Global prevalence of suicide in patients living with HIV/AIDS: a systematic review and meta-analysis

Background: In fact, people living with HIV are at a greater risk of mental health disorders. Based on lack of necessary information in this area the present systematic review and meta-analysis study was conducted to determine the magnitude of committed suicides among HIV/AIDS people as well as their associated factors in a global setting. Method: Firstly we registered the protocol of study in PROSPRO. Then the publications were searched in the 4 main databases from January 2000 to April 2022. After removing duplication and inappropriate studies we applied inclusion and exclusion criteria. Finally 60 studies were included for analysis. Comprehensive meta-analysis software were used for analyzing. Results: After reviewing 60 articles published from January 2000 to April 2021 in 24 countries, the total prevalence rate of suicide among 61,904 patients was estimated at 0.249 (95 % CI, 0.2–0.306). Findings indicated that the highest suicide prevalence was related to single patients estimated at 0.257 (95 % CI, 0.184–0.347). A gender-based meta-analysis depicted that the prevalence of suicide/ suicidal ideation was higher among females estimated at 0.22 (95 % CI, 0.15–0.29) compared with men at 0.17 (95 % CI, 0.11–0.23). Conclusion: Health planners and policymakers should develop suicide-prevention strategies aimed at female patients in younger age groups who live alone and are deprived of social support to effectively promote their self-efficacy in successful management of the disease. Integrating mental health services into anti-retroviral therapy for HIV/AIDS patients is also suggested in order to effectively design integrated programs for the management of individuals living with HIV/AIDS

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

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

Participation of People With Schizophrenia in Everyday Life: Family’s Perspective

Objectives: People with chronic mental health condition like schizophrenia experience a lot of changes in their lives, in addition to their symptoms. The present study used a thematic analysis to explore the participation of people with schizophrenia in daily life from family perspective. It has uncovered some of the contributing factors in the everyday life participation of this group. Methods: Semi-structured interviews were held with 8 family members of patients with schizophrenia. All the interviews were recorded and transcribed verbatim. The data were then analyzed in 6 phases of thematic analysis. Results: Three main themes and 10 subthemes were extracted from the interviews. The main themes included impaired function, family types, and treatment dimensions. The subthemes identified within the family circumstance theme were supportive family, pitying family, ignored family, and confused family. Discussion: According to the findings, besides the effects of the disease and its treatment on the performance of people with schizophrenia, the family also has a substantial role in the participation of their ill member in daily life activities. Considering the identified effects of families on patients; participation and their needs, designing family-based interventions and training programs can facilitate the participation of patients with schizophrenia in everyday life

Stabilization of Excess Sludge From Poultry Slaughterhouse Wastewater Treatment Plant by the Fenton Process

Abstract For stabilization of excess sludge in activated sludge process, the Fenton process was applied as a safe technique and its effectiveness was experimentally examined. In order to carry out experiments, a batch reactor with the effective volume of 0.5 L was used. Effect of hydraulic retention time, pH, H2O2, and Fe concentrations on sludge stabilization were investigated. Before and after the process, the content of total solids (TS), volatile solid (VS), chemical oxygen demand (COD), and color were measured. The study showed that, the best efficiency was obtained when iron concentration was 60 mg/L, duration of the process was 150 minutes, pH = 3, and H2O2 concentration was 4000 mg/L. The Fenton process can reduce the values of TS, VS, COD, and color to 50%, 61%, 53% and 61%, respectively. By analogy to conventional methods, the Fenton process is an effective method that can be suggested to stabilize excess sludge

Effect of irrigation intervals on establishment of Ziziphus spina-christi saplings

In southern parts of Fars province in Iran, Christ's Thorn Jujube (Ziziphus spina-christi) is considered as the dominant species amongst other woody species. However, the lack of its ability for natural regeneration is coupled with high mortality rates of cultivated individuals. Moreover, a common drought within the arid areas of Iran contributes to those limitations. In order to investigate the effect of irrigation intervals on establishment of Z. spina-christi saplings, a complete randomized blocks design with 4 treatments and 3 replications was conducted across a study area near Lar, Fars province. Treatments included irrigation intervals of 0, 15, 30, 45 days, where irrigation was solely done in the first year. Following this, the healthy saplings as well as the heights were inventoried in the second year to determine the sapling establishment as a function of the most appropriate irrigation. The results showed significant effect of treatments on sapling height. However, no significant effect was observed for number of saplings. Therefore, the irrigation intervals 30 and 45 days during the first year, each with 30 litters are suggested for establishment of Z. spina-christi saplings

Investigation of Phenol Removal from Aqueous Solutions by Electrofenton and Electropersulfate Processes

Phenol, or benzene hydroxyl is a toxic aromatic hydrocarbon discharged into the environment through certian industrial effluents which, thereby, pollute water resources. This study examines phenol removal from aqueous solutions through electro-Fenton and electro/persulfate processes using iron electrodes. For this purpose, a laboratory-scale electrochemical batch reactor was used that was equipped with four electrodes and a direct DC power supply. In the tests carried out, the effects of operational parameters such as initial pH; current density; and initial concentrations of phenol, hydrogen peroxide, and persulfate on the removal of phenol were investigated. The results showed that EPS and EF processes achieved phenol removal efficiencies of 95.18% and 93.99%, respectively, at operating conditions of pH = 3, initial phenol concentration of 100 mg/l, hydrogen peroxide and persulfate concentration of 0. 4 mM, and a current density 0.07A/dm2 over 45 min. Increasing persulfate and hydrogen peroxide concentration from 0.4 to 0.8 mM reduced phenol removal efficiencies from 95.18% and 93.99% to 43% and 85%, respectively. Generally speaking, EPS and EF processes exhibited almost identical phenol removal efficiencies. Finally, the integrated electrochemical and persulphate process was found to be more productive in producing electrical iron and persulphate activation than using each single process in isolation

The Impact of Psychosomatic Factors on Treatment Adherence of Acute Myocardial Infarction Survivors; A Two-Year Follow-Up Study

Backgroud: Because of the important role of adhering to treatment to reduce major adverse cardiovascular events and mortality, studying the factors affecting treatment adherence (TA) is warranted. This study aimed to identify the impact of psychosomatic factors on adhering to treatment among patients with acute myocardial infarction. Materials and Methods: This is a cohort study as a part of the Isfahan ST-segment-elevated Myocardial Infarction Cohort Study. Psychosomatic factors such as health anxiety, illness denial, irritable mood, and demoralization were assessed among 867 patients at the first visit. The patients were followed for 2 years; TA and major adverse cardiovascular events were checked annually in survivors. Results: The results from binary logistic regression applied to find the association between TA and psychosomatic factors showed that the patients with health anxiety, irritable mood, and demoralization were significantly poor adherent to treatment (odds ratio [95% confidence interval]: 1.39 [1.02, 2.73], 1.51 [1.02, 2.37], and 1.66 [1.02, 2.91]), respectively. The associations remained the same when adjusted for various potential confounders. Conclusions: Psychosomatic factors played an essential role in adhering to treatment among patients with acute myocardial infarction. As a result, appropriate psychological interventions may help the patients adhere to their treatment better

بررسی تأثیر حضور متخصص طب اورژانس بر بالین بیماران مراجعه‌کننده در اورژانس بیمارستان‌های هفت‌تیر، فیروزگر و رسول اکرم

مقدمه: بخش اورژانس بیمارستانی از پرحجم‌ترین و حساس‌ترین بخش‌ها در هر  بیمارستان است که از اهمیت ویژه‌ای برخوردار بوده و یکی از پرخطرترین بخش‌های درمانی محسوب می‌شود. طب اورژانس تمرین طب در یک جایگاه حاد و تحت حاد است. یک پزشک اورژانس آموزش‌دیده نه‌تنها قادر است تروما را رهبري کند، بلکه همچنین می‌تواند اکثر مسائل حاد و غیر حاد قابل‌تصور دیگر را رهبري نماید. این مطالعه باهدف بررسی تأثیر حضور متخصص طب اورژانس بر بالین بیماران مراجعه‌کننده در اورژانس بیمارستان‌های هفت‌تیر، فیروزگر و رسول اکرم طراحی و انجام گردید. نتایج حاصل از این مطالعه می‌تواند در برنامه‌ریزی به‌منظور آموزش پزشکان طب اورژانس در بیمارستان‌های مذکور نقش مهمی ایفا کند. مواد و روش‌ها: در این مطالعه از 30 بیمار مراجعه‌کننده به اورژانس‌های بیمارستان‌های رسول اکرم و شهدای هفتم تیر و فیروزگر در سال 1396، به‌صورت یک مصاحبه نظام‌مند خواسته شد که نحوه حضور متخصص طب اورژانس را بر بالین خود را بیان نمایند. همچنین با 20 نفر از کارکنان بیمارستان‌های مذکور در مورد شرایط اورژانس قبل و بعد از استقرار طب اورژانس مصاحبه به عمل آمد. اطلاعات حاصل توسط نرم‌افزار  SPSS مورد تجزیه‌وتحلیل قرار گرفت. یافته‌ها: در مصاحبه با بیماران، آنان بیان کردند که 15/46% توسط پزشک، 76/30% توسط دانشجو و  07/23% توسط پرستار ویزیت شده‌اند، که نشان‌دهنده این است که هیچ‌یک از آنان اطلاع نداشتند که متخصص طب اورژانس آنان را ویزیت کرده است. 16/46% بیان کردند که در زمان مناسب ویزیت شده‌اند و 84/53%  از آنان ناراضی بودند و اظهار داشتند که در زمان مناسب برای معاینه و ویزیت بر بالین آنان حاضر نشده‌اند. 92/76% از نحوه برخورد راضی و 08/23% از آنان ناراضی بودند. 57/54% از نحوه معاینه و شرح‌حال گیری راضی و 43/45% از آنان ناراضی بودند. 45/66% از کیفیت تشخیص و اقدامات درمانی راضی و 55/33% از آنان ناراضی بودند. ازنظر 26/44% بیماران، وضعیت رسیدگی مناسب  و ازنظر 74/55% بیماران وضعیت رسیدگی نامناسب بود. همچنین مهم‌ترین مزایای استقرار طب اورژانس ازنظر کارکنان کاهش مرگ‌ومیر بیماران در اورژانس، سرعت در تعیین تکلیف بیماران، کاهش مشاوره‌های تخصصی، انجام دستورالعمل‌ها توسط متخصص طب اورژانس، کاهش زمان ماندگاری بیماران در اورژانس و افزایش رضایت بیماران بوده است. نتیجه‌گیری: حضور متخصصین طب اورژانس باعث بهبود کیفیت خدمات درمانی و افزایش میزان رضایت بیماران است و با ارجاع درست و به‌موقع بیماران به بخش‌های مربوطه در زمان و هزینه درمان صرفه‌جویی می‌شود، بنابراین پیشنهاد می‌شود استقرار طب اورژانس در تمامی واحدهای اورژانس بیمارستانی کشور انجام گیرد، و برای آشنایی بیشتر افراد جامعه با این رشته نیز آگاهی‌رسانی‌های لازم انجام شود.Introduction: Emergency department is one of the most voluminous and most sensitive part of hospital departments, which is of particular importance and one of the most dangerous medical departments. A trained emergency physician not only will be able to guide trauma, but also can handle most other acute and non-acute issues imaginable. The aim of this study was to determine the presence of an emergency medical specialist on the bedside of patients referred to the emergency department of hospitals. The obtained results can play a significant role in planning for training physician and play important role in emergency departments of Rasool Akram, Shahdadi Haftom Tir and Firoozghar Hospitals. Materials and Methods: In this study, 30 patients referred to the emergency department of Rasool Akram, Shahdadi Haftom Tir and Firoozghar Hospitals in 2018 were asked to provide a structured interview to determine the presence of a specialist in emergency medicine at their clinic. Also, 20 personnel of these hospitals, were interviewed about the condition of the emergency departments, before and after the establishment of emergency medicine. Data were analyzed by SPSS software. Results: In interviews with patients, they stated that 46.15% were visited by the doctor, 30.76% by student and 23.07% by the nurse, indicating that none of them knew that the specialist Emergency medicine has visited them. 16.66% stated that they were visited at the right time and 53.44% were dissatisfied and they reported that they did not attend the clinic at the right time for proper examination. 76.92% were satisfied with the procedure and 23.08% were dissatisfied. 54.57% were satisfied with the review and 42.43% of them were dissatisfied. 66.45% of the diagnostic quality and therapeutic measures were satisfied and 33.55% were dissatisfied. 44.26% of cases were in good condition and 55.74% were inappropriate. Also, the most important advantages of establishing emergency medicine in terms of personnel was reduction in patient mortality in emergency department, speed in disposition of patients, reducing expert advice, performing procedures by an emergency medicine specialist, reducing the patient's time in the emergency department and increasing patient satisfaction. Conclusion: The presence of emergency medicine specialists improves the quality of health care services and increases patient satisfaction. By timely and accurate referral of patients to the relevant departments, time and cost of treatment are saved. Therefore, it is suggested that the establishment of emergency medicine in all emergency medical units of the country, And, for the community of people to become more familiar with this field, the necessary knowledge is also needed. &nbsp