Women’s perception of sexual socialization in Iran: A qualitative study

Introduction: Sexual behavior and performance is not only influenced by biological factors but also, affected by sexual socialization. Family and society are two key institutions over this procedure. The aim of this study was exploring the married women’s perceptions of social structure related to sexuality in Iran. Method: This was a qualitative study with interpretive approach and conventional content analysis strategy. Purposive sampling was carried out of 5 health care centers of university affiliated centers and one health institute in Tehran and Shiraz. Data collection was performed through 17 in-depth interviews, and 14 sexual life narratives to reach to data saturation. Constant comparative method was used to analyze concurrently with the data collection. Results: Two main categories emerged as “parent’s conservation related to child’s sexuality issues” and “passive social support systems”. The main theme emerged study was “passive sexual socialization”. Conclusion: Findings indicate that there is an essential need for revising current paradigm about sexuality in Iran. Not only, the conservative and passive approach is not helpful for resolving difficulties surround this issue, but also, leads to greater vulnerabilities. Therefore, based on the social constructionism, in Iran, age-specific sexuality education and providing sexual health care in public health care system based on the Islamic ideology, social norms, and moral principles are suggested. Keywords: Sexuality issues, content analysis, women, family, social structur

Exploration of Factors Promoting and Inhibiting Fast Food Consumption among Adolescents

Introduction: In recent years, fast food consumption has increased among adolescents and it has become a concern, a health threat, and a major health problem. There are few studies and evidences about factors promoting and inhibiting the consumption of fast food. This study aimed to identify factors promoting or inhibiting the consumption of fast food among adolescents. Method: This qualitative study was conducted in Tehran. Using purposive sampling method, a total of 42 adolescents were enrolled in the study. Data were collected using in-depth, semi-structured interviews. Results: According to the findings of this study, all factors inhibiting the consumption of fast food were classified into three main themes: personal views, social and family inhibiting factors. And promoting factors include: personal views, social and family promoting factors. Conclusion: This study identified the factors promoting and inhibiting the consumption of fast food among adolescents. According to the results, the factors promoting fast food consumption were stronger than the inhibiting factors. In other words, there are many factors promoting adolescents to consume fast foods. The findings of this study can be a valuable groundwork for designing interventions for reducing the consumption of fast food; however, more research is needed to investigate and understand effective strategies to reduce fast food consumption in adolescents

Major and minor criteria for gastric dystemperaments in Persian Medicine: Sari gastric dystemperament criteria-I (SGDC-I)

<div class="msocomtxt" id="com1" language="JavaScript" onmouseout="msoCommentHide('com1')" onmouseover="msoCommentShow('anchor1','com1')">Background: Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era. Methods: This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City. Results: Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament. Conclusion: Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools. &#160

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

The empowerment of pregnant women in Tonekabon, Iran

Background: Pregnant women empowerment is viewed by policy makers and health care practitioners as a mechanism to help pregnant women adapt to physical and psychological changes after pregnancy, and gain a satisfactory experience of childbirth. The aim of this study was to determine the pregnancy-related empowerment of urban women in Tonekabon, Iran Methods: The design of the study was cross-sectional. A valid empowerment scale for pregnant women was used to determine pregnancy-related empowerment. The questionnaire containing 27 questions comprised five factors: self-efficacy, future image, self-esteem, support and assurance from others, and joy of an addition to family. Higher scores in all factors mean better empowerment score. In addition, a demographic and reproductive questionnaire was also used to obtain demographics and reproductive information. A total of 200 individuals, from two active urban primary healthcare centers in Tonekabon, were selected using cluster random sampling method. All analyses were performed using SPSS version 17. Independent t-test was used to determine the relationship between demographic and reproductive variables with empowerment. Results: The mean for the empowerment score of pregnant women was 78.7±6.7 (27 items scored from 1 to 4). The women who worked outside home had higher self esteem score than those who worked just at home (19.3 vs. 17.7) (p= 0.024). Also the mean score of self efficacy in women with support of spouse was higher than those without their spouse support (18.1 vs. 16.1) (p= 0.001). In women with wanted pregnancy, the joy of an addition to the score was higher compared with those with unwanted pregnancy (P= 0.048). There was no statistically significant result found in the mean scores of the five factors (self-efficacy, future image, self-esteem, support and assurance from others, and joy of an addition to family) with age, own education, husband education, and number of pregnancy. Conclusion: The results of this survey could be used not only to make efficient interventions for pregnant women, but also to promote empowerment of pregnant women

Social support and health-related quality of life among older adults: a descriptive study

Abstract: Background: Social support is presently receiving increased attention in health care. Many few studies investigated about the association of social support and health among elderly people in Iran. The purpose of the study was to ascertain if a relationship exists between social support and health-related quality of life of older adults. Methods: This was a cross sectional study. The study participants were 180 elders aged 60 years and over living in Tehran, Iran. In addition to demographic information the Social Support Scale (SSS) and the Short Form Health Survey (SF-36) were used to collect data. The data were analyzed in a descriptive fashion. Results: The findings showed a high level of perceived social support among older adults. The highest and lowest aspects of health-related quality of life derived from the SF-36 were social functioning and physical functioning, respectively. Furthermore the results from Spearman test indicated that there were significant correlation between social support and all aspects of the SF-36. The correlation between social support and vitality was the highest. Conclusion: The findings suggest that social support could play an important role in improving health-related quality of life of older adults

Effects of L-carnitine Supplement on Nitrogen Balance, Serum BUN, Some Hematological Measures, Duration of Hospitalization and Surgical Outcome in Patients with Esophageal Cancer

Background & objectives: &nbsp;The use of supplements such as L-carnitine, optimum nutritional support and early feeding after surgery in cancer patients can be important in the prevention of cancer complications. The aim of this study was to determine the effects of early L-carnitine-rich feeding on complications of esophageal cancer surgery and duration of hospitalization. Methods: In a clinical trial, 50 patients with esophageal cancer under surgery in two equal groups were randomly selected. Nutritional information was obtained using food record&nbsp;questionnaire. Basic blood samples and 24-hour urine samples were taken in order to measure the hematological parameters (like blood cell count, hemoglobin, hematocrit and blood urea) and nitrogen balance, respectively from two groups at the beginning and end of the study. Then, the intervention group received 3 g L-carnitine daily in 3 doses on the first day after the complementary operation, with a routine hospital diet at each meal, and the control group received a routine hospital diet for ten days. Data were analyzed using independent t-test, paired t-test and chi-square test. Results: The results showed that changes in the mean BUN and nitrogen balance were significantly different after intervention between the study groups (p<0.05). Patients with early L-carnitine-rich feeding had less hospitalization time in hospital wards and were discharged earlier (p<0.05). Conclusion: &nbsp;The results of this study showed that early L-carnitine-rich feeding after surgery has probably a positive effect on the duration of hospital stay in patients with esophageal cancer

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

BackgroundEstimates 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.Methods22 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.FindingsGlobal 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.InterpretationGlobal 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