Levels and Trends of Maternal Mortality and Morbidity by Cause in North Africa and Middle East, 1990 to 2019: An Analysis for the Global Burden of Disease Study 2019

Background: Since 1990, the maternal mortality significantly decreased at global scale as well as the North Africa and Middle East. However, estimates for mortality and morbidity by cause and age at national scale in this region are not available. Method(s): This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 21 countries in the region from 1990 to 2019. Result(s): Between 1990 and 2019, maternal mortality ratio (MMR) dropped from 148.8 (129.6-171.2) to 94.3 (73.4-121.1) per 100 000 live births in North Africa and Middle East. In 1990, MMR ranged from 6.0 (5.3-6.8) in Kuwait to 502.9 (375.2-655.3) per 100 000 live births in Afghanistan. Respective figures for 2019 were 5.1 (4.0-6.4) in Kuwait to 269.9 (195.8-368.6) in Afghanistan. Percentages of deaths under 25 years was 26.0% in 1990 and 23.8% in 2019. Maternal hemorrhage, indirect maternal deaths, and other maternal disorders rank 1st to 3rd in the entire region. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic index from 1990 to 2019 in all countries in the region and an evident convergence across nations. Conclusion(s): MMR has significantly declined in the region since 1990 and only five countries (Afghanistan, Sudan, Yemen, Morocco, and Algeria) out of 21 nations didn't achieve the Sustainable Development Goal (SDG) target of 70 deaths per 100 000 live births in 2019. Despite the convergence in trends, there are still disparities across countries.Copyright © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.

Emotional Reactions to COVID-19 and Coping Strategies in Nursing Students

Introduction: Nursing students are continuously exposed to carriers or patients with COVID-19 during the pandemic. The COVID-19 pandemic and its consequences can lead to many emotional reactions in nursing students. The aim of this study was to investigate emotional reactions to COVID-19 and coping strategies in nursing students. Methods: This descriptive and correlational study was conducted in 2021 at Saveh University of Medical Sciences, Iran, on 106 nursing students chosen by census method. The tools used in this study included two standard questionnaires of emotional reactions to COVID-19 Huang et al. and Carver's coping strategies questionnaire (brief form). Data analysis was performed using SPSS version 19. Results: The mean score of the dimensions of emotional reactions was 4.06 ±0.56, 4.19 ±0.77, 3.08 ±0.56, and 2.89 ±0.56, in the field of fear, anxiety, sadness, and anger, respectively. There was a statistically significant difference between the mean scores of fear and anxiety with gender (P<0.05). The mean scores of problem-focused and emotion-focused coping strategies were 2.97 ±0.97 and 3.06 ±0.97, respectively (P>0.05). There was a significant positive correlation between emotion-based coping strategies with fear, anxiety, and anger (P<0.05 (. Conclusion: Months after the beginning of the COVID-19 pandemic outbreak, the rate of negative emotional reactions (including fear, anxiety, anger, and sadness) is high in nursing students. There was a positive correlation between emotion-based coping strategies and emotional reactions. Therefore, particular emphasis should be placed on providing psychological support to nursing students as well as teaching coping strategies. © 2021 by the Author(s).

The Relationship between Mental Distress and Perception of COVID-19 Stress in Healthcare Students

Introduction/Aim: Healthcare students are among the groups affected by the COVID-19 pandemic in various ways. This study aimed to investigate the relationship between mental distress and perceptions of COVID-19 stress in healthcare students. Methods: The present analytical cross-sectional study included all students of Saveh University of Medical Sciences in 2021 as the statistical population. Through convenience sampling, 419 students were included in the study. A 12-item general health questionnaire (GHQ-12) and a 19-item the COVID-19 related healthcare students stress scale were used to collect data. Data analysis was performed using SPSS and descriptive and analytical statistical methods methods (Pearson correlation coefficient, paired t-test and analysis of variance). Results: The mean score of students' mental health status was 12.91, and 41.05% (N = 172) of them had some degree of mental distress. There was a significant relationship between mental distress score with the perception of COVID-19 stress, gender and field of study (P < 0.05). Conclusion: A significant number of students had some degree of mental distress, which had a direct and significant correlation with the perception of COVID-19 stress. Therefore, planning to identify and reduce the stressors associated with COVID-19 is one of the most beneficial actions for the students in restoring their mental health.