Are health promoting lifestyles associated with pain intensity and menstrual distress among Iranian adolescent girls?

Objective: The present study investigated the relationship between a health-promoting lifestyle and menstrual pain intensity and distress among adolescent girls in Qazvin. Methods: A cross-sectional survey study using a two-stage sampling method was conducted. The participants (n = 986) were female high school students aged 14–19 years living in Qazvin. Random cluster sampling was used to recruit participants from schools and classes from each grade. An online survey was provided to all participants to complete. Data were collected using a Demographic and Menstrual Characteristics Checklist, the Visual Analogue Scale (VAS) to assess dysmenorrhea intensity, the Andresh Milsom Scale (AMS) to assess dysmenorrhea severity, the Moos Menstrual Distress Questionnaire (MMDS) to assess menstrual distress, and the Health-Promoting Lifestyle Profile (HPLP) to assess a health promoting lifestyle. Data were analyzed using an univariable linear regression model at a significance level of 0.05. Results: The findings indicated that 421 participants (42.7%) experienced dysmenorrhea with a mean duration of 2.24 days (SD = 1.57) and a mean pain intensity of 4.62 on the VAS (SD = 2.87). The mean score on the menstrual distress on the MDDS was 13.55 (SD = 8.88) and the mean score on the HPLP was 2.55 (SD = 0.50). Based on the results of univariable linear regression, nutrition (β=-0.18, p < 0.001) and exercise (β=-0.17, p < 0.001) had the most significant effect on the severity of dysmenorrhea pain. Also, self-actualization (β=-0.29, p < 0.001), stress management (β=-0.25, p < 0.001) and nutrition (β=-0.25, p < 0.001) had the most significant effect on menstrual distress. Conclusion: Based on these findings, it is suggested that (i) improving nutrition and exercise might reduce the severity of dysmenorrhea pain and (ii) improving self-actualization, stress management and nutrition might reduce the severity of menstrual distress. Overall, it seems that improving health-promoting lifestyle behaviors can help improve the severity of dysmenorrhea pain and menstrual distress among adolescent girls

Fear of COVID-19 and trust in the healthcare system mediates the association between individual's risk perception and preventive COVID-19 behaviours among Iranians

Problems caused by the novel coronavirus disease-2019 (COVID-19) and its mutations have brought challenges in pandemic control for all countries worldwide. The present study examines the mediating roles of fear of COVID-19 and trust in the healthcare system in the association between individual's risk perception and performing preventive COVID-19 behaviours among Iranians. A cross-sectional study design was used to collect data from 3652 residents of Qazvin province in Iran from 3 February to 15 April 2021 using a multistage stratified cluster sampling method. Participants responded to an online questionnaire concerning their fear of COVID-19, risk perception, trust in the healthcare system, and preventive COVID-19 behaviours. Small to medium positive interrelationships were observed between the variables of the study. Fear of COVID-19, trust in the healthcare system or both (fear of COVID-19 and trust in the healthcare system) mediated the association between an individual's risk perception and performing preventive COVID-19 behaviours. The study demonstrated there are at least four ways through which an individual's risk perception can influence preventive COVID-19 behaviours. Therefore, clinicians, health communicators, and researchers may capitalize on these findings to enhance preventive COVID-19 behaviours to help mitigate the spread of COVID-19 infection

Effects of cognitive behavioral therapy for insomnia (CBT-I) on quality of life: a systematic review and meta-analysis

The effects of cognitive behavioral therapy for insomnia (CBT-I) have consistently been shown to improve insomnia symptoms and other health-related outcomes, but the effects on QoL have been inconsistent. Many factors including the type CBT-I delivery and type of instrument used to assess QoL make the topic complex. The present systematic review and meta-analysis synthesized the evidence of CBT-I efficacy on QoL outcomes across different populations, delivery modes, and methodological aspects. Following the guidelines on preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a literature search was conducted through PubMed, Web of Science, Scopus, and PsycINFO using keywords from relevant MeSH terms based on PICOS (Participants, Intervention, Comparison, Outcome and Study) criteria. Clinical trials investigating the effect of CBT-I as an intervention on QoL with any kind of control group were eligible if they reported mean scores and variation of QoL. Meta-analysis using a random-effect model was conducted to calculate the standardized mean differences (SMDs) in a set including all identified studies, as well as in three sub-sets: face-to-face CBT-I using randomized controlled trials (RCTs), online CBT-I using RCTs, and one-group pre- and post-treatment design. A total of 24 studies comprising 1977 participants (808 in an intervention group) from 12 countries were eligible for meta-analysis. The overall pooled estimate of SMD of QoL when all 24 studies were included was 0.47 (95% CI: 0.22; 0.72; I2 = 84.5%; tau2 = 0.31; p < 0.001). The overall pooled estimate of SMD of QoL was 0.46 (95% CI: 0.01–0.90; I2 = 87.5%; tau2 = 0.48, p < 0.001) for intervention groups with face-to-face CBT-I compared to controls; 0.47 (95% CI: 0.02–0.92; I2 = 88.3%; tau2 = 0.36; p = 0.04) for intervention groups with digital CBT-I compared to controls, and 0.46 (95% CI: 0.12–0.80; I2 = 52.9%; tau2 = 0.07; p = 0.08) for one-group pre- and post-comparison using CBT-I intervention compared to baseline. Moreover, effects of CBT-I on QoL were different across populations (pooled SMD = 0.59 for patients with insomnia; 0.29 for patients with insomnia comorbid with another major disorder; and 0.48 for other conditions) and types of QoL instruments (pooled SMD = 0.36 for disease-specific QoL instrument not on insomnia, 0.43 for generic QoL instrument, and 0.67 for a single-QoL-item instrument). The probability of publication bias was ruled out in overall and design specific sub-group analysis based on funnel plot and Egger's test. In conclusion, this meta-analysis confirmed a moderate, overall effect of CBT-I in improving QoL. However, due to small power and heterogeneity, future studies are needed to better explore the impact of moderating factors such as mode of delivery and type of QoL measure for assessment used

Predicting physical and verbal aggression perpetration among teenage boys: an application of the theory of planned behavior

Purpose: Aggression has been introduced as one of the serious problems in public health. The purpose of this paper is to evaluate the ability of the extended theory of planned behavior (TPB) to predict the physical and verbal aggression behavior. Design/methodology/approach: In this research, 462 teenagers were evaluated through the demographic questionnaire along with the main structures of the TPB as a predictor of behavior. After one month of follow-up, physical and verbal aggression was evaluated. Demographic data were analyzed descriptively by SPSS21 and predictability of the structures for intention and behavior of the physical and verbal aggression was analyzed by AMOS. Findings: Mean and standard deviation of participants’ age were 14.70 and 1.12 years, respectively. In this research, 22.5% of the participants did not show physical aggression over the last one month and 20% of them did not show verbal aggression over the last month. Path analysis revealed that the variables of the TPB predicted 61% and 32% of variance of intention and physical aggression behavior, respectively, while these variables could describe 43% and 22% of the variance of intention and verbal aggression behavior, respectively. All of the concepts could be significant predictors of the behaviors. Subjective norms were the best predictor of the intention for physical and verbal aggression. Intention and perceived behavioral control were good predictors of physical and verbal aggression. Research limitations/implications: Given the role of subjective norms in intention and also the role of intention and perceived behavioral control of people for aggression, it can be concluded that emphasis on social and psychological education about subjective norms, peer groups and self-control can help reduce this problem. Originality/value: A few studies have predicted behavior occurrence in the future. Given the lack of focus on the role of constructs that may bring about future behaviors, the current research was conducted to use the structures of the TPB to predict behavioral intention as well as perpetration of physical and verbal aggressive behaviors, independentl

Death anxiety in patients with cancer: A systematic review and meta-analysis

PURPOSE: The present study was designed to estimate the rate of death anxiety and the factors influencing its occurrence in cancer patients using a systematic review and meta-analysis approach. METHOD: Five academic databases, including Scopus, PubMed, Science Direct, Embase, and ProQuest, were searched systematically from inception until the end of January 2020. Observational studies that reported mean score of death anxiety in cancer patients, regardless of language restriction, were eligible to be included. The Newcastle-Ottawa Scale was used to assess the methodological quality of included studies. A meta-analysis was performed using a random effect model with the DerSimonian and Laird weighted method. Publication bias was assessed using the funnel plot and Begg's and Egger's tests. RESULTS: The estimated pooled mean for death anxiety among cancer patients was 6.84 (CI95% = [5.98, 7.69]). Publication bias and small study effects were not detected. Subgroup analysis and a meta-regression showed that the estimated pooled mean was higher in Asian studies (M = 7.57) compared to European (M = 6.47) and North American studies (M = 5.57); in breast cancer patients (M = 9.68) compared to studies examining different types of cancers; in female only participants (M = 7.37) compared to studies with both genders (M = 6.60); and in married participants compared to non-married participants. CONCLUSIONS: The findings suggest that death anxiety in patients with cancer is moderate and is influenced by socio-demographic factors such as region, type of cancer, sex, and marital status

Nitric oxide-releasing nanoparticles improve doxorubicin anticancer activity

Houman Alimoradi,1,* Khaled Greish,2,3,* Anita Barzegar-Fallah,1 Lama Alshaibani,2 Valeria Pittal&agrave;4 1Department of Pharmacology and Toxicology, University of Otago, Dunedin, New Zealand; 2College of Medicine and Medical Sciences, Department of Molecular Medicine, and Nanomedicine Unit, Princess Al-Jawhara Centre for Molecular Medicine and Inherited Disorders, Arabian Gulf University, Manama, Kingdom of Bahrain; 3Department of Oncology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 4Department of Drug Science, University of Catania, Catania, Italy *These authors contributed equally to this work Purpose: Anticancer drug delivery systems are often limited by hurdles, such as off-target distribution, slow cellular internalization, limited lysosomal escape, and drug resistance. To overcome these limitations, we have developed a stable nitric oxide (NO)-releasing nanoparticle (polystyrene-maleic acid [SMA]-tert-dodecane S-nitrosothiol [tDodSNO]) with the aim of enhancing the anticancer properties of doxorubicin (Dox) and a Dox-loaded nanoparticle (SMA-Dox) carrier. Materials and methods: Effects of SMA-tDodSNO and/or in combination with Dox or SMA-Dox on cell viability, apoptosis, mitochondrial membrane potential, lysosomal membrane permeability, tumor tissue, and tumor growth were studied using in vitro and in vivo model of triple-negative breast cancer (TNBC). In addition, the concentrations of SMA-Dox and Dox in combination with SMA-tDodSNO were measured in cells and tumor tissues. Results: Combination of SMA-tDodSNO and Dox synergistically decreased cell viability and induced apoptosis in 4T1 (TNBC cells). Incubation of 4T1 cells with SMA-tDodSNO (40 &micro;M) significantly enhanced the cellular uptake of SMA-Dox and increased Dox concentration in the cells resulting in a twofold increase (P&lt;0.001). Lysosomal membrane integrity, evaluated by acridine orange (AO) staining, was impaired by 40 &micro;M SMA-tDodSNO (P&lt;0.05 vs control) and when combined with SMA-Dox, this effect was significantly potentiated (P&lt;0.001 vs SMA-Dox). Subcutaneous administration of SMA-tDodSNO (1 mg/kg) to xenografted mice bearing 4T1 cells showed that SMA-tDodSNO alone caused a twofold decrease in the tumor size compared to the control group. SMA-tDodSNO in combination with SMA-Dox resulted in a statistically significant 4.7-fold reduction in the tumor volume (P&lt;0.001 vs control), without causing significant toxicity as monitored through body weight loss. Conclusion: Taken together, these results suggest that SMA-tDodSNO can be used as a successful strategy to increase the efficacy of Dox and SMA-Dox in a model of TNBC. Keywords: biologic barriers, nanoparticles, nitric oxide, doxorubicin, synergistic cytotoxicity, SMA-tDodSN

Effects of occupational exposures on respiratory health in steel factory workers

Abstract Background: The steel factory work environment contains various chemical exposures that can affect indoor air quality and have impact on respiratory health of the workers. Aims: The objective of this study was to assess potential effects of occupational exposures in steel factory workers in Iran on the respiratory symptoms, occurrence and the lung function levels. Method: This was a cross-sectional study of 133 men working in a steel factory forming the exposed group and 133 male office workers forming the reference group from a steel company in Iran. The participants filled in a questionnaire and underwent spirometry. Work history was used both as dichotomous (exposed/reference) and a quantitative measure of exposure, the latter measured as duration of exposure in the specified work (in years) for the exposed group and zero for the reference group. Results: Multiple linear regression and Poisson regression were used to adjust for confounding. In Poisson regression analyses, an increased prevalence ratio (PR) of all respiratory symptoms was observed in the exposed group. Lung function parameters were significantly reduced in the exposed group (p &lt; 0.001). There was a dose–response relation between duration of occupational exposures and reduction in the predicted value of FEV1/FVC level (0.177, 95% CI −0.198 to −0.156) in all models. Conclusion: The results of these analyses showed that occupational exposures in steel factory work increase the prevalence of respiratory symptoms and reduce lung function. Safety training and workplace conditions were found to need improvement. In addition, use of proper personal protective equipment is recommended