The Effect of the Art Therapy Interventions on Depression Symptoms Among Older Adults: A Meta-analysis of Controlled Clinical Trials.

BACKGROUND: To our knowledge, no systematic reviews and meta-analyses have yet been published that examine the effect of art therapy (AT) interventions on depression symptoms among older adults, and this study aimed to systematically review and meta-analysis of clinical trials, summarize eligible relevant studies and provide a true effect measure for the association between AT and depression symptoms in older adults. METHODS: The databases of PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials were searched until 15 February 2022. The methodological quality of the included studies was evaluated by the Delphi checklist. The heterogeneity across studies was conducted by chi-squared test and measured its quantity by the I2 statistic. We performed this meta-analysis to obtain a summary measure of the mean difference in depression scores between AT and control groups using a random-effects model. All statistical analyses were carried out at a significance level of .05 using Stata software, version 14. RESULTS: Until 15 February 2022, 222 studies through databases and 199 studies through review of references were included in the present meta-analysis. In total, the analysis covered 8 studies. The difference in mean depression score between the intervention and control groups showed significant reductions in the AT group (MD -.78; 95% CI: -1.17, -.38; I 2 = 67.9%). CONCLUSION: Our findings suggest that AT can be considered an effective intervention for reducing depression symptoms among older adults and art therapists/psychotherapists can use this method to reduce the symptoms of depression among older adults.

The relationship between social support and dimensions of elder maltreatment: a systematic review and Meta-analysis.

INTRODUCTION AND AIMS: Many studies have investigated the relationship between social support and the prevention of elder abuse; however, their results are somehow inconsistent in terms of the association. This systematic review and meta-analysis aimed to investigate the published studies on the relationship between social support and the prevention of elder maltreatment. MATERIALS AND METHODS: An electronic search was conducted until January 2023, using such databases as PubMed, Scopus, and Web of Science. The present research included cross-sectional, longitudinal, and case-control studies. Study selection, data extraction, and risk of bias assessment were conducted by two researchers independently. The Newcastle-Ottawa checklist was utilized to evaluate the quality of studies. The random effects model was employed to perform a meta-analysis. RESULTS: In total, 32 studies were included in this systematic review, out of which 26 articles were eligible for meta-analysis. The results showed that 68.75% of the studies were of high quality, and there is a significant relationship between social support and elder maltreatment. Accordingly, the lack of social support increased overall maltreatment (odds ratio: 1.24, 95% confidence interval: 1.16-1.33; I2 = 92.3%, p = 0.000)). Moreover, lack of social support had an increasing effect on the level of psychological abuse (1.55, 1.18-2.04; 88.7%, p = 0.000), physical abuse (1.31, 0.42-4.11; 76.3%, p = 0.005), and neglect (2.02, 0.86-4.72; 87.9%, p = 0.000), which shows heterogeneities among the results of the included studies. On the contrary, the lack of social support showed a decreasing effect on financial abuse (0.92, 0.70-1.21; 62.1%, p = 0.022). CONCLUSION: This systematic review provides evidence that social support in the form of structural or functional support may plays an important role in improving the quality of life of the elderly.

The impact of health education interventions on oral health promotion among older people: a systematic review.

BACKGROUND: One of the most common pathologic changes in older people is oral and dental problems. The oral health of older people is a public health concern. Promotion of good oral health for this cohort will have beneficial impacts on the longer-term quality of life. This study aimed to identify the types of health education interventions for the oral health of older people and to determine their effects on the oral and dental health of older people. METHODS: Potential articles were retrieved from four electronic databases (PubMed/Medline, Scopus, Web of Sciences, and Embase) up to 31 September 2022 in English without limit of time. Experimental and quasi-experimental interventional studies investigating the impact of educational interventions on oral and dental health among older people over 60 years old in both sexes were considered. The quality assessment tool was the Effective Public Health Practice Project (EPHPP). RESULTS: In the initial search, 1104 articles were retrieved. Finally, according to the inclusion criteria, 23 studies (seventeen randomized controlled trials (RCT) and six quasi-experimental studies) were reviewed. In this review, educational interventions for older people and their caregivers are classified. Theoretical frameworks were used in only three interventions related to older people. Outcome measures were both self-reported and objective measures. Fifteen of the included studies were of moderate quality. CONCLUSION: This review provides evidence that the use of oral and dental health educational interventions was effective in improving the oral health of older people. Educational interventions were carried out both among older people and among their caregivers. Although a variety of interventions were used in the reviewed studies, more lectures were used in the interventions related to older people. In the interventions related to caregivers, in addition to lectures, practical education was also used. It is recommended to perform higher quality studies for assessing the effectiveness of interventions in this field.

Prevalence of HIV, Hepatitis B and C Virus Co-infections among Iranian High-Risk Groups: A Systematic Review and Meta-Analysis.

Co-infection with hepatitis B and C among HIV infected patients are prevalent among high-risk populations. This meta-analysis aimed to estimate the prevalence of HIV, HCV and HBV co-infections among high-risk populations in Iran. We systematically searched the national and international electronic databases until 2016. The primary outcome was the prevalence of HIV, HBV, HCV and HIV co-infections in different high-risk populations in Iran. All English and Persian studies conducted on Iranian high-risk groups were included in the study. The review was reported based on PRISMA guidelines and data were analysed at 95% confidence level using random effect models. Overall, 916 relevant papers were recognised and 14 articles were included in the meta-analysis. The pooled estimates of HBV/HCV, HCV/HIV, HBV/HIV and HBV/HCV/HIV were 1.3% (95%CI: 0.5-2.1), 16.3% (95%CI: 1.1-31.6), 0.5% (95%CI: 0-1.4) and 0.5% (95%CI: 0.2-0.8), respectively. Based on subgroup analysis, there was a higher proportion of all co-infections from the years 2010-2016 as compared to that of the years 2003-2009. Our results highlighted that HCV/HIV co-infection in Iranian high-risk groups including injection drug users (IDUs) and prisoners is common. In addition, the increasing trend of coinfections should be considered alarming for policymakers.

Relationship Between Social Determinants of Health and the Thalassemia Prenatal Diagnosis Test in Zahedan, South Eastern Iran.

Little is known about the social determinants of health (SDH) of taking the prenatal diagnosis (PND) test as a pivotal strategy to prevent occurrences of ß-thalasssemia major (ß-TM). This study sought to evaluate the relationship between socio-demographic characteristics of parents and taking the PND test at Zahedan, Iran from 2015 to 2016. The design of the present study was a case-control. Data on socio-demographic characteristics of parents including age, education, job, ethnicity, and family relationships, kind of marriage as well as pre marriage test status and PND test status, were obtained from registered medical records. The relationship between socio-demographic characteristics and taking the PND test was evaluated using binary logistic regression. The study included 256 ß-thalassemia (ß-thal) carrier couples who were referred to the Zahedan Prenatal Diagnosis Center to take the PND test and 47 ß-thal carrier couples who already had a newborn with ß-TM and had not taken the PND test. Univariate analysis showed that the higher education level of the father, consanguineous parents, official marriages, pre marriage test and consultation, significantly increased the odds of taking the PND test. The significant relationships were not observed in multivariable analysis, however, pre marriage tests and official marriages can be considered as determinants of taking the PND test with odds ratio (OR) [95% confidence interval (95% CI)] of 14.67 (0.64, 334.93) and 3.41 (0.55, 20.94), respectively. Our results provided evidence in which socio-demographic characteristics of the parents may determine their taking the PND test.

Decomposing difference in the kidney cancer burden measures between 1990 and 2019 based on the global burden of disease study.

The kidney cancer (KC) burden measures have changed dramatically in recent years due to changes in exposure to the determinants over time. We aimed to decompose the difference in the KC burden measures between 1990 and 2019. This ecological study included data on the KC burden measures as well as socio-demographic index (SDI), behavioral, dietary, and metabolic risk factors from the global burden of disease study. Non-linear multivariate decomposition analysis was applied to decompose the difference in the burden of KC. Globally, ASIR, ASMR, and ASDR of KC increased from 2.88 to 4.37, from 1.70 to 2.16, and from 46.13 to 54.96 per 100,000 people between 1990 and 2019, respectively. The global burden of KC was more concentrated in developed countries. From 1990 to 2019, the burden of KC has increased the most in Eastern European countries. More than 70% of the difference in the KC burden measures between 1990 and 2019 was due to changes in exposure to the risk factors over time. The SDI, high body mass index (BMI), and alcohol use had the greatest contribution to the difference in the KC burden measures. Changes in characteristics over time, including SDI, high BMI, and alcohol consumption, appear to be important in the evolving landscape of KC worldwide. This finding may help policymakers design policies and implement prevention programs to control and manage KC.

Medication discrepancies identified by medication reconciliation among patients with acute coronary syndrome.

Medication errors such as medication discrepancies are known as one of the leading cause of death. Medication discrepancies mostly occur during admission and at time transfer of care and discharge. Medication reconciliation process has pivotal role to avert medication discrepancies and improve patient safety and quality. Patients with acute coronary syndrome (ACS) are prone to medication discrepancies due to acute manifestations, simultaneous use of different medicines and having different co-morbidities. This study aimed to determine medication discrepancies identified by medication reconciliation among patients with ACS. In an observational study, patients with ACS admitted to a specialized Hospital in Baneh County, Kurdistan province during September 2023 and January 2024 were included. Medication reconciliation process was done when the patient was admitted. The history of medicine use was collected through interviews with the patient, their caregivers, as well as observing the medicines that were accompany with the patients. Number and type of unintentional medication discrepancies and related factors were evaluated. A total of 280 ACS patients (mean age: 63.8 ± 14.2, male gender: 59.3%) were included in the study. About 68% had at least 2 underlying diseases. The mean daily medicines taken by the patients during admission were 8.5 ± 1.54. The number (percentage) of unintentional inconsistency was observed in 78 (27.3%), and omission (39.7%) and changes in dosage (20.5%) had the highest frequency of unintentional medication discrepancies, respectively. Cardiovascular agents such as anti-dyslipidemia and antiplatelet had the highest frequency of unintentional medication discrepancies. The number of underlying diseases and daily medications before hospitalization increase the odds of discrepancies by 2.15 and 1.49 times, respectively (p-value < 0.05). Medication discrepancies identified by medication reconciliation among patients is relatively common. Unintentional medication discrepancies that have the potential to harm the ACS patients should be given more attention, especially in patients with multiple comorbidities and polypharmacy.

The experiences of the elderly regarding the use of rehabilitation assistive technologies: a directed qualitative content analysis.

PURPOSE: The elderly population faces reduced levels of health and performance, which necessitates the use of rehabilitation assistive technologies to maximize functional independence in daily activities. This study aimed to explain the experiences of the elderly regarding the use of rehabilitation assistive technologies based on the Unified Theory of Acceptance and Use of Technology. METHODS: The present study was a qualitative study of the type of content analysis that was conducted in the city of Hamadan in 2022. Participants included 20 elderly aged 60 years or above who were selected as a purposive sample and subjected to individual semi-structured in-depth interviews. Data were analyzed using directed qualitative content analysis based on Hsieh and Shannon's approach. Data were coded using MAXQDA software (MAXQDA Analytics Pro 2020, VERBI GmbH Berlin). RESULTS: According to the results, 260 primary codes were extracted, and they were classified into five predetermined categories of the Unified Theory of Acceptance and Use of Technology, including performance expectancy, effort expectancy, social influence, facilitating conditions, and behavioral intention, as well as two new categories of technology anxiety and perceived need for technology. After extracting 260 primary codes based on the Unified Theory of Acceptance and Use of Technology, 75 sub-categories were identified in 14 main categories. CONCLUSION: The themes obtained from the study indicate the necessity of providing the required conditions to maintain the complete independence and health of the elderly and strengthen their morale. The results can be helpful in the development of support strategies for family members, healthcare providers, and policymakers.

Assistive rehabilitation technologies include low-tech assistive technologies.The use of assistive rehabilitation technologies is a potential solution to improve balance, quality of life, and increase activity and functional independence in the elderly.Since peers play a very important role as technology advocates in the intention to accept and use assistive technologies, the expression of the experiences and views of the elderly can encourage and support the use of assistive rehabilitation technologies by other elderly.This study found that the use of assistive rehabilitation technologies by the elderly is a relatively complex issue with various personal, social, economic, cultural and physical aspects.

Psychosocial determinants of functional independence among older adults: A systematic review and meta-analysis.

Background: In current years, the increase in older population has led to creating one of the main public health challenges, worldwide. Because of the special characteristics of older adults, this age group is exposed to possible problems, such as mental and physical disorders, that usually affect their functional independence. The study aimed to determine the psychosocial determinants (e.g., depression, social support, and self-efficacy) affecting functional independence among older population. Methods: Our search was conducted on three international databases (Web of Sciences, PubMed/Medline, and Scopus) for all the observational studies (cross-sectional, cohort or longitudinal designs) on the social and psychological determinants of functional independence among older adults. Papers published in English without limitation of time were reviewed from inception to 26 August 2023. The quality assessment tool was the Newcastle-Ottawa Scale (NOS). The I2 index was used to quantify the degree of heterogeneity among the studies. In the case of heterogeneity higher than 50%, the random effects model has been used for overall estimation of the effects; otherwise, the fixed effects model was used. The pooled associations were expressed as odds ratio (OR) and 95% confidence intervals (CIs). Stata version 14 software (StataCorp LP) was used for data analysis. The significance level was considered at 0.05. Results: In the initial search, 6978 articles were retrieved, and finally, considering the inclusion criteria, 46 articles were examined. Finally, 18 articles were eligible for meta-analysis. The findings indicated that among all the determinants affecting functional independence among older adults, depression could lead to a 76% increase in functional dependence. Conclusion: The findings provide a statistically significant relationship between psychosocial factors and functional independence. Depression was the strongest determinant of functional dependence among older adults.

Human endogenous retroviruses type W (HERV-) activation and schizophrenia: A meta-analysis.

OBJECTIVE: Human endogenous retroviruses (HERV) are the remnants of infections that occurred million years ago. They gradually integrated into the human genome, comprising 8 % of it. There are growing reports suggesting their potential role in various diseases, including schizophrenia. Schizophrenia, a serious psychiatric disorder, is caused by the interaction of genetic and environmental factors. In the present paper, we investigated studies focusing on the association between schizophrenia and HERV-W. METHODS: We registered this study at PROSPERO (registration number: CRD42022301122). The entire steps of this study were based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We searched PubMed, Scopus, Web of Science, and Google Scholar up to 1 August 2022. Heterogeneity was estimated through I2 statistics, and the association was measured using the first estimate and penalization methods. RESULTS: Finally, 13 eligible studies were analyzed, including 698 cases and 728 controls. The overall odds ratio indicated a significant association in both the first estimate (OR = 9.34, 95 % CI = 4.92-17.75; P = 0.002) and penalization (OR = 7.38, 95 % CI = 4.15-13.10; P = 0.003) methods. In the subgroup analysis, among HERV-W fragments, the HERV-W envelope protein or RNA (OR = 11.41, 95 % CI: 5.67-22.97; P = 0.03) showed the strongest association with schizophrenia. CONCLUSION: Our meta-analysis showed that HERV-W is significantly associated with schizophrenia. More studies are required to determine the pathophysiological mechanism and the diagnostic, prognostic, and therapeutic value of HERV-W in schizophrenia.

Pre and perinatal predictors on autism spectrum disorders: a case-control study in the west of Iran.

INTRODUCTION: The constellation of pre and perinatal predictors are introduced as predictor for autism spectrum disorders (ASD), however, the information about the direction and strength of these predictors are lacking in Western, Iran. The current study aimed to determine the pre and perinatal predictors of ASD among children in this region. METHODS: This case-control study was conducted in Hamadan, Western Iran during January to March 2022. The study included 100 children with ASD who referred to the autism center as case group. Hundred children without ASD from registration system of health service centers were selected as control group and were matched (1:1) to cases by age and place of residency. A structured questionnaire about pre and perinatal predictors of ASD was developed by an expert panel. The questionnaire was administered by interviewing the mothers of children. RESULTS: Boy gender (OR: 3.51, 95% CI: 1.74-7.10, p-value < 0.001), small for gestational age (SGA) (3.92, 1.64-9.39, 0.002), maternal diabetes (3.51, 1.03-24.95, 0.04) and family history of mental disorders (3.64, 1.18-11.27, 0.04) were identified as significant predictors in a multivariable analysis. CONCLUSION: Our study emphasizes on the importance of screening and monitoring for ASD in the boys, those with history of SGA, from mothers with history of diabetes and with family history of mental disorders. Proposing the replication of findings emphasizes the necessity of conducting studies with larger sample sizes.

Neonatal risk factors associated with autism spectrum disorders: an umbrella review.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by severe social communication deficits and stereotypical repetitive behaviors. PURPOSE: This umbrella review assessed neonatal risk factors associated with ASD using meta-analyses and systematic reviews. METHODS: We conducted a systematic search of interna- tional databases including PubMed, Scopus, and Web of Science for studies published through April 2022 utilizing pertinent keywords. A random-effects model was used to calculate the odds ratio (OR) and 95% confidence interval (CI). Substantial heterogeneity was considered at values of I2≥50%. A quality assessment of the included studies was performed using the A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) checklist. RESULTS: A total of 207,221 children with ASD and 22,993,128 neurotypical children were included. Six meta- analyses were included in this umbrella review. The factors of congenital heart disease (OR, 1.35; 95% CI, 1.17-1.52), macrosomia (OR, 1.11; 95% CI, 1.05-1.18), low birth weight (OR, 1.63; 95% CI, 1.48-1.81), very low birth weight (OR, 2.25; 95% CI, 1.79-2.83), small for gestational age (OR, 1.17; 95% CI, 1.09-1.24), jaundice (OR, 1.74; 95% CI, 1.42- 2.12), male sex (OR, 1.47; 95% CI, 1.39-1.55) and 1-minute Apgar score <7 (OR, 1.40; 95% CI, 1.26-1.55) were graded as suggestive evidence (class III). Only 3 studies reported heterogeneity (I2<50%). Based on the AMSTAR2 analysis, the methodological quality was critically low in 3 meta- analyses, low in 2, and moderate in 1. CONCLUSION: Based on these results, clinicians should consider the risk factors for ASD and screen children in clinics.