Psychometric evaluation of the Persian version of the Sense of Belonging in Nursing School (SBNS): a quantitative and cross-sectional design.

BACKGROUND: This study aimed to evaluate the psychometric indicators of the Persian version of the Sense of Belonging in Nursing School scale (SBNS). METHODS: The study conducted in Shahroud and Semnan schools of nursing and midwifery in Iran examined nursing students using a cross-sectional approach by convenience sampling method from 3/6/2023 to 24/8/2023. To assess the SBNS scale, the forward-backward procedure was used to translate it into Persian. Face and content validity were evaluated, and exploratory and confirmatory factor analyses were conducted with sample sizes of 200 and 182, respectively. Reliability was assessed using Cronbach's alpha coefficient, MacDonald's omega, and intra-class correlation coefficient. RESULTS: The exploratory factor analysis resulted in the exclusion of four items, leaving a final selection of 15 items. These items were categorized into three factors: classmates, clinical staff, and inclusive educational environment, which accounted for 49.16% of the overall variance. The confirmatory factor analysis indicated that the model was a good fit for the observed data, and the subscales had high internal consistency (Cronbach's alpha coefficient was 0.752 to 0.880) and stability (intra-class correlation coefficient was 0.889 to 0.968). CONCLUSION: According to the results, it can be concluded that the Persian version of the SBNS scale demonstrates sufficient validity and reliability in assessing students' sense of belonging to the nursing school.

A Systematic Review of Health Management Mobile Applications in COVID-19 Pandemic: Features, Advantages, and Disadvantages.

Introduction: With the increasing accessibility of smartphones, their use has been considered in healthcare services. Mobile applications have played a pivotal role in providing health services during COVID-19. This study is aimed at identifying the features, advantages, and disadvantages of health management mobile applications during COVID-19. Methods: This systematic review was conducted in PubMed, Scopus, and Web of Science using the related keywords up to November 2021. The original articles in English about the health management mobile applications in COVID-19 were selected. The study selection was done by two researchers independently according to inclusion and exclusion criteria. Data extraction was done using a data extraction form, and the results were summarized and reported in related tables and figures. Results: Finally, 12 articles were included based on the criteria. The benefits of mobile health applications for health management during COVID-19 were in four themes and 19 subthemes, and the most advantages of the application were in disease management and the possibility of recording information by users, digital tracking of calls, and data confidentiality. Furthermore, the disadvantages of them have been presented in two themes and 14 subthemes. The most common disadvantages are reduced adherence to daily symptom reports, personal interpretation of questions, and result bias. Conclusion: The study results showed that mobile applications have been effective in controlling the prevalence of COVID-19 by identifying virus-infested environments, identifying and monitoring infected people, controlling social distancing, and maintaining quarantine. It is suggested that usability, ethical and security considerations, protection of personal information, and privacy of users be considered in application design and development.

Investigating the advantages and disadvantages of electronic logbooks for education goals promotion in medical sciences students: A systematic review.

Background and Aims: Electronic logbook (E-Logbook) is one of the practical software in medical science that serves as an auxiliary tool for comprehensive education, formative evaluation, and student learning documentation in clinical education. E-logbooks are available to people on the Internet without any time or place restrictions. Experts' familiarity with e-logbooks and their advantages and disadvantages can be effective in their better design so professors and students can use their potential benefits. Therefore, this study examines the advantages and disadvantages of an e-logbook. Methods: This systematic review was conducted until June 13, 2022, by searching relevant keywords such as logbook, e-logbook, and medical students in PubMed, Scopus, and Web of Science databases. Data were extracted using the data extraction form. The contents of the studies were analyzed based on the study's aim. The results of the analyses were presented in the form of descriptive statistics (tables and figures). Results: Out of 365 retrieved studies, 13 were selected to investigate the advantages and disadvantages of e-logbooks. Most studies were conducted in Pakistan (n = 4) and focused on medical students with different specialties (n = 10). The advantages and disadvantages of e-logbooks were classified into nine and four categories, respectively. Most advantages of e-logbooks were related to monitoring and evaluating the performance of students and instructors (n = 11). Their most disadvantages were associated with hardware and software (n = 8). Conclusion: According to the results, e-logbooks can improve clinical education, provide feedback to people, control the achievement of educational goals, and increase professor-student interaction. Hence, it is recommended to address their disadvantages and barriers to improve the quality of students' performance.

The effect of using mobile health on self-management of type 2 diabetic patients: A systematic review in Iran.

Type 2 diabetes, as one of the most common chronic diseases, requires ongoing management and support from the patient; therefore, patient participation and self-management play a pivotal role in controlling and preventing this disease. The increasing use of smartphones has provided a good opportunity for controlling and managing patients with type 2 diabetes. This study aimed to investigate the effect of mobile health on the self-management of patients with type 2 diabetes in Iran. A systematic review study was conducted from 2010 to 2021. Searches in Persian and English scientific databases, IranDoc, MagIran, SID Web of science, and PubMed, were performed using keywords such as diabetes and mobile health. The process of reviewing and selecting articles based on inclusion and exclusion criteria was performed by two researchers independently. The study evaluation was performed by using a standard tool. After selecting articles, data extraction was performed using a data extraction form. Data analysis was performed with a content analysis approach. Finally, 23 articles were included from the 7767 articles found in the initial search stage, which examined patients' self-care in 11 areas using mobile health. Fourteen studies (61%) considered mobile health to be effective in increasing hemoglobin control. Other studies also found the use of mobile health in increasing adherence to exercise (n = 10), increasing adherence to medication (n = 9), increasing adherence to diet (n = 11), increasing care for diabetic foot ulcers (n = 8), increasing self-efficacy and empowerment (n = 5), increasing cholesterol control (n = 4), increasing awareness and attitude (n = 4), increasing control of insulin dose (n = 2), increasing adherence to education (n = 1), and increasing control of blood urea (n = 1), which were considered effective. The use of m-health effectively controls the disease and promotes self-management in type 2 diabetic patients. Considering the high cost of diabetes treatment, policymakers should implement appropriate interventions and strategies in the field of using mobile health to improve adherence to self-management of the disease.

Partial nephrectomy and positive surgical margin, oncologic outcomes and predictors: a 15-year single institution experience.

INTRODUCTION: The aim of this article was to compare oncological outcomes after partial nephrectomy between patients with positive (PSM) and negative (NSM) surgical margins. MATERIAL AND METHODS: In this retrospective study, the data of 733 patients who underwent partial nephrectomy with diagnosis of renal cell carcinoma (RCC) were analyzed. A total of 80 patients from the NSM group were matched to 42 PSM patients. The Kaplan-Meier method was used to estimate freedom from local disease recurrence and metastatic progression and overall survival. Cox proportional hazards models were used to assess the predictors for recurrence/metastasis. RESULTS: The mean age was 58.4 ±11.4 years (range: 29 to 82). Median follow-up was 24 months (IQ25-75: 15-36.2). A total of 5 patients from the PSM group (6.2%) developed local recurrence and metastasis was detected in 2 (2.5%) of them while no metastasis or recurrence was observed in the NSM group. In the multivariate analysis, positive surgical margin was the only independent predictor for recurrence/metastasis (HR[CI] = 0.19[0.04-0.75], p = 0.019). Recurrence-free survival was higher in the NSM group (100% for the NSM group vs 88.1%, p = 0.002) and recurrence/metastasis-free survival was also higher in the NSM group (100% for the NSM group vs 85.7%, p = 0.001), but there were no differences in overall survival between the two groups (96.3% for the NSM group vs 97.6% for the PSM group, p = 0.68). CONCLUSIONS: Although tumor recurrence was more prevalent in positive surgical margin patients who underwent partial nephrectomy, there were no differences in overall survival between the two groups. Therefore, active surveillance against further surgery would be a proper option after finding the tumor-involved margins.

You Get What You Pay for on Health Care Question and Answer Platforms: Nonparticipant Observational Study.

BACKGROUND: Seeking health information on the internet is very popular despite the debatable ability of lay users to evaluate the quality of health information and uneven quality of information available on the Web. Consulting the internet for health information is pervasive, particularly when other sources are inaccessible because of time, distance, and money constraints or when sensitive or embarrassing questions are to be explored. Question and answer (Q&A) platforms are Web-based services that provide personalized health advice upon the information seekers' request. However, it is not clear how the quality of health advices is ensured on these platforms. OBJECTIVE: The objective of this study was to identify how platform design impacts the quality of Web-based health advices and equal access to health information on the internet. METHODS: A total of 900 Q&As were collected from 9 Q&A platforms with different design features. Data on the design features for each platform were generated. Paid physicians evaluated the data to quantify the quality of health advices. Guided by the literature, the design features that affected information quality were identified and recorded for each Q&A platform. The least absolute shrinkage and selection operator and unbiased regression tree methods were used for the analysis. RESULTS: Q&A platform design and health advice quality were related. Expertise of information providers (beta=.48; P=.001), financial incentive (beta=.4; P=.001), external reputation (beta=.28; P=.002), and question quality (beta=.12; P=.001) best predicted health advice quality. Virtual incentive, Web 2.0 mechanisms, and reputation systems were not associated with health advice quality. CONCLUSIONS: Access to high-quality health advices on the internet is unequal and skewed toward high-income and high-literacy groups. However, there are possibilities to generate high-quality health advices for free.

The Vitamins Involved in One-Carbon Metabolisms are Associated with Reduced Risk of Breast Cancer in Overall and Subtypes.

Background: Some micronutrients like folate, vitamin B12, B6, and B2 are the source of coenzymes, which participate in one-carbon metabolism. Any disruption in this metabolism can interfere with DNA replication, repair and regulation of gene expression and ultimately promote the likelihood of carcinogenesis. This study aimed at investigating the relationship between the intakes of micronutrients involved in one-carbon metabolism with breast cancer (BrCa) and its subtype's odds. Methods: Nutrients' intake from diet and supplements were collected through interviewing 151 cases and 154 controls by a 168-item semiquantitative food frequency questionnaire. Logistic regression was used to determine the relationship between dietary and/or total intake of studied nutrients and odds of BrCa and its subtypes. Results: After adjusting the effects of confounding variables in the models, the odds of BrCa was significantly lower in the highest intake quartile compared with the lowest quartile for total intake of vitamin B2 (OR = 0.17, 95% CI, 0.07-0.39; Ptrend < 0.001), vitamin B6 (OR = 0.11, 95% CI, 0.05-0.27; Ptrend < 0.001), vitamin B12 (OR = 0.20, 95% CI, 0.09-0.43; Ptrend < 0.001) and folate (OR = 0.09, 95% CI, 0.04-0.21; Ptrend < 0.001). Also, those with the highest quartile of vitamin B6, B12, B2 and folate intake compared with the lowest quartile were less likely to develop estrogen receptor (ER)+ and progesterone receptor (PR)+ subtypes, ER- status, PR- and human epidermal growth factor receptor 2 (HER2)+ subtypes and HER2- status. Conclusion: High intakes of vitamins B2, B6 and folate are associated with reduced odds of BrCa in overall and all ER, PR and HER2 subtypes. Also, high intakes of vitamin B12 reduced the odds of all subtypes of BrCa except ER- subtype.

Salvage autologous fascial sling after failed anti-incontinence surgeries: Long term follow up.

OBJECTIVE: To evaluate long term outcomes of autologous pubovaginal fascial sling (AFPVS) as a salvage procedure following different types of failed anti-incontinence surgeries. MATERIALS AND METHODS: We retrospectively reviewed medical records of patients who had undergone salvage AFPVS after any kind of anti-incontinence surgery from 2005-2015 at our medical center. Patients were contacted by telephone. Revised Urinary Incontinence Scale (RUIS) was used to determine the success rate. RESULTS: A total of 40 patients out of 51 were successfully contacted. Mean patient age was 50.8± 9.8 years (range30-75) and mean follow up was 62.6±32.4 months (range12-120). Of 40 patients, 14(35%) had pure SUI and 26(65%) complained of mixed urinary incontinence. A total of 15(37.5%) patients had a failed Burch colposuspention, 5(12.5%) TVT, 8(20%) TOT, 3 (7.5%) AFPVS and five (12.5%) patients had history of failed mini-sling procedure. Four (10%) patients had undergone more than one anti incontinence surgeries. Overall success rate was 65% in our study. New onset urge urinary incontinence was detected in 25% of patient which was negatively associated with satisfaction and recommendation.  There was no statistically significant correlation between mixed urinary incontinence, type or number of previous failed surgeries with success however presence of pure SUI had a strongCOCLUSION: Autologous pubovaginal fascial sling might be considered as a safe and efficacious salvage surgical option following failed midurethral slings, Burch colposuspention and even AFPVS itself. It will provide reasonable long term results with no major complications.

Association between Dietary Inflammatory Index (DII) and Risk of Breast Cancer: a Case-Control Study

Background: Breast cancer (BrCa) is the most common cancer among women worldwide and is the second leading cause of cancer-related death in women, in developed countries. This cancer is among the top five most common cancers in Iran. Studies have shown that dietary components are implicated in the etiology of BrCa. The existence of molecular connections between inflammation and BrCa has been demonstrated via different bimolecular events. Methods: We examined the ability of the dietary inflammatory index (DIITM) to predict the risk of BrCa. This included 145 cases and 148 controls, who attended the specialized centers. DII scores were computed based on dietary intake assessed using a 168-item FFQ. Logistic regression models were used to estimate multivariable ORs. Results: Modeling DII as a continuous variable in relation to risk of BrCa showed a positive association after adjustment for age and energy (OR=1.76; 95% CI=1.43-2.18); and were nearly identical in the multivariable analyses (OR=1.80; 95% CI=1.42-2.28). DII as tertiles, and adjusting for age and energy, subjects in tertile 3 had an OR of 6.94 (95% CI= 3.26-14.79; P-trend ≤0.0001) in comparison to subjects in tertile 1. After multivariable adjustment, results were essentially identical as in the model adjusting for age and energy (OR tertile 3vs1=7.24; 95% CI=3.14-16.68; P-trend ≤0.001). Sub group analyses revealed similar positive associations with HER 2 receptor +ve, progesterone receptor +ve, estrogen receptor +ve and lymph node invasive cases. Conclusion: Subjects who consumed a more pro-inflammatory diet were at increased risk of BrCa compared to those who consumed a more anti-inflammatory diet.

The association between the Index of Nutritional Quality (INQ) and breast cancer and the evaluation of nutrient intake of breast cancer patients: A case-control study.

OBJECTIVE: Breast cancer (BrCa) is the most frequently diagnosed cancer among females and second cancer after lung cancer in many societies. In Iran, the risk for BrCa is 1 in 35 and each year, 8000 new patients have been diagnosed with BrCa. Studies have shown that dietary components are implicated in the etiology of BrCa. The Index of Nutritional Quality (INQ) is a method of quantitative and qualitative analysis of single foods, meals, and diets. The aim of this study was to determine the usefulness of INQs in predicting BrCa risk. METHODS: Our case-control study was conducted from March 2015 to February 2016. The study included 145 cases and 148 controls who attended the Shahid Beheshti University of Medical Sciences Cancer Research Center. INQ scores were computed based on dietary intake using a validated 168-item food frequency questionnaire. Logistic regression models were used to estimate multivariable odds ratios adjusted body mass index, education, employment, marital status, menarche age, childbirth number, smoking, menopause status, and physical activity. RESULTS: Vitamins A, C, B1, B2, and B12 and selenium INQs as a continuous variable in relation to risk for BrCa showed a significant association after multivariate adjustment (odds ratio [OR]vitA, 0.41 [0.27-0.64]; ORvitC, 0.30 [0.20-0.47]; ORvitB1, 0.08 [0.04-0.17]; ORvitB2, 0.19 [0.11-0.34]; ORvitB12, 0.44 [0.31-0.61]; and ORselenium, 0.42 [0.26-0.67]). CONCLUSION: Women who consumed a healthier diet including vitamin A, ß-carotene, vitamin C, and folate and low-fat milk were at decreased risk for developing BrCa compared with those whose diet included more high fat and lamb meat.

The effect of n-3 fatty acids on bone biomarkers in Iranian postmenopausal osteoporotic women: a randomized clinical trial.

Recently, n-3 fatty acids are in the center of attention for their potent anti-inflammatory effects. Osteoporosis as a chronic senile disease is associated with inflammation, and the role of inflammatory mediators has been demonstrated in recent years. The beneficial effects of n-3 fatty acids on bone were proven in many animal studies, while to date, no conclusive data is available in human. The aim of this study was to evaluate the impact of n-3 fatty acids on bone biomarkers in osteoporotic postmenopausal women. Twenty-five osteoporotic postmenopausal women were recruited in the study and randomized in treatment and control groups. The patients received 900 mg n-3 fatty acid capsules or placebo per day for 6 months. Serum levels of osteocalcin, bone alkaline phosphatase (BALP), calcium, vitamin D, and parathormone and urine concentration of pyridinoline (Pyd) were measured at baseline, second month, and sixth month in both groups. In the treatment group, compared with baseline, at the second month, osteocalcin increased slightly; thereafter, it showed decrement trend until the end of the study. In the control group, it decreased all over the study. None of these changes was significant. BALP showed nonsignificant decrease from baseline over the time in both groups. Urine level of Pyd decreased significantly (P < 0.05) in the treatment group, while no significant change was seen in the control group. Serum calcium and vitamin D increased in both groups; however, changes were not significant. No significant changes were seen in calcium clearance and parathormone. In conclusion, n-3 fatty acids can decrease bone resorption; however, it could not affect bone formation significantly after 6 months treatment. Further investigations are recommended.