Geographic pattern of the prevalence of intimate partner violence against women in Zanjan (Iran).

Introduction: Intimate partner violence (IPV) against women is a serious public health issue and refers to physically, sexually and psychologically harmful behaviors as well as emotionally controlling behaviors and financial abuse that occur in the form of marriage or cohabitation. Knowing the current situation of the IPV prevalence against women and high-risk areas in the Zanjan city, Iran, can help policymakers to establish better health programs for risk reduction. Methods: This population-based cross-sectional study consisted of married women aged 18-55 years living in Zanjan city in 2021. 760 married women covered by 19 urban comprehensive health service centers (UCHSCs) were selected by the stratified systematic random sampling method. The prevalence of IPV against women was measured in four types: psychological, physical, sexual, and economic. Results: Mean (SD) age of the women was 35.49 (8.76) years. 606 women (79.7%) experienced one type of IPV. The highest and lowest IPV prevalence against women were psychological (76.6%) and economic (12%), respectively. The highest and lowest prevalence of psychological violence were observed in CUHSCs 2 and 17, physical violence in CUHSCs 1 and 14, sexual violence in CUHSCs 2 and 17, and economic violence in CUHSCs 2 and 8, respectively. The severity of violence was higher among self-employment or workers husbands, with low monthly household income, and among younger women. Discussion: The IPV rate in the target population is high, and the highest rate is related to psychological violence. These results highlight the need to intervention in the society and high-risk women for policymakers of the health system.

A randomized clinical trial: Efficacy of group-based acceptance and commitment therapy program for breast cancer patients with high fear of progression.

BACKGROUND: Fear of progression (FOP) is a common and significant concern among cancer patients, encompassing worries about cancer progression during active treatment. Elevated levels of FOP can be dysfunctional. This study aims to assess the efficacy of an Acceptance and Commitment Therapy (ACT)-based intervention on FOP, anxiety sensitivity (AS), and quality of life (QOL) in breast cancer patients. METHODS: A clinical trial was conducted involving 80 stage I-III active-treatment breast cancer patients with a score greater than 34 on the Fear of Progression Questionnaire-Short Form scale. These patients were randomly assigned in a 1:1 ratio to either an intervention group, which received weekly 70-min sessions of 5-ACT-bsed group-therapy, or a control group that received usual treatment. Variables including FOP, AS, QOL, and ACT-related factors were assessed using ASQ, QLQ-C30, Cognitive Fusion Questionnaire, and Acceptance and Action Questionnaire-II at three time points: baseline, post-intervention, and 3-month follow-up. The efficacy of the intervention was evaluated using mixed model analysis across all time-points. RESULTS: The fidelity and acceptability of the ACT-based manual were confirmed using significant methods. A significant reduction in FOP was observed only in the ACT group at post-intervention (P-valueACT < 0.001; Cohen dACT = 1.099). Furthermore, the ACT group demonstrated a more significant reduction in FOP at follow-up. Furthermore, all secondary and ACT-related variables, except for the physical symptoms subscale, showed significant improvement in the ACT group compared to the control group. CONCLUSIONS: Our ACT-based manual showed promise for reducing FOP, AS, and improving QOL, and ACT-related variables in breast cancer patients 3 months following the intervention.

Health literacy and nutrition literacy among mother with preschool children: What factors are effective?

Children's obesity behaviors are associated with parents' low health literacy. Nutrition Literacy (NL) is an essential component to enhancing nutrition quality, as well as health and well-being. The study's objective was to determine health literacy (HL) and NL among mothers with children preschool children (under 7 years old in Zanjan city, Iran). Participants in this cross-sectional were 162 mothers with preschool children referred to Ayatollah Mousavi Hospital's pediatric clinic in Zanjan, Iran, during July and August 2022. The sample technique was convenient. In IBM SPSS 20 software, a two-step cluster analysis, the Chi-square\ Fisher exact, and Man-Whitney tests were used. HL and NL had a mean ± SD of 71.26 ± 15.84 and 71.78 ± 11.86, respectively. The two-step cluster analysis identified two clusters, with mothers in cluster 1 (n = 141) having sufficient HL and NL and mothers in cluster 2 (n = 21) having insufficient HL and NL. Cluster 1 mothers were older, had a college degree, lived in a city, were employed, and had a better financial situation. They obtained health and nutrition information from the Internet, either alone or in conjunction with other sources. Based on clustering analysis, it was observed that the low level of education, living in the village and being a housewife of the mothers, is related to the low level of HL and NL. By increasing the level of education of mothers, it is possible to help protect children from malnutrition or overfeeding in the future. Also, providing suitable job opportunities for mothers can help in this matter.

Difference Between Various Countries in Mortality and Incidence Rate of the Atrial Fibrillation Based on Human Development Index in Worldwide: Data From Global Burden of Disease 2010-2019.

The most common cardiac arrhythmia is Atrial Fibrillation. The prevalence of AF has doubled in the last 30 years and has become a 21st century epidemic. Various studies have found that the overall burden of AF is larger in developed communities as well as higher-income nations. Data on AF were collected from the GBD database from 2010 to 2019, while HDI data was derived from the UNDP website. Men had a higher incidence than women, although women had a higher mortality. South America, West Europe, and South Africa had higher MIR (Mortality-to-Incidence Rate) than other countries. In the last study years, MIR significantly was higher in more developed countries. According to differences between genders and various countries, by expansion of the infrastructures and diagnostic methods such as electrocardiography and continuous training of doctors for early diagnosis, we can help in better management of AF and controlling this silent pandemic.

Competing risks model for clustered data based on the subdistribution hazards with spatial random effects.

In some applications, the clustered survival data are arranged spatially such as clinical centers or geographical regions. Incorporating spatial variation in these data not only can improve the accuracy and efficiency of the parameter estimation, but it also investigates the spatial patterns of survivorship for identifying high-risk areas. Competing risks in survival data concern a situation where there is more than one cause of failure, but only the occurrence of the first one is observable. In this paper, we considered Bayesian subdistribution hazard regression models with spatial random effects for the clustered HIV/AIDS data. An intrinsic conditional autoregressive (ICAR) distribution was employed to model the areal spatial random effects. Comparison among competing models was performed by the deviance information criterion. We illustrated the gains of our model through application to the HIV/AIDS data and the simulation studies.

Clustering trends of melanoma incidence and mortality: A worldwide assessment from 1995 to 2019.

BACKGROUND: Melanoma is a skin cancer that has higher mortality among cutaneous malignant tumours. Tumour incidence in most world regions is rising. Here, we intend to highlight these trends in the world. METHODS: We used the global burden of disease dataset to assess the incidence and mortality of melanoma from 1995 to 2019 in 204 countries/territories. To identify country/territory groups with similar trends of melanoma incidence and mortality, a model-based clustering with a mixture of multivariate t-distributions was used. RESULTS: Australia and New Zealand had the largest incidence and mortality rates. Men in Egypt and women in Sri Lanka and Guam had the lowest incidence and mortality rates. The clustering analysis revealed 4 classes of incidence in both gender and 3 and 2 classes of mortality in male and female, respectively. All groups had a growing incidence rate in both gender, similar to the worldwide trend. In 10% of the countries/territories, central and Western Europe, the incidence increase rate was greater than in the countries/territories with the greatest incidence. The total mortality rate for men was steadily growing, although it was decreasing in Asian and African countries/territories. Overall, the mortality rate for women remained relatively steady over time. CONCLUSION: Due to the increasing trend of melanoma in the world, primary and secondary prevention of this disease, especially in areas with higher incidence and mortality, is essential. Raising awareness about the disease is helpful in prevention and early detection of melanoma.

Temporal Incidence and Prevalence Trends of Multiple Sclerosis in Markazi Province, Iran.

BACKGROUND: The epidemiology of multiple sclerosis (MS) exhibits significant variability all over the world. Additionally, the incidence and prevalence of the disease are geographically diverse in the different provinces of Iran. OBJECTIVES: Due to the lack of a research about the epidemiology of MS in the Markazi province of Iran, the present study aimed to estimate its prevalence and incidence in this province. METHODS: This cross-sectional register study was conducted according to the data related to the MS Society of Markazi province. The inclusion criteria were definite MS during 2010-2019, residence in Markazi province, and membership in the MS society of Markazi province. The annual incidence and prevalence of MS (per 100,000 person-years) were computed by sex and age groups. Further, age-standardized prevalence and incidence rates were calculated based on the Iranian population. A gamma regression model with log link was utilized for comparing the rates over time statistically. The prevalence and incidence rates were computed by using Excel, and R 4.0.5 was applied to fit the gamma model. RESULTS: In the study, the total number of MS cases was 1,391, among whom 1,098 (78.9%) and 293 (21.1%) were females and males, respectively. The onset of MS occurred at the mean (S.D) age of 31.76 (8.98) years with a female/male ratio of 3.75. During the study period (2010-2019), the incidence rate of the disease was on the decline, while the prevalence rate elevated, by indicating a rising trend in MS prevalence in both sexes. CONCLUSION: The results represented the decreasing and increasing trend of the incidence and prevalence of MS in Markazi province over the recent years. The province is one of the regions with a high prevalence and incidence rate of MS compared to the national and global statistical data.

Sexual assertiveness in women with and without substance-dependent partners: a comparative study.

Sexual assertiveness is one of the main issues in the sexual relationships between couples. Since substance dependence might disrupt this relationship, the present cross-sectional study was conducted to assess and compare sexual assertiveness in women with and without substance-dependent partners living in Tehran, Iran. To assess sexual assertiveness, the Hurlbert Index of Sexual Assertiveness was used. The data then were compared between the study samples. Logistic regression analysis was performed. In all 300 women with and without substance-dependent partners entered into the study. The mean age of women was 37.31 ± 8.79 and 32.70 ± 7.24 years respectively. The mean score of sexual assertiveness was 50.66 ± 14.31 in the women with substance-dependent partners and 58.42 ± 13.86 in those with non-substance-dependent partners (P < .001). In addition, sexual assertiveness differed significantly among subgroups of women having a partner using different types of substances (P = .039). The risk of lower assertiveness for women with substance-dependent partners was 2.2 times more than women with non-substance-dependent partners (OR = 2.2, 95% CI: 1.28-3.70; P = .004). Indeed, the partner's substance dependency is an issue that is worthy of attention in sexual and marital counseling. Perhaps sexual assertiveness can be improved in women with substance-dependent partners through the implementation of appropriate interventions, such as educational and counseling programs.

Novel Study of Model-Based Clustering Time Series Gene Expression in Different Tissues: Applications to Aging Process.

BACKGROUND: Aging is an organized biological process that is regulated by highly interconnected pathways between different cells and tissues in the living organism. Identification of similar genes between tissues in different ages may also help to discover the general mechanism of aging or to discover more effective therapeutic decisions. OBJECTIVE: According to the wide application of model-based clustering techniques, the aim is to evaluate the performance of the Mixture of Multivariate Normal Distributions (MMNDs) as a valid method for clustering time series gene expression data with the Mixture of Matrix-Variate Normal Distributions (MMVNDs). METHODS: In this study, the expression of aging data from NCBI's Gene Expression Omnibus was elaborated to utilize proper data. A set of common genes which were differentially expressed between different tissues were selected and then clustered together through two methods. Finally, the biological significance of clusters was evaluated, using their ability to find genes in the cell using Enricher. RESULTS: The MMVNDs is more efficient to find co-express genes. Six clusters of genes were observed using the MMVNDs. According to the functional analysis, most genes in clusters 1-6 are related to the B-cell receptors and IgG immunoglobulin complex, proliferating cell nuclear antigen complex, the metabolic pathways of iron, fat, and body mass control, the defense against bacteria, the cancer development incidence, and the chronic kidney failure, respectively. CONCLUSION: Results showed that most biological changes of aging between tissues are related to the specific components of immune cells. Also, the application of MMVNDs can increase the ability to find similar genes.

Relationship between time management skills and anxiety and academic motivation of nursing students in Tehran.

INTRODUCTION: Time management skills are essential for nursing students' success, and development of clinical competence. The purpose of this study was to determine the relationship between time management skills and anxiety and academic motivation of nursing students in Tehran medical sciences universities in 2015. METHODS: This cross-sectional study was carried out on 441 nursing students in three medical universities in Tehran. Random stratified sampling was done to select the samples. Data were collected using demographic Questionnaire, Time Management Questionnaire (TMQ), Spielberger State-Trait Anxiety Inventory (STAI) and Academic Motivation Scale (AMS), which was completed t by self-report. Data were analyzed using SPSS 18 software with descriptive and analytical statistics such as ANOVA, independent t-test, Regression and Pearson Correlation Coefficient. RESULTS: Most participants had a moderate level of time Management skills (49%), State Anxiety (58%), Trait Anxiety (60%) and Academic Motivation (58%). The results also showed a statistically significant negative correlation between the students' TMQ scores and the state anxiety (r= -0.282, p< 0.001) and trait anxiety scores (r= -0.325, p<0.001). Moreover, there was a statistically significant positive correlation between the students' TMQ scores and AMS scores (r= 0.279, p< 0.001). CONCLUSION: Regarding the findings, it seems that it is necessary to plan for improving time management skills in order to enhance academic motivation and reduce anxiety rates among nursing students.

Associations of demographic and socioeconomic factors with stage at diagnosis of breast cancer.

BACKGROUND: Stage at diagnosis is one of the most important prognostic factors of breast cancer survival. Because in the breast cancer case this may vary with socioeconomic characteristics, this study was performed to recognize the relationship between demographic and socioeconomic factors with stage at diagnosis in Iran. MATERIALS AND METHODS: This cross-sectional, descriptive study conducted on 526 patients suffering from breast cancer and registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from 2008 to 2013. A reliable and valid questionnaire about family levels of socioeconomic status filled in by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests were executed by SPSS22. Economic status, educational attainment of patient and household head and/or a combination of these were considered as parameters for socioeconomic status. First, the relationship between stage at diagnosis and demographic and socioeconomic status was assessed in univariate analysis then these relationships assessed in two different models of multinomial logistic regression. RESULTS: The mean age of the patients was 48.3 (SD=11.4). According to the results of this study, there were significant relationships between stage at diagnosis of breast cancer with patient education (p=0.011), living place (p=0.044) and combined socioeconomic status (p=0.024). These relationships persisted in multiple multinomial logistic regressions. Other variables, however, had no significant correlation. CONCLUSIONS: Patient education, combined socioeconomic status and living place are important variables in stage at diagnosis of breast cancer in Iranian women. Interventions have to be applied with the aim of raising women's accessibility to diagnostic and medical facilities and also awareness in order to reducing delay in referring. In addition, covering breast cancer screening services by insurance is recommended.

The Correlation between the Family Levels of Socioeconomic Status and Stage at Diagnosis of Breast Cancer.

BACKGROUND: Stage is one of the most important prognostic factors for the cancer diagnosis, including the breast cancer. Studies have found that the rate of breast cancer late-stage diagnosis, among the women with lower socioeconomic status, is more than the others. The aim of this study was investigation the relationship between family levels of socioeconomic status and stage at diagnosis of breast cancer. METHODS: This cross-sectional, descriptive study has conducted on 526 patients who have suffered from breast cancer, and have registered in Cancer Research Center of Shahid Beheshti university of Medical science, from March 2008 till December 2013. A reliable and valid questionnaire about family status of socioeconomic status, have filled by interviewing the patients via phone. For analyzing the data, Multinomial logistic regression, Kendal tau-b correlation coefficient and Contingency Coefficient tests have executed by SPSS 19. RESULTS: The results have indicated that the mean age of the patients was 48.30 (SD=11.41). There was a significant relationship between stage at diagnosis of breast cancer and family levels of socioeconomic status at the time of diagnosis (p=0.024). Also, the relationship between stage at diagnosis and living place (in or out of Tehran) was significant (p=0.044). In the Multiple logistic regressions, these associations were significant. There wasn't any significant relationship between stage of diagnosis of breast cancer and age, marital status and family history. CONCLUSION: Regarding the results of this study, deep paying attention to the family socioeconomic status as an important variable in stage at diagnosis of breast cancer, among Iranian women, was too important, and then providing the prevention plans related to this topic has seemed necessary.