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      • Modeling of Influential Predictors of Gastric Cancer Incidence Rates in Golestan Province, North Iran

        Behnampour, Nasser,Hajizadeh, Ebrahim,Zayeri, Farid,Semnani, Shahriar Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.3

        Golestan province has a reputation for relatively high incidence rates of gastric cancer in Iran. Along with dietary, lifestyle and environmental influential factors, soil selenium and high levels of pesticide used may exert influence in this region. The present study was designed for modeling the influential predictors on incidence of gastric cancer in Golestan. All registered cases of gastric cancer from March 2009 to March 2010 (49 females and 107 males) were investigated. Data were gathered by both check list and researcher made questionnaire (demographic, clinical and lifestyle characteristics) and analysed using logistic regression. Mean (${\pm}SD$) age at diagnosis was $62.9{\pm}13.8$ years. CIR and ASR of gastric cancer showed 9.16 and 13.9 per 100,000 people, respectively. Based on univariate logistic regression, a history of smoking (OR= 2.076), unwashed hands after defecation (OR= 2.612), history of cancer in relatives (OR= 2.473), history of gastric cancer in first-degree relatives (OR= 2.278), numbers of gastric cancers in first-degree relatives (OR= 2.078), history of X-ray and dye exposure (OR= 2.395), history of CT scan encounter (OR= 2.915), improper food habits (OR= 3.320), specific eating behavior (OR= 0.740), consumption of probable high risk foods (OR= 2.942), charred flesh (OR= 1.945), and animal fat (OR= 2.716) were confirmed as a risk factors. Changes in lifestyle may be expected to increase gastric cancer incidence dramatically in the near future. Therefore, appropriate educational interventions should be designed and implemented by competent authorities.

      • Finding Genes Discriminating Smokers from Non-smokers by Applying a Growing Self-organizing Clustering Method to Large Airway Epithelium Cell Microarray Data

        Shahdoust, Maryam,Hajizadeh, Ebrahim,Mozdarani, Hossein,Chehrei, Ali Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.1

        Background: Cigarette smoking is the major risk factor for development of lung cancer. Identification of effects of tobacco on airway gene expression may provide insight into the causes. This research aimed to compare gene expression of large airway epithelium cells in normal smokers (n=13) and non-smokers (n=9) in order to find genes which discriminate the two groups and assess cigarette smoking effects on large airway epithelium cells.Materials and Methods: Genes discriminating smokers from non-smokers were identified by applying a neural network clustering method, growing self-organizing maps (GSOM), to microarray data according to class discrimination scores. An index was computed based on differentiation between each mean of gene expression in the two groups. This clustering approach provided the possibility of comparing thousands of genes simultaneously. Results: The applied approach compared the mean of 7,129 genes in smokers and non-smokers simultaneously and classified the genes of large airway epithelium cells which had differently expressed in smokers comparing with non-smokers. Seven genes were identified which had the highest different expression in smokers compared with the non-smokers group: NQO1, H19, ALDH3A1, AKR1C1, ABHD2, GPX2 and ADH7. Most (NQO1, ALDH3A1, AKR1C1, H19 and GPX2) are known to be clinically notable in lung cancer studies. Furthermore, statistical discriminate analysis showed that these genes could classify samples in smokers and non-smokers correctly with 100% accuracy. With the performed GSOM map, other nodes with high average discriminate scores included genes with alterations strongly related to the lung cancer such as AKR1C3, CYP1B1, UCHL1 and AKR1B10. Conclusions: This clustering by comparing expression of thousands of genes at the same time revealed alteration in normal smokers. Most of the identified genes were strongly relevant to lung cancer in the existing literature. The genes may be utilized to identify smokers with increased risk for lung cancer. A large sample study is now recommended to determine relations between the genes ABHD2 and ADH7 and smoking.

      • Determination of a Change Point in the Age at Diagnosis of Breast Cancer Using a Survival Model

        Abdollahi, Mahbubeh,Hajizadeh, Ebrahim,Baghestani, Ahmad Reza,Haghighat, Shahpar Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.no.sup3

        Breast cancer, the second cause of cancer-related death after lung cancer and the most common cancer in women after skin cancer, is curable if detected in early stages of clinical presentation. Knowledge as to any age cut-off points which might have significance for prognostic groups is important in screening and treatment planning. Therefore, determining a change-point could improve resource allocation. This study aimed to determine if a change point for survival might exist in the age of breast cancer diagnosis. This study included 568 cases of breast cancer that were registered in Breast Cancer Research Center, Tehran, Iran, during the period 1986-2006 and were followed up to 2012. In the presence of curable cases of breast cancer, a change point in the age of breast cancer diagnosis was estimated using a mixture survival cure model. The data were analyzed using SPSS (versions 20) and R (version 2.15.0) software. The results revealed that a change point in the age of breast cancer diagnosis was at 50 years age. Based on our estimation, 35% of the patients diagnosed with breast cancer at age less than or equal to 50 years of age were cured while the figure was 57% for those diagnosed after 50 years of age. Those in the older age group had better survival compared to their younger counterparts during 12 years of follow up. Our results suggest that it is better to estimate change points in age for cancers which are curable in early stages using survival cure models, and that the cure rate would increase with timely screening for breast cancer.

      • Development of an Instrument based on the Protection Motivation Theory to Measure Factors Influencing Women's Intention to First Pap Test Practice

        Hassani, Laleh,Dehdari, Tahereh,Hajizadeh, Ebrahim,Shojaeizadeh, Davoud,Abedini, Mehrandokht,Nedjat, Saharnaz Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.3

        Background: Given that there are many Iranian women who have never had a Pap smear, this study was designed to develop and validate a measurement tool based on the Protection Motivation Theory to assess factors influencing the Iranian women's intention to perform first Pap testing. Materials and Methods: In this psychometric research, to determine the Content Validity Index (CVI) and the Content Validity Ratio (CVR), a panel of experts (n=10) reviewed scale items. Reliability was estimated through the Intraclass Correlation Coefficient (n=30) and internal consistency (n=240). Also, factor analysis (exploratory and conformity) was performed on the data of the sample women who had never had a Pap smear test (n=240). Results: A 26-item questionnaire was developed. The CVI and CVR scores of the scale were 0.89 and 0.90, respectively. Exploratory factor analysis loaded a 26-item with seven factors questionnaire (perceived vulnerability and severity, fear, response costs, response efficacy, self-efficacy, and protection motivation (or intention)) that jointly accounted for 72.76% of the observed variance. Confirmatory factor analysis indicated a good fit for the data. Internal consistency (range 0.70-0.93) and test-retest reliability (range 0.72-0.96) of sub-scales were acceptable. Conclusions: This study showed that the designed instrument was a valid and reliable tool for measuring the factors influencing the women's intention to perform their first Pap testing.

      • Effects of an Educational Intervention Based on the Protection Motivation Theory and Implementation Intentions on First and Second Pap Test Practice in Iran

        Dehdari, Tahereh,Hassani, Laleh,Hajizadeh, Ebrahim,Shojaeizadeh, Davoud,Nedjat, Saharnaz,Abedini, Mehrandokht Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.17

        Background: Few Iranian women take the Papanicolaou test despite its important role in preventing cervical cancer. This study aimed to determine the effectiveness of an educational intervention based on the protection motivation theory (PMT) variables and implementation intentions in the first and second Pap test practice among Iranian women. Materials and Methods: In this quasi-randomized controlled trial, 200 women who were referred to 30 primary health care clinics in Tehran were randomly selected. PMT variables and Pap test practice were measured at baseline and again after 3 and 15 months. The 4-week educational intervention program was conducted for the intervention group. Results: Following the intervention, the mean scores of self-efficacy, perceived vulnerability, and behavior intention variables were significantly higher in the intervention group when compared to the control group (p<0.05). No significant differences were found in the perceived severity, response efficacy, response cost, and fear between the two groups following the intervention. Higher percent of women in the intervention group had obtained first and second Pap test compared to the controls. Conclusions: The PMT and implementation intentions provide a suitable theory-based framework for developing educational interventions regarding Pap test practice in Iran.

      • Refusal Self Efficacy, Self Esteem, Smoking Refusal Skills and Water Pipe (Hookah) Smoking among Iranian Male Adolescents

        Karimy, Mahmood,Niknami, Shamsaddin,Heidarnia, Ali Reza,Hajizadeh, Ebrahim,Shamsi, Mohsen Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.12

        Background: Tobacco use among adolescents is a major public health concern, and identifying predictors of smoking is necessary for planning prevention programs. The present study examined the relationship between refusal self efficacy, self esteem, smoking refusal skills and water pipe (hookah) smoking among Iranian male adolescents. Materials and Methods: A cross-sectional study was conducted with 380 Iranian male adolescents aged between 15-19 years selected by multistage sampling. The participants completed an anonymous, voluntary, self-report questionnaire. Variables independently associated with water pipe (WP) smoking were identified by multiple logistic regression analysis. Results: The mean age of the participants was $16.7{\pm}1.3$ years. The prevalence of WP smoking was 17.3%. Logistic regression analysis revealed that knowledge (OR=0.56; 95% CI: (0.37-0.79), attitude (OR=0.69; 95% CI: (0.52-0.89), self esteem (OR=0.67; 95% CI: (0.55-0.82), smoking refusal skills (OR=0.73; 95% CI: (0.55-0.87), and self efficacy (OR=.82; 95% CI: (0.61-0.93) were all signifcant prediting facotrs for adolescents WP smoking. Conclusions: The findings have implications for public health interventions. Indeed, self efficacy and smoking refusal skills should be considered when developing tailored measures for the prevention of WP smoking among adolescents.

      • KCI등재

        Exploring the Contributory Factors of Confined Space Accidents Using Accident Investigation Reports and Semistructured Interviews

        Zahra Naghavi K.,Seyed B. Mortazavi,Hassan Asilian M,Ebrahim Hajizadeh 한국산업안전보건공단 산업안전보건연구원 2019 Safety and health at work Vol.10 No.3

        Background: The oil and gas industry is one of the riskiest industries for confined space injuries. This study aimed to understand an overall picture of the causal factors of confined space accidents through analyzing accident reports and the use of a qualitative approach. Methods: Twenty-one fatal occupational accidents were analyzed according to the Human Factors Analysis and Classification System approach. Furthermore, thirty-three semistructured interviews were conducted with employees in different roles to capture their experiences regarding the contributory factors. The content analyses of the interview transcripts were conducted using MAXQDA software. Results: Based on accident reports, the largest proportions of causal factors (77%) were attributed to the organizational and supervisory levels, with the predominant influence of the organizational process. We identified 25 contributory factors in confined space accidents that were causal factors outside of the original Human Factors Analysis and Classification System framework. Therefore, modifications were made to deal with factors outside the organization and newly explored causal factors at the organizational level. External Influences as the fifth level considered contributory factors beyond the organization including Laws, Regulations and Standards, Government Policies, Political Influences, and Economic Status categories. Moreover, Contracting/Contract Management and Emergency Management were two extra categories identified at the organizational level. Conclusions: Preventing confined space accidents requires addressing issues from the organizational to operator level and external influences beyond the organization. The recommended modifications provide a basis for accident investigation and risk analysis, which may be applicable across a broad range of industries and accident types.

      • SCOPUSKCI등재

        Exploring the Contributory Factors of Confined Space Accidents Using Accident Investigation Reports and Semistructured Interviews

        Naghavi K., Zahra,Mortazavi, Seyed B.,Asilian M., Hassan,Hajizadeh, Ebrahim Occupational Safety and Health Research Institute 2019 Safety and health at work Vol.10 No.3

        Background: The oil and gas industry is one of the riskiest industries for confined space injuries. This study aimed to understand an overall picture of the causal factors of confined space accidents through analyzing accident reports and the use of a qualitative approach. Methods: Twenty-one fatal occupational accidents were analyzed according to the Human Factors Analysis and Classification System approach. Furthermore, thirty-three semistructured interviews were conducted with employees in different roles to capture their experiences regarding the contributory factors. The content analyses of the interview transcripts were conducted using MAXQDA software. Results: Based on accident reports, the largest proportions of causal factors (77%) were attributed to the organizational and supervisory levels, with the predominant influence of the organizational process. We identified 25 contributory factors in confined space accidents that were causal factors outside of the original Human Factors Analysis and Classification System framework. Therefore, modifications were made to deal with factors outside the organization and newly explored causal factors at the organizational level. External Influences as the fifth level considered contributory factors beyond the organization including Laws, Regulations and Standards, Government Policies, Political Influences, and Economic Status categories. Moreover, Contracting/Contract Management and Emergency Management were two extra categories identified at the organizational level. Conclusions: Preventing confined space accidents requires addressing issues from the organizational to operator level and external influences beyond the organization. The recommended modifications provide a basis for accident investigation and risk analysis, which may be applicable across a broad range of industries and accident types.

      • KCI등재

        Factors Influencing Physical Activity Behavior among Iranian Women with Type 2 Diabetes Using the Extended Theory of Reasoned Action

        Alireza Didarloo,Davoud Shojaeizadeh,Hassan Eftekhar Ardebili,Shamsaddin Niknami,Ebrahim Hajizadeh,Mohammad Alizadeh 대한당뇨병학회 2011 Diabetes and Metabolism Journal Vol.35 No.5

        Background: Findings of most studies indicate that the only way to control diabetes and prevent its debilitating effects is through the continuous performance of self-care behaviors. Physical activity is a non-pharmacological method of diabetes treatment and because of its positive effects on diabetic patients, it is being increasingly considered by researchers and practitioners. This study aimed at determining factors influencing physical activity among diabetic women in Iran, using the extended theory of reasoned action in Iran. Methods: A sample of 352 women with type 2 diabetes, referring to a Diabetes Clinic in Khoy, Iran, participated in the study. Appropriate instruments were designed to measure the desired variables (knowledge of diabetes, personal beliefs, subjective norms, perceived self-efficacy, behavioral intention and physical activity behavior). The reliability and validity of the instruments were examined and approved. Statistical analyses of the study were conducted by inferential statistical techniques (independent t–test, correlations and regressions) using the SPSS package. Results: The findings of this investigation indicated that among the constructs of the model, self efficacy was the strongest predictor of intentions among women with type 2 diabetes and both directly and indirectly affected physical activity. In addition to self efficacy, diabetic patients’ physical activity also was influenced by other variables of the model and sociodemographic factors. Conclusion: Our findings suggest that the high ability of the theory of reasoned action extended by self-efficacy in forecasting and explaining physical activity can be a base for educational intervention. Educational interventions based on the proposed model are necessary for improving diabetics’ physical activity behavior and controlling disease.

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