Prevalence of Depression among Iranian Elderly: Systematic Review and M

Objective: depression is one of the most serious and prevalent mood disorders. Aging population is an important economic, social, and health challenge of the 21st century. The present study aimed at estimating the prevalence of depression among the Iranian elderly through meta-analysis method. Method: Studies were searched in ISI, Scopus, Pub Med, Google Scholar, and in Iranian databases including Iran Medex, Magiran, SID, and Med Lib using the following keywords: "depression", "prevalence", and "elderly". Data were analyzed using meta-analysis (random effects model). Heterogeneity among the results of the studies was examined by "I2" index. Beck, DASS-21, GHQ-28, and G DS questionnaires were used in this study, and analyses were performed using STATA Ver.11. Results: A total of 26 studies in Iran with a sample size of 5781 individuals had been found during 2001 and 2015. Prevalence of depression among Iranian elderly was estimated to be 43% (95% confidence interval (CI):30% - 55%). The findings showed that the prevalence of depression among Iranians were49% in women, 48% in men, 37% in unmarried, and 45%in the married. In addition, the prevalence of very severe, severe, moderate, and mild depression levels were estimated to be 5%, 19%, 33%, and 38% of the participants, respectively. No significant difference was observed between married and unmarried individuals. Most of Iranian elderly suffered from mild depression. Conclusion: There was high level of depression prevalence among Iranian elderly, and women were more depressed than men. So, policy makers must design and run mental health programs to decrease the prevalence of depression among Iranian elderly

The effect of continuous-educational program in interferon therapy on quality of life in patients suffering from Hepatitis B and C.

چکیده: زمینه و هدف: مؤثرترین روش در درمان بیماران مبتلا به هپاتیت های مزمن B و C درمان ترکیبی با اینتروفرون می باشد. این درمان ها به هر حال درجات مختلفی از عوارض جانبی ایجاد می کنند که ممکن است تأثیر منفی بر روی حیات بیمار، تعاملات اجتماعی و توانایی انجام کار و دیگر فعالیت های آنها داشته باشد. هدف از این مطالعه بررسی تأثیر آموزش نحوه مصرف صحیح اینترفرون، کنترل عوارض جانبی و پی گیری بیماران به مدت 28 هفته بر روی کیفیت زندگی بیماران مبتلا به هپاتیت B و C بود. روش بررسی: این پژوهش یک پژوهش نیمه تجربی است که به صورت پیش آزمون- پس آزمون بر روی بیماران مبتلا به هپاتیت مزمن B و C کاندید اینترفرون تراپی در مرکز هپاتیت تهران صورت گرفت. تعداد 60 بیمار به روش نمونه گیری در دسترس با توجه به مشخصات نمونه انتخاب و به طور تصادفی در گروه شاهد و آزمون (30 نفر شاهد، 30 نفر آزمون) قرار گرفتند. ابزار گردآوری داده ها پرسشنامه اطلاعات دموگرافیک و پرسشنامه کیفیت زندگی ویژه بیماران کبدی ( CLDQ=Chronic Liver Disease Questionnaire) بود. برای گروه آزمون و همراهان برنامه آموزشی به صورت 4 جلسه 45 دقیقه ای اجرا شد و بیماران به مدت 28 هفته پیگیری شدند. کیفیت زندگی بیماران هپاتیتی در دو مرحله قبل و 28 هفته پس از شروع اینترفرون تراپی و اجرای برنامه آموزشی سنجیده شد و در پایان کیفیت زندگی در دو گروه با استفاده از آزمون های همبستگی و کای دو، من ویتنی و ویلکاکسون مقایسه گردید. یافته ها: قبل از اجرای مداخله متغیرهای دموگرافیک و امتیاز کلی کیفیت زندگی در دو گروه اختلاف معنی داری مشاهده نشد. میانگین امتیاز کلی کیفیت زندگی در گروه آزمون از 4/21±6/158 به 17±4/183 افزایش یافت (001/0p) امتیاز کلی کیفیت زندگی پس از مداخله بین دو گروه دارای تفاوت معنی دار بود (001/0

The Effect of Education on Quality of Life in Patients under Interferon Therapy

Background and Aims: The main purpose of treating and caring for patients with chronic viral hepatitis is to promote life satisfaction and a feeling of well-being in patients suffering from this disease. The aim of this study was to evaluate the effect of education on quality of life in patients with chronic hepatitis who were treated with Interferon alpha. Methods: This quasi-experimental study was conducted on 60 patients with viral hepatitis. The intervention included teaching them the method of self injection of Interferon alpha 2 b, giving them educational pamphlets and then following their continuing treatment with interferon. Patients were randomly assigned to two 30-patient groups. The data- gathering tool was a demographic characteristics questionnaire and the Quality of Life Questionnaire for Patients with Chronic Liver Disease (CLDQ). The educational program was done in four 45- minute sessions for the case group and their relatives. The follow-up period was 12 weeks. Quality of life in patients with chronic hepatitis was measured before initiating interferon therapy, and after the educational period. Quality of life in the two groups was compared. Results: The total quality of life score in the two groups before therapy did not show any significant difference (P = 0.351); while 12 weeks after education there was a significant difference between the two groups (P < 0.001) in three items including abdominal symptoms (P = 0.01), worry (P < 0.001) and emotional factors (P < 0.001). The other three items did not show a significant difference between the two groups. The total quality of life score in the case group was significantly different before and after education (P < 0.001), and improved after education. The total quality of life score in the control group did not differ significantly after 12 weeks (P = 0.143). Conclusions: Planning short and simple educational programs has a significant effect on the patient's control of his/her disease and its side effects; and can improve quality of life, life satisfaction, and mechanisms of coping with treatment in patients with viral hepatitis

Psychometric evaluation of the Farsi version of the diabetes foot self-care bahavior scale

Background: Diabetes foot self-care is one of the self-management behaviors of diabetic patients leading to a reduction in the incidence of pressure ulcers and amputation. Having a valid, reliable, simple and comprehensive tool is essential in measuring the self-care behavior of diabetic patients. The aim of this study was to evaluate the psychometric properties of the Farsi version of the diabetes foot self-care bahavior scale (DFSBS) in Iran. Methods: In this cross-sectional and methodological study, 500 patients with type 2 diabetes were recruited by convenience sampling. Construct validity was assessed by exploratory factor analysis (over 300 patients) and confirmatory factor analysis (over 200 patients). Internal consistency was calculated by Cronbach’s alpha coefficient and its stability was calculated by intraclass correlation coefficient (ICC). Results: In the exploratory factor analysis, two self-care factors related to feet and shoes were extracted which had specific values of 38.49 and 1.24, respectively, and were able to account for 56.22% of the total self-care variance of diabetes foot. Confirmatory factor analysis had excellent fit model. The internal consistency and ICC of the whole instrument were 0.83 and 0.791 (95% CI: 0.575–0.925; P < 0.001), respectively. Conclusions: The Farsi version of DFSBS (F-DFSBS) has good validity and reliability, and due to its appropriate psychometric properties, this tool can be used in future studie

Examination of the psychometric properties of the persian version of the COVID-19-impact on Quality of Life Scale

Introduction As a result of high transmission and mortality rates, the Covid-19 pandemic has led to a worldwide health crisis, isolation, and widespread fear, therefore negatively influencing people's quality of life (QOL). The goal of the present study was to examine the psychometric properties (validity and reliability) of the Persian version of the COVID-19-Impact on Quality of Life (COV19-QoL) scale. Methods After translating the scale using the forward-backward method, face and content validly was qualitatively assessed. Then the scale was distributed to 488 individuals from the general population via online platforms. Construct validity was assessed using exploratory (EFA) and confirmatory (CFA) factor analysis. In addition, internal consistency was examined using Cronbach's alpha coefficient and McDonald's omega, relative stability was assessed using interclass correlation coefficient (ICC), and absolute stability was calculated through examination of standard error of measurement. Results The EFA revealed one factor that explained 55.96% of the total variance of the scale. Internal consistencies of 0.823 and 0.882 were found using Cronbach's alpha coefficient and McDonald's omega, respectively. In addition, an ICC of 0.837 (with a two-week interval) was found. Covid-19 had a greater impact on the QOL of healthy participants than that of those with underling conditions (p = 0.004), and also on the QOL of single participants than that of married ones (p = 0.032). Conclusion The Persian version of the COV19-QoL is a valid and reliable instrument that can be used to examine the impact of Covid-19 on QOL

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Renal cell carcinoma in a child

Renal cell carcinoma is a rare disease in children and adolescent. Less than <i> 2&#x0025; </i> of cases occur in childhood and no treatment protocols exist among urologists and oncologists for management. We present a case of renal cell carcinoma in a child with uncommon presentation

Prevalence of Depression among Iranian Elderly: Systematic Review and Meta-analysis

Objective: depression is one of the most serious and prevalent mood disorders. Aging population is an important economic, social, and health challenge of the 21st century. The present study aimed at estimating the prevalence of depression among the Iranian elderly through meta-analysis method. Method: Studies were searched in ISI, Scopus, Pub Med, Google Scholar, and in Iranian databases including Iran Medex, Magiran, SID, and Med Lib using the following keywords: “depression”, “prevalence”, and “elderly”. Data were analyzed using meta-analysis (random effects model). Heterogeneity among the results of the studies was examined by “I2” index. Beck, DASS-21, GHQ-28, and G DS questionnaires were used in this study, and analyses were performed using STATA Ver.11. Results: A total of 26 studies in Iran with a sample size of 5781 individuals had been found during 2001 and 2015. Prevalence of depression among Iranian elderly was estimated to be 43% (95% confidence interval (CI):30% - 55%). The findings showed that the prevalence of depression among Iranians were49% in women, 48% in men, 37% in unmarried, and 45%in the married. In addition, the prevalence of very severe, severe, moderate, and mild depression levels were estimated to be 5%, 19%, 33%, and 38% of the participants, respectively. No significant difference was observed between married and unmarried individuals. Most of Iranian elderly suffered from mild depression. Conclusion: There was high level of depression prevalence among Iranian elderly, and women were more depressed than men. So, policy makers must design and run mental health programs to decrease the prevalence of depression among Iranian elderly

Evaluation of psychometric properties of persian version of quality of life of stroke caregivers

Background: Patients with stroke need complete care due to physical and mental problems and prevention of exacerbation of symptoms. The quality of life of caregivers of these patients is affected by full-time care. The aim of this study was to investigate the psychometric properties of the Persian version of the adult carers quality of life questionnaire (AC-QoL) on stroke caregivers. Methods: In this cross-sectional study, the original scale was translated as forward-backward method. Face and content validity were performed qualitatively. In construct validity, 358 caregivers with a mean age of 36.32 ± 8.42 years were included in the study. Exploratory factor analysis was performed by maximum likelihood method and Promax rotation. Internal consistency was assessed with Cronbach’s alpha and McDonald omega coefficients. Results: In exploratory factor analysis, 7 factors were extracted of caring choice, sense of value, personal growth, support of caring, ability to care, money matter and carer satisfaction extracted, which together explained 41.04% of the total variance. The alpha coefficient of all items was 0.899. Cronbach alpha and McDonald omega coefficients for all dimensions of the questionnaire were above 0.7. Conclusions: The Persian version of the AC-QoL is valid for caregivers of patients with stroke and can be used in future studie