Gaps in the provision of spiritual care for terminally ill patients in Islamic societies - a systematic review

Background. Islam has a profound concept about death and aftermath. Believing in living after death and resurrection is one of the three main principles of Islam. Since the increasing incidence of people in need of palliative care in developing countries and the fact that Muslims, who dominantly live in developing world, are very dependent on spirituality, describing the ways that spiritual care is described and provided in the Islamic context is highly demanded. This paper aims at delineating original research in this subject in a systematic manner. Method. Several medical databases were reviewed in a systematic manner to investigate original quantitative or qualitative researches about providing spiritual care in Muslim societies. Results. Searching main databases lead to identifying 84 articles alongside with 18 papers from hand searching, which all were reviewed by two investigators. Of this collection, only five papers met the criteria as being original research either quantitative or qualitative, published during the last 10 years. Cultural background plays an important role. Our findings conceded that very few papers are available in Islamic context about spiritual care at the end of life, where only three were quantitative. Research in this field, however, is rapidly growing compared with the previous year. Conclusion. While cancer is rapidly increasing specially in developing world, the need of terminally ill patients with other conditions should be equally considered. Spirituality in Islamic societies does exist profoundly, which needs more research especially in terminal life and even bereavement.Background. Islam has a profound concept about death and aftermath. Believing in living after death and resurrection is one of the three main principles of Islam. Since the increasing incidence of people in need of palliative care in developing countries and the fact that Muslims, who dominantly live in developing world, are very dependent on spirituality, describing the ways that spiritual care is described and provided in the Islamic context is highly demanded. This paper aims at delineating original research in this subject in a systematic manner. Method. Several medical databases were reviewed in a systematic manner to investigate original quantitative or qualitative researches about providing spiritual care in Muslim societies. Results. Searching main databases lead to identifying 84 articles alongside with 18 papers from hand searching, which all were reviewed by two investigators. Of this collection, only five papers met the criteria as being original research either quantitative or qualitative, published during the last 10 years. Cultural background plays an important role. Our findings conceded that very few papers are available in Islamic context about spiritual care at the end of life, where only three were quantitative. Research in this field, however, is rapidly growing compared with the previous year. Conclusion. While cancer is rapidly increasing specially in developing world, the need of terminally ill patients with other conditions should be equally considered. Spirituality in Islamic societies does exist profoundly, which needs more research especially in terminal life and even bereavement

Development, implementation and evaluation of the ‘BELIEVE’ program for improving physical activity among women: a mixed method action research study

Abstract Background There is insufficient physical activity among women. Yet the implementation of effective, multilevel, and evidence-based interventions may address this. Since the lifestyle of individuals is formed in many different social, physical and cultural contexts, it will be necessary in designing such interventions to involve many stakeholders. Consequently, the present study took a mixed method action research approach in developing, implementing and evaluating a bespoke program to improve physical activity among women. Methods This study was conducted within the Khoramroudi neighborhood of Tehran between 2013 and 2015 utilizing the four main phases of action research. The Mobilizing for Action through Planning and Partnerships (MAPP) process was used to design the study. During the initial phase, participants were organized into three groups; a core support committee, a steering committee, and a study population. Qualitative and quantitative data were also collected during this first phase. During the second phase, interventions were developed and implemented. In the third phase, an evaluation was carried out using both quantitative (Designing a quasi-experimental study) and qualitative methods. During the fourth phase, an exploration of the structure and process of action research was completed with the aim of providing a conceptual model and descriptions of the context. Results Three strategic interventions were effective in improving physical activity among women: (1) utilization of sports assistants; (2) Local health promotion and the dissemination of an informational, motivational and culturally competent booklet entitled “Educational content for sport assistants" (3) Group-based cognitive behavioral therapy. Quantitative results [Significant difference between the total score of PA before the intervention, and 1 and 3 months after the intervention (P < 0.001)] and the results of qualitative evaluations were shown to improve physical activity among participants. The newly co-created “adjusted MAPP model” was offered within three action cycles. The structure of this was described to capture the impacts of interactions among a variety of stakeholders. Conclusion The comprehensive identification of problems led to the development of collaborative strategies. Strategies of action research can positively affect physical activity among women. To improve physical activity outcomes more generally, the use of MAPP principles and strategies is suggested to meet the specific needs and strengths of all community members

Comparing clinical outcomes in patients with diabetes undergoing coronary artery bypass graft and percutaneous coronary intervention in real world practice in Iranian population

Funding Information: I would like to thank the Deutsche Forschungsgemeinschaft (DFG) for the financial support of our conference. Part of the funding for the conference also came from the European Union’s Horizon 2020 research and innovation program (RISE) under the Marie Skłodowska‐Curie grant agreement No. 101008129 ( project acronym “Mycobiomics”). Last but not least, I would like to thank Mr. Georg Schabel for the nice photographs that he took during the meeting.Peer reviewedPublisher PD

The 12-item medical outcomes study short form health survey version 2.0 (SF-12v2): a population-based validation study from Tehran, Iran

<p>Abstract</p> <p>Background</p> <p>The SF-12v2 is the improved version of the SF-12v1. This study aimed to validate the SF-12v2 in Iran.</p> <p>Methods</p> <p>A random sample of the general population aged 18 years and over living in Tehran, Iran completed the instrument. Reliability was estimated using internal consistency and validity was assessed using known-groups comparison and convergent validity. In addition the factor structure of the questionnaire was extracted by performing both exploratory and confirmatory factor analyses (EFA and CFA).</p> <p>Results</p> <p>In all, 3685 individuals were studied (1887male and 1798 female). Internal consistency for both summary measures was satisfactory. Cronbach's α for the Physical Component Summary (PCS-12) was 0.87 and for the Mental Component Summary (MCS-12) it was 0.82. Known-groups comparison showed that the SF-12v2 discriminated well between men and women and those who differed in age and educational status (P < 0.05). Furthermore, as hypothesized the physical functioning, role physical, bodily pain and general health subscales correlated higher with the PCS-12, while the vitality, social functioning, role emotional and mental health subscales correlated higher with the MCS-12. Finally the exploratory factor analysis indicated a two-factor structure (physical and mental health) that jointly accounted for 59.9% of the variance. The confirmatory factory analysis also indicated a good fit to the data for the two-latent structure (physical and mental health).</p> <p>Conclusion</p> <p>Although the findings could not be generalized to the Iranian population, overall the findings suggest that the SF-12v2 is a reliable and valid measure of health related quality of life among Iranians and now could be used in future health outcome studies. However, further studies are recommended to establish its stability, responsiveness to change, and concurrent validity for this health survey in Iran.</p

How within-city socioeconomic disparities affect life expectancy? Results of Urban HEART in Tehran, Iran

There is substantial lack of knowledge about the role of socioeconomic status (SES) indicators on life expectancy (LE) within-cities, especially within mega-cities. We aimed to investigate the disparities of LE within city districts of Tehran, Iran, and specify how SES inequalities play role on LE.; The death and population data for 2010 by different age, gender, and residency district were obtained from the main cemetery of Tehran and statistical centre of Iran, respectively. Age-specific mortality rates and consequently LE were calculated for all 22 districts by different genders. Finally, based on the results of first Tehran's Urban Health Equity Assessment and Response Tool (Urban HEART) project in 2008, the influence of social classes (SCs), total costs, and education indicators were analyzed on LE at birth (e0).; The e0 for total males and females in Tehran were calculated as 74.6 and 78.4 years for 2010, respectively. The maximum LE of 80 years was observed in females of northern part with higher SES, and the minimum e0 of 72.7 years observed in males of southern part with lower SES. The e0 gender gap among districts was 5.5 years for females and 3.7 years for males. The highest and lowest mean of e0 observed in SC1 (highest class) and SC5 (lowest class), were 77.6 and 76.0 years, respectively. The lowest mean of e0 observed in the first group of total costs indicator and was 76.2 years. In addition, the lowest observed mean of e0 was in the first category of education indicator (illiterate) and was 76.0 years.; RESULTS indicate substantial disparities in LE within city districts. This confirms that SES disparities within-cities would have direct influences on LE

Knowledge and information needs of informal caregivers in palliative care : a qualitative systematic review

Objectives: To review current understanding of the knowledge and information needs of informal caregivers in palliative settings. Data sources: Seven electronic databases were searched for the period January 1994–November 2006: Medline, CINAHL, PsychINFO, Embase, Ovid, Zetoc and Pubmed using a meta-search engine (Metalib®). Key journals and reference lists of selected papers were hand searched. Review methods: Included studies were peer-reviewed journal articles presenting original research. Given a variety of approaches to palliative care research, a validated systematic review methodology for assessing disparate evidence was used in order to assign scores to different aspects of each study (introduction and aims, method and data, sampling, data analysis, ethics and bias, findings/results, transferability/generalizability, implications and usefulness). Analysis was assisted by abstraction of key details of study into a table. Results: Thirty-four studies were included from eight different countries. The evidence was strongest in relation to pain management, where inadequacies in caregiver knowledge and the importance of education were emphasized. The significance of effective communication and information sharing between patient, caregiver and service provider was also emphasized. The evidence for other caregiver knowledge and information needs, for example in relation to welfare and social support was weaker. There was limited literature on non-cancer conditions and the care-giving information needs of black and minority ethnic populations. Overall, the evidence base was predominantly descriptive and dominated by small-scale studies, limiting generalizability. Conclusions: As palliative care shifts into patients’ homes, a more rigorously researched evidence base devoted to understanding caregivers knowledge and information needs is required. Research design needs to move beyond the current focus on dyads to incorporate the complex, three-way interactions between patients, service providers and caregivers in end-of-life care setting

Understanding determinants of socioeconomic inequality in mental health in Iran's capital, Tehran: a concentration index decomposition approach

<p>Abstract</p> <p>Background</p> <p>Mental health is of special importance regarding socioeconomic inequalities in health. On the one hand, mental health status mediates the relationship between economic inequality and health; on the other hand, mental health as an "end state" is affected by social factors and socioeconomic inequality. In spite of this, in examining socioeconomic inequalities in health, mental health has attracted less attention than physical health. As a first attempt in Iran, the objectives of this paper were to measure socioeconomic inequality in mental health, and then to untangle and quantify the contributions of potential determinants of mental health to the measured socioeconomic inequality.</p> <p>Methods</p> <p>In a cross-sectional observational study, mental health data were taken from an Urban Health Equity Assessment and Response Tool (Urban HEART) survey, conducted on 22 300 Tehran households in 2007 and covering people aged 15 and above. Principal component analysis was used to measure the economic status of households. As a measure of socioeconomic inequality, a concentration index of mental health was applied and decomposed into its determinants.</p> <p>Results</p> <p>The overall concentration index of mental health in Tehran was -0.0673 (95% CI = -0.070 - -0.057). Decomposition of the concentration index revealed that economic status made the largest contribution (44.7%) to socioeconomic inequality in mental health. Educational status (13.4%), age group (13.1%), district of residence (12.5%) and employment status (6.5%) also proved further important contributors to the inequality.</p> <p>Conclusions</p> <p>Socioeconomic inequalities exist in mental health status in Iran's capital, Tehran. Since the root of this avoidable inequality is in sectors outside the health system, a holistic mental health policy approach which includes social and economic determinants should be adopted to redress the inequitable distribution of mental health.</p

Prevalence and Burden of Refractive Errors at National and Sub-national Levels in Iran

Purpose: To estimate the prevalence, burden of refractive errors and their associated trend from 1990 to 2018 and geographic inequalities in Iran. Methods: Data regarding the epidemiology of refractive errors was extracted from three different sources: systematic review of published literature, data from visual school screening programs, and data from Iran’s national health survey (NHS). The pool of all available data on refractive errors as well as demographic, location, and socioeconomic status covariates were fitted in spatio-temporal and Gaussian process regression models to predict the prevalence of refractive errors from the years 1990 to 2018 in 31 provinces grouped by age and sex in order to calculate years lived with disability (YLDs). Results: In 2018, the age-adjusted prevalence of refractive errors was 16.32% (95% uncertainty interval [UI]: 12.44–21.48%) in both sexes, 17.98% (95% UI: 13.74– 23.61%) in women, and 14.66% (95% UI: 11.14–19.36%) in men. The prevalence of refractive errors reveals that it increases with age. Refractive errors contributed to 441.41 and 348.38 YLDs in men and women, respectively. The age-standardized prevalence growth was 31.30% in females and 24.32% in males from the years 1990 to 2018. Significant geographical heterogeneity was observed. The age-standardized YLDs rates of refractive errors represent an increasing trend of 28.9% increase from 1990 to 2018. Conclusion: Over 28 years, the prevalence of refractive errors increased significantly. Women tend to have higher rates of prevalence. The prevalence increased in older ages. Border provinces had the lowest prevalence. Age-standardized YLDs rates of refractive errors increased by about 30%

Seasonal pattern in admissions and mortality from acute myocardial infarction in elderly patients in Isfahan, Iran

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