The relationship between fear of hypoglycemia and sleep quality among type 2 diabetic patients

Background. Fear of hypoglycemia can result in anxiety, stress, anger, depression and severe avoidance behaviors that it affects the sleep quality of diabetic patients. Therefore, the present study was conducted with the aim of investigating the relationship between fear of hypoglycemia and sleep quality among type 2 diabetic patients. Methods. The present cross-sectional study was conducted on 400 type 2 diabetic patients referred to endocrinology clinic of Velayat Hospital and Boali Hospital in Qazvin, in 2019. Data were collected using a checklist for demographic variables, the Fear of Hypoglycemia Survey (FHS-W), and the Pittsburgh sleep quality index (PSQI). Descriptive statistics and Spearman correlation test were performed for data analysis using SPSS v24. Results. In this study, the mean age of diabetic patients was 55.75 ± 10.31. The majority of the participants were female (n = 299, 74.8%) and were treated with oral anti-diabetic drugs (n = 174, 43.5%). The mean score of sleep quality in patients was 8.98 ± 3.64 and the fear of hypoglycemia was 21.27 ± 11.92. The results of this study showed that there was a signifcant relationship between the fear of hypoglycemia and the poor sleep quality among patients (P < 0.001, r = 0.305). Conclusion. The fear of hypoglycemia has a direct and signifcant relationship with poor sleep quality in diabetic patients; so that this fear reduces the quality of sleep in diabetic patients. Therefore, in order to provide adequate sleep to prevent inappropriate sleep complications, great attention should be paid to the issue of fear of hypoglycemia, and consider some actions to reduce this fear. (Clin Diabetol 2020; 10, 1: 149–154) Key words: fear of hypoglycemia, sleep quality, type 2 diabete

Relationship between Fear of Hypoglycemia and Spiritual Well-Being in People with Type 2 Diabetes: A Single Center, Cross-Sectional Study from Iran

Objective: One of the most important complications in patients with type 2 diabetes is the fear of hypoglycemia (FOH). Spiritual health as the last dimension of health can affect the complications caused by the disease. The present study aimed to determine the relationship between FOH and spiritual well-being (SWB) in patients with type 2 diabetes. Materials and methods: This study is a cross-sectional descriptive study of correlation type. 380 patients with type 2 diabetes were included in the study with convenience sampling. Two questionnaires of FOH (HSF-II) and Palutzian &amp; Ellison SWB were used to collect data. Data were analyzed using R software version 4.0.4. In the analysis, Pearson’s correlation coefficient and simple and multivariable linear regression were used. Results: A total of 380 patients with type 2 diabetes were included in this study. The mean and standard deviation of the age and diabetes duration of participants were 56.89 ± 11.42 and 11.7 ± 15.55 years, respectively. Most of the participants were women 244 (64.2%). The mean score of SWB and FOH in patients were 89.55 ± 14.32 and 13.34 ± 16.12, respectively. There was also a positive and significant relationship between SWB and FOH using Pearson correlation coefficient (p = 0.001). Conclusions: According to the results, with increasing the score of FOH, the score of SWB also increased. Although increasing SWB has no effect on reducing the FOH, it is a unique energy that relates to the physical, mental, and social dimensions of humans

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

Burden of tracheal, bronchus, and lung cancer in North Africa and Middle East countries, 1990 to 2019: Results from the GBD study 2019

ObjectiveTo provide estimates on the regional and national burden of tracheal, bronchus, and lung (TBL) cancer and its attributable risk factors from 1990 to 2019 in the North Africa and Middle East (NAME) region.Methods and materialsThe Global Burden of Disease (GBD) 2019 data were used. Disability-adjusted life years (DALYs), death, incidence, and prevalence rates were categorized by sex and age groups in the NAME region, in 21 countries, from 1990 to 2019. Decomposition analysis was performed to calculate the proportion of responsible factors in the emergence of new cases. Data are presented as point estimates with their 95% uncertainty intervals (UIs).ResultsIn the NAME region, TBL cancer caused 15,396 and 57,114 deaths in women and men, respectively, in 2019. The age-standardized incidence rate (ASIR) increased by 0.7% (95% UI -20.6 to 24.1) and reached 16.8 per 100,000 (14.9 to 19.0) in 2019. All the age-standardized indices had a decreasing trend in men and an increasing trend in women from 1990 to 2019. Turkey (34.9 per 100,000 [27.6 to 43.5]) and Sudan (8.0 per 100,000 [5.2 to 12.5]) had the highest and lowest age-standardized prevalence rates (ASPRs) in 2019, respectively. The highest and lowest absolute slopes of change in ASPR, from 1990 to 2019, were seen in Bahrain (-50.0% (-63.6 to -31.7)) and the United Arab Emirates (-1.2% (-34.1 to 53.8)), respectively. The number of deaths attributable to risk factors was 58,816 (51,709 to 67,323) in 2019 and increased by 136.5%. Decomposition analysis showed that population growth and age structure change positively contributed to new incident cases. More than 80% of DALYs could be decreased by controlling risk factors, particularly tobacco use.ConclusionThe incidence, prevalence, and DALY rates of TBL cancer increased, and the death rate remained unchanged from 1990 to 2019. All the indices and contribution of risk factors decreased in men but increased in women. Tobacco is still the leading risk factor. Early diagnosis and tobacco cessation policies should be improved

Effect of Assertiveness Training on Adaptive and Aggressive Assertiveness in Nurses

Background Assertiveness is one of the most important skills needed by nurses to reduce interpersonal conflict and build an effective teamwork in complex hospital environments. Objective The aim of this study was to determine the effect of an assertiveness training program on nurses’ aggressive and adaptive assertiveness. Methods In this interventional study, participants were 64 nurses working in hospitals of Abhar city in Iran, randomly divided into two groups of intervention (n=32) and control (n=32). Assertive training program was presented as a two-day training workshop (10 hours) to the intervention group, while the control group received no training. Thompson and Burnham’s Adaptive and Aggressive Assertiveness Scale were completed by the participants in both groups at baseline, immediately, one and three months after the intervention. After collecting the data, Friedman, Mann–Whitney, Chi-squared, and Fisher tests were used for their analysis. Findings The mean of adaptive assertiveness score was significantly different between the the two groups immediately (P=0.002) and 1 month after the intervention (P=0.025). The aggressive assertiveness scores were not significantly different immediately, 1 and 3 months after the intervention (P>0.05), but the results of Friedman test showed a statistically significant decrease in the aggressive assertiveness scores compared to its baseline score (P=0.002). Conclusion The assertiveness training program increased adaptive assertiveness and decreased aggressive assertiveness in nurses. Relevant authorities can design continuous and useful assertiveness training programs to promot this valuable skill in nurses

Factors Predicting Death Depression of Emergency Medical Technicians in Iran

Background Psychological problems such as death depression can have adverse effects on Emergency Medical Technicians (EMTs) including reduced quality of medical services, job dissatisfaction, feelings of incompetence, depression, and reduced job values. Objective This study aims to determine the factors predicting death depression of EMTs in Iran. Methods In this descriptive cross-sectional study conducted in 2019, participants were 125 eligible EMTs in hospitals affiliated to Qazvin University of Medical Sciences in Qazvin, Iran. Templer’s Death Depression Scale (DDS) and a demographic form were used to collect data. The collected data were analyzed using descriptive and inferential statistics. Findings The Mean±SD DDS score was reported 4.73±2.93. Most of subjects (n=79, 63.2%) had low death depression. According to the results of linear regression analysis, “number of resuscitation attempts in the last 3 months”, “organizational position” and “history of depression” were the predictors of death depression (P<0.05). In total, the regression model predicts 9% of the variance in death depression. Conclusion Death depression of EMTs in Iran is low. Due to the importance of mental health in medical staff in providing quality clinical services, it is recommended that further studies should be conducted in this area using a larger sample size

The relationship between fear of hypoglycemia and sleep quality among type 2 diabetic patient

Background. Fear of hypoglycemia can result in anxiety, stress, anger, depression and severe avoidance behaviors that it affects the sleep quality of diabetic patients. Therefore, the present study was conducted with the aim of investigating the relationship between fear of hypoglycemia and sleep quality among type 2 diabetic patients. Methods. The present cross-sectional study was conducted on 400 type 2 diabetic patients referred to endocrinology clinic of Velayat Hospital and Boali Hospital in Qazvin, in 2019. Data were collected using a checklist for demographic variables, the Fear of Hypoglycemia Survey (FHS-W), and the Pittsburgh sleep quality index (PSQI). Descriptive statistics and Spearman correlation test were performed for data analysis using SPSS v24. Results. In this study, the mean age of diabetic patients was 55.75 ± 10.31. The majority of the participants were female (n = 299, 74.8%) and were treated with oral anti-diabetic drugs (n = 174, 43.5%). The mean score of sleep quality in patients was 8.98 ± 3.64 and the fear of hypoglycemia was 21.27 ± 11.92. The results of this study showed that there was a significant relationship between the fear of hypoglycemia and the poor sleep quality among patients (P < 0.001, r = 0.305). Conclusion. The fear of hypoglycemia has a direct and significant relationship with poor sleep quality in diabetic patients; so that this fear reduces the quality of sleep in diabetic patients. Therefore, in order to provide adequate sleep to prevent inappropriate sleep complications, great attention should be paid to the issue of fear of hypoglycemia, and consider some actions to reduce this fear