Factors Associated with Musculoskeletal Pain Among Music Students in Iran.

BACKGROUND: Playing-related musculoskeletal pain is common among music students. We aimed to assess the prevalence of musculoskeletal pain and the factors associated with the presence of musculoskeletal pain among music students in public music conservatories in Tehran, Iran. METHODS: Participants included 383 music students, age 12-18 years, from Tehran, Iran. A cross-sectional study was performed from October to November 2021 through convenience sampling. Demographic characteristics and musculoskeletal pain were collected using a self-report questionnaire, the Numerical Rating Scale, and the Nordic Body Map questionnaire, respectively. Postural behavior of participants was assessed using the Rapid Entire Body Assessment checklist. RESULTS: In the convenience sample, 59.3% of music students reported at least one symptomatic musculoskeletal pain in the last week. Female gender (OR 2.34, 95% C:1.37-3.99, p<0.001), age (OR 1.66, 95% C:1.08-2.54, p<0.001), postural behavior (OR 1.07, 95% CI 0.81-1.39, p<0.001), and duration of playing (OR 0.97, 95% CI 0.95-0.99, p<0.001) were significantly associated with the playing-related musculoskeletal pain. History of playing and instrument type had no relationship to pain. DISCUSSION: The main risk factors associated with playing-related musculoskeletal pain in music students were the participants' characteristics (female gender and age), postural behavior, and playing duration. The findings support the need to design educational programs for music students in order to prevent playing-related musculoskeletal pain.

Treatment of low back pain: Second extended follow up of an original trial (NCT00600197) comparing a multidisciplinary group-based rehabilitation program with oral drug treatment alone up to 30 months.

BACKGROUND: The aim of this study is to investigate the effects of the extended 30-month follow-up of an original trial (NCT00600197) which has been published in the Clinical Journal of Pain. METHODS: Seventy-four percent (146/197) of the participants who had taken part in the original study, including 69 patients in the intervention group and 77 patients in the control group, were followed up to 30 months after intervention. The intervention group continued receiving monthly motivational consultation and booster classes plus oral medication but the other group received just medication. Data on measures from the Short Form 36 (SF-36), Quebec Disability Scale (QDS) and Ronald Morris Disability Questionnaire (RDQ) were collected at 3-, 6-, 12-, 18-, 24- and 30-month follow-ups and analyzed through repeated measures analysis of variance. RESULTS: The two groups were comparable regarding all baseline characteristics (P > 0.05) except for education level and mental health, which were better in the intervention group (P < 0.05). The two groups improved regarding all studied variables over time up to 30 months (P < 0.001). Moreover, the intervention group in comparison with the control group had consistently better outcomes regarding all variables. There were significant differences within each group by time in terms of mental health (P = 0.01) and disability measured through QDS (P = 0.005) and RDQ (P = 0.014). CONCLUSION: The proposed multidisciplinary program could improve mental health and disability up to 30 months in chronic low back pain patients.

Promoting sexual abstinence intention among female university students: A quasi-experimental study.

BACKGROUND: The effectiveness of a theory-based educational intervention on intension for sexual abstinence among female university students was evaluated. MATERIALS AND METHODS: Female students were recruited from humanity sciences department through cluster sampling. Educational intervention was applied for four 90-min sessions and by application of cognitive theories during 4 weeks. RESULTS: One hundred and nine female students with mean age of 20.74 ± 1.57 years took part in the study. Despite the similarity of two groups of intervention (n = 53) and control (n = 59) at baseline, there were significant differences between the two groups in mean scores of the variables, knowledge (4.62 ± 1.38 vs. 3.53 ± 1.61), perceived susceptibility (14.05 ± 1.51 vs. 12.37 ± 2.11), and perceived benefits (28.41 ± 2.14 vs. 27.51 ± 3.05), at follow-up time after 3 months (P < 0.05). Additionally, these variables were observed with improvement over 3 months in the intervention group (P < 0.05). However, this study showed no significant effect on the behavior intention and self-efficacy. CONCLUSION: This study showed that educational intervention could improve knowledge, perceived benefits, and self-efficacy of the female students regarding HIV/AIDS.

A qualitative evaluation of men living with HIV: views on condom use.

BACKGROUND: Unprotected sexual activity is an important reason for the currently growing incidence of HIV infection in Iran. Recognizing barriers to safe sexual practice and affordance of behavioral changes can improve planning for condom promotion. The main objective of our study is to evaluate the opinions of HIV-positive men on condom use. METHODS: Our study was performed at three behavioral disease consultation clinics (HIV care clinics) in Tehran, Iran. Participants were initially selected among HIV-positive male patients by convenience sampling and narrowed-down by maximum diversity sampling in order to obtain the number of patients that would express various viewpoints regarding barriers and benefits to condom use. Data were collected using in-depth semi-structured individual interviews. All interviews were recorded and transcribed, and the codes were extracted after reviewing them several times. RESULTS: In this study, 22 HIV-positive men with a mean age of 37.5 ± 7.3 years were interviewed. Participants mentioned the prevention of HIV and sexually transmitted diseases as a benefit of condom use. However, most named decreased sexual satisfaction as the most important reason for not using condom. Because of decreased sexual satisfaction and unpleasantness, 9% of participants had not used condom during sexual intercourse. CONCLUSION: The most important reason for not using condom was decreased sexual satisfaction. This study has indicated a need for consultations with HIV-positive and at risk populations to change their attitudes towards condom use and demonstrate the advantages of condom. To achieve this, government programs and media should be utilized.

Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran.

BACKGROUND: People living with HIV (PLHIV) sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran. METHODS: In-depth, semi-structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach. RESULTS AND DISCUSSION: Nearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value-based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1) refusal of care; (2) sub-optimal care; (3) excessive precautions and physical distancing; and (4) humiliation and blaming. The participants' healthcare-seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress. CONCLUSIONS: While previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will lead to stigma reduction. National policies to strengthen medical training and to provide funding for stigma-reduction programming are strongly recommended. Investigating Islamic literature and instruction, as well as requesting official public statements from religious leaders regarding stigma and discrimination in healthcare settings, should be used in educational intervention programmes targeting healthcare providers. Finally, further studies are needed to investigate the role of the physician and religion in the local context.