International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928A Systematic Review and Meta‑analysis on the Prevalence of HBsAg in Health Care Workers from Eastern Mediterranean and Middle Eastern Countries21152115ENSocial Determinants of Health Research Center, Saveh University of Medical Sciences, SavehDepartment of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, TehranBaqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran20190903<p><span><strong>Background: </strong><span>The present study aimed to determine the prevalence of HBsAg in Health Care <span>Workers (HCWs) in Eastern Mediterranean Region Office (EMRO) and Middle Eastern countries <span>from 2000 to 2016. </span></span></span></span></p><p><span><span><span><span><span><strong>Methods: </strong><span>In a meta‑analysis study, the databases of PubMed, ISI, Ovid, Scopus, <span>Google Scholar, and Persian databases were searched for relevant articles on the prevalence of <span>HBsAg in HCWs in EMRO and Middle Eastern countries. Homogeneity was assessed based on <span>Cochran’s Q‑test results. </span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>A total of 43 articles (110,179 people) were included. The pooled<br /><span>prevalence of HBsAg in HCWs of EMRO and Middle East countries was found 2.77% (95%CI: <span>2.64‑2.83). The specific prevalence of HBsAg was 2.84% (95% CI: 2.6‑3.11) in EMRO and <span>2.22% (95%CI: 2.13‑2.31) in Middle Eastern countries. The highest and lowest prevalence rates <span>of HBsAg among HCWs for countries with more than one study were 6.85% (95% CI: 5.74%–<span>8.16%) in Sudan and 1.00% (95% CI: 0.94%–1.07%) in Turkey, respectively. The trends of HBsAg <span>prevalence among HCWs decreased from 2000 to 2016. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>Based on the World Health <span>Organization classification of HBV prevalence, intermediate HBsAg prevalence rates were detected <span>in HCWs of EMRO and Middle East countries during 2000–2016.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Eastern Mediterranean, health care workers, hepatitis B, meta‑analysis, Middle East, </em><span><em>prevalence</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2115http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2115/717717979International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Identifying the Most Effective Hydatid Cyst Fluid Fraction for Anticancer Vaccination of 4T1 Breast Tumor‑Bearing Mice21162116ENDepartment of Parasitology and Mycology, Isfahan University of Medical Sciences, IsfahanClinical Research Development Center, Najafabad Branch, Islamic Azad University, NajafabadCancer Prevention Research Center, Isfahan University of Medical Sciences, IsfahanDepartment of Biochemistry, Bioinformatics Research Center, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, IsfahanCancer Prevention Research Center, Isfahan University of Medical Sciences, IsfahanDepartment of Parasitology and Mycology, Isfahan University of Medical Sciences, Isfahan20190903<p><span><strong>Background: </strong><span>The hydatid cyst fluid antigens have high homology with cancer cell antigens and also <span>exhibit considerable immunogenicity. Therefore, their utilization for cancer immunization can cause an <span>effective antitumor immune response. However, the main challenge is identifying the most effective<br /><span>antigens for this purpose. </span></span></span></span></span></p><p><span><span><span><span><span><span><strong>Methods: </strong><span>Hydatid cyst fluid fractions including the glycolipid fraction,<br /><span>glycoprotein fraction, 78 kDa fraction, and antigen B fraction were prepared. Then, the BALB/c <span>mice were immunized against different antigens and, subsequently, 4T1 cells were subcutaneously <span>implanted. The tumors’ growth, metastasis, and tumor‑bearing mice survival were assessed in different<br /><span>immunized groups. In addition, IL‑2, IL‑4, IFN‑<span>γ<span>, and TNF‑<span>α <span>serum levels were estimated to evaluate <span>the immune system response. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>BALB/c mice immunization against the complete hydatid cyst<br /><span>fluid antigens exhibited more significant inhibition of the tumors’ growth and metastasis and increase <span>of tumor‑bearing mice survival in comparison with its derived fractions. However, the 78 kDa fraction <span>exhibited the best results according to the same factors in comparison with all the prepared fractions.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>The 78 kDa fraction of the hydatid cyst fluid was the most effective fraction of hydatid <span>cyst fluid for immunization against 4T1 breast tumors.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Breast neoplasm, cyst fluid, immunization, immunotherapy, neoplasm metastasis</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2116http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2116/717717980International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Vinpocetine Improves Oxidative Stress and Pro‑Inflammatory Mediators in Acute Kidney Injury21172117ENDepartment of Pharmacology, Toxicology and Medicine, College of Medicine, Almustansiriya University, BaghdadDepartment of Pharmacology, Toxicology and Medicine, College of Medicine, Almustansiriya University, BaghdadDepartment of Pharmacology, Toxicology and Medicine, College of Medicine, Almustansiriya University, Baghdad20190903<p><span><strong>Background: </strong><span>Gentamicin‑induced‑acute kidney injury (AKI) is a multifaceted phenomenon which <span>previously linked to the oxidative stress only. Vinpocetine prevents reactive free radical generation <span>which contributed in reduction of damage. Therefore, objective of the present study was to <span>investigate the renoprotective effect of vinpocetine on gentamicin‑induced‑AKI in rats. </span></span></span></span></span></p><p><span><span><span><span><span><span><strong>Methods: </strong><span>Thirty Sprague Dawley Male rat were divided into three groups. Control group (<span><em>n </em><span>= 10): Rats <span>treated with distilled water + intra‑peritoneal injection of normal saline 2 ml/kg/day. Gentamicin <span>group (<span><em>n </em><span>= 10): Rats treated with distilled water + intra‑peritoneal injection of gentamicin 100 mg/<span>kg/day. Vinpocetine group (<span><em>n </em><span>= 10): Rats treated with vinpocetine + intra‑peritoneal injection of </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span> gentamicin 100 mg/kg/day. Blood urea and serum creatinine were estimated by auto‑analyzer. Serum malondialdehyde (MDA), superoxide dismutase (SOD), Neutrophil Gelatinase Associated Lipocalin (NGAL), kidney injury molecules (KIM‑1), and Cystatin‑c were measured by ELISA kit methods.</p><p><strong>Results: </strong>Vinpocetine led to significant renoprotective effect on gentamicin induced‑AKI through amelioration of blood urea and serum creatinine compared with gentamicin group <em>P </em>< 0.01. Vinpocetine improved oxidative stress through reduction of MDA serum level and elevation of SOD significantly compared with gentamicin group <em>P </em>= 0.001 and <em>P </em>= 0.03, respectively. Indeed, vinpocetine reduced glomerular and renal tubular injury via reduction of inflammatory biomarkers including KIM‑1, NGALand Cystatin‑c sera levels significantly <em>P </em>< 0.01 compared to gentamicin group.</p><p><strong>Conclusions: </strong>Vinpocetine leads to significant attenuation of gentamicin‑induced‑AKI through modulation of oxidative stress and pro‑inflammatory pathway.</p><p><strong>Keywords: </strong><em>AKI, gentamicins, oxidative stresses, pro‑inflammatory pathways, vinpocetines</em></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2117http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2117/717717981International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928TCS is to Blame: The Impact of Divorce on Physical and Mental Health21182118ENDepartment of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, SE-351 95, Växjö20190904<p><span><strong>Background: </strong><span>Divorce rate reaches up to 50–70%. Indisputably divorce recently became one of the <span>most epidemic factors negatively influencing humans’ health whereas its impact on the involved <span>couples and their children is serious and sometimes fatal. The article presents the results of a research <span>study to analyze the most critical grounds for divorce leading to negative health-related consequences.<br /></span></span></span></span></span></p><p><span><span><span><span><span><span><strong>Method: </strong><span>This research adopts a cross-sectional study design with a quantitative approach based on <span>the data from 195 surveyed respondents. A structured questionnaire covering multiple constructs was <span>used to collect and analyze the data. </span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>This study found that the most critical causes of the <span>marriage failure are the lack of trust, commitment and communication, sensuality and sexuality (TCS) <span>as they lead to declining of the marginal utility (DMU). These factors not only lead to divorce, but <span>also increase the probability of facing different diseases such as depression, aggression, increasing <span>levels of neuroendocrine, epinephrine and norepinephrine as well as conflict ACTH levels. The <span>regression model shows that communication (C) was the most significant outcome in relation to the<br /><span>MU = 0.45 and <span><em>P </em><span>< 0.0) followed by trust and commitment (TC) (β = 0.34 and <span><em>P </em><span>< 0.0) and then by <span>S (β = 0.23 and <span><em>P </em><span>< 0.0). </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>The marginal utility (MU) is directly and positively affected<br /><span>by TCS. The study suggests that lack of MU, lack of intimacy, sensual, and sexual components can <span>lead to frustration, annoyance, anxiety and relationship failure.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Divorce, epinephrine, infidelity, marital sex, neuroendocrine, sexuality</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2118http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2118/717717982International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Effects of food restriction and/or aerobic exercise on the GLUT4 in type 2 diabetic male rats21212121ENDepartment of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, IsfahanDepartment of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, IsfahanResearch Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, JahromDepartment of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, IsfahanFaculty of Physical Education and Sport Sciences, Alzahra University, Tehran20190904<p><span><strong>Background: </strong><span>The aim of present study was to compare the effects of negative energy balance <span>with food restriction and/or aerobic exercise on the glucose, insulin, and GLUT4 levels in diabetic <span>male rats. </span></span></span></span></p><p><span><span><span><span><span><strong>Methods: </strong><span>Fifty‑six 10‑week old male Wistar rats were randomly assigned to seven <span>groups: a non‑diabetic (ND) group and six diabetic groups. After an infusion of type 2 diabetes, <span>the diabetic groups were given labels as well, namely diabetic control (DC) group, exercise (Ex) <span>group, food restriction with standard diet (FRSD) group, food restriction with low‑carbohydrate <span>diet (FRLCD) group, food restriction with standard diet combination in exercise (FRSDE)<br /><span>group, and food restriction with low‑carbohydrate diet combination in exercise (FRLCDE) <span>group. Further, to induce caloric restriction (CR), food intake was reduced by 20% and given <span>to food restriction consists of both of (FRSD and FRLCD). Hundred percent food consumption <span>for the Ex group was fixed, but instead, 20% of their energy intake in exercise was calculated, <span>and time of daily exercise was determined. Finally, a combination of reduced food intake (10%)<br /><span>and exercise (10%) was applied in each group FRSDE and FRLCDE for 8 weeks. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>The <span>results showed that type 2 diabetes inductions had reduced glucose, insulin, and GLUT4 gene <span>expression compared to the ND group (<span><em>P </em><span>= 0.001). However, there were significant differences <span>in GLUT4 gene expression between groups after 8 weeks of intervention (<span><em>P </em><span>= 0.001). A post hoc <span>least significant difference test show that compared to DC group, GLUT4 gene expression level <span>of Ex, FRSDE, and FRLCDE groups was significantly increased 47% (<span><em>P </em><span>= 0.004), 60% (<span><em>P </em><span>= <span>0.001), and 65% (<span><em>P </em><span>= 0.001), respectively after 8 week of intervention, but it was not significant <span>or with any other diabetic groups (<span><em>P </em><span>> 0.05). Moreover, glucose levels were significantly higher <span>in the FRLCDE, FRLCD, FRSD, FRSDE, Ex groups compared with the DC group in the same<br /><span>period (<span><em>P </em><span>= 0.0.01). </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>It was concluded that FRSD and FRLCD combination in <span>regular exercise was elevated of GLUT4 gene expression in type 2 diabetes. These results may <span>help to develop new methods for the treatment of obesity and type 2 diabetes mellitus.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>GLUT4 gene expression, low-carbohydrate diet, standard diet, type 2 diabetes</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2121http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2121/717717983International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Cervical Cancer Screening in Low Resource Settings: Cytology versus HPV Triage for VIA Positive Women21222122ENDepartment of Preventive Oncology, Tata Memorial Hospital, Mumbai, MaharashtraDepartment of Preventive Oncology, Tata Memorial Hospital, Mumbai, MaharashtraDepartment of Preventive Oncology, Tata Memorial Hospital, Mumbai, Maharashtra20190904<p><span><strong>Background: </strong><span>The objective of the study is to comparatively evaluate performance of human <span>papillomavirus (HPV) hybrid capture 2 (HC2) and cytology as triage tests among visual inspection <span>after application of 3–5% acetic acid (VIA) screen positive women, thus aiming to reduce the referral<br /><span>burden. </span></span></span></span></span></p><p><span><span><span><span><span><span><strong>Methods: </strong><span>The community-based cross sectional cervical cancer screening with VIA was <span>conducted among women aged between 30 and 65, residing in selected low socio-economic areas <span>of Mumbai, India, during October 2010–March 2017. After obtaining informed consent, delivering <span>health education and collecting socio-demographic data, participants were offered VIA screening <span>by trained primary health workers. The VIA screen positive women underwent cytology, HPV HC2 <span>and diagnostic colposcopy at nodal hospital. Women with positive colposcopy underwent cervical <span>biopsies. </span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>231 VIA positive women underwent cytology and HPV HC2 test, followed by <span>colposcopy. Cervical biopsies were obtained in 83 cases. The sensitivity and specificity in detecting <span>≥ CIN 2 were 77.8 and 92.3 for HC2 and 66.7 and 98.2 for cytology. The false positivity and <span>negativity rates were 7.7 and 22.2 for HC2 and 1.8 and 33.3 for cytology. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>HPV HC2 <span>reduces referrals to larger extent and misses fewer cases compared to cytology, thus appearing a <span>better triage test among VIA positive women.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Cell biology, human papillomavirus DNA tests, mass screening, triage</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2122http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2122/717717984International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Interleukin – 17 and Interleukin‑10 as Inflammatory and Prevention Biomarkers in Periimplant Diseases21232123ENDepartment of Periodontics, School of Dentistry, Isfahan (Khorasgan) Branch, Isalmic Azad University, IsfahanGeneral Dentist, IsfahanGeneral Dentist, Isfahan20190904<p><span><strong>Background: </strong><span>Periimplant diseases are inflammatory diseases. Thus, the level of preinflammatory <span>cytokines which has important role in the inflammation processes can consider as biomchemical <span>markers for early diagnosis and prevention of periimplant diseases. The aim of this study was to <span>determine and compare the level of interleukin (IL)‑17 and IL‑10 in patients with periimplant mucositis <span>and periimplantitis. </span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><strong>Methods: </strong><span>This case‑‑control study was conducted on 51 patients with implants<br /><span>which were loaded at least 1 year previously, 17 patients with periimplant mucositis, 17 patients with <span>periimplantitis, and 17 individuals with healthy implants. After clinical examination, gingival crevicular <span>fluid sampling was carried out by paper point number 25 for 4 min and the mean value of IL‑17, IL‑10 <span>in samples was measured using enzyme linked immunosorbent assay (ELISA), least square differences <span>(LSD) reader in laboratory. The data was analyzed using statistical software SPSS 22. Quantitative <span>analysis was done using One‑way analysis of variance (ANOVA) test and LSD past test. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>The <span>results of analysis showed that there was a significant difference in the mean value of IL‑17 and IL‑10 <span>between the three study groups (<span><em>P </em><span>< 0.001). Individuals with healthy implants showed a significant <span>lower level of IL‑17 than patients with periimplantitis (<span><em>P </em><span>= 0.001) and for patients with periimplantitis,<br /><span>the level of IL‑17 was significantly lower than that of patients with periimplant mucositis (<span><em>P </em><span>< 0.001) <span>and IL‑10 level was significantly lower in mucositis than periimplantitis (<span><em>P </em><span>< 0.001). </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>The <span>level of IL‑17 and IL‑10 increased in patients with periimplant compared to individuals with healthy <span>periimplant tissues and the results showed that the highest concentrations of IL‑17 and IL‑10 were <span>observed in patients with periimplant mucositis and periimplantitis, respectively.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Interleukin‑10, interleukin‑17, mucositis, periimplantitis</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2123http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2123/717717985International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Factors Associated with the Completion of the Continuum of Care for Maternal, Newborn, and Child Health Services in Ethiopia. Multilevel Model Analysis21242124ENDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences International Campus (TUMS‑IC), Tehran, Iran & Department of Public Health, College of Medicine and Health Sciences, Ambo University, AmboDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, TehranDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran20190904<p><span><strong>Introduction: </strong><span>Assuring completion of a continuum of maternal health care is a key program strategy <span>to minimize morbidity and mortality of maternal and child. We aimed to examine completion of a <span>continuum of care and its associated factors. </span></span></span></span></p><p><span><span><span><span><span><strong>Methods</strong><span>: This cross‑sectional study was analyzed <span>from the 2016 Ethiopian Demographic and Health Survey data. Multilevel logistic regression <span>was used to assess the relationship between completion of a continuum of care and independent <span>variables, in which each individual woman (level‑1) nested within a community (level‑2). </span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>About 9.1% of Ethiopian women complete the continuum of care. Odds of completing continuum <span>of care was more likely among those women formally employed (odds ratio, OR = 2.14; 95% <span>confidence interval, CI: 1.37–3.35), from the female‑headed household (OR = 1.58; 95% CI: 1.08– <span>2.31), and gave birth at health facility (OR = 4.85; 95% CI: 1.75–13.37) than their counterpart.<br /><span>Maternal health services during antenatal care, such as blood pressure measured (OR = 4.31;95% <span>CI: 2.47–7.52), informed about pregnancy complication (OR = 1.57;95% CI 1.61–2.11), and <span>received tetanus injection (OR = 2.04; 95% CI: 1.42–2.92) were associated with completion of <span>continuum of care. Similarly, the perception of women that money is not a problem in accessing <span>healthcare (OR = 1.40; 95% CI: 1.03–1.90) was significantly associated with completion of a<br /><span>continuum of care. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>Most women failed to complete the continuum of care. Factors<br /><span>related to individual, community, access to health services, and services provided during antenatal <span>care were positively affect completion of the continuum of care. Therefore, effort should focus <span>on the integration of maternal health care services and targeting those factors facilitating the <span>completion of the continuum of care.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Continuity of patient care, maternal health, postnatal care, prenatal care</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2124http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2124/717717986International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Advanced Parental Age and Risk of Positive Autism Spectrum Disorders Screening21202120ENSocial Determinants of Health Research Center, Yasuj University of Medical Sciences, YasujStudent Research Committee, Yasuj University of Medical Sciences, YasujDepartment of Pediatrics, School of Medicine, Yasuj University of Medical Sciences, YasujDepartment of Psychiatry, School of Medicine, Yasuj University of Medical Sciences, Yasuj20190904<p><span><strong>Background: </strong><span>Autism Spectrum Disorder (ASD) is a life ‑long neurodevelopmental disorder and <span>significantly influences the quality of life in children. The screening of ASD in children aged <span>between 16‑30 months to early detection and early intervention for better prognosis. </span></span></span></span></p><p><span><span><span><span><span><strong>Methods: </strong><span>This <span>cross‑sectional study was conducted in the southwest of Iran (Yasuj) with dominant Lore ethnicity <span>in 2017. A total of 1504 mother‑ child pairs with children aged between 16‑30 months were selected <span>through simple random sampling from the integrated national health system as the framework. <span>ASD screening was implemented using the Modified checklist for autism in toddlers‑ revised, <span>with follow‑up interview (M‑CHAT‑R/F). Demographic data such as sex of children, and parental <span>age at their time of pregnancy were collected for all children. </span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>Risk of ASD was low, <span>moderate and high in 1447 (96.2%), 54 (3.6%) and 3 (0.2%) in screening, respectively. The <span>estimated rate of ASD prevalence was 80 per 10000 (12 out of 1504) or 1 in 125. Mother’s <span>age ≥35 (<span><em>P </em><span>value = 0.002, OR = 11.65, CI<span>95%<span>: 2.49‑54.35) and father’s age ≥40 (<span><em>P </em><span>value = 0.0001, <span>OR = 19.64, CI <span>95%<span>: 4.89‑78.82) were predicting factors of ASD in toddlers aged 16‑30 months.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>Given that, increasing the age of marriage in Iran and recent trend towards delayed <span>childbearing; children born to older parents are at a higher risk for having ASD. So, increasing the <span>public awareness is necessary.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Autism spectrum disorder, mass screening, parent</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2120http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2120/717717987International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Depression Literacy in Urban and Suburban Residents of Tehran, the Capital of Iran; Recognition, Help Seeking and Stigmatizing Attitude and the Predicting Factors21252125ENCommunity Based Participatory Research Center, Iranian Institute for Reduction of High‑Risk Behaviors, Tehran University of Medical Sciences, TehranCommunity Based Participatory Research Center, Iranian Institute for Reduction of High‑Risk Behaviors, Tehran University of Medical Sciences, Tehran20190904<p><span><strong>Background: </strong><span>Recognizing the mental health literacy condition among the people is an <span>important step towards promotion of mental health of a society. This study has been conducted <span>to evaluate the depression literacy among Tehran city and its suburban residents. </span></span></span></span></p><p><span><span><span><span><span><strong>Methods: </strong><span>This <span>is a cross‑sectional study of 18‑ to 68‑year‑old residents in Tehran city and suburb in 2017. <span>Sampling in Tehran city was conducted using Random Digit Dialing (RDD) and 1340 people <span>were recruited. In suburb Shamsabad and Salehabad from south of Tehran were considered as <span>clusters and data gathering conducted by face to face interview. Depression literacy was assessed <span>by a structured questionnaire. After introducing a vignette with a psychiatric disorder, participants <span>were questioned in the domains of recognition of the disorder, intention to seek help and attitudes <span>toward social stigma. </span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>Correct recognition was 52.2% and 30% and intention to seek<br /><span>help was 54% and 33.3% in Tehran city and suburb, respectively. Female gender (<span><em>P </em><span>< 0.001), <span>age increasing (<span><em>P </em><span>= 0.002) and higher education (<span><em>P </em><span>< 0.001) significantly scaled up the chance of <span>correct recognition of depression, when female gender (<span><em>P </em><span>= 0.001), increasing age (<span><em>P </em><span>< 0.001), <span>and being married (<span><em>P </em><span>= 0.01) could significantly improve the probability of seeking help. <span>Results also showed that being married (<span><em>P </em><span>= 0.005) and higher education (<span><em>P </em><span>< 0.001) predicted <span>lower stigma. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>Overall depression literacy in Tehran city and suburb was low, so<br /><span>intervention among target population in order to increase the depression literacy seems to be <span>necessary.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Depression, health literacy, help‑seeking, recognition, social stigma</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2125http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2125/717717988International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Employment Condition Modifies the Using Patterns of Screening Mammography in Workers Insured by the Mexican Government: A Case– Control Study21262126ENDepartment of Surgical Oncology, Hospital General Tacuba, ISSSTE & Department of Surgery, Faculty of Medicine, National Autonomous University of Mexico, Mexico CityDepartment of Gynecology and Obstetrics. Hospital General Tacuba, ISSSTE, Mexico City20190904<p><span><strong>Background: </strong><span>Our main aim was to investigate whether the employment condition modifies the use <span>patterns of the screening mammography in workers insured by the Mexican government (<span><em>Instituto </em><span><em>de Seguridad y Servicios Sociales de los Trabajadores del Estado</em><span>, ISSSTE; medical facilities of the <span>Mexican government). </span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><strong>Methods: </strong><span>A case–control study age‑matched was done in women insured<br /><span>by the Mexican government, aged 40–69 years, attending a general hospital (ISSSTE). All subjects <span>were submitted to an interview and anthropometric data registry. In the interview were obtained: <span>demographic data, of schooling, breast cancer family history, and reproductive history; besides, <span>mammography history during the past 2 years and place of performance (in or outside of the <span>ISSSTE). Finally, it was evaluated whether the mammography use in the ISSSTE was related to <span>their employment condition: Active workers (cases) vs. dependents or retired workers (controls).<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>The sample was of 252 women: 126 cases and 126 controls. Cases obtained less <span>mammograms in the ISSSTE (<span><em>P </em><span>= 0.03, odds ratio = 0.54, 95% confidence interval, CI 0.30–0.96), <span>than their dependents or the retired workers. Furthermore, cases with high education (university or <span>higher) also obtained fewer mammograms in the ISSSTE (<span><em>P </em><span>= 0.03, odds ratio = 0.26, 95% CI<br /><span>0.05–0.93). </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>Women active workers with higher education are obtaining less screening <span>mammograms in the ISSSTE than their dependents or the retired workers.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Breast neoplasms, epidemiology, mammography, México, neoplasms, radiology</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2126http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2126/717717989International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Effectiveness of Educational Physical Activity Intervention for Preventive of Musculoskeletal Disorders in Bus Drivers21272127ENDepartment of Environmental Manangment, Najafabad Branch, Islamic Azad University, NajafabadDepartment of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan20190904<p><span><strong>Background: </strong><span>Driving is a challenging job. Drivers always face the high risk of musculoskeletal <span>disorders (MSDs). Educational interventions could be effective in preventing and controlling these <span>disorders. The present study aims to assess the effectiveness of an educational physical activity <span>intervention in preventing MSDs among bus drivers in Isfahan, Iran.</span></span></span></span></span></p><p><span><span><span><span><span> <span><strong>Methods: </strong><span>This quasi‑experimental <span>study was conducted on 60 urban bus drivers, who were selected using multistage sampling. They <span>were evaluated at two time points, namely before and three months after the intervention. The<br /><span>intervention was conducted in three 90‑minute sessions. The HBM‑based educational content was <span>delivered through lectures, PowerPoint presentations, videos, practical demonstrations of corrective <span>exercises, and educational pamphlets. Data were analysed using the SPSS program, version 20, the<br /><span>paired <span><em>t</em><span>‑test, and the independent <span><em>t</em><span>‑test. </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>Before the intervention, there was no significant <span>difference between the two groups with respect to the mean scores of the HBM constructs. However, <span>later on, the mean scores of perceived susceptibility, perceived severity, perceived benefits, perceived <span>barriers, self‑efficacy, and behaviour increased significantly in the intervention group, compared with <span>those in the control group. (<span><em>P </em><span>< 0.001). </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>The results showed that the physical activity <span>as an HBM‑based educational intervention had a positive effect on the prevention of MSDs in urban <span>bus drivers.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Exercise, health education, musculoskeletal diseases</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2127http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2127/717717990International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Comparison of the Effect of 8‑Week Rebound Therapy‑Based Exercise Program and Weight‑Supported Exercises on the Range of Motion, Proprioception, and the Quality of Life in Patients with Parkinson’s Disease21282128ENDepartment of Sports Injury and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, IsfahaDepartment of Sports Injury and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, IsfahaDepartment of Sports Injury and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, IsfahaDepartment of Orthotics and Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz20190904<p><span><strong>Introduction: </strong><span>Parkinson’s disease (PD) is a chronic, progressive disorder that mainly affects <span>the central nervous system and, consequently, the patient’s functional status. This study aimed <span>to compare the effect of 8‑week rebound therapy‑based exercise program and weight‑supported <span>exercises on the range of motion, proprioception, and the quality of life in patients with PD.<br /></span></span></span></span></span></p><p><span><span><span><span><span><span><strong>Methods: </strong><span>Twenty patients were randomly divided into two equal groups of weight‑bearing <span>exercises and rebound exercise with no significant differences in age, weight, and height. <span>The variables of the range of motion, proprioception, and the quality of life were assessed in <span>pre‑ and posttest. Data were analyzed using repeated measure ANOVA and t‑test at a significant <span>level of <span><em>P </em><span>< 0.05. </span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Results: </strong><span>All of the variables in the two groups were significantly improved<br /><span>after 8 weeks of exercise, whereas the improvement rate in the rebound therapy group was more <span>than the weight‑bearing exercises group in range of motion (134.60 ± 13.22 vs. 118.38 ± 12.48), <span>proprioception (7.60 ± 3.22 vs. 10.38 ± 2.48), and the quality of life (147.60 ± 13.22 vs. <span>118.38 ± 12.48) of the patients (<span><em>P </em><span>< 0.001 for all variables). </span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Conclusions: </strong><span>Given that both <span>rebound and weight‑supported exercises are effective on improving the range of motion, <span>proprioception, and the quality of life of people with PD, it is recommended that the benefits <span>of these exercises to be used in physical rehabilitation programs. However, rebound therapy <span>exercises have had a greater effect on people with PD, and it seems better to use these exercises <span>more than others.<br /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><p><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><span><strong>Keywords: </strong><span><em>Parkinson’s disease, proprioception, quality of life, range of motion, rebound exercises, </em><span><em>weight‑supported exercises</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span><br /></span></span></span></span></span></span></span></span></span></span></span></span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2128http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2128/717717991International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Iranian Version of Barthel Index: Validity and Reliability in Outpatients’ Elderly21322132ENDepartment of Elderly Health Research, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, TehranDepartment of Elderly Health Research, Endocrinology and Metabolism Population Sciences Institute & Department of Gerontology and Geriatric, Medical School, Tehran University of Medical Sciences, TehranDepartment of Elderly Health Research, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, TehranDepartment of Elderly Health Research, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, TehranDepartment of Gerontology and Geriatric, Medical School, Tehran University of Medical Sciences, TehranDepartment of Elderly Health Research, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, TehranDepartment of Occupational Therapy, Shohada Hospital, Shahid Beheshti University of Medical Sciences, TehranDepartment of Elderly Health Research, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran20190928<p><strong>Background</strong>: Validation study of Barthel Index for elderly patients being attended in outpatient and rehabilitation clinics in Iran.</p><p><strong>Methods</strong>: Face‑to‑face interview with 395 out patients geriatric 60+ years was done in a cross‑sectional study. The internal consistency Barthel‑ADL was used to approve reliability. Criterion validity and factor analysis were used to verify validity.</p><p><strong>Results</strong>: Reliability the Iranian version BI was significant at 0.938. In criterion validity analysis, the high correlation tools included Functional Ambulation Category (FAC) and Foot and Ankle Ability Measure (FAAM‑subscales ADL) at 0.947 and –0.945, respectively. In factor analyses, two domains obtained, the variance of 10 items achieved 69.79%; also, the Item Total Correlation (ITC) of each item was measured.</p><p><strong>Conclusions</strong>: The Barthel Index shows a good validity and reliability, and recommended to use in the Iranian geriatric outpatients in evaluating physical ability.</p><p><strong>Keywords</strong>: Barthel-ADL, elderly, geriatric outpatients, Iran, validity</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2132http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2132/717717992International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Identification of R249 Mutation in P53 Gene in Tumoral Tissue of Tongue Cancer21332133ENDepartment of ENT, Isfahan University of Medical Sciences, IsfahanDepartment of ENT, Isfahan University of Medical Sciences, IsfahanDepartment of ENT, Isfahan University of Medical Sciences, IsfahanDepartment of ENT, Isfahan University of Medical Sciences, IsfahanDepartment of ENT, Isfahan University of Medical Sciences, Isfahan20190928<p><strong>Background</strong>: Tongue cancer is the most common malignancy of the mouth. In recent decades, reported tongue cancer incidence and mortality rates have increased all over the world while survival has not improved that sometimes is related to mutation, especially in gene P53 (such R249, R248 mutations). Hence, this study aimed to identification of R249 mutation in P53 gene of tumor tissue in tongue cancer.</p><p><strong>Methods</strong>: In a cross‑sectional study, 48 patients with squamous cell carcinoma (SCC) of tongue were selected, and mutation of R249 was investigated in sample of tumors. In addition, demographic data and medical history of patients were determined and registered in a collected data form. Finally added data were entered to computer and analyzed by SPSS software.</p><p><strong>Results</strong>: Polymerase‑chain reaction test done on tissue samples from cancer patients showed that in a studied sample of 48 patients, 4 of them (8.3%) had R249 mutation. After selecting the codon 249 as a hotspot in oral cancer, forward and reverse primers for amplification of exon 7 were obtained from the articles.</p><p><strong>Conclusions</strong>: Considering the findings of our study, R249 mutation in P53 gene in patients with SCC is relatively high. Age and alcohol consumption were factors affecting incidence of the mutation. It is necessary to take an early treatment with a single lesion of tongue to prevent severe disease and prevent disease in patient’s family with screening test and prevent cancer in future with gene therapy.</p><p><strong>Keywords</strong>: Gene P53, mutation and R249, tongue squamous cell carcinoma</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2133http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2133/717717993International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Middle‑aged Health Checks Program Outputs in Non‑communicable Diseases Screening in Iran21342134ENDepartment of Family and Community Medicine, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Family and Community Medicine, School of Medicine, Isfahan University of Medical Sciences, IsfahanDepartment of Family and Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan20190928<p><strong>Background</strong>: The aim of the present study is identifying the outputs of middle‑aged health checks program (MAHCP) in Isfahan province in central of Islamic Republic of Iran.</p><p><strong> Methods</strong>: This is a cross‑sectional study. During 30 months, from March 2014 to September 2016, 30–59 years old females and males were screened for abdominal obesity, overweight, obesity, physical inactivity, dyslipidemia, hypertension, diabetes, and also breast, skin, cervix, colorectal, and prostate cancers in all health houses, health posts, and health centers in the province. Based on the data bank of the family health office of the health center of Isfahan province, we estimated the outputs of MAHCP.</p><p><strong>Results</strong>: The utilization rate of MAHCP was 0.39–273.06 per 1000 middle‑aged population (MAP). The utilization rate in 2015 was higher for women (43.02–273.06 per 1000 MAP), particularly in rural areas (273.06 per 1000 MAP). The case detection rate of physical inactivity was 26.40– 498.6, abdominal obesity was 16.50–428.38, overweight was 38.73–365.59, obesity was 3.30– 261.99, and body mass index (BMI) ≥25 was 63.21–593.41 per 1000 MAP. Also dyslipidemia was 21.51–171.62, hypertension was12.33–53.88, and diabetes mellitus was 10.71 – 36.99 per 1000 MAP. Cancers detection rate in women included: breast cancers (99.52–330.32), skin (14.24– 245.52), cervix (11.94–87.43), and colorectal (0–47.4) per 100,000 MAP. Cancer detection rate in men included: skin (0–59.18), colorectal (0–80.06), and prostate (0–42.03) per 100,000 MAP.</p><p><strong>Conclusions</strong>: The MAHCP utilization rate in both the genders, particularly in men, was lower than it had been expected.</p><p><strong>Keywords</strong>: Cancer, diabetes mellitus, dyslipidemia, hypertension, screening</p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2134http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2134/717717994International Journal of Preventive Medicine (Int J Prev Med)2008-780210820190928Brain‑Derived Neurotrophic Factor: A Promising Biomarker for Predicting Prematurity‑Related Complications21192119ENNursing and Midwifery Care Research Center & Department of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, MashhadDepartment of Medical‑Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari20190904----http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2119http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2119/717717995