Psychometric Evaluation of the Farsi Version of the Surgical Anxiety Questionnaire.

PURPOSE: The aim of this study was to evaluate the psychometric properties of the Farsi version of the Surgical Anxiety Questionnaire. DESIGN: Cross-sectional study. METHODS: This study was performed on 402 patients who were candidates for elective surgery in Mashhad [East Iran) hospitals in winter 2021. After forward-backward translation, face and content validity checks were performed qualitatively. The construct validity was assessed by exploratory and confirmatory factor analysis. Data analysis was performed with SPSS 16 and AMOS 26. FINDINGS: In exploratory factor analysis, two factors were extracted: concerns about surgery and anesthesia; and postdischarge concerns, which explained 52% of the total variance. The Cronbach's alpha for the entire questionnaire was 0.91 and for the subscales ranged from 0.80 to 0.87. The final model had a good fit as determined by confirmatory factor analysis. CONCLUSIONS: The Farsi version of the surgical anxiety questionnaire has acceptable validity and reliability. The existence of this scale measuring domain-specific anxiety allows for further research in this area.

Evaluating the Correlation of Death Anxiety With Spirituality, Religious Attitude, and Resilience in Patients With Cardiovascular Diseases.

This study aimed to determine the correlation between spirituality, religious attitude, and resilience with death anxiety in cardiovascular patients in Sanandaj, Iran. This study was conducted on 414 cardiovascular patients, who were selected by convenience sampling method. Demographic information forms, Spiritual Well Being Scale, Golriz and Burhani's Religious Attitude, Connor-Davidson Resilience Questionnaire, and Templer's Death Anxiety Scale were used to collect data. Results indicated that compared to urban areas, living in rural areas significantly increased the average score of death anxiety by 0.55 points (p = 0.026). Additionally, a one-unit increase in religious attitude and resilience significantly reduced the mean score of death anxiety by 0.05 (p = 0.003) and 0.13 (p <0.001) on average, respectively. Spearman rank correlation indicated that religious attitudes and resilience were inversely and significantly correlated with death anxiety. Therefore, providing counseling sessions with psychologists and clergy seems necessary for a favorable change in the state of death anxiety in these patients.

Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review.

BACKGROUND: Changes in sex hormones during menopause may have detrimental effects on a woman's sexual function and cause mood disorders. The treatment of both conditions is a challenge in gynecology. AIM: To review the published literature on sexual function and mood disorders among peri- and postmenopausal women. METHODS: The review is based on the methodological framework of scoping reviews. We searched electronic databases including Medline (PubMed), Scopus, Embase, and Web of Science (WoS). Publications that reported data about the relationship between sexual function and mood disorders among menopausal women were included in the review. The search was not subject to any limitation in terms of time or method. OUTCOMES: The main outcome measures used for the review were sexual dysfunction and mood disorders. RESULTS: We found 106 total records. After a full-text screening we included 19 studies from 1986 to 2020 based on various methodologies; the majority of the studies16 were cross-sectional. Investigations that addressed the symptoms of mood disorders and some domains of sexual function showed a close relationship between sexual dysfunction and mood disorders among menopausal women. CLINICAL IMPLICATIONS: In clinical practice, it would be appropriate to screen women for at least one mood disorder or sexual dysfunction. If a woman suffers from either, it will be necessary to assess for a further disorder as well. STRENGTHS & LIMITATIONS: The review was based on a detailed search of the published literature concerning mood disorders and sexual dysfunction among menopausal women compared to women of reproductive age. Despite the clinical importance of the subject, the number of studies eligible for inclusion in the review are rather small. Further investigation of the topic is clearly warranted. CONCLUSIONS: While the association between sexual dysfunction and mood disorders appears to be bidirectional, future studies will have to investigate the specific mechanisms by which sexual dysfunction could lead to mood disorders (or vice versa). Future studies should specifically address sexual dysfunctions and attitudes of partners, BMI, family support, sleep, and multiparity. Azam Rahmani, Elahe Afsharnia, Julia Fedotova, Shirin Shahbazi, Arezoo Fallahi, Leila Allahqoli, Reza GhaneipoklGheshlagh, Sarah Abboud, Ibrahim Alkatout. Sexual Function and Mood Disorders Among Menopausal Women: A Systematic Scoping Review. J Sex Med 2022;19:1098-1115.

Prevelence of depression in Iranian women with breast cancer: a systematic review and meta-analysis.

INTRODUCTION: Depression is a debilitating disease that is highly prevalent among cancer patients. Various studies in Iran have reported different prevalence. This systematic review and meta-analysis was conducted to estimate the overall prevalence of depression in Iranian women with breast cancer. MATERIAL AND METHODS: In this study, published articles in Persian and English were collected without time limit. Keyword searches for depression, depressive disorder, dysthymic disorder, major depressive disorder, breast cancer, breast neoplasm, and Iran and all of their potential combinations were performed in Scientific Information Database (SID), MagIran, PubMed, Scopus, Web of Science databases. The heterogeneity between studies was assessed using the Q-Cochrane test and, given the significant heterogeneity, a random-effects model was used to estimate the overall prevalence of depression. Data were analyzed using STATA version 11 software. RESULTS: The analysis of 22 selected articles with a total sample size of 3,082 showed that the overall prevalence of depression in women with breast cancer was 49.98% (95% confidence interval: 48.43-52.52). The prevalence of depression in Region 1 in the country was (28%; 95% confidence interval: 25.53-52.55) and in other regions, it was (63.79% with 95% confidence interval of 61.82-76.76). The highest and the lowest prevalence of depression were related to BDI (69.33%; 95% confidence interval: 67.19-71.48) and HADS (26.43%; 95% confidence interval: 23.14-29.72), respectively. CONCLUSIONS: Half of the Iranian women with breast cancer had depression. Given the overlap of physical symptoms of cancer with depression, identifying at-risk patients for controlling and providing therapeutic interventions seems necessary.

Validation of the persian version of the COVID-19 prevention, recognition and home-management self-efficacy scale.

INTRODUCTION: Adopting preventive behaviors and following the guidelines for controlling the COVID-19 epidemic depend on people's self-efficacy in carrying out these behaviors and instructions. The aim of this study was to investigate the psychometric properties of the Persian version of the COVID-19 Self-Efficacy Scale (COVID-19 SES, Hernández-Padilla et al., 2020). MATERIAL AND METHODS: This cross-sectional study was performed in a group of 400 people who were residents of the city of Asadabad in western Iran from December 2020 to January 2021. The participants were selected using a convenience sampling method. Face and content validity was assessed qualitatively based on feedback from the participants and experts, and the necessary changes were applied to the final version of the questionnaire. For construct validity, exploratory factor analysis (n=200) and confirmatory factor analysis (n=200) were performed. Internal consistency was expressed as Cronbach's alpha coefficient. Relative stability was assessed using the intraclass correlation coefficient (ICC), and absolute stability was calculated through examination of standard error of measurement (SEM). RESULTS: In exploratory factor analysis, three factors of prevention, symptom recognition, and homemanagement of COVID-19 were extracted that together explained 71.35% of the total variance. The internal consistency of the whole instrument was 0.955 and its three dimensions were 0.894, 0.916 and 0.955, respectively. In addition, an ICC of 0.986 (95% CI: 0.975-0.993, p=0.001) was found. In the confirmatory factor analysis, comparative and parsimonious fit indices were excellent, and absolute fit indices were moderate. CONCLUSIONS: The Persian version of the COVID-19 SES has good validity and reliability and can be used to measure self-efficacy in prevention, symptoms recognition, and home-management of COVID-19.

A Systematic Review and Meta-analysis of Death Anxiety Among Iranian Patients With Cancer.

Death anxiety in cancer patients can cause and exacerbate mental disorders and affect the healing process and survival. In this study, percentage score of death anxiety among Iranian cancer patients was reported. The databases of Scopus, PubMed, ISI, MagIran, and Scientific Information Database were searched and 396 articles were retrieved. Twenty-three eligible studies were included in the analysis considering the inclusion criteria. Heterogeneity among selected studies was assessed through the Cochrane Q test and I2 test. The percentage of death anxiety scores in Iranian patients with cancer was 59.91% (95% confidence interval: 51.57-62.24). The results of subgroup analysis showed that the percentage of death anxiety scores in patients with breast cancer was 67.55% (95% CI: 56.50-78.60) and in patients with other malignancies was 53.78% (95% CI: 50.20-57.36). Death anxiety is high among Iranian patients with cancer and counseling sessions to control and manage this challenge seems necessary.

Death Anxiety in the Iranian Elderly: A Systematic Review and Meta-Analysis Study.

The present study aimed to estimate the standard score of death anxiety in the Iranian elderly. In this systematic review and meta-analysis, national and international databases were searched from inception to January 2022. All the observational studies published in Persian and English, which reported a death anxiety score based on the Templer death anxiety scale, were selected. The standard score of death anxiety in the elderly was 50% (95% CI: 45-56). No correlation was observed between the year of publication (p = .092) and sample size (p = .94) with the standard score of death anxiety in the elderly. With increased age, death anxiety scores declined. Publication bias was not significant (p = .340). Iranian seniors achieved half of the total score of death anxiety, which indicated the average level of death anxiety. Providing training to effectively manage death anxiety is essential to preventing the adverse consequences of extreme death anxiety.

Prevalence of HIV infection and high-risk behaviors in truck and bus drivers in Kurdistan province.

BACKGROUND: Truck, bus, transit drivers, and men with mobile jobs are at high risk for HIV/AIDS. The purpose of this study was to investigate the prevalence of HIV and risky behaviors among truck and bus drivers in Kurdistan province. METHODS: This cross-sectional study was conducted on 601 bus and truck drivers in Kurdistan province during 2018-2019. Data on high-risk behaviors were collected using a standard questionnaire. ELISA test was used to detect HIV in the study participants. Data were analyzed using Chi-square, Mann-Whitney U tests, and logistic regression modeling in Stata-14 software. RESULTS: The mean and standard deviation of the age of study participants was 44.04 ± 11.44 years. HIV rapid test was positive in two subjects; in other words, the prevalence of HIV in the study population was 0.33%. Ninety-two (15.3%) individuals reported a history of drug use, with one (1.1%) having a history of injecting drugs. One hundred and thirty-one (21.8%) of them had a history of high-risk sexual behavior outside of marriage. CONCLUSION: According to the results of the present study, the prevalence of high-risk behaviors in bus and truck drivers is high. It seems necessary to direct the drivers' attention to self-care while considering disciplinary intervention programs to prevent the use of drugs, cigarettes, alcohol along with high-risk sexual behaviors to maintain the health of drivers and passengers.

Investigating the relationship between organizational justice, job satisfaction, and intention to leave the nursing profession: A cross-sectional study.

AIMS: This study aims to test a hypothetical model linking various dimensions of organizational justice to the job satisfaction and nurses' intention to leave the profession based on the theoretical assumptions of the Alexander model of voluntary turnover. DESIGN: A cross-sectional survey. METHODS: This study was conducted on 317 inpatient ward nurses of six teaching hospitals in Tehran, Iran during 1 September 2017-14 November 2018. Clinical nurses were recruited by a multistage random sampling. Data were collected using structured questionnaires of organizational justice, job satisfaction, and nurses' intention to leave. Data were analysed by structural equation modelling using Amos 22 statistical program. RESULTS: The structural equation model demonstrated adequate fit and the hypothesized correlations were partially supported. The findings suggested that the distributive justice (p < .001; ß = 0.24) and interactional justice (p < .001; ß = 0.44) could indirectly affect the nurses' intention to leave the nursing profession via the direct impact on job satisfaction, while job satisfaction had a significant, negative effect on the nurses' intention to leave (p < .001; ß = -0.71). CONCLUSIONS: According to the results, the model fit was acceptable, suggesting the validity of the final model. Furthermore, distributive and interactional justice could reduce the intention to leave the nursing profession by influencing the job satisfaction of the clinical nurses. IMPACT: This was one of the first studies to determine the aspects of justice that must be further emphasized by healthcare managers to increase the job satisfaction of nurses and their retention in healthcare systems. The findings indicated that fair interactions have a greater impact on job satisfaction and retention of nurses than procedural and distributive justice. The results of this study provide valuable references for nursing managers to increase the job satisfaction of nurses and their retention in healthcare settings.

Examination of the psychometric properties of the Persian version of the attitude towards pressure ulcer prevention instrument in nurses.

INTRODUCTION: Pressure ulcer development is a known indicator of the quality of care. Negative attitudes towards the prevention of pressure ulcers can lead to preventive care with suboptimal quality. There is no valid and reliable instrument in Iran to assess clinicians' attitudes towards pressure ulcer prevention; therefore, this study aimed to examine the psychometric properties of the Persian version of the Attitude towards Pressure ulcer Prevention instrument (APuP) in Nurses. METHODS: In this cross-sectional study, 250 nurses were selected using a convenience sampling method. Face, content, and construct validity were examined using exploratory factor analysis (EFA). Internal consistency was assessed using the McDonald's omega (ω), and reliability was assessed using the test-retest method. RESULTS: In the EFA, five factors of Competence, Responsibility, Perceived Consequences of Pressure Ulcers on Patients, Priority, and Confidence in the Effectiveness of Prevention were extracted that together explained 50.26% of the total variance. A McDonald's ω of 0.891 demonstrated the internal consistency of the total scale, and internal consistencies ranging from 0.70 to 0.86 were found for different dimensions of the instrument. In addition, an intraclass correlation coefficient (ICC) of 0.876 was found that indicated the reliability (stability) of the total scale (95% Confidence Interval [CI]: 0.736-0.963). CONCLUSION: The Persian version of the Attitude towards Pressure ulcer Prevention instrument (APuP) has good validity and reliability in Iranian nurses and can be used in future clinical studies.

Prevalence of restless legs syndrome in pregnant women: a systematic review and meta-analysis.

BACKGROUND: Restless legs syndrome (RLS) is a neurological disorder characterized by sleep disorders, which leads to adverse health consequences in the mother and fetus. Studies have reported different prevalence rates for RLS in pregnant women. This systematic review and meta-analysis aimed to estimate the prevalence of RLS in pregnant women. METHODS: A literature search was performed via national and international databases, including Scientific Information Database (SID), MagIran, IranMedex, Google Scholar, Science Direct, PubMed, ProQuest, and Scopus. In total, 31 articles were selected without a time limit. The random effects model was used to analyze the data, and the heterogeneity between the studies was examined using the I2 index. The analyses were performed in the Stata software, version 12 and R, version 4. RESULTS: The reviewed studies (n=31) were conducted on a total sample size of 59,151, and the prevalence of RLS in pregnant women was estimated at 21.4% [95% confidence interval CI: 17.7-25.1]. Asia with a prevalence rate of 18.5%, [95% CI: 13.8-23.1] and Europe with a prevalence rate of 25.5%, [95% CI: 19.5-31.6] had the lowest and highest RLS prevalence, respectively. No significant correlations were observed between the prevalence of RLS, publication year of the articles (P=0.972), and participants' age (P=0.202). CONCLUSION: According to the results, RLS is highly common in pregnant women, and it is essential to identify women with RLS to control and eliminate the adverse consequences of the disorder.

Burden of Care in Caregivers of Iranian patients with chronic disorders: a systematic review and meta-analysis.

INTRODUCTION: Caring for patients with chronic disorders can lead to different problems for caregivers in physical, psychological, social, family, and financial domains. High levels of burden of care can make caregivers vulnerable to physical and psychological conditions and influence their quality of life. Therefore, the goal of the present study was to estimate the overall percentage of burden of care in caregivers of Iranian patients with chronic disorders. METHODS: A total of 25 articles published from inception to February 2019 were reviewed. Search for articles was conducted in international (Scopus, Web of Science, and PubMed) and domestic (Scientific Information Database (SID) and MagIran) databases, using the following keywords: "Caregiver," "Burden," and "Iran," and their possible combinations. The data were analyzed using the meta-analysis method and the random effects model. All the analyses were performed using STATA, version 14. RESULTS: The overall percentage of burden of care in caregivers of Iranian patients with chronic disorders was 53.28% (95% CI: 46.13-60.43). The highest percentage of burden of care was related to dialysis (62.75; 95% CI: 56.11-69.38), mental disorders (58.69; 95% CI: 49.70-67.69), and Alzheimer's disease (57.07; 95% CI: 46.23-67.92), respectively; and the lowest percentage of burden of care was related to diabetes (34.92; 95% CI: 18.01-51.82). CONCLUSIONS: Caregivers of Iranian patients with chronic disorders experience high levels of burden of care, especially those caring for patients undergoing dialysis, patients with mental disorders, and patients with Alzheimer's disease. Therefore, necessary measures need to be taken by Iranian health care officials to reduce burden of care in caregivers.

Prevalence of needlestick and sharps injuries in the healthcare workers of Iranian hospitals: an updated meta-analysis.

BACKGROUND: Needlestick and sharps injuries (NSIs) are critical occupational risk among health care workers (HCWs), which is extremely worrying due to the potential risk of transmitting bloodborn pathogens (BBPs). This study was carried out to evaluate the prevalence of NSIs among Iranian HCWs. METHODS: In this systematic review and meta-analysis, the key terms percu* injur*, needle* stick injur*, needlestick* injur*, or sharp* injur* were searched in the Scientific Information Database (SID), MagIran, IranMedex, Google Scholar, Science Direct, PubMed, and Scopus. A prefabricated checklist, including variables: first author, publication year, study population, sample size, gender, total prevalence of needlestick in each gender, type of questionnaire, region, and type of hospitals, was used to extract data from the selected articles included which were published between 2003 and 2016. RESULTS: The analysis showed that the prevalence of NSIs in the Iranian HCWs was 42.5% (95% CI 37-48). Moreover, the prevalence of NSIs was more in women (47%; 95% CI 36-58) compared to men (42%; 95% CI 26-58). CONCLUSION: Given the high prevalence of NSIs, it is necessary to supply safe needles and instruments, hold training programs focused on new methods of using sharp objects safely, observe safety principles and standards, reinforce the practical skills of personnel, and pay more attention to reporting and improving occupational behaviors like avoiding needle recapping in order to reduce the prevalence of NSIs and consequently reduce potential risk of transmission of BBPs.

Examination of the Psychometric Properties of the Persian Version of the Challenges to Stopping Smoking Scale (CSS) in Patients with Cardiovascular Disease (CVD).

Background: Smoking is one of the modifiable risk factors for cardiovascular disease (CVD) that is related to different types of chronic disorders. Many patients with CVD consider smoking cessation a difficult task due to various reasons. The goal of the present study was to translate the Challenges to Stopping Smoking Scale (CSS) into Persian and examine its psychometric properties. Materials and Methods: In this cross-sectional methodological study, a total of 341 patients with CVD [141 for exploratory factor analysis (EFA) and 200 for confirmatory factor analysis (CFA)] participated, and were selected using a convenience sampling method. Participants completed the Persian version of the CSS. Face, content, and construct validities were examined. Internal consistency was assessed using the McDonald's Omega and Cronbach's alpha coefficients, and stability was examined using the test-retest method. Results: In the EFA, two factors of Internal Challenges and External Challenges were extracted that together explained 42.619% of the total variance. Cronbach's alpha coefficients of 0.740 and 0.799 and Intraclass correlation coefficients of 0.862 and 0.869 were found for Internal and External Challenges, respectively. According to the results of CFA, the three-factor model had a good fit to the data. (RMSEA: 0.059; CFI: 0.94; GFI: 0.97; NFI: 0.90; PNFI: 0.77). Conclusion: The Persian version of the CSS has good validity and reliability, and can be used as a valid and reliable instrument in future studies.

Examining the Psychometric Properties of the Farsi Version of the Body Image Scale for Breast Cancer Survivors.

Background: Mastectomy as a surgical treatment in women with breast cancer causes a change in their body image due to the loss of femininity and body integrity, decreased sense of sexual attractiveness, and dissatisfaction with the presence of surgical scars. The present study was conducted to evaluate the psychometric properties of the Farsi version of the body image scale for breast cancer survivors. Methods: This cross-sectional study was conducted on 204 women with a mastectomy referred to Kermanshah's surgery and oncology office in 2021. Face and content validity were evaluated qualitatively. Construct validity was evaluated by exploratory factor analysis (with maximum likelihood and Promax rotation) and confirmatory factor analysis. Cronbach's alpha and McDonald's omega coefficients were used to verify internal consistency. Results: The mean age of the participants was 46.57 (SD = 9.47). One factor was extracted that explained 46.56% of the total variance of body image. The factor load of the items varied between 0.561 and 0.801. The results of CFA also showed that the final model has a perfect fit: CMIN = 20.931; DF = 13; CMIN/FD = 1.610; p = 0.074; GFI = 0.972; AGFI = 0.939; IFI = 0.985; CFI = 0.985; TLI = 0.975; PNFI = 0.595; PCFI = 0.610; RMSEA = 0.055. internal consistency based on Cronbach's alpha and McDonald's omega coefficients was 0.856 and 0.861, respectively. Conclusion: The Farsi version of the body image scale for breast cancer survivors has good construct validity and may be used in various studies in clinical and research settings.

Determine phenotypical patterns of resistance to antibiotics in COVID-19 patients with associated bacterial infection: largest medical center in Iran.

Background and Objectives: Antibacterial resistance (AMR) is a serious threat and major concern, especially in developing countries. Therefore, we aimed to determine phenotypical patterns of resistance to antibiotics in COVID-19 patients with associated bacterial infection in intensive care units. Materials and Methods: In this cross-sectional study, 6524 COVID-19 patients admitted for more than 48 h in the ICUs of Imam Khomeini Complex Hospital (IKCH) in Tehran from March 2020 to January 2022 were included in the study with initial diagnosis of COVID-19 (PCR test and chest imaging). Data were collected regarding severity of the illness, primary reason for ICU admission, presence of risk factors, presence of infection, length of ICU and hospital stay, microbial type, and antibiotic resistance. In this study, the pattern of antibiotic resistance was determined using the Kirby-Bauer disk diffusion method. Results: In this study, 439 (37.5%) were ventilator-related events (VAEs), and 46% of all hospitalized patients had an underlying disease. The most common microorganisms in COVID-19 patients were carbapenem resistant Klebsiella pneumoniae (KPCs) (31.6%), Escherichia coli (E. coli) (15.8%), and Acinetobacter baumannii (A. baumannii) (15.7%), respectively. Prevalence of vancomycin-resistant enterococci (VRE) and KPCs were 88% and 82%, respectively. Conclusion: A study on AMR surveillance is the need of the hour as it will help centers to generate local antibiograms that will further help formulate national data. It will guide doctors to choose the appropriate empiric treatment, and these studies will be the basis for establishing antimicrobial surveillance and monitoring and regulating of the use of antimicrobials.

Psychometric properties of the Farsi version of diabetes burnout scale in patients with type 1 diabetes.

OBJECTIVE: Diabetes burnout refers to the feeling of exhaustion and frustration in the management of diabetes, which can lead to treatment non-adherence, poor glycemic control, and a high prevalence of diabetes complications. Measuring diabetes burnout requires accurate and standard instruments. The aim of this study was to evaluate the psychometric properties of the Farsi version Diabetes Burnout Scale (F-DBS). METHODS: This cross-sectional study was performed on 550 patients with type 1 diabetes (262 men and 288 women) referred to diabetes centers in different cities of Hamedan province (Asadabad, Hamedan, Malayer, and Nahavand) in 2021. The mean age and duration of the disease in these patients were 35.58 (SD=14.32) and 15.02 (SD=10.60) years, respectively. Data were collected using the Diabetes Burnout Scale (DBS), Patient Health Questionnaire-9 and Kessler psychological distress scale. After forward-backward translation, face, content and convergent validity were performed. To evaluate the construct validity, convergent validity, exploratory and confirmatory factor analysis were performed. Internal consistency was examined with Cronbach's alpha coefficients. RESULTS: In the exploratory factor analysis, two factors of exhaustion (five items) and detachment (seven items) were extracted, which together explained 46.58% of the total variance. In confirmatory factor analysis, the fit indices were appropriate. There was a significant positive correlation between diabetes burnout and depression (r = 0.30, p < 0.001) and psychological distress (r = 0.36, p < 0.001). Cronbach's alpha coefficient of diabetes burnout, exhaustion and detachment were 0.813, 0.846 and 0.812, respectively. CONCLUSION: The Farsi version of the Diabetes Burnout scale has acceptable validity and reliability and can be used in various studies.

Prevalence of hookah smoking among Iranian pupils and university students: An updated systematic review and meta-analysis.

OBJECTIVE: Today, smoking is considered a pressing global health issue. The present study aimed to estimate the total prevalence of hookah smoking among pupils and university students in Iran. MATERIALS AND METHODS: This systematic review and meta-analysis were conducted via searching in databases such as Scientific Information Database (SID), MagIran, Scopus, PubMed and Web of Sciences from inception to October 2021. We targeted observational studies evaluating the prevalence or frequency of hookah smoking among Iranian pupils and university students. Data analysis was performed using a random-effects model, and the heterogeneity of the articles was assessed using Cochran's Q test and the I2 statistic. RESULTS: In total, 124 studies conducted on 155 115 subjects were reviewed. The lifetime prevalence of hookah smoking among high school students and university students was estimated at 34.4% and 32.3%, respectively. In addition, the frequency of hookah smoking within the past month/week (point prevalence) was estimated at 21.5% and 16.6% in university students and pupils, respectively. The frequency of hookah smoking within the past year (period prevalence) was also reported to be 22.5% and 20.8% in these groups, respectively. No significant correlation was observed between the prevalence of hookah smoking, sample size, year of publication and the mean age of the participants. Region 5 had the highest lifetime prevalence (41.7%) and period prevalence (27.1%). However, Region 1 had the highest point prevalence of hookah smoking (27.2%). CONCLUSIONS: According to the results, hookah smoking is highly prevalent among Iranian pupils and university students. Therefore, proper educational interventions are required in the form of workshops and curricula to raise awareness regarding the hazardous effects of this unhealthy habit on the young generation.

Prevalence and Associated Risk Factors of Hypertension for the Middle-Aged Population (30-59 Years) in Iran: A National Cross-Sectional Study.

INTRODUCTION: The prevalence of hypertension (HTN) is increasing in the middle-aged population, but few studies have examined the prevalence and risk factors associated with hypertension in this age group. AIM: To estimate the prevalence of HTN and its associated demographic risk factors in the middle-aged population (30-59 years) of Iran. METHODS: In this cross-sectional study, 4112 middle-aged people from five provinces of the country were selected by multi-stage sampling and entered into the study. HTN or high blood pressure (HBP) was defined as systolic blood pressure ≥ 140 mmHg and diastolic blood pressure ≥ 90 mmHg. The relationship between demographic risk factors and the prevalence of HTN was assessed by multivariate logistic regression in Stata software version 14. RESULTS: The prevalence of HTN was 17.8% (95% CI 16.5-19.0) and was higher in women than men (19.1% vs. 16.5%). The prevalence of HTN in three studied age groups including 30-39, 40-49 and 50-59 years were 7.2, 18.7 and 38.0%, respectively. The frequency of HTN in urban residents was higher than rural residents (18.4% vs. 15.6%). The chance of developing hypertension in urban residents (OR 1.25), overweight (OR 3.94) and obese persons (OR 7.54) was higher. CONCLUSIONS: Hypertension has a relatively high prevalence in the middle-aged Iranian population. According to our results, age, living in urban regions, being illiterate, overweight and obesity are independent risk factors for HBP. It seems that the administration of prevention programs in general population especially in younger ages based on existing risk factors is a necessity.

Health-related quality of life in patients with breast cancer: A systematic review and meta-analysis.

BACKGROUND: Breast cancer is the most common type of cancer of women across the world, which can affect the quality of life in patients due to complications caused by the disease and related treatments. Various treatments have been designed for these patients to improve their life quality. This study aimed to estimate the mean score of health-related quality of life patients with breast cancer in Iran. METHODS: In this study, we searched the national and international databases of SID, MagIran, Google Scholar, ISI/Web of Science, PubMed and Scopus with no time limits using the keywords of "health-related quality of life", "health related quality of life", "quality of life", "breast neoplasm", "breast cancer", and "breast tumors". Data analysis was performed in STATA version 14 based on the heterogeneity state using random effects model. RESULTS: In this study, 15 articles with a sample size of 1883 were evaluated, and the mean global quality of life in patients was reported at 72.48 (95% CI: 64.94-79.82). In addition, the worst performance and symptoms were related to emotional functioning (56.70) (95% CI: 49.84-63.55) and financial difficulties (43.57) (95% CI: 31.47-55.67). CONCLUSION: According to the results of the present study, the Iranian patients with breast cancer had a moderate quality of life in most dimensions.