Risk Factors and Psychosocial Correlates of Emotionally Negative Dreams in Patients Referred to a Cardiac Rehabilitation Centre

@#Introduction: Dream, as a kind of mental activity, includes various functions such as mood regulation, adjustment and integration of new information with the available memory system. The study was done for assessing the relationship between physiological and psychological components of cardiac diseases with emotionally negative dreams in cardiac rehabilitation. Methods: At the baseline of this cross-sectional study, 156 patients from Western Iran participated during April–November 2016. People 20 years–80 years able to recall the emotional content of dreams after cardiac surgery entered the study. The Beck depression inventory (BDI), Beck anxiety inventory (BAI), Buss and Perry’s aggression questionnaire (BPAQ) and Schredl’s dream emotions manual were used for collecting data. A binary logistic regression analysis used for the study of the relationship between risk factors and emotionally negative dreams. Results: The mean age of participants was 59 (SD = 9) years (men: 64.1%). The results showed that 25% of patients have negative emotional content. After adjustment for demographic variables, the results showed that increased anxiety [adjusted odds ratio (adj OR) = 1.08 [1.01– 1.16], P = 0.020] and anger (adj OR = 1.03 [1.00–1.06], P = 0.024) and hypertension (adj OR = 2.71 [1.10–6.68], P = 0.030) can predict the dreams with negative content significantly. Conclusion: The increasing rates of anxiety and anger and history of hypertension are related to increasing dreams with the negative emotional load. The control of risk factors of dreams with negative emotional load can be the target of future interventions.

Interventions in Reducing Caesarean Section in the World: A Systematic Review

@#Caesarean section without medical indication imposes many problems to families, personnel and medical equipment causing some side effects to pregnant woman and foetus, compared to natural childbirth. The present study aimed to evaluate the interventions in reducing caesarean section in the world. This study was a systematic review using Embase, PubMed, Scopus, Web of Science, Science Direct, Magiran and SID databases and grey literature. All studies conducted during 2000–2018 were reviewed and finally the studies with inclusion and exclusion criteria were selected. A total of 19 studies were selected among 5,559 studies. The interventions conducted for reducing caesarean section included training the specialists and women by using Six Sigma method, changing the guidelines, reviewing the definition of natural childbirth various stages, encouraging the natural childbirth and expanding painless childbirth. All interventions were divided into educational strategy and managerial strategy. The interventions can be implemented to change the behaviour of physicians and attitude of pregnant women in order to reduce caesarean section. In this regard, the authorities are recommended to make more efforts.

A hybrid cardiac rehabilitation is as effective as a hospital-based program in reducing chest pain intensity and discomfort

BACKGROUND: Health care services effort to provide alternative cardiac rehabilitation (CR) models to serve patients according to their preferences and needs. So, the present study aimed to assess and compare the effects of hospital-based and hybrid CR programs on chest pain intensity and discomfort in cardiac surgery patients. METHODS: In this prospective study, 110 cardiac surgery patients were invited to the CR department of a hospital in the western part of Iran between March and July 2016. Patients were divided into two groups: hospital-based and hybrid CR. The hospital-based program included 26 sessions, and the hybrid program included 10 training sessions and exercise. The Brief Pain Inventory and Pain Discomfort Scale were used as research instrument, and data were analyzed using the paired t-test and ANCOVA. RESULTS: The results indicated that both hospital-based and hybrid CR are effective in reducing the chest pain intensity and discomfort of cardiac surgery patients (P 0.05). CONCLUSIONS: Traditional hospital-based CR delivery is still the first choice for treatment in developing countries. However, hybrid CR is as effective as a hospital-based program in reducing pain components and it includes only 38% of the total cost in comparison to hospital-based delivery. So, we recommend using hybrid CR according with the recommendations of American Heart Association about using CR for the management of angina symptoms.

The Role of Oral Contraceptive Pills on Increased Risk of Breast Cancer in Iranian Populations: A Meta-analysis

BACKGROUND: Cancer is one of the main public health issues in the world. Breast cancer is one of the most common types of cancer among women. It is also the second cause of mortality in women. The association between the use of oral contraceptive pills and breast cancer is controversial and a main issue in public health. Some findings have shown that taking these pills does not have a significant effect in increasing the risk of breast cancer, while others have confirmed the carcinogenic effect of these products. These contradictory findings necessitated this meta-analysis, through of all correlated studies in Iran. METHODS: All published studies were considered from June 2000 until June 2015, using reliable Latin databases like PubMed, Google Scholar, Google search, Scopus, and Science Direct, and Persian database like SID, Irandoc, IranMedex, and Magiran. Finally, 26 papers were selected: 24 studies were case control while two were population based studies. A total of 26 papers with 46,260 participants were assessed since 2001. RESULTS: Overall estimate of OR for the effect of oral contraceptive pills on breast cancer is 1.521 (CI = 1.25–1.85), which shows that the intervention group had more chance (52%) compared to the control group (P = 0.001). Using these pills increased the risk of breast cancer up to 1.52 times. CONCLUSIONS: Because of directly increasing levels of estrogen and the role of estrogen in gaining weight indirectly, oral contraceptive pills can stimulate the occurrence of breast cancer. More studies should be conducted for controlling the period of pill use.

Irrational beliefs predict pain/discomfort and emotional distress as a result of pain in patients with non-cardiac chest pain

No abstract available.

Sociodemographic Predictors in Failure to Complete Outpatient Cardiac Rehabilitation

OBJECTIVE: To investigate the role of sociodemographic factors in failure to complete outpatient cardiac rehabilitation (CR). METHODS: This was a retrospective study that used information obtained from the database of the cardiac rehabilitation department of a cardiac hospital in Iran. Data from 1,050 CR patients treated at the hospital between January 2001 and January 2013 was analyzed using binary logistic regression analysis. RESULTS: Only 49% of the patients completed the CR program. After adjustment for baseline variables, it was found that the following were significantly associated with failure to complete the CR program: illiteracy (p<0.001), old age (p<0.001), being an employee or retired (p<0.05), having a low capacity for exercise (p<0.001), depression (p<0.001), low anxiety (p<0.001), and not currently being a smoker (p<0.001). CONCLUSION: Paying more attention to older patients with low literacy levels and limited exercise capacity, who are employed or retired, and who are not current smokers, and taking therapeutic measures to control psychological complications such as depression, may be effective in ensuring that patients complete outpatient cardiac rehabilitation.

Which Factors Unexpectedly Increase Depressive Symptom Severity in Patients at the End of a Cardiac Rehabilitation Program?

OBJECTIVE: To investigate predictors of depressive symptom aggravation at the end of a cardiac rehabilitation (CR) program. METHODS: The design of the study was retrospective. The administrative data were obtained from the database of the CR department of a heart hospital in Iran. The demographic and clinical information of 615 CR patients between January 2000 and January 2010 was analyzed using binary logistic regression analysis. RESULTS: The results showed that 10.7% of the patients completed the CR program with aggravated depressive symptoms. After adjustment for gender, age, and pre-intervention depression score, lower education level (p<0.05) and smoking (p<0.01) were significant predictors of increased depressive symptoms at the end of the program. Our model variables could explain 6% to 13% of the dependent variable variance. CONCLUSION: The results suggest that targeting patients who are less literate or who smoke could allow for taking the required measures to prevent or control depression at the end of a CR program. It is suggested that future studies consider other variables.

Gender differences in patients' beliefs about biological, environmental, behavioral, and psychological risk factors in a cardiac rehabilitation program

Introduction: There are significant gender differences in the epidemiology and presentation of cardiovascular diseases [CVDs], physiological aspects of CVDs, response to diagnostic tests or interventions, and prevalence or incidence of the associated risk factors. Considering the independent influence of gender on early dire consequences of such diseases, this study was conducted to investigate gender differences in patients' beliefs about biological, environmental, behavioral, and psychological risk factors in a cardiac rehabilitation program

Materials and Methods: This study has cross sectional design. The sample was composed of 775 patients referred to cardiac rehabilitation unit in Imam Ali Hospital in Kermanshah, Iran. The data were collected using clinical interview and patients' medical records. The data were analyzed using descriptive statistics such as mean, standard deviation, and chi-square test. To do the statistical analysis, SPSS version 20 was utilized

Results: As the results indicated, there was a significant difference between the beliefs of men and women about risk factors of heart disease [X[2]= 48.36; P<0.01]. Men considered behavioral [55.1%] and psychological [33.7%] risk factors as the main causes of their disease, respectively. On the other hand, women regarded psychological [38.2%] and behavioral factors [26.6%] as the most common causes of cardiac conditions, respectively. Both men and women considered stress as the most important heart disease risk factor [21% and 22.3%, respectively]. Also, women were less aware of the risk factors, compared to men

Conclusion: From the patients' perspective, psychological and behavioral risk factors were the most important causes of cardiovascular diseases [CVDs]; moreover, stress was the most influential risk factor for developing cardiac diseases. Thus, learning to control and manage these risk factors can help to prevent the development of CVDs and reduce the occurrence of subsequent cardiac events

Effects of A 6-month walking study on blood pressure and cardiorespiratory fitness in U.S. and swedish adults: asuki step study

The aim of this study was to assess the effects of a six-month pedometer-based workplace intervention on changes in resting blood pressure [BP] and cardjorespiratory fitness [CRF]. A subsample of ASUKI Step participants [n= 355] were randomly selected to have changes in their BP and CHF monitored during the intervention. Pedometers were used co monitor steps taken with a goal of walking more than 10.000 steps/day. Systolic and diastolic BP were taken using an Omron automated BP cuff. Estimated VO[2] max was obtained using the Astrand-Rhyming cycle ergometer test. A multi-level growth modeling approach, and a mixed d model ANOVA were used to predict changes in systolic and diastolic BP, and estimated VO[2] max over time by steps, age, gender, and university site. Steps/day averaged 12,256 [SD=3,180] during month 1 and steadily decreased to month 6. There were significant linear and quadratic trends in systolic and diastolic BP over time. Age was positively related to initial starting values for systolic and diastolic BP, and approached significance for systolic BP changes over time. Steps/day approached significance for linear changes in systolic BP. There was a significant difference between ASl and KI participants' estimated VO[2] max. There was a significant change over time in the estimated VO[2] max. The number of steps taken was significantly related to changes in estimated VO[2] max over time. The results of the present study indicate that healthy individuals who took part in a pedometer intervention improved several cardiovascular disease risk factors