فهرست مطالب fatemeh varse

Vaccination seems to be the most critical means of halting the COVID-19 pandemic. It is crucial to understand the factors that influence COVID-19 vaccine acceptance to avoid low vaccination rates. This study intended to monitor the COVID-19 vaccine acceptance and its association with socio-demographic factors and prior diagnosis of COVID-19 in Iranian adults during the COVID-19 pandemic.

The study utilized data from the COVID-19 Population Survey of Iran (COPSIR), a repeated national survey designed to monitor COVID-19-related behavioral insights. From April 2020 to November 2021, thirteen iterations of a series of cross-sectional studies involving computer-assisted telephone interviews were conducted.

The COVID-19 vaccine acceptance rate remained above 80% until the ninth wave in February 2021, when it dropped to 62.9%. However, throughout the next four surveys, it rose gradually from 72.0% to 85.7%. The multilevel regression model revealed that the COVID-19 vaccine acceptance was significantly and positively linked with age and education.

Despite the relatively high COVID-19 vaccine acceptance rate among Iranian adults, after the emergence of vaccines on the global market and controversies about their safety in Iran, the initially high vaccine acceptance rate dropped significantly, and then increased over time and returned to its peak level (85%). According to the Commodity Theory, this rise in vaccine acceptance can be attributed to the COVID-19 vaccine shortage in the country between January and July 2022. For Iranian adults to accept vaccines more readily, health promotion programs should target the youth and the less literate adults.

The worldwide emergence and rapid expansion of COVID-19 emphasizes the need to assess the knowledge gap and to predict the disease-related behaviors and reactions during this epidemic.

 Methods and design: 

COVID19 Population Survey of Iran (COPSIR) is a repeated cross sectional survey that will be conducted in 8 waves. In each wave, 515 Iranian adults aged 18 years or older will be randomly selected and interviewed by phone. The study waves will be performed at approximately weekly intervals. The survey tool is adapted from COSMO (COVID-19 Snapshot MOnitoring) study. This study will provide information on trends of knowledge, risk perception, preventive behaviors, psychological problems, essential needs, and public trust among Iranian adults during COVID-19 epidemic.

The key findings of each wave will be immediately reported to the National Headquarters for Coronavirus Control to set better policies for disease control and prevention. Moreover, if a message is extracted from the results of this study that needs to be communicated to the public, it will be done through the mass media.

Randomized clinical trials have been considered as the gold standard for evaluating the effectiveness and safety of medical interventions; however, there are major barriers to their design, conduct, analysis, and reporting. They are multidisciplinary and involve different steps and face a variety of challenges that may vary from one country to another. The aim of this study was to provide a comprehensive presentation of the challenges of clinical trial studies in different steps including design, conducting, analysis, and reporting.

In this study, all original articles conducted during 1991-2017 that reviewed the barriers to clinical trial studies at one of the steps of design, conducing, analysis, and reporting of the results in Medline (through PubMed), Embase, Web of Sciences, Scopus, and Google Scholar were considered. The searched keywords were as follow: challenges, barriers, and randomized clinical trial.

The following barriers in different steps of randomized clinical trials were identified: general barriers include insufficient knowledge and understanding of clinical research and research methodology, barriers to ethical and regulatory systems, and lack of funding. The investigator-initiated trials may face similar problems to those of sponsor-initiated trials, such as handling regulatory systems, administrative and financial issues, multiple languages, and different patient compensation approaches. The challenge related to design was poor planning. Other challenges were lack of manpower and financial resources, inappropriate statistical methods for analysis (analysis challenges), and challenges related to reporting which include selective reporting.

Based on the results of this systematic review, the most important challenges were barriers related to handling ethical and regulatory systems, patient recruitment, and lack of budget and skilled staff for conducting clinical trials. Training to improve the quality of randomized clinical trial studies in different steps and levels was the most important recommendation in these studies.

Cancer is the second leading cause of death worldwide and the third in Iran. Among cancers, cervical cancer is the third leading cause of death in women. Thus, recognizing the epidemiology and trends of cervical cancer can be effective for planning and policy-making. This study aims to investigate the incidence and trends of cervical cancer in Iran due to the few studies that have addressed this issue and the unclear trend for cervical cancer in Iran.
This study re-analyzed existing data from the cancer data recording system in Iran during years 2003 to 2009. We used available data from the National Cancer Registry and Center for Disease Control of the Ministry of Health, Treatment and Medical Education. Stata software (version 11) was used for data analysis and the significance of the incidence trend diagram was derived with WINPEPI software.
Assessment of the National Cancer Registry statistics from 2003 to 2009 showed an increased trend in cervical cancer from 2003 to 2008 and a decreased trend from 2008 to 2009. During this period, there were 4273 cases of cervical cancer registered. From these, 394 cases were registered in 2003 which peaked at 907 cases in 2009. The registered cancer cases had an approximately 3-fold increase during this period. Most provinces reported an increased trend of incidence in cervical cancer.
Based on the results of this study, the incidence of cervical cancer is increasing in Iran, especially in the central regions of the country. Therefore, considering the growing trend of cancer, we recommend early detection through screening programs, public awareness, and public training programs that particularly target high risk populations.