Socioeconomic inequalities in cervical cancer mortality in Canada, 1990 and 2019: a trend analysis.

OBJECTIVE: It is increasingly recognized that those of lower socioeconomic status (SES) are disproportionately affected by cancer mortality. The association between cervical cancer mortality and SES have been reported; however, it remains poorly understood in the Canadian population. Thus, this study investigates trends in income and education inequalities in cervical cancer mortality in Canada over the last three decades. STUDY DESIGN: Trend analysis. METHODS: A dataset constructed at the census division level (n = 280), comprising the Canadian Vital Statistics Death Database, the Canadian Census of Population, and the National Household Survey was used to measure cervical cancer mortality in Canada. Income and education inequalities in cervical cancer mortality were measured using age-standardized Concentration index (C). RESULTS: Crude cervical cancer mortality rates decreased significantly during the study period. Age-standardized C values were negative for the majority of years for income and education inequalities, reaching significance in some years. Trend analyses indicated an increasing concentration of cervical cancer mortality amongst those with lower education levels. CONCLUSION: Despite recent decreases in cervical cancer mortality rates, socioeconomic inequalities in cervical cancer mortality in Canada are persistent. Notably, those of lower income and education levels are disproportionately affected, underscoring an opportunity to improve clinical outcomes by addressing these inequalities.

Socioeconomic disparities in diabetes-concordant comorbidity: national health interview survey, 1997-2018.

OBJECTIVE: Although social disparities in morbidity and mortality are well-documented, little is known how socioeconomic status (SES) shapes diabetes-concordant comorbidity (DCC). This study examines socioeconomic inequalities in DCC among adults with diabetes in the United States. STUDY DESIGN: The study incorporated a cross-sectional nationally representative household health survey. METHODS: This study used data from the National Health Interview Survey, 1997-2018. The analysis included 56,192 adults aged 30 or above with diabetes. Multinomial logistic regression was used to obtain relative risk ratios in gender-stratified models after adjusting for sociodemographic covariates. RESULTS: The multivariable-adjusted analyses suggest that across all SES indicators and in both men and women, individuals with lower SES had greater odds of DCC than individuals with higher SES. The associations of SES indicators with DCC were larger in magnitude among women than in men. For example, compared to individuals with a college or higher degree, men with less than a high school degree were 2.06 times (95% confidence interval = 1.76-2.41) and women with less than a high school degree were 3.19 times (95% confidence interval = 2.67-3.82) more likely to have 3 or more DCCs. Similar associations were observed for other indicators of SES. CONCLUSION: Study findings suggest strong social status and gender-based patterns in DCC. Identifying population groups with poor social status may be useful for informing interventions aiming to improve healthcare services of diabetes-related complications.

Socio-economic inequalities in lung cancer incidence in Canada, 1992-2010: results from the Canadian Cancer Registry.

OBJECTIVES: Lung cancer is the most commonly diagnosed cancer in Canada. This study aims to assess trends in income and education inequalities in the incidence of lung cancer in Canada. STUDY DESIGN: The study design is a time-trend analysis of nationally collected data. METHODS: Using a linked data set of the Canadian Cancer Registry (CCR) data file, the Canadian Census of Population and National Household Survey, we calculated the incidence of lung cancer in Canada over the period between 1992 and 2010. The age-adjusted concentration index (C), which captures socio-economic inequality across a continuous spectrum of socio-economic status, was used to measure income and education inequalities in the incidence of lung cancer in men and women. RESULTS: The crude incidence rate for men decreased significantly over time in Canada from 85 to 78 per 100,000 population from 1992 to 2010, respectively. For women, the crude incidence rate increased significantly over time in Canada from 45 to 67 per 100,000 population from 1992 to 2010, respectively. The age-adjusted C indicated a higher concentration of lung cancer incidence among low income and less educated Canadians over the study period. Although income inequality in lung cancer incidence decreased significantly over time for men, education inequality increased significantly for both men and women. CONCLUSIONS: Increased occurrence of lung cancer among the poor and less educated populations in Canada remains a challenge in Canada. Income and education gradients in the lung cancer incidence are likely explained by variations in known risk factors especially smoking across socio-economic groups. Continuous efforts are required to reduce the causes of lung cancer among low socio-economic status Canadians.

The effect of gender inequality on HIV incidence in Sub-Saharan Africa.

OBJECTIVE: We aimed to quantify the extent to which country-level trends in HIV incidence in Sub-Saharan Africa (SSA) were influenced by gender inequalities, measured by gender gaps in educational attainment, income, and a Gender Inequality Index (GII). STUDY DESIGN: We examined the relation between gender inequality and HIV incidence using country-level panel data from 24 SSA countries for the period between 2000 and 2016. METHODS: Our goal was to estimate the relation between within-country changes in gender inequality and HIV incidence. We compared results from fixed effects and random effects models for estimating the effect of gender inequalities on changes in HIV incidence. Based on the results of the Hausman test, the fixed effects model was selected as the preferred approach. RESULTS: HIV incidence decreased by nearly one-half over the period from 2000 to 2016. We estimated that a one percent increase in the GII was associated with a 1.6 percent increase in HIV incidence (95% confidence interval = [0.21%; 3.00%]), after adjusting by country-level socio-economic and governance variables. CONCLUSIONS: Our study suggests that addressing gender inequalities is a potential strategy to reduce HIV incidence in the SSA region. To control HIV infection, policymakers and public health practitioners should support relevant interventions for promoting gender equality. Further work is needed to identify specific interventions to improve gender inequality and to examine their impacts on changes in HIV incidence.

Effects of carfilzomib alone and in combination with cisplatin on the cell death in cisplatin-sensitive and cisplatin-resistant ovarian carcinoma cell lines.

BACKGROUND: Previous studies on the efficacy of platinum-based drugs and selective inhibitors of proteasome have revealed promising outcomes. This study is aimed to evaluate the effects of the combination of cisplatin and carfilzomib on the cell death induction and drug efflux transporters expression in cisplatin-sensitive (A2780s) and cisplatin-resistant (A2780cp) ovarian cancer cells lines. METHODS: MTT cytotoxic assay was conducted to determine the cytotoxicity. Drug interactions were analyzed based on Chou-Talalay's principles and real-time PCR analysis was performed to determine possible alterations in mRNA levels of MRP1 and BCRP. RESULTS: A2780s cells were more susceptible to both cisplatin and carfilzomib while analyses of drug interactions between the two agents showed synergistic effects in all affected fractions of drug-treated A2780s and A2780cp cells (CI<0.9) with the combination indices being significantly lower in A2780cp cells (p < 0.01). We also found that although mRNA levels of BCRP and MRP1 were significantly altered in both cells exposed to each drug alone, only the combination regimen was able to significantly reduce the mRNA levels of these genes in A2780cp cells (p<0.001). CONCLUSION: This combination might be a potential strategy for suppressing cell growth via downregulating the drug efflux transporters expression, especially in cisplatin-resistant ovarian cancer cells (Fig. 3, Ref. 45).

Prevalence of burnout among nurses in Iran: a systematic review and meta-analysis.

AIM: This study aimed to summarize the available information in the literature to make an accurate estimate of the prevalence of burnout among Iranian nurses. BACKGROUND AND INTRODUCTION: Burnout is a work-related stress syndrome that has negative impact on healthcare providers, patients and healthcare delivery systems. METHOD: A comprehensive search of literature using international [PubMed, Scopus and the Institute for Scientific Information (ISI)] and Iranian scientific data bases [Scientific Information Database (SID), IranMedex and Magiran] was conducted to identify English and Persian language studies, published between 2000 and 2016, that examined the prevalence of burnout among nurses in Iran. The I-squared test and Chi-squared-based Q-test suggested heterogeneity of reported prevalence among the qualified studies; thus, a random-effects model was applied to estimate the overall prevalence of burnout among nurses in Iran. RESULTS: Based on 21 selected articles with 4180 participants, the overall prevalence of burnout among Iranian nurses was estimated to be 36% [95% confidence interval (CI), 20-53%] in Iran. Meta-regression indicated that sample size and year of data collection, mean age of samples, female to male ratio and geographic regions were not statistically significantly associated with the prevalence of burnout. Also, based on Egger's test and funnel plot, there is no publication bias among studies included in the analysis. CONCLUSION: Professional burnout affects more than one-third of nursing staff in Iran; thus, effective interventions and strategies are required to reduce and prevent burnout among nurses. IMPLICATION FOR NURSING AND HEALTH POLICY: Due to the negative consequences of burnout on patients, nurses and organizations, nursing and healthcare managers should intervene to prevent and reduce burnout among nurses in Iran. Policy attention should focus on developing effective interventions to prevent and minimize the burden of burnout among nurses in Iran. Nurses' involvement in the policy-making process is crucial in the implementation of effective programs and initiatives tailored to address the higher prevalence of burnout among Iranian nurses.

Regulatory effects of the novel synthesized Indole-3-carbaldehyde on expression of cell cycle genes: A study on Cyclin D and P21 expression by acute promylocytic leukemia cell line (NB4)

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Induction of apoptosis by pistachio (Pistacia vera L.) hull extract and its molecular mechanisms of action in human hepatoma cell line HepG2.

Several important Pistacia species such as P. vera have been traditionally used for treating a wide range of diseases (for instance, liver-related disorders). There is a relative lack of research into pharmacological aspects of pistachio hull. Hence, this study was aimed at investigating whether pistachio rosy hull (PRH) extract exerts apoptotic impacts on HepG2 liver cancer cell line. In order to evaluate cell viability and apoptosis in response to treatment with the extract, MTT assay and Annexin-V-fluorescein/propidium iodide (PI) double staining were performed, respectively. Moreover, molecular mechanism of apoptosis induced by the extract was determined using human apoptosis PCR array. Our findings showed that PRH extract treatment reduced cell viability (IC50 ~ 0.3 mg/ml) in a dose-dependent manner. Flow cytometric analysis revealed that the extract significantly induced apoptosis in HepG2 cells. In addition, quantitative PCR array results demonstrated the regulation of a considerable number of apoptosis-related genes belonging to the TNF, BCL2, IAP, TRAF, and caspase families. We observed altered expression of both pro-apoptotic and anti-apoptotic genes associated with the extrinsic and intrinsic apoptosis signaling pathways. These results suggest that the aqueous extract of PRH possesses apoptotic activity through cytotoxic and apoptosis-inducing effects on HepG2 cells.

Study of the effects of raw garlic consumption on the level of lipids and other blood biochemical factors in hyperlipidemic individuals.

Hyperlipidemia is one of the famous disorders that can lead to atherosclerosis. Garlic has been considered as one of the blood lipids lowering agents for ages, and various studies have been carried out, some of them confirmed this effect of garlic and some did not. The aim of this study was to evaluate the effect of raw garlic consumption on human blood biochemical factors in hyperlipidemic individuals. This clinical trial was conducted on 30 volunteer individuals with blood cholesterol higher than 245 mg/dl. Fasting blood samples were collected for biochemical tests. The volunteers consumed 5 g raw garlic twice a day for 42 days. Second fasting blood samples were collected and the individuals did not use any kind of garlic for next 42 days. After that, the third fasting blood samples were collected and the biochemical factors were measured. After 42 days of garlic consumption the mean of blood total cholesterol (p<0.001) triglycerides (p<0.01) and FBS (p<0.01) were reduced significantly, but HDL-C was increased (p<0.001) significantly. Following 42 days of no garlic consumption total cholesterol (p<0.001), triglycerides and FBS (p<0.05) were significantly increased and HDL-C (p<0.01) decreased. Garlic consumption alone can decrease serum lipids, but it cannot be used as the main therapeutic agent for hyperlipidemia. Garlic can be used in mild hyperlipidemia or when the patients cannot tolerate the chemical drugs.