فهرست مطالب ali reza mirahmadizadeh

Exposure to air pollution is a major health problem worldwide. This study aimed to investigate the effect of the level of air pollutants and meteorological parameters with their related lag time on the transmission and severity of coronavirus disease 19 (COVID-19) using machine learning (ML) techniques in Shiraz, Iran.

Study Design:

 An ecological study.

In this ecological research, three main ML techniques, including decision trees, random forest, and extreme gradient boosting (XGBoost), have been applied to correlate meteorological parameters and air pollutants with infection transmission, hospitalization, and death due to COVID-19 from 1 October 2020 to 1 March 2022. These parameters and pollutants included particulate matter (PM2), sulfur dioxide (SO2 ), nitrogen dioxide (NO2 ), nitric oxide (NO), ozone (O3 ), carbon monoxide (CO), temperature (T), relative humidity (RH), dew point (DP), air pressure (AP), and wind speed (WS).

Based on the three ML techniques, NO2 (lag 5 day), CO (lag 4), and T (lag 25) were the most important environmental features affecting the spread of COVID-19 infection. In addition, the most important features contributing to hospitalization due to COVID-19 included RH (lag 28), T (lag 11), and O3 (lag 10). After adjusting for the number of infections, the most important features affecting the number of deaths caused by COVID-19 were NO2 (lag 20), O3 (lag 22), and NO (lag 23).

Our findings suggested that epidemics caused by COVID-19 and (possibly) similarly viral transmitted infections, including flu, air pollutants, and meteorological parameters, can be used to predict their burden on the community and health system. In addition, meteorological and air quality data should be included in preventive measures.

The outbreak of the Covid-19 has been a serious threat to the health and lives of many people. This study aimed to determine the survival rate and its contributing factors in Covid-19 patients who were hospitalized in hospitals in Fars province.

This study is a hospital-based carried out on 119429 of Covid-19 hospitalized patients in the south of Iran within 2019 – 2022. Information of demographics and clinical characteristics, symptoms, and comorbidity of patients were extracted from medical records. The Kaplan–Meier curve and the Log rank test were used to compare survival rate in different groups. Cox regression was employed to determine the factors that affect survival.

The mean age of the participants was 51.5 year. The density incidence of death was estimated to be 16.8, 4.6, and 43.9 per 1000 person-days for all of patient, intensive care unit patients, and intubated patients, respectively. The Multiple Cox Regression results suggested that risk of mortality is 5.61 times higher in patients over 75 years, 3 times higher in patients admitted to the intensive care unit, and 3.4 times higher in intubated patients. Also, the risk of mortality was higher in men and those with underlying disease.

We found out that being elder, being a male, hospitalization in the intensive care unit, and being intubated would increase the risk of mortality. Thus, it is treatment management of hospitalized patients is necessary, especially elderly patients and those with underlying diseases.

Musculoskeletal Disorders (MSDs) are damage to the tissue of the musculoskeletal system that disrupt the flow and functionality of the human body. The current study evaluated changes in years of life lost (YLL) due to MSDs and mortality rates associated with MSDs in the 16 year-period from 2004 to 2019.

In this descriptive study, YLL for MSDs for the years 2004-2019 in Fars province was calculated using the YLL template from World Health Organization (WHO), and the number of total deaths due to MSDs in Fars province was obtained from the electronic population-based death registration system (EDRS).

Between the years 2004 and 2019, 746 deaths due to MSDs occurred in Fars province. The crude mortality rate increased in men from 1.29 (per 100,000 population) in 2004 to 1.47 in 2019 (p-value for trend=0.057) and in women from 1.18 in 2004 to 2.58 in 2019 (p-value for trend <0.001). Total YLL due to MSDs over the same period was 4,690 and 6,852 (0.14 and 0.22 per 1000 population) in men and women, respectively (female/male gender ratio =1.46).

The findings revealed that YLL due to MSDs was higher in females than males. The highest and lowest YLL due to MSDs was seen in the age group of 40-49 and 0-9 years, respectively. To minimize the effects of MSDs, further adjustment in the policies and regulations tailored for appropriate age groups and populations is recommended.

There is an increase in the incidence of breast and gynecologic cancers in Iran during the last three decades. Literature is inadequate about the Years of Life Lost (YLL) attributed to these cancers in Iran.

Mortality data due to these cancers amongst females aged >20 yr from 2004 to 2019 was acquired from “Electronic Death Registry System”, Fars Province, Iran. Using local health centers’ databases and national census reports from 1996 to 2016, the age-standardized incidence rate (ASR) per 100,000 people were estimated. YLLs were calculated using the WHO’s 2015 “YLL template”.

During 2004–2019, 1886 and 829 deaths occurred due to breast and gynecologic cancers, respectively. The ASR due to breast and gynecologic cancers showed a significant increasing trend (P<0.001 for each). The total YLL due to breast, cervical/uterine/vaginal/vulvar, and ovary cancers’ deaths in the 16-year period were 33,077, 7,172 and 6,584 yr, respectively. The highest YLLs were observed in 50-59-year-old females, followed by 40-49- and 60-69-year-old females. The 16- year trend of YLL rate due to premature mortality in breast cancer, ovary cancer and cervix cancer was increasing: annual percent change (APC) was 7.6% (95% CI: 5.5-9.7, P<0.001), 19.0% (95% CI: 12.2-26.1, P<0.001) and 9.2% (95% CI: -9.2 to 31.3, P>0.05, respectively.

Mortality rate and YLLs due to breast and gynecologic cancers have been increased in southern Iran during the last twenty years. Early detection programs and allocating treatments at early stages should be prioritized.

Unintentional falls are one of the main causes of death and a significant burden on victims, fami-lies, and communities. This study aimed to determine thetrend analysis ofmortality rate and years of life lost (YLL) due to unintentional falls in Fars Province, Iran.

All deaths due to unintentional fall in Fars Province, central Iran from the electronic population-based death registration system (EDRS) were obtained. Crude and age-standardized mortality rate, YLL and YLL rate data were calculated andto examine the trend, joinpointregression was used.

During the 16-year study period (2004-2019), 1816 deaths due to falls occurred in Fars Province. Crude mortality rate had stable trend in men and increasing trend in women. The total years of life lost due to falls, were 25,437 in men and 5,720 in women. According to the joinpoint regression analysis, the 16-year trend of YLL rate due to premature mortality was decreasing in males. The annual percent change (APC) was -2.8% (95% CI -4.5 to -1.0, P=0.005). However, there were stable trends for females, APC was 3.5% (95% CI -1.8 to 9.1, P=0.181).

Due to the increase in mortality caused by falls in women and stable trend in men, there is an ur-gent need to plan and implement preventive strategies to reduce the incidence of injuries caused by falls. Home and behavioral modifications such as increasing home lighting, providing handrails on stairs and bathrooms, and educating the people may play an important role in reducing fall deaths.

 This study aimed to investigate mortality and years of life lost (YLL) due to suicide and homicide in children aged 10-19 years in southern Iran from 2004 to 2019.

Study Design:

 A cross-sectional study.

 The data on all deaths due to suicide and homicide in Fars province were obtained from the population-based electronic death registration system (EDRS). Crude mortality rate and YLL were calculated. The joinpoint regression method was used to examine the trend.

 During the study period, 563 cases of suicide and 218 cases of homicide in children aged 10-19 have occurred. The total number of YLL due to suicide was 9766 in men and 6261 in women. According to the joinpoint regression analysis, the trend of YLL due to suicide was increasing in males. In other words, the annual percent change (APC) was 4.8% (95% CI 0.4 to 9.5, P=0.036). Additionally, there was a constant trend in females, and APC was 2.7% (95% CI -2.0 to 7.7, P=0.241). The number of YLL due to homicide was 4890 in males and 1294 in females. The trend of YLL due to homicide was stable in males and females. In other words, APC was -1.6% (95% CI -5.6 to -2.6, P=0.422) in males and -2.7% (95% CI -10.0 to 5.2, P=0.467) in females.

 Based on the findings of this study, the trend of mortality rate and YLL due to suicide in men has been increasing and it has been stable in women. Moreover, the trend of mortality due to homicide was stable for both males and females. Therefore, it is necessary to take preventive actions.

Gastrointestinal cancers can cause major health problems globally since their burden is increas-ing in many countries. We aimed to investigate the trend of years of life lost due to gastrointestinal cancers in Fars Province, southern Iran during the 2004-2019.

In this cross-sectional survey study, we obtained the information regarding all deaths due to gastro-intestinal cancers in Fars Province from the electronic population-based death registration system (EDRS).Years of Life Lost(YLL) was calculated using the YLL template of 2015 by the WHO. To examine the trend for different years, join point regression based on the log-linear model was used. Joinpoint regression analysis describes changing trends over successive periods of time and the increasing or decreasing rate within each period.

During the years of 2004-2019, 9742 deaths due to gastrointestinal cancers occurred in Fars Prov-ince. 6013 (61.72%) cases were male and 3729 (38.28%) cases were female (Male / Female Sex Ratio: 1.61). Overall, 4152 cases (42.63%) were due to gastric cancer and 2112 cases (21.68%) were due to liver cancer. Total years of life lost due to premature death from gastrointestinal cancers during the 16-year study period was 73565 yr (2.33 per 1000 persons) in men, 52766 yr (1.71 per 1000 persons) in women, and 126331 yr (2.02 per 1000 persons) in both sexes.

Among all cancers, the highest mortality rates in both sexes belong to gastric cancer. This study showed the trend of YLL rate of malignant neoplasms of liver and intrahepatic bile ducts, esophagus, oral cavity, and colon cancer were increasing in both sexes, however, the trend of YLL rate for malignant neo-plasms of the small intestine was decreasing in both sexes. Variation of GI cancers patterns and trends around the Fars Province indicated that a more comprehensive control plan is needed to control these variations

We aimed to determine the mortality rate and Years of Life Lost (YLL) due to lung cancer in Fars, Iran, during the period from 2004 to 2019.

All deaths due to lung cancer in Fars Province, Iran from the electronic population-based death registration system (EDRS) were obtained. Crude mortality rate, age-standardized mortality rate, YLL and YLL rate data were calculated and trends examined.

During 2004-2019, 3346 deaths occurred due to lung cancer in Fars Province, which was 10.8% (3346/30936) of the total cancer deaths in this period. Crude mortality rate of lung cancer had increased 70% and 53% in male and female respectively from 2004 to 2019. The total YLL of lung cancer during the 16-year study period was 28,094 (0.9 per 1000) in men, 14,174 (0.5 per 1000) in women, and 42,268 (0.8 per 1000) in both sexes (sex ratio male/female=2). According to the join point regression, the 16- year trend of YLL rate due to premature mortality was increasing: APC was 2.5% (95% CI 0.9 to 4.2, P=0.005) for males, 1.4% (95% CI 0.3 to 2.6, P=0.017) for females.

The mortality rate and YLL due to lung cancer in Fars Province is increasing, although the standardized mortality has a constant trend. Tobacco control is the most effective and least expensive way to reduce the number of lung cancer patients worldwide. National and local media can also play an important role in informing people about the risk factors.

Although the incidence of leukemia’s is not high, many of these cancers lead to death over a short period. This is a cross-sectional study on leukemia deaths in southern Iran.

All deaths due to leukemia in the Fars province were obtained from the population-based electronic death registration system (EDRS). Crude and age-standardized mortality rate (ASMR), YLL, and YLL rate data were calculated, and joinpoint regression was used to examine the trend.

Totally, 3141 deaths from leukemia occurred in the Fars province during the study period (2004-2019). Of these, 61.5% (1933 cases) pertained to men. The crude mortality rate was 6.1 (95% CI: 5.8 to 6.4) in men and 3.9 (95% CI: 3.7 to 4.2) in women. Also, ASMR was 6.6 (95% CI: 6.3 to 6.9) and 4.2 (95% CI: 4.0 to 4.4) in men and women, respectively. The total YLLs due to leukemia were 32 804 in men and 23 064 in women. The joinpoint regression analysis demonstrated that the trend of YLL rate due to premature mortality was stable: the annual percent change (APC) was -1.2% (95% CI: -2.5 to 0.2, P = 0.090) for males, and -1.0% (95% CI: -2.9 to 0.9, P = 0.274) for females.

The mortality and YLL due to leukemia had a stable trend. However, this trend has been decreasing or increasing in some age groups. Determining and controlling essential risk factors, especially the environmental factors of leukemia, may reduce its burden in the Fars province. 

 This study was conducted to determine the mortality rate and the years of life lost (YLL) due to unintentional poisoning in Fars province in the south of Iran.

Study Design: 

A cross-sectional study.

 In this study, data from all of the deaths due to unintentional poisoning in the south of Iran between 2004 and 2019 was extracted from the population-based Electronic Death Registry System (EDRS). The Joinpoint Regression method was used to examine the trend of the crude mortality rate, the age-standardized mortality rate (ASMR), and the YLL rate.

 During the 16-year study period (2004-2019), 1466 deaths due to poisoning occurred in Fars province. Of this number, 75.2% (1103 cases) were in men, and 37.5% (550 cases) were in the age group of 15-29 years. The total YLL due to poisoning during the 16-year study period were 25149 and 8392 in men and women, respectively. According to the joinpoint regression analysis, the 16-year trend of YLL rate due to premature mortality was stable. Moreover, the annual percent change (APC) was -0.7% (95% CI: -4.0 to 2.7, P=0.677) for males and - 0.3% (95% CI: -3.8 to 3.3, P=0.862) for females.

 The trend of crude mortality rate, ASMR and YLL due to unintentional poisonings was stable. Considering the high rate of mortality and YLL due to unintentional poisoning in the age group of 15-29 years, it is essential to take necessary actions in this age group.

Traditionally, mortality rates are used to estimate public health problems and determine the relative significance of different causes of mortality, but they cannot necessarily determine the burden of premature death.  We aimed to investigate the 16-year trend of burden of premature mortality in Southern Iran.

In this cross-sectional study, all deaths due to various causes of death in Fars Province from the electronic population-based death registration system (EDRS) were obtained. Crude and age-standardized mortality rate, Years of Life Lost (YLL) and YLL rate data were calculated and to examine the trend, joinpoint regression was used.  

During the study period, 281,903 deaths occurred, of which, 59.85% (n=168,735) occurred in men. Also, 42.18% of these deaths (n=118,610) occurred due to cardiovascular diseases (CVDs). The total number of YLLs due to premature death was 4,154,828 years. Of these, 2,591,564 years (62.37%) were in men. The highest number of YLL was due to CVDs, external causes of death and cancer. Trend of YLL rate due to premature mortality was decreasing: the annual percent change (APC) was -2.1% (95% CI -2.6 to -1.6, P<0.001) for males, -0.9% (95% CI -1.4 to -0.4, P=0.002) (P=0.002) for females.

Although the trend of premature death has been decreasing during the years of study, but the seven major causes of premature death in 2004 to 2019 were non-communicable diseases, especially ischemic heart diseases, stroke, external cause of morbidity, and cancer.  Furthermore, our findings indicate a change in the role of non-communicable diseases in premature mortality in recent years.

 Concerns about the side effects of SARS-CoV-2 vaccines have been raised nationwide. We aimed to compare the time to report the side effects of the Oxford-AstraZeneca and Sinopharm COVID-19 vaccines. 

 Information on side effects of AstraZeneca and Sinopharm COVID-19 vaccines was obtained from the COVID-19 Symptom Study App affiliated with Shiraz University of Medical Science during 2021. A COX regression model with an adjusted Hazard Ratio and 95% Confidence Interval; HR (95% C.I) was reported at the significance level of < 0.05.  

 4478 and 5555 participants received the AstraZeneca and Sinopharm vaccines, respectively; more age, history of SARS-CoV-2 infection, first vaccine dose, hypertension, and hypertension with cardiovascular disease were seen in the AstraZeneca group (P < 0.05 for all). However, the AstraZeneca group had lower immune deficiency and time to report the side effects (P < 0.05 for both). There was significantly less time to pain HR(95% C.I.); 0.50 (0.47-0.52), vertigo 0.65 (0.61-0.69), weakness 0.41 (0.38-0.44), headache 0.43 (0.39-0.74), anorexia 0.31 (0.28-0.34), nausea 0.56 (0.51-0.62), severer allergy 0.71 (0.63-0.81), general inflammation 0.27 (0.23-0.31), fever > 38oC 0.12 (0.1-0.15), eye inflammation 0.45 (0.39-0.52), diarrhea 0.85 (0.73-0.99), blurred vision 0.73 (0.61-0.86), injection site redness 0.32 (0.26-0.39), fatigue/paleness 0.53 (0.50-0.57), joint pain 0.55 (0.41-0.73), auxiliary gland inflation 0.59 (0.43-0.80), convulsions 0.30 (0.17-0.52), and severe side effects 0.3 (0.27-0.33) in the AstraZeneca group; However, skin rash 0.77 (0.57-1.05) and hospitalization 0.72 (0.21-2.55) were the same.  

 Sinopharm COVID-19 vaccine recipients reported longer times to report vaccine-related side effects than AstraZeneca; due to the lack of adverse effects like hospitalization, vaccination should continue to control the pandemic; more real-population studies are needed on the long-term effects of vaccination against COVID-19.

Traffic accidents are one of the most critical health problems and the ninth leading cause of death globally. We aimed to determine the Mortality rate and the number of Years of Life Lost (YLL) due to road traffic accidents.

In this retrospective cohort study, mortality rate and YLL due to road traffic accidents were exam-ined in Fars province, central Iran during the years 2004-2019. Mortality statistics were collected through death registration of ministry of health and medical education for Fars Province. Age Standardized mortality Rate (ASR) was calculated and join point regression analysis carried out to examine the trend of YLL rate. Data were analyzed using Excel spreadsheet version 2016 and Join point Regression Program 4.9.0.0.

During the 16-year study period, 25,858 deaths due to road traffic accidents occurred in the province. 79.2% (20483 cases) were in men, and 33.7% (8703 cases) were aged 15-29 years. Total YLL during the 16-year study period were 458,975 (14.6 per 1000 people) in men, 117,999 (3.8 per 1000 people) in women. According to the join point regression, the 16- year trend of YLL rate due to premature mortality was decreasing: AAPC was -4.9% (95% CI: -8.8 to -0.9; P=0.018) for male, and -3.5% (95% CI: -6.3 to-0.5; P=0.011) for female.

Considering that the number of deaths, mortality rate and YLL has decreased in Fars province during the 16 years under study. Therefore, because the mortality rate due to road traffic accidents in Iran is higher than the global average, the need for training programs for drivers, compliance with standards and retro-fitting of vehicles, road safety, driving supervision and the use of seat belts are essential.

 According to the Global Burden of Disease Study (GBD), cerebrovascular diseases are the second leading cause of death in the world. This is a cross-sectional study on deaths due to cerebrovascular diseases in southern Iran.

 In this cross-sectional study, data on all deaths caused by cerebrovascular diseases in the Fars province between 2004 and 2019 was extracted from the Electronic Death Registry System (EDRS). To eliminate or minimize the influence of age composition, standardized mortality rate was used based on the 2013 Segi standard populations of low- and middle-income countries. In order to measure the years of life lost (YLL) from cerebrovascular diseases, the standardized life table was considered. The Joinpoint Regression method was used to examine the trend of the crude and standardized mortality rate and the YLL rate.

 Over the study period, 24,051 deaths occurred due to cerebrovascular diseases in Fars with 12,586 cases in men (52.3%). The trend of standardized mortality rate in males and females was decreasing (P value=0.001 and<0.001 for males and females, respectively). All YLL due to premature mortality from cerebrovascular disease during the 16-year study period were 119,436 (3.8 per 1000 persons) in men, and 111,172 (3.6 per 1000 persons) in women. Based on the joinpoint regression, the 16-year trend of YLL rate due to premature death was decreasing: annual percent change (APC) was -1.6% (95% CI -3.4 to 0.3, P=0.098) for males, and -2.0% (95% CI -3.6 to -0.4, P=0.017) for females.

 The trend of mortality rate and YLL caused by cerebrovascular diseases has decreased in our study. Necessary measures, mainly primary and secondary prevention, should be taken to continue the diminishing trend of cerebrovascular diseases.

Background: 

Burns constitute one of the most important etiologies of infection and mortality worldwide, with the most significant number of cases in low- and middle-income countries. This is a cross-sectional study on deaths due to burns in southern Iran.

Methods: 

In this study, data on all deaths due to burns in southern Iran between 2004 and 2019 was extracted from the population-based Electronic Death Registry System (EDRS). The Joinpoint Regression method was used to examine the trend of crude mortality rate, standardized mortality rate, and years of life lost (YLL) rate. In order to measure YLL, the number of deaths and life expectancy for different age and gender groups were used, for which the standard life table was considered.

Results: 

During this study, 2175 deaths due to burns occurred, 50.6% (1106 cases) of which were in men and 38.7% (841 cases) were in the 15-29 age group. The crude and the standardized mortality rate had a decreasing trend during the study years. The total number of YLL was 25260 (0.8 per 1000) in men, 25,785 (0.8 per 1000) in women, and 51,045 (0.8 per 1000) in both genders during the 16 years of the study.

Conclusion: 

Considering the high mortality rate in the 15-29 age group, which consists of the active and productive labor force, necessary actions are needed in order to improve safety equipment and to make the workplace safe.

Liver diseases in children and adolescents are a significant and arising public health issue and should be surveyed from different dimensions (clinical and para-clinical, psychological, socio-economic) and in diverse populations. Shiraz Liver Transplant Center, Shiraz, Iran is the only center for pediatric liver transplantation and its pre-operative evaluations. This provides a unique and valuable situation for studying this vulnerable population. The Shiraz Pediatric Liver Cirrhosis Cohort Study (SPLCCS) was established to assess cirrhotic children, the course of their disease, and treatment over time. This cohort study aimed to prospectively evaluate the natural course and factors that contributed to complications and death of children with chronic liver disease in the region. SPLCCS was launched in September 2018 after obtaining ethical approval; until August 2022, 370 children with end-stage liver disease were enrolled and followed every six months. Here, the cohort’s features, the included population’s baseline characteristics, and primary outcomes are reported.

Knowledge and awareness of disease transmission modes and basic hygiene principles during a public health crisis are crucial for developing effective control measures. The researchers aimed to evaluate Iranians’ knowledge, attitude, and practice (KAP) throughout the coronavirus disease 2019 (COVID-19) pandemic to detect related sociodemographic variables. This cross-sectional, web-based survey was conducted from the 2nd - 8th March 2020 among the general population of Iran above 15 years of age. A 76-item self-designed questionnaire regarding KAP towards COVID-19 was used, and the participants’ demographic characteristics and sources of information were collected. The Snowball sampling method was applied for data collection, and responses were scored based on the Likert scale. Simple and multiple linear regression was performed using SPSS version 26. The statistical significance level was P<0.05. Among 8591 participants, the overall achieved knowledge, attitude, and practice score regarding COVID- 19 characteristics were 90%, 90%, and 89%. Also, an overall score of 85% was achieved regarding the knowledge of the transmission mode and high-risk groups for COVID-19. There was a significant association between female gender, higher age, and higher education with knowledge, attitude, and practice. Male gender, being single, and lower education levels were associated with lower scores in knowledge and practice (P<0.001) and poorer attitudes towards COVID-19 (P<0.001, 0.002, and <0.001, respectively). During its outbreak, the Iranian population demonstrated decent knowledge, appropriate practice, and a positive attitude towards COVID-19. Furthermore, health education programs, mainly targeting lower-knowledge individuals regarding COVID-19, are essential for encouraging a positive attitude and maintaining safe practices. Hopefully, by increasing knowledge via public health policymakers and the cooperation of the Iranian authorities and the general population, optimistic control and elimination of the disease can be anticipated.

HIV, Tuberculosis, and Malariaare neglected due to the high pressure imposed on healthcare systems by COVID-19; however, since these diseases afflict a large number of patients globally, their effect on COVID-19, as a world pandemic, should be assessed. We aimed to assess the relationship between the prevalence of these diseases and COVID-19 indices. In this ecological study, a data set was provided, which included the epidemiologic indices of COVID-19 for each country. The scatter plots of the social capital for the studied countries based on the epidemiologic indices of COVID-19 and HIV (human immunodeficiency virus), and Malaria were drawn. The prevalence of HIV, Tuberculosis, and Malaria were inversely correlated with the cumulative incidence rate of cases, the cumulative incidence rate of death, and COVID-19 tests performed per million, and was directly correlated with the recovery rate. No correlation was seen between case fatality rate and the prevalence of these infectious diseases. However, the results of this study were in favor of people afflicted with HIV, and Further studies should be conducted on the concurrence of infectious events and their adverse consequences with future analytical protocols.

It is estimated that in 2025, the cost of diabetes will account for 40% of total health spending. In Iran, 4.5 to 5 million people are afflicted with diabetes, and its prevalence has doubled during the past three decades. The aim of this study was to determine the function and preparedness of diabetes surveillance system in Iran. In this cross-sectional study, all managers, health policymakers and experts of diabetes(N:125) entered the study and completed a questionnaire on the existence and implementation of the surveillance system domains (from data collection to evaluation) and the relationship between domains of this system and their function. The descriptive statistical method, path analysis, was employed using Amos. A ccording t o m anager’s v iewpoint, t he r ange o f existence and implementation of all domains of surveillance system were 12% to 68.7% in average. They believed that 10-69% of domains of surveillance system were working properly. Most of respondents (59-87%) declared that investing in diabetes at different levels of prevention was less than expected. Satisfaction with both diabetes surveillance system function and diabetic patients was low and they don’t have a good and bright future for diabetes and its various aspects. By modeling analytical structural equations, some components of surveillance system were moderately worked together. we conclude that we must first formulate and prepare a standard surveillance system as well as train the relevant personnel and make clear changes in the existing care system. With the current surveillance system, we have a long way to go to prevent and control diabetes to an acceptable the average level of performance of the care system is lower than expected

Given that COVID-19 spreads worldwide, it has become a public health priority. This study aims to investigate the correlation between social capital and the epidemiological indicators of COVID-19. 

This survey is an ecological study, so all studied variables are aggregated. To collect the variables in the study, a data set was provided, which included the information of each country based on the cumulative deaths, case fatality rate, recovery rate, and the number of performed COVID-19 tests. We drew scatter plots of the social capital for the studied countries based on COVID-19 indices. 

In all the studied countries, the highest cumulative incidence rate of COVID-19 cases was in Montenegro (60310.56 per million), while the lowest cumulative incidence rate of cases was in Tanzania (8.42 per million). The highest and lowest cumulative incidence rate of death due to COVID-19 was in Belgium (1425.15 per million) and Burundi (0.08 per million), respectively. Also, social capital has a significant direct correlation with the cumulative incidence rate of cases (r=0.42, P<0.001), the cumulative incidence rate of death (r=0.31, P<0.001), and the number of performed COVID-19 diagnostic tests per million. Social capital was correlated with recovery and mortality rates (r= -0.21, P=0.007).

Considering that social capital has a statistically significant relationship with the indices of case fatality and recovery rates, it is possible to increase social capital with appropriate interventions by relevant individuals and organizations to improve the pandemic management in different countries.

 Of all teenage deaths caused by coronavirus disease 2019 (COVID-19), 47% occurred in children aged 0 - 9. Like many other infectious diseases, reducing mortality in children requires widespread vaccination. Despite the availability of the COVID-19 vaccine, a large percentage of children have not received the vaccine.

 This survey aimed to study parents’ reluctance to receive the COVID-19 vaccine for their children in Shiraz, Iran.

 An online questionnaire was sent to parents whose 5 to 11-year-old children had received no COVID-9 vaccine through the health educators of primary schools in Shiraz, Iran. The questionnaire contained demographic questions and 16 beliefs about COVID-19 vaccination that were answered as yes/no.

 We assessed 1093 respondents, including 49.5% (n = 542) male and 50.5% female students’ parents. The mean number of wrong beliefs was 7.21 ± 2.80 in parents who had boys and 7.78 ± 2.95 in girls’ parents. Also, 78.6% of participants had at least five wrong beliefs or excuses for not vaccinating their children. Notably, 82.8% of mothers and 84.3% of fathers were vaccinated with 2 - 3 doses against COVID-19. The most common wrong beliefs were probable vaccines’ side effects in the future, the undesirable effect of vaccination on children’s growth, and the awful effect of the vaccine on fertility, with a prevalence of 82.7%, 81.2%, and 76.7%, respectively.

 This study identified that most participants believed that COVID-19 vaccines have side effects for their children and unfavorable effects on children’s growth and infertility.

This study was conducted to determine the mortality rate and years of life lost (YLL) due to homicide in Fars province. Study Design: This was a cross-sectional study.

All data related to deaths due to homicide in Fars province were obtained from the Populationbased Electronic Death Registration System. Crude and age-standardized mortality rate, YLL, and YLL rate data were calculated and joinpoint regression was used to examine the trend.

During 2004-2019, 2148 deaths due to homicide occurred in Fars province, and (1782 cases (83.0%) were men. The crude mortality rate in men decreased by 44.0% from 2004 to 2019, but a stable trend was observed in women. The total YLL due to homicide during these 16 years was 43 230 (1.37 per 1000 people) in men and 8931 (0.29 per 1000 people) in women. According to the joinpoint regression analysis, the 16-year trend of the YLL rate due to premature mortality in men was decreasing, and the annual percent change (APC) was -4.00% (95% confidence interval [CI]: -6.60 to -1.20, P = 0.008). However, women demonstrated stable trends in this respect, and APC was -0.50% (95% CI: -3.10 to 2.20, P = 0.704).

The crude and standardized mortality rates and the number of YLL due to homicide in the study period had a significant decreasing trend in men but a stable trend in women. To control this issue, officials and policymakers should identify the areas of homicide and control its risk factors such as economic and social issues, drug addiction, and the state of violence.

According to the hypothesis, COVID-19 is less prevalent in regions with warm climates. Contradictory results have led us to investigate the correlation between temperature and the cumulative COVID-19 incidence rate.

We obtained COVID-19 data from CRONALAB, COVID-DASHBOARD, and MCMC databases of Fars Province, Iran, linked the data and finalized daily COVID-19 cases. The daily data on the temperature was gotten from meteorological stations’ reports from March 21, 2020, to March 21, 2021, for each county of Fars Province, Southern Iran. The daily weighted cumulative incidence rate of COVID-19 cases was calculated for all counties, separately. Initially, for uniform data visualization, the average air temperature data were transformed into ranked percentiles. Then, to visually assess the study hypothesis, the distribution of COVID-19 cumulative incidence was visualized on percentiles of temperature. Given the non-linear distribution of the data, we performed exploratory analyses using the generalized additive models and locally weighted (polynomial) regressions to choose the best response function. Then, the generalized linear models were used to parametrically build the model.

The generalized additive models showed a small decreasing, near horizontal, linear pattern for COVID-19 incidence rate as the function of temperature (pseudo R2: 0.001, deviance explained: 0.13%, coefficient: -0.02). The GLMs showed head-to-head results (deviance explained: 0.13%, coefficient: -0.02], supported by similar Akaike information criteria (AICs) (34945). However, according to the locally weighted regressions model’s curve, lower COVID-19 incidence rates were recorded on days when the temperatures ranged from 60 to 80 percentiles, equal to 20°C to 25°C in a cold climate and 25°C to 35°C in a warm climate. This is while the rates increased at lower and upper temperatures.

Daily COVID-19 incidence rate cannot be explained as a function of daily temperature in Southern parts of Iran. Higher rates of disease transmission out of the range of 20°C to 25°C for cold temperatures and 25°C to 35°C for warm climates might be linked to people’s indoor gatherings, coupled with insufficient ventilation.

The aim of this study was to examine the effect of a volunteer-led food safety training program based on social cognitive theory on behaviors and their determinants among community women. This is a single-blinded randomized controlled trial conducted in 8 urban health centers in Marvdasht city, southern Iran. 60 volunteers and 502 women who were selected through multi-stage cluster random sampling method participated in the study. A 4-session food safety training program was implemented for health volunteers in the experimental group (n=30). They then trained the women in the experimental group (n=260) in their local community for a month. Data were collected using validated questionnaires in the group of volunteers before and one week after the intervention and in the group of women before and one month after the intervention. Data were entered in SPSS software version 22 and analyzed using Chi-Square and comparisons between the two groups were conducted by ANCOVA. P<0.05 was considered as the significant level. The results of the study showed significant improvements in food safety-related behaviors and their determinants in the experimental groups, i.e., among both health volunteers and community women after the intervention. No significant changes in the study constructs (knowledge, self-efficacy, outcome expectations and behavior) were observed among women in the control group after the intervention. The findings of this study were in favor of the success of health volunteers in food safety training with the aim of improving food safety-related behaviors and their determinants (within the framework of cognitive theory) among community women.