Considering time-interaction terms using parametric survival models for interval-censoring data

Background: Many of the variables which are investigated in survival research are time-invariant, i.e. their values do not change over time. But their effects, may yet vary over time. Thus, the change in behavior that occurs over time needs to be included in the analysis. This can be done by adding time-interaction terms to the model. Method: In this research, a parametric survival model, which is capable of evaluating the effects of time-dependent variables, was applied for interval-censored data such that the time to invariant variables interaction terms were considered as time-dependent variables. Results: Using a practical example, the results of the study show that this model can alter the interpretations regarding the effects of exploratory variables. Conclusion: when dealing with fixed variables whose effects change over time, the researcher can incorporate their interaction effect with time, and treat them as time-dependent variables and obtain appropriate inferences

Investigating the Effect of Adhan on Anxiety and Pain Level in Patients after Cesarean Operation by Spinal Anesthesia: A Prospective Clinical Trial Study

For downloading the full-text of this article please click here.Background and Objective: Severe pain and post-surgical anxiety cause unpleasant psychological and physical complications. Today, the common method used for relieving pain and anxiety is the use of medication. However, due to the side effects associated with anesthetics, there is a greater desire for a non-drug method including music therapy. The aim of the present study was to investigate the effect of Adhan on anxiety and pain in patients undergoing caesarean section by spinal anesthesia.Methods: In a clinical trial study, 64 women, who were candidates for caesarean section in Mahdieh hospital in Tehran from 2016 to 2017, were selected for the purpose of the study by random sampling method and assigned to two groups of 32, one as the experimental and the other as the control group. Adhan was played for one group but not for the control group. Data were collected using a questionnaire and pain visual analogue. The collected data were analyzed using independent samples t-test. In this study, the value (P<0.05) was considered statistically significant. In this study, all the ethical considerations have been observed and no conflict of interest was reported by the authors.Results: One hour after operation, the mean score related to anxiety was found to be significantly lower in the experimental group than the control group (P<0.001). Pain mean score in the baseline time was not significantly different (P=0.20), but 15 minutes (P<0.001), 30 minutes (P=0.006) and 60 minutes (P=0.04) after the operation it was significantly lower in the experimental group than the control group.Conclusion: In the present study, the tone of Adhan could efficiently decrease anxiety and pain.For downloading the full-text of this article please click here.Please cite this article as: Naeiji Z, Lorestani Kh, Baghestani AR. Investigating the Effect of Adhan on Anxiety and Pain Level in Patients after Cesarean Operation by Spinal Anesthesia: A Prospective Clinical Trial Study. Journal of Pizhūhish dar dīn va salāmat. 2020;6(2):7-19.  https://doi.org/10.22037/jrrh.v6i2.2347

A Cure Rate Model with Discrete Frailty on Hodgkin Lymphoma Patients after Diagnosis

Introduction: Hodgkin lymphoma (HL) is an uncommon cancer of lymphocytes, characterized by cancerous Reed-Sternberg cells in an inflammatory background. HL is an exceptionally curable disease with combination chemotherapy, radiotherapy, or combined modality treatment. This analysis aimed to identify significant prognostic factors on the cure rate. Materials and Methods: The medical records of 110 patients hospitalized from 2007 up to 2014 with 18 months follow-up was retrospectively reviewed in Taleghani hospital of Tehran, Iran. The survival time was set as the time interval between diagnosis and a patient's death from HL. Also, if the cure rate was present in survival, data encompasses zero frailty. Thus, using hyper-Poisson (hP) distribution as discrete frailty, the unobserved heterogeneity and random effects were accounted for. Results: The estimated cure fraction was 81.2%, which was obtained after 2717 days (7.4 years). In noncured cases, the mean survival time was 1535 days (4.2 years). Also, the five and ten-year survival rates were 0.91 and 0.80, respectively. After diagnosis, results revealed that patients with age  45, hemoglobin  12, WBC  15000, and BMI  30 were associated with poor outcome by using simple analysis. More importantly, there is no significant difference between males and females in the cure of HL patients. Conclusion: As expected, the study indicated that a high proportion of HL patients got cured. A cure rate model with discrete frailty utilization provided a suitable way to account for heterogeneity among HL patients. &nbsp

Under-estimation and Over-estimation in Gastric Cancer Incidence Registry in Khorasan Provinces, Iran

Gastric cancer is a disease which the cells forming the inner lining of the stomach start to divide uncontrollably, forming a mass called a tumor. Patients with gastric cancer from low facility provinces like North and South Khorasans may diagnose and registered in full featured provinces like Razavi-Khorasan; this causes misclassification error. The presence of this error makes the registry systems inaccurate and unreliable for estimating the burden of cancer and policy making. Two approaches are recommended for reducing the effects of misclassification; the first is using a small validation sample and the second is a Bayesian analysis which provides subjective prior information for the subset of the parameters to correct the statistics. Data for this study extracted from Iranian annual of national cancer registration report in 2008. The age standardized rate due to gastric cancer [ICD-10; C16] were expressed as rate per/100,000 population for male and female of North, South and Razavi Khorasans. To correct the misclassification effect, a Bayesian approach was used with Poisson count regression and beta prior. The reported expected coverage of cancer incidence for Razavi-Khorasan was 155.5% and exceeds than what expected, whereas the North and South Khorasans have just observed respectively 34.8% and 41.4% of their expected coverage. The results of the Bayesian analysis indicated that there was about 34% misclassification in gastric cancer incidence registry from North and South Khorasans in Razavi-Khorasan. In planning for resource allocation, authorities should consider that, low incidence of gastric cancer in North and South Khorasans, may be the effect of misclassification and it is needed to allocate them more health facilities and improve their address registration accuracy using National ID, electric bill, etc.

Educational Climate Measurement Tools in Medical Sciences Universities: A Review Article

Introduction: Educational climate is one of the most important factors affecting achievement and satisfaction of students and determining their behavior. Measuring educational climate is necessary for reforming and idealizing educational environment. The purpose of this study was to introduce educational climate measurement tools and their subscales and application in medical sciences universities. Methods: In this review study, the data was collected by searching of online databases, such as Google Scholar, Science Direct, SID, Iran Medex, Magiran, ProQuest, Scopus, PubMed and Web of Science. Key words such as educational climate, educational environment, educational climate measurement tools, educational environment measurement tools, medical education, and medical Sciences universities were used separately and in combination to obtain the relevant researches without time limitation. After analysis and duplicates removal, common educational climate measurement tools in medical sciences universities were introduced and classified in terms of subscales and applications. Results: Twenty-five most common educational climate measurement tools in medical sciences universities along with subscales were introduced and classified in three groups in terms of application: diagnosis, comparison, and evaluation. Conclusion: Some of the most common educational climate measurement tools in medical sciences universities are somewhat similar in their full or abbreviated names. In addition, some of these tools are designed for specific disciplines and not applicable to all medical fields. Therefore, when choosing a tool, researchers should take a number of points into account such as the name, similarities and specialty of that tool

Relationship of Coping Strategies with Quality of Life in Women Living with Husband on Hemodialysis

Introduction: Women living with husband on hemodialysis face multiple challenges which impact their quality of lives and coping styles. This study was performed to investigate the relationship of coping strategies with quality of life in women living with husband on hemodialysis. Methods: This was a correlational study. The convenience sample consisted of 212 women living with husband on hemodialysis who had come to hospitals of Shahid Beheshti University of Medical Sciences in 2016. Data were collected using the brief COPE and World Health organization (WHO) quality of life. Pearson’s correlation coefficient and ANOVA by SPSS software (version 21) were conducted for data analysis. Results: Psychological health of women was found the lowest among the other sub-scales of quality of life. Quality of life had a positive significant correlation with problem-oriented coping strategies (r = 0.71, P = 0.001) and a negative relationship with emotion focused coping strategies (r = -0.53, P = 0.04). The results showed that religious (3.74 ± 0.57) and substance use (1.99 ± 0.7) as two coping strategies were the highest and lowest strategies used by women living with husband on hemodialysis. Conclusions: Coping strategies are influential in quality of life in women living with husband on hemodialysis. Psychology support programs are needed to help to frequent use of problem-focused coping and reduce emotion-focused coping strategies to improve overall quality of life

Detection of cut-off point for rapid automized naming test in good readers and dyslexics

Background and Aim: Rapid automized naming test is an appropriate tool to diagnose learning disability even before teaching reading. This study aimed to detect the cut-off point of this test for good readers and dyslexics.Methods: The test has 4 parts including: objects, colors, numbers and letters. 5 items are repeated on cards randomly for 10 times. Children were asked to name items rapidly. We studied 18 dyslexic students and 18 age-matched good readers between 7 and 8 years of age at second and third grades of elementary school; they were recruited by non-randomize sampling into 2 groups: children with developmental dyslexia from learning disabilities centers with mean age of 100 months, and normal children with mean age of 107 months from general schools in Tehran. Good readers selected from the same class of dyslexics.Results: The area under the receiver operating characteristic curve was 0.849 for letter naming, 0.892 for color naming, 0.971 for number naming, 0.887 for picture naming, and 0.965 totally. The overall sensitivity and specificity was 1 and was 0.79, respectively. The highest sensitivity and specificity were related to number naming (1 and 0.90, respectively).Conclusion: Findings showed that the rapid automized naming test could diagnose good readers from dyslexics appropriately

Perceived organizational support and moral distress among nurses

Abstract Background Moral distress is prevalent in the health care environment at different levels. Nurses in all roles and positions are exposed to ethically challenging conditions. Development of supportive climates in organizations may drive nurses towards coping moral distress and other related factors. This study aimed at determining the level of perceived organizational support and moral distress among nurses and investigating the relationship between the two variables. Methods This was a correlational-descriptive study. A total of 120 nurses were selected using random quota sampling method. A demographic questionnaire, Survey of Perceived Organizational Support, and Moral Distress Scale were used to collect the data which were analyzed using descriptive and analytical tests in SPSS20. Results The mean perceived organizational support was low (2.63 ± 0.79). The mean moral distress was 2.19 ± 0.58, which shows a high level of moral distress. Moreover, Statistical analysis showed no significant relationship between perceived organizational support and moral distress (r = 0.01, p = 0.86). Conclusion Given the low level of perceived organizational support and high moral distress among nurses in this study, it is necessary to provide a supportive environment in hospitals and to consider strategies for diminishing moral distress

The Effectiveness of Limited Dynamic Wrist Splints on the Symptoms, Function, and Strength of Women with Carpal Tunnel Syndrome: A Controlled Trial Study

Background: Splinting is the most common conservative method of treating patients with mild and moderate Carpal Tunnel Syndrome (CTS). The aim of this study was to determine the effectiveness of the limited dynamic wrist splint on the symptoms, function, and strength of women with CTS. In this controlled trial study, the subjects wore a splint of a new design called the “limited dynamic wrist splint”, which allowed the wrist motion in the range (between 15-degree flexion and 15-degree extension) that exerts minimum pressure on the median nerve and prevents extra pressure on the nerve by limiting the range of motions out of the allowed range. Methods: In this study, 24 women diagnosed with mild to moderate CTS were initially evaluated on the basis of the Boston questionnaire, the dexterity test of the Purdue pegboard, grip and pinch strength, distal sensory latency, and sensory nerve conduction velocity. The subjects were randomly divided into two groups, control and treatment. Both groups received routine rehabilitation treatment for six weeks. The treatment group received the limited dynamic wrist splint for about six to eight hours a day. After six weeks, the initial examinations were repeated. The SPSS-16, independent t, and paired t-tests were used for data analysis. Results: All the variables in the treatment and the control groups showed improvement. The function test of the Boston questionnaire, the Purdue pegboard test, and the pinch strength were significantly improved in the treatment group. The “severity of the symptoms” test of the Boston questionnaire and the pinch strength in the control group showed a statistically significant difference (P < 0.05). In a comparison of the two groups, the function test of the Boston questionnaire showed a significant difference. Conclusion: This study showed that the use of the limited dynamic wrist splint for about six weeks for six to eight hours a day could have a significant effect on the function, dexterity, and the pinch strength of patients with CTS. Not only can the patients receive treatment by this method, but they can also perform their daily activities to some extent

Effects of Vestibular Rehabilitation on Fatigue and Activities of Daily Living in People with Parkinson’s Disease: A Pilot Randomized Controlled Trial Study

One of the most disabling nonmotor symptoms in persons with Parkinson’s disease is fatigue, which can decrease the quality of life by restricting the function and activities of daily living (ADL). Nonetheless, sufficient evidence for treating fatigue, including drug or nondrug treatment, is not available. In this study, we evaluated the probable effects of vestibular rehabilitation on fatigue and ADL in patients with Parkinson’s disease. Methods. This was a single-blind clinical trial study in which patients with Parkinson’s disease voluntarily participated based on the inclusion and exclusion criteria. The patients were randomly assigned to the case and control groups. The case group received 24 sessions of vestibular rehabilitation protocol, and conventional rehabilitation was performed in the control group (i.e., 3 sessions each week, each lasted about 60 minutes). Both groups were also given fatigue management advice. Fatigue was measured by the Parkinson Fatigue Scale (PFS) and the Modified Fatigue Impact Scale (MFIS). ADL was measured by the Functional Independence Measure (FIM). All changes were measured from the baseline at the completion of the intervention. Results. Both fatigue (P≤0.001) and ADL (P≤0.001) improved significantly more in the vestibular intervention group than in the control one. Conclusion. Vestibular rehabilitation may improve fatigue and ADL and therefore can be used as an effective intervention for patients with Parkinson’s disease, which was also found to be well tolerated