مقالات رزومه دکتر حمید علوی مجد

Neurodevelopmental disorders comprise a group of neuropsychiatric conditions. Presently, behavior-based diagnostic approaches are utilized in clinical settings, but the overlapping features among these disorders obscure their recognition and management. Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) have common characteristics across various levels, from genes to symptoms. Designing a computational framework based on the neuroimaging findings could provide a discriminative tool for ultimate more efficient treatment. Machine learning approaches, specifically classification methods are among the most applied techniques to reach this goal.

We applied a novel two-level multi-class data maximum dispersion classifier (DMDC) algorithm to classify the functional neuroimaging data (utilizing datasets: ADHD-200 and autism brain imaging data exchange (ABIDE)) into two categories: Neurodevelopmental disorders (ASD and ADHD) or healthy participants, based on calculated functional connectivity values (statistical temporal correlation).

Our model achieved a total accuracy of 62% for healthy controls. Specifically, it demonstrated an accuracy of 51% for healthy subjects, 61% for autism spectrum disorder, and 84% for ADHD. The support vector machine (SVM) model achieved an accuracy of 46% for both the healthy control and ASD groups, while the ADHD group classification accuracy was estimated to be 84%. These two models showed similar classification indices for the ADHD group. However, the discrimination power was higher in the ASD class. 

The method employed in this study demonstrated acceptable performance in classifying disorders and healthy conditions compared to the more commonly used SVM method. Notably, functional connections associated with the cerebellum showed discriminative power.

Parkinson disease is a neurodegenerative disease that disrupts functional brain networks. Many neurodegenerative disorders are associated with changes in brain communication patterns. Resting-state functional connectivity studies can distinguish the topological structure of Parkinson patients from healthy individuals by analyzing patterns between different regions of the brain. Accordingly, the present study aimed to determine the brain topological features and functional connectivity in patients with Parkinson disease, using a Bayesian approach. 

The data of this study were downloaded from the open neuro site. These data include resting-state functional magnetic resonance imaging (rs-fMRI) of 11 healthy individuals and 11 Parkinson patients with mean ages of 64.36 and 63.73, respectively. An advanced nonparametric Bayesian model was used to evaluate topological characteristics, including clustering of brain regions and correlation coefficient of the clusters. The significance of functional relationships based on each edge between the two groups was examined through false discovery rate (FDR) and network-based statistics (NBS) methods. 

Brain connectivity results showed a major difference in terms of the number of regions in each cluster and the correlation coefficient between the patient and healthy groups. The largest clusters in the patient and control groups were 26 and 53 regions, respectively, with clustering correlation values of 0.36 and 0.26. Although there are 15 common areas across the two clusters, the intensity of the functional relationship between these areas was different in the two groups. Moreover, using NBS and FDR methods, no significant difference was observed for each edge between the patient and healthy groups (P>0.05). 

The results of this study show a different topological configuration of the brain network between the patient and healthy groups, indicating changes in the functional relationship between a set of areas of the brain.

Autism spectrum disorder is a neurodevelopmental condition in which impaired connectivity of the brain network. The functional magnetic resonance imaging (fMRI) technique can provide information on the early diagnosis of autism by evaluating communication patterns in the brain. The present study aimed to assess functional connectivity (FC) variations in autism patients.

Resting‑state fMRI data were obtained from the “ABIDE” website. These data include 294 autism patients with a mean (standard deviation) age of 16.49 (7.63) and 312 healthy individuals with a mean (standard deviation) age of 15.98 (6.31). In this study, changes in communication patterns across different brain regions in autism patients were investigated using graph‑based models.

The FC cluster of 17 regions in the brain, such as the hippocampus, cuneus, and inferior temporal, was different between the patient and healthy groups. Based on connectivity analysis of pair regions, 36 of the 136 correlations in the cluster were significantly different between the two groups. The middle temporal gyrus had more communication than the other regions. The largest difference between groups was – 0.112, which corresponding to the right middle temporal and right thalamus regions.

The findings of this study revealed functional relationship alterations in patients with autism compared to healthy individuals, indicating the disease’s effects on the brain connectivity network.

Autism spectrum disorder is a neurodevelopmental condition in which impaired connectivity of the brain network. The functional magnetic resonance imaging (fMRI) technique can provide information on the early diagnosis of autism by evaluating communication patterns in the brain. The present study aimed to assess functional connectivity (FC) variations in autism patients.

Resting?state fMRI data were obtained from the “ABIDE” website. These data include 294 autism patients with a mean (standard deviation) age of 16.49 (7.63) and 312 healthy individuals with a mean (standard deviation) age of 15.98 (6.31). In this study, changes in communication patterns across different brain regions in autism patients were investigated using graph?basedmodels.

The FC cluster of 17 regions in the brain, such as the  ippocampus, cuneus, and inferior temporal, was different between the patient and healthy groups. Based on connectivity analysis of pair regions, 36 of the 136 correlations in the cluster were significantly different between the two groups. The middle temporal gyrus had more communication than the other regions. The largest difference between groups was – 0.112, which corresponding to the right middle temporal and right thalamus regions.

The findings of this study revealed functional relationship alterations in patients with autism compared to healthy individuals, indicating the disease’s effects on the brain connectivity network.

Gestational diabetes is is associated with some degree of sexual dysfunction in women. Therefore, this study aimed to explore the perceptions and experiences of women with gestational diabetes regarding their sexual function.

This study was a qualitative research using the conventional content analysis approach and was conducted from April to December 2020 in Mazandaran Province, Iran. The participants included 15 women with gestational diabetes, six key individuals, and two husbands of women with gestational diabetes who were selected using a purposive sampling. The data were collected through in-depth semi-structured interviews. The content analysis approach was used based on the Graneheim and Lundman (2004) method. Guba and Lincoln's criteria including credibility, transferability, confirmability, and dependability were applied to achieve trustworthiness. MAXQDA10 software was used for data management.

Data analysis illustrated four themes: "sexual problems in women with gestational diabetes", "worries and problems caused by gestational diabetes", "non-comprehensive services", and " need to empower the individuals and significant others ". 

Worries and problems caused by gestational diabetes that develop in women who receive inappropriate and non-comprehensive services can affect their sexual function. Therefore the supportive role of health care providers and significant others are necessary to empower the patients to overcome their sexual problems.

Job satisfaction of midwives plays an important role in the efficiency and performance of health centers and the quality of midwifery services. This study reviewed job satisfaction and its related factors among midwives working in health systems in Iran.

In this systematic review, the databases of Web of Science, Scopus, PubMed, PsycINFO, Embase, Google Scholar and Magiran, were searched between 2000 and 2021 using keywords of midwife, job satisfaction, occupational stress, and Iran. The research steps were based on PRISMA. For quality assessment, the articles were evaluated according to the inclusion criteria by two researchers with the Newcastle-Ottawa scale. 

A total of 23 articles including 3,352 midwives working in the health and medical centers were reviewed. The level of job satisfaction was moderate, and the job satisfaction of midwives working in hospitals was lower than that of those working in health centers. The highest level of satisfaction was related to the job positions and relationships with colleagues, and the lowest level was in relation to the salary and job benefits. Marital status, age, income, salary, organizational position, education, employment status, interest in the field of education, and workplace had a relationship with increasing job satisfaction. Tensions in the workplace environment was associated with decreasing job satisfaction.

It is necessary to provide conditions to improve job satisfaction of midwives in order to identify and removing barriers and improving professional belonging to promote occupational health and optimize the quality of providing midwifery services.

Research has demonstrated the negative effects of type-1 diabetes mellitus (T1DM) on the female sexual health and reproductive function. The present study was conducted to develop the concept of sexual and reproductive health (SRH) in women with T1DM.

This concept development was conducted by directed content analysis of relevant literature. A search was carried out for articles published from 2000 to 2019 in English databases including PubMed, Web of Science, Scopus, Embase and Persian databases including Magiran, SID, and IranDoc and search engine such as Google Scholar based on a search strategy developed for each database using Boolean operators. The initial matrix was designed based on the framework proposed by the United Nations Population Fund (UNFPA) and the World Health Organization (WHO) and information resources related to them for the concept of women's sexual and reproductive health (SRH). The selected articles were analyzed using directed content analysis with deductive approach proposed by Hsieh and Shannon. 

The final codes were extracted from the review of 151 articles based on their conceptual differences and similarities, and categories were then defined and a matrix was developed. Four categories were extracted in this study for the concept of SRH in women with T1DM, including reproductive system, safe motherhood, sexual and gender-based violence, and sexual function, along with 20 subcategories.

The findings can be utilized to develop specific tools for assessing SRH in women with T1DM as well as designing programs targeting SRH promotion in this vulnerable group.

Pregnancy is a complex and vulnerable period that causes some challenges including the development of postpartum psychiatric disorders (PPDs) for women. Identifying the factors associated with these disorders can be effective in reducing maternal symptoms and supporting mother, child and family. The aim of this study was to identify the relationship between postpartum mental health and mediating social determinants of health in Iran.

In this systematic review, the Persian and English observational studies in Iran were obtained through advanced search in online databases, such as PubMed, Scopus, EMBASE, SID, Magiran, Psycinfo, and Google Scholar search engine in the period of January 2005 to August 5, 2021 using the following keywords: social determinants, mediating factors, social support, mental health, risk factors, postpartum, Iran, and their English equivalents through Mesh. Articles were selected based on the inclusion and exclusion criteria and quality assessment of articles was performed using the standard Newcastle-Ottawa Scale (NOS).

Out of 42 eligible articles (total sample: 39216), 40 articles examined the relationship between postpartum depression and 2 articles studied the relationship of maternal grief with some mediating social determinants. In general, these factors were classified into five categories, including midwifery and pregnancy-related factors, psychosocial conditions, factors related to postpartum status, behavioral factors and material status or conditions, and health care.

Mothers' mental health is affected by many underlying factors; Therefore, identifying the risk factors associated with mental disorders in this population based on the model of the WHO (World Health Organization), especially in the mediating area (Material and environmental conditions, Psychosocial, Behavioral factors, Health system) due to the extent of this area is very important.

There is little knowledge about the underlying motivations that cause caregivers to care for the patient or not. This study aimed to identify the motivations of providing care in family caregivers of hemodialysis patients

This qualitative study was conducted using the conventional content analysis method. Fifteen family caregivers of hemodialysis patients were enrolled in the study via purposive with a maximum variation sampling method. The setting was hemodialysis wards of Tehran teaching hospitals. Data were collected via semi-structured interviews. The analysis was performed using conventional content analysis with MAXQDA version 10. To ensure the trustworthiness of the data, the criteria of Credibility, Dependability, Transferability, and Confirmability were taken into account

Fifteen participants (eight women and three men) were interviewed. The majority (eight of them) were spouses. Totally 200 codes, 12 subcategories, four generic categories, and two main categories were extracted. The main categories included Social Motivation (including two generic categories: providing care influenced by norms and culture and providing care inspired by social influence) and Internal motivation (including two generic categories: religious-spiritual motivation to provide care and emotional-moral motivation to provide care).

To benefit from the valuable capabilities of family caregivers, must pay attention to their social and internal motivations in providing care.  The findings of this study can be helpful for future planning to strengthen internal motivations and improve and guide the external motivations of caregivers.

Infertility is a global health issue and is reported differently worldwide.

To assess the longitudinal trends of primary and secondary infertility prevalence rate (PSIPR) per 100000 across all countries during past decades.

The PSIPR was extracted from the global burden of disease (GBD) database for 195 countries during 1993-2017. The longitudinal trends of PSIPR were explored across the seven epidemiological regions designated by GBD.

Globally, the PSIPR was lower among men than women. Over time, the prevalence of primary infertility in men and women had a decreasing trend of -9.3 and -11.6 in High-Income countries. Other regions have seen an increase, the highest being in South Asian women, and men of the Middle East and North Africa, with rates of 40.9 and 19.0, respectively. Over time, the secondary infertility prevalence in women of Central Asia, Central Europe and, Eastern Europe, as well as High-Income countries, has been declining, (rates of -16.9 and -11.7, respectively). Other regions have been on the rise, with the highest increase among women of Middle East, North Africa, and South Asia (trend of 119.9 and 83.4, respectively), and in South Asian men (trend of 48.4).

The overall trend of infertility prevalence shows a downward trajectory in high-income and developed countries and an upward trend in others. These findings might be explained by missed cases of infertility due to a low tendency for reproduction and the presence of more infertility treatment facilities in these regions.

Caregiver burden is defined as the physical, financial, mental, and social problems stemmed from providing care for one of the family members who is involved with a medical problem. The precise measurement of caregiver burden is crucial, and it is essential to have an appropriate and specific tool for measuring caregiver burden. This study will be carried out using sequential exploratory mixed-method design with the aim of development and psychometric evaluation of a questionnaire for caregiver burden in family caregivers of hemodialysis patients.

The study will be done in 2 phases: 1. qualitative study and literature review, and 2. designing and psychometric evaluation of the questionnaire. In the qualitative phase, family caregivers of hemodialysis patients, patients, nurses, physicians, and social workers will be selected using the maximum variation purposive sampling method. Data will be gathered through semi-structured interviews using a combination of the questions derived from the model and open-ended questions and will be analyzed using directed content analysis. The literature review will be carried out based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses to improve the reporting of the systematic review. After developing the primary item pool, in the quantitative phase, the psychometric properties of the questionnaire will be evaluated. In this regard, face, content, and construct validity (exploratory factor analysis),internal consistency (Alpha’s Cronbach), reliability (test-retest), responsiveness, interpretability, and feasibility of the questionnaire will be assessed.

The primary questionnaire will be developedbased on the qualitative and systematic literature review; then, its psychometric properties will be assessed in the second phase.The result section will consist of the findings of these two phases.

It seems that a specific questionnaire could be a facilitator of identifying and measuring the actual caregiver burden.

Due to the increased effect of environmental factors on the age of menarche and the correlation between the mothers’ and daughters’ age of menarche, we aimed at performing a meta-analysis to compare the mean age of menarche between the mothers and their daughters, examining the correlation between them. This systematic review was conducted to determine the heritability of daughters’ age of menarche. In this systematic review and meta-analysis, a complete search was carried out in PubMed, Scopus, Google Scholar, Web of Science, Science Direct, and CINAHL electronic databases in English with no time limitation. A meta-regression analysis was then performed to evaluate the effect of age and sample size. 13 studies with a total sample size of 9719 for calculating the standardized mean difference and 15 articles with a total sample size of 8840, related to the research objectives, were analyzed in this meta-analysis. The pooled mean of the daughters’ age of menarche was 12.62 yrs. (95% CI: 12.37 – 12.87) and that of the mothers’ age of menarche was 13.58 yrs. (95% CI: 13.31 – 13.81). The standardized mean difference between the mothers’ and daughters’ ages of menarche was -0.72 (CI: -0.99 to -0.44). The results of the meta-analysis revealed that, overall, there is a significant positive correlation between the mothers’ and daughters’ ages of menarche (r=0.27 [CI 95%: 0.17-0.36]). The daughters’ ages of menarche were positively correlated to those of their mothers, but the other environmental factors that may affect this decreasing trend should also be taken into account. Health policy-makers should plan to identify strong predictors, which can be effective in reducing the age of menarche.

 Considering importance of developing maternal care, the present study was designed to compare the implications of a midwifery-led care (MLC) and standard model on maternal and neonatal outcomes during pregnancy, childbirth and postpartum.

 This clinical trial performed through quasi- experimental method on 200 pregnant women referred to health centers of Kashan, Iran, between 2014 and 2017. Participants were randomly assigned to MLC and standard model of care group (each 100). Data on maternal and neonatal outcomes were collected using self-structured questionnaires and checklists. The validity and reliability of tools were evaluated through content validity and also test-retest and observer reliability. The collected data were analyzed using SPSS version 21 by T test, chi-square and Mann-Whitney.

 The implementation of MLC resulted in improved outcomes including decrease in cesarean section, increase in spontaneous delivery, increase in physiological delivery, increased participation in preparatory classes for labor, decrease in induction, decrease in hospital stay, decrease in the number of prenatal visits, decrease in ultrasound, and increase in mean gestational age at admission (p <0.05). The results also pointed to increased lactation and decreased hospitalization due to jaundice (p < 0.05). There was no statistically significant difference in terms of anesthesia, narcotic use, postpartum hemorrhage, curettage, episiotomy, postpartum infection and postpartum depression. No maternal mortality was observed in two groups.

 Midwifery-led care can lead to improved maternal and neonatal outcomes at least in low-risk pregnant women. More chance of physiological delivery, spontaneous labor and less cesarean section, induction and augmentation were significant.

  Infertility stigma is a phenomenon associated with various psychological and social tensions especially for women. The stigma is associated with a feeling of shame and secrecy. The present study was aimed to explore the concept of infertility stigma based on the experiences and perceptions of infertile women. This qualitative conventional content analysis study was conducted in Isfahan Fertility and Infertility Center, Iran. Data were collected through in-depth interviews with 17 women who had primary infertility. All the interviews were recorded, transcribed and analyzed according to the steps suggested by Graneheim and Lundman. The Standards for Reporting Qualitative Research (SRQR) checklist was followed for this research. Eight hundred thirty-six initial codes were extracted from the interviews and divided into 25 sub-categories, 10 categories, and four themes. The themes included “stigma profile, self-stigma, defensive mechanism and balancing”. Stigma profile was perceived in the form of verbal, social and same sex stigma. Self-stigma was experienced as negative feelings and devaluation. Defensive mechanism was formed from three categories of escaping from the stigma, acceptance and infertility behind the mask. Two categories; empowered women and pressure levers, created a balancing theme against the infertility stigma.   Infertile women face social and self-stigma which threatenstheir psychosocial wellbeing and self-esteem. They use defensive response mechanisms and social support to mitigate these effects. Education focused on coping strategies might be helpful against infertility stigma.

Postpartum psychiatric disorders are a key concept in maternal-infant mental health, and determining the related factors is necessary. We aimed to determine the relationship between postpartum mental health and social-structural determinants of health in Iran.

In this systematic review, all Persian and English observational studies in Iran carried out through advanced search in online databases such as Medline, Scopus, Web of Science, EMBASE, SID and Magiran, as well as the Google Scholar between 2005 and 2020, using keywords of social determinants, structural factors, socio-economic status, risk factors, mental health, postpartum, Iran, and their English equivalents were obtained from MESH. Article quality was assessed using the standard Newcastle-Ottawa Scale (NOS).

Out of 56 eligible articles (sample size: 36,515), 49 articles reported the prevalence of postpartum depression and one article reported the prevalence of postpartum psychosis. The lowest and highest prevalence of postpartum depression was between 4.8-68.5% using the Edinburgh tool in 2014-2017 and using the Beck tool between 3-78.27% in 2013-2014. Structurally significant effective factors on postpartum depression were identified including mother's age, mother's education, father's education, mother's job, father's job, family economic status (income adequacy), ethnicity and race, social class, culture, and religion, and in the field of postpartum psychosis, age, level of education, and mother's job. The most common structural determinant related to postpartum mental health was education and the least factor was related to social class.

Due to the effects of numerous related factors on common postpartum mental disorders, it is suggested that longitudinal studies be conducted to investigate the role of all the known factors, especially Intermediate factors, on postpartum mental health.