nayyereh aminisani

Cognitive disorders affect the elderly’s personal and social life  by causing disturbances in their nervous system, and it is important to identify who is at the highest risk of these disorders; therefore, the present study aims to investigate demographic determinants of the cognitive status in the elderly visiting the Geriatric Cohort Center in Neyshabur.

This cross-sectional study was conducted on 3451 people aged 60 and above (52.5% women and 47.5% men) from 2015 to the end of 2017. The selection of statistical sample was done first by classification method, and then, by random method. Data collection was done using demographic questionnaires, and the questionnaires of Mini Mental State Examination (MMSE)and Montreal Cognitive Assessment (MOCA), and data were analyzed using independent t-test, ANOVA, and hierarchical multiple regression in software. were analyzed by SPSS16 software.

With MMSE, one fifth of the participants (20/3%) and with MOCA, almost half of the respondents (49/3%) did not have cognitive disorder. Cognitive disorder became more severe with aging. The severity of cognitive disorder was higher in women (P< 0/05)  those who were living alone(P <0/05), the women who only did housework(P < 0/05), and the cases who were illiterate (P< 0/05).

Screening of cognitive disorders in the elderly and early interventions including holding educational classes, especially for women with low literacy levels whose husbands have died, can prevent the progression of the disorder and improve their quality of life.

This study aimed to investigate the relationship between Vitamin D levels and Cardiovascular Diseases (CVDs) such as myocardial infarction (MI), stroke, and angina. Data for this cross-sectional study were collected as part of the Neyshabur Longitudinal Study on Ageing (NeLSA) between 2016 and 2018. The effect of Vitamin D on CVDs was analyzed in conjunction with socioeconomic and medical history variables. Statistical analysis was conducted using the Chi-square test and logistic regression in the R. Vitamin D levels were evaluated in 3414 participants (1527 men and 1889 women), with over two-thirds of participants showing insufficiency or deficiency of Vitamin D. Among them, 362 participants had self-reported diagnosed CADs. The study did not find a significant association between serum 25OH Vitamin D levels and the risk of CADs. Adjusted logistic regression revealed that male gender was a risk factor for MI (OR=4.7; 95% CI: 3.125-6), stroke (OR=1.75; 95% CI: 1.08-2.85), and angina (OR=1.6; 95% CI: 1.03-2.7). Additionally, having one or more medical conditions other than hypertension and diabetes was associated with angina (OR=7.14; 95% CI: 3.7-14.7), MI (OR=5; 95% CI: 2.97-8.3), and stroke (OR=2.7; 95% CI: 1.2-4.7). Participants aged over 70 years were more likely to experience angina (OR=2.43; 95% CI: 1.36-4.5) and stroke (OR=2.5; 95% CI: 1.35-4.5). The study revealed a high prevalence of Vitamin D deficiency and insufficiency. While the protective role of Vitamin D against CADs was not supported in this study, it does not discount the potential benefits of Vitamin D supplementation for overall health in older individuals.

Aging has caused physical and cognitive defects in older adults, requiring serious intervention to support them. This research was conducted with the aim of investigating relationship between social support and cognitive status among older adults of Neyshabur city.

This cross-sectional study was conducted based on the data of the first phase of registration of the longitudinal Neyshabur Geriatric Cohort on 3451 people of 60 years and above. Data collection was done using demographic questionnaires, MMSE, MOCA and Duke social support questionnaire. .data was analyzed using SPSS v.16 software.

With the MMSE, one fifth of the participants (20.3%) and with the MOCA, almost half of the respondents (49.3%) did not have cognitive disorder. 84% of the respondents were satisfied with the social support received most of the time, and they were satisfied, had the least cognitive impairment. Education level was the strongest factor in predicting cognitive disorder, and MOCA was more influenced by demographic variables than MMSE.

Due to the high prevalence of cognitive disorders among older adults, careful examination and screening of cognitive disorders can lead to early diagnosis and prevention of disorder progression. Also, considering the relationship between social support and cognitive status, increasing the use of mass media, online technologies, designing programs and group recreational and sports activities can be effective in improving the cognitive status in older adults.

 The quality of sleep has different physical and psychological consequences, and can affect students' academic achievement.

 This study aimed to explore factors associated with sleep quality in university students using panel regression.

 This study was conducted based on the data from a longitudinal study, namely the “Health and Lifestyle of University Students”. The Pittsburgh Sleep Quality Index (PSQI), a self-administered questionnaire containing general information about sleep quality, Beck Anxiety Inventory (BAI), a questionnaire consisting of information about anxiety, Healthy Lifestyle Scale for University Students (HLSUS), and a questionnaire including information about lifestyle were completed by students during the first eight weeks of their first semester. The Panel linear regression and frontier model were used to assess the association of sleep quality with sex, unit, residency, marital status, teeth brushing, drug use, alcoholic drinks, age, anxiety, and healthy lifestyle.

 A total of 706 individuals (46.8%) suffered from poor sleep quality. Between the two models of panel linear regression and frontier, the former (i.e., panel linear regression) was determined to be a more powerful model with the Akaike information criteria = 3790.68 and Bayesian information criteria = 3899.712, suggesting that the dormitory students with a high level of anxiety and low level of healthy lifestyle had significantly poor sleep quality.

 Residency, drug use, anxiety, and healthy lifestyle scale were found to be closely associated with sleep quality of university students by using panel linear regression model. Our finding may have been of valuable help to policymakers and planners in their effort to improve the sleep quality of university students.

Immunosuppressive agents used in the treatment of inflammatory bowel diseases (IBDs) could potentially increase the risk of coronavirus disease 2019 (COVID-19). We aimed to compare COVID-19 frequency in patients with IBD with their households and identify the related risk factors.

Firstly, a multi-centered, observational study on 2110 patients with IBD and 2110 age-matched household members was conducted to compare COVID-19 frequency. Secondly, the data of patients with IBD and COVID-19 who had called the COVID-19 hotline were added. Multivariable logistic regression was used to evaluate the effect of age, type and severity of IBD, the number of comorbidities, and medications on the frequency of COVID-19 among the patients with IBD.

The prevalence of COVID-19 in patients with IBD and household groups was similar (34 [1.61%] versus 35 [1.65%]; P = 0.995). The prevalence of COVID-19 increased from 2.1% to 7.1% in those with three or more comorbidities (P = 0.015) and it was significantly higher in those with severe IBD (P = 0.026). The multivariable analysis only showed a significant association with anti-TNF monotherapy (OR: 2.5, CI: 0.97-6.71, P = 0.05), and other medications were not associated with COVID-19.

The prevalence of COVID-19 in patients with IBD was similar to the household members. Only patients with IBD receiving anti-TNF monotherapy had a higher risk of COVID-19 susceptibility. This finding could be attributed to the higher exposure to the virus during administration in health care facilities.

Dementia is a growing public health problem worldwide, and its early detection can help to manage the disease more effectively. This study aimed to validate the Persian version of the Telephone Interview for Cognitive Status-modified (TICS-m) questionnaire in older adults in the northeast of Iran.

This cross-sectional study was accomplished as part of the Neyshabur Longitudinal Study on Ageing (NeLSA) from January to May 2019. The translated Persian version of TICS-m was tested for content and face validity. The construct validity of the questionnaire was also assessed using exploratory factor analysis (EFA) with the extraction method of principal component analysis (PCA) and Oblimin rotation.

A total of 210 community-dwelling adults (aged ≥ 50; mean age: 59.6 ± 6.8 years) were registered in the NeLSA. The content validity ratio (CVR) of all items in the TICS-m questionnaire was higher than 0.62. The content validity index (CVI) of the three items was less than 0.78; so, these items were revised and replaced with alternative words. The face validity of the questionnaire was also confirmed. According to the results of EFA, the six extracted factors accounted for 68.8% of the total variance.

Our results revealed that the construct validity of the Persian version of the TICS-m is satisfactory.

 Most data on the effect of inflammatory bowel disease (IBD) and its treatments on coronavirus disease 2019 (COVID-19) outcomes have not had non-IBD comparators. Hence, we aimed to describe COVID-19 outcomes in IBD compared to non-IBD patients.

 We conducted a prospective cohort study of registered IBD patients with confirmed COVID-19 from six provinces in Iran from February to April 2020. Proven COVID-19 patients were followed up at four weeks and the frequency of outcomes was assessed. Multivariable logistic regression was used to assess associations between demographics, clinical characteristics and COVID-19 outcomes.

 Overall, 2159 IBD patients and 4721 household members were enrolled, with 84 (3.9%) and 49 (1.1%) participants having confirmed COVID-19, respectively. Household spread of COVID-19 was not common in this cohort (1.2%). While hospitalization was significantly more frequent in IBD patients compared with non-IBD household members (27.1% vs. 6.0%, P=0.002), there was no significant difference in the frequency of severe cases. Age and presence of IBD were positively associated with hospitalization in IBD compared with non-IBD household members (OR: 1.06, 95% CI: 1.03-1.10; OR: 5.7, 95% CI: 2.02– 16.07, respectively). Age, presence of new gastrointestinal symptoms, and 5-aminosalicylic acid (5-ASA) use were associated with higher hospitalization rate in IBD patients (OR: 1.13, 95% CI: 1.05–1.23; OR: 6.49, 95% CI: 1.87–22.54; OR: 6.22, 95% CI: 1.90–20.36, respectively). Anti-tumor necrosis factor (TNF) was not associated with more severe outcomes.

 Age, presence of new gastrointestinal symptoms and use of 5-ASA were associated with increased hospitalization rate among IBD patients, while anti-TNF therapy had no statistical association.

The endometriosis prevalence in the general population is about 7%-10%. In 30% of women, endometriosis is one of the causes of primary and secondary infertility. There are various risk factors for this disease. The present study aimed to determine the reproductive and menstrual risk factors of endometriosis.

In this case-control study, 185 women of reproductive age with confirmed endometriosis were compared with 370 women of reproductive age who referred to the same center for other problems in terms of reproductive and menstruation risk factors for endometriosis. The two groups were matched for age. Data were collected using a researcher-made questionnaire based on previous studies. Finally, bivariate analysis was done by the chi-square test, and multivariate analysis was performed by the conditional logistic regression for controlling confounder variables.

Based on multivariate logistic regression, early menarche age (P=0.004), no history of pregnancy (P<0.001), no child (P=0.002), no lactation history (P<0.001), high age of the first lactation (P=0.029), short duration of breastfeeding (P=0.015), no regular menstruation (P<0.001), short intervals between menstrual bleedings (P=0.016), prolonged menstruation (P<0.001), dysmenorrhea (P<0.001), dyspareunia (P<0.001), and recurrent vaginitis (P<0.001) had a significant relationship with endometriosis.

In general, there was a relationship between some reproductive and menstrual characteristics and endometriosis. Therefore, it seems that these characteristics can predict the occurrence of endometriosis disease.

BACKGROUND The COVID-19 pandemic has affected the health care infrastructure dramatically, with abundant resources necessarily being redirected to COVID-19 patients and their care. Also, patients with chronic diseases like inflammatory bowel disease (IBD) may be affected in several ways during this pandemic. METHODS We used the Iranian registry of Crohn’s and colitis (IRCC) infrastructure. We called and sent messages to follow-up and support the care of all registered patients. Besides, we prepared and distributed educational materials for these patients and physicians to reduce the risk of COVID-19 infection. We risk-stratified them and prepared outpatient clinics and hospitalization guidance for IBD patients. RESULTS Of 13165 Iranian patients with IBD, 51 have been diagnosed as having COVID-19. IBD patients made 1920 hotline calls. Among the patients with suspicious presentations, 14 COVID-19 infections were diagnosed. Additionally, 1782 patients with IBD from five provinces actively phone-called among whom 28 definite cases were diagnosed. CONCLUSION IBD patients’ follow-up could help in diagnosing the affected IBD patients with COVID-19. Additionally, the performance of protective actions and preparing the patients and physicians for decisive proceedings are the principles of protection of IBD patients.

Sedentary lifestyle plays a key role in the emergence of many noncommunicable diseases. Given the importance of physical activity (PA) in population‑based studies, the present study was conducted to investigate the pattern of PA and its correlates in the pilot phase of Azar cohort study.

In the pilot phase of Azar cohort study, 1236 individuals aged 35–70 years in Khameneh, a city in East Azarbaijan, Iran, were invited to participate in thestudy. A total of 952 individuals completed the overall and the PA questionnaire, a response rate of 82%. The PA level was evaluated using the classifed PA questionnaire based on the equivalent metabolic activities. The general linear model was used to determine the factors affecting PA.

The overall mean score of PA was 36.54 (standard deviation = 5.3). In multivariate analysis, after adjustment for sociodemographic variables, total PA score was associated with gender (adjusted β = 0.014, confdence interval [CI] 95% = [0.01–0.82]), occupation (adjusted βs ranged over 0.015–0.059, (CI 95% = 0.01–0.079), level of education (adjusted βs ranged over 0.010–0.018,CI 95% = 0.001–0.026). In other word, sex (mean ranged over 35.49–36.81), educational level (mean ranged over 35.01–36.73) and occupation status (mean ranged over 34.62–39.62) were predictors of PA (all P < 0.05). This variable could also predict 20% of the variance of the PA.

The current study identifes that gender, occupation and level of education could be factors that influence on PA level in the study population.

The prevalence of endometriosis in the general population is estimated at 7-10%. Endometriosis is one of the causes of primary and secondary infertility in 30% of women. There are various risk factors for this disease. The present study aimed to determine the association between sexual activity during menstruation and endometriosis. This case-control study recruited 555 women visiting Alzahra Hospital in Tabriz, Northwest of Iran in 2017. The case group comprised 185 women of reproductive age with confirmed endometriosis. The control group comprised 370 women of reproductive age without endometriosis visiting the hospital for other problems. Data were collected using a researcher-made questionnaire based on previous studies. Univariate analysis was performed using the chi-squared test, and multivariate analysis was done using conditional logistic regression to control confounding variables. Based on multivariate logistic regression, the sexual activity of two groups during menstruation was significantly different. Having vaginal intercourse leading to orgasm during menstruation [OR (95% CI) = 5.23 (2.16 to 12.66)] and non-coital sexual activity leading to orgasm during menstruation [OR (95% CI) = 2.90 (1.28 to 6.55)] increase the risk of endometriosis approximately five and three times higher in those women who stated they had vaginal intercourse leading to orgasm during menstruation compared to those who stated they did not. Based on the results, vaginal intercourse or non-coital sexual activity leading to orgasm during menstruation increases the risk of endometriosis.

Although chronic bronchitis is markedly under-diagnosed in the general population, it has a significant impact on the health status and the well-being of patients as well as healthcare resource consumption. This study aimed to determine the prevalence of chronic bronchitis and its correlates in the northwest of Iran. In 2014, all residents aged 35 and over in Khameneh city, East Azerbaijan, were invited to participate in the pilot phase of the Azar cohort study. The respiratory symptoms questionnaires were filled out by two trained general practitioners. Participants with a cough and phlegm on most days during at least three successive months in the previous two years were classified as chronic bronchitis group. Chi-square test was used to compare the chronic bronchitis and smoking status between males and females. A total of 1036 participants were interviewed, 1006 of whom had completed a respiratory questionnaire, from them 544 (54.1%) were females, and 462 (45.9%) were males. The mean age was 52.5 ± 10.5 years. The prevalence of smoking was 16.2%. According to the chronic bronchitis definition, 24 (2.4%) subjects were classified with chronic bronchitis, and the prevalence was higher in the males (4.1%) than that in the females (0.9%). The prevalence was higher among the active smokers and ex-smokers compared to non- smokers (8.6% and 4.1% vs. 0.8%). The prevalence of cigarette smoking was 16.2% and it was higher in the males than that in the females (33.5% vs. 1.5%). the prevalence of chronic bronchitis in the population of the region under study was relatively low in comparison to the other parts of Iran and its prevalence was higher in the males than that in the females.

The present study aimed at assessing the validity of self-reported drug use in people aged 35 and older in a pilot phase of a population-based cohort study.
A total of 1038 adults over 35 years old in Khamene city in East Azerbaijan province were recruited for the pilot phase of Azar cohort; a province-level of a nationwide PERSIAN cohort study completing a questionnaire and providing biological samples from October to December 2014. Information about the history and duration of smoking tobacco, using drug and medication were obtained by the physician. The validity of the drug use was assessed through comparing the questionnaire response with three urine strip tests for the detection of morphine, amphetamine and methamphetamine among 259 randomly selected subjects.
The prevalence of drug use according to self-report was 2.6% (95% CI: 1.7%-3.8%).One-step drug test as the gold standard for the use of drug self-reported demonstrated a sensitivity(95% CI) and specificity 15% (10-22) and 99.7% (98.9%-99.9%) respectively. All participants with positive self-report were male; however, in the urine analysis drug test, it was positive for 7out of 68 randomly selected women.
The validity of self-reported drug use in this population was low; therefore, the self reported use of the drug should be used with caution in this population. It is recommended to use alternative techniques to improve the validity of data using the self-report procedure.

There is remarkable alteration in hypertension prevalence and awareness, and their correlates among various geographic locations and ethnic groups. The aim of this study was to report hypertension prevalence, awareness, and its correlates as well as hypertension treatment, and control among Azari people aged 35 years and older.

The pilot phase of the Azar Cohort Study; a state level of a nationwide PERSIAN cohort study was conducted in Khameneh city between October 2014 and January 2015. All people 35 years of age and above were invited to take part in this study. A comprehensive range of different biomarkers, lifestyle, socioeconomic factors, and health‑related factors was collected. Blood pressure was measured by a trained nurse/midwife. Descriptive statistical methods were used to present general characteristics of the study population as frequency tables. Separate multiple logistic regression models were built to assess the predictors of hypertension prevalence.

A total of 1038 people were included in this study. The overall prevalence of hypertension was 22.9%. Awareness of hypertension was 60.5% and in those with known hypertension, 84% were using the antihypertensive medications, of those 68.5% had controlled hypertension. After adjustment; age (odds ratios [OR] adj = 1.12 95% confidence interval [CI]: 1.09–1.15), gender (ORadj = 1.65 95% CI: 1.08–2.51), obesity ORadj = 2.51 (1.40–4.88), waist‑to‑hip ratio (WHR) (ORadj = 1.70 (1.05–2.75), and comorbidities (ORadj = 2.51 (1.72–3.66) were independent predictors of hypertension.

Age, sex, body mass index, WHR, and comorbidities were known as predictors of hypertension in this study, health promotion strategies including lifestyle modification to reduce overweight/obesity and secondary prevention programs for early detection of hypertension in high‑risk groups according to age, gender, and disease profile are recommended.

Variations in learning styles among students could explain many differences in students’ acquisition of knowledge. This study examined the association between learning styles and academic achievement among students at Tabriz University of Medical Sciences in the northwest of Iran. This research is part of a longitudinal study entitled, "Health and Lifestyle of University Students" among undergraduate, medical, dentistry, and pharmacy students at Tabriz University of Medical Sciences who entered the university in October 2014. A self-administered questionnaire that consisted of general information and Kolb’s learning style was completed by these students during the first eight weeks of their first semester. Academic achievement was assessed using grade point average (GPA) in the following semesters (1 and 2) of the academic year. A total of 452 students were included in this study with a mean age of 19.16 ±1.03. The most prevalent learning style was convergent and the second most common was accommodative.The average GPA of the students was 15.74 ± 1.57 out of a possible 20. The results of a multivariate regression showed that the effect of learning style on academic achievement, in the presence of other variables, was not statistically significant. Sex was able to predict academic progression (β = 0.188, P = 0.001). In addition, GPA was higher among dentistry students(β = 0.128, P = 0.012) and lower among nursing and medical students (β = =-0.211, P = 0.001;β = -0.127, P = 0.015 respectively). Although students’ academic achievement was correlated with their learning style, the popularity of convergent and accommodative styles should be considered in that acknowledging the prevailing learning styles of students could promote academic achievement.

Hypertension affects the quality of life of patients and their caregivers. The aim of this study was to assess the knowledge and self-care behaviors and health-related quality of life (HRQOL) among hypertensive people
All people aged 35 years and older with hypertension were invited to participate in this study. Information on self-care behavior for hypertension (H-scale), and health-related quality of life (WHOHRQOL-BRFF) were completed by trained interviewer. Data analysis was done using SPSS 16.
The median age of hypertensive patients was 62.5(25th to 75th percentile: 55 to 72 years), the correlation between quality of life and overall self-care scores was not significant (r = -0.048, P = 0.520). Physical activity was the only significant predictor for quality of life, showing that the quality of life of hypertensive people increased by 3.371 units per day of being physically active in the cohort study (β = 0.223, P No association was observed between self-care and HRQOL total score in hypertensive patients in the study. Among the self-care domains, only medication adherence and physical activity had significant association with social health. There was a reverse association between smoking and HRQOL.

Sleep deprivation and drowsiness are very common among university students. The aim of this study was to examine the sleep quality and academic achievement among university students across all medical disciplines in Northwest of Iran.
This study was based on data from a longitudinal study, the "Health and Lifestyle of University Students" (HeLiS). The Pittsburgh Sleep Quality Index (PSQI), a self-administered questionnaire consisting of general information about sleep quality, was completed by students during the first eight weeks of the first semester and academic achievement was assessed via Grade Point Average (GPA) in the two semesters following the administration of the PSQI.
The mean age of students was 19.16±1.04 and the majority were female (64%). The mean overall score on the PSQI was 6.87±2.25; the majority of students (70%) had a global PSQI score greater than 5, indicating they were poor sleepers. Only 28% reported getting over 7 hours of sleep. Female students had higher scores than male students in subjective sleep quality, which was statistically significant (2.15 vs. 1.95 respectively, P = 0.01); however, there was no difference between males and females on other component scores or on the global score. Results of a multiple regression model showed that PSQI score was a predictor of academic achievement (β=-.07, P=0.035), which implies that GPA will be lower among students whose quality of sleep is lower.
Based on our sleep quality should be considered and assessed, and sleep hygiene should be promoted among medical university students in order to improve academic achievement.

Unhealthy lifestyle behaviors during young adulthood can have negative impacts on health for the rest of a person’s life. University students are in a transition stage to adulthood and face considerable changes in their life during their time at university. Therefore, the evaluation of their lifestyle and its changes over time using a valid and reliable tool is very important. This study aimed at assessing reliability and validity of the Persian version of the Healthy Lifestyle Scale for University Students (HLSUS).
The HLSUS was developed by Wong et al., based on Pender’s Health Promotion Model, and was translated into Persian using forward/backward translation methods. Content validity of the scale was assessed by a panel of eleven experts. Moreover, Cronbach alpha coefficient was calculated to examine internal consistency. The construct validity was assessed via detecting the factor structure of measurements on a sample of 400 students from different faculties of Tabriz University of Medical Sciences. Scale-item correlations and known group analyses were used to evaluate. convergent and discriminant validity.
The HLSUS demonstrated good content validity (content validity index [CVI] values 0.80-1.00 and content validity ratio [CVR] values 0.71-1.00), internal consistency (α = 0.87) and test–retest reliability (intraclass correlation coefficient [ICC] = 0.89). Based on exploratory factor analysis, it was determined that the eight factor solution was optimal for distinguishing the underlying factors.
The Persian version of the HLSUS demonstrated initial reliability and validity.

The clinical diagnosis of chronic obstructive pulmonary disease (COPD) should be considered in any patient who has dyspnea, chronic cough or sputum production, and diagnosis should be confirmed by performing spirometry in presence of airflow limitation. The aim of this study was to assess the validity of a questionnaire used to detect COPD based on spirometry findings.
The validity of a questionnaire for COPD diagnosis was examined using spirometry based on both Global Initiative for Chronic Obstructive Lung Disease (GOLD) and American Thoracic Society/European Respiratory Society (ATS/ERS) criteria for patients 35 years old and older. In total, 350 questionnaires were completed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio and negative likelihood ratio were calculated to determine the accuracy of the questionnaire.
The sensitivity of the questionnaire in detection of airflow limitation was 8.3% and 6.7% by the GOLD and the ATS/ERS criteria, respectively; whereas, specificity was 96% by both criteria.
The high specificity of the questionnaire indicates that the questionnaire is more capable to identify people who do not have airflow limitation; whereas, the low sensitivity of the questionnaire could underestimate the actual prevalence of COPD in the general population.

Competency-based education has been recommended in training and education of public health to reduce the gap between traditional teaching and the competencies required in practice. Epidemiology as a fundamental of public health science has come to attention. The aim of this study was to introduce a complementary core competency program for Master of Science (MSc) in epidemiology students in Iran.
A workgroup in the department of statistics and epidemiology of Tabriz University of Medical Sciences including five epidemiologists and three biostatisticians prepared an outline of complementary core competencies for epidemiology MSc students. In the first step several discussion rounds were done to review the current curriculum, then the workgroup sought students’ opinions to find out about their needs. In addition, a review of the current literature around the topic was done. In the final step the program components were developed by the workgroup and initially implemented.
A complementary program consists of eight domains: general knowledge, problem finding, data analysis and interpretation, communications, management, consultation, leadership skills and professionalism. This program focused on basic competencies and those competencies outside the major field for a graduate of epidemiology to enhance their knowledge, attitude and skills. The program was scheduled to run in the third semester and approximate time for completion was three months.
The development and initial implementation of the complementary core competency program was successful and the authors will attempt to extend the program and evaluate the implementation phase.

Recently, a national breast cancer screening program has been introduced in Iran. The aim of this study was to examine the determinants of breast cancer screening uptake among Kurdish women, in order to identify those characteristics that may be potentially associated with the screening uptake
Through a cross sectional study, in 2014, a random sample of 561 women aged 40 years and older without the history of breast cancer and identified with Kurdish background in Baneh county, Iran, were recruited and interviewed by two trained interviewers. Data were collected using a valid and reliable researcher made questionnaire. Univariate and multivariate logistic regression models with self-reported screening history as the dependent variable were used to estimate the odds ratios (ORs) with 95% of CI.
The mean age of women was 43.64 (SD = 5.17). The participation rate in the mammography program was 16.8% (95% CI: 13.7-19.8%). The lowest level of participation was found among women aged 60 and older (OR = 0.30, 95% CI: 0.14-0.69), illiterate (OR = 0.63, 95% CI: 0.40-0.99) and post-menopausal (OR = 0.56, 95% CI: 0.35-0.91) women.
It was found that the level of breast screening uptake was low among Kurdish women compared to those reported in the previous studies. Designing participation enhancing interventions with a specific focus on older, illiterate and post-menopausal women are recommended.
Article

Colorectal cancer has a significant impact on physical، mental and social discomfort of patients. The aim of this study was to assess different aspects of health-related quality of life and its association with demographic characteristics and some clinical features in colorectal cancer survivors in the city of Babol. This cross-sectional study was conducted in 2013 among 120 colorectal cancer survivors identified in the cancer registry from 2007 to 2012. A questionnaire containing demographic data، disease characteristics and health-related quality of life (EORTC-QLQ-C30 standard questionnaire) was completed via face to face interview at patients’ homes. The mean total score of performance scale was significantly higher in men (69/24± 16/71) than in women (57/67 ± 17/87) (P=0. 001). Men obtained higher scores in all 5 performance scales which was statistically significant in the domains of physical، emotional and cognitive performance. Among the demographic variables، comorbidities، education and employment were identified as the independent predictors of quality of life. The patients had an average quality of life which was associated with employment، education and comorbidities. Therefore،، empowering the health staff، increasing the awareness of patients and their families as well as better management of comorbidities can help the patients to return to an active life.

There is little information on the detailed patterns of cervical screening uptake in older migrant women in Australia. This linkage study was performed to assess cervical screening participation in older migrants. We linked year 2000-2001 records for 14,228 Middle Eastern/Asian-born women 40-64 years of age, and an age and area matched random sample of 13,939 Australian-born women in the New South Wales (NSW) Admitted Patients Data Collection (APDC), which records country of birth, to screening register records. Screening behaviour after 1st July 2001 was assessed in women without a recorded prior cervical abnormality Compared to Australian-born women, women born in South Central Asia had a lower screening participation rate (odds ratio for being screened at least once within a 3 year period 0.78, 95% CI 0.70-0.88). However, participation appeared relatively higher (17%-25%) in women born in the Middle East or other parts of Asia. Screening increased with increasing socioeconomic status (SES) in Australian-born women, but this trend was not observed in the migrant women. When we broadly corrected for hysterectomy, the apparent excess of screening in women from the Middle East and other parts of Asia was substantially eliminated and in contrast, the apparent deficiency in screening in women from South Central Asia increased. Older women from the Middle East, and North East and South East Asian countries appeared to have similar overall screening participation to that of Australian-born women. Women from South Central Asia appeared less likely than Australian-born women to participate in cervical screening at the recommended interval.