Tehran University of Medical Sciences Journal of Biostatistics and Epidemiology 2383-4196 7 1 2021 05 15 1 6 Fateme Mirhadi Health Services Management Department, Islamic Azad University Science and Research Branch, Tehran, Iran. Seyed Jamaledin Tabibi Health Services Management Department, Islamic Azad University Science and Research Branch, Tehran, Iran. Leila Riahi Health Services Management Department, Islamic Azad University Science and Research Branch, Tehran, Iran. Kamran Haji Nabi Health Services Management Department, Islamic Azad University Science and Research Branch, Tehran, Iran. 2020 10 04 2021 03 07 Introduction: Substance abuse is currently a crippling problem worldwide. The hindering effect it has upon the development and prosperity of each society has turned it into a serious threat. Due to the importance of the problem the current study was aimed to investigate the effect of health promotion programs on the smoking cessation of the adolescent and youth in Iran.  Methods: The current study was a quasi-experimental study. The target population consisted of the teenagers and the youth people of district 12 of Tehran City. The understudied cases were divided into intervention and control groups. Each groups included 20 participants. The researcher-constructed questionnaire was used for data collection. Data analysis was conducted using SPSS version 20.  Results: Analysis of Cognitive-Therapy Co-Variance and its Effect on Health Promotion Scores show that Mean Square in Pre-Intervention sample and follow-up was 7854.365 and 5632.845 respectively. Also in Post-Intervention and follow-up was 4785.123 and 2865.563 that show a significant relationship between the pre and post-intervention and follow-up scores. Mean Square in Post-Intervention and follow-up for Effectiveness of Health Promotion Programs on Smoke cessation with 39 degrees of freedom was 730.58 and 746.420. The Ancova results showed that the improvement in wrong beliefs is permanent.  Conclusion: Research findings revealed that onetime and recurrent health promotion programs have significant impacts upon smoking cessation of the teenagers and the youth. Since drug abuse is a motivational disorder, educational programs and improving the living condition for treating drug abuse is highly recommended. https://jbe.tums.ac.ir/index.php/jbe/article/view/402

Tehran University of Medical Sciences Journal of Biostatistics and Epidemiology 2383-4196 7 1 2021 05 18 86 107 EN alireza molaei Biostatistics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran. Mohammad Gholami-Fesharaki Biostatistics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran. 2021 02 01 2021 02 23 Introduction: Hepatitis C is one of the most serious viral infections that cause chronic liver disease. Objectives: The current study was conducted to estimate the pooled prevalence and geographical distribution of Hepatitis C Virus (HCV) in thalassemic, hemodialysis, and hemophiliac patients in Iran. Evidence Acquisition: Articles were identified through international searching databases including PubMed, Scopus, Elsevier, Google Scholar, and Web of Science and Iranian scientific information database (SID), Health.barakatkns, IranDoc, Civilica and MagIran. We reviewed systematically all studies reporting the prevalence of HCV in thalassemic, hemodialysis, and hemophiliac patients. All studies conducted ELISA tests for the evaluation of HCV antibodies In this study meta-analysis method has been used to estimate the pooled prevalence. Results: 270 records were identified by the electronic search, of which 151 studies were identified as relevant papers that were meta-analyzed for the pooled HCV prevalence. Overall, prevalence of HCV were 18.27%(15.99%-20.55%), 11.60%(9.98%-13.22%) and 45.16%(36.72%-53.60%) in thalassemic, hemodialysis and hemophiliac patients. Conclusion: Concerning the high prevalence of HCV among hemophiliac patients, ongoing preventive actions for this group are recommended. https://jbe.tums.ac.ir/index.php/jbe/article/view/437

Tehran University of Medical Sciences Journal of Biostatistics and Epidemiology 2383-4196 7 1 2021 05 15 7 24 Masoume Babajanpour Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran. Zeinab Iraji Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran. Homayoun Sadeghi-Bazargani Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Mohammad Asghari Jafarabadi Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran , Center for the development of interdisciplinary research in Islamic sciences and health sciences, Tabriz University of Medical Sciences, Tabriz, Iran , Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. 2020 12 12 2021 02 13 Introduction: Motorcyclists have the highest proportion of casualty toll caused by street accidents in Iran, and they endanger themselves and others by those risky behaviors. Health and safety education will not be sufficient without knowing the causes of such behaviors. Since no studies have been carried out based on accurate statistical methods on bounded response variables for motorcyclists' high-risk behaviors in Iran, this study aimed to predict MRBQ by ADHD and the underlying predictors using the Beta Regression as an alternative strategy. Methods: The present sectional study included 311 Motorcyclists randomly selected using a cluster sampling method in Bukan city to evaluating the relationship between the limited response MRBQ with ADHD and its subscales. We used an innovative beta regression method for the analysis and carried out unadjusted and adjusted modeling. Results: Direct and significant relationships were observed between MRBQ score and ADHD score and its subscales, including (DSS score) (coefficients ranged over 0.01 to 0.6, All P<0.05). Additionally, the riding period (coefficients ranged over -0.32 to -0.48, P<0.05), hours of riding (coefficients ranged over: 0.31 to 0.34, P<0.05), using the helmet (coefficients: 0.26 to 0.31, P<0.05), and sub-accident (coefficients ranged over 0.35 to 0.37, P<0.05) also turned out to be significant predictors of MRBQ score. Conclusion: ADHD score and riding parameters can be taken into account when contriving actions on the motorcycle rider behaviors as measured by MRBQ. https://jbe.tums.ac.ir/index.php/jbe/article/view/422

Tehran University of Medical Sciences Journal of Biostatistics and Epidemiology 2383-4196 7 1 2021 05 15 25 35 Lakshmi Sridhar Department of Chemical Engineering , University of Puerto Rico, Mayaguez, Puerto Rico. 2021 01 05 2021 02 02 Introduction: A rigorous multiobjective optimal control strategy (that does not require the use of weighting functions) of the epidemic models that consider vaccination and treatment strategies is presented. Modifications of the standard susceptible-infectious-removed, susceptible-exposed-infectious-removed, and the modified susceptible-infectious-removed models are dynamically optimized to minimize the number of infected individuals while, controlling the rate at which the individuals are vaccinated and treated. Method: The optimization program, Pyomo , where the differential equations are automatically converted to a Nonlinear Program using the orthogonal collocation method is used for performing the dynamic optimization calculations. The Lagrange-Radau quadrature with three collocation points and 10 finite elements are chosen. The resulting nonlinear optimization problem was solved using the solver BARON 19.3, accessed through the Pyomo-GAMS27.2 interface.  Results: The computational results how that the multiobjective optimal control profiles generated by this strategy are very similar to those produced when weighting functions are used.  Conclusion: The main conclusion of this work is to demonstrate that one can perform a rigorous dynamic optimization of epidemic models without the use of weighting functions that have the potential to produce some uncertainty and doubt in the results, in addition to dealing with unnecessary additional variables. https://jbe.tums.ac.ir/index.php/jbe/article/view/423

Tehran University of Medical Sciences Journal of Biostatistics and Epidemiology 2383-4196 7 1 2021 05 15 36 47 Samuel Adams Department of Statistics, University of Abuja, Abuja, Nigeria Davies Obaromi Department of Statistics, Confluence University of Science and Technology, Lokoja, Kogi State, Nigeria Rauf Rauf Department of Statistics, University of Abuja, Abuja, Nigeria. 2021 01 31 2021 04 04 Introduction: The need to model the impact of some demographic indicators on the frequency of household visits to healthcare centres in Nigeria's community is very important for preventing and spreading community diseases. This study aimed to investigate the effect of the patents' age, gender, marital status, type of illness and amount spent on the frequency of visits to community health care centres in Nigeria and to compared Negative Binomial Regression (NBR) and Generalized Poisson Regression GPR) models to determine the preferred count regression model for the number of household visits to health centres in some communities in Nigeria.  Methods: Survey of 132640 households in some Nigeria communities obtained from the 2018/2019 Nigeria Living Standard Survey (NLSS) were extracted from the National Bureau of Statistics (NBS) in collaboration with the World Bank. The Negative Binomial and Generalised Poisson regression models were used to investigate the five demographic variables on the frequency of visit to the community health centres. The performance of the count regression model was assessed using the Chi-square -2log Likelihood Statistic (2logL), Akaike Information Criterion (AIC) and Bayesian Information Criterion BIC) selection criteria.  Results: Findings from the study showed that the type of illness and amount spent has a significantly positive effect on the number of household members' visits to the community health care centres in Nigeria while age, gender, and marital status was discovered to have a negative effect on the number of household members' visits to the community health care centres in Nigeria.  Conclusion: The Nigeria Government, health centre management and community healthcare service providers' need to be aware that the amount spent and the nature of illness determines the level of health care services utilisation in the Nigeria community, hence the need for the drastic reduction in charges to encourage a household visit to the community health centres whenever the need arises. https://jbe.tums.ac.ir/index.php/jbe/article/view/435

Tehran University of Medical Sciences Journal of Biostatistics and Epidemiology 2383-4196 7 1 2021 05 18 48 59 Cornelious Nyakundi Department of Mathematics, Physics & computing, Moi University, P.O Box, 3900, Eldoret, Kenya. Joseph Koske Department of Mathematics, Physics & computing, Moi University, P.O Box, 3900, Eldoret, Kenya. John Mutiso Department of Mathematics, Physics & computing, Moi University, P.O Box, 3900, Eldoret, Kenya. Isaac Tum Department of Mathematics, Physics & computing, Moi University, P.O Box, 3900, Eldoret, Kenya. 2020 12 11 2021 02 01 Introduction: A cross-over design is a repeated measurements design such that each experimental unit receives different treatments during different time periods.  Lower order cross-over designs such as the two treatments, two periods and two sequences C (2, 2, 2) design have been discovered to be inefficient and erroneous in their analysis of treatments efficacy. In this regard, higher order cross-over designs have been recommended and developed like: the two treatments, three periods and four sequence C (2, 3, 4) design; and the two treatments, four periods and four sequence C (2, 4, 4) designs. However, there still exists more efficient higher order cross-over designs for two treatments which can be used in bioequivalence experiments. This study gives a new design and analysis for two treatments, five periods and four sequence C (2, 5, 4) cross-over design that gives more precise estimates and provides estimates for intra subject variability. Method: A hypothetical case study was considered on 160 experimental units which are assumed to be randomly selected from a given population. A cross over design of two treatments (A, B) in five periods whose sequences are given by BABAA, ABABB, BAABA and ABBAB were used. Each of the experimental units was used as its own control. The estimates for both direct treatments and treatments carry-over effects were obtained using best linear unbiased estimation method (BLUE). We simulated data for two treatments in five periods and four sequences and used it to test the null hypotheses of no significant differences in both the direct treatments and treatments carry-over effects using the  test. The subject profiles plots were used to determine the general trend so as to enable an experimenter make a decision on which of the two treatments under consideration was more efficacious. Results: In testing the null hypothesis of no significant difference in carry-over effects for the two treatments (A&B), the calculated value was found to be 0.55 which was less than the tabular value at 156 degrees of freedom at 95 % confidence level, hence the null hypothesis was not rejected. Similarly, In testing the null hypothesis of no significant difference in treatment effects for A&B, the calculated value was found to be 11.73 which was higher than the tabular value at 156 degrees of freedom at 95% confidence level hence the null hypothesis was rejected, and it was concluded that there was indeed a significant difference in the treatment effects. The mean subject profiles plots for a majority of periods and their respective sequences indicated that the general trend implied that treatment B was more effective as compared to treatment A. Conclusion: In cross-over designs, the presence carry-over effects affect the precision of treatments effects estimates in an experiment. Apart from increasing the washout periods, increasing the number of periods in cross-over designs can help in eliminating the carry-over effects. The C (2, 5, 4) design in this study gives more precise estimates and can provide estimates for intra subject variability. The simulated data indicated that there was significant difference in the treatment effects, and in comparison of the two treatments, treatment B was more effective as compared to treatment A. https://jbe.tums.ac.ir/index.php/jbe/article/view/421

Tehran University of Medical Sciences Journal of Biostatistics and Epidemiology 2383-4196 7 1 2021 05 18 60 69 Adem Doganer Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey Abdullah Tok Deparment of Obstetric and Gynecology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey Gulbahtiyar Demirel Department of Midwifery, Faculty of Health Sciences, Sivas Cumhuriyet University, Turkey. 2021 02 12 2021 03 14 Introduction: This study compared the outcomes of cognitive function assessments between pregnant and non-pregnant women groups to demonstrate alterations occurring during pregnancy. Furthermore, we aimed to determine the factors acting on cognitive functions in pregnant women.  Material and Methods: 42 pregnant and 42 non-pregnant women were included in the study. In order to compare cognitive performances, Montreal Cognitive Assessment test was applied to women.  Results: The assessed scores of cognitive functioning were significantly different between pregnant and non-pregnant women (p <0.001). The test value was obtained as 22.29±4.57 with pregnants and as 26.02±2.19 with non-pregnant womens. The cognitive measurements yielded lower scores in the pregnant women. A negative correlation was found between the progesterone hormone levels and cognitive scores (p = 0.025). Progesterone hormone, TSH hormone and age of the pregnant were found to be important among the factors affecting the cognitive performances in pregnants (p=0.04; p=0.001; p=0.033, respectively).  Conclusion: Significant reductions in cognitive functions are observed in women during pregnancy. During pregnancy, in order to increase the cognitive level of women, hormonal values of pregnant women should be followed https://jbe.tums.ac.ir/index.php/jbe/article/view/446

Tehran University of Medical Sciences Journal of Biostatistics and Epidemiology 2383-4196 7 1 2021 05 18 70 85 Pegah Hemmatyar Department of Nutrition, Faculty of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch, Tehran, Iran. Sahar Hemmatyar Department of Nutrition, Faculty of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch, Tehran, Iran. Shahryar Eghtesadi Department of Nutrition, Faculty of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch, Tehran, Iran. Anahita Hoshyarrad National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mahmoud Mahmoudi Majdabadi Department of Health Services, Faculty of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch, Tehran, Iran. 2021 02 11 2021 04 03 Introduction: The incidence of multiple births in the world has increased significantly .There are few studies on the nutritional status of twins, to our knowledge, no study has been conducted in this field in Iran. These are among many reasons that make this study, which aims to identify major dietary patterns and Chronic Disease’s Effective Factors on the General Health Condition of Tehran’s Opposite Gender Adult Twins, valuable.  Materials and Methods: 128 people (64 pairs) of Opposite Gender Twins participated in this study. After completing the general information questionnaires, International Physical Activity, Semi-quantitative food frequency, and general health, anthropometric indices, and their blood pressure were measured. Dietary patterns were identified by factor analysis. The relationship between dietary patterns and factors affecting chronic diseases with general health was calculated using the logistic regression method.  Results: Two western and healthy dietary patterns were identified. There was a significant relationship between the Western dietary pattern and age, gender, and father's education. Twin participants who scored higher in a quarter of the Western dietary pattern were younger than those with lower scores, with men increasing and women decreasing. There was a significant difference in the distribution of healthy dietary  pattern with age, economic status, and systolic blood pressure. An increasing relationship was observed in age. The results showed that in first Twins, only Birth Weight, and Physical Activity, whereas, in second Twins besides Birth Weight, gender and Marital status were among the most significant factors in determining the general health of participants.  Conclusion: The present study shows that there are two major dietary patterns: healthy and western. The Western dietary pattern has the most variance and this indicates the nutritional transition and prevalence of the Western dietary pattern in Iran. The main finding of this study is the association of birth weight with general health in both twins. Birth weight is directly related to health. Those with low birth weight have more health problems in contrast to those with normal birth weight.   https://jbe.tums.ac.ir/index.php/jbe/article/view/444