Publications (19)39.92 Total impact
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Article: Economic inequality in presenting near vision acuity in a middle-aged population: a Blinder-Oaxaca decomposition.
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ABSTRACT: PURPOSE: To investigate economic inequality and its determinants in near vision, in a middle-aged population. METHODS: In this population-based study, the presenting near vision in the better eye was investigated as the main outcome. If this vision revealed a value ≥1.6 M, the participant was considered to have presenting near vision impairment (PNVI). The effect of variables studied on PNVI was investigated using logistic regression. Economic inequality in PNVI was investigated using the Oaxaca-Blinder decomposition method. RESULTS: PNVI in the better eye was observed in 18.2% (95% CI 16.8 to 19.6) of participants. The prevalence of PNVI in the high and low economic groups was 11.7% (95% CI 10.3 to 13.0) and 28.5% (95% CI 26.0 to 31.0), respectively. Age and education were observed as the main factors in the explained portion of this gap and were in favour of the high economic group. Gender and eye care utilisation were factors affecting the unexplained portion of this gap and were in favour of the low economic group. CONCLUSIONS: Economic inequality plays a significant role in PNVI, while age and education are among the main factors affecting this gap. The effect caused by any change in these two factors was found to have a greater effect on women with low economic status.The British journal of ophthalmology 05/2013; · 2.92 Impact Factor -
Article: The prevalence of anisometropia and its associated factors in an adult population from Shahroud, Iran.
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ABSTRACT: BACKGROUND: The aim of this study was to evaluate the prevalence of anisometropia in an urban adult population in the north of Iran. METHODS: This cross-sectional study was conducted among the 40-64-year-old population in Shahroud, Iran. Random cluster sampling was applied to select 6,311 people. Following an interview, optometric and ophthalmologic examinations, including objective non-cycloplegic refractions, were carried out. The prevalence of anisometropia was reported according to non-cycloplegic refraction and with cut-off points of 0.50, 1.00, 2.00 and 3.00 D. RESULTS: Of the sampled people, 5,190 (82.2 per cent) took part in the study. After considering exclusion criteria, data from 4,918 participants were included in the final analysis. Most participants were female (57.6 per cent) and the average age (with standard deviation) was 50.7 ± 6.2 years. The prevalence of anisometropia with cut-off points of 0.50, 1.00 and 2.00 D were 23.1 (95%CI: 22.0-24.3), 7.7 (95%CI: 7.0-8.4) and 3.2 per cent (95%CI: 2.7-3.7), respectively. The prevalence of severe anisometropia (3.00 D or more) was 1.9 per cent (95%CI: 1.5-2.3). The odds ratio (OR) of anisometropia was 1.06 times higher for every year of increasing age. The OR of anisometropia in participants with cataract was 2.78 times more than in those without (p < 0.001). Anisometropia was more frequent among participants with unilateral cataract (21.7 per cent) compared to those with bilateral cataract (13.4 per cent). Anisometropia of 1.00 D or more was significantly more prevalent among myopic participants compared to hyperopic participants (13.8 versus 12.7 per cent, p < 0.001) and there was a stronger association between anisometropia and myopia (OR = 2.93) than hyperopia (OR = 2.23). With increasing educational level, the prevalence of anisometropia decreased significantly (p < 0.001). The prevalence of aniso-astigmatism of 1.00 D or more was 11.1 per cent (95%CI: 10.2-11.9). CONCLUSION: In the present study, the prevalence of anisometropia in Iran was not negligible; however, it is less than in Eastern Asia. Myopia, cataract, age and educational level were associated with anisometropia.Clinical and Experimental Optometry 04/2013; · 1.05 Impact Factor -
Article: Important Risk Factors of Mortality Among Children Aged 1-59 Months in Rural Areas of Shahroud, Iran: A Community-based Nested Case-Control Study.
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ABSTRACT: The aim of the study was to evaluate potential risk factors of children mortality between 1-59 months of age. This nested case-control study was conducted among children born from June 1999 to March 2009 in rural areas of Shahroud, located in the central region of Iran using health care visit reports and follow-up data available in household health records. MORTALITY WAS SIGNIFICANTLY ASSOCIATED WITH BREASTFEEDING DURATION (OR: 0.87, 95% CI: 0.81-0.93), total health care visits (OR: 0.90, 95% CI: 0.83-0.98) and low birth weight (LBW) (OR: 7.38, 95% CI: 1.37-39.67). In our study, a longer breastfeeding period and more frequent health care visits were two important protective factors, while LBW was an important risk factor for 1-59 month child mortality. It seems, that complex and multiple factors may be involved in mortality of under 5-year-old children, so combined efforts would be necessary to improve child health indicators.International journal of preventive medicine 12/2012; 3(12):875-9. -
Article: Cohort Profile: Shahroud Eye Cohort Study.
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ABSTRACT: The Shahroud Eye Cohort Study was set up to determine the prevalence and incidence of visual impairment and major eye conditions in the 40-64-year-old population of Shahroud as a Middle Eastern population. The first phase of the study was conducted in 2009-10. Using random cluster sampling, 6311 Shahroud inhabitants were invited for ophthalmologic examinations; of these, 5190 participants completed phase 1 (participation rate of 82.2%). All participants were interviewed to collect data on participants' demographics, occupation status, socioeconomic status, history of smoking, and medical and ophthalmic history, as well as history of medication, and the quality and duration of their insurance. DNA and plasma samples, as well as four dots of whole blood were collected from participants. Extensive optometric and ophthalmologic examinations were performed for each participant, including lensometry of current glasses, testing near and far visual acuity; determining objective and subjective refraction; eye motility; cycloplegic refraction; colour vision test; slit-lamp biomicroscopy and intraocular pressure measurement; direct and indirect fundoscopy; perimetry test; ocular biometry; corneal topography; lens and fundus photography; and the Schirmer's (1008 participants) and tear breakup time tests (1013 participants). The study data are available for collaborative research at Noor Ophthalmology Research Center, Tehran, Iran.International Journal of Epidemiology 10/2012; · 6.41 Impact Factor -
Article: The prevalence and determinants of pterygium and pinguecula in an urban population in shahroud, iran.
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ABSTRACT: While pterygium is considered a common eye disorder, the etiology and pathogenesis is still not known. The aim of this study was to describe the prevalence of pterygium and pinguecula in the over 40 population of Shahroud and assess associated factors. The present study is part of the phase one of the Shahroud Eye Cohort Study conducted in 2009, in which the target population was people between 40 and 64 years of age. Ophthalmic examinations were performed by two ophthalmologists who made the diagnosis of pterygium and pinguecula. We used Chi-square tests, analysis of variance, and multiple logistic regression tests to examine associations. Of the 6311 invitees, 5190 people participated in the study (response rate: 82.2%). The prevalence of pterygium in at least one eye was 9.4% (95% CI, 8.6-10.3), while 2.9% (95%CI, 2.4-3.3) had bilateral pterygium. The prevalence was significantly higher in men (11.4% vs. 8.0%), and remained relatively constant with age, while the prevalence in women significantly increased with age. The prevalence of pinguecula was 61.0% (95%CI, 59.1-62.9) in at least one eye, and 49.0% (95%CI, 47.1-50.9) in both eyes. The age difference between those with and without pinguecula was significant and the prevalence was significantly higher among men than women (70.6% vs. 53.8%). The prevalence of pterygium in our study was lower than reported rates in the world but higher than Tehran and was significantly associated with age, gender, working outdoors, and the level of education. The prevalence of unilateral and bilateral pinguecula falls in the mid range and was significantly associated with age, male gender, smoking, working outdoors, and level of education.Acta medica Iranica 10/2012; 50(10):689-96. -
Article: The distribution of axial length, anterior chamber depth, lens thickness, and vitreous chamber depth in an adult population of Shahroud, Iran.
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ABSTRACT: BACKGROUND: Ocular biometric parameters can be influenced by race, ethnicity, and genetics; their differences across different populations can probably explain differences in refractive errors in these populations. The aim of this study is to determine the normal range of axial length, anterior chamber depth, lens thickness, and vitreous chamber depth in the population of Shahroud in the north of Iran. METHODS: In the first phase of Shahroud Eye Cohort Study, the 40--64 year old population were sampled cross-sectionally; 6311 were invited and 5190 (82.2 %) participated in the study. Biometric examinations were done using the LENSTAR/BioGraph (WaveLight AG, Erlangen, Germany) after vision tests and before cycloplegic refraction tests. Any type of eye surgery, extensive pterygium, and lack of cooperation were used as exclusion criteria, and analyses were done with data from 4869 eyes. RESULTS: We found a mean axial length of 23.14 mm (95 % confidence interval [CI], 23.11-23.17), mean anterior chamber depth of 2.62 mm (95 % CI, 2.60-2.63), mean lens thickness of 4.28 mm (95 % CI, 4.27-4.29), and the mean vitreous chamber depth was 15.72 mm (95 % CI, 15.70-15.75).Kolmogorov-Smirnov tests showed that the distribution of axial length, anterior chamber depth, lens thickness, and vitreous chamber depth significantly differed from normal; axial length and vitreous chamber depth demonstrated a leptokurtic distribution as well.Axial length, anterior chamber depth, and vitreous chamber depth significantly decreased with age, and lens thickness significantly increased with age (p < 0.001). All indices were significantly higher in men. CONCLUSIONS: The distributions of axial length, vitreous chamber depth, and lens thickness are reported for the first time in an Iranian adult population. Compared to other studies, axial length was in the mid range, nonetheless, studying axial length components showed that the Iranian population had smaller anterior chamber depth and lens thickness. Age and gender were significantly associated with all indices assessed in this study.BMC Ophthalmology 09/2012; 12(1):50. · 1.00 Impact Factor -
Article: High prevalence of myopia in an adult population, Shahroud, Iran.
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ABSTRACT: To determine the prevalence of myopia and hyperopia and the associated risk factors in the presbyopic age group of the population in Shahroud, Iran. Through a multistage random cluster sampling approach, 6311 people of the 40- to 64-year-old population residing in Shahroud were invited to this study. The prevalence of a cycloplegic spherical equivalent (SE) ≥-0.5 diopter (D) and hyperopia >+0.50 D was determined by age and gender. Of the invitees, 5190 (82.2%) participated in the study and data from 4864 people was used in the analyses. On the basis of cycloplegic refraction, the prevalence of myopia and hyperopia was 30.2% [95% confidence interval (CI): 28.9 to 31.5] and 35.6 (95% CI: 34.1 to 37.1), respectively. In the multiple logistic regression model, the odds of myopia significantly increased with higher education [odds ratio (OR) = 1.02, p < 0.001] and nuclear cataract (OR = 3.23, p < 0.001). After the age of 54 years, the odds of hyperopia significantly increased compared with the 40- to 44-year age group, whereas higher education and nuclear cataract had negative association with hyperopia. The prevalence of high myopia (SE >-6.0 D) and high hyperopia (SE > 4.0 D) was 1.9% (95% CI: 1.5 to 2.3) and 1.1% (95% CI: 0.8 to 1.4), respectively. Nuclear cataract significantly correlated with high myopia (OR = 6.44) and older age significantly correlated with high hyperopia (OR = 1.12). The prevalence of myopia was unexpectedly higher than that found in other parts of the Middle East. The prevalence of hyperopia was lower than that previously reported in Iran. Education correlated directly with myopia and inversely with hyperopia; however, nuclear cataract was the most important risk factor for myopia. Adjusted for other variables, the prevalence of hyperopia still increased with age.Optometry and vision science: official publication of the American Academy of Optometry 06/2012; 89(7):993-9. · 1.53 Impact Factor -
Article: Corneal Refractive Power and Eccentricity in the 40- to 64-Year-Old Population of Shahroud, Iran.
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ABSTRACT: PURPOSE: To determine the normal corneal curvature, power, and eccentricity in an Iranian population and their determinants. METHODS: This report is part of a population-based study conducted in 2009. Of the 5190 participants of the study, Pentacam data from 8532 eyes of 4266 people who met the inclusion criteria for this analysis were used. For each eye, we extracted minimum and maximum keratometry readings, the average of the 2 readings (mean-K), the difference between these 2 parameters (keratometric astigmatism), and corneal eccentricity. RESULTS: The average mean-K, keratometric astigmatism, and eccentricity were 43.73 ± 2.47, 0.90 ± 0.93, and 0.27 ± 0.63 diopter, respectively. Mean-K was directly correlated with age; inversely correlated with body mass index, axial length, white-to-white corneal diameter, and anterior chamber depth; increased at higher amounts of myopia; and was higher in women compared with men. Keratometric astigmatism was significantly higher in women, increased at higher amount of refractive error, but showed no association with other variables. Eccentricity was correlated indirectly with age and white-to-white corneal diameter, and directly with axial length. It increased with myopia. CONCLUSIONS: Compared with other studies, the mean corneal power and eccentricity values were lower in this Iranian population sample. Our findings may have implications for clinical interventions, especially refractive surgery. Further studies can identify the causes of such differences in the shape and size of the cornea, which may also be attributable to the choice of the measuring device.Cornea 05/2012; · 1.73 Impact Factor -
Article: Unmet refractive need and its determinants in Shahroud, Iran.
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ABSTRACT: Uncorrected refractive error plays a significant role in poor vision and blindness, and its correction is the most cost-effective intervention in eye care. In this study, we report the status of the unmet refractive need and the role of economic inequality in determining the level of this need in Shahroud, Iran. This cross-sectional nested case-control study was performed on 5,190 individuals aged 40-64 years. Cases and controls were individuals with uncorrected visual acuity worse than 0.3 LogMAR in the better eye who showed at least 0.2 LogMAR improvement after correction. Cases were individuals whose presenting vision was worse than 0.3 in the better eye but improved by at least 0.2 LogMAR after correction. Controls were individuals in whom the difference between the presenting and corrected vision was less than 0.2 LogMAR. The prevalence of the unmet need was 5.7 % and it was more prevalent in women (6.5 %) than in men (4.6 %) (p = 0.003). There was a gap of 19.6 % between the two groups of high and low economic status. The Oaxaca-Blinder decomposition method revealed that differences in the education level of the two groups accounted for half of this gap. Spectacle usage is better in Iran than in some other developing countries; however, in this study, about 40 % of those who required spectacles did not have them.International Ophthalmology 05/2012; 32(4):329-36. -
Article: Population-based study of presbyopia.
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ABSTRACT: Background: There is limited information regarding the prevalence of presbyopia in different parts of the world. The add power and the prevalence of presbyopia by age and gender in general population of Shahroud, north of Iran, were studied. Design: Population based cross sectional study. Participants: Using random cluster sampling, 6311 people from the 40- to 64- year old population of Shahroud were invited for eye examinations. Of the invited population, 5190 individuals (82.2%) participated in the study. Methods: Presbyopia was defined as the correction of near vision to LogMAR 1 (N8 point) with at least 1 diopter (D) of add power. Main Outcome Measures: Near visual acuity of participants was evaluated with a LogMAR chart at a distance of 40cm. Results: Mean add power in the age groups of 40-44, 45-49, 50-54, 55-59 and 60-64 years was 0.65, 1.30, 1.70, 1.87 and 2.08D, respectively. For each 5-year increase in age, a 0.35D increase in add power was noted. The prevalence of presbyopia was 58.15% (95%CI: 56.46-59.84). Presbyopia was more prevalent in women (p < 0.001) increased with aging more in women than in men (p < 0.001). Furthermore, in the 60-64 year old age group, 11% of men and 23% of women were not presbyopic. Conclusions: Compared to other reports, the add power in different age groups between 40 and 64 years was 0.5D less, and presbyopia was less prevalent. More than 50% of the over 45 year old individuals were presbyopic and 17% of the over 60 individuals were free of this condition. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.Clinical and Experimental Ophthalmology 03/2012; · 1.98 Impact Factor -
Article: Contrast sensitivity evaluation in a population-based study in Shahroud, Iran.
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ABSTRACT: To determine the normal range of contrast sensitivity and its determinants through a population-based study in Shahroud, in northern Iran. Population-based cross-sectional study. Using random cluster sampling in Shahroud, 6311 people between 40 and 64 years of age were sampled; 5190 (82.24%) responded, and 965 participants were selected randomly for contrast sensitivity testing. Participants underwent thorough eye examinations, including visual acuity and refraction tests, funduscopy, and slit-lamp examination. Contrast sensitivity was tested with best correction using the CVS1000 grating charts (VectorVision, Inc., Greenville, OH), and results are reported here in log units. Overall, mean ± standard deviation contrast sensitivity in spatial frequencies of 3, 6, 12, and 18 cycles per degree was 1.62 ± 0.19, 1.87 ± 0.22, 1.53 ± 0.28, and 1.09 ± 0.30 log units, respectively. Contrast sensitivity worsened significantly with age and with lower levels of uncorrected visual acuity (P<0.001). Compared with men, contrast sensitivity was worse among women in spatial frequencies of 3 and 6. Contrast sensitivity was significantly worse with myopia of more than 5.0 diopters (P<0.001). There was an inverse correlation between the amount of astigmatism and contrast sensitivity in all spatial frequencies (P<0.001). Contrast sensitivity showed a significant variability among people with normal vision that increased at higher spatial frequencies. The present findings can be used as a reference guide for contrast sensitivity in a general population and for comparison in future studies. Contrast sensitivity declines with age, high myopia, and astigmatism. The wide range variability, even in the presence of normal visual acuity, should be considered when contrast sensitivity is tested.Ophthalmology 12/2011; 119(3):541-6. · 5.45 Impact Factor -
Article: The distribution of corneal thickness in a 40- to 64-year-old population of Shahroud, Iran.
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ABSTRACT: To determine the distribution of central and peripheral corneal thickness values and its determinants in an Iranian population. This population-based study was conducted between 2009 and 2010 in Shahroud, with a response rate of 82.2%. Here in, we present the data on central and peripheral corneal thickness in 3890 participants of the study, which included all 40- to 64-year-old participants except those with a history of ocular surgery. Measurements were done with the Pentacam, and correlations with age, gender, height, body mass index, and refraction were tested. The mean age (± standard deviation) of the participants was 50.7 years (± 6.2 years). Mean corneal thickness in the thinnest point, the center, and 3 mm away from it in the inferior, superior, nasal, and temporal directions were 525.5 ± 35.9 μm, 528.5 ± 35.8 μm, 608.2 ± 39.8 μm, 635.5 ± 41.9 μm, 611.7 ± 43.2 μm, and 601.0 ± 40.4 μm, respectively. The thinnest point was in the inferotemporal quadrant in 87.5% of cases. The center of the cornea was thinner than 500 μm in 36.6% of myopic cases and 21.8% of hyperopic cases. The thickness and location difference between the center and thinnest point were statistically significant (P < 0.001). Central corneal thickness was directly correlated with refraction (P = 0.028) and inversely with age (P = 0.027). In this population-based study, the thinnest point was usually located inferotemporally and the thickest point superiorly. The peripheral cornea was significantly thicker than the central cornea but thinned faster with age. The thickness difference between the thinnest and central points was significantly greater in men. People with hyperopia had thicker corneas compared with those with myopia.Cornea 12/2011; 30(12):1409-13. · 1.73 Impact Factor -
Article: High prevalence of astigmatism in the 40- to 64-year-old population of Shahroud, Iran.
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ABSTRACT: The prevalence of astigmatism, its axis and determinants were determined in the 40- to 64-year-old population of Shahroud, Iran. Population-based cross sectional study. Using random cluster sampling, 6311 subjects were invited for eye examinations. Of 5190 participants (response rate=82.2%), data of 5020 were eligible for analysis. Participants received visual acuity measurement, manifest refraction and eye examinations. The prevalence of astigmatism based on cylinder powers of more than 0.5, 1 and 3 D were studied. The prevalence (and 95% confidence interval) of astigmatism based on a cylinder power worse than 0.5, 1, and 3 D was 49.1% (47.6-50.5), 24.1% (22.9-25.3), and 3.4% (2.9-3.9), respectively. In a multiple logistic regression model, the prevalence of astigmatism was higher in men (odds ratio=1.25) and increased with age (odds ratio for each 5 years=1.21). Higher education was found to be inversely correlated to astigmatism (P < 0.001). The prevalence of with-the-rule, against-the-rule and oblique astigmatism was 12.6%, 25.9% and 10.6%, respectively. Oblique astigmatism was significantly higher in women and the older age groups (P < 0.001). Against-the-rule astigmatism increased with age from 19.9% in the age group of 40-44 to 37.0% in the age group of 60-64 (P < 0.001). In comparison with those studies conducted in Iran and other countries, the prevalence of astigmatism was higher in this study. Astigmatism was higher in men and age had an important role in astigmatism and its axis. The prevalence of against-the-rule and oblique astigmatism increased with age.Clinical and Experimental Ophthalmology 06/2011; 40(3):247-54. · 1.98 Impact Factor -
Article: The gap of visual impairment between economic groups in Shahroud, Iran: a Blinder-Oaxaca decomposition.
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ABSTRACT: The authors assessed the role of economic inequality in visual impairment and decomposed the gap between high and low income groups. Study data were extracted from the first phase of the Shahroud Eye Cohort Study, performed in 2009, with 5,190 participants aged between 40 and 64 years. The participants were divided into low, medium, and high economic groups according to their assets by using a principal component analysis. The gap between low and high economic groups was decomposed to its determinants by using the Blinder-Oaxaca method. The prevalence of visual impairment, a presenting vision worse than 20/40 in the better eye, was 3.57% and 11.07% in the high and low economic groups, respectively. Age and education were the major factors in the decomposition model, contributing to 41.38% of the gap. Insurance status, gender, and education of the head of the household had no effect on this gap. Economic inequality in visual impairment was noteworthy. Although part of the gap between low and high economic groups was explained by differences in age and education, the greater part (58.62%) could be due to differences in health-care access and utilization.American journal of epidemiology 06/2011; 173(12):1463-7. · 5.59 Impact Factor -
Article: Mental health of medical students: a cross-sectional study in Tehran.
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ABSTRACT: Medical students are subject to stress from sources related to medical training in addition to personal problems, resulting in significant mental distress. This study evaluates the scope of the problem in Tehran medical schools and sheds light on some of its associations. Students (604) of medicine from four medical schools in the city of Tehran responded to the Persian version of 28-item General Health Questionnaire (GHQ-28) in conjunction with a data collection sheet asking about age, sex, marital status, current training level, living place, grade point average in previous semester, and perceptions of their financial status. Of 602 students, 40.7% had mental distress (45.7% of female and 36.7% of male students). Distress was associated with being a woman (female to male odds ratio: 1.55) and very poor financial status (OR: 18.0).Psychological Reports 05/2007; 100(2):346-54. · 0.44 Impact Factor -
Article: Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes.
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ABSTRACT: The objective of this study was to determine the incidence of gestational diabetes mellitus (GDM) and compare fetal, maternal and neonatal complications amongst women with GDM and pregnant women with normal glucose tolerance in an urban Iranian population. In a prospective cohort study, universal screening for gestational diabetes mellitus was performed for 1310 pregnant women who were referred from private clinics and community health care centers to Fatemiyeh Hospital in Shahrood City. Screening was performed with a 50 g oral Glucose Challenge Test (GCT) with 130 mg/dl cut-off point, then a diagnostic 100 g Oral Glucose Tolerance Test (OGTT) was done according to Carpenter and Coustan criteria. The incidence of GDM was 4.8%. There were differences in risk factors: age >30 years, family history of diabetes, obesity, previous macrosomia, glycosuria between the two groups (P<0.001). Women with GDM had a higher rate of stillbirth (P<0.001; odds ratio 17.1, 95% CI=4.5-65.5), hydramnios (P<0.001; odds ratio 15.5, 95% CI=4.8-50.5), gestational hypertension (P<0.001; odds ratio 6, 95% CI=2.3-15.3), macrosomia (P<0.05; odds ratio 3.2, 95% CI=1.2-8.6) and caesarean section (P<0.001). We have found that the incidence of GDM in an urban Iranian population is similar to developed countries. Complications were more common in the GDM group than in the normal group and outcomes for women with persistent diabetes post-partum were particularly poor. We recommend screening for GDM in Iran, but further evaluation of selective screening and cost effectiveness will need to be performed. Measures to improve the outcome of GDM pregnancy will also need to be addressed in the future.Diabetes Research and Clinical Practice 09/2005; 69(3):279-86. · 2.75 Impact Factor -
Article: Psychological distress among Bam earthquake survivors in Iran: a population-based study.
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ABSTRACT: An earthquake measuring 6.3 on the Richter scale struck the city of Bam in Iran on the 26th of December 2003 at 5.26 A.M. It was devastating, and left over 40,000 dead and around 30,000 injured. The profound tragedy of thousands killed has caused emotional and psychological trauma for tens of thousands of people who have survived. A study was carried out to assess psychological distress among Bam earthquake survivors and factors associated with severe mental health in those who survived the tragedy. This was a population-based study measuring psychological distress among the survivors of Bam earthquake in Iran. Using a multi-stage stratified sampling method a random sample of individuals aged 15 years and over living in Bam were interviewed. Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12). In all 916 survivors were interviewed. The mean age of the respondents was 32.9 years (SD = 12.4), mostly were males (53%), married (66%) and had secondary school education (50%). Forty-one percent reported they lost 3 to 5 members of their family in the earthquake. In addition the findings showed that 58% of the respondents suffered from severe mental health as measured by the GHQ-12 and this was three times higher than reported psychological distress among the general population. There were significant differences between sub-groups of the study sample with regard to their psychological distress. The results of the logistic regression analysis also indicated that female gender; lower education, unemployment, and loss of family members were associated with severe psychological distress among earthquake victims. The study findings indicated that the amount of psychological distress among earthquake survivors was high and there is an urgent need to deliver mental health care to disaster victims in local medical settings and to reduce negative health impacts of the earthquake adequate psychological counseling is needed for those who survived the tragedy.BMC Public Health 02/2005; 5:4. · 2.00 Impact Factor -
Article: The 12-item General Health Questionnaire (GHQ-12): translation and validation study of the Iranian version.
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ABSTRACT: The objective of this study was to translate and to test the reliability and validity of the 12-item General Health Questionnaire (GHQ-12) in Iran. Using a standard 'forward-backward' translation procedure, the English language version of the questionnaire was translated into Persian (Iranian language). Then a sample of young people aged 18 to 25 years old completed the questionnaire. In addition, a short questionnaire containing demographic questions and a single measure of global quality of life was administered. To test reliability the internal consistency was assessed by Cronbach's alpha coefficient. Validity was performed using convergent validity. Finally, the factor structure of the questionnaire was extracted by performing principal component analysis using oblique factor solution. In all 748 young people entered into the study. The mean age of respondents was 21.1 (SD = 2.1) years. Employing the recommended method of scoring (ranging from 0 to 12), the mean GHQ score was 3.7 (SD = 3.5). Reliability analysis showed satisfactory result (Cronbach's alpha coefficient = 0.87). Convergent validity indicated a significant negative correlation between the GHQ-12 and global quality of life scores as expected (r = -0.56, P < 0.0001). The principal component analysis with oblique rotation solution showed that the GHQ-12 was a measure of psychological morbidity with two-factor structure that jointly accounted for 51% of the variance. The study findings showed that the Iranian version of the GHQ-12 has a good structural characteristic and is a reliable and valid instrument that can be used for measuring psychological well being in Iran.Health and Quality of Life Outcomes 01/2003; 1:66. · 2.11 Impact Factor -
Article: Virtual patients in undergraduate surgery education: a randomized controlled study.
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ABSTRACT: This study aims to clarify the effects of implementing a series of virtual patients in undergraduate surgery education on various dimensions of skills as applied to clinical problems. In a randomized controlled trial 48 surgery clerks were assigned to an intervention group who worked on 14 simulated cases of abdominal pain during 7 weeks in a computer lab and a control group without access to software. At the end of the intervention, both groups were tested by a structured, seven-part paper-based exam evaluating certain areas of competence. Forty-five students took the exam. Results showed a significant improvement in history taking (P < 0.001) and no improvement in scores related to appropriate use of radiology and lab tests, proposing differential diagnoses and management plans and factual knowledge. From the intervention group, 20 students completed a virtual case exam whose results had a poor correlation with the written exam. Overall, our findings indicate that virtual patients are strong tools in enhancing history-taking skills of students, but they do not affect other areas of competence significantly. Educators are recommended to be sceptical about enthusiastic reports on various computer applications and avoid falling into false expectations of their implementation.ANZ Journal of Surgery 77(1-2):54-9. · 1.25 Impact Factor
Top co-authors
Top Journals
Institutions
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2011–2013
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Noor Eye Hospital
Tehrān, Ostan-e Tehran, Iran
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2012
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Shahroud University of Medical Sciences
Shāhrūd, Semnan, Iran
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2007–2011
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Tehran University of Medical Sciences
- Department of Epidemiology and Biostatistics
Tehrān, Ostan-e Tehran, Iran
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2005
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Iranian Institute for Health Sciences Research
Tehrān, Ostan-e Tehran, Iran
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