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1.  A New Measurement Equivalence Technique Based on Latent Class Regression as Compared with Multiple Indicators Multiple Causes 
Acta Informatica Medica  2016;24(3):168-171.
Measurement equivalence is an essential prerequisite for making valid comparisons in mental health questionnaires across groups. In most methods used for assessing measurement equivalence, which is known as Differential Item Functioning (DIF), latent variables are assumed to be continuous.
To compare a new method called Latent Class Regression (LCR) designed for discrete latent variable with the multiple indicators multiple cause (MIMIC) as a continuous latent variable technique to assess the measurement equivalence of the 12-item General Health Questionnaire (GHQ-12), which is a cross deferent subgroup of Iranian nurses.
A cross-sectional survey was conducted in 2014 among 771 nurses working in the hospitals of Fars and Bushehr provinces of southern Iran. To identify the Minor Psychiatric Disorders (MPD), the nurses completed self-report GHQ-12 questionnaires and sociodemographic questions. Two uniform-DIF detection methods, LCR and MIMIC, were applied for comparability when the GHQ-12 score was assumed to be discrete and continuous, respectively.
The result of fitting LCR with 2 classes indicated that 27.4% of the nurses had MPD. Gender was identified as an influential factor of the level of MPD.LCR and MIMIC agree with detection of DIF and DIF-free items by gender, age, education and marital status in 83.3, 100.0, 91.7 and 83.3% cases, respectively.
The results indicated that the GHQ-12 is to a great degree, an invariant measure for the assessment of MPD among nurses. High convergence between the two methods suggests using the LCR approach in cases of discrete latent variable, e.g. GHQ-12 and adequate sample size.
PMCID: PMC4949036  PMID: 27482129
mental disorders; measurement equivalence; latent class regression; MIMIC model; GHQ-12
2.  Evaluation of the Relationship between Social Desirability and Minor Psychiatric Disorders among Nurses in Southern Iran: A Robust Regression Approach 
Social desirability may affect different aspects of people’s quality of life. One of the impressive dimensions of quality of life is mental health. The prevalence of Minor Psychiatric Disorders (MPD) among health care workers is higher than other health workers. This article aims at evaluating the relationship between social desirability and MPD among nurses in southern Iran.
A cross-sectional study was carried out on 765 nurses who had been employed in hospitals in the southern provinces of Iran. The 12-item General Health Questionnaire (GHQ-12) and Marlowe-Crowne Social Desirability Scale (MC-SDS) were used for evaluating the MPD and social desirability in nurses, respectively. The Robust Regression was used to determine any quantified relationship between social desirability and the level of MPD with adjusted age, gender, work experience, marital status, and level of education.
The mean scores of GHQ-12 and MC-SDS were 13.02±5.64 (out of 36) and 20.17±4.76 (out of 33), respectively. The result of Robust Regression indicated that gender and social desirability were statistically significant in affecting MPD.
The prevalence of MPD in female nurses was higher than males. Nurses with higher social desirability scores had the tendency to report lower levels of MPD.
PMCID: PMC4591569  PMID: 26448957
Iran; Mental disorders; Nurses; Robust regression; Social desirability
Materia Socio-Medica  2015;27(5):337-341.
Nurses constitute the most providers of health care systems. Their mental health can affect the quality of services and patients’ satisfaction. General Health Questionnaire (GHQ-12) is a general screening tool used to detect mental disorders. Scoring method and determining thresholds for this questionnaire are debatable and the cut-off points can vary from sample to sample. This study was conducted to estimate the prevalence of mental disorders among Iranian nurses using GHQ-12 and also compare Latent Class Analysis (LCA) and K-means clustering with traditional scoring method.
A cross-sectional study was carried out in Fars and Bushehr provinces of southern Iran in 2014. Participants were 771 Iranian nurses, who filled out the GHQ-12 questionnaire. Traditional scoring method, LCA and K-means were used to estimate the prevalence of mental disorder among Iranian nurses. Cohen’s kappa statistic was applied to assess the agreement between the LCA and K-means with traditional scoring method of GHQ-12.
The nurses with mental disorder by scoring method, LCA and K-mean were 36.3% (n=280), 32.2% (n=248), and 26.5% (n=204), respectively. LCA and logistic regression revealed that the prevalence of mental disorder in females was significantly higher than males.
Mental disorder in nurses was in a medium level compared to other people living in Iran. There was a little difference between prevalence of mental disorder estimated by scoring method, K-means and LCA. According to the advantages of LCA than K-means and different results in scoring method, we suggest LCA for classification of Iranian nurses according to their mental health outcomes using GHQ-12 questionnaire
PMCID: PMC4639329  PMID: 26622202
Mental health; GHQ-12; Latent Class Analysis; K-means clustering; nurses; Iran
4.  Factors Affecting Minor Psychiatric Disorder in Southern Iranian Nurses: A Latent Class Regression Analysis 
Nursing and Midwifery Studies  2015;4(2):e28017.
Mental health is one of the most important dimensions of life and its quality. Minor Psychiatric Disorder as a type of mental health problem is prevalent among health workers. Nursing is considered to be one of the most stressful occupations.
This study aimed to evaluate the prevalence of minor psychiatric disorder and its associated factors among nurses in southern Iran.
Patients and Methods:
A cross-sectional study was carried out on 771 nurses working in 20 cities of Bushehr and Fars provinces in southern Iran. Participants were recruited through multi-stage sampling during 2014. The General Health Questionnaire (GHQ-12) was used for screening of minor psychiatric disorder in nurses. Latent Class Regression was used to analyze the data.
The prevalence of minor psychiatric disorder among nurses was estimated to be 27.5%. Gender and sleep disorders were significant factors in determining the level of minor psychiatric disorder (P Values of 0.04 and < 0.001, respectively). Female nurses were 20% more likely than males to be classified into the minor psychiatric disorder group.
The results of this study provide information about the prevalence of minor psychiatric disorder among nurses, and factors, which affect the prevalence of such disorders. These findings can be used in strategic planning processes to improve nurses’ mental health.
PMCID: PMC4557411  PMID: 26339670
Mental Disorders; Regression; Nurses; Iran
6.  Factors Affecting Journal Quality Indicator in Scopus (SCImago Journal Rank) in Obstetrics and Gynecology Journals: a Longitudinal Study (1999-2013) 
Acta Informatica Medica  2014;22(6):385-388.
Awareness of the latest scientific research and publishing articles in top journals is one of the major concerns of health researchers. In this study, we first introduced top journals of obstetrics and gynecology field based on their Impact Factor (IF), Eigenfactor Score (ES) and SCImago Journal Rank (SJR) indicator indexed in Scopus databases and then the scientometric features of longitudinal changes of SJR in this field were presented.
Method and material:
In our analytical and bibiliometric study, we included all the journals of obstetrics and gynecology field which were indexed by Scopus from 1999 to 2013. The scientometric features in Scopus were derived from SCImago Institute and IF and ES were obtained from Journal Citation Report through the Institute for Scientific Information. Generalized Estimating Equation was used to assess the scientometric features affecting SJR.
From 256 journals reviewed, 54.2% and 41.8% were indexed in the Pubmed and the Web of Sciences, respectively. Human Reproduction Update based on the IF (5.924±2.542) and SJR (2.682±1.185), and American Journal of obstetrics and gynecology based on the ES (0.05685±0.00633) obtained the first rank among the other journals. Time, Index in Pubmed, H_index, Citable per Document, Cites per Document, and IF affected changes of SJR in the period of study.
Our study showed a significant association between SJR and scientometric features in obstetrics and gynecology journals. According to this relationship, SJR may be an appropriate index for assessing journal quality.
PMCID: PMC4315645  PMID: 25684846
Journal quality; obstetrics and gynecology; Impact Factor; Eigenfactor Score; SCImago Journal Rank
7.  Homocysteine, Cobalamin and Folate Status and their Relations to Neurocognitive and Psychological Markers in Elderly in Northeasten of Iran 
Objective(s): Incidence of neurocognitive and psychological disorders may be related to serum homocystein (Hcy), cobalamin (vitamin B12) and folate levels in old people. The aim of this study was to assess the relation between Hcy, cobalamin, folate and neurocognitive and/or psychological disorders in the elderly.
Materials and Methods: In this cross-sectional study, 280 subjects with ≥ 65 years old ,were evaluated. The subjects were selected from 12 regions of Mashhad, Iran, over March to October 2009. After blood sampling, data were collected by questionnaire, face to face interview and performing neurocognitive and psychological tests. The sera of 250 persons were analyzed for cobalamin and folate by RIA method. Amongst the aforementioned samples, 78 cases with cobalamin <300 pg/ml and folate <6.5 ng/ml were analyzed for Hcy by ELISA method.
Results: Amongst the people, 126 (45%) were male and 154 (55%) were female. The prevalence of hyperhomocysteinemia (HHcy) was 59.5% and 37.1% in male and female respectively (P -value =0.049). Hcy inversely correlated to cobalamin (r=-0.282, P=0.014) and to folate (r=-0.203, P=0.014). Hcy, cobalamin and folate correlations to neurocognitive and psychological impairments were not statically significant.
Conclusion: Hyper Hcy or low cobalamin and folate in the elderly, are prevalent but their relationships with neurocognitive and psychological impairments is controversial. If these relationships had been confirmed, performing a single serum Hcy or cobalamin test would have been enough enough to diagnose and prevent neurocognitive impairments and inversely, neurocognitive-psychological sign and symptoms could have meant probable tissue vitamin deficiencies. However methods of assessing neurocognitive and psychological markers with validity and reliability of clinical and laboratory tests for finding aforementioned relationships should be revised.
PMCID: PMC3758032  PMID: 23997903
Cobalamin; Folate; Homocystein; Psychological; Neurocognitive; The elderly
8.  Assessing Awareness Level about Warning Signs of Cancer and its Determinants in an Iranian General Population 
The present study was aimed at investigating the awareness level about warning signs of cancer and its determinants in an Iranian general population. This cross-sectional interview-based survey investigated 2,500 people aged 18 years and over, as a representative sample of Tehran population. Latent class regression was applied for analyzing data. A small (18.8%) proportion of the respondents had high level of knowledge, and 54.5% had moderate awareness, and 26.7% had low level of awareness. Most effective predictors for awareness were educational attainment, sex, and marital status. The findings suggest that the overall level of knowledge about warning signs of cancer among the public is low, particularly about some specific signs. Accordingly, educational and intervention programmes, with special attention placed on particular at-risk populations, to increase awareness about the disease leading to its early diagnosis are needed.
PMCID: PMC3259730  PMID: 22283041
Awareness; Cancer; Cross-sectional studies; Health education; Neoplasms; Public education; Signs and symptoms; Iran

Results 1-8 (8)