The Effect of Psychoeducation on Anxiety in Subsequent Pregnancy Following Stillbirth: A Quasi-Experimental Study

Objective: We aimed to determine the effect of psychoeducation on women’s anxiety in subsequent pregnancy following stillbirth. Materials and methods: This two-arm, semi-experimental study was conducted on 100 women with subsequent pregnancy after stillbirth who visited the healthcare centers affiliated to a university of medical sciences in southeast of Iran in 2017. The eligible women were selected by using the convenience sampling method and were randomly divided into the intervention and control groups. The intervention group attended four psychoeducation sessions during four weeks according to the determined content. On the other hand, the control group received the routine care education. After eight weeks, data were collected using Pregnancy Related Anxiety Questionnaire (PRAQ). To analyze the data, independent t-test, Paired t-test and Chi-square U test, were run in SPSS, version 21. Results: No significant differences were observed between the study groups in terms of demographic characteristics (p > 0.05). Although the mean score of anxiety was not significantly different in the intervention and control groups prior to the psychoeducation sessions (p = 0.83), it was significantly lower in the intervention group after the psychoeducation intervention, compared to the control group (50.64 ± 20.05 vs. 63.54 ± 22.90; p = 0.0001). Conclusion: Psychoeducation intervention could diminish anxiety in women with subsequent pregnancy after stillbirth. Therefore, we recommend incorporating the components of psychoeducation related to the special needs of this group of women as a part of the routine prenatal care and educating healthcare providers to use these interventions

Comparing the Severity of Injury and Trauma Pattern between Scooter and Street Motorcycle Riders; a Prospective Cohort Study

Introduction: The popularity of motorcycle riding in Iran is increasing. However, there is a lack of information about the safety of different motorcycle types. This study aimed to compare the severity of injury and trauma pattern between scooter (vespa) and street (standard) motorcycle riders. Method: In a prospective cohort study, a comparison of demographics, injury severity, trauma pattern, and clinical characteristics between 324 riders (162 Vespa and 162 standard motorcycles) admitted to emergency departments was undertaken. The risk factors associated with severe injuries in the two groups were also determined. An emergency medicine specialist determined the severity of trauma based on the abbreviated injury scale (AIS). Results: The Odds Ratio (OR) of severe injuries was significantly higher in the standard motorcycle riders’ group (OR: 3.09; 95% CI: 1.9-4.21; p: 0.013). The frequency of lower extremity fractures was significantly lower in the Vespa group (OR: 4.11; 95% CI: 2.01-6.25; p = 0.012). The frequency of admission to the intensive care unit was significantly higher in the standard motorbike riders’ group (OR: 1.64; 95% CI: 1.11-2.51; p = 0.033). The multivariate analysis indicated that motorcycle type, the speed at the time of the accident, use of helmet, and age of riders are the most important predictors of trauma severity in riders (p<0.05). Conclusion: The pattern of injury varies between standard and Vespa motorcycles. The standard motorcycle riders were prone to a higher risk of adverse outcomes such as severe injuries. Due to the particular structure of scooters, the rate of lower limb injuries was significantly lower than standard motorcycles

Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019

Background: Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades. Methods: Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10–14, 15–19, and 20–24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. Findings: In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10–24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010–19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010–19. Interpretation: As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low–middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury. Funding: Bill &amp; Melinda Gates Foundation

Global, regional, and national mortality among young people aged 10-24 years, 1950-2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10-24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10-24 years by age group (10-14 years, 15-19 years, and 20-24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10-24 years with that in children aged 0-9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10-24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). Findings In 2019 there were 1.49 million deaths (95% uncertainty interval 1.39-1.59) worldwide in people aged 10-24 years, of which 61% occurred in males. 32.7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32.1% were due to communicable, nutritional, or maternal causes; 27.0% were due to non-communicable diseases; and 8.2% were due to self-harm. Since 1950, deaths in this age group decreased by 30.0% in females and 15.3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10-14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15-19 years was 1.3% in males and 1.6% in females, almost half that of males aged 1-4 years (2.4%), and around a third less than in females aged 1-4 years (2.5%). The proportion of global deaths in people aged 0-24 years that occurred in people aged 10-24 years more than doubled between 1950 and 2019, from 9.5% to 21.6%. Interpretation Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10-24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd

The effects of omega 3 fatty acids on the serum concentrations of pro inflammatory cytokines anddepression status in patients with bipolar disorder: A randomized double-blind controlled clinical trial

Background: The inflammation accelerates the progression of bipolar disorder. Supplementation of anti-inflammatory supplements in adjuvant with medications may alleviate disorder signs. This study aimed to investigate the effects of omega-3 fatty acid supplementation on the serum concentrations of pro-inflammatory cytokines and depression status in patients with bipolar disorder. Materials and Methods: This randomized clinical trial study was conducted in Zahedan city in 2021. Patients with bipolar disorder (n = 60) were grouped into two groups: omega-3 fatty acid supplement group (n = 30, 15 men and 15 women) and placebo one using a permuted block stratified randomization. The patients in the omega-3 group received 2 g of omega-3 fatty acids daily for 2 months while patients in the placebo group received 2 g soft gels daily in the same form. Depression score and the serum concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) were assessed before and after the study. Results: Depression score and the serum concentrations of TNF-α, IL-6, and hs-CRP were decreased after intervention in the omega-3 fatty acid group also compared with the placebo group (P < 0.001). The results also show a positive correlation between the serum concentrations of TNF-α, IL-6, and hs-CRP with depression scores (P < 0.001). Conclusion: Prescription of omega-3 fatty acids can decrease inflammatory parameters and help to decrease depression in patients with bipolar disorder. This supplement can be used along with medications for decreasing the inflammatory markers in these patients

Lack of Association between Dopamine Beta-Hydroxylase (DBH) 19-bp Insertion/Deletion Polymorphism and Risk of Schizophrenia

Objective: Interaction between genetic and environmental factors is considered as major factors in Schizophrenia (SCZ). It has been shown that dopaminergic and noradrenergic neurotransmission dysfunction play an essential role in the SCZ pathogenesis. This study aimed to find the impact of functional 19-bp insertion/deletion (ins/del) polymorphism in dopamine beta-hydroxylase (DBH) gene on SCZ risk in a sample of Iranian population. Method: This case-control study was conducted on 109 SCZ patients and 116 matched healthy subjects. Genomic DNA samples were extracted from peripheral blood cells using salting out method. Genotyping of 19-bp ins/del DBH polymorphism was done using Polymerase Chain Reaction (PCR) method. Results: Neither the overall chi-square comparison of cases and controls

Inhibition of Foot-and-Mouth Disease Virus Replication by Hydro-alcoholic and Aqueous-Acetic Acid Extracts of Alhagi maurorum: Antiviral activity of of Alhagi maurorum against FMDV

Foot-and-mouth disease (FMD) is a major infectious disease of cloven-hoofed animals that is caused by the FMD virus (FMDV). This disease has significantly adverse economic impacts; therefore, rapid control measures are urgent. Hydro-alcoholic and aqueous-acetic acid extracts of A. maurorum were prepared and their anti-FMDV activity was evaluated. Gas Chromatography–Mass Spectrometry (GC-MS) analysis of methanolic and ethanolic extracts was performed to find the likely active compounds of A. maurorum. The cytotoxicity of the extracts was assayed and the antiviral activity of them was evaluated by measuring the percentage of viable FMDV infected-cells via the MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyl tetrazolium bromide) assay at different stages of the virus replication cycle. The results indicated that the plant extracts exhibit antiviral activity against FMDV at all stages of the experiment, although the most significant effects were observed in virucidal and pre-treatment assays. GC-MS of the extracts resulted in the separation of 3 and 2 main peaks for the methanolic and ethanolic extracts respectively. The major compound was found to be 1, 2-Benzenedicarboxylic acid, diisooctyl ester. These findings represent the anti-FMDV activities of A. maurorum extracts at several stages of the virus replication cycle; therefore, it could be considered for the potential development of anti-FMDV therapeutics