Abbas Moghimbeigi

Background/Introduction: Breast cancer is recognized as the most prevalent malignancy worldwide and the leading cause of mortality among women, which influences individuals in lowand middle-income countries. Mammography, as the most effective method for early detection among asymptomatic women, significantly reduces mortality rates among women aged 40 and above. This study aimed to examine the predictive role of health literacy and the Extended Parallel Process Model (EPPM) constructs on intention to undergo mammography among women aged 40 years and older attending health care centers in Rey City in 2023. Methods: This cross-sectional study was conducted on 336 women using a two-stage sampling method. Data were collected through questionnaires developed based on the EPPM and health literacy constructs and analyzed using SPSS version 26 and SmartPLS version 3. Results: The mean age of women was 48.12 ± 5.67 years. Approximately 70.2% of the women were Iranian, while 29.8% were immigrants, and the majority (71.1%) were housekeepers. The constructs of perceived susceptibility, perceived self-efficacy, and perceived response efficacy significantly influenced the intention to undergo mammography. However, perceived severity and fear were not significantly associated with intention. No significant direct association was found between health literacy and mammography intention (β = 0.041, p = 0.312). However, health literacy exerted a significant total indirect effect on mammography intention (β = 0.411, 95% CI [0.292, 0.531], p < 0.001), fully mediated through perceived susceptibility, self-efficacy, and response efficacy, indicating full mediation. Discussion: The findings suggest that health literacy may contribute to mammography intention through its associations with key EPPM constructs, particularly perceived susceptibility, selfefficacy, and response efficacy. These results underscore the importance of addressing both cognitive and motivational factors when designing interventions to promote breast cancer screening. Conclusion: EPPM serves as an appropriate framework for predicting mammography intention. Among the EPPM constructs, perceived self-efficacy, response efficacy, and perceived susceptibility emerged as key determinants significantly influencing women's intention to undergo mammography. Health interventions should focus on enhancing these factors to promote preventive health behaviors.

Objectives: This study investigates the relationship between internet addiction and suicidal Ideations among adolescents, aiming to understand the connection between these two phenomena. Methods: This cross-sectional study was conducted in 2023 on 333 adolescent boys and girls aged 14 to 19, who were studying in Ahvaz city, using a cluster random sampling method. Data were collected using a multi-section questionnaire comprising demographic characteristics, internet addiction, suicidal Ideations, the adolescent depression questionnaire, and life satisfaction. Data were analyzed using path analysis modeling, Chi-square test, and Fisher’s exact test, with the help of SPSS 21 and Amos version 24 software. Results: In total, 10.5% were regular users, 40.5% had mild addiction, 44.7% had moderate addiction, and 4.2% had severe internet addiction. The results showed that internet addiction affects negative suicidal Ideations through the mediation of depression and positive suicidal Ideations (desire to live) through the mediation of life satisfaction. The average depression score among adolescents was 8.82 ± 8.76, and the average life satisfaction was 21.25 ± 7.76. Conclusions: Based on the results of the present study, suicidal Ideations among adolescents cannot be directly attributed to their internet addiction. The component of depression acts as a mediating factor in creating negative suicidal Ideations, while life satisfaction serves as a supportive factor in the relationship between internet addiction and positive suicidal Ideations (desire to continue living) in adolescents.

Background: Vaccination is one of the most cost-effective ways to prevent the spread of COVID-19. Objectives: The present study aimed to determine the prevalence of vaccine acceptance, side effects, and factors encouraging/disincentivizing vaccination among healthcare workers. Methods: A descriptive-analytical cross-sectional study was conducted on 315 health workers at Imam Reza Hospital, Kermanshah, Iran, in 2021. The samples were selected through a simple random sampling method. The data collection tool was a researcher-made questionnaire, and the collected data were analyzed in STATA-17 software. Results: The vaccine acceptance rate was 84.1% (n = 265), and the vaccine refusal rate was 15.9% (n = 50). The most injected vaccines were Sinopharm (n = 112, 42.3%) and Sputnik (n = 88, 33.2%), respectively. The most common side effects after vaccine injection were fatigue (34.8%, n=39) and myalgia (14.3%, n = 16). Being in a high-risk place (n = 199, 75.2%) and fear of contracting COVID-19 (n = 88, 33.5%) were the most important reasons for encouraging vaccination. About 36.7% (n = 18) of blood clotting, 26.5% (n = 14) cardiac arrest, short-term safety, and distrust were the essential factors for not accepting the vaccine. Conclusions: Based on the results, the prevalence of vaccine acceptance among health workers was high. However, a small percentage did not want to accept the vaccine due to negative news and a lack of trust in the vaccine. Therefore, it is necessary to establish strong educational and awareness-raising associations that transmit knowledge of the COVID-19 vaccine by focusing on false information.

Background: Brucellosis is recognized as one of the most prevalent diseases among humans and animals. This study investigated and followed up brucellosis in seropositive participants in the Famenin (Hamadan province, Iran) cohort of brucellosis and their families by culture and serology methods. Methods: Blood samples were taken from 66 subjects, including 18 subjects in the Famenin brucellosis cohort study with antibody titers≥1:180 and 36 subjects from their families and 12 subjects in the Famenin brucellosis cohort study with antibody titers<1:80. In the serological method, standard tube agglutination test (STAT positive with≥1:80) and 2-mercaptoethanol (2-ME) test (positive with≥1:40) were performed using the patient serum. Finally, 8 cc of the blood of all subjects was used for culture in the BACTEC culture medium. Results: Of the 66 serum samples, 20 (30.3%) samples, including 5, 4, and 10 samples at 1:20, 1:40, and 1:80 dilution, respectively, and 1 sample at 1:160 dilution were positive by the STAT, of which 13 (65%) samples belonged to patients’ family members. Using the 2-ME test, 10 (15.2%) serum samples were positive, of which 5 (50%) cases were related to patients’ family members. Eventually, no growth of Brucella was observed in 66 flasks of the BACTEC culture medium. Conclusion: Considering that a definite diagnostic method is not yet accessible, a combination of methods must be applied to diagnose the disease.

Background: The incidence of stomach cancer in Iran, especially in the western and northwestern regions, has increased in recent years. Objectives: This study aimed to report the identified factors related to stomach cancer in Hamadan province. Methods: In this retrospective descriptive study, the data were collected by a researcher-made checklist. The 1: 2 matched controls were considered for each patient. Controls were age (± 5 years) and sex-matched. The control group was selected from a hospital sample with and without a family history of cancer. The data analysis was analyzed using a conditional logistic regression model under Stata software. Results: A total of 100 patients (male n = 77 and female n = 23) with gastric cancer (cases) were studied. The results showed that many variables such as smoking (P < 0.05), blood type (P < 0.05), job (P < 0.05), red meat (P < 0.05), pickle (P < 0.05), hot food (P < 0.05), salt (P < 0.05), alcohol (P < 0.05), and black tea (P < 0.05) were risk factors and variables such as education (P < 0.05), vegetables (P < 0.05), fruit (P < 0.05), fish (P < 0.05), physical activity (P < 0.05), broccoli (P < 0.05), and garlic (P < 0.05) were the preventive factors for gastric cancer. There was no difference between the investigated factors of controls with a family history of cancer and those without one. Conclusions: Health and treatment organizations and health policymakers are expected to reduce the incidence of stomach cancer by raising awareness and promoting proper diet by reporting the preventive and risk factors.

Background: Cervical cancer (CC) is one of the treatable forms of cancer that can be prevented in its long precancerous conditions and good screening programs. Aim: Using directed content analysis, the present study, as qualitative research, aimed to investigate married women’s perspectives on screening for CC based on the protection motivation theory (PMT). Methods: To this end, a total number of 20 married women, considering maximum variation in sampling in terms of age and level of education, were interviewed. Therefore, an in-depth semistructured interview was used for data collection until saturation was reached. The PMT was also applied as the main framework to develop the interview items. Results: Eight categories, namely, intention, fear, perceived susceptibility, perceived severity, response efficacy, self-efficacy, response cost, and social support, were identified based on data classification. The majority of the participants intended to have a Pap smear. Moreover, they believed that if women knew more about screening for cervical cancer, they would definitely do so. Most of the participants, 60 %, had a high level of perceived susceptibility, and 100 % of them had self-efficacy related to doing a Pap smear. Almost all the interviewees acknowledged the effectiveness of a Pap smear and its consequences, but 80 % of the participants reported that they could not follow regular tests due to response cost despite their self-efficacy and knowledge about the effectiveness and the benefits of this type of screening. All the study participants also put more emphasis on the role of social support to push them to get a Pap smear. Conclusion: The cost of a Pap smear and social support should be considered when encouraging married women to participate in screening programs.

Semi-continuous data characterized by an excessive proportion of zeros and right-skewed continuous positive values appear frequently in medical research. One example would be the pharmaceutical expenditure (PE) data for which a substantial proportion of subjects investigated may report zero. Two-part mixed-effects models have been developed to analyse clustered measures of semi-continuous data from multilevel studies. In this study, we propose a new flexible two-part mixed-effects model with skew distributions for nested semi-continuous cost data under the framework of a Bayesian approach. The proposed model specification consists of two mixed-effects models linked by the correlated random effects: Part I) a model on the occurrence of positive values using a generalized logistic mixed model; and Part II) a model on the magnitude of positive values using a linear mixed model where the model errors follow skew distributions including beta-prime (BP). The proposed method is illustrated with pharmaceutical expenditure data from a multilevel observational study and the analytic results are reported by comparing potential models under different skew distributions. Simulation studies are conducted to assess the performance of the proposed model. The DIC₃, LPML, WAIC, and LOO as the Bayesian model selection criteria and measures of divergence used to compare the models.

Because the age at which a person first starts smoking has such a strong correlation with future smoking behaviours, it's crucial to examine its relationship with smoking intensity. However, it is still challenging to accurately prove this relationship due to limitations in the methodology of the performed studies. Therefore the main purpose of this study is to evaluate the potential risk factors affecting the intensity of smoking, especially the age of smoking onset among Iranian adult male smokers over 18 years of age using a generalized additive model (GAM). In GAM a latent variable with logistic distribution and identity link function was considered. Data from 913 Iranian male current smokers over the age of 18 was evaluated from a national cross-sectional survey of non-communicable disease (NCD) risk factors in 2016. Individuals were classified into: light, moderate, and heavy smokers. A GAM was used to assess the relationship. The results showed that 246 (26.9%) subjects were light smokers, 190 (20.8%) subjects were moderate smokers and 477 (52.2%) subjects were heavy smokers. According to the GAM results, the relationship was nonlinear and smokers who started smoking at a younger age were more likely to become heavy smokers. The factors of unemployment (OR = 1.364, 95% CI 0.725–2.563), retirement (OR = 1.217, 95% CI 0.667–2.223), and exposure to secondhand smoke at home (OR = 1.364, 95% CI 1.055–1.763) increased the risk of heavy smoking. but, smokers with high-income (OR = 0.742, 95% CI 0.552–0.998) had a low tendency to heavy smoking. GAM identified the nonlinear relationship between the age of onset of smoking and smoking intensity. Tobacco control programs should be focused on young and adolescent groups and poorer socio-economic communities.

Background and aims: Cervical cancer is one of the most common cancers of the female reproductive system. Despite the importance of cervical cancer screening in early detection, the uptake of screening is poor. The present study aimed to predict the factors that influence the cervical cancer screening behavior of Iranian women visiting health centers. Methods: This cross-sectional study was performed on 661 women of reproductive age referred to health centers in Karaj, Iran, in 2021, who were selected by convenience sampling. Data collection was performed with a multi-sectional questionnaire designed to collect information about demographic characteristics and constructs of Protection Motivation Theory (PMT) and emotional support. Data analysis was performed using SPSS version 24.0, and AMOS version 24. Results: The mean age of the participants was 38.2±13.77. Most of the participants had a high school diploma and a moderate socioeconomic status. The results showed the direct effect of intention on behavior (β=0.54) and the direct effect of fear on intention (β=-0.66). Perceived self-efficacy had the greatest indirect effect on behavior through intention (β=0.34). All protection motivation constructs except response cost (β=0.06) showed a significant effect on cervical cancer screening behavior. Model fit indices showed the good capability of the extended protection motivation model to predict cervical cancer screening behavior. Conclusion: Perceived self-efficacy is the strongest predictor of cervical cancer screening behavior, and emotional support affects this behavior through self-efficacy and intention. Therefore, it is recommended to pay attention to these factors when designing and planning educational interventions for improving cervical cancer screening behavior.

هدف: هدف این پژوهش مقایسه اثربخشی امیددرمانی و معنویت درمانی بر کیفیت زندگی، قند خون و فشار خون زنان میانسال مبتلا به دیابت نوع دو بود. روش: پژوهش حاضر نیمه آزمایشی با طرح پیش آزمون- پس آزمون- پیگیری با گروه گواه بود. جامعه آماری شامل تمام زنان میانسال مبتلا به دیابت نوع 2 مراجعه کننده به مرکز تحقیقات دیابت، متابولیسم و غدد شهر تهران در سال 1399 بودند که ‏45 نفر به شیوه نمونه‌گیری در دسترس انتخاب و به صورت تصادفی در دو گروه آزمایش و یک گروه گواه (هر گروه 15 نفر) قرار گرفتند. ابزار پژوهش شامل پرسشنامه کوتاه کیفیت زندگی بالینی دیابتی بروس و همکاران (2004) و آزمایش خون جهت اندازه‌­گیری فشارخون و قند خون ناشتا بود. بعد از 8 جلسه 90 دقیقه­ای برای هفته­ای 1 بار، امیددرمانی و معنویت درمانی برای گروه‌­های آزمایش، داده­‌های پژوهش حاضر با استفاده از روش تحلیل واریانس با اندازه‌­گیری مکرر تجزیه و تحلیل شدند. یافته­‌ها: نتایج نشان داد معنویت درمانی و امیددرمانی بر کیفیت زندگی (038/0=P) اثر افزاینده داشتند. نتیجه‌­گیری: از جمله تلویحات کاربردی پژوهش حاضر ارائه درمان­‌های روان­شناختی برای بیماران مبتلا به دیابت نوع 2 است. پیشنهاد می‌شود درمان‌هایی نظیر امید و...