A COMPARISON ON ELDERLY ABUSE IN PERSIAN AND TURKISH RACE IN CHAHARMAHAL BAKHTIARI PROVINCE

Background: In Iran, as in many developing countries, a report that reflects the impact of different cultures on the elderly abuse does not exist. Therefore this study conducted to compare elderly abuse and related factors in groups of Persian and Turk in Chahatmahal Bakhtiari province. Materials & Methods: This descriptive-comparative study was carried out on 400 elderly people in Chahatmahal Bakhtiari province. Sampling method was random. The researcher visiting several parks and places which elderly people were eligible for the study and Elder Abuse Questionnaires were completed. For analyzing the data, descriptive and inferential statistics were used. Results: Finding showed that 17.14% of participants have experienced at least one type of abuse, which 35.9% was physical abuse, 15.9% verbal-psychological abuse, 16% Nonverbal abuse, 10.1% self-neglect, 4.5% others neglect, 23.3% experience of rejection from others, and 14.3% financial abuse. All types of abuse in both Persian and Turkish groups were significantly different. Conclusion: Despite our cultural emphasis on respecting to the elderly people, they experience various forms of abuses. Therefore, understanding their abuse and related factors can promote the awareness and sensitivity of community and related organizations which finally prevents this health problem

The attitude of Iranian nurses about do not resuscitate orders

Background: Do not resuscitate (DNR) orders are one of many challenging issues in end of life care. Previous research has not investigated Muslim nurses′ attitudes towards DNR orders. Aims: This study aims to investigate the attitude of Iranian nurses towards DNR orders and determine the role of religious sects in forming attitudes. Materials and Methods: In this descriptive-comparative study, 306 nurses from five hospitals affiliated to Tabriz University of Medical Sciences (TUOMS) in East Azerbaijan Province and three hospitals in Kurdistan province participated. Data were gathered by a survey design on attitudes on DNR orders. Data were analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL) software examining descriptive and inferential statistics. Results: Participants showed their willingness to learn more about DNR orders and highlights the importance of respecting patients and their families in DNR orders. In contrast, in many key items participants reported their negative attitude towards DNR orders. There were statistical differences in two items between the attitude of Shiite and Sunni nurses. Conclusions: Iranian nurses, regardless of their religious sects, reported negative attitude towards many aspects of DNR orders. It may be possible to change the attitude of Iranian nurses towards DNR through education

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

The Global Burden of Diseases, Injuries and Risk Factors 2017 includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. METHODS: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.; We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs s1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury

Designing a theory baesd educational intervention on Improving Adherence to Treatment in Patients with Hypertension in sarab city: A Social Networking Trial

High blood pressure is one of the most important issues of public health and not following the treatment regimen as an undesirable therapeutic behavior has an effect on poor control of high blood pressure which causes harmful consequences. One of the effective strategies in this field is education. One of the educational models that has helped to better understand the factors affecting behavior change is the health action process approach (HAPA). The aim of this study was to design an educational intervention to improve adherence to treatment in patients with hypertension in Sarab city: a social network-based trial

Quality of Sleep and Daily Activity of the Elderly in Zanjan

Background: Poor quality of sleep and daily activity in elderly people are associated with many physical and psychological problems that increase disability and need to use health services. The aim of this study was to determine the relationship between daily activities and quality of sleep in the elderly people. Methods: This Study was a correlational-descriptivestudy on390 elderly people in Zanjan in 2013. The sampling was done using a cluster and multistage method. Data were collected via face-to-face interview, using Pittsburgh Sleep Quality Index (PSQI) and a questionnaire on "activities of daily living(ADL)" and "instrumental activities of daily living (IADL)". Data analysis was performed using descriptive statistic including number, percentage, mean, standard deviation, and inferential statistical tests including Spearman's rank correlation coefficient, independent t-test and one-way analysis of variance. Results: The mean score of ADLand IADL was 11.58±0.81 (score range 0-14) and 11.23±2.93 (score range 0-18), respectively. In addition, 85.7%of the subjects in the study had poor sleep quality and only 14.3% had good sleep quality. The results also indicated no significant relationship between the daily activities and quality of sleep in the elderly, while instrumental activities had a weak positive and significant correlation with their sleep quality (P≥ 0.05). Conclusion: Although the elderlyin this study have poor sleep quality, they are independent inperforming ADL and IADL. Furthermore, there is a weak and direct correlation between sleep quality and instrumental activities of the old people. Improvement of activity in the elderly can improve their quality of sleep

Nursing Students’ Perspectives on Actual and Ideal Support and Supervision in Clinical Learning Environments in Zanjan University of Medical Sciences in 2011

Introduction: Clinical learning environment has an important role in clinical learning of nursing students. Any differences between students’ perspectives in expected and actual environment may result in decreased clinical learning. Therefore, the present study aimed to compare nursing students’ perspectives on actual and ideal support and supervision in clinical setting. Methods: In this descriptive study a census sample of 96 nursing students in Zanjan University of Medical Sciences were chosen. For data gathering, the actual and ideal parallel forms of "Perception of Extent of Support and Supervision Survey" were used. Each form has 29 items in two support and supervision subscales. Data analysis was done using descriptive and inferential statistics. Results: There were statistical differences between actual and ideal perception of nursing students in support and supervision domains, so that in support domain, the expectation of nursing students was not met by clinical instructors and in supervision domain, the actual degree of supervision is greater than the students' expectation (p> .000). Conclusion: There is a gap between actual and ideal perception of nursing students about support and supervision in clinical setting. This gap may have negative effects on clinical learning of students