Background and Purpose: Intimate partner violence (IPV) is an important global issue. Refugee women face higher IPV due to displacement, sociocultural barriers, and limited access to support. This study aimed to explore Afghan refugee men’s perspectives on IPV against women using the PRECEDE-PROCEED model, focusing on identifying predisposing, enabling, and reinforcing factors. Materials and Methods: This is a qualitative study using thematic analysis. Data were collected using semi-structured in-depth interviews with 17 Afghan men residing in Torbat-e Jam Refugee Camp in Iran, whose wives had reported IPV in the past two months. They were selected using a purposive sampling method until theoretical saturation. Interviews were conducted from August to October 2024. Interviews were conducted at the Torbat Jam refugee camp clinic, recorded and transcribed verbatim. Data analysis was performed in MAXQDA software, version 18. The themes were developed deductively based on the PRECEDE constructs. Results: Four main themes were identified: Predisposing factors, enabling factors, reinforcing factors, and other factors. Predisposing factors included perceived norms, self-efficacy, beliefs (perceived barriers, perceived benefits, perceived threats), values, attitudes, and knowledge. Enabling factors included skills, availability of resources, accessibility of services, and community/government laws/policies. Reinforcing factors included Families, peers, media, and community leaders. Other factors (non-behavioral) included economic status, age, gender, ethnicity, and genetics. Conclusion: The findings highlight that predisposing, enabling, and reinforcing factors significantly shape Afghan men’s violent behaviors toward women. Targeted interventions addressing these factors can effectively reduce IPV and promote healthier attitudes, contributing to a more respectful society.
Background and Purpose: The increase in road traffic accidents (RTAs) due to urban and suburban expansion and rising vehicle numbers complicates mortality trend analysis. This study aims to compare RTA mortality rates in urban and suburban areas of Golestan Province, north of Iran, using time-series forecasting models. Materials and Methods: This retrospective study examined all RTA data (n=37, 409) recorded by the emergency medical service system of Golestan Province from March 2021 to March 2023 for urban and suburban areas. We employed three forecasting models, including multiple logistic regression (MLR), autoregressive integrated moving average (ARIMA), and propensity score matching (PSM), within a time-series data framework, to evaluate their performance in predicting RTA mortality rates in urban and suburban areas and find the demographic factors predicting the mortality rates. We calculated the root mean square error (RMSE) and the mean absolute percentage error (MAPE) to evaluate the prediction accuracy of each model. Results: The survival rate was 98.7% (n=36931) and only 1.3% (n=478) led to death. Over the two-year period, the RTA mortality rate was significantly higher in suburban areas (1.6%) than in urban areas (0.8%) (P=0.001). The PSM model outperformed other models with lower RMSE and MAPE for both urban and suburban areas. Age and oxygen saturation (SPO2) were the significant predictors of RTA mortality rate. Conclusion: The RTA mortality rate is higher in suburban areas of Golestan Province than in its urban areas. The PSM model provides higher prediction accuracy than the RTA and MLR models for both urban and suburban areas.
Background and purpose: Addressing survival in lung cancer patients is crucial because it directly informs prognosis, guides personalized treatment strategies, and highlights disparities in healthcare access. Understanding survival patterns and their determinants is key to improving patient outcomes, allocating resources effectively, and advancing oncological research for better therapies and early detection methods. Thus, given the existing gaps in literature regarding different survival rates and disparities in the impact of demographical and clinical factors such as age, gender, residence, and tumor type on survival, the present study aimed to assess up-to-date and comprehensive data from lung cancer (LC) patients in Mazandaran province by employing a diverse set of more sophisticated survival models. Materials and Methods: This prospective cohort study consisted of 708 LC patients diagnosed between 2017 and 2019 and followed up until February 2023 from the Cancer Registry Center of Mazandaran University of Medical Sciences using census-based sampling. For survival analysis, non-parametric, semi-parametric, and parametric models such as Kaplan-Meier survival curves, log-rank test, Univariate, multivariate cox proportional-hazards regression, multivariate cox regression with time-varying covariates, and Exponential PH model with Gamma Frailty Distribution models were used on variables including age, gender, residential area, and tumor type. Results: Out of 708 LC patients, 431 (61.02%) patients died during the follow up period. Mean age of LC patients was 64 ± 12.42 years. Majority of patients were male (75%), 198 (27.97%) patients were older than 70 years old, and 31 (4.38%), 24 (3.39%), and 53 (7.49%) patients had well differentiated, moderately differentiated, and poorly differentiated tumors, respectively. The Exponential PH model with Gamma Frailty Distribution was selected and presented as the best fitting parametric model. The overall survival rate was 69% at 6 month, 54% at 1 year, 44% at 2 years, and 39% at 3 years. Tumor type was the most significant predictor of survival (HR: 1.98, 95%CI: 1.32-2.95 for small cell LC in comparison to non-small LC). However, age, gender, and residential location had no significant association with survival. Also, time-varying analysis uncovered that the influence of tumor type diminishes over the course of follow-up (HR: 0.998, 95%CI: 0.997-0.998). Conclusion: This study highlights the importance of utilizing advanced models and time-varying analyses to identify factors influencing the survival of lung cancer patients.
Sexual dysfunction is a significant concern for individuals with cardiovascular diseases (CVD). Research indicates that individuals with CVD are three times more likely to experience sexual dysfunction compared to those without CVD. Contributing factors encompass both physical and psychological changes, as well as the side effects of medications. This study aims to determine the global prevalence of sexual dysfunction in patients with CVDs and present solutions and policy recommendations to address it in Iranian society. This is a policy brief that utilizes data from a comprehensive 17-year systematic review and meta-analysis (2003–2023). The results estimated a 62.6% global prevalence of sexual dysfunction in CVD patients. Proposed solutions included culturally appropriate educational programs, training for healthcare providers, and the establishment of gender-specific support groups and mobile clinics. These solutions can mitigate cultural barriers, such as stigma and limited access to healthcare in rural areas, while prioritizing health equity and cultural acceptability. Although these solutions are backed by substantial evidence, their successful implementation depends on multi-sectoral collaboration and a phased approach to effectively navigate logistical challenges and cultural conservatism.
Background and Purpose: Functional constipation (FC) is a gastrointestinal disorder that mainly affects the quality of life (QoL) of children under five years of age. This systematic review aims to compare the effectiveness of drug and behavioral therapies, their treatment outcomes, and preventive strategies for FC in children aged 0-5 years. Materials and Methods: This is a systematic review study based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A comprehensive search was conducted in PubMed, Web of Science, CINAHL, EBSCO, and Cochrane CENTRAL for English-language studies published from 2014 to June 2025. Thirty one studies met the inclusion criteria. Data extraction and quality assessment were performed independently by two reviewers using the Cochrane risk-of-bias tool. Results: Polyethylene glycol (PEG) showed rapid symptom relief in most studies. In one study, the PEG group achieved 7.9 defecations per week versus 5.7 in the lactulose group (P=0.008). Adverse events were also fewer in the PEG group (15 vs 23, P=0.02). In another study, PEG 3350+electrolytes showed higher treatment efficiency (79.5%) compared to rectal enemas (58.3%) in children under two years of age. PEG at doses of 0.45–1.1 g/kg/day was safe and effective in children under 24 months of age, with lower side effects. Behavioral interventions, including toilet training and dietary changes, were effective in reducing recurrence and improving long-term bowel regularity. Their efficacy and impact on QoL can vary based on age, severity of constipation, and duration of treatment. Conclusion: The combined use of drug and behavioral therapies for FC in children aged 0-5 years is more effective and provides sustainable outcomes. This holistic treatment approach should consider age, constipation severity, and individual needs. To improve the efficacy of combined therapies, further high-quality RCTs are required to determine the most effective age-specific behavioral strategies and the best timing for their implementation.
Background and Purpose: Nursing education with intense academic and clinical demands often leads to high levels of stress among students. To cope with stress, students use different strategies, influenced by personal factors and personality type. This study aimed to explore the use of stress coping strategies among Filipino nursing students and investigate the role of individual characteristics and personality traits. Materials and Methods: This is a descriptive cross-sectional study. A total of 149 third-year nursing students from the College of Nursing in Cagayan de Oro City, Philippines, were selected using a stratified random sampling method. Data collection was done in March 2024 using a self-report questionnaire including a socio-demographic form (sex, birth order, family monthly income), a coping strategies inventory, and the Myers-Briggs type indicator (MBTI). Statistical analyses were conducted using independent t-tests and one-way analysis of variance. Results: There were no statistically significant differences in coping strategies based on sex, birth order, or family income (P>0.05). However, significant differences were observed based on personality types; those with a Judging type had significantly higher mean scores in two problem-focused (Mean=3.13; P=0.001) and meaning-focused (mean=3.20, P=0.004) coping strategies compared to those with a perceiving type (Mean=2.93 and 2.96, respectively), but not in the emotion-focused coping strategies (P=0.685). The differences in problem-focused, emotion-focused, and meaning-focused coping scores between introverted and extroverted types were not significant (P>0.05). Conclusion: Personality traits, particularly the judging versus perceiving types, significantly influence Filipino nursing students’ stress coping strategies. These findings highlight the potential benefits of incorporating personality-based approaches in designing stress management programs for nursing students.
Background and Purpose: Healthcare workers face numerous challenges due to their working conditions. This study aims to evaluate the effectiveness of compassion-focused therapy (CFT) on self-value, cognitive flexibility, and marital stress of female healthcare workers in Iran. Materials and Methods: This is a quasi-experimental study with a pre-test/post-test design. The participants were 30 female healthcare workers from Imam Khomeini Hospital in Tehran, Iran. They were selected using a voluntary sampling method and randomly assigned to intervention (n=15) and control (n=15) groups. They completed the contingencies of self-worth scale (CSWS), the cognitive flexibility inventory (CFI), and the Stockholm marital stress scale (SMSS). The intervention included eight sessions of CFT, each session for 90 minutes. The collected data were analyzed in SPSS software, version 26. Results: The post-test score of CSWS was significantly higher in the intervention group compared to the control group (Mean±SD 124.07±3.105 vs 109.2±4.931; P=0.001). The post-test CFI score was also significantly higher in the intervention group than in the control group (Mean±SD 85.67±5.653 vs 74.4±7.5; P=0.001). Regarding the SMSS score, the intervention group showed a significant reduction in the post-test phase compared to the control group (Mean±SD 6.47±1.995 vs 9.33±2.024; P=0.001). Conclusion: The CFT can reduce marital stress and improve self-value and cognitive flexibility of female healthcare workers. Therefore, hospital managers should hold such intervention courses for female healthcare workers.
Background and Purpose: Liver diseases remain a major global health challenge, with limited therapeutic options primarily due to donor organ scarcity and inadequate preclinical models. Bioartificial liver (BAL) support systems and liver organoids have emerged as innovative technologies for liver disease modeling, drug screening, and therapeutic development. This study systematically reviews current advances and challenges in both technologies, aiming to identify knowledge gaps and propose future directions for integrating these approaches to improve liver disease research and therapy. Materials and Methods: This narrative review was conducted on related articles in English published from January 2015 to May 2024. Searches were performed in PubMed, Scopus, Web of Science, and Embase databases using keywords related to “bioartificial liver,” “liver organoids,” “drug screening,” and “liver disease modeling.” The PICO framework was used to form the research question: Human-relevant liver models (population), BAL systems and liver organoids (intervention), conventional models or comparative technologies (comparison), and outcomes related to metabolic functionality and drug screening efficacy (outcome). Results: BAL systems primarily provide extracorporeal detoxification and metabolic support, with clinical trials demonstrating transient liver function improvement but limited long-term efficacy. Advances in cell source optimization, notably induced pluripotent stem cell (iPSC)-derived hepatocytes, and perfusion bioreactors have improved viability and function. Liver organoids, derived from stem cells or adult tissues, exhibit higher fidelity in replicating liver metabolic pathways, including albumin synthesis and bile acid metabolism, enabling superior predictive accuracy in drug toxicity screening and personalized disease modeling. Genetic engineering enhances organoid applicability for precision medicine. However, organoid scalability and vascularization remain challenges. Conclusion: While BAL systems offer valuable temporary liver support, liver organoids outperform BAL in metabolic functionality and drug screening applications. Future research should focus on integrating organoids with BAL systems, advancing bioreactor design, and standardizing protocols to accelerate clinical translation and personalized therapeutics development.
Background and Purpose: It is important to offer reproductive and sexual healthcare services to improve the health of society. However, healthcare personnel lack sufficient knowledge and skills to provide such services in disasters. This study aims to investigate the role of healthcare service providers in delivering reproductive and sexual healthcare services during disasters. Materials and Methods: This study is a narrative review conducted in five stages: Designing the research question, searching and extracting the related studies, selecting the relevant studies, developing the timetable, summarizing the data and information, and reporting the results. After extracting the keywords through the MeSH database, the studies done in Iran and abroad were checked by searching the databases, including Google Scholar, Scopus, the Cochrane Library, ScienceDirect, PubMed, Web of Science, and UpToDate. We used the different combinations of the following keywords: “Healthcare personnel,” “nurses,” “midwives,” “service providers,” “healthcare providers,” “reproductive healthcare,” “sexual healthcare,” “sexual and reproductive healthcare,” “calamity,” “crisis,” “disaster,” and “emergency” from 2009 to 2024. Results: Using the search strategy, 403 articles were found, and 10 studies were included in this narrative review. Regarding the reproductive and sexual healthcare services in disasters, four main categories were found: Providing educational and counseling services, planning and providing reproductive healthcare services, providing emergency services in the field of gynecology, obstetrics, and newborn care; and preventing and managing the consequences of sexual violence. Conclusion: Regarding the many obstacles in providing reproductive healthcare services, this study can be employed to plan, design, and implement some effective interventions for providing the due services. Healthcare service providers can benefit from this review by familiarizing themselves with their role during disasters. It is hoped that the extracted results in the present study can effectively depict the role of healthcare workers in reproductive healthcare in disasters.
Background and Purpose: Spasticity is a disabling complication of spinal cord injury (SCI). The administration of various medications is not satisfactory. Studies show the effects of onabotulinumtoxinA treatment for spasticity in patients with SCI. We designed this study to systematically review the effects of onabotulinumtoxinA toxin on spasticity status in patients with SCI. Materials and Methods: PubMed, Scopus, EMBASE, Web of Science, Google Scholar, and gray literature, including references and conference abstracts, were systematically searched by two researchers published before September 2023. Data regarding the total number of participants, first author, publication year, country of origin, mean age, follow-up time, the site of injection, main findings, and side effects were extracted and recorded. Results: A literature search revealed 2914 articles. After deleting duplicates, 1688 remained. After careful evaluation of the full texts, six articles remained. Two studies reported improvement in the modified Ashworth scale after treatment, while one showed opposite results. Improvement of spasticity and spasticity-related pain was observed in one study, and a decrease in the modified Tardieu scale was found in another study. Improvement in upper-extremity function, positioning, and pain after treatment was shown in a study done in the USA. Conclusion: The results of this systematic review show that administration of onabotulinumtoxinA toxin may improve spasticity in patients with SCI.
Background and Purpose: Drug addiction, as one of the most important health, mental, and social problems, causes people to conduct dangerous behaviors. Different population groups are predisposed to drug addiction. This study aimed to compare the predisposing factors of women and men to drug addiction. Materials and Methods: The present study was a comparative descriptive study in which 350 drug addicts referred to addiction treatment centers in Tehran City, Iran, participated. They were selected using the convenience sampling method. The data collection tool was a questionnaire of demographic characteristics and a researcher-made questionnaire of factors predisposing to addiction, which included 62 questions in 5 dimensions. Data were analyzed using SPSS software, version 22. Descriptive statistics were used to describe the data, and inferential statistical tests (t-test, Fisher exact test, chi-square test) were used to analyze them. A significance level of 0.05 was considered significant. Results: The Mean±SD female and male addicts’ ages were 29.62±7.5 and 33.08±7.9 years, respectively. The most common cause of addiction to drugs in both groups was psychological factors. Among the problems in the family, both groups stated that they had a lot of strictness, laxity, tension, and violent behavior in the family, which was statistically significant (P<0.005). Conclusion: Di-oblems in society. Our results will increase managers’ and planners’ awareness of implementing policies and preventive and control measures for addiction to prevent its consequences.
