Personal Characteristics and Urinary Stones

BackgroundUrinary stone disease is a common, painful and costly condition that has affected humankind since antiquity, and there is evidence to show that its incidence has continually increased during past decades. Studies have shown that many extrinsic and intrinsic factors are related to this disease in different population groups. The aim of this study was to identify the personal characteristics that are associated with urinary stone formation.MethodsAll subjects were recruited in the same 7-month period: there were 161 patients with idiopathic renal stone disease and 254 age- and gender-matched healthy subjects. Each participant was individually interviewed with regard to their sociodemographic characteristics and family medical history.ResultsOf patients with renal stones, 66.5% were male; the male to female ratio was 1.98 to 1. The prevalence of renal stone was highest in men aged 30–50 years and in women aged 40–60 years. The main differences between stone formers and healthy subjects were that stone formers had higher body mass index (p = 0.007), lower educational (p = 0.001) and economic (p = 0.037) levels, and more positive family history of urinary stones (p < 0.0001), especially in their siblings. The percentage of unemployed subjects and housekeepers were higher in the case group. The type and duration of employment were significantly different in the two groups (p = 0.014 for type and p = 0.003 for duration). With regard to the job environment (i.e. workplace), most of the individuals in the case group worked outdoors (p = 0.025) and in warm places (p < 0.0001).ConclusionThere are many personal characteristics that might be associated with an elevated risk of renal stone formation. People with high-risk characteristics could be more prone to stone formation and should be more carefully evaluated and followed-up

Trend in global burden attributable to low bone mineral density in different WHO regions: 2000 and beyond, results from the Global Burden of Disease (GBD) study 2019

Background: We aimed to document the current state of exposure to low bone mineral density (BMD) and trends in attributable burdens between 2000 and 2019 globally and in different World Health Organization (WHO) regions using the Glob al Burden of Disease (GBD) study 2019. Methods: We reviewed the sex-region-specific summary exposure value (SEV) of low BMD and the all-ages numbers and age-standardized rates of disabili ty-adjusted life years (DALYs), years lived with disability (YLDs), years of life lost (YLLs), and deaths attributed to low BMD. We compared different WHO regions (Africa, the Easte rn Mediterranean Region, Europe, Region of the Americas, Southeast Asia, and Wes tern Pacific), age categories, and sexes according to the estimates of the GBD 2019 report. Results: The global age-standardized SEV of low BMD is estimated to be 2 0.7% in women and 11.3% in men in 2019. Among the WHO regions, Africa had the highest age-standardized SEV of low BMD in women (28.8% (95% uncertainty in terval 22.0–36.3)) and men (16.8% (11.5–23.8)). The lowest SEV was observed in Europe in both women (14.7% (9.9–21.0)) and men (8.0% (4.3–13.4)). An improving trend in th e global rate of DALY, death, and YLL was observed during 2000–2019 (−5.7%, −4.7%, and −11.9% change, respectively); however, the absolute numbers increased with the highest increase observed in global YLD (70.9%) and death numbers (67.6%). South east Asia Region had the highest age-standardized rates of DALY (303.4 (249.2–357.2) ), death (10.6 (8.5–12.3)), YLD (133.5 (96.9–177.3)), and YLL (170.0 (139–197.7)). Conclusions: Overall, the highest-burden attributed to low BMD was observed in the Southeast Asia Region. Knowledge of the SEV of low BMD and the attributed burden can increase the awareness of healthcare decision-makers to adopt appropriate strategies for early screening, and also strategies to prevent falls and fragility fractures and their consequent morbidity and mortality

The association of cardio-metabolic risk factors and history of falling in men with osteosarcopenia: a cross-sectional analysis of Bushehr Elderly Health (BEH) program

Osteosarcopenia, defined as sarcopenia plus osteopenia/osteoporosis, may increase the risk of fractures and affects morbidity and mortality in the older population. Falling is also common in the elderly and increases the risk of fractures and mortality. We examined the association of cardio-metabolic risk factors with a history of falling in osteosarcopenic men. Methods We used the baseline data of the Bushehr Elderly Health (BEH) program. Osteosarcopenia was defined as having both sarcopenia (reduced skeletal muscle mass plus low physical performance and/or low muscle strength) and osteopenia/osteoporosis (T-score ≤ − 1.0). Falling was defined as a self-reported history of an unintentional down on the ground during the previous year before the study. We used logistic regression analysis to estimate the adjusted odds ratio (AOR) with a 95% Confidence Interval (CI) to quantify the associations. Results All elderly men diagnosed with osteosarcopenia (n = 341), with a mean age of 73.3(±7.4) years, were included. Almost 50(14.7%) participants reported falling. Age showed a positive association with falling (AOR: 1.09, 95%CI: 1.04–1.14). An increase of 10 mmHg in systolic blood pressure(SBP), reduces the odds of falling by 26%(AOR:0.74, 95%CI:0.62–0.89), while a positive association was detected for fasting plasma glucose (FPG), as 10 mg/dl increase in the FPG, raises the chance of falling by 14%(AOR = 1.14, 95%CI:1.06,1.23). Hypertriglyceridemia was inversely associated with falling (AOR = 0.33, 95% CI: 0.12, 0.89). Conclusions Falling is a major public health problem in rapidly aging countries, especially in individuals with a higher risk of fragility fractures. Older age-raised fasting plasma glucose and low SBP are associated with falling in osteosarcopenic patients. Considering the higher risk of fracture in osteosarcopenic men, comprehensive strategies are needed to prevent fall-related injuries in this high-risk population

Verbal abuse against nurses in hospitals in Iran

Introduction: The rising rate of doing behavioral violence to people working in health-care centersis a major problem for nurse’s population. This study was run with the aim of ascertaining how muchnurses working in hospitals all over the country (Iran) are under verbal violence and finding out itsrelation with some individual and environmental factors.Materials and Methods: This study is a descriptive cross-sectional one which was run with 1317nurses as the participants in hospitals all over the country of Iran during 2007. Data collection wasdone through self-report questionnaire.Results: 87.4% of nurses experienced verbal violence at least once in their working surroundingsduring the last six months. Most of the verbal violence (64.4%) was done by patients' relatives,(44.2%) between 7:30 am to 14:30 pm in the patient's room (48.3%). Results show that only 35.9% ofverbal violence was reported by nurses. Investigating the frequency of verbal violence, the results ofcorrelation analysis (x²) showed that there is a significant relationship between verbal violence andvariables such as age (P=0.009), sex (P=0.001), job experience (P=0.007), work hours (P=0.001) andjob rank (P=0.048).Conclusion: Since lots of violence happens and the risk factors were investigated, more attentionmust be paid to this issue and the necessary steps must be taken in this regard. The findings of thisstudy can be helpful to reduce, prevent and control the violence to nurses

Barriers and facilitators of nursing research utilization in Iran: A systematic review

Background: According to professionalization in nursing profession, the nursing researches expanded dramatically and rapidly in a very short period. Research results showed improvement in quality of provided care by using research findings. But there is still a gap between nursing research and practice, which led scientists to explore the barriers and facilitators of research utilization that could affect the application of research results. The aim of this review was to appraise and synthesize evidences of studies about the facilitators and barriers to research utilization in Iranian nurses. Material and Methods: A systematic review of quantitative and qualitative studies about the barriers and facilitators of nursing research utilization in Iran was undertaken. Results: The results showed that items such as "The nurse is isolated from knowledgeable colleagues with whom to discuss the research," "There is insufficient time on the job to implement new ideas," "The nurse does not have time to read research," "The nurse does not feel she/he has enough authority to change patient care procedures," "The facilities are inadequate for implementation," "Physicians will not cooperate with implementation," and "The relevant literature is not compiled in one place" were rated as the main barriers. Conclusions: The results of 10 studies about research utilization in Iran showed that the barriers and facilitators remained constant through time and across different locations. The rank orders of barriers and facilitators were the same approximately. The nurse managers and administrators could utilize the findings of this review to allocate human resources and other sources and promote nursing research utilization in clinical field

Interaction of Vitamin D Receptor Gene FokI Variants and Omega-3 Fatty Acids on Perceived Stress Score and Serum Cortisol Levels in Nurses: A Cross-Sectional Study

There is a high prevalence of perceived stress among nurses. Recent studies have shown that omega-3 fatty acids and genetic variants contribute to perceived stress. This study aimed to examine interactions between vitamin D receptor (VDR) gene FokI polymorphism and omega-3 fatty acids on perceived stress score and serum cortisol levels in nurses. Methods: A total of 268 Iranian nurses (248 women; 20 men) participated in this cross-sectional study. Omega-3 fatty acids and perceived stress score of participants were evaluated using a 3-day food record and the Perceived Stress Scale (PSS)-10, respectively. Serum cortisol concentrations were evaluated by ELISA. VDR FokI polymorphism was genotyped using the restriction fragment length polymorphism method. Results: No significant relationship was found between omega-3 fatty acids with perceived stress score or cortisol level in FF genotype carriers, but lower intake of PUFA was related to higher cortisol level (P=0.04) in Ff carriers. Significant interactions were observed between VDR FOKI polymorphism and intakes of eicosapentaenoic acid (EPA) (P Interaction=0.06), linoleic acid (P Interaction=0.06), and docosahexaenoic acid (DHA) (P Interaction=0.06) on serum cortisol, so that lower intake of EPA, linoleic acid, and DHA was associated with an increase in cortisol levels in individuals with ff genotype. Moreover, in carriers of ff genotype, lower intake of EPA was related to the elevated perceived stress score (P Interaction=0.06). Conclusion: FokI polymorphism interacts with omega-3 fatty acids (EPA, linoleic acid, and DHA) to increase cortisol level and with EPA to increase perceived stress score in nurses

The Necessity for Specialty Education in Nursing MS Program: Viewpoints of the Faculty Members of School of Nursing and Midwifery in Iran

Introduction: Academic specialty nursing courses are so limited in our country, being available just in a few schools. This study was performed in order to determine the necessity for having specialty education programs in MS level and the type of educational program needed. Methods: This descriptive cross-sectional study was performed through year 2008 in schools of nursing and midwifery of the country. The study population was faculty members of the schools of nursing and midwifery who were selected clustery and randomly (n=300). A questionnaire was sent to schools of nursing and midwifery. Nursing faculty members were asked to send the completed questionnaires back to nursing organization. Data was analyzed by SPSS software using Chi². Results: 76.6% of participants believed that graduates of nursing MS are not efficient in clinical settings. 92.7% stated that presenting specialty clinical courses is necessary in MS level. From these persons' viewpoints, the reasons for establishing these specialized courses are prioritized as follows: promotion of service quality, the increasing requirement of society for specialized function of medical professions, establi-shing a desirable occupational position for nurses, and reducing the expenses of health services. Conclusion: MS graduates are not efficient enough in clinical settings, so it calls for making some revisions in educational courses of MS level. It is recommended to conduct more comprehensive researches on this area considering evaluation of educational programs

Effect of parental depressive symptoms on offspring\u27s brain structure and function: A systematic review of neuroimaging studies

Perinatal Depression (PND) is a severe mental disorder that appears during pregnancy or in the post-partum. Although PND has been associated with behavioral problems in the offspring, its effects on brain development are unclear. With this review we aimed at summarizing the existing literature on the effects of perinatal depressive symptoms on children\u27s brains. A search on PubMed and Embase of structural, functional Magnetic Resonance Imaging (MRI) and Diffusion Tensor Imaging (DTI) studies exploring the effect of PND on offspring\u27s brain was conducted. We selected twenty-six studies, ten structural MRI, five DTI, six fMRI and five with combined techniques. Overall, the studies showed: a) gray matter alterations in amygdala and fronto-temporal lobes; b) microstructural alterations in amygdala, frontal lobe, cingulum, longitudinal fasciculus and fornix; and c) functional alterations between limbic and mesocortical networks. The small sample size and the heterogeneity in populations and methodologies limit this review. In conclusion, PND seems to influence structure and function of offspring, that may contribute to the risk of behavioral disturbances later in life

The Effectiveness of a Peer Coaching Education on Control and Management of Type 2 Diabetes in Women: A Protocol for a Randomized Controlled Trial

Background: Diabetes Education by Peer Coaching is a strategy which helps the patients with diabetes in the field of behavioral and emotional problems. However, the results of studies in this field in other countries could not be generalized in our context. So, the current study aimed to examine the effectiveness of Diabetes Education by Peer Coaching on Diabetes Management. Methods: Outcome variables for patients and peer coaches are measured at baseline and in3,6 and 12 months. The primary outcome consisted of Fasting Blood Sugar (FBS) and HbA1c. Secondary outcomes included Blood Pressure (BP), Body Mass Index (BMI,) Waist–Hip Ratio (WHR), Lipid Profile, diabetes self-care activities, diabetes-related quality of life, depression, and Social Capital levels.Initial analyses compared the frequency of baseline levels of outcome and other variables using a simple Chi-square test, t-test and the Mann-Whitney- U test. Sequential measurements in each group were evaluated by two-way analysis of variance. If significant differences in baseline characteristics were found, analyses were repeated adjusting for these differences using ANOVA and logistic regression for multivariate analyses. Additional analyses were conducted to look for the evidence of effect modification by pre-specified subgroups. Conclusion: The fact is that self-control and self-efficacy in diabetes management and treatment of diabetes could be important components. It seems that this research in this special setting with cultural differences would provide more evidence about peer-coaching model. It seems that if the peer-coaching model improves learning situations between patients with diabetes by offering one-on-one Diabetes Self Management Education, it could be an interactive approach to diabetic educatio

Challenges of Type 2 Diabetes Mellitus Management From the Perspective of Patients: Conventional Content Analysis

BackgroundPatients with type 2 diabetes mellitus (T2DM) face significant challenges in the treatment process, which can have a negative impact on disease management. Proper management of the disease can reduce symptoms and complications, improve glycemic indices, and reduce mortality and readmission. ObjectiveGiven the influential role of patients in prevention and self-care, this study was conducted to explore the challenges of diabetes management from the perspective of patients. MethodsTwo rounds of focus group discussions with T2DM patients were conducted. The principal investigator of the study and a research assistant compiled a list of volunteer patients with names and contact information and selected participants based on their medical information. Participants were chosen via a purposive sampling technique. The questions were designed to encourage patients to share their views on how the treatment team communicates and participates in treatment, how they are trained, and the health care system. The discussion continued until data saturation. During 2 rounds of focus group discussions, the voices of the participants were recorded by 2 voice recorders, and one of the team members was a transcriber. After discussion, participant views were transcribed, and common issues were identified, sorted, and reported as categories and subcategories. ResultsAccording to the conventional content analysis, 88 primary codes were extracted from the detailed and in-depth description of the participants. The codes were summarized after repeated readings and classified based on their similarities and semantic relevance. Through analysis and comparison, 4 categories and 7 subcategories were identified: communication challenges (poor medical staff communication, lack of psychological support), challenges to participation in treatment (lack of patient participation), educational challenges (training program bugs, inadequate training), and challenges of the health care system (inefficiency of the care system, caregiver inefficiency). ConclusionsThis study showed that the treatment team members should pay more attention to the challenges of care and treatment from the perspective of patients with T2DM. Therefore, recommendations for future policies to overcome these obstacles include establishing a multidisciplinary health care team; using trained health care workers to provide organized treatment and care services; holding individual counseling sessions with patients in need of counseling; and providing counseling services, involving patients in the treatment and self-care process, and designing a comprehensive diabetes education program with an emphasis on education. Necessary information should be provided to the patients, and effective communicate should address patient concerns