Association of menopausal sexual dysfunction with demographic and obstetric factors in postmenopausal women in Hamadan, Iran

Background: Sexual dysfunction is a common menopausal problem that may be affected by demographic factors. The present study aimed to determine demographic and obstetric factors affecting sexual dysfunction in menopause.Methods: The present cross-sectional descriptive-analytical study was conducted on 315 postmenopausal women in Hamadan. The research instruments included demographic questionnaire, and female sexual function index (FSFI). Univariate and multivariate linear regressions were used to investigate the association of different factors and sexual function at a significance level of less than 0.05.Results: The participants' mean age was 54.15±4.24 years. Their mean sexual function score was 18.92±4.25 indicating poor sexual function. The multivariate analysis indicated that increasing the number of spouse marriage, sexual function score decreased by 2.45 (p=0.006). Furthermore, the sexual function score in those, who were not satisfied with their marriage, was 5.58 points lower than those who were satisfied with their marriage status (p <0.001).Conclusions: Given the relationship between number of spouse marriage and marital satisfaction with sexual function in postmenopausal women, it is necessary to design and implement training sessions for them.

Effectiveness of kangaroo mother care on maternal resilience and breastfeeding self-efficacy using the role-play method in a neonatal intensive care unit

BACKGROUND: Kangaroo mother care (KMC) offers several benefits for neonates and mothers. Although many studies have evaluated the effectiveness of KMC on infants, only few studies have examined the effects on mothers. This study aimed to evaluate the effectiveness of KMC on maternal resilience and breastfeeding self-efficacy via the role-play method in a neonatal intensive care unit. METHODS: We conducted a randomized controlled trial. Mothers were randomized into two groups. Mothers in the intervention group were trained using the role-play method. Questionnaires were administered before and after the intervention. Data were analyzed with SPSS version 22. RESULTS: The training demonstrated a statistically significant difference in resilience score and breastfeeding self-efficacy in each group after the intervention. In addition, a statistically significant difference was revealed between both groups in resilience scores and breastfeeding self-efficacy after the intervention. CONCLUSIONS: KMC training with the role-play method was most effective. Role-play and routine methods are recommended as methods of therapeutic care in clinical settings to improve maternal resilience and breastfeeding self-efficacy.</p

Psychometrics assessment of ethical decision-making around end-of-life care scale for adolescents in the final stage of life

IntroductionHealthcare professionals have a critical role in ethical decision-making around end-of-life care. Properly evaluating the ethical decision-making of health care professionals in end-of-life care requires reliable, tailored, and comprehensive assessments. The current study aimed to translate and assess psychometrically a Persian version of the ethical decision making in end-of-life care scale for Iranian adolescents in the final stages of life.MethodsThe present study investigates the methodology and multicenter research. 310 healthcare professionals who treat/care for adolescents at the end of life were selected from 7 cities in Iran. The original version of the end-of-life care decision-making scale was translated into Persian using the forward-backward translation method, and its psychometric properties were evaluated using COSMIN criteria.ResultsExploratory factor analysis revealed that the factor loadings of the items ranged from 0.68 to 0.89, all of which were statistically significant. Furthermore, three factors had eigenvalues greater than 1, accounting for 81.64% of the total variance. Confirmatory factor analysis indicated a proper goodness of fit in the hypothesized factor structure. The internal consistency reliability of the tool was assessed in terms of its homogeneity, yielding a Cronbach's alpha coefficient of 0.93.ConclusionThe Persian version of the End-of-Life Care Decision-Making Scale demonstrates satisfactory validity and reliability among healthcare professionals working with adolescents in the final stages of life. Therefore, nursing managers can utilize this tool to measure and evaluate ethical decision-making in end-of-life care for adolescents in the final stages of life and identify the most appropriate strategies, including educational interventions, to improve ethical decision-making in end-of-life care if necessary

Evaluating the Effect of Cardiac Rehabilitation Care Plan on Quality of Life of Patients Undergoing Coronary Artery Bypass Graft Surgery

Introduction: Cardiovascular surgeries are among the conventional surgeries aimed at increasing the survival rate and improving the quality of life of patients. This study aimed to evaluate the effect of cardiac rehabilitation on quality of life of patients undergoing Coronary artery bypass graft (CABG) surgery.Methods: This was a semi-experimental study performed on 160 patients undergoing CABG surgery. The rehabilitation program was carried out for 13 weeks (three sessions per week) in 40 sessions, six weeks after the CABG surgery. The MacNew standard questionnaire and the general health questionnaire (S-f 36) were completed before the beginning of rehabilitation sessions as well as after completion of these sessions by patients.Results: According to the results, the quality of life of patients significantly increased in the physical and emotional areas after the rehabilitation program. The results also indicated that there was a significant difference between various levels of research in the physical functioning variables, dysfunction due to physical health, dysfunction due to emotional health, energy/fatigue of individuals, emotional well-being, social functioning, pain, and general health.Conclusions: The present results indicated the improved quality of life of patients in all the areas after cardiac rehabilitation intervention, compared to before that. Therefore, paying more attention to cardiac rehabilitation is necessary due to its positive effects on increasing the quality of life of patients

Investigating the relationship between domestic violence with substance abuse and suicide resilience in mothers with disabled children

IntroductionMothers with disabled children are among the most critical groups exposed to domestic violence. Although domestic violence strongly affects these mothers’ physical and mental health, it subsequently affects their drug addiction and resilience to suicide. Based on this, it is crucial to investigate domestic violence, drug addiction, and resilience against suicide in mothers with disabled children. This study investigated the relationship between domestic violence, substance dependence, and resilience against suicide in mothers with disabled children in Iranian society.MethodsFrom January to April 2023, a cross-sectional study was conducted in central and western Iran with the participation of 267 mothers with disabled children. The mothers of disabled children were selected through convenience and snowball sampling. Then they completed questionnaires included domestic violence, substance dependence and resilience against suicide. The collected data were analyzed using SPSS version 22 with descriptive statistics, such as prevalence, percentage, mean, and standard deviation, and expository measurements, including ANOVA, independent t, and regression tests.ResultsThe study revealed that there was a strong direct correlation between domestic violence and substance abuse (r = 0.89, p &lt; 0.001), as well as a strong indirect correlation between domestic violence and suicide resilience (r = −0.90, p &lt; 0.001). Additionally, substance abuse and suicide resilience were negatively correlated (r = −0.93, p &lt; 0.001). Other variables, such as the severity of children’s disability, education, financial status, and the fathers’ involvement, were predictors of domestic violence, accounting for 73.28% of the variance.ConclusionMothers with disabled children reported moderate levels of domestic violence, which strongly impacts their physical and mental well-being, leading to drug dependency and suicide. So, it is essential to implement comprehensive planning and provide extensive support to reduce domestic violence against them. By doing so, we can enhance their physical and mental health and ultimately improve their overall quality of life

Effect of Carob Supplement on Spermogram Parameters and Sexual Function of Infertile Men Referred to the Infertility Center, Hamadan, Iran, 2019: A Randomized Controlled Trial

Objective: The purpose of this study is comparison of carob with placebo in the treatment of male infertility. Materials and methods: This study was performed as a clinical trial with two-group pretest-posttest design. Each group consisted of 30 members. The first group received 1.5 grams of carob per day, and the second group received placebo treatments. Treatment lasted for 12 weeks. Semen analysis as well as testosterone, prolactin, (LH), (FSH) and (TSH) were performed before and after drug treatment in two groups. Sexual function was assessed in the groups in two stages before and after the intervention using the standard International Index of Erectile Function. P-value less than 0.05 was considered statistically significant. Statistical analysis of data was performed using SPSS 16. Results: The participants’ mean age was 34.83 ±6.22 in the placebo and 33.67 ±5.82 years in the Carob group. The results showed in the carob group compared to the placebo group, the rate of normal sperm counts increased by 17% and also the normal level of testosterone was 40% higher than the abnormal levels of the placebo group and these differences were statistically significant (P 0.05). Conclusion: It is recommended to use carob supplements to improve spermogram parameters and male sex hormones

Global depression in Breast Cancer patients: systematic review and meta-analysis

Background: Breast cancer is known as one of the most common diseases among women, the psychological consequences of which are common in women and affect various aspects of their lives, so this study aims to investigate the prevalence of depression among women with breast cancer globally. Method: The present meta-analysis was performed by searching for keywords related to breast cancer and depression in 4 main databases: PubMed, Embase, Web of Sciences and Scopus in the period of January 2000 to November 2021 and the results of the study using R and CMA software were analyzed. Results: A total of 71 studies were selected in English and the results of the analysis showed that the prevalence of depression in women with breast cancer is 30.2%, with Pakistan having the highest (83%) prevalence of depression and Taiwan having the lowest (8.3%). And in the WHO regions, EMRO region had the highest (49.7%) rate and SEARO region had the lowest (23%) prevalence of depression. Also, with increasing age, the prevalence of depression among women with breast cancer increases. Conclusion: Community and family support for women with breast cancer, holding psychology and psychotherapy courses, lifestyle modifications and training in this area can be effective in preventing the reduction of the prevalence of depression, and given the pivotal role of women in family affairs, this This can be in line with the work of health system policymakers

Performance of deep learning models for automatic histopathological grading of meningiomas: a systematic review and meta-analysis

BackgroundAccurate preoperative grading of meningiomas is crucial for selecting the most suitable treatment strategies and predicting patient outcomes. Traditional MRI-based assessments are often insufficient to distinguish between low- and high-grade meningiomas reliably. Deep learning (DL) models have emerged as promising tools for automated histopathological grading using imaging data. This systematic review and meta-analysis aimed to comprehensively evaluate the diagnostic performance of deep learning (DL) models for meningioma grading.MethodsThis study was conducted in accordance with the PRISMA-DTA guidelines and was prospectively registered on the Open Science Framework. A systematic search of PubMed, Scopus, and Web of Science was performed up to March 2025. Studies using DL models to classify meningiomas based on imaging data were included. A random-effects meta-analysis was used to pool sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve (AUC). A bivariate random-effects model was used to fit the summary receiver operating characteristic (SROC) curve. Study quality was assessed using the Newcastle-Ottawa Scale, and publication bias was evaluated using Egger's test.ResultsTwenty-seven studies involving 13,130 patients were included. The pooled sensitivity was 92.31% (95% CI: 92.1–92.52%), specificity 95.3% (95% CI: 95.11–95.48%), and accuracy 97.97% (95% CI: 97.35–97.98%), with an AUC of 0.97 (95% CI: 0.96–0.98). The bivariate SROC curve demonstrated excellent diagnostic performance, characterized by a relatively narrow 95% confidence interval despite moderate to high heterogeneity (I2 = 79.7%, p &lt; 0.001).ConclusionDL models demonstrate high diagnostic accuracy for automatic meningioma grading and could serve as valuable clinical decision-support tools.Systematic review registrationDOI: 10.17605/OSF.IO/RXEB

Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019

Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. Methods: We distinguished the overall HAQ Index (ages 0–74 years) from scores for select age groups: the young (ages 0–14 years), working (ages 15–64 years), and post-working (ages 65–74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Findings: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9–21·3), as well as among the young (22·5, 19·9–24·7), working (17·2, 15·2–19·1), and post-working (15·1, 13·2–17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6–33·0) on average in low-SDI countries to 83·4 (82·4–84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4–89·0), working (33·8–82·8), and post-working (30·4–79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding: Bill & Melinda Gates Foundation

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe