The trend of marriage, childbearing, and divorce and its determinants of socioeconomic factors on divorce in Yazd province 2016-2021: A cross-sectional study

Background: In recent decades, families and their stability as an important social institution have changed significantly. Objective: This study aimed to investigate the marriage trends, childbearing, and divorce changes in Yazd province from 2016 to 2021 to estimate the effect of socioeconomic factors on divorce. Materials and Methods: A cross-sectional study was done in 2 phases. In the first phase, an ecological (time trend) was conducted to investigate the 5 yr trend in the occurrence of marriage, childbearing, and divorce, as well as the factors affecting the occurrence of divorce in the second phase. For the second phase of the study, 600 participants were selected. 300 divorced and 300 married applicants were chosen between 2016 and 2021. A binary logistic regression model was used to find the related factors affecting the occurrence of divorce. Results: The results showed a declining marriage (p = 0.05) and childbearing trend (p = 0.84), as well as an increasing trend in divorces (p = 0.02) in Yazd. Logistic regression analysis showed that college education (OR = 0.22, CI: 0.116-0.430, p < 0.001) and being self-employed (OR = 0.48, CI: 0.255-0.934, p = 0.03) could reduce the odds of divorce. In addition, nonresidents (OR = 2.1, CI: 1.314-3.562, p < 0.001), with > 10-yr age differences (OR = 3.8, CI: 1.803-8.213, p < 0.001) or the woman being older than her husband (OR = 3.4, CI: 1.981-5.848, p < 0.001) could increase the odds of divorce. Conclusion: Our results confirmed that a combination of socioeconomic characteristics affects the stability of family institutions. Key words: Family, Marriage, Childbearing, Divorce, Socioeconomic factors

Bacteriospermia and its association with seminal fluid parameters and infertility in infertile men, Kerman, Iran: A cross-sectional study

Background: The role of genital Ureaplasma species, genital Mycoplasma (M) species, and Chlamydia (C.) trachomatis, the most prevalent sexually transmitted bacteria, in male infertility are still not clear. Different reports about the impact of these bacteria on semen quality are controversial. Objective: This study was proposed to determine the frequency of bacteriospermia in men and investigate the relationship between the presence of these bacteria and semen quality using molecular assay. Materials and Methods: In this cross-sectional study, 200 semen samples obtained from men attending the research and clinical centers for fertility in Kerman, Iran, between July and December 2019 were analyzed for semen volume, progressive motility, nonprogressive motility, total progressive motility, and viability according to the World Health Organization guidelines. The polymerase chain reaction was used for the detection of related bacteria. Results: The mean values of volume, progressive motility, non-progressive motility, total progressive motility, and viability were significantly lower in infertile men (p < 0.001). Statistically significant correlations were observed between the presence of M. genitalium and progressive sperm motility, M. hominis and semen volume, Ureaplasma parvum and the sperm normal form, and C. trachomatis and the sperm progressive motility and viability. Logistic regression analysis showed that M. genitalium (OR = 8.06, p < 0.001) and C. trachomatis (OR = 16, p = 0.01) were significantly associated with male infertility. Conclusion: During the infertility assessment, clinicians should consider the role of C. trachomatis and M. genitalium in male infertility. Screening test particularly for asymptomatic individuals is recommended. Key words: Chlamydia trachomatis, Infertility, Mycoplasma, Semen analysis, Ureaplasma

Population Size Estimation of Tramadol Misusers in Urban Population in Iran: Synthesis of Methods and Results

Background: Estimating the population who use drugs is essential for planning, monitoring, and evaluation of substance use prevention and treatment. This study aims to estimate the population who misuse tramadol in urban population in Iran. Methods: We used the wisdom of the experts (WOTE) and network scale-up (NSU) methods to calculate the population of tramadol misusers in 10 provincial capitals of Iran, in 2016. The WOTE was conducted among pharmacists in drugstores and the personnel of traditional medicinal herbs stores. They guessed the best estimation of tramadol misusers population in their cities. The NSU method was conducted among the general population and participants were questioned about ever and daily, non-medical use of tramadol during last 12 months in their network. The median of the methods was used to calculate the proportion of the adult population (15-49 years old). Findings: The population size of tramadol misusers in studied cities was 83300 [95% uncertainty limits (UL): 47960-256220]. This corresponded to 6.6 per 1000 (95% UL: 3.88-20.30) of the 15-49-year-old population. The projected number of tramadol misusers for all 31 provincial capitals was 118290 (95% UL: 68100-363130840) and 212440 (95% UL: 122310-653410) for all urban areas. NSU also estimated the number of people who misuse tramadol on daily basis. These numbers were 52000 (95% UL: 19940-176570) for studied cities, 73840 (95% UL: 28320-250740) for all 31 provincial capital cities, and 132610 (95% UL: 50860-450310) for all urban areas in Iran. Conclusion: This study presents information on high prevalence of tramadol misuse in urban population. We need national control measures and demand reduction programs to control tramadol misuse

The unfinished agenda of communicable diseases among children and adolescents before the COVID-19 pandemic, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019

BACKGROUND: Communicable disease control has long been a focus of global health policy. There have been substantial reductions in the burden and mortality of communicable diseases among children younger than 5 years, but we know less about this burden in older children and adolescents, and it is unclear whether current programmes and policies remain aligned with targets for intervention. This knowledge is especially important for policy and programmes in the context of the COVID-19 pandemic. We aimed to use the Global Burden of Disease (GBD) Study 2019 to systematically characterise the burden of communicable diseases across childhood and adolescence. METHODS: In this systematic analysis of the GBD study from 1990 to 2019, all communicable diseases and their manifestations as modelled within GBD 2019 were included, categorised as 16 subgroups of common diseases or presentations. Data were reported for absolute count, prevalence, and incidence across measures of cause-specific mortality (deaths and years of life lost), disability (years lived with disability [YLDs]), and disease burden (disability-adjusted life-years [DALYs]) for children and adolescents aged 0-24 years. Data were reported across the Socio-demographic Index (SDI) and across time (1990-2019), and for 204 countries and territories. For HIV, we reported the mortality-to-incidence ratio (MIR) as a measure of health system performance. FINDINGS: In 2019, there were 3·0 million deaths and 30·0 million years of healthy life lost to disability (as measured by YLDs), corresponding to 288·4 million DALYs from communicable diseases among children and adolescents globally (57·3% of total communicable disease burden across all ages). Over time, there has been a shift in communicable disease burden from young children to older children and adolescents (largely driven by the considerable reductions in children younger than 5 years and slower progress elsewhere), although children younger than 5 years still accounted for most of the communicable disease burden in 2019. Disease burden and mortality were predominantly in low-SDI settings, with high and high-middle SDI settings also having an appreciable burden of communicable disease morbidity (4·0 million YLDs in 2019 alone). Three cause groups (enteric infections, lower-respiratory-tract infections, and malaria) accounted for 59·8% of the global communicable disease burden in children and adolescents, with tuberculosis and HIV both emerging as important causes during adolescence. HIV was the only cause for which disease burden increased over time, particularly in children and adolescents older than 5 years, and especially in females. Excess MIRs for HIV were observed for males aged 15-19 years in low-SDI settings. INTERPRETATION: Our analysis supports continued policy focus on enteric infections and lower-respiratory-tract infections, with orientation to children younger than 5 years in settings of low socioeconomic development. However, efforts should also be targeted to other conditions, particularly HIV, given its increased burden in older children and adolescents. Older children and adolescents also experience a large burden of communicable disease, further highlighting the need for efforts to extend beyond the first 5 years of life. Our analysis also identified substantial morbidity caused by communicable diseases affecting child and adolescent health across the world. FUNDING: The Australian National Health and Medical Research Council Centre for Research Excellence for Driving Investment in Global Adolescent Health and the Bill & Melinda Gates Foundation

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

Burden of tracheal, bronchus, and lung cancer in North Africa and Middle East countries, 1990 to 2019: Results from the GBD study 2019

ObjectiveTo provide estimates on the regional and national burden of tracheal, bronchus, and lung (TBL) cancer and its attributable risk factors from 1990 to 2019 in the North Africa and Middle East (NAME) region.Methods and materialsThe Global Burden of Disease (GBD) 2019 data were used. Disability-adjusted life years (DALYs), death, incidence, and prevalence rates were categorized by sex and age groups in the NAME region, in 21 countries, from 1990 to 2019. Decomposition analysis was performed to calculate the proportion of responsible factors in the emergence of new cases. Data are presented as point estimates with their 95% uncertainty intervals (UIs).ResultsIn the NAME region, TBL cancer caused 15,396 and 57,114 deaths in women and men, respectively, in 2019. The age-standardized incidence rate (ASIR) increased by 0.7% (95% UI -20.6 to 24.1) and reached 16.8 per 100,000 (14.9 to 19.0) in 2019. All the age-standardized indices had a decreasing trend in men and an increasing trend in women from 1990 to 2019. Turkey (34.9 per 100,000 [27.6 to 43.5]) and Sudan (8.0 per 100,000 [5.2 to 12.5]) had the highest and lowest age-standardized prevalence rates (ASPRs) in 2019, respectively. The highest and lowest absolute slopes of change in ASPR, from 1990 to 2019, were seen in Bahrain (-50.0% (-63.6 to -31.7)) and the United Arab Emirates (-1.2% (-34.1 to 53.8)), respectively. The number of deaths attributable to risk factors was 58,816 (51,709 to 67,323) in 2019 and increased by 136.5%. Decomposition analysis showed that population growth and age structure change positively contributed to new incident cases. More than 80% of DALYs could be decreased by controlling risk factors, particularly tobacco use.ConclusionThe incidence, prevalence, and DALY rates of TBL cancer increased, and the death rate remained unchanged from 1990 to 2019. All the indices and contribution of risk factors decreased in men but increased in women. Tobacco is still the leading risk factor. Early diagnosis and tobacco cessation policies should be improved

Five Common Cancers in Iran in 2019: Secondary Analysis to Discovering Cluster of Cancers

Introduction: This study reports the prevalence of the 5 most common cancers and their geographical distribution based on the last update of cancer statistics in Iran (2019). Materials and methods: The data used in this study were extracted from the Global Burden of Disease (GBD) studies. It was prepared regarding sex in different provinces. Moran’s I test was used to check geographical correlation and identify hot spots and cold spots. A significance level of 5% was considered in all tests. Results: The most prevalent cancers among Iranian women reported Breast (312 per 100 000; 95% UI: 281-345), Thyroid (43 per 100 000; 95% UI: 26-51), Colon and Rectum (43 per 100 000; 95% UI: 39-47), Leukemia (33 per 100 000; 95% UI: 21 -41), and Uterine (29 per 100 000; 95% UI: 14-35) respectively; further, the most prevalent cancers among Iranian men reported Prostate (219 per 100 000; 95% UI: 158-258), Colon and Rectum (80; 72-88), Bladder (65 per 100 000; 95% UI: 58-71), Leukemia (40 per 100 000; 95% UI: 20-51), and Testicular (33 per 100 000; 95% UI: 20-48) respectively. Conclusion: exclusive of any type of skin cancer, Breast, prostate, colon and rectum, bladder, thyroid, testicular, uterine, and leukemia are most prevalent cancers in Iranian population

Adverse Effects of Influenza Vaccination among Healthcare Staff in Shiraz in 2014, Iran

Background and Objectives: Influenza vaccination is one of the most important ways to prevent influenza acquisition in healthcare staff. This study was conducted to determine the cumulative incidence rate of side effects associated with influenza vaccination among healthcare staff in some of the hospitals in Shiraz. Methods: This descriptive study was conducted on the staff of a number of hospitals in Shiraz who received influenza vaccine in 1392. Instrument in this study was a researcher-developed questionnaire about common side effects that was collected up to 10 days after the vaccination. Incidence of side effects was reported with 95% confidence interval. The data were analyzed by chi-square test, Fisher's exact test, and univariate logistic regression. Results: From the 450 vaccinated staff, 424 (94.23%) completed the questionnaire. 53.8% of vaccine recipients were female and 46.2% male. The mean age of the participants was 34.94 years.  Up to 10 days after vaccination, cumulative incidence rate of side effects following vaccination was obtained 21.7% for common cold-like symptoms, 71.2% for muscle pain, 16.5% for pain where the shot was given, 15.3% for fever, 14.4% for runny nose, 12.3% for severe headache, 9% for severe coughing, 0.9% for diarrhea, and 1.7% for abdominal pain (1.7%). No severe side effects such as acute allergic reactions and Guillain-Barré syndrome were reported. Conclusion: The reported incidence rate of side effects in this study, high risk of acquiring disease among health care staff, and their role in controlling influenza epidemics represent the necessity of influenza vaccination in this occupational population

COVID-19: an Alarm to Move Faster towards “Smart Hospital”: Smart Hospital and COVID-19

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