Examining the effectiveness of home-based cardiac rehabilitation programs for heart failure patients with reduced ejection fraction: a critical review.

BACKGROUND: Heart failure (HF) is the most common cardiovascular reason for hospital admission, particularly among patients older than 60 years old. Heart failure with reduced ejection fraction (HFrEF) comprises approximately 50% of all heart failure cases. Home-based cardiac rehabilitation (HBCR) is an alternative option to enhance the participation rate in cardiac rehabilitation (CR) interventions for patients who are not able to attend center-based cardiac rehabilitation (CBCR). The purpose of this review is to clarify the extent to which present studies of HBCR align with the core components defined by both the European Society of Cardiology (ESC) and the British Association for Cardiac Prevention and Rehabilitation (BACPR). METHODS: A critical review was conducted through four databases, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews, to identify randomized controlled trials up until June 2022. We scrutinized the commonalities between BACPR and ESC and developed a list of standards. The risk of bias was assessed using the RoB 2 tool. RESULTS: Among the 87 papers selected for full-text screening, 11 studies met the inclusion criteria. Six papers possessed a high proportion of fidelity to essential standards, four studies had a medium alliance, and one intervention had a low level of alliance. CONCLUSION: Overall, the majority of included studies had medium to high alignment with standards and core components. However, a need for more attention to long-term strategy as an important standard is revealed. Rapid identification and initial assessment are the most met standards; however, lifestyle risk factor management and long-term outcomes were recognized as the least met standards.

The Burden of Cancer in a Sample of Iranian Population.

BACKGROUND: We aimed at estimating the burden of cancer in Kurdistan Province, western Iran during 2011-2017. METHODS: In this cross-sectional study, incidence data extracted from the cancer registry system and death data were extracted from the system of registration and classification of causes of death of Kurdistan Province. We applied the WHO' methods to calculate the disability-adjusted life year (DALYs). RESULTS: The burden of cancer increased from a DALYs of 12309 in 2011 to 13969 in 2017, the YLL from 11644 in 2011 to 12951 in 2017 and the YLD from 665 in 2011 to 1018 in 2017. The top five cancers, according to DALYs (%) in both sex during 2011-2017 were: stomach (25%), lung (14%), liver (9%), esophagus (6%), and colon (6%). The most burden of cancer related to gastrointestinal tract (54% vs. 45%). Totally, more than 25% of DALYs were related to stomach cancer. CONCLUSION: The increasing DALYs of cancer in Kurdistan Province is one of the major public health concerns as in most developed countries. More than half of the burden of cancer in the Kurdistan Province is related to gastrointestinal tract. Stomach cancer, is accounting for more than 25% of the burden in both sexes. Urgent policy, management and public health measures such as general education, screening, early detection and effective treatment are recommended to reduce the burden of cancers and especially gastrointestinal tract malignancies.

Effect of female genital mutilation on mental health: a case-control study.

Objectives: The study aimed to investigate the mental health status of women with female genital mutilation/cutting (FGM/C) and compare it with that of a similar group of women without FGM/C.Methods: A case-control study was carried out in 2018 among 122 women with FGM/C and 125 women without FGM/C who had been referred to one of the general health service centres in Kermanshah Province, western Iran. The 28 item General Health Questionnaire (GHQ-28) was used to collect data on participants' mental health. A multivariate logistic model with odds ratios (ORs) was used to determine the relationship of independent variables with the outcome variable, mental health status.Results: The mean age of the FGM/C and control groups was 35.7 (standard deviation [SD] 8.6) and 31.3 (SD 7.2) years, respectively. According to the GHQ-28 questionnaire, 65.6% (n = 80) of the FGM/C group and 52% (n = 65) of the control group had symptoms of a mental health disorder; the difference between the groups was statistically significant (p = .03). The prevalence of severe depression in the FGM/C group was significantly higher than in the control group (p = .021). Multivariate logistic regression showed that having a history of FGM/C (adjusted OR 1.79; 95% confidence interval [CI] 1.05, 3.05) and being in employment (adjusted OR 3.46; 95% CI 1.23, 9.74) had a significant effect on presentation with symptoms of a mental health disorder (p < .05).Conclusion: Women who suffer from FGM/C are more vulnerable to mental health disorders such as depression.