Unpublished Data Sources Research Articles

Genetic improvement of indigenous cattle breeds in Ethiopia: A systematic review of the Fogera cattle open nucleus breeding scheme

Fogera cattle are one of the valuable indigenous milk-type local breeds of Ethiopia, widely adapted to the area around Lake Tana in the Amhara region. The objective of this systematic review was to evaluate the performance of the Fogera cattle breed under an open nucleus breeding scheme. The review was done systematically by collecting published and unpublished data sources on the breed. The overall milk yield of the nucleus Fogera cattle herd was 2.26±0.794L/day. From the total herd, the top 10% and 25% of them produced daily milk yields of 3.31 and 2.87L, respectively, and some elite cows gave an average of 5.45±0.73L/day with a maximum yield of 8L/day. The predicted 305-day milk yield for the top 10% and 25% of the total herd was 883.64 and 772.83L, respectively. The average lactation milk yield and lactation length were reported to be 489±184L and 243±72.79 days, respectively. The respective heritability estimates for the aforementioned traits were 0.20±0.23 and 0.27±0.001. The birth and weaning weights (at 8 months of age) of village Fogera cattle born from community-based breeding programmes (CBBP) were 23.77±.21 and 85.89±1.07kg, respectively. The average weaning age for the CBBP herds was reduced to 8 months. The overall calf mortality in the nucleus herd was 3%. The CBBP demonstrated that it could act as a significant entry point for ensuring the conservation and restocking efforts of this breed as a country asset.

Implementation of the New Senior High School Standards-Based Curriculum in Ghana and Matters Arising: From 21st Century Skills to a Bipolar Global Problem?

Education is an essential vehicle that could be used to promote the development drive of developing countries including Ghana. This is because education imbibe in the citizens useful cultural traits including knowledge, values, attitudes and skills. A combination of internal and external factors however, combine to limit the levels of educational attainment for people in developing countries, but also act to alter the sociocultural standards of these countries. Using a combination of mixed methods and desktop review of published and unpublished data sources the author attempts a chronicle of Ghana's past curriculum designs and its local cultural impacts viz-a-viz its correlation with issues bothering the global community.

The Formal Seed System of Maize in Ethiopia: Implications for Reducing the Yield Gap

Smallholder farmers’ access to and use of quality seeds of improved varieties and hybrids is an integral component of sustainable maize production and the reduction of the yield gap in Ethiopia. Formal seed supply systems play a pivotal role in ensuring farmers’ access to good quality seed and increasing the productivity of maize. However, the contribution of the formal seed system to the increase in the average national maize yield in the country is not well documented. This paper specifically analyzes the formal seed supply systems and contributions of improved seed to maize productivity increase in Ethiopia. Secondary sources of information, including published and unpublished data, were used. Analysis of the seed value chain from research to commercial seed producers indicated that public and private maize hybrids dominate the formal seed system. Increased use of improved seed and associated management practices has contributed to the yield increase at the national level. For every 10,000 MT of additional maize-improved seed used by smallholder farmers, the national average maize yield increased by 400 kg per hectare (R sq. = 0.59). Hence, in addition to other yield-increasing technologies and extension support, ensuring the availability of improved seed to farmers can significantly contribute to reducing the maize yield gap between the national average yield and the average yield from on-farm demonstrations already attained by farmers in Ethiopia. Various policy interventions are suggested to improve the maize seed system performance and increase the supply of maize improved seeds.

Abstract 14: The impact of genetic background on cancer phenotypes of mouse models

Abstract The laboratory mouse is the premier animal model system for in vivo studies of the genetic and genomic basis of cancer in humans. Although thousands of mouse models have been generated, finding relevant data and knowledge about these models is complicated by a general lack of compliance in the published literature with nomenclature and annotation standards for genes, alleles, mouse strains, and cancer types. The Mouse Models of Human Cancer database (MMHCdb; tumor.informatics.jax.org) is an expertly curated knowledgebase of cancer phenotypes reported for diverse types of mouse models of human cancer such as inbred mouse strains, genetically engineered mouse models (GEMMs), Patient Derived Xenografts (PDXs), and mouse genetic diversity panels (e.g., the Collaborative Cross). MMHCdb includes data on more than 60,000 mouse models for over 1200 tumor classifications curated from more than 25,000 peer-reviewed publications. One of the primary goals of the MMHCdb is to highlight the impact of genetic background on the incidence and presentation of different tumor types in mice. The same allele on different backgrounds can result in very different cancer characteristics and, therefore, impact the appropriateness of a model for a specific research application. In MMHCdb, users can review the impact of genetic background on the frequency of spontaneous tumors for inbred mouse strains using an interactive table generated from different published and unpublished data sources. In addition, color-coded tabular summaries of individual papers are available that allow researchers to quickly assess how genetic background affects cancer phenotypes in the mouse models reported in a specific publication. We will highlight examples of how genetic background can profoundly change the types and frequencies of tumor types that can be expected in mouse models of human cancer. MMHCdb is supported by NCI R01 CA089713 Citation Format: Dale A. Begley, Debra M. Krupke, Steven B. Neuhauser, Emily L. Jocoy, John P. Sundberg, Carol J. Bult. The impact of genetic background on cancer phenotypes of mouse models [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 14.

Cost-effectiveness and cost-utility of traditional and telemedicine combined population-based age-related macular degeneration and diabetic retinopathy screening in rural and urban China

SummaryBackgroundTo assess the cost-effectiveness and cost-utility of a population-level traditional and telemedicine combined age-related macular degeneration (AMD) and diabetic retinopathy (DR) screening program in rural and urban China.MethodsDecision-analytic Markov models were conducted to evaluate the costs and benefits of traditional and telemedicine combined AMD and DR screening from a societal perspective. A cohort of all participants aged 50 years old and above was followed through a total of 30 1-year Markov cycles. Separate analyses were performed for rural and urban settings. Relevant parameters such as the prevalence of AMD and DR, transition probability, compliance with screening and treatment, screening sensitivity, specificity, utility, and mortality were collected from published studies specific to China, other Asian counties' studies, or unpublished data sources such as the National Committee for the Prevention of Blindness. Costs of screening, full examination, and treatment come from the real medical environments and unified pricing of Beijing Municipal Medical Insurance Bureau. Primary outcomes were incremental cost-utility ratios (ICURs) using quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) using years of blindness avoided. One-way deterministic and simulated probabilistic sensitivity analyses were conducted to reflect uncertainty.FindingsUnder the status quo, the total expected medical costs for a 50-year-old patient with AMD or DR were $869·59 and $1,514·18 in rural and urban settings, respectively. Both traditional and telemedicine screening were highly cost-effective. In rural settings, ICURs were $191 (95% confidence interval [CI]: $66 to $239) and $199 (95% CI: $-12 to $217), and ICERs were $2,436 (95% CI: $1,089 to $3,254) and $2,441 (95% CI: $1,452 to $3,900) for traditional and telemedicine screening separately. Even more surprising, both screening strategies dominated no screening in urban settings. Our results were insensitive and robust to extensive sensitivity analyses. Among all acceptable screening intervals (from 1 to 5 years), annual screening could not only produce biggest benefits but also keep ICERs less than three times and one time the per capita gross domestic product (GDP) in rural and urban settings separately. When compared with traditional screening, ICERs of telescreening were less than three times the per capita GDP in rural settings ($2,559 to $8,809) and less than one time the per capita GDP in urban settings (less than $5,564), annual telescreening produced the biggest benefits, it could avert 119 and 270 years of blindness in rural and urban areas separately when 100,000 people were screened.InterpretationWe performed decision-analytic Markov models for combined AMD and DR screening in rural and urban China, and the results showed that population-level combined screening for AMD and DR is likely to be highly cost-effective in both rural and urban China for people over 50 years old. Optimal screening may have an interval of every year based on teleophthalmology platforms. In the future, China should pay more attention to chronic eye diseases and the government should establish a sound chronic disease management system and make every patient enjoy equal medical services.FundingNational Natural Science Foundation of China, NSFC (82171051); the Major Innovation Platform of Public Health & Disease Control and Prevention, Renmin University of China and Beijing Nova program (Z191100001119072).

Inequalities in the uptake of, adherence to and effectiveness of behavioural weight management interventions: systematic review protocol

IntroductionIt has been suggested that interventions focusing on individual behaviour change, such as behavioural weight management interventions, may exacerbate health inequalities. These intervention-generated inequalities may occur at different stages, including...

Foundation of Addis Ababa and the Emergence of Safars

The main purpose of this study was to reveal the impact of the eviction of the Oromo from their hereditary land of Finfinne and their possession by Menilek in the late 19th century. The study deals with the history of the transformation of Finfinne to Addis Ababa and the eviction of the Oromo from the area which followed by the emergence of different Safars. In this study, the socio-economic and political conditions of Finfinne Oromo and the surrounding are explored. After the eviction of the Oromo from Finfinne area, the settlement of different ethnic groups in the areas was also discussed. In this study the researcher attempted to employ both primary and secondary sources. The secondary data sources were collected through a brief review of related literatures by assessing published materials. The primary and unpublished data sources were collected through oral interview based on focused group and questionnaire. All these data were carefully analyzed and critically interpreted qualitatively according to the standardized rules and disciplines of social sciences. Even though some earlier attempts have been made by scholars to write the history of Finfinne, most of the areas have received only very minimal attention. Therefore, this article is an attempt to fill the gap that has been created so far by other scholars and something to contribute to the history of the foundation of Safars in Addis Ababa. The study, hence, tried to highlight the history of the foundation of different Safars until the dawn fall of the imperial regime. Certainly this study is far from being exhaustive. However, the researcher hopes it can at least serve as an introduction to give clue to the study of Finfinne history and the eviction of Oromo from the area which later on its name was changed by the imperial rule unjustifiably to Addis Ababa “New Flower”.

Long-term dataset on aquatic responses to concurrent climate change and recovery from acidification

Concurrent regional and global environmental changes are affecting freshwater ecosystems. Decadal-scale data on lake ecosystems that can describe processes affected by these changes are important as multiple stressors often interact to alter the trajectory of key ecological phenomena in complex ways. Due to the practical challenges associated with long-term data collections, the majority of existing long-term data sets focus on only a small number of lakes or few response variables. Here we present physical, chemical, and biological data from 28 lakes in the Adirondack Mountains of northern New York State. These data span the period from 1994–2012 and harmonize multiple open and as-yet unpublished data sources. The dataset creation is reproducible and transparent; R code and all original files used to create the dataset are provided in an appendix. This dataset will be useful for examining ecological change in lakes undergoing multiple stressors.

A review of transition experiences in perinatally and behaviourally acquired HIV-1 infection; same, same but different?

Introduction: Despite sharing common psychosocial and developmental experiences, adolescents living with perinatally and behaviourally acquired HIV-1 infection are different in terms of timing of HIV infection and developmental stage at infection. Therefore, it is of interest to identify similarities and differences between these two groups of adolescents living with HIV in their experiences, facilitators and barriers during the transition process.Methods: A detailed literature search of peer-reviewed published papers was conducted on PubMed to identify relevant original research or viewpoints published up to September 2016. Conference abstracts and other unpublished data sources were not included.Results: Existing published literature, mainly using qualitative methods, explores the transition from paediatric to adult healthcare provision, as experienced by these two groups of young people. Reports highlight the variation and similarities in their experiences and challenges of transition. Findings from the USA and Europe predominate, while experience from Africa and Asia is lacking, despite the importance of these regions in the global epidemic.Conclusions: Published transition data remain limited, and there are few studies focusing on behaviourally infected adolescents and key population groups (e.g. adolescents who use drugs, lesbian/gay/transgender individuals). Robust definitions of the transition process and standardized outcome measures are required to facilitate cross-study and geographic comparisons.

Low Bycatch Rates Add Up to Big Numbers for a Genus of Small Fishes

Nonselective fishing gears extract a great many small marine species, with limited documentation or assessment of their impacts. Among those species, seahorses (genus Hippocampus) are unusual because this genus has been the focus of scientific surveys and international trade regulation. Our review of published and unpublished data sources analyzed data on seahorse bycatch for five gear‐type categories and 22 countries. The median catch per unit effort of seahorse bycatch across all five gear types was 0.96 seahorses per vessel−1 day−1. Nonetheless, fleet sizes were so large that annual catches were estimated at approximately 37 million seahorses across our sampled countries. Fisher interviews suggested that seahorse catches were declining (although information on changes in effort over time were not available). Furthermore, international export data did not capture the magnitude of seahorses in bycatch. Our work emphasizes the importance of evaluating bycatch, even for taxa where reported daily catch rates are low.

Value and usability of unpublished data sources for systematic reviews and network meta-analyses

Peer-reviewed publications and conference proceedings are the mainstay of data sources for systematic reviews and network meta-analyses (NMA), but access to informative unpublished data is now becoming commonplace. To explore...

Health in times of uncertainty in the eastern Mediterranean region, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

BackgroundThe eastern Mediterranean region is comprised of 22 countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, the United Arab Emirates, and Yemen. Since our Global Burden of Disease Study 2010 (GBD 2010), the region has faced unrest as a result of revolutions, wars, and the so-called Arab uprisings. The objective of this study was to present the burden of diseases, injuries, and risk factors in the eastern Mediterranean region as of 2013.MethodsGBD 2013 includes an annual assessment covering 188 countries from 1990 to 2013. The study covers 306 diseases and injuries, 1233 sequelae, and 79 risk factors. Our GBD 2013 analyses included the addition of new data through updated systematic reviews and through the contribution of unpublished data sources from collaborators, an updated version of modelling software, and several improvements in our methods. In this systematic analysis, we use data from GBD 2013 to analyse the burden of disease and injuries in the eastern Mediterranean region specifically.FindingsThe leading cause of death in the region in 2013 was ischaemic heart disease (90·3 deaths per 100 000 people), which increased by 17·2% since 1990. However, diarrhoeal diseases were the leading cause of death in Somalia (186·7 deaths per 100 000 people) in 2013, which decreased by 26·9% since 1990. The leading cause of disability-adjusted life-years (DALYs) was ischaemic heart disease for males and lower respiratory infection for females. High blood pressure was the leading risk factor for DALYs in 2013, with an increase of 83·3% since 1990. Risk factors for DALYs varied by country. In low-income countries, childhood wasting was the leading cause of DALYs in Afghanistan, Somalia, and Yemen, whereas unsafe sex was the leading cause in Djibouti. Non-communicable risk factors were the leading cause of DALYs in high-income and middle-income countries in the region. DALY risk factors varied by age, with child and maternal malnutrition affecting the younger age groups (aged 28 days to 4 years), whereas high bodyweight and systolic blood pressure affected older people (aged 60–80 years). The proportion of DALYs attributed to high body-mass index increased from 3·7% to 7·5% between 1990 and 2013. Burden of mental health problems and drug use increased. Most increases in DALYs, especially from non-communicable diseases, were due to population growth. The crises in Egypt, Yemen, Libya, and Syria have resulted in a reduction in life expectancy; life expectancy in Syria would have been 5 years higher than that recorded for females and 6 years higher for males had the crisis not occurred.InterpretationOur study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth, will have a major impact on the region's health and resources. The region has historically seen improvements in life expectancy and other health indicators, even under stress. However, the current situation will cause deteriorating health conditions for many countries and for many years and will have an impact on the region and the rest of the world. Based on our findings, we call for increased investment in health in the region in addition to reducing the conflicts.FundingBill & Melinda Gates Foundation.

Epidemiology and Reporting Characteristics of Systematic Reviews of Biomedical Research: A Cross-Sectional Study.

BackgroundSystematic reviews (SRs) can help decision makers interpret the deluge of published biomedical literature. However, a SR may be of limited use if the methods used to conduct the SR are flawed, and reporting of the SR is incomplete. To our knowledge, since 2004 there has been no cross-sectional study of the prevalence, focus, and completeness of reporting of SRs across different specialties. Therefore, the aim of our study was to investigate the epidemiological and reporting characteristics of a more recent cross-section of SRs.Methods and FindingsWe searched MEDLINE to identify potentially eligible SRs indexed during the month of February 2014. Citations were screened using prespecified eligibility criteria. Epidemiological and reporting characteristics of a random sample of 300 SRs were extracted by one reviewer, with a 10% sample extracted in duplicate. We compared characteristics of Cochrane versus non-Cochrane reviews, and the 2014 sample of SRs versus a 2004 sample of SRs. We identified 682 SRs, suggesting that more than 8,000 SRs are being indexed in MEDLINE annually, corresponding to a 3-fold increase over the last decade. The majority of SRs addressed a therapeutic question and were conducted by authors based in China, the UK, or the US; they included a median of 15 studies involving 2,072 participants. Meta-analysis was performed in 63% of SRs, mostly using standard pairwise methods. Study risk of bias/quality assessment was performed in 70% of SRs but was rarely incorporated into the analysis (16%). Few SRs (7%) searched sources of unpublished data, and the risk of publication bias was considered in less than half of SRs. Reporting quality was highly variable; at least a third of SRs did not report use of a SR protocol, eligibility criteria relating to publication status, years of coverage of the search, a full Boolean search logic for at least one database, methods for data extraction, methods for study risk of bias assessment, a primary outcome, an abstract conclusion that incorporated study limitations, or the funding source of the SR. Cochrane SRs, which accounted for 15% of the sample, had more complete reporting than all other types of SRs. Reporting has generally improved since 2004, but remains suboptimal for many characteristics.ConclusionsAn increasing number of SRs are being published, and many are poorly conducted and reported. Strategies are needed to help reduce this avoidable waste in research.

Public Service Delivery System and E-Governance Projects in India: An Overview

Public services are considered to be an important notion of governance system. Governance can be used in several contexts such as corporate governance, international governance, national governance and local governance. Providing effective public services with minimum cost in all of these levels is always a dilemma in the part of government. E-governance is one of resolving innovative project of the government to strengthen public service delivery system. This paper will examine the e-governance initiatives in India, its role in efficient public service delivery. The paper will also evaluate its scope, performance, challenge and prospects. The study is based on secondary data sources. The data have been collected from various published and unpublished data sources like publications of government of India, annual reports of Electronics and Information of various years; various study reports, websites of Department of Electronics and Information Technology, Government of India etc. The paper concluded that the e-governance project reached every citizen at the grass root level and provided them with information, access to different government services there by ensuring inclusive growth so that the gains from increased national income are shared by all sections society.

Women at War

Back to table of contents Previous article Next article Book ReviewsFull AccessWomen at WarLaura Curtis, C.N.S.Laura CurtisSearch for more papers by this author, C.N.S.Published Online:1 Feb 2016https://doi.org/10.1176/appi.ps.670205AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail edited by Elspeth Cameron Ritchie and Anne L. Naclerio; New York, Oxford University Press, 2015, 392 pagesWomen at War does not do for military women what Grossman’s On Killing (1) does for military men, but it’s a good start. The book’s editors, affiliated with the Uniformed Services University of Health Sciences, gathered a gifted group of practitioners, researchers, and military-experienced women to contribute chapters, using previously published and unpublished data sources. The resulting book is a comprehensive compilation of the psychiatric and physical and general medical needs of military women preparing for, deployed in, and returning from combat zones since 2001. The authors also identify gaps in knowledge and indicate areas in need of exploration, documentation, and dissemination in order to further the health of women as more direct combat roles open to them.The book is written in the context of the relatively recent announcement that combat roles are opening to women for the first time in the history of the U.S. military. The paradox of military women having been officially excluded from combat roles is that the intention was to protect women from the dangers of direct warfare. Because women were not recognized as experiencing combat, fewer people recognized the need to study and plan for their psychological and general medical needs in combat (as has been done for men), thus placing women experiencing combat at increased risk of negative impact from direct warfare. The editors therefore sought not only to establish a resource for the physical, medical, and psychological care of military women preparing for, currently serving in, and returning from combat zones but also to support the erosion of a paradox interfering with provision of state-of-the-art preparation and care for these women.Each chapter was written by experts from diverse backgrounds commenting from different perspectives. Pragmatic clinical pearls are interspersed in the chapters for use by medical, psychiatric, psychological, social worker, nursing, and occupational therapy providers working in health care settings ranging from private civilian to government-run and combat environments. Future research implications are described throughout the book, making it relevant for military science and clinical health care researchers. For the reader who has an interest, Women at War is an excellent read from cover to cover.This is the clinical value of the book: with only approximately 300,000 female combat veterans deployed since September 11, 2001, it is rare but significant to treat one, unless you work in a location with a high-density cohort such as near a military installation or in a Veteran’s Health Administration facility. Therefore, this book is a great addition to a resource library for providers who are looking for a general resource to understand the issues of treating women with military experience since 2001 and their families.Ms. Curtis is with the Worcester Recovery Center, Worcester, Massachusetts. She is a combat veteran of Operation Iraqi Freedom and served in the U.S. Army Nurse Corps.The reviewer reports no financial relationships with commercial interests.Reference1 Grossman D: On Killing: The Psychological Cost of Learning to Kill in War and Society. Boston, Little, Brown, 1995Google Scholar FiguresReferencesCited byDetailsCited byNone Volume 67Issue 2 February 01, 2016Pages e2-e2 Metrics PDF download History Published online 1 February 2016 Published in print 1 February 2016

Protected areas, tourism and community livelihoods linkages: a comprehensive analysis approach

This study explores the linkages among protected areas, tourism and community livelihoods in a rural setting. The Chobe National Park and Chobe Enclave Community Trust, Botswana, provide the context for this study. Data were collected through a community asset mapping exercise, semi-structured interviews, and published and unpublished data sources. Data were analyzed and interpreted using the community capital framework (CCF) that provided a comprehensive approach. The study identified that protected areas, tourism and community livelihoods linkages have many inter-dependent community capitals relationships. The enhancement of community capitals was facilitated by a shift from government-controlled to multi-level governance arrangements that recognize community wildlife-based tourism potential co-exist with protected areas, have influence on community livelihoods and nurture positive linkages. Results also indicate that linkages are dependent on community capitals transformation or lack thereof; the linkages have an influential effect on the whole ecosystem on which protected areas, tourism and community livelihoods operate. The study provides a new methodological approach in understanding the changing relationships among tourism, conservation and community development by expanding community capitals framework. This study's findings also inform planners, managers, and policy makers to critically evaluate the processes of change and devise interventions accordingly.

Burden of Hemoglobinopathies (Thalassemia, Sickle Cell Disorders and G6PD Deficiency) in Iran, 1990-2010: findings from the Global Burden of Disease Study 2010.

Hemoglobinopathies are known as the most common genetic disorders in Iran. The paper aims to provide global estimates of deaths and disability adjusted life years (DALYs) due to hemoglobinopathies in Iran by sex and age during 1990 to 2010 and describe the challenges due to limitations of the Global Burden of Disease Study 2010 (GBD 2010). GBD 2010 estimates of the numbers of deaths and years of life lost (YLLs) due to premature mortality were calculated using the Cause of Death Ensemble model (CODEm). Years of life lost due to disability (YLDs) were computed by multiplication of prevalence, the disability weight for occurrence of sequelae, and the duration of symptoms. Prevalence was estimated through a systematic search of published and available unpublished data sources, with a Bayesian meta-regression model developed for GBD 2010. Disability weights were produced using collected data from population-based surveys. Uncertainty from all inputs was incorporated into the computations of DALYs using simulation methods. We aim to prepare and criticize the results of GBD 2010 and provide some recommendations for reaching better conclusions about the burden of hemoglobinopathies in Iran. Between 1990 and 2010, the overall deaths attributed to hemoglobinopathies decreased from 0.51% to 0.36% of total deaths, with the corresponding burden declining from 1% to 0.82% of total DALYs. There was a reduction in deaths and DALYs rates for all ages and the rates attributed to all ages followed the same pattern in Iranian men and women. The highest DALYs for hemoglobinopathies, thalassemia, sickle cell disorder, and glucose-6-phosphate dehydrogenase deficiency (G6PD-D) were found in those aged less than 5 years. The collective burden of all of these hemoglobin disorder was lower in 2010 than in 1990. Although the screening programs in Iran have been very successful in reducing the number of thalassemia patients between 1990 to 2010, in order to provide a better estimation of the burden of hemoglobin disorders, it is necessary to perform a national and sub-national study of hemoglobinopathies using multiple national and sub-national surveys.

National and sub-national prevalence, trend, and burden of asthma in Iran from 1990 to 2013; the study protocol.

Asthma is a chronic inflammatory airway disease caused or worsened by environmental factors in genetically vulnerable people. The study of national and sub-national burden of asthma aims to provide a quantitative method and valid estimates for the prevalence, incidence, and economic burden of asthma disease in Iran from 1990 to 2013 and this papers explains measures, data sources, methods, and challenges that we will use in the study. In order to conduct this study, we will use all available unpublished data sources, including claim databases and data collected by the food and drug organization (FDO). Moreover, we will devise and run a systematic review of all studies and literature published about asthma epidemiology in Iran, which includes all cross-sectional, cohort and case-control studies with asthma epidemiology focus that are population based. In this study, we will use two statistical models, including spatio-temporal and multilevel autoregressive models to estimate mean and uncertainty intervals for the parameters under study by gender, age, year, and province. All programs will be written in R statistical packages (version 3.0.1). This study helps to obtain information concerning the variation among regions and provinces, and in general among sub-national divisions. Our study can be contribute to better allocation of resources, since it helps policymakers to recognize inequalities between regions and provinces and consequently help them to allocate resources more efficiently.

National and sub-national burden of chronic diseases attributable to lifestyle risk factors in Iran 1990 - 2013; study protocol.

Non-communicable diseases, as the major public health problem, are caused by different risk factors. The main leading lifestyle risk factors for most diseases burden in Iran are unhealthy diet, physical inactivity, and smoking. The aim of this study is to provide data collection and methodology processes for estimating the trends of exposures to the selected lifestyle risk factors and their attributed burden at national and sub-national levels. Systematic review will be performed through PubMed/MEDLINE, Scopus and ISI/Web of Science as well as Iranian databases such as IranMedex, Irandoc and Scientific Information Database (SID). In addition, hand searching of unpublished data sources will be used to identify relevant population-based studies. The searched studies will be included only if it is reasonably population-based and representative, and exposure data has been reported or could be plausibly obtained from the study. For risk factors with no surveys identified, other sources of potential data will be considered. The target population is healthy Iranian adult population living within Iran from 1990 to 2013. Other data sources include national censuses, national registration systems, and national and sub-national surveys. Spatio-temporal Bayesian hierarchical model and Bayesian multilevel autoregressive model will be used to overcome the problem of data gaps in provinces, and in some age or sex groups or in urban/rural areas. The problem of misaligned areal units will be also addressed in these models. National and sub-national assessment of major lifestyle risk factors such as unhealthy diet, physical inactivity, and smoking is necessary for priority setting and policy making in different regions of Iran.

Bayesian autoregressive multilevel modeling of burden of diseases, injuries and risk factors in Iran 1990 - 2013.

Statistical modeling and developing new methods for estimating burden of diseases, injuries and risk factors is a fundamental concern in studying the country health situation for better health management and policy making. Bayesian autoregressive multilevel model is a strong method for this kind of study though in complex situations it has its own challenges. Our study aims to describe the way of modeling space and time data through an autoregressive multilevel model and address challenges in complex situation. We will obtain data from different published and unpublished secondary data sources including population-based health surveys (e. g. NHS, DHS, STEP) at national and provincial levels and we also assess epidemiological studies via systematic review for each disease, injuries and risk factor over the period of 1990-2013. These data generally have a multilevel hierarchy and also time correlation. However, statistical analysis of diseases, injuries and risk factors data is primarily facing the problem of information scarcity. Data are generally too scarce to ensure reliable estimates in many practical problems. Also, there may be nonlinear changes over time, different kind of uncertainties in data and incompatible geographical data. We describe Bayesian autoregressive multilevel modeling approach that provides a natural solution to these problems through its ability to sensibly combine information from several sources of data and available prior information. In this hierarchy model levels of each hierarchy borrow information from each other and also lower levels borrow information from higher levels. We will fit the model using Markov Chain Monte Carlo (MCMC) methods because of its capabilities and benefits in complex cases. Our analyses will include different existing sources of data in Iran for 24 years through a rational and reasonable model to estimate burden of diseases, injuries and risk factors for Iran at national, regional and provincial levels while considering several kinds of uncertainties. Comprehensive and realistic estimates are always an issue of request that will be obtained through a suitable statistical modeling considering all dimensions and then can be used for making better decision in real situations.