Designing a virtual breast cancer prevention program for Iranian women: A study protocol.

BACKGROUND: The growing number of breast cancer patients in Iran, following the lower referrals of women to screening centers after the outbreak of the COVID-19, suggests the need for designing virtual educational interventions to teach self-care methods to women. The aim of this study is to design a virtual training program for the prevention of breast cancer in women based on the steps of the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) educational design model. MATERIALS AND METHODS: This developmental study will be conducted based on the steps of the ADDIE model. In the first step (analysis), a qualitative study, literature review, and a panel of experts will be conducted to analyze the situation (learners, content, platforms, and media for the electronic presentation of the program). In the design step, the learning objectives, educational strategies, and the way of program's implementation and evaluation will be specified. In the third step, not only are the content, storyboard, and educational program developed, but the pilot study is also conducted and formative assessment is performed. In the fourth step, the program will be provided to the audience and will be implemented as a preliminary program. In the final step, the final virtual education program for the prevention of breast cancer in women will be presented based on the results of the evaluation. CONCLUSIONS: Using a comprehensive and systematic educational design model can be a step toward making changes and encouraging innovations in breast cancer prevention education programs in women based on virtual education. Given the existing needs and conditions, this program can promote cancer preventive behaviors as much as possible, reduce the costs imposed on the family and healthcare systems, and lower the complications and mortality rate caused by the delayed diagnosis of the disease.

Voices unheard, insights into the lives of people with disabilities: A needs assessment study.

BACKGROUND: The phenomenon of disability in society is as ancient as human history itself. Approximately one billion people worldwide experience some form of disability, with a fifth of these individuals facing significant disabilities. Disability affects various life dimensions, including access to health services. This study aimed to identify the needs and challenges encountered by people with disabilities and to propose solutions for these issues. MATERIALS AND METHODS: This qualitative content analysis research was conducted at Isfahan University of Medical Sciences in 2019. Participants included faculty members from the rehabilitation school, senior students, therapists, disabled individuals, and their families (23 interviews in total). These participants were chosen for their extensive knowledge of the challenges faced by people with disabilities. Semi-structured interviews were conducted, with informed consent obtained before each interview. The interviews were analyzed using the Graneheim and Lundman content analysis method and MAXQDA software. To ensure data accuracy, the criteria of conformability, credibility, dependability, and transferability were applied. RESULTS: The analysis of the interviews yielded two main categories and 10 subcategories. In the category of disability-related problems, family problems, therapeutic problems, psychological problems, academic problems, and social problems were identified as the most significant. As for solutions, educational solutions, therapeutic solutions, social solutions, research solutions, and solutions for reintegrating patients into normal life were proposed to address the problems faced by disabled individuals. CONCLUSION: People with disabilities are an integral part of any country's society. To adequately address their therapeutic needs, it is essential to equip our health workers with the knowledge and skills tailored to the specific needs and challenges of disabled individuals.

Comparative Effectiveness of Antidiabetic Drugs as an Additional Therapy to Metformin in Women with Polycystic Ovary Syndrome: A Systematic Review of Metabolic Approaches.

Background: Metformin is commonly prescribed to treat polycystic ovary syndrome (PCOS) patients, but in some cases, it may not be effective even at high doses or may cause intolerable side effects. Therefore, recent studies have examined the impact of combining metformin with other antidiabetic medications. Methods: A systematic search was performed in Scopus, PubMed, Web of Science, and Embase up to 30 June 2023. All interventional studies that assessed the efficacy of different antidiabetic agents were included. Results: Among the 3488 records found in the primary search, 16 papers were included. Our study showed that dipeptidyl peptidase-4 inhibitors (DPP4i) had the most significant impact on glycemic profile, while thiazolidinediones (TZDs) had the most influence on lipid levels. However, it was observed that patients taking only metformin experienced a greater increase in high-density lipoprotein cholesterol (HDL-C) levels. Glucagon-like peptide-1 receptor agonists (GLP1RAs) effectively modified various anthropometric measurements, such as weight, body mass index, waist circumference, and waist-to-hip ratio. The effects of different antidiabetic drugs on hormone levels were inconclusive, although testosterone levels were more affected by GLP1RA, sodium-glucose cotransporter-2 inhibitors (SGLT2i), and TZDs. None of the combined therapies showed a significant change in blood pressure. Conclusion: Since PCOS is a metabolic disorder, choosing the best combination of antidiabetic drugs in the clinical course of PCOS patients will be very important. Today, it seems that we need a new metabolic approach for better treatment of the metabolic aspects of these patients.

Anatomy education during COVID-19 era: Evaluation of an anatomy blended course for medical students.

BACKGROUND: The COVID-19 pandemic has prompted a need to change traditional teaching methods. This study was conducted to evaluate the educational quality of a blended anatomy course and measure student satisfaction and knowledge after completing the course. MATERIALS AND METHODS: Tyler's model was used to develop a new blended curriculum. The study guide for this curriculum was also developed using Association for Medical Education in Europe guide no. 16. A quasi-experimental study compared educational quality, students' satisfaction, and students' satisfaction using Students' Evaluations of Educational Quality (SEEQ), Borim Nejad's satisfaction survey, and multiple choice questions, respectively. Independent t-tests and Chi-square were used to compare the groups. RESULTS: A total of 122 students participated in this study, 62 and 60 in the intervention and control groups, respectively. The satisfaction score was significantly higher in the intervention group than in the control group (40.6 versus 38.6, P value = 0.03). The score of SEEQ was not significantly different (91.9 versus 91.08, P value = 0.52), but the subscales of learning (17.23 versus 16.32, P = 0.01), group interaction (16.87 versus 18.1, P = 0.01), and breadth (17.73 versus 16.65, P = 0.02) were significant. The knowledge score was also significantly higher in the intervention group than in the control group (18.13 versus 16.68, P value < 0.001). CONCLUSION: Using blended learning approaches for anatomy courses can increase students' satisfaction, improve the learning and breadth of educational quality subscales, but worsen group interaction. Although this study shows improvement in medical students' knowledge, further studies are needed because of the limitations of this study.

Development of a Web-Based Virtual Simulated Learning Environment for Pharmacy Practice Education.

Objective: In the present study, we aimed to develop a virtual simulation that allows pharmacy students to play through actual prescriptions and pharmacy practice scenarios productively and on a personal computer. If designed properly, this program may serve as a supplementary educational tool without the need for an existing human tutor that could provide learning outcomes as good as those resulting from traditional paper-based pharmacy practice tutorials. Methods: A computer-based simulation of a community pharmacy was developed. This program mainly targeted three basic learning needs of pharmacy students: drug dispensing, patient counseling, and dealing with clinical situations related to the patients' prescription or demand for over-the-counter (OTC) recommendations. Fundamental design decisions were based on breaking down the dispensing process into logical components to provide discrete development elements. For teaching patient counseling and clinical skills, instructors wrote scenarios covering the most prevalent pharmacy practice issues, mainly focused on medication use during pregnancy or lactation, OTC recommendations, information related to drug interactions and adverse drug reactions, and interactions between prescription drugs and patient's underlying disease. Findings: Based on the primary curriculum topics, the development team designed exercises for pharmacy practice units presented to year 5 pharmacy students. Accordingly, exercises were developed to authentically reflect tasks and challenges a community pharmacist would regularly face in the workplace. To fulfill this part, over 2000 real prescriptions were scanned and categorized based on the main drugs included. These prescriptions were used for both activities, namely medication dispensing and clinical scenarios. Furthermore, five senior pharmacy students wrote more than 200 clinical scenarios under a clinical pharmacist's supervision. The main objectives of pharmacy practice courses were followed to cover the most important must-to-know clinical tips, whether related to giving relevant advice as an OTC recommendation, referring the patient to a primary care physician, or just providing a piece of general health advice, which is expected to be comprehensively learned by pharmacy students. Conclusion: This program was designed as a simulated learning environment to help students develop prescription dispensing and clinical skills. To be considered a success, this simulation needed to provide equivalent or better learning outcomes than the current practice approach, which should be assessed in the future evaluation of the software, and then be promoted accordingly.

Hypophosphatemia in Coronavirus Disease 2019 (COVID-19), Complications, and Considerations: A Systematic Review.

Coronavirus disease 2019 (COVID-19) has various manifestations on different body organs, including the lungs, heart, kidneys, and central nervous system. However, the frequency of electrolyte abnormalities, especially hypophosphatemia, is still debated in this pandemic. Our main aim in this review is to evaluate the frequency and complications of hypophosphatemia in COVID-19-infected individuals. A systematic literature review was performed in Web of Science, Scopus, PubMed, EMBASE, and Cochrane electronic databases with the combination of different keywords till October 2021. We recruited all relevant published records (including cross-sectional and case-control studies as well as editorials and brief reports) assessing hypophosphatemia among patients with COVID-19 infection. After assessing all 928 recruited records and discarding duplicates, 4 records met the inclusion criteria. Three articles were further included during a manual search of the literature. Overall, the included studies reported 1757 subjects (males: 51.3%), with the mean age ranging from 37.2 ± 13.6 years to 65.9 ± 13.9 years. Hypophosphatemia prevalence has been reported from 7.6% to 19.5%. Patients with the severe status of COVID-19 had a higher prevalence of low serum phosphate levels than those with moderate infection. This review indicates that hypophosphatemia might be categorized as a complication in clinical settings during the COVID-19 pandemic, requiring a high clinical suspicion to implement appropriate diagnostic and therapeutic interventions to prevent life-threatening outcomes. However, it needs to be more elucidated by further studies whether hypophosphatemia in severe COVID-19 is directly related to COVID-19 or is just a complication of severe illness.

A narrative review of psychomotor abilities in medical sciences: Definition, categorization, tests, and training.

Extensive research in the past decades has evidenced differences in the psychomotor ability of individuals resulting from varying levels of experience, age, gender, response precision, compatibility, performance, and ability. Many studies have called for the need to identify psychomotor ability and appropriate tests that can assess it. This review article surveys the definition, categorization, and tests of psychomotor ability as well as training based on psychomotor ability in medical sciences. We searched the literature with no time limit, using the ProQuest, PubMed, and Eric databases, as well as the Google Scholar search engine. The keywords for the search involved psychomotor, psychomotor performance, assessment, psychomotor ability, motor learning, education, training, psychomotor ability testing, and psychomotor skills. Other relevant papers found through hand searching and snowballing were also included in the review. The EndNote X8 was employed as a reference manager tool. Only abstracts of the papers whose full texts were accessible were reviewed after repetitious papers were excluded. The documents were categorized into five groups: definition of psychomotor skills and ability, psychomotor ability components, psychomotor ability tests, identification of psychomotor ability (task analysis), and training. This review article revealed that there is not a single definition for psychomotor ability and its components. However, it can be said that motor abilities are the foundation for the rapid acquisition of skills and according to the neuroplasticity process are learned through training and practice. Given psychomotor abilities vary among individuals, training courses should also provide different levels of psychomotor training for learners. The literature introduces psychomotor tests as a selection tool, a predictor of future professional behavior, and a means to evaluate progress in performance, academic guidance (ability-oriented medical specialty), and curriculum implementation tailored to the needs of learners of varying graduate disciplines. The tests should be profession-specific because each profession entails its peculiar characteristics and abilities. On the other hand, the major problem in studying and analyzing underlying psychomotor skills and abilities is that the components are being investigated by researchers from varying, and usually unrelated, scientific fields. Therefore, it is necessary to have a holistic view through close interaction between the researchers of different sciences to better understand this area.

Effect of sense of coherence on oral health behavior and status: A systematic review and meta-analysis.

The sense of coherence (SOC) is defined as a personal orientation to life. People with higher SOC are better at dealing with stressful situations, psychological stress, and problems and are more able to manage them, leading to better general health. The purpose of this study was to evaluate the effect of SOC on the oral health status of people in different age groups. A systematic search up to May 2019 was carried out in PubMed,Scopus, Psycho info, and Persian sources. Studies were included if they evaluated the relationship between SOC and oral health behaviors (OHBs) or oral health status including dental caries. The Newcastle-Ottawa checklist was used to appraise the selected articles and meta-analysis of included studies were performed using Comprehensive Meta-Analysis software. Value of P < 0.05 was considered to be statistically significant. Odds ratio (OR) was used to measure effect size with 95% confidence interval (CI). The random-effects model was chosen in the presence of heterogenicity. I 2 index and Q index were used to measure the heterogeneity present between the studies. Fifteen articles received the minimum score of criticism. In general, SOC could significantly affect the oral health and OHBs of adults independently of the underlying factors. There was a significant relationship between SOC and tooth decay in adolescents, but this association was poor after adjusting for the underlying factors. In children, only one article revealed an association with OHBs. Meta-analysis revealed that SOC was significantly associated with the caries rate (OR = 0.78, CI 95% = 0.9-0.67, P = 0.001) and tooth brushing frequency (OR = 1.22, CI 95% = 1.1-1.31 and P < 0.001). Sense of coherence appears to be one of the effective factors in predicting oral health behaviors and ultimately oral health, especially in adults. The number of articles available for children and adolescents was not sufficient in this regard.

Psychomotor abilities in diagnostic upper gastrointestinal endoscopy derived from procedural task analysis techniques and expert review.

BACKGROUND: Any prediction of a person's ability to succeed in a motor skill depends on the detection and accurate measurement of the basic abilities for the performance of that skill. Task analysis is needed to determine the psychomotor skills and abilities required to perform an action. This study aimed to determine the components of psychomotor abilities for diagnostic upper gastrointestinal (GI) endoscopy through procedural task analysis (PTA) and expert review. MATERIAL AND METHODS: A multisource, multimethod task analysis was conducted in six metropolitan teaching hospitals affiliated with the adult gastroenterology and hepatology training centers in the Islamic Republic of Iran in 2019. Observation, video-recording, and think-aloud protocols were used while diagnostic upper GI endoscopy was performed. To confirm the accuracy of the PTA, the incorporated the views of the adult gastroenterology and hepatology subspecialty experts through the checklist of PTA assessment criteria. Finally, to determine the psychomotor abilities for each stage of the procedure, the study incorporated a panel of experts from occupational therapy, physical education, physical medicine, and adult gastroenterology and hepatology subspecialty. RESULTS: Of the 15 psychomotor abilities examined, 11 were determined for upper GI endoscopy procedure, of which six cases (including visuospatial and perceptual abilities, hand-eye coordination, multilimb coordination, finger dexterity, arm-hand steadiness, and manual dexterity) were the most frequent. CONCLUSIONS: PTA techniques and subsequent expert review were used to identify the components of psychomotor abilities for diagnostic upper GI endoscopy. It is suggested that PTA is performed for other procedures, and after psychomotor abilities are specified, proportional tests are developed.

The relationship between emotional intelligence, social responsibility, and job performance in health service providers.

BACKGROUND: Responsibility of individuals in adapting to life events depends on the intertwined cooperation of intellectual and emotional capacities, and a person's success in life depends on his emotional responses. Given that health-care providers are at the forefront of providing health services, they need to improve their job performance with better control of their emotions and better social relationships. The aim of this study was to determine the relationship between emotional intelligence, social responsibility, and job performance in health-care providers and caregivers. MATERIALS AND METHODS: A cross-sectional correlational study was performed on 270 health workers working in the western cities of Isfahan province in the first quarter of 1998 by random classification sampling method. To collect information, two questionnaires of Bradbury emotional intelligence, responsibility, social responsibility, whose validity and reliability had been proven in previous studies, and job performance scores of the samples were used. The collected data were analyzed using descriptive tests and Pearson correlation. RESULTS: The participants were 270 health workers and caregivers with a mean age of 34.54 ± 7.26. 87.5% of the samples were female and 21.5% were male. The mean score of social responsibility was 124.95 ± 10.41, the mean score of emotional intelligence was 125.58 ± 15.86, and the mean score of job performance was 86.91 ± 9.0.18. The results of Pearson correlation showed that all four components of social responsibility and total emotional intelligence have a significant correlation at the level of 0.01. Total emotional intelligence and each of its components did not show a significant correlation with job performance. Between social responsibility and job performance of health workers, only the moral component significantly predicts job performance (r = 0.133 and P = 0.026). CONCLUSION: Although the results of the study showed that the job performance, social responsibility, and emotional intelligence of the study group were desirable, the score of some components of social responsibility and emotional intelligence is lower than their maximum score. In addition, according to the results of the study that showed the relationship between emotional intelligence and social responsibility and some of their components with job performance, improving the knowledge and skills of health-care providers and caregivers in the field of social responsibility and emotional intelligence and their components seems necessary.

Statistical Learning in Late Talkers and Normal Peers.

BACKGROUND: Late talkers (LTs) are children under three with poor vocabularies and no developmental problems. Statistical learning (SL) is defined as processing or learning patterns of environmental stimuli, for example, spoken language, music, or motor, that will unfold in time. We hypothesize if some LTs outgrow as developmental language disorder, they might be identified using SL tasks at the onset. We aimed to find any correlation between language measures and SL outcomes in LTs and normal children (NC). MATERIALS AND METHODS: Sixteen pairs of LTs and NCs were recruited using a convenient sampling method from day-care centers and speech therapy clinics of the Comprehensive Center for Child Development in Isfahan city, Iran. Visual sequences presented using Habit software version 2.2.4. Children's eye movements to visual sequences were monitored, and their reaction times and the number of anticipatory looks were analyzed offline. The language measures were determined in the free-play context. RESULTS: Results indicated no significant correlation between SL and language measures and no difference observed in SL between the groups (P = 0.73). CONCLUSIONS: The results may refer to no overt correlation between SL and delayed overall linguistic measures along with inadequate samples, children's fatigue, or insufficiency of the visual task in presenting SL.

Quality of training in oral health educational programs: What do primary healthcare providers think?

INTRODUCTION: Due to changes in scientific findings and assigned tasks, continuing education and other enabling programs are increasingly critical for primary healthcare providers to keep them up-to-date in delivering oral health services. Planning these educational courses based on actual PHCPs' needs is fundamental to provide effective ones. The purpose of this study was to elucidate the experiences and needs of PHCPs regarding the quality of the oral health training provided in continuing education and other enabling courses. SUBJECTS AND METHODS: A qualitative study with content analysis approach was conducted in Najaf-Abad, Isfahan, Iran, in 2017. Data were gathered through in-depth semi-structured interviews with 19 primary healthcare providers. The sampling was started with purposeful method and continued through snowball method. Qualitative data were coded and analyzed using MAXQDA (VER 12). RESULTS: Factors affecting the quality of oral health training were categorized into three themes and nine subthemes, including instructor's related factors (knowledge, skills, and relevant experiences), educational content (content relevance, content innovation, and content update), and teaching methods and educational tools (fitting educational contents, covering learners' needs, and considering available possibilities). CONCLUSION: Instructors with inadequate level of knowledge, skills, and relevant experiences as well as inappropriate selection of educational content, teaching methods, and educational tools, were recognized as affecting factors on the quality of oral health training and effectiveness of continuous education and enabling programs.

The Correlation between Psychological Empowerment and Job Burnout in Midwives Working in the Labor Ward of Hospitals.

BACKGROUND: Job Burnout (JB) is a multifactorial psycho-cognitive syndrome that leads to physical and psychological problems and declines the efficiency and productivity. Psychological Empowerment (PE) indicates that an individual feels motivated and competent to fulfill work expectations actively. This study assessed the correlation between PE and JB in midwives. MATERIALS AND METHODS: This cross-sectional correlational study was conducted on 282 midwives working in labor wards of hospitals in Isfahan (Iran). Convenience sampling was used. Psychological Empowerment Questionnaire (PEQ) with four domains (meaning, competence, autonomy, and impact) and Maslach Burnout Inventory (MBI) with three domains (emotional exhaustion, depersonalization, and personal accomplishment) were used. Partial correlation and regression analysis were used to analyze the data. p < 0.05 was considered significant. RESULTS: None of the demographic variables had a significant association with PE and JB. There were no significant correlations between the total scores of PE and three domains of JB. However, personal accomplishment was positively correlated with the domains of meaning and competence (r = 0.16, p = 0.02; r = 0.27, p < 0.001, respectively). Autonomy was the only significant predictive variable for emotional exhaustion and depersonalization, respectively (ß =0.17, t235=2.34, p = 0.020, ß =0.09, t249=1.29, p = 0.020); also, competency was the only significant predictive variable for personal accomplishment (ß = 0.29, t263=4.20, p < 0.001). The domains of PE were significant predictors of variance of JB in personal accomplishment domain (R2 = 0.10, F6=4.85, p < 0.001). CONCLUSIONS: Meaning and competence could be promoted through attendance in continuous training programs to increase personal accomplishment. In addition, it is suggested to promote midwives' authority to decline their emotional exhaustion and depersonalization.

Association between health literacy with knowledge, attitude, and performance of health-care providers in applying health literacy education strategies for health education delivery.

BACKGROUND AND AIM: Recognized as one of the key elements of growth and development, education is an important strategy for successful provision of services in all social dimensions. Moreover, it is categorized among empowerment tools to achieve goals. In the field of health, health education encourages people to be healthy. This study aimed to evaluate the health literacy of health-care providers and its relationship with strategies of using health literacy in the provision of health education. MATERIALS AND METHODS: This cross-section correlational study was carried out on a group of health-care providers in Isfahan, Iran, in the second trimester of the Persian year 1397 (2018). Participants were selected by multistage sampling, for which two questionnaires of Test of Functional Health Literacy in Adults and inventory of strategies of using health literacy in education were applied. The validity and reliability of the research tools were formerly approved. In addition, data analysis was performed in SPSS version 21 using Pearson's correlation coefficient and linear regression model. RESULTS: In total, 230 participants with a mean age of 34.32 ± 7.71 years were entered into the study, 92.9% of whom were female and 7.1% were male. The mean health literacy score of the participants was 79.60 ± 12.41. In the sections of knowledge, attitude, and performance were related to the use of health literacy education strategies, and we obtained the means 5.20 ± 1.94, 43.11 ± 4.11, and 28.96 ± 6.73, respectively. Moreover, Pearson's results were indicative of a significant relationship between health literacy of health-care providers and knowledge (r = 0.245; P < 0.05) and performance (r = 0.208. P < 0.05) regarding the use of education strategies. However, no significant association was found between health literacy of health-care providers and attitude toward the use of health literacy education strategies (r = 0.081; P = 0.225). DISCUSSION AND CONCLUSION: While the results showed that 75% of health-care providers had a favorable level of health literacy, and despite the proper attitude toward the use of health literacy education strategies, the knowledge and performance of the participants were estimated at < 60% in this regard. It is suggested that the potential of health-care providers in terms of achieving, processing, and perceiving health-related information and fundamental services be improved to enhance their knowledge and performance regarding the use of health literacy education strategies.

Improving menopausal symptoms and reducing depression in postmenopausal women: Effectiveness of transferring experiences in group education.

INTRODUCTION: One of the most critical stages of women's lives is menopause. Meanwhile, group training can have a significant effect on reducing menopausal symptoms. The aim of this study was to investigate the effectiveness of group training on reducing menopausal symptoms in postmenopausal women. METHODS: This study was a randomized controlled trial. The study population was 96 postmenopausal women visiting health centers in the city of Shazand (Markazi Province, Iran). Data collection tools in this study were the Menopausal Rating Scale Questionnaire and the Beck Depression Inventory. Group training intervention consisted of four training sessions. The duration of each session was 2 h. The questionnaires were completed in two stages of pre- and post-test (8 weeks later) for the intervention and control groups. Data were analyzed using descriptive statistics (absolute and relative frequency, mean and standard deviation) and analytical statistics (independent t-test, paired t-test, and analysis of covariance). RESULTS: The mean age in the intervention group and the control group was 49.93 ± 3.44 and 51.66 ± 2.93 years, respectively. In the intervention group, the mean menstrual time was 2.37 ± 167 years and in the control group, the mean time elapsed from the last menstrual period was 3.91 ± 2.68 years. The mean scores of menopausal physical symptoms (F = 58.69), menopausal symptoms (F = 43.45), menopausal urinary and genital symptoms (F = 33.50), and depression (F = 58.25) had a significant decrease in intervention group, while in the control group, these changes were not significant (P < 0.001). CONCLUSION: Regarding the findings of this study, which indicates the effect of group training program on the improvement of physical, psychological, urinary and genital symptoms, and menopausal depression, it seems that group training in menopause can be an effective method.

Effects of somatostatin analog treatment on cardiovascular parameters in patients with acromegaly: A systematic review.

BACKGROUND: There is a belief that in patients with acromegaly, first-generation somatostatin analogs (SSAs) might improve cardiovascular (CV) structure and function. However, most published clinical trials involved only a few patients and their results are rather variable. We aimed to conduct a systematic review on available studies on the impact of these drugs on CV parameters. MATERIALS AND METHODS: A literature search was conducted in MEDLINE (OVID), EMBase, Cochrane, and ISI Web of Science for citations published until April 30 2018 to identify studies on our objective that considered changes in CV parameters. For this search, we established a Boolean search strategy using keywords related to "acromegaly," "Somatostatin analog," and "cardiovascular diseases and parameters." All study types except for case reports or conference abstracts were included. Twenty-four studies (n = 558) fulfilled the inclusion criteria and were selected for final analysis. RESULTS: In 12 studies (n = 350), decrease in heart rate (HR) and in 4 studies (n = 128), decrease in blood pressure (BP) was significant. In 15 studies (n = 320), left ventricular mass index (LVMi) changes were significant. In 9 studies (n = 202), the early diastole to peak velocity flow in late diastole (E/A ratio) was evaluated, and in 5 of them (n = 141), the improvement was significant. Eighteen studies (n = 366) examined changes in left ventricular ejection fraction (LVEF), 5 of which (n = 171) reported that these changes were significant. Decrease of left ventricular end-diastolic diameter was reported in only 2 studies (n = 27). CONCLUSION: We found that first-generation SSAs have a beneficial effect on cardiac parameters such as HR and LVMi. For other parameters such as LVEF, BP, LV diameter, and E/A ratio, we were not able to draw a firm conclusion.

Barriers to medication adherence in patients with hypertension: A qualitative study.

INTRODUCTION: Barriers to medication adherence in patients with hypertension can have significant differences that made researchers confute to conclude that medication adherence is required to be more explored, and then, beneficial interventions develop to decrease these barriers. Thus, the current study was aimed to identify barriers to adherence in Iranian society. MATERIALS AND METHODS: A qualitative content analysis was carried out. Participants were as follow: Patients with hypertension who had clinic records in the health centers of Isfahan University of Medical Science. Purposive sampling method was conducted and continued until data saturation, as well. Semi-structured interview was selected as the best-qualified technique to select data. Data were analyzed using qualitative content, constant comparative analysis, and MAXQDA (Ver 10) software. RESULTS: After study and separation of basic concepts, 1620 basic codes were extracted from interviews. Classes were made based on codes and after multiple reviews, summarizing as well as similarity. Primary themes were identified using more explorations and comparison of classes. Based on the nature, the conceptual themes were named. These themes include (1) environmental challenges of life, (2) incompatibility of patients; (3) forget to take medicine, and (4) inefficient recommendations of family. CONCLUSION: Findings revealed that barriers to patient adherence to the treatment had four dimensions that may be likely useful for managers and planners in the health field to plan and intervene regarding medication adherence as the most critical preventing factor for patients with hypertension.

Prevalence of orthodontic treatment need in permanent dentition of Iranian population: A systematic review and meta-analysis of observational studies.

BACKGROUND: Malocclusion is a common oral health problem and can affect the psychosocial well-being in the long term. Therefore, in the recent decades, demand for orthodontic treatment to correct malocclusion has greatly increased worldwide. This systematic review and meta-analysis was undertaken to assess existing evidence on the prevalence of orthodontic treatment need in Iran. MATERIALS AND METHODS: National and international databases were searched for articles on the prevalence of orthodontic treatment need using index of orthodontic treatment need (IOTN) and dental aesthetic index (DAI). The required data were completed by hand-searching. After applying the inclusion and exclusion criteria, the quality of articles was checked by a professional checklist. Data extraction and meta-analysis were performed. A random effects model was employed, and publication bias was checked. RESULTS: From a total of 443 articles that reported orthodontic treatment need in Iran, 24 articles were included in the meta-analysis process. Meta-analysis was performed on components of IOTN and DAI. The pooled prevalence of orthodontic treatment need based on Dental Health Component and Aesthetic Component of IOTN and DAI was 23.8% (19.5%-28.7%), 4.8% (3.3%-7%), and 16.1% (12.3%-20.8%). The results were found to be heterogeneous (P < 0.05). CONCLUSION: The results of this study revealed that orthodontic treatment need was not high in the Iranian population. Considering the differing prevalence of orthodontic treatment need based on normative index and self-perceived index, it is essential to improve the people's awareness of malocclusion and its side effects on their oral and general health.

Prevalence of Malocclusion in Permanent Dentition of Iranian Population: A Review Article.

BACKGROUND: The aim of this study was systematic review and meta-analysis of prevalence in current and relevant literature about this developmental disorder to present the profile of malocclusion in Iran. METHODS: This review study was carried out with systematically identified and critically assessed studies reporting malocclusion prevalence among Iranian population in permanent dentition. National and international databases were searched for articles about prevalence of malocclusion by Angle classification in different regions of Iran from 1994 to 2015. After applying inclusion and exclusion criteria, the quality of articles was checked by professional checklist. Data extraction and meta-analysis was performed. A random-effect model was employed. Publication bias was checked. RESULTS: Of 2768 articles, 21 cases were included. The pooled prevalence of malocclusion was about 87% (95% CI: 78.3-92.2) in Iranian population; however, the prevalence of malocclusion across individual studies varied considerably (ranging from 23.7% to 99.7%). Prevalence of normal occlusion, class I, II and III malocclusion were reported as 13.3% (CI 95%: 7.8-21.7), 50.7% (CI 95%: 42.9-58.4), 21% (CI 95%: 17.5-25.1), 5.5% (CI 95%: 3-10); respectively. Maximum prevalence of malocclusion was in the East of Iran. CONCLUSION: The results showed a high prevalence of malocclusion in Iranian population. The baseline information could be appropriately utilized for the future planning to meet the orthodontic treatment need among the Iranian population.

Impact of Orthognathic Surgery on Quality of Life in Patients with Dentofacial Deformities.

The aim of this investigation was to determine the impact of orthognathic surgery on quality of life in patients with dentofacial deformities at immediate presurgery and at 3-week, 3-month, and 6-month intervals following the surgery. Subjects included forty-three 18-40-year-old Iranian orthognathic patients who were referred to private offices in Isfahan. Data collection was performed using the 22-item Orthognathic Quality of Life Questionnaire (OQLQ). Participants completed the questionnaire prior to surgery and 3 weeks, 3 months, and 6 months after it. Differences and correlations were calculated by the two-tailed t-test, ANOVA with Repeated Measure test, and the Pearson correlation coefficient. The results showed significant reduction returned to baseline in OQLQ mean scores and aesthetic, awareness, and social subdomains in all 3 intervals after surgery. However oral function domain showed an increase at T2 and then a decrease at next intervals. Maximum and minimum effect size were observed in aesthetic (ES = 0.7) and oral function (ES = 0.3) domain, respectively. Based on the finding of this study, in 6-month interval after surgery, orthognathic surgery causes significant improvements in quality of life in patients with dentofacial deformities as assessed in emotional, psychological, oral function, and social domains and maximum changes occurred in emotional domain.