Evaluate the Effectiveness of a Group Psychoeducational Intervention in Reducing the Level of Cancer-Related Fatigue in Women Receiving Chemotherapy for Breast Cancer: A Randomized Controlled Trial.

Background: One of the most debilitating symptoms in breast cancer survivors is cancer-related fatigue (CRF). CRF weakens patients' physical, cognitive, and occupational functions. It is associated with poorer quality of life and may reduce recurrence-free and overall survival. This study aimed to evaluate the efficacy of a group psychoeducational intervention in improving CRF in breast cancer patients. Materials and Methods: Fifty breast cancer patients who suffered from CRF were randomly assigned to receive a group psychoeducational intervention or control group. This study was designed as an eight weeks clinical trial. The psychoeducational intervention mainly consisted of concentrative movement therapy and energy conservation strategies. Primary outcome measures were the changes in the Fatigue Visual Analogue scale, Cancer Fatigue scale, and Piper Fatigue scale at the study endpoint. Measure assessments were made on four occasions: at baseline, after the intervention, one week, and four weeks post intervention. Statistical analysis was performed using SPSS26. Results: The intervention improved CRF significantly (P < 0.001). All subscales of the Cancer Fatigue scale and the sensory, affective, and cognitive subscales of the Piper Fatigue scale showed statistically significant effects (P < 0.001) at all time points. However, the behavioral subscale of the Piper Fatigue scale was different only at the end of the study (P < 0.001). Conclusions: The group psychoeducational intervention improved CRF significantly. All the sensory, behavioral, physical, affective, and cognitive subscales improved. Accessible and confirmatory treatment can help patients to cope with fatigue in communities.

Systematic review and meta-analysis of maternal mortality ratio and related factors in the Islamic Republic of Iran.

Background: Maternal mortality is an indication of the health status of women in the society. Aims: To investigate the maternal mortality ratio, causes of maternal mortality, and related risk factors among Iranian women. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and the Peer Review of Electronic Search Strategies (PRESS) guideline, we systematically searched electronic databases, and the grey literature, for publications in Farsi and English from 1970 to January 2022 for studies that reported the number of maternal deaths and/or maternal mortality ratio and their related factors. Data analysis was conducted using Stata 16 and 2-sided P ≤ 0.05 was considered statistically significant, if not otherwise specified. Results: A subgroup meta-analysis of studies conducted since 2000 estimated the maternal mortality ratio as 45.03 per 100 000 births during 2000-2004, 36.05 during 2005-2009, and 23.71 after 2010. The most frequent risk factors for maternal mortality were caesarean section, poor antenatal and delivery care, unskilled birth attendance, age, low maternal education level, lower human development index, and residence in rural or remote areas. Conclusion: There has been a significant decrease in maternal mortality in the Islamic Republic of Iran during the last few decades. Mothers in the country need to be monitored more carefully by trained healthcare workers during the pregnancy, delivery and postpartum periods so they can effectively handle postpartum complications, such as haemorrhage and infection, thereby further reducing maternal mortality.

Social media and mental health in students: a cross-sectional study during the Covid-19 pandemic.

BACKGROUND: Social media causes increased use and problems due to their attractions. Hence, it can affect mental health, especially in students. The present study was conducted with the aim of determining the relationship between the use of social media and the mental health of students. MATERIALS AND METHODS: The current cross-sectional study was conducted in 2021 on 781 university students in Lorestan province, who were selected by the Convenience Sampling method. The data was collected using a questionnaire on demographic characteristics, social media, problematic use of social media, and mental health (DASS-21). Data were analyzed in SPSS-26 software. RESULTS: Shows that marital status, major, and household income are significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Also, problematic use of social media (ß = 3.54, 95% CI: (3.23, 3.85)) was significantly associated with higher mental health scores (a higher DASS21 score means worse mental health status). Income and social media use (ß = 1.02, 95% CI: 0.78, 1.25) were significantly associated with higher DASS21 scores (a higher DASS21 score means worse mental health status). Major was significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). CONCLUSION: This study indicated that social media had a direct relationship with mental health. Despite the large amount of evidence suggesting that social media harms mental health, more research is still necessary to determine the cause and how social media can be used without harmful effects.

Comparing depression, anxiety, and quality of life in individuals with cardiac and non-cardiac chest pain.

Background: Psychological factors are often overlooked as potential contributors to cardiovascular disease. This study aimed to investigate the relationship between depression, anxiety, and quality of life with chest pain origin. Method: This cross-sectional study was performed from 2019 to 2020 and included participants from multiple medical centers across Shahrekord, Iran. Participants were recruited through advertisements in medical centers. Participants were divided into three groups: healthy control (n = 67), chest pain with cardiac origin (CCP) (n = 70), and chest pain with non-cardiac origin (NCCP) (n = 73). Data were collected using the Beck's Anxiety scale, Beck's Depression scale, and Short-Form Health Survey questionnaires. The chi-square, exact test, t-test, Kruskal-Wallis, and logistic regression models were used for statistical analysis. All analysis was performed using SPSS 26. Results: The mean scores of depression and anxiety in the NCCP group (depression = 17.03 ± 11.93, anxiety = 17.18 ± 11.37) were significantly higher than those in the CCP (depression = 9.73 ± 5.76, anxiety = 8.77 ± 5.96) and healthy (depression = 7.00 ± 7.61, anxiety = 6.18 ± 7.63) groups (p < 0.05). The mean score of quality of life in the NCCP group (54.87 ± 12.66) was significantly lower than that in the CCP (76.31 ± 12.49) and healthy (80.94 ± 15.78) groups (p < 0.05). Patients with NCCP had higher odds of having depression (adjusted OR = 4.39, 95% CI: 1.25, 15.35) and lower odds for having mental quality of life scores than the CCP and health groups, respectively (adjusted OR = 0.90, 95% CI: 0.87, 0.94). Conclusion: Our findings suggest that collaboration between psychiatrists and other specialists may be necessary to improve patients' health conditions and quality of life.

Trends in the Incidence Rates of Breast and Gynecological Cancers in Asia from 1998-2012: An Ecological Study.

BACKGROUND: There is limited evidence on the epidemiology and time trend analysis of incidence rates of gynecological cancer in Asia as a whole. We conducted this study to demonstrate breast and gynecological cancers incidence and trends in selected Asian populations. METHODS: We conducted this ecological study using cancer and population data from cancer incidence in five continents (CI5). We extracted the data of breast, uterine, cervix and ovary cancers in selected Asian populations from 1998 to 2012 from CI5plus. We used Joinpoint regression model (version 4.8.0.1) to evaluate the annual percentage change (APC), which characterizes trends in cancer rates over time, and the average annual percent changes (AAPCs), which describes the average APCs over a period of multiple years. Results were considered statistically significant at P < 0.05. RESULTS: Between breast and gynecological cancers, breast cancer has the highest incidence rates among women in Asia. The time trend of the incidence rates showed a constant growth in breast, ovary and corpus uteri cancers. This rising trend was obviously sharper for uterine cancer (AAPC 95% CI = 3.4 [3.0, 3.7]) followed by breast [AAPC 95% CI = 2.1 (2.0, 2.2)] and ovarian cancers (AAPC 95% CI = 0.5 [-0.4, 1.3]). The age-adjusted incidence rate (ASR) of cervical cancer displayed a declining trend from 1998 to 2012 (AAPC 95% CI = -1.4 [-2.4, -0.5]). CONCLUSION: Incidence rates of breast and gynecological cancers have a rising trend in Asian countries. However, breast and gynecological cancers have different patterns of time trend.

Psychometrics of the Persian version of the COVID-19-related health literacy in the Iranian population.

Background: Since the occurrence of the COVID-19 pandemic, information dissemination has increased rapidly. Promoting health literacy is currently crucial to prepare people to respond quickly to situations, such as the COVID-19 pandemic. Due to the importance of health literacy in this critical situation, we are looking for a questionnaire to measure COVID-19 health literacy. The COVID-19 Germany Health Literacy Questionnaire (HLS-COVID-Q22) is an excellent tool, so the study aimed to create a cultural validity of this questionnaire for the Iranian population. Methods: In this validation study, 880 samples were enrolled using a convenient sampling method. The questionnaire was translated through a backward forwarding procedure. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were employed for Persian version validity. McDonald's omega (Ω), Cronbach's alpha, and average inter-item correlation (AIC) coefficients were assessed for reliability. Results: Using EFA on the random half sample (n = 440), the EFA indicated that the scale had four factors: accessing, understanding, appraising, and applying health-related information in the COVID-19 pandemic context, which explained 59.3% of the total variance. CFA was used for the sample's second part (n = 440) to evaluate the goodness of fit of the four-factor solution. CFA showed the model fit. All indices RMSEA = 0.067, CFI = 0.934, IFI = 0.934, PCFI = 0.772, PNFI = 0.747, and CMIN/DF = 2.972 confirmed the model fit. The convergent validity of the HLS-COVID-Q22 was confirmed. McDonald's omega and Cronbach's alpha were very good (α and Ω >0.80). Conclusion: The Persian version of the HLS-COVID-Q22 had acceptable psychometric properties and is applicable to measure COVID-19 health literacy.

Predictors of Persistence of Anxiety, Hyperarousal Stress, and Resilience During the COVID-19 Epidemic: A National Study in Iran.

Background: The coronavirus pandemic can cause unprecedented global anxiety, and, in contrast, resilience can help the mental health of people in stressful situations. This study aimed to assess anxiety, hyperarousal stress, the resilience of the Iranian population, and their related factors during the coronavirus disease 2019 (COVID-19) epidemic. Methods: A cross-sectional study was conducted in 31 provinces in Iran between March 18 and 25, 2020. A four-part questionnaire, including the demographic information, the State-Trait Anxiety Inventory (STAI-y1-a 20-item standard questionnaire for obvious anxiety), the Connor-Davidson Resilience Scale (CD-RISC-a 25 item standard questionnaire), and the stress hyperarousal subscale from the Impact of Event Scale-Revised (IES-R), was used to collect data. The ordinal multivariable generalized estimating equation (GEE) model was used to identify correlates of the psychological factors mentioned above. The Fisher exact test was used to investigate the relationship between anxiety, stress, resilience, and the COVID-19 outbreak. All analyses were conducted with SPSS 26 and GIS 10.71. Results: The findings show that most people had moderate-to-severe anxiety (80.17%) and a high level of resilience (96.4%) during the COVID-19 epidemic. The majority of participants had a moderate level of stress (58.9%). The lowest and highest prevalences of psychiatric disorders were in Sistan and Baluchestan (3.14 cases per 100,000 people) and Semnan (75.9 cases per 100,000 people) provinces, respectively. Men and unmarried people were the only variables significantly associated with anxiety and resilience. Age, gender, and education were significantly associated with hyperarousal stress. Conclusion: The high and moderate levels of anxiety and stress in Iranians can have negative effects on the well-being and performance of the people and can lead to serious problems. Also, high resilience during negative life events (such as the COVID-19 pandemic) is associated with the well-being in the lives of people. The results of this study can be used in interventions and other psychological studies.

A review of copper concentrations in Iranian populations.

Copper contamination is increasing and can be a threat to human health. This review tries to summarize copper levels measured in humans in Iran. Persian databases such as SID, Magiran, and IranMedex and English databases such as Scopus, Pubmed, Science Direct, and the Google Scholar were searched using both English and Persian keywords. Twenty-six articles that measured the concentration of copper in human samples in Iran were included. According to the results of the reviewed studies, copper levels in some Iranian populations were higher than normal levels. These populations included pregnant women with preeclampsia, patients with oral cancer, patients with Giardiasis infection, patients with Parkinson's, children under the age of 12 years with ß-thalassemia major, pregnant women in the third trimester, and type 2 diabetic patients. Copper levels were less than normal, in patients with tuberculosis after treatment and post-menopausal women with osteopenia and osteoporosis. Also, copper concentrations in patients with tuberculosis, cutaneous leishmaniasis, brucellosis, and molybdenum unit workers were higher, and copper concentrations in patients with Pemphigus vulgaris and coronary artery disease were less than those of their controls, but all were in the normal range (70-140 µg/dL). The amount of copper adsorption in various teeth was different. High levels of copper have been reported in some Iranian populations and this can be a threat to human health. Monitoring copper levels in some Iranian populations is necessary.