Assessing and Improving Fitness to Drive in the Elderly People: A Scoping Review of Policies and Guidelines

Background: This study has been conducted to analyze the processes, models, and policies to assess fitness to drive and improving driving in the elderly in the world. Methods: The Arkesy and O’Malley frameworks were employed. Articles with at least one aspect of driving eligibility in the elderly were included. Expected data were collected using appropriate keywords from PubMed, Web of Science, Scopus, Embase, IranDoc, SID, and MagIran. Data were analyzed using the Content Analysis method. Results: Out of 675 records, 24 papers and reports were included in the study that all of them were High-Income Countries (HICs). Among the studies that referred to the baseline age, the highest frequency was 70 yr old (4 studies). Vision assessment was the main item to judge driving fitness (mentioned in 75% of the studies). The in-person (5 studies) was the most common method of renewal. General practitioners were the principal performers to measure driving fitness (7 studies). Thirteen studies referred to the road tests as part of the driver's license renewal process. In most all reports and papers, there were policies on empowering the elderly driver, including providing safe driving tips, optional driving skills tests, holding retraining courses, etc. The most frequently supporting policies included introducing alternative transportation. Conclusion: Most HICs have worthwhile experience in measuring and improving the fitness to drive in the elderly and enforce different laws according to social and political conditions. Utilizing these experiences by considering economic and social differences can be useful and practical for middle and low-income countries.

Prevalence and Reasons of Self-Medication in Pregnant Women: A Systematic Review and Meta-Analysis

Background: Given the importance of having valid information about the prevalence and reasons of self-medication among pregnant women for preventing self-medication during this period, this study aimed to systematically review and perform a meta-analysis on the prevalence and reasons of self-medication during pregnancy. Methods: This systematic review and meta-analysis was conducted in 2018 to estimate the overall self-medication prevalence based on the database sources PubMed, Scopus, Google Scholar, MagIran, IranMedex and SID. Required data were collected using keywords: medication, self-medication, over-the-counter, non-prescription, prevalence, etiology, and occurrence and pregnant. Descriptive and cross-sectional studies in English and Persian languages were included. There was no time limitation for search. R software was applied for meta-analysis. Random-effects model was applied to estimate the self-medication prevalence with 95% confidence interval. Q statistics and I2 were used to measure the heterogeneity. Results: Out of 490 retrieved articles, finally 13 studies were included in meta-analysis, 6 studies of which reported the cause of self-medication. The overall estimated prevalence of self-medication based on the random effect model was 32% (95% CI, 22% - 44%). The most important reasons of self-medication were previous experience of the disease. The most important group of disease in which patients self-medicated was anemia. Also, the most important group of medication was herbal. Conclusion: The results of this study showed that the prevalence of self-medication among pregnant women was relatively high and required effective interventions to reduce and prevent self-medication among this group. Providing required information and raising awareness about complications resulting from self-medication, in particular herbal medicines and dietary supplements, should be taken into account

Status of decayed, missing, filled teeth index among Iranian children and adults: A systematic review and meta-analysis

Introduction: Oral health status is one of the health-related priorities in Iran. The present study was conducted with the aim to systematically review the status of oral health in Iran using the decayed, missing, filled teeth (DMFT) index. Methods: In this meta-analysis, all data available on DMFT were reviewed and 35 published studies were included in the study based on search strategy. To estimate overall DMFT and perform the meta-analyses, Comprehensive Meta-Analysis (CMA) software was used. Results: Of all 876 articles, 35 were included in the study. A total of 21849 individuals were included in the meta-analysis. The overall DMFT index was 3.65 [95% confidence interval (CI), 3.01-4.34]. In addition, this rate was 2.30, 8.60, and 3.85 among children, adults, and children with mental/physical disabilities with (CI 95%, 1.76-2.95), (CI 95%, 6.10-9.60), and (CI 95, 2.98-4.80), respectively. Conclusion: Mean DMFT in the assessed published data was higher than that set forth by the World Health Organization (WHO). Further planning and taking effective preventive measures to improve the oral health status seems necessary

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Evidence-based care in Iran: A Systematic Review

Background and Aim: Evidence-based care is defined as combining research findings with caring skills. The current study aimed at a systematic review of obstructions, facilitators, awareness, knowledge, function, perception, and results of interventions in evidence-based care in Iran. Materials and Methods: In the present survey different data base searching methods and manual search were applied using the key words of “evidence-based”, “evidence-based medical”, “evidence-based nursing”, “evidence-based practice”, “evidence-based care”, “evidence-based activity”, “evidence-based education”, “applying research results”, “research application”, and their combinations with the key words of “obstructions”, “facilitators”, “awareness”, “knowledge”,” function”, “perception”, and” Iran” and their English synonyms in data bases of PubMed, Medlib, Magiran, SID, CINAHL, Google Scholar, and Iranmedex to collect articles. Results: Out of 819 articles, finally 25articls were used for this study. The most important barriers of evidence-based practice were lack of facilities, lack of time, and lack of expertise in research methods. The rate of familiarity with evidence-based practice specific terms was low (44.22%). Reference books were considered as the most important information sources. Awareness, knowledge, function, and usage of evidence-based practice was low (<50%). Main concepts of evidence-based practice from providers’ point of views were scientific and professional care, patient-oriented and considering service quality. Interventional studies had a positive effect on the improvement of evidence-based practice. Conclusion: Weak knowledge, weak attitude, and time shortage .are among the most significant barriers of evidence-based care in Iran. These problems require more accurate planning and more favorable policies on the part of medical science authorities

The Main Issues and Challenges Older Adults Face in the SARS-CoV-2 Pandemic: A Scoping Review of Literature

BACKGROUND: The Severe Acute Respiratory Syndrome Coronavirus Disease 2019 (SARS-CoV-2) severely affects those above the age of 60 yr and those with other conditions. This study aimed to review the available evidence on older adult\u27s issues in facing the COVID-19 pandemic. METHODS: The framework is based on scoping review of literature published from Jan 10 to Jul 31, 2020. Medline, Scopus, Web of Science, and Google Scholar databases and other sources of information, to identify grey literature, were selected for data collection. Two researchers independently screened all studies and extracted data. All types of studies published about SARS-CoV-2 and related to older adults\u27 issues were eligible. RESULTS: Overall, 210 documents were included in the final analysis. Letter to the editor was the most frequent article format (20.95%). Most of the papers were from the United States (38.09%) and published in Jun 2020 (29.52%). After content analysis, six following themes were extracted: Supporting and information sources, e-health services, access to essential supplies, Long Term Care Facilities (LTCFs), physical and mental consequences of self-isolation, neglect of older adults, ageism and age discrimination. CONCLUSION: In the pandemic, there is an urgent need for interventional research and innovational implementations to address issues related to providing services for older adults. This can help older adults to maintain their physical and mental health, and reduce the spread of infection in nursing homes. Further studies focusing on the rights of the older adults are needed on all issues associated with COVID-19

Cardiovascular patients’ experiences of living with pacemaker: Qualitative study

BACKGROUND: A pacemaker implantation is considered major life event for cardiovascular patients, so they will probably have very interesting experiences of living with this device. The aim of this study was to explore the experiences of cardiovascular patients living with the pacemaker. METHODS: In this qualitative study, 27 patients were chosen through purposive sampling to achieve data saturation, and their experiences were examined using semi-structured interviews. The patients&rsquo; statements were recorded with their consent and analyzed using content analysis method. RESULTS: Participants&rsquo; experiences included three main themes: &ldquo;Problems and limitations,&rdquo; &ldquo;feeling and dealing with pacemaker&rdquo;, and &ldquo;sources of comfort&rdquo; and 10 sub-themes including: physical problems, financial problems, social problems, the first encounter, the feeling of living with the pacemaker, how to cope with pacemaker, satisfaction with pacemaker, good family support, hospital and hospital staff performance, and role of religious beliefs. CONCLUSION: Planning to solve social problems, identifying and changing feelings of patients using pacemakers, reinforcing the resources of comfort especially family support seem to be necessary steps for improving quality of life and impact of using pacemaker.&nbsp;</p

مروری نظام‌مند بر مطالعات انجام گرفته در زمینه اسب‌درمانی (Hippotherapy) و گزارش توصیفی نتایج آن‌ها

چکیده مقدمه: اسب درمانی یکی از روشهای توانبخشی میباشد که در سالهای اخیر کاربرد زیادی یافته است. هدف مطالعه حاضر جمع بندی مطالعات و گزارش توصیفی نتایج اسب درمانی در درمان و توانبخشی ناتوانی ها و معلولیت ها میباشد. مواد و روش‌ها: این مطالعه از نوع مطالعات مروری نظام‌مند می‌باشد. اطلاعات مورد نیاز از طریق جستجو در پایگاه‌های داده‌ای: PubMed ، Medline، ,Cinahl , Web of knowledge , Science Directو SIDبا استفاده از کلیدواژه‌های hippotherapy، Equine- assisted therapy, Horseback riding, Horse riding , Therapeutic riding, و اسب درمانی جمع‌آوری گردید. بازه زمانی جمع‌آوری مقالات بین سال‌های 2012 – 1990 انتخاب گردید و در نهایت تعداد 35 مقاله وارد مطالعه گردید. مقالات انتخاب شده به طور کامل مورد مطالعه قرار گرفته و نتایج با استفاده از (Extraction table) استخراج، خلاصه‌سازی و گزارش گردید. یافته‌ها: میانگین تعداد نمونه‌ها برای هر مطالعه برابر با 5/22 نفر بود. میانگین مدت زمان مداخله برای هر مطالعه نیز برابر با 16/13 هفته بود. بیشترین گروه سنی مورد مطالعه کودکان بودند و بیشترین ناتوانی بررسی شده نیز فلج نخاعی بود. در 33 مطالعه (حدود94%) نتایج مطالعات نشان دهنده تاثیر مثبت و اثربخش اسب درمانی بود. نتیجه‌گیری: بر اساس نتایج مطالعات بررسی شده اسب درمانی تاثیر مثبتی در توانبخشی داشته و این اثربخشی در مواردی مانند فلج نخاعی، ثبات سر و اندام‌های فوقانی، مالتیپل اسکلروسیز، ناتوانی‌های فیزیکی و ... مشاهده می‌شود. با این وجود مطالعات صورت گرفته در این زمینه محدود بوده و نمی‌توان با این تعداد نتیجه‌گیری کرد و نیاز به انجام مطالعات بیشتر در این زمینه می‌باشد. کلیدواژه‌ها: اسب درمانی، روش‌های توانبخشی، مروری نظام‌مند، گزارش توصیفی، ناتوانی و مصدومی