The Effect of Ear Acupressure on Behavioral Problems in Children with Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial.

Objective: Due to the limits on treatment for people with attention-deficit/hyperactivity disorder (ADHD), ear acupressure treatment has been considered. This study examined the effect of ear acupressure on behavioral problems of children with ADHD. Materials and Methods: This randomized controlled trial was conducted in 70 children with ADHD who were randomized into 2 groups. The intervention group received ear acupressure in treatment points and the control group received massage at neutral points. Behavioral problems were measured 3 times: (1) baseline; week 4; and week 8. The last timepoint was a follow-up, using the Child Behavior Checklist. Results: The intervention group had fewer behavioral problems at all 3 timepoints than the control group (Cohen's ∂ = 1.49; 95% confidence interval at week 4: 20.97, 47.43).The ear acupressure group had a large effect size with respect to reduction of attention problems at week 4 (∂ = 1.88) and week 8 (∂ = 1.48) than the control group. Conclusions: Ear acupressure induced significant reduction of the behavioral problems of children with ADHD. Further research can evaluate the use and continuity of the effectiveness of this treatment as a complementary treatment in addition to the usual treatments for these children.

Prevalence of hallucinations in Parkinson's patients: meta-analysis of International studies.

BACKGROUND: Parkinson's disease (PD) is one of the common causes of disability in the elderly. This study aims to estimate the prevalence of hallucinations in Parkinson's patients in the world. METHODS: A systematic review of PubMed/Medline, ISI Web of Knowledge, and Google Scholar was conducted from 2017 to 2022. This study investigated the prevalence of hallucinations in Parkinson's patients. Point prevalence was analyzed with a 95% confidence interval. The variances of each study were calculated using the binomial distribution formula The researcher used Cochrane Q-test with a significance level of less than 0.1 to check the heterogeneity between studies and the change index assigned to heterogeneity I2. Due to the heterogeneity between the studies, the random effects model was used to combine the results of the studies. All statistical analyses were performed by STATA version 14 software using meta-analysis commands. RESULTS: Reports indicated that the prevalence of hallucinations in Parkinson's patients in 32 studies was 28% (0.22-0.34 = 95%CI). The highest prevalence was 34% and 95% CI = 0.07- 0.61 in developing countries and 27% with CI = 0.33-0.21 in developed countries. Reports showed the prevalence in men was 30% (CI = 0.22-0.38) and in women 23% (95% CI = 0.14-0.31). CONCLUSIONS: Considering the relatively high prevalence of hallucinations in these patients, checking up for the presence of hallucinations on every visit of Parkinson's patients is recommended, and providing appropriate treatment for that is necessary.

Reliability, validity, and psychometric properties of the Persian version of the Tayside children's sleep questionnaire.

Tayside Children's Sleep Questionnaire (TCSQ) is a simple tool for screening the disorders of initiating and Maintaining Sleep among children aged between 1 and 5 years. This study aimed to translate TCSQ into Persian and evaluate its validity and reliability of TCSQ among Persian speakers. This cross-sectional study was conducted among 311 children aged 1-5 years in Isfahan. After permission, the forward-backward translation method was used to develop the Persian version. Finally, 311 children participated in this survey, which 30 were repeated a second time. Google Forms, SPSS16, and STATA14 were used for data collection, descriptive statistics, and factor analysis. BEARS questionnaire was used to assess concurrent validity. Three expert opinions were used for content validity. In this study, 404 mothers of children in Isfahan volunteered to participate in the survey, of which 311 remained. The mean and standard deviation age of their children were 3.47 ± 1.91 years. Cronbach Alpha of the Persian version of TCSQ was 0.76 CI (0.78-0.66). The intra-class correlation coefficient was 0.67 CI (0.60-0.74). The content validity index was 0.88, and three factors (disturbance, nighttime, parents) with a specific value greater than 0.4 is determined by factor analysis. The current study results indicate that TCSQ has good reliability and validity among Persian speakers.

Workload and quality of nursing care: the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion by using structural equations modeling approach.

BACKGROUND: Nursing workload and its effects on the quality of nursing care is a major concern for nurse managers. Factors which mediate the relationship between workload and the quality of nursing care have not been extensively studied. This study aimed to investigate the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion in the relationship between workload and quality of nursing care. METHODS: In this cross-sectional study, 311 nurses from four different hospitals in center of Iran were selected by convenience sampling method. Six self-reported questionnaires were completed by the nurses. The data were analyzed by SPSS version 16. Structural equation modeling was used to determine the relationships between the components using Stata 14 software. RESULTS: Except direct and mutual relationship between workload and quality of nursing care (P ≥ 0.05), the relationship between other variables was statistically significant (P < 0.05). The hypothesized model fitted the empirical data and confirmed the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion in the relationship between workload and the quality of nursing care (TLI, CFI > 0.9 and RMSEA < 0.08 and χ2/df < 3). CONCLUSION: Workload affects the quality of the provided nursing care by affecting implicit rationing of nursing care, job satisfaction and emotional exhaustion. Nurse managers need to acknowledge the importance of quality of nursing care and its related factors. Regular supervision of these factors and provision of best related strategies, will ultimately lead to improve the quality of nursing care.

Epidemiological Features and the Incidence Trend of Brain Cancers in Iran (2004-2008).

Background: The objective of this research is to consider the incidence of brain cancers in Iran during the years 2004-2008 to improve reporting, distribution of the disease. Methods: In this cross-section study, the study population was all brain cancer cases diagnosed in Iran between 2004 and 2008. Age-standardized rate (ASR) per 100,000 persons and crude rate were calculated using direct standardization. Data were analyzed using Statistical Package for the Social Sciences (SPSS version 16) and Microsoft Office Excel 2010. Results: During the period 2004-2008, the ASR and crude rate of brain cancers among males were 2.37, 2.46, 2.77, 2.84, 4.16 and 2.13, 2.11, 2.40, 2.49, 3.61, respectively, and among females the ASR and crude rates were (1.64, 1.67, 2.04, 2.17, 3.09) and (1.45, 1.45, 1.76, 1.84, 2.62), respectively. Conclusions: According to the study results, a significant increase in the incidence of brain cancer was observed over a 4-year period in Iran. Hence, screening and early detection programs for this type of cancer are highly recommended.

A meta-analysis study of worldwide prevalence of mortality in cocaine-consuming motorcyclists.

For this meta-analysis, the aim is to estimate the prevalence and to determine the factors associated with changes in this prevalence in the world. A systematic review of PubMed/Medline, ISI Web of Knowledge, Scopus, and Science Direct, SID, and Google Scholar from 2011 to April 2020 was performed. Point prevalence was analyzed with a 95% confidence interval. The variances of each study were calculated using a two-sentence distribution formula, and the heterogeneity between the studies was assessed by the Q-Cochran test with a significance level of less than 0.1. Also, the index of changes attributed to I2 was examined. Due to the heterogeneity between the studies, the random-effects model was used to combine the results of the studies. All statistical analyses were performed by the STATA software version 11 using Meta-Analysis commands. The significance level of the tests was considered to be P < 0.05. The prevalence of mortality in motorcyclists in six studies was reported to be 12% (0.05-0.18 = 95% CI). We stratified this study by participant geographical region and age group. In this study, the highest prevalence of mortality was in the under-30 age group. Furthermore, planning educational campaigns and advertisements by state authorities that are pointing out the harmful effects of motorcyclists' cocaine and/or other substances consumption is necessary.

Epidemiology and trends of gastrointestinal cancer in Iran (2004-2008).

AIM: Gastrointestinal (GI) cancer is among the most common cancers in Iran. The main purpose of this study was to evaluate changes in the time trends of stomach, colon and rectum, and esophageal cancer during the past decade in Iran. MATERIALS AND METHODS: In this cross-sectional study, the study population was all cases of GI cancers diagnosed in Iran between 2004 and 2008. Cancer incidence data for the years 2004-2008 were obtained from the cancer registry system of the Ministry of Health. All incidence rates were directly age standardized to the world standard population. Age-Satndardized incidence rate (ASR)per 105 persons was calculated using direct standardization and the world standard population. The crude rate was calculated in this study. Data were analyzed using SPSS (version 17) and Microsoft Office Excel 2007. RESULTS: During the 2004-2008 period, the ASR and crude rates of GI cancers, including esophagus, stomach, colon and rectum, among males were 5.05, 15.02, and 8.29 and 4.01, 11.81, and 6.4, respectively, and among females were 6.52, 7.055, and 7.75 and 4.40, 4.85, and 5.49, respectively. The most common cancers in women were colon and rectum, and stomach cancer had the highest incidence in males. In this study, most cases of stomach cancer were adenocarcinoma adenocarcinoma (Nos) in both women and men. The most common type of colorectal cancer was adenocarcinoma, which was greater in men than women. The most common type of esophageal cancer was squamous cell carcinoma in both sexes. The north and northwestern regions of Iran have the highest risk of GI cancer. CONCLUSION: According to this study, a significant increase was observed in the incidence of cancers in the north and western regions of Iran. Hence, screening and early detection programs are highly recommended in these high-risk areas.

Prevalence of Suicidal Ideation in Multiple Sclerosis Patients: Meta-Analysis of International Studies.

The aim of this study is to estimate the worldwide prevalence of suicidal ideation in multiple sclerosis patients. Two researchers selected words such as "epidemiology" or "prevalence" or "incidence" and "suicidal ideation in multiple sclerosis" and searched them as relevant keywords in international databases such as PubMed, Web of Science CINAHL, Embase, Psyc INFO, and Scopus. A point prevalence with 95% confidence interval was estimated. The variances of each study were calculated using the binomial distribution formula. Heterogeneity among the studies was tested by a Q-Cochran test with a significance level less than 0.1. Index of changes attributed to heterogeneity (I2) was assessed. From among the 170 total articles found from 2011 to February 2019, we pooled and analyzed the data of eight final eligible studies, based on the inclusion criteria. The prevalence of suicidal ideation in multiple sclerosis patients was estimated as 13% (CI 95% = 0.09-0.17). A subgroup analysis was conducted based on the type of countries; it revealed that prevalence is higher in developed countries (15%; CI 95% = 0.1-0.2). Pooled worldwide prevalence of suicidal ideation in the MS population was calculated at 13% by random effect. It is recommended that training, counseling, and psychological support be used to help these patients.

Reliability and validity of Persian version of Brief Self-Control Scale (BSCS) in motorcyclists.

Objective: The present study aimed to investigate the validity and reliability of the Persian version of brief self-control scale (BSCS) in Iranian motorcyclists.Methods: The original English questionnaire of BSCS has been translated into Persian using the direct-reverse approach. A total of 130 motorcyclists aged 18-65 years old in Iran-Kashan completed the questionnaire. Validity was determined by content validity methods, structural validity through factor analysis, and also the convergence and divergence validity using Spearman correlation coefficient. The intra class correlation coefficient (ICC) was calculated to estimate the reliability of the self-control tool. Reliability was calculated using Cronbach's alpha.Results: The mean and standard deviation of the age at the time of study was 38.5 ± 13.5 years old and all of the subjects were male. Cronbach's alpha coefficient of the whole questionnaire (BSCS) was 0.81, which was good in this regard. The ICC coefficient was 0.88 with confidence interval of (0.8-0.93), which confirmed the repeatability of this tool. Exploratory factor analysis (EFA) yielded a two-factor solution accounted for 42% of the observed variance.Conclusion: This study showed that Persian version of BSCS has a good reliability and validity for self-control in the Persian language community.Key pointsThe Brief Self-Control Scale (BSCS) has good internal consistency.The Brief Self-Control Scale (BSCS) has acceptable reliability.Brief Self-control Scale (BSCS) has acceptable validity and reliability in the population studies.

Prevalence of mortality in cannabis consumer motorcyclists: meta-analysis of international studies.

The purpose of this study was to estimate prevalence of mortality in cannabis consumer motorcyclists across the world. A systematic review was conducted from publications PubMed/Medline, ISI Web of Knowledge, EMBASE, Scopus, and Google Scholar from August 2010 to March2019. The variances of each study were calculated using the binomial distribution formula and the heterogeneity among the studies was analyzed by Q-Cochran test with a significant level less than 0.1 and the index of changes attributed to I2 heterogeneity. The prevalence of mortality in cannabis consumer motorcyclists was estimated 0.15 (95% CI = 0.08-0.22). Subgroup analysis based on country type showed that the mortality rate of cannabis consumer motorcyclists in developed countries is 16% (0.08-0.24) and in developing countries is 8% (0.04-0.10). These findings have implications for developing interventions through presenting appropriate solution, educating people and raising awareness to address the changing nature of drug use among motorcyclists in the world.

Predictors of suicidal ideation among Iranian patients with multiple sclerosis.

Background: Considering the high probability of suicidal behaviors in multiple sclerosis (MS) population of other countries and the unlikeliness of its diagnosis in patients with MS by specialists, the current research targets the frequency of suicidal thoughts and mood symptoms in a group of patients with MS in Iran. Also, we investigated the relationships among suicidal thoughts, anxiety, depression, anticipated stigma, social support, some disease characteristics, and sociodemographic factors. Methods: A sample of 276 subjects were selected from community-based MS clinics and referral out-patient MS clinic of Sina Hospital affiliated to Tehran University of Medical Sciences, Tehran, Iran. Participants completed the Patient Health Questionnaire (PHQ), the Hospital Anxiety and Depression Scale (HADS), the Chronic Illness Anticipated Stigma Scale (CIASS), the Multidimensional Scale of Perceived Social Support (MSPSS), and a personal information questionnaire. Results: 36.2% of the participants had suicidal thoughts. Suicidal ideation was significantly more likely among people who reported higher anxiety and depression scores or anticipated stigma from their friends and families. Women and patients with higher education experienced suicidal ideation more frequently than others. Conclusion: Findings regarding the comorbidity of suicidal thoughts with anticipated stigma, depression and anxiety in MS patients emphasizes therapeutic interventions focused on the alleviation of perceived stigma as well as mood symptoms.

Mediating Role of Anxiety and Depression in the Relationship Between Posttraumatic Stress Disorder and Aggression in Motor Vehicle Accident: A Structural Equation Modelling Approach.

OBJECTIVE: This study investigated the existence of anxiety and depression mediating effect on the relationship between PTSD and aggression in the hope of providing more comprehensive and effective trauma treatment in motor vehicle accident. METHODS: The studied population of the study consisted of motor vehicles with posttraumatic stress disorder in Kashan. Three questionnaires of post-traumatic stress disorder, Hospital Anxiety and Depression Scale ( HADS ) and Aggression Questionnaire ( Buss & Perry , 1992) were used for data collection. In order to analyze the mediating effects of anxiety and depression on the relationship between PTSD and aggression, structural equation modeling(SEM) was performed with the maximum likelihood ratio as the method of estimation. RESULTS: Evaluation of the research hypothesis model using fitness indices showed that the hypothetical model fits with the measurement model. NFI=0.96, CFI =0.95, RMSEA=0.06 and the results showed that PTSD had indirect exacerbating effects on aggression. The results also confirmed the mediating role of anxiety and depression in the relationship between post-traumatic stress disorder and aggression in motor vehicle accident. CONCLUSION: The findings demonstrate that anxiety mediates the relationship between PTSD and aggression. Therefore, this finding can help to prioritize therapeutic goals and determine therapeutic focus for mental health professionals. It is possible to reduce one's aggression by focusing on his anxiety and increasing his/her ability to handle and manage it.

Worldwide prevalence of alcohol in fatally injured motorcyclists: A meta-analysis.

Objective: The aim of this study was to estimate the prevalence of alcohol in fatally injured motorcyclists and to determine the factors that are related to the prevalence worldwide. Methods: A systematic review was conducted using PubMed/Medline, ISI Web of Knowledge, and Google Scholar until 2018. Point prevalence with 95% confidence intervals was estimated. The variances of each study were calculated using by binomial distribution formula. Heterogeneity among the studies was tested using Cochran's Q test with a significance level less than .1. The index of changes attributed to heterogeneity (I2) was assessed. Regarding the heterogeneity of the studies, a random effects model was employed to combine the results of the studies. All statistical analyses were performed using STATA Ver. 11 using the meta-analysis commands. Results: Of 916 articles from 2011 to 2018, 12 studies were examined and analyzed based on inclusion criteria. The prevalence of alcohol in fatally injured motorcyclists was 0.30 (95% confidence interval [CI], 0.25-0.35). Subgroup analysis based on the type of country showed that the prevalence of alcohol in fatally injured motorcyclists in developing countries was 34% (95% CI, 0.18-0.49), which was higher than that in developed countries (29%; 95% CI, 0.24-0.33). In addition, the prevalence of alcohol among fatally injured motorcyclists aged 25-35 years was greater than that of other age groups (0.34; 95% CI, 0. 27-0.4). Conclusions: Motorcyclists dominated the picture of fatal crashes and deserve more attention by the public and government. With the proper planning and adoption of health policies, increasing prevalence and complications of the disease will be prevented.

Emotional Intelligence and the Occurrence of Accidents in Motorcycle Drivers in Kashan, Iran.

There is an inherent risk of death and injury for motorcyclists. Some factors such as personality and psychological characteristics may be contributors of motor vehicle accidents/crashes. This study aimed to determine the relationship between emotional intelligence and its related components and the occurrence of accidents/crashes in motorcycle drivers. In this case-control study, 280 motorcycle drivers with and without a history of motorcycle-related accidents or crashes in Kashan, Iran, were selected for convenience sampling. The tool used was the Bar-On Emotional Intelligence Questionnaire and included 90 items. Logistic regression revealed that components of emotional intelligence identified as happiness, optimism, flexibility, self-actualization, autonomy, and interpersonal relationships were different between motorcycle drivers with and without an accident/crash. Our findings emphasized the important role of developing and enhancing the skills of emotional intelligence as related to the prevention of accidents/crashes.

Psychometric Evaluation of the Persian Version of the Chronic Illness Anticipated Stigma Scale (CIASS).

PURPOSE: The present study aimed to evaluate the cross-cultural validation and psychometric properties of the Persian version of the Chronic Illness Anticipated Stigma Scale (CIASS) among the patients with chronic illness in Iran. METHOD: Following standard procedures, the questionnaire was administered to a total sample of 186 patients with chronic illness who were recruited from the referral hospital, including hospitalized and clinic outpatients plus several referral clinics. Test-retest reliability and internal consistency were analyzed through intraclass correlation coefficient and Cronbach's alpha tests, respectively. Validity was evaluated in the areas of content and face validity, convergent, and also structural validity. RESULTS: Cronbach's alpha coefficient for the reliability of the scale was 0.88.The results of explanatory factor analysis confirmed extraction of all dimensions in three factors, consisting of family and friends, work colleagues, and healthcare workers. Evaluating convergent validity using Spearman's correlations showed satisfactory results; the correlation between the domains of the CIASS demonstrated internal agreement of the measure determining additional evidence to suggest the validity of the Persian CIASS. CONCLUSION: The preliminary study of the Persian version of the CIASS indicates good reliability and validity of the measure in Iranian patients with chronic illnesses.