Background Discrepancy between child self-report and parent proxy-report has long been documented in the health-related quality of life (HRQoL) measurement of children with chronic health conditions. This study aims to assess whether child and parent reports of the Kinder Lebensqualität fragebogen (KINDL) questionnaire measure the same construct of HRQoL in children with attention-deficit hyperactivity disorders (ADHD). Methods Participants were 122 Iranian children with ADHD and 127 of their parents, who completed the child and parent reports of the KINDL, respectively. Internal consistency of the child and parent reports were assessed by Cronbach's alpha. The intra-class correlation (ICC) coefficient and factor analysis were applied to assess whether the child self-report and the parent proxy-report measured the same construct of HRQoL. Additionally, convergent and discriminant validity were assessed using the Spearman correlation. Results The results of factor analysis revealed that the child self-report and parent proxy-report measure two different aspects of HRQoL. Moreover, both versions of the KINDL instrument showed excellent convergent and discriminant validity. The internal consistency was close to or greater than 0.7 for all domains of both child and parent reports. Conclusions Although the child self-report and the parent proxy-report of the Persian version of the KINDL have good psychometric properties, they are not interchangeable. This finding indicates that Iranian children with ADHD and their parents evaluate children's HRQoL from their own viewpoints.

Our results suggest that heterogeneity metrics extracted from ADC-maps in metastatic lymph nodes, before and after IC, can be used as supplementary IC response indicators.

Background: The present study was conducted to jointly assess some specific factors related to body fat measures using a multivariate multilevel analysis in a representative sample of Iranian mid-adolescents. Methods: This study was conducted among 2538 students (1286 boys) aged 14-20 years old, who were randomly selected among 16 public high schools by multi-stage random sampling procedure from all education districts of Shiraz, Iran. Data on demographic characteristics, family history of obesity, physical activity, socioeconomic (SES) variables and screen time were collected. Height, weight, triceps (TST), abdominal (AST), and subscapular (SST) skinfold thickness were measured and their body mass index (BMI) was calculated. A multivariate multilevel approach was used to analyze the factors associated with obesity measures of the TST, AST, SST at the child and district levels. Results: In this study, the prevalence of overweight and obesity was estimated to be 10.2 and 5.1%, respectively. Overall, the major portion of the total variance in TST (97.1%), AST (97.7%), and SST (97.5%) was found at the child level. The results of multivariate multilevel method revealed that being girls, having a family history of obesity, and SES were significantly associated with increasing of three body fat measures (all the p-values were less than 0.05). There were significant positive associations between moderate to vigorous physical activities with AST and SST (for AST: β =2.54, SE = 1.40, p = 0.05; for SST: β =2.24, SE = 1.20, p = 0.05). Compared to children in 14-16 age group, children in age group 16-18 years had less TST (β = − 0.67, SE = 0.34, p = 0.04). Furthermore, other age groups and screen time did not play an important role in three outcome variables. Conclusions: The results showed some factors that contribute to three body fat measures. Therefore, it is necessary to develop effective interventions to prevent the effects of individual and environmental undesirable factors on childhood obesity in both family and community levels.

BackgroundIn the first stage of meta-analytic structural equation modeling (MASEM), researchers synthesized studies using univariate meta-analysis (UM) and multivariate meta-analysis (MM) approaches. The MM approaches are known to be of better performance than the UM approaches in the meta-analysis with equal sized studies. However in real situations, where the studies might be of different sizes, the empirical performance of these approaches is yet to be studied in the first and second stages of MASEM. The present study aimed to evaluate the performance of the UM and MM methods, having unequal sample sizes in different primary studies. Testing the homogeneity of correlation matrices and the empirical power, estimating the pooled correlation matrix and also, estimating parameters of a path model were investigated using these approaches by simulation.ResultsThe results of the first stage showed that Type I error rate was well under control at 0.05 level when the average sample sizes were 200 or more, irrespective of the types of the methods or the sample sizes used. Moreover, the relative percentage biases of the pooled correlation matrices were also lower than 2.5% for all methods. There was a dramatic decrease in the empirical power for all synthesis methods when the inequality of the sample sizes was increased. In fitting the path model at the second stage, MM methods provided better estimation of the parameters.ConclusionsThis study showed the different performance of the four methods in the statistical power, especially when the sample sizes of primary studies were highly unequal. Moreover, in fitting the path model, the MM approaches provided better estimation of the parameters.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-017-2768-5) contains supplementary material, which is available to authorized users.

Purpose. Healthcare access is one of the determinants of visual impairment (VI), as a public health problem. The objective of this study was to estimate VI prevalence, related causes, and its correlation with access to physicians in Iran. Methods: This systematic review and meta-analysis include observational studies published in Iran. PubMed, Web of Science, Scopus, Google Scholar, and local databases were systematically searched by using the MeSH headings. Data on the provincial distribution of physicians, as an index of access to healthcare, was retrieved. A random-effect meta-analysis was performed to assess. Results. Eight articles were included. The pooled prevalence of blindness, low vision, and VI was 0.80% (95% CI: 0.61–0.99%), 2.92% (95% CI: 2.40–3.44%), and 5.57% (95% CI: 4.71–6.43%). Refractive errors were the most common causes of VI based on PVA with the pooled prevalence of 54.6% (95% CI: 43.4–65.8%). Based on BCVA, we found that the pooled prevalence of cataracts was 37.4% (95% CI: 29.5–45.3%) as the most common cause of VI. The results of metaregression showed that the greater number of general practitioners (GPs) ( P   value = 0.01 ) and pharmacists ( P   value = 0.024 ) per population were associated with a lower prevalence of blindness. Conclusion. Some of the main causes of visual impairment in Iran are preventable. Access to healthcare services may lead to early diagnosis of preventable causes of VI. Further well-designed studies and national surveys should be conducted to provide accurate data from different regions of Iran.