is mostly not successful. Outcome-based education has been proposed for CME programs. Aim: To evaluate the effectiveness of an outcome-based educational intervention with a new approach based on outcomes and aligned teaching methods, on knowledge and skills of general physicians (GPs) working in primary care compared with a concurrent CME program in the field of "Rational prescribing". Method: The method used was cluster randomized controlled design. All GPs working in six cities in one province in Iran were invited to participate. The cities were matched and randomly divided into an intervention arm for education on rational prescribing with an outcome-based approach, and a control arm for a traditional program on the same topic. Knowledge and skills were assessed using a pre- and post-test, including case scenarios. Results: In total, 112 GPs participated. There were significant improvements in knowledge and prescribing skills after the training in the intervention arm as well as in comparison with the changes in the control arm. The overall intervention effect was 26 percentage units. Conclusion: The introduction of an outcome-based approach in CME appears to be effective when creating programs to improve GPs' knowledge and skills.
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| 5. |
- Leoncini, Emanuele, et al.
(författare)
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How Valid Are the Rates of Down Syndrome Internationally? : Findings from the International Clearinghouse for Birth Defects Surveillance and Research
- 2010
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Ingår i: American Journal of Medical Genetics, Part A. - : Wiley. - 1552-4825 .- 1552-4833. ; 152A:7, s. 1670-1680
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Tidskriftsartikel (refereegranskat)abstract
- Rates of Down syndrome (DS) show considerable international variation, but a systematic assessment of this variation is lacking. The goal of this study was to develop and test a method to assess the validity of DS rates in surveillance programs, as an indicator of quality of ascertainment. The proposed method compares the observed number of cases with DS (livebirths plus elective pregnancy terminations, adjusted for spontaneous fetal losses that would have occurred if the pregnancy had been allowed to continue) in each single year of maternal age, with the expected number of cases based on the best-published data on rates by year of maternal age. To test this method we used data from birth years 2000 to 2005 from 32 surveillance programs of the International Clearinghouse for Birth Defects Surveillance and Research. We computed the adjusted observed versus expected ratio (aOE) of DS birth prevalence among women 25-44 years old. The aOE ratio was close to unity in 13 programs (the 95% confidence interval included 1), above 1 in 2 programs and below 1 in 18 programs (P < 0.05). These findings suggest that DS rates internationally can be evaluated simply and systematically, and underscores how adjusting for spontaneous fetal loss is crucial and feasible. The aOE ratio can help better interpret and compare the reported rates, measure the degree of under- or over-registration, and promote quality improvement in surveillance programs that will ultimately provide better data for research, service planning, and public health programs.
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| 6. |
- Mc Goldrick, Niall, et al.
(författare)
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A multi-program analysis of cleft lip with cleft palate prevalence and mortality using data from 22 International Clearinghouse for Birth Defects Surveillance and Research programs, 1974–2014
- 2023
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Ingår i: Birth Defects Research. - 2472-1727. ; 115:10, s. 980-997
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cleft lip with cleft palate (CLP) is a congenital condition that affects both the oral cavity and the lips. This study estimated the prevalence and mortality of CLP using surveillance data collected from birth defect registries around the world. Methods: Data from 22 population- and hospital-based surveillance programs affiliated with the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR) in 18 countries on live births (LB), stillbirths (SB), and elective terminations of pregnancy for fetal anomaly (ETOPFA) for CLP from 1974 to 2014 were analyzed. Prevalence and survival (survival for LB only) estimates were calculated for total and subclassifications of CLP and by pregnancy outcome. Results: The pooled prevalence of total CLP cases was 6.4 CLP per 10,000 births. The prevalence of CLP and all of the pregnancy outcomes varied across programs. Higher ETOPFA rates were recorded in most European programs compared to programs in other continents. In programs reporting low ETOPFA rates or where there was no ascertainment of ETOPFA, the rate of CLP among LB and SB was higher compared to those where ETOPFA rates were ascertained. Overall survival for total CLP was 91%. For isolated CLP, the survival was 97.7%. CLP associated with multiple congenital anomalies had an overall survival of 77.1%, and for CLP associated with genetic/chromosomal syndromes, overall survival was 40.9%. Conclusions: Total CLP prevalence reported in this study is lower than estimates from prior studies, with variation by pregnancy outcomes between programs. Survival was lower when CLP was associated with other congenital anomalies or syndromes compared to isolated CLP.
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| 7. |
- Sepehri, Maryam, et al.
(författare)
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Health-Behavioral Patterns of High School Students in Tabriz
- 2020
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Ingår i: Depiction of Health. - : Maad Rayan Publishing Company. - 2008-9058 .- 2423-6640. ; 11:1, s. 40-51
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives: Chronic diseases are the leading causes of death in many countries in the globe. Behavioral risk factors such as smoking, alcohol consumption and the lack of physical activity are the most important determinants of these diseases and mortality. The source of behavioral risk factors in chronic diseases are in childhood and adolescence. The aim of this study was to investigate the behavioral risk factors and pattern in adolescents in Tabriz city, northwest of Iran. Material and Methods: A total of 1517 high school students were recruited for this cross-sectional study in Tabriz city using cluster random sampling. The data were collected using Global School-based Student Health Survey tool introduced by the World Health Organization. Results: Five percent of students had smoked once or more within the last 30 days. Nearly, twenty percent of students had a previous experience of cigarette smoking. About one percent of the cases had experienced different forms of drug consumption. Our findings showed that 4.2 percent (CI: 3.1-5.2) had committed suicide at least once during the last year and 4.2 percent of the students had carried cold weapons with them at least once every week. Eighty percent never used bike for sports, work or leisure. More than 45 percent of the students had some training courses in the classroom on the prevention of HIV infection, and 41.9 percent had talked to their parents about this matter. Conclusion : Based on our findings, more educational courses are needed in schools. Multi-sectoral collaboration in education, health and policy-making would also have a key role to improve adolescent health status in the community.
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| 8. |
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| 9. |
- Ziaei, Reza, 1982-, et al.
(författare)
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Reliability and validity of the Persian version of Global School-based Student Health Survey adapted for Iranian school students
- 2014
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Ingår i: Journal of Clinical Research & Governance. - : Swedish Science Pioneers. - 2001-5682. ; 3:2
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Global School-based Student Health Survey (GSHS) is a project supported by the World Health Organization to assess adolescent health-risk behaviours and protective factors. The present study reports test-retest and internal consistency reliability as well as Content Validity Index (CVI) for the Persian version of GSHS and Global Youth Tobacco Survey (GYTS) adapted for Iranian students.Methods: The original English GSHS, GYTS and Optional Shisha modules were translated and back-translated, pilot-tested, reformed and corrected for clarity. The back-translated and English versions were compared and the Persian version was then edited to reach consistency for two versions. In order to evaluate the performance of this measure for our study sample (n= 47), we examined its test-retest reliability, internal consistency, and correlation between total test and re-test scales score as well as CVI.Results: The internal consistency (Cronbach's alpha) for the whole GSHS Core modules was 0.69, and for Core-Expanded GSHS, GYTS and Optional Modules for Shisha was 0.90. Test-retest reliability varied between 0.51 and 1.00 for Core and 0.23 to 1.00 for Core-Expanded GYTS and Optional Modules of Shisha. Total test and re-test scales score for GSHS Core varied from 0.64 to 1.00, and for Core-Expanded GSHS, GYTS and Optional Modules of Shisha varied 0.67 to 0.91.Conclusion: The Persian version of GSHS Core, Core-Expanded and GYTS has acceptable reliability and validity, and can serve as a reliable instrument for Persian-speaking communities.
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| 10. |
- Ziaei, Reza, 1982-, et al.
(författare)
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Suicidal ideation and its correlates among high school students in Iran : A cross-sectional study
- 2017
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundGlobally, the second leading cause of death among adolescents is suicide and in middle-income countries adolescents’ suicidal ideation is a neglected public health area. The present study was conducted to determine the prevalence and correlates of suicidal ideation among 15–17-year-old high school students in Iran.MethodsSelf-administered, Global School-based Student Health Survey (GSHS) questionnaires were distributed to a representative sample (N =1517) of high-school students aged 15–17 in the city of Tabriz. Multivariate logistic regression was used to assess the association between relevant independent variables (e.g. gender) and the dependent outcome variable (suicidal ideation in the past 12 months).ResultsOverall, 62 (4.1%, 95% CI= 3.1, 5.2) of 1,517 students had thoughts of suicide. Three hundred and thirteen (20.6%, 95% CI= 18.6, 22.7) students reported being bullied in the previous 30 days. In addition, 134 (8.8%, 95% CI= 7.5, 10.3) students reported having been sexually abused. Being worried that they could not eat or did not feel hungry (Adjusted Odds Ratio (AOR) = 4.15; 95% Cl [1.71, 10.07]; current cigarette smoking (AOR = 3.00; 95% CI [1.69, 5.30]; thinking about using alcohol or other drugs (AOR = 4.28; 95% CI [2.41, 7.59]; and being sexually abused (AOR = 2.63; 95% CI [1.32, 5.24]) were all factors positively associated with suicidal ideation.ConclusionThe prevalence of suicidal ideation was lower in our school students than in earlier studies. Interventions that address the issue of current cigarette smoking, worries, thinking about using alcohol or other drugs and sexual abuse should be given more priority by the public health authorities.
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| 11. |
- Ziaei, Reza, Dr, 1982-, et al.
(författare)
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The prevalence and correlates of physical activity/inactivity and sedentary behaviour among high-school adolescents in Iran : a cross-sectional study
- 2022
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Ingår i: Journal of Public Health. - : Springer Science and Business Media LLC. - 2198-1833 .- 1613-2238. ; 30:5, s. 1121-1131
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physical inactivity and sedentary behaviour are the main risk factors for non-communicable diseases in all stages of life. However, there is a lack of reliable data regarding the recommended level of physical activity and its correlates related to physical inactivity and sedentary behaviour among school students in Iran. The aim of the present study was to report the prevalence and correlates of physical activity/inactivity and sedentary behaviour among Iranian high school adolescents. Methods: The Global School-based Student Health Survey (GSHS) was used for data collection. Related data comprising socio-demographics, health risk behaviour and protective factors were obtained from 1517 high school students. Multivariate logistic regression was used to assess the association between relevant independent variables (e.g. gender) and the dependent outcome variable (physical inactivity/sedentary behaviour). Results: The prevalence of recommended physical activity by WHO was 27.8%, physical inactivity 72.2% and sedentary behaviour 71.4%. Being female, being overweight or obese, walking/cycling to or from school on 1–4 days, sitting 3 or more hours/day (sedentary behaviour), insufficient vegetable intake, being bullied and lack of parental support, peer support and parental connectivity (protective factors) were positively associated with physical inactivity. On the other hand, walking/cycling to or from school on 5–7 days and inadequate fruit intake were negatively associated with physical inactivity. Walking/cycling to or from school on 1–4 days, being physically inactive, inadequate fruit intake and being bullied were positively associated with sedentary behaviour. Conclusion: The prevalence of physical inactivity and sedentary behaviour was high in our studied sample. Interventions that address the issue of active school transport, sedentary behaviour, fruit and vegetable intake, family and peer support and bullying should be given more priority by the public health authorities.
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| 12. |
- Ziaei, Reza, et al.
(författare)
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The Prevalence, Attitudes, and Correlates of Waterpipe Smoking Among High School Students in Iran : a Cross-Sectional Study
- 2016
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 23:6, s. 686-696
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe purpose of the present study was to determine the correlates of waterpipe (WP) smoking among 15–17-year-old high school students in Iran.MethodData were collected using the Global Youth Tobacco Survey (GYTS), a self-administrated questionnaire distributed to a representative sample of high school students aged 15–17 in the city of Tabriz. Current WP smoking was defined as past 30-day use, and ever WP smoking was defined as at least one or two lifetime puffs. Differences in WP use, knowledge, and attitudes were analyzed using chi-square and Fisher exact tests. Binary logistic regression estimated the association between relevant independent variables (e.g., age) and the dependent variables (current/ever WP smoking).ResultsOf 1517 students, 21.6 % (95 % confidence interval [CI] = 19.5, 23.8) were ever WP smokers, and 9.7 % (95 % CI = 8.2, 11.2) were current WP smokers. Of current WP smokers, 40.3 % have stated that they want to stop smoking now. Moreover, 14.1 % of non-WP smokers reported that they might enjoy smoking WP. Of current WP smokers, 49.0 % have smoked at cafés. Additionally, 95.3 % of current WP smokers reported that their age did not prevent them from being served a WP. Studying in high school third grade (adjusted odds ratios (AORs) = 1.70; 95 % CI [1.10, 2.63]), experience of cigarette smoking (AORs = 1.57; 95 % CI [1.12, 2.20]), and being prepared to accept a WP offered by close friends (AORs = 3.31; 95 % CI [2.17, 5.04]) were independently associated with ever WP smoking, and accepting a WP offered by close friends (AORs = 4.36; 95 % CI [2.69, 7.07]) and gender (female) (AORs = 0.45; 95 % CI [0.30, 0.70] were independently associated with current WP smoking.ConclusionPrevalence of current and ever WP smoking is high in Tabriz. There is an urgent need to design interventions in order to increase students’ and their parents’ awareness regarding the harmfulness of WP, and to establish legal measures to restrict adolescents’ access to WPs and tobacco in society.
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