Health education models application by peer group for improving breast cancer screening among Iranian women with a family history of breast cancer: A randomized control trial

Background: Studies have shown that participation of Iranian women with family history of breast cancer in screening service is low. This investigation has evaluated the effectiveness of health models according to peer group in improving clinical breast exam (CBE) among Iranian women with a family history of breast cancer. Methods: This was a randomized control trial conducted during June and August 2015 in Isfahan. A total of 54 women were assigned into intervention and 53 to control group. Women 20 years or older with an affected relative were included. CBE screening, stage of change screening, knowledge, and belief were considered as outcomes after educational program. Data were analyzed by ANOVA and descriptive statistics by SPSS. Significance level was set at 0.025. Results: Investigation was completed by 98 women; and we considered 22% as effect size. Three months after the intervention, screening practice was 52% in interventional versus 18% in control group (p<0.001). Knowledge and all health belief subscales scores were significantly affected by time factor and time-group interaction (p<0.001). The effect of group factor was significantly related to knowledge score and perceived sensitivity, benefits, and health motivation subscales. Three months after the intervention, most women in the intermediation group were in the action stage of CBE compared to the controls who continued to be in contemplation stage (p<0.001). Conclusion: Peer group interventions, which can be organized by health models, have positive effects on CBE in women with positive history of breast cancer

A randomized field trial for the primary prevention of osteoporosis among adolescent females: Comparison of two methods, mother centered and daughter centered

Background: Osteoporosis is a serious public health. Since the majority of bone mass occurs during adolescence, primary prevention is important. Probably mother's participation in health education interventions leads to promote health behaviors in children. Aims: To assess a lifestyle modification intervention focused on mothers and students has an impact on osteoporosis preventive behaviors in adolescent girls. Materials and Methods: It is a randomized field trial in female high schools. 210 girls aged between 11 and 15 were randomly selected. Students in groups A and C and mothers in group B were selected Through the sampling frame. Our lifestyle modification was based on group based education in the public girls' high schools. Subjects in the intervention groups participated in three educational sessions. Students' osteoporosis preventive behaviors were measured by using a lifestyle questionnaire consisting of items assessing nutrition, physical activity and sun exposure. Repeated measure ANOVA at baseline, 4 week, 2 months and 6 months and were used to analyze the data. Results: After 1 month, diet and sun exposure scores increased significantly (P < 0.001) but it was higher in group B compared with group A. (About diet P < 0.001 and sun exposure = 0. 001). After 6 months, diet and sun exposure status in the group A approximately decreased to baseline, while in group B, diet components were significantly different compared to baseline (P < 0.001). There was no change in physical activity. Conclusion: Osteoporosis prevention intervention of adolescent can be effective when parents or girls participate in training sessions, but education is associated with better outcomes when focused on mothers

Evaluation of social capital among students of Isfahan University of Medical Sciences in 2016

Background: Social capital includes a series of issues and values, which is potentially in relation with social groups and organizations. Due to the importance of social capital as a determining factor in the health, this study aimed to evaluate the social capital in the students of the Isfahan University of Medical Science. &nbsp; Methods: This survey was the first phase of a survey that was carried out in Isfahan University of Medical Sciences on 700 students. Students were selected by a stratified random sampling method. Data on social capital of students were collected using Bullen questionnaire. For data analysis, IBM SPSS Statistics for Windows, Version 22.0. software was used. &nbsp; &nbsp; Results: The mean (SD) score of social capital of the students in this study were 62.11 (14.6), in which the lowest score belonged to the cooperation domain and the highest one belonged to the identity. The most important factors that related to the social capital of the students, included the gender (male: 58.82 (15.87) vs. female: 65.44 (15.87), P=0.028), residency (dormitory: 62.89 (14.3), live with family: 62.22 (14.27), personal home: 50.53 (20.63), P=0.006) and educational level (doctorate degree: 60.48 (13.79) vs. bachelor degree: 63.27 (15.07), P=0.019).&nbsp; &nbsp; Conclusion: The results of this study showed that the social capital score of college students was in a moderate level and policymakers need to design interventions in order to improve students' social capital especially in the level of their participation in the society

Coping skills improve quality of life in women with breast cancer and maladaptive coping Style

Background: Breast cancer (BC) is a common malignancy among women. BC is a stressor in life that affects coping strategies and quality of life. This study performed to improve the quality of life in women with maladaptive coping style.  Methods: A randomized clinical trial, held in 2011. Patients with maladaptive coping strategy were included in the study. 62 patients were randomized into two groups. Before and after 8 weeks of coping therapy, the quality of life was measured. General linear model was used for analysis.  Results: The mean age in the intervention and control group was 45.10±7.34, 46.52±6.20 respectively (P-value&gt;0.5). Functional health significantly improved after the intervention (p-value&lt;0.005), but in the control it decreased (p-value=0.029). Symptom health between the two groups demonstrated no difference before and after intervention. General health improved in the intervention group (p-value=0.017). However, in the control group it was not significant (p-value=0.128). Problem-focused coping strategies in the intervention group improved markedly (p-value= 0.003) whereas, the control group did not reveal significant differences (p-value=0.196).  Conclusion: The results showed that the coping skill training program can improve the overall quality of life of breast cancer in women, and indicated that the care of breast cancer should address psychological issues and the finding points to the importance of taking individual coping strategies into account when evaluating the impact of breast cancer on psychosocial well-being

Diagnostic Accuracy of Optic Nerve Ultrasonography and Ophthalmoscopy in Prediction of Elevated Intracranial Pressure

Introduction: Elevated intracranial pressure (ICP) is a major and potentially lethal disorder in patients admitted to the emergency department (ED). Several methods are being used to investigate for elevated ICP. Here we assessed and compared the diagnostic accuracy of two existing tools of ophthalmoscopy and optic nerve ultrasonography in detection of elevated ICP. Methods: 131 participants with probable elevation of ICP referred to the emergency department of Al-Zahra Hospital, Isfahan, Iran, from 2012 to 2014, were enrolled. Brain computed tomography (CT) scan, ultrasonography of optic nerve sheath, and ophthalmoscopy were performed for them. The optic nerves sheath with diameter more than 5 millimeters was considered as elevated ICP. Widening of optic nerve, ocular venous engorgement, blurring, hemorrhage over optic disk, elevation of optic disk, and retinal venous tortuosity were recorded as evidences of ICP rising in ophthalmoscopy. Diagnostic accuracy of the two tools in prediction of ICP rising were compared with the results of brain CT scan as a gold standard. Results: The mean age of participants was 46.29 ± 10 years (77% male). The number of diagnosed elevated ICPs with ophthalmoscopy and ultrasound were 98 (74.8%) and 102 (77.9%) cases, respectively. The calculated sensitivity and specificity of ophthalmoscopy and ultrasonography in detection of ICP rising were 100.0% (95% CI: 88.6-100.0) and 35.4% (95% CI: 26.0-46.2), 100.0% (95% CI: 84.0-100.0) and 31.9% (95% CI: 23.0-41.7), respectively. Conclusion: The present study reveals that bedside ultrasonography of optic nerve sheath and ophthalmoscopy have enough accuracy for screening of patients with probable elevation of ICP. Of course, it should be considered that despite of high sensitivity of both tools, their specificity is low

Spiritual Well-Being and Quality of Life of Iranian Adults with Type 2 Diabetes

Introduction. Diabetes is a major public health problem. Little is known about the spiritual well-being and its relationship with quality of life (QOL) in Iranian Muslim patients with diabetes. This study investigated the spiritual well-being and QOL of Iranian adults with type 2 diabetes and the association between spiritual well-being, QOL, and depression. Methods. A cross-sectional study was done among 203 patients with type 2 diabetes mellitus in Isfahan, Iran. Quality of life and spiritual well-being were measured using the functional assessment of chronic illness therapy-spiritual well-being (FACIT-Sp). Depression was assessed using the Patient Health Questionnaire-2 (PHQ-2). Descriptive analysis, Pearson’s correlation, and multiple regression analysis were performed for statistical assessment. Results. The mean QOL was 61.00 (SD = 9.97) and the mean spiritual well-being was 30.59 (SD = 6.14). Sixty-four percent of our studied population had depressive disorders. There was a significant positive correlation between all QOL subscales and meaning, peace, and total spiritual well-being score. Conclusion. The results of this study showed poor QOL and spiritual well-being and high prevalence of depression in Iranian patients with type 2 diabetes compared to other studies’ findings especially western studies. This indicates the need for psychosocial and spiritual support in caring for Iranian patients with diabetes

Iranian version of the quality of life in adult cancer survivors (Qlacs) questionnaire: Examining face and content validity, exploratory factor analysis and reliability

Background: Quality of life among cancer patients after diagnosis and treatment steps is an important factor in preventing further cancer complications. Thus, appropriate tools to evaluate the quality of life among this group are required. Quality of life in Adult Cancer Survivors (QLACS) questionnaire is a suitable tool which evaluates different aspects of life among cancer survivors. Objectives: This study evaluated the Persian version of the QLACS questionnaire among Iranian short-survivors of breast cancer by assessing its validity and reliability. Methods: The QLACS was translated to Persian for this study. The questionnaire�s face and content validity were assessed by a panel of experts by the impact score, content validity ratio, and index methods. In the next step, the questionnaire was filled out by 150 women with breast cancer who were diagnosed 1.5-5 years before this study. Explanatory factor analysis was performed to assess factors. Reliability was evaluated using Cronbach�s alpha. Results: Overall, 37 items were selected for explanatory factor analysis that had an impact score of more than 1.5, content validity ratio (CVR) more than 0.99, and a suitable content validity index (CVI). In factor analysis, 10 factors were extracted via varimax rota-tion, accounting for 75.8 of the total variance. Cronbach�s alpha of all the factors was more than 0.7, that was similar to the original questionnaire. Conclusions: We conclude that the Persian version of the QLACS questionnaire has optimal properties for the assessment of quality of life among Iranian short-survivors of breast cancer

Is Admission Serum Sodium Concentration a Clinical Predictor for the Outcome of Therapy in Critically Ill Poisoned Patients?

BACKGROUND Disorders of serum sodium concentration are some of the most electrolyte abnormalities in the intensive care unit (ICU) patients. These disorders adversely affect the function of vital organs and are associated with increased hospital mortality. PURPOSE In the present study we aimed to evaluate the effects of serum sodium concentration abnormalities at the time of hospital admission on the clinical outcome of therapy in a cohort of critically ill poisoned patients. METHODS In this cross-sectional study, 184 critically ill poisoned patients aged >18 years and in the first 8 hours of their poisoning, hospitalized in the ICU of a tertiary care university hospital (Isfahan, Iran) between 2010-2012, were evaluated at the admission time and 24 hours later for serum sodium concentration abnormalities and its relationship with age, gender, consciousness status, ingested drugs and clinical outcome of therapy. The clinical outcome was considered as recovery and mortality. Logistic Regression analysis was performed for predictive variables including serum sodium concentration abnormalities in patients' clinical outcome. FINDINGS On admission, 152 patients (82.6%) were eunatremic, 21 patients (11.4%) were hyponatremic and 11 patients (6%) were hypernatremic. In the second day eunatremia, hyponatremia and hypernatremia was observed in 84.4%, 13% and 2.2% respectively. Age (OR=1.92; CI=1.18-3.12) and severity of toxicity (OR=1.32; CI=1.12-2.41) were predicting factors of mortality in ICU poisoning patients. CONCLUSIONS Serum sodium concentration abnormalities are prevalent in critically ill poisoned patient but do not seem to have a predictive value for the clinical outcome of therapy

Vitamin D deficiency and coronary artery disease

BACKGROUND: Several factors such as hyperlipidemia, diabetes and hypertension have a determining role in cardiovascular disease. In recent years, the effect of vitamin D deficiency on cardiovascular disease has been emphasized. This study compares vitamin D deficiency in coronary heart disease patients with the control group. METHODS: In a cross-sectional study, 25-hydroxycholecalciferol level was compared in 119 individuals including 57 people with confirmed coronary heart disease and 62 healthy people. 25-hydroxyvitamin D [25(OH)D] was assessed using standard protocol. The level of 25(OH)D under 20 ng/dl was determined as cutoff point. RESULTS: The calculated odds ratio was 3.9 (95% confidence interval 2.6-5.5). Vitamin D deficiency significantly different between patients and the control group (p = 0.01). Of 37 (31%) individuals having vitamin D deficiency, 36 (97.3%) had coronary artery disease and from 57 patients with coronary artery disease 36 (63.2%) had vitamin D deficiency. CONCLUSIONS: Vitamin D deficiency is a relatively common disorder. Risk of cardiovascular disease in people with vitamin D deficiency is almost four times of those with normal levels of vitamin D. To confirm the casual relationship between vitamin D and cardiovascular disease, clinical trial studies are suggested

A Short Communication: Non-acid Nucleic Blood Multi-Factors Panels for Primary Breast Cancer Detection - A Systematic Review and Network Meta-Analysis

This study aimed to compare the non-acid nucleic blood multi-factor panels together and with mammography in terms of sensitivity, specificity, and accuracy in primary breast cancer detection (I, II, III, and IV). We systematically reviewed studies assessing non-acid nucleic blood tumor markers panels’ diagnostic value in both healthy women and patients (before any anticancer treatment) for the detection of primary breast cancer. Out of the 2358 titles initially identified, 12 studies and 9 panels were included in the network meta-analysis. Panels I (MSA + B2m) and J (GATA3 + E-cadherin) had the highest sensitivity in all stages of primary breast cancer but had no significant difference with mammography. Panels L (MSA + CA15–3) and B (M-CSF + CA15–3) had the highest specificity in all stages compared to other panels but no remarkable difference with mammography. Panels J (GATA3 + E-cadherin) and I (MSA + B2m) respectively had the highest accuracy in primary breast cancer detection but no considerable difference with mammography in terms of accuracy. Panel J, including GATA3 + E-cadherin, demonstrated a higher diagnostic value for primary breast cancer detection (I, II, III, and IV) than the rest of the panels