BACKGROUND AND PURPOSE: The aim of this study was to determine the face and criterion validity, stability reliability, and internal consistency of the Persian version of the Impact on Participation and Autonomy (IPA-p) scale among Iranian people with multiple sclerosis (MS). METHODS: Trained experts interviewed 364 MS patients and their relatives to assess the criterion validity, stability reliability, and internal consistency of the IPA-p scale. Ten specialists from different disciplines were also recruited to assess its face validity. A consent form was completed by the patients and their relatives. Internal consistency reliability was measured using Cronbach's alpha and stability reliability was assessed using interclass correlation coefficients (ICCs). The test-retest method was used to detect the reliability of the questioner. The study subjects completed the IPA-p scale on two occasions separated by an interval of 30-45 days. Study checklists were also used to assess the face validity, stability reliability, and internal consistency of the IPA-p scale. RESULTS: About 50% of the respondents reported their perceived overall participation to be "good" or "very good" and 60% of the specialists rated the ability of the IPA-p scale to measure what it was designed for as "excellent." Spearman correlation coefficients were >0.8 for all but one IPA-p domain. Cronbach's alpha between the mean IPA-p scale scores achieved on two separate occasions ranged from 0.858 to 0.913. The highest and lowest internal consistencies belonged to the "social relationships" and "education and learning" domains, respectively. The test-retest ICCs for the nine domains were between 0.789 and 0.919, and all were significant at p<0.001. CONCLUSIONS: The IPA-p questionnaire can be considered a valid and reliable instrument for assessing self-reported participation among Iranian MS patients.
Checklist ; Consent Forms ; Surveys and Questionnaires ; Humans ; Multiple Sclerosis* ; Quality of Life ; Specialization

OBJECTIVES: Stillbirth is an undesirable outcome of pregnancy. In light of the increasing use of pesticides and growing concerns about the possible health effects of agricultural pesticides, we investigated the effect of exposure to pistachio pesticides on stillbirth in pregnant mothers. METHODS: This case-control study was conducted in Rafsanjan, Iran from 2011 to 2012. A total of 125 females who had a recent stillbirth were included as the case group, and 250 controls were selected from females who had a recent live birth. For each case, two controls with the nearest propensity score to the case were selected. Data were collected using a protocol developed by the researcher that involved interviewing respondents and reviewing their medical records. Conditional multivariate and univariate logistic regression analysis were performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: The ORs of stillbirth in mothers living in pistachio gardens and those who were exposed to sprayed pesticides, in comparison to the controls, were 14.1 (95% CI, 3.3 to 63.4) and 5.0 (95% CI, 1.2 to 28.6), respectively. No significant differences were found in stillbirth rates according to the distance between the mother's residence and a pistachio garden or involvement in agricultural activities. CONCLUSIONS: The results of our study showed that exposure to pistachio pesticides during pregnancy may increase the likelihood of stillbirth in mothers.
Agriculture ; Case-Control Studies* ; Female ; Humans ; Iran ; Live Birth ; Logistic Models ; Medical Records ; Mothers ; Odds Ratio ; Pesticides* ; Pistacia* ; Pregnancy ; Propensity Score ; Stillbirth* ; Surveys and Questionnaires