Using a participatory approach to encourage uptake of breast, colorectal, and cervical cancer screening for Scottish Muslim women: a pilot qualitative study.

BACKGROUND: Muslim women use cancer screening less often than the general female population, which puts them at risk of delayed detection. We used an asset-based approach to co-design a faith-based intervention to increase uptake of breast, colorectal, and cervical screening in Scottish Muslim women. METHODS: In this pilot qualitative study, we recruited Muslim women (n=28) of Asian and Arab ethnicity, aged 25-74 years, through snowball sampling from community organisations in Glasgow and Edinburgh. Ten of these women participated in four online workshops in February, 2021, with the aim to codesign the intervention, underpinned by the socio-ecological model and the behaviour change wheel. The final intervention included health education delivered by doctors, testimonials by Muslim women sharing experiences of cancer or screening, and the perspective on cancer screening from a female religious scholar. The intervention was delivered to two groups of eight and ten Muslim women respectively, in March 2021. A week later, the 18 women participated in two focus groups to qualitatively evaluate the intervention. Analyses were conducted thematically. FINDINGS: Themes included barriers to screening, acceptability of content and delivery, attitudinal change, and intervention improvement. Participants believed that lack of awareness was an important barrier to screening. They found the intervention informative. They particularly liked the combination of multiple components, including spirituality, culture, and health education. They valued the faith-based element and highlighted how Islam could facilitate overcoming cultural barriers including social stigma, embarrassment, and modesty, although this could vary with different levels of religiosity. Participants also emphasised that faith-based approaches in isolation would not be enough. They appreciated input of trusted sources such as doctors and religious scholars and were especially drawn to personal narratives. Participants expressed preference for face-to-face delivery and advised using translators to overcome language barriers. INTERPRETATION: Barriers to screening are complex. Using faith as an asset, integrated with the socio-ecological model and behaviour change wheel, resulted in a holistic intervention tackling multiple barriers, which appealed to participants. Collaborating with communities and faith leaders can help to develop culturally sensitive interventions that harness positive aspects of faith for better health outcomes. Intervention effectiveness needs more robust investigation, which we are undertaking in a feasibility study with 200 Muslim women in northeast England and Scotland. FUNDING: Scottish Inequalities Fund, the Scottish Government.

Intimate Partner Violence in the Middle East Region: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVE: Intimate partner violence (IPV) is a clinical and social problem globally, especially in the Middle East. This study aimed to analyze the prevalence of IPV and its types against women in the Middle East region. METHOD: PubMed, Scopus, and Web of Science were searched in January 2020. From 1995 to 2020, all studies performed in the Middle East, investigating at least one type of abuse against women and written in English, entered the study. All included studies were appraised using Joanna Briggs Institute Checklist, which was adapted for prevalence studies. The random effect model of meta-analysis was performed using the Mantel-Haenszel method by comprehensive meta-analysis software. Each type of abuse as event rate with 95% CI was calculated for each variable. Heterogeneity was investigated using the I 2 statistic test. RESULTS: Fifty-five studies encompassing 138,692 participants were included in our meta-analysis. The rate of overall abuse was 26.3 (n = 55, 95% CI: [15.8, 40.5], p = .002). The highest rate of abuse in the included studies was reported for psychological abuse 48.6% (n = 46, 95% CI: [39.8, 57.5], p = .758). The rate of abuse for physical, economical, sexual, and injury were 28.4% (n = 53, 95% CI: [22.1, 35.7], p = .0001), 19% (n = 10, 95% CI: [9.8, 33.7], p = .0001), 18.5% (n = 45, 95% CI: [13.6, 24.6], p = .0001), and 18.4% (n = 5, 95% CI: [7.1, 40.2], p = 0.008), respectively. The overall abuse reported by World Health Organization Multi-Country Domestic Violence (DV)Questionnaire was 25.7% (n = 17, 95% CI: [18.4, 34.7], p = .0001). This value was 41.8% (n = 11, 95% CI: [29.7, 55], p = .223) for the Conflict Tactics Scale Questionnaire. CONCLUSION: Although this review highlights the lack of or insufficient IPV data in some contexts and inconsistencies in defining and measuring IPV among studies, the evidence shows that a moderate to high pattern of abuse has been observed in the study population. Due to this region's unique cultural-religious characteristics, it is urgent to reduce this phenomenon.

Qualitative evaluation of a codesigned faith-based intervention for Muslim women in Scotland to encourage uptake of breast, colorectal and cervical cancer screening.

OBJECTIVES: This pilot study aimed to evaluate the acceptability of a codesigned, culturally tailored, faith-based online intervention to increase uptake of breast, colorectal and cervical screening in Scottish Muslim women. The intervention was codesigned with Scottish Muslim women (n=10) and underpinned by the reframe, reprioritise and reform model and the behaviour change wheel. SETTING: The study was conducted online, using Zoom, due to the COVID-19 pandemic. PARTICIPANTS: Participants (n=18) taking part in the intervention and subsequently in its evaluation, were Muslim women residing in Scotland, recruited through purposive and snowball sampling from a mosque and community organisations. Participants were aged between 25 years and 54 years and of Asian and Arab ethnicity. DESIGN: The study's codesigned intervention included (1) a peer-led discussion of barriers to screening, (2) a health education session led by a healthcare provider, (3) videos of Muslim women's experiences of cancer or screening, and (4) a religious perspective on cancer screening delivered by a female religious scholar (alimah). The intervention was delivered twice online in March 2021, followed 1 week later by two focus groups, consisting of the same participants, respectively, to discuss participants' experiences of the intervention. Focus group transcripts were analysed thematically. RESULTS: Participants accepted the content and delivery of the intervention and were positive about their experience of the intervention. Participants reported their knowledge of screening had increased and shared positive views towards cancer screening. They valued the multidimensional delivery of the intervention, appreciated the faith-based perspective, and in particular liked the personal stories and input from a healthcare provider. CONCLUSION: Participatory and community-centred approaches can play an important role in tackling health inequalities in cancer and its screening. Despite limitations, the intervention showed potential and was positively received by participants. Feasibility testing is needed to investigate effectiveness on a larger scale in a full trial.

Global collaboration and social practices to mitigate impacts of COVID-19 in the world: a lived experience of infecting.

COVID-19 pandemic is one of the most serious threatening conditions and the complex situation in the recent century, which shook the world. This unprecedented crisis has caused many disruptions and distractions for humans in different local and global levels. This reflexive essay aims to review challenges and opportunities originated by the Corona-virus pandemic within social groups through a moral perspective. Focusing on both negative and positive aspects would help us find the required skills and strategies to adapt to the crises and mitigate the issues based on our capacities and resources.

Role of Zinc Supplementation in the Improvement of Acute Respiratory Infections among Iranian Children: A Systematic Review.

BACKGROUND: Respiratory infectious disease is considered as one of the most serious problems among children in developing countries. The importance of zinc in the improvement of respiratory disease has been indicated. However, there are some unanswered questions and uncertainty. This systematic review aimed at assessing the therapeutic benefits of zinc supplementation on respiratory infections of Iranian children. MATERIALS AND METHODS: Databases, such as PubMed, Scopus, Embase, Magiran, and IranDoc, were searched for randomized controlled trials published from January 1998 to December 2017 on Zinc supplementation for the treatment or improvement of acute respiratory disease among Iranian children, during March 2018. Studies were screened according to the PICO framework, and irrelevant studies were excluded. RESULTS: A total of 5 studies conducted on 522 children were included in this review. Except for one study, others had indicated the beneficial effect of zinc supplement on improving signs and symptoms of respiratory infectious disease and earlier discharge from the hospital. CONCLUSION: Although studies on the efficacy of zinc on respiratory infectious disease of children in Iran have not widely considered and more studies should be conducted, all published articles (except for one of them) had indicated the effectiveness of zinc supplementation on respiratory infections among children. Other criteria, such as age, gender, birth weight, diet, and type of respiratory infections, should be considered during zinc therapy. Controlling these confounding variables and measuring the level of blood zinc are necessary to understand how much zinc should be prescribed for respiratory treatment of children.

Health-Seeking Behavior of Afghan Women Immigrants: An Ethnographic Study.

BACKGROUND: Nowadays, in light of gender inequity, new concern has been raised for health-seeking behavior of women in clinical setting. The aim of this study was to investigate the perceptions and health-seeking behaviors of Afghan immigrant women residing in Mashhad, Iran. METHOD: An ethnographic design was used to examine the health-seeking behavior of Afghan women. This study took place in Tollab Tabarsi area of Mashhad, Iran, from March 2013 to July 2014. For gathering of data, participant observations, fieldwork, and formal interviews were included. Data were analyzed using thematic analysis. RESULTS: Fourteen Afghan women immigrants and five health care professionals were interviewed. The overarching category derived from the data was gender inequity. The emergent three themes were cultural taboos, women position, and information gap. DISCUSSIONS: The displaced Afghan women were found to be at significant risk of adverse health events, which affected both their physical health and mental health.

Nurses' Experiences of Caring for Patients with Different Cultures in Mashhad, Iran.

BACKGROUND: Mashhad is a center of diverse cultures, where many local and foreign cultures live together in its context. One of the main needs of a society with cultural diversity is transcultural care of patients. Hence, the present study took the first step for care of culturally diversified and minority patients in Mashhad. This research has been conducted to explore the nurses' experience of caring from patients with different cultures. MATERIALS AND METHODS: This study is a qualitative research using phenomenological hermeneutics approach. The participations include nurses who have been working 5 or less than 5 years in the hospitals affiliated to Medical University of Mashhad. They were selected using purposeful sampling method. For data collection, semi-structured, in-depth interview was used. For data analysis, interpretation method was used. The interviews continued until saturation of data was obtained. RESULTS: Data analysis resulted in extraction of 4 themes including ethnocentrism, contradicting perceptions of care, it is not our fault, and lack of cultural knowledge. CONCLUSIONS: The experience of nurses in taking care of patients with other cultures showed that minorities and small cultures have been neglected in Mashhad and hospitalization of such people in hospitals and other clinics is not specific. We recommend that an educational curriculum about transcultural care should be added to nursing courses. Also, necessary equipment and facilities should be considered and prepared for culturally different patients in hospitals.

Challenges of Transcultural Caring Among Health Workers in Mashhad-Iran: A Qualitative Study.

BACKGROUND: One of the consequences of migration is cultural diversity in various communities. This has created challenges for healthcare systems. OBJECTIVES: The aim of this study is to explore the health care staffs' experience of caring for Immigrants in Mashhad- Iran. SETTING: This study is done in Tollab area (wherein most immigrants live) of Mashhad. Clinics and hospitals that immigrants had more referral were selected. PARTICIPANTS: Data were collected through in-depth interviews with medical and nursing staffs. 15 participants (7 Doctors and 8 Nurses) who worked in the more referred immigrants' clinics and hospitals were entered to the study. DESIGN: This is a qualitative study with content analysis approach. Sampling method was purposive. The accuracy and consistency of data were confirmed. Interviews were conducted until no new data were emerged. Data were analyzed by using latent qualitative content analysis. RESULTS: The data analysis consisted of four main categories; (1) communication barrier, (2) irregular follow- up, (3) lack of trust, (4) cultural- personal trait. CONCLUSION: Result revealed that health workers are confronting with some trans- cultural issues in caring of immigrants. Some of these issues are related to immigration status and some related to cultural difference between health workers and immigrants. These issues indicate that there is transcultural care challenges in care of immigrants among health workers. Due to the fact that Iran is the context of various cultures, it is necessary to consider the transcultural care in medical staffs. The study indicates that training and development in the area of cultural competence is necessary.

Comparative Study of Hearing Impairment among Healthy and Intensive Care unit Neonates in Mashhad, North East Iran.

INTRODUCTION: According to World Health Organization (WHO) 2001 statistics, hearing disorders are the most common congenital disease, and the incidence rate among high-risk newborns is as much as ten times as high as that in healthy neonates. However, 78% of screening test failures are well-baby nursery babies. The Joint Committee on Infants' Hearing (JCIH) has emphasized the importance of early diagnosis and treatment in neonates with hearing impairments in order to preserve their maximum linguistic skills. The aim of our study was to compare the prevalence of hearing loss among babies in the neonatal intensive care unit (NICU) and the rooming-in unit (RIU). MATERIALS AND METHODS: Neonates born in three hospitals in Mashhad between 2008 to 2010 were studied prospectively and screened for auditory disorders using the oto acoustic emission (OAE) test at the time of discharge and 3 weeks later. To confirm hearing loss, the auditory steady state response (ASSR) test was used among those participants who failed both OAE tests. RESULTS: Two-thousand and sixty-three neonates from the NICU were screened and compared with a control group consisting of 8,724 neonates from the RIU or the well-baby nursery. At the end of the study, hearing impairment as confirmed by failure in the ASSR test was diagnosed in 31 neonates (26 in the control group [0.30%] and five in the NICU group [1.94%]). CONCLUSION: In our study, the prevalence of hearing disorders among NICU neonates was 6.5-times greater than that among babies from the RIU or well-baby unit. This observation demonstrates the importance of universal screening programs particularly for high-risk population neonates.

Ophthalmic, hearing, speaking and school readiness outcomes in low birth weight and normal birth weight primary school children in Mashhad-Iran.

Low Birth weight infants are at risk of many problems. Therefore their outcome must evaluate in different ages especially in school age. In this study we determined prevalence of ophthalmic, hearing, speaking and school readiness problems in children who were born low birth weight and compared them with normal birth weight children. In a cross-sectional and retrospective study, all Primary School children referred to special educational organization center for screening before entrance to school were elected in Mashhad, Iran. In this study 2400 children enrolled to study and were checked for ophthalmic, hearing, speaking and school readiness problems by valid instrument. Data were analyzed by SPSS 11.5. This study showed that 8.3% of our population had birth weight less than 2500 gram. Visual impairment in LBW (Low Birth Weight) and NBW (Normal Birth Weight) was 8.29% vs. 5.74% and there was statistically significant difference between them (P=0.015). Hearing problem in LBW and NBW was 2.1% vs. 1.3 and it was not statistically significant. Speaking problem in LBW and NBW was 2.6% vs. 2.2% and it was not statistically significant. School readiness problem in LBW and NBW was 12.4% vs. 5.8% and it was statistically significant (P<0.001). According to the results, neurological problems in our society is more than other society and pay attention to this problem is critical. We believe that in our country, it is necessary to provide a program to routinely evaluate LBW children.

Effect of Birth Weight and Socioeconomic Status on Children's Growth in Mashhad, Iran.

Background. Socioeconomic status and birth weight are prominent factors for future growing of children. Also Studies show that this criterion is associated with reduced cognitive outcomes, school achievement, and adult work capacity. So in this paper we determined the effects of some socio-economic statuses and birth weight on physical growth of children in Mashhad, Iran. Method and materials. This is a cross sectional study that determined effect of socio-economic status and birth weight on weight, heighting and BMI of school age children. Healthy six years old children who were screened before enter, to school were eligible for participating in our study between 6 June 2006 and 31 July. Weight and standing height were documented at birth and measured at 6 years old. Then, their BMI were calculated in childhood period. Data were analyzed by using SPSS software. Result. Results show that some socio-economic variables and birth weight is associated with and, perhaps, influence the variation of growth in the children. The variables which show the most consistent and significant association were birth weight, sex, economic status and education of parents. Conclusion. In this paper, we found that birth weight, economic status and education parents of neonates have directly significant effect on growth childhood period. We recommended that paying attention to these criteria for improving growth of children in our society should be considered by authorities.