Colorectal cancer literacy and related factors in northeast of Iran: A cross-sectional study.

BACKGROUND: Colorectal cancer (CRC) is a health challenge and the second most common cancer worldwide. Increasing colorectal cancer literacy (CRCL) is one of the most effective factors in CRC prevention. AIM: The aim of this study was to determine and evaluate CRCL and its related factors in Torbat Heydarieh, northeastern Iran. METHODS AND RESULTS: This study was a cross-sectional survey conducted in 2021 in Torbat Heydarieh, a city in northeastern Iran, on 200 clients presenting to a comprehensive health service centers. In addition to collecting sociodemographic characteristics, participants were administered the Knowledge and Attitude Questionnaire and the Colorectal Cancer Literacy Questionnaire (CRCLQ). Data were analyzed with SPSS software version 25 using independent samples t-tests, one-way analysis, chi-square, and Pearson correlation coefficients. The statistical significance level was set at p < .05. The results showed that the mean age of the participants was 51.12 ± 8.45 years. The majority of participants (84%) stated that their friends and relatives had no history of CRC. Pearson correlation coefficient results showed a significant correlation between knowledge and attitude toward CRC (r = .15, p = .041). A significant correlation was also found between knowledge and CRCL (r = .4, p ≤ .001). CONCLUSION: We found low CRCL among clients of comprehensive health service centers. More targeted educational interventions are needed to promote CRCL among Iranian adults.

Burnout syndrome and related factors among health team employees.

BACKGROUND: Burnout is not only related to mental health but also to efficiency. Thus, recognizing effective coping strategies has a significant role in improving mental health, the efficiency and productivity of human resources, and making better the level of quality of service. OBJECTIVE: To determine burnout syndrome and examine related factors among the employees of Mashhad University of Medical Sciences. METHOD: This cross-sectional study was conducted among 600 employees at Mashhad University of Medical Sciences. They were selected by a stratified sampling method. The data collection tool was the demographic information and the Burnout Self-Test Maslach Burnout Inventory (MBI) questionnaire. Data were analyzed through SPSS software version 20, using descriptive statistics and independent samples t-tests, one-way ANOVA, and Pearson and Spearman regression. RESULTS: The findings showed that emotional exhaustion (EE) and depersonalization (DP) in the majority of employees were high and personal accomplishment (PA) was low at 88.33% of cases. All participants presented burnout. However, participants aged 35-40 years, those with professional and Ph.D. degrees, and research staff reported higher burnout levels. CONCLUSION: Job burnout and its subscale levels among the employees were high. Job burnout is associated with socioeconomic status that can be affected by individual, organizational, management, and environmental factors. Therefore, this study suggests that employees need to get out of EE and DP conditions for higher job performance. Additionally, further research is required to examine the long-term effects of workplace burnout.

The Correlation of Social Support and Fear of Breast Cancer among Women in Northeast of Iran: A Cross-Sectional Study.

Background: Breast cancer (BC) is the most commonly diagnosed cancer worldwide. Screening programs are the most common prevention methods. Perceived social support and fear are two important factors affecting women's participation in breast cancer screening. This study aimed to determine the relationship between fear of BC and perceived social support among women in Torbat Heydarieh, northeast of Iran. Methods: This study is an online cross-sectional survey that was conducted on 352 women in Torbat Heydarieh city of Northeast Iran, from October 26th, 2021 to December 26th, 2022. Along with collecting sociodemographic characteristics, the Breast Cancer Fear Scale (BCFS), and the Multidimensional Scale of Perceived Social Support were electronically administered to participants. Data were analyzed through SPSS software version 25, using independent samples t-tests, one-way analysis, Pearson's correlation coefficient, and multiple linear regression models. The statistical significance level was set at P<0.05. Results: The mean score for the BCFS was 20.67±1.03 which was in the moderate range for the total score of 40. Assessment of perceived social support indicated a moderate level of perceived support for all dimensions. Also, a significant correlation was found between the women's BCFS scores and perceived social support (r=-0.29, P<0.001). Conclusion: We found that there was a negative statistically significant correlation between the BCF and social support. Therefore, this study suggests that healthcare providers pay attention to these factors. Moreover, further research is needed to explore the long-term effects of BCF due to low social support.

Community Behavioral and Perceived Responses in the COVID-19 Outbreak in Afghanistan: A Cross-Sectional Study.

OBJECTIVE: Community responses are important for the management of early-phase outbreaks of coronavirus disease 2019 (COVID-19). Perceived susceptibility and severity are considered key elements that motivate people to adopt nonpharmaceutical interventions. This study aimed to (i) explore perceived susceptibility and severity of the COVID-19 pandemic, (ii) examine the practice of nonpharmaceutical interventions, and (iii) assess the potential association of perceived COVID-19 susceptibility and severity with the practice of nonpharmaceutical interventions among people living in Afghanistan. METHODS: A cross-sectional design was used, using online surveys disseminated from April to May 2020. Convenience sampling was used to recruit the participants of this study. The previously developed scales were used to assess the participants' demographic information, perceived risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and perceived severity of COVID-19. Multivariate analyses were conducted to assess the potential association of perceived COVID-19 susceptibility and severity with the practice of nonpharmaceutical interventions. RESULTS: The Internet was the main source for obtaining COVID-19 information among participants in this study. While 45.8% of the participants believed it was "very unlikely" for them to get infected with COVID-19, 76.7% perceived COVID-19 as a severe disease. Similarly, 37.5% believed the chance of being cured if infected with COVID-19 is "unlikely/very unlikely." The majority of participants (95.6%) perceived their health to be in "good" and "very good" status. Overall, 74.2% mentioned that they stopped visiting public places, 49.7% started using gloves, and 70.4% started wearing a mask. Participants who believed they have a low probability of survival if infected with COVID-19 were more likely to wear masks and practice hand washing. CONCLUSIONS: It appears that communities' psychological and behavioral responses were affected by the early phase of the COVID-19 pandemic in Afghanistan, especially among young Internet users. The findings gained from a timely behavioral assessment of the community might be useful to develop interventions and risk communication strategies in epidemics within and beyond COVID-19.

Efficacy, safety, and tolerability of sublingual fentanyl orally disintegrating tablet in the treatment of breakthrough cancer pain: a randomized, double-blind, placebo-controlled study.

BACKGROUND: Breakthrough pain (BTP) is an important challenge in treatment and requires a rapid onset of action for pain control. BTP should be adequately controlled with a stable dose of a short-acting oral opioid. So far, no drug is available for the treatment of BTP in cancer patients in Iran, so we designed the first study in Iran to investigate the effect of sublingual fentanyl in relief of pain episodes in these patients. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of sublingual fentanyl in the treatment of breakthrough pain in cancer patients. METHOD: This study was a randomized double-blind placebo-controlled clinical trial in cancer patients with breakthrough pain (at least 1-4 episodes of acute pain with moderate to severe pain daily) referred to the pain clinic of Akhtar and Masih Daneshvari hospitals in 2019. The study consisted of two stages: 100 patients were selected by simple, non-random sampling and entered the open-label titration phase. The primary efficacy endpoint was the sum of pain intensity difference over 30 min post-administration. Secondary efficacy endpoints included pain intensity difference (PID) and pain relief (PR) throughout the 60-min post-dose assessment period. In the double-blind study, patients were randomly divided into two groups of placebo (n=50) and intervention (sublingual fentanyl tablet) (n=50). For evaluation of efficacy, 10 episodes were treated in each group and the results were recorded by the patient. (Clinical trial registration: IRCT20131124015515N8). RESULTS: A total of 100 patients entered the titration phase, primary efficacy of sublingual fentanyl was 3.5±0.6 and secondary efficacy of sublingual fentanyl (60 min, after treatment) was 0.3±0.6 which was statistically significant. In the titration phase, the treatment success rate was 100%. In the double-blind phase of the study, the pain intensity in multiple episodes showed a significant improvement at 15, 30, 45, and 60 min after drug administration (P=0.0001). The intensity of pain in each episode was significantly decreased compared to the next episode (P=0.0001). The mean frequency of pain episodes in the sublingual fentanyl group showed a significant decrease (P=0.0001). The most common adverse drug events in the titration phase were drowsiness (20%), dizziness (7%), and nausea 4%, and in the double-blind phase only drowsiness (12%). (Cancer Research Center, Shahid Beheshti University of Medical Sciences, Survey). CONCLUSION: Sublingual fentanyl appears to be effective for patients with rapid-onset analgesia, has short-acting duration, is effective medication, safe, and well tolerated. It is a suitable choice in Iranian patients with chronic cancer-related pain controlled suffering from acute pain episodes related to cancer.

Effects of educational program based on Precede-Proceed model in promoting low back pain behaviors (EPPLBP) in health care workers Shahid Beheshti University of medical sciences: randomized trial.

The PRECEDE-PROCEED model is an adaptable planning model that could be served in public health issues. The purpose of this study is to investigate the effects of an educational program based on Precede-Proceed model on promoting Low Back Pain (LBP) behaviors among health care workers (HCWs). This Double-blinded randomized trial study was conducted on 112 from 120 HCWs aged from 30 to 55 years The eligible HCWs were randomly divided to intervention group 1 (N = 38), respectively intervention group 2 and control group (N = 37) for which the Precede-Proceed - based educational program was implemented and control group (N = 37). The random multi-stage cluster sampling method was used to recruit HCWs. HCWs completed a self-reported questionnaire on their Low Back Pain Behaviors assessment questionnaire based on the Precede-Proceed Model and a visual analogue scale (VAS) was also used. The data were gathered at initial of the study, 6 and 12 months follow-ups from three groups and were analyzed through SPSS version 19. There was a significant interaction between the factors "group" and "test time" (p < 0.05, p < 0.001) of knowledge, perceived self-efficacy, and attitude, reinforcing factors, enabling factors, public health, quality of life and LBP preventive behaviors of the intervention group., although, no significant alternate became located in the mean score of above structures of the control group. The findings of the present study confirmed the effectiveness of the PRECEDE-PROCEED model-based educational program on preventing LBP by enhancing scores of model constructs. However, these results should be repeated in further studies to be able to apply this program in health system.

The Long-term Effects of Percutaneous Laser Disc Decompression (PLDD) Treatment on Lumbar Disc Protrusion: A 2-Year Follow-up.

Introduction: Nowadays many physicians have focused their attention on using low invasive methods for the treatment of disc protrusion. Thus, the current study was carried out to evaluate the effect and therapeutic outcomes of clinical percutaneous laser disc decompression (PLDD) in the treatment of chronic low back pain caused by disc protrusion during a two-year follow-up. Methods: This historical cohort study was conducted on 40 patients, who were suffering from chronic low back pain caused by disc protrusion diagnosed, and referred to the pain clinic of Akhtar Hospital from March to August 2016 were treated with PLDD and were followed up for at least two years after performing PLDD (from 2018 to 2019). All the information has been extracted using medical records and patient interview. The severity of pain was measured by the Numeric Rating Scale (NRS), and the Oswestry disability index (ODI) was measured before and two years after the treatment. Results: The most common sites for two-level PLDD were L4-S1 and L3-L5, and the most common sites for one-level PLDD were L5-S1 and L4-L5. Overall, the levels of pain and functional disability two years after PLDD showed significant improvements (P =0.0001). The results revealed no statistically significant differences in NRS and ODI scores between the two groups of men and women two years after PLDD (P >0.05). Furthermore, they indicated no statistically significant differences in NRS and ODI scores between the different disc protrusion levels two years after PLDD (P >0.05). Conclusion: It seems that the PLDD is a low-invasive, safe, and effective method that can be used in patients with chronic low back pain caused by a disc protrusion. Therefore, it can be considered as a suitable choice in treating patients with chronic low back pain caused by a disc protrusion.

Factors predicting the oral health behaviors of the Iranian students in the District 1 Tehran, Iran

Aim: The purpose of this examination is determining the predictors of oral health behaviors among Iranian students in district 1 Tehran based on the health belief model with added commitment to plan construct. Methods: This cross-sectional study was conducted on 351 four grade female students in the first district of Tehran, Iran in 2017. The multi­stage random cluster sampling method was used to recruit students. The inclusion criteria were being in four ­ graded level of elementary schools of the 1st district in Tehran, being female students aged between 9-11 years and being physically and psychologically healthy student. Logistic regression analysis was used to identify the variables that predict oral health behaviors. Results: Totally, (N= 31.8%) students reported that they were brushing less than twice a day and (N= 55.2% ) students claimed using of dental floss once a week or less than once a day. The results indicated that perceived self-efficacy (OR=1.46, 95% CI=0.57-3.78, P<0.001), commitment to plan (OR=1.13, 95% CI=1.04-1.23, P<0.001) and cues to action (OR=1.42, 95% CI=1.14­1.76, P=0.002) were the significant predicting variables of brushing twice a day, and use of dental floss once a day or more (OR=1.02, 95% CI=0.23-3.53, P=0.003). Conclusion: This study has shown the effectiveness of the health belief model with added commitment to plan construct to predict oral health behavior in female students. Thus, it seems that the model as a acceptable framework for designing training programs to improve oral health behavior in students

Determinants of Quality of Life in Children and Adolescents With Hemophilia in Kabul, Afghanistan: First Report.

BACKGROUND: Hemophilia is a rare inherited disorder associated with abnormal repeated bleeding and debilitating joint pain due to deficiency in coagulating factors VIII and IX. This study aimed to provide an updated account on the health-related quality of life (HRQoL) in children with hemophilia in Afghanistan. METHODS: This cross-sectional study included 65 randomly selected hemophiliacs out of 350 children registered with the Afghanistan Hemophilia Patient Association (AHPA). The patients were 8-16 years old and voluntarily entered the study. Data were collected through a demographic questionnaire and a Persian version of Haemo-QoL Questionnaire (short version) for children aged 8-16 years. RESULTS: The patients' age averaged 12.9 ± 3.9 years with a mean QoL score of 75.9 ± 17.4. The patients were suffering from hemophilia A, mostly the severe type (80%). They were born to low income families (95 %) with high illiteracy rates (>50%) and hemophilia family history (90%). Spearman test showed a significant correlation between age and QoL scores (r = 0.8, P = 0.02). One-way ANOVA indicated no significant difference between QoL scores of patients categorized based on hemophilia severity (P = 0.2, F = 1.3), family incomes (P = 0.9, F = 0.01) and parents' levels of education (P = 0.2-0.4, F = 0.82-1.3). The Cronbach alpha for the instrument was 0.82. CONCLUSION: Regardless of hemophilia severity, Family and Sports were the most impaired domains of QoL. Herein, we have presented the first reliable and updated data on hemophiliacs' demographic characteristics and their quality of life in Kabul.

Educational intervention for promoting stretching exercise behavior among a sample of Iranian office employees: applying the Health Promotion Model.

INTRODUCTION: Health Promotion Model (HPM) is one comprehensive model by which health behavior predicting factors could be determined. PURPOSE: This study aimed to investigate the effects of a designed interventional program based on HPM on promoting stretching exercise (SE) behavior among office employees. PATIENTS AND METHODS: This interventional designed study was carried out on 87 office employees who were working in the three health networks affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran. These participants were randomly divided into intervention group (N=44) who complied with educational program based on HPM and control group (N=43) who did not receive the program. The data were collected through a demographic questionnaire and a researcher-made questionnaire based on HPM at three times of baseline, 3- and 6-month follow-ups and analyzed using SPSS version 19. RESULTS: Totally, 40 office employees with mean age of (37.70±7.40) in intervention and 37 ones with mean age of (35.97±7.34) in control group were assessed. At baseline, both groups were the same regarding the HPM constructs of perceived barriers, perceived self-efficacy, commitment to plan, and interpersonal influences (P>0.05). However, following intervention, there was a significant difference between two groups during 6-month follow-up in all these predictor factors (P<0.0001). Furthermore, the mean score of SE behavior in intervention group (22.43±6.50) was significantly better than the control group (15.45±0.93) (P<0.001). The pain severity also in intervention group (1±1.22) also was significantly less than control group (2±2.03) after 6-month follow-up (P<0.001). CONCLUSION: The SE educational programs applied in this study were effective for promoting SE among office employees.