Background: We systematically reviewed (evaluated methodological quality) meta-analysis studies on the suicidal ideation of South Koreans using a measurement tool to assess systematic reviews version 2 (AMSTAR-2) to present the ways for improving the quality of follow-up meta-analysis studies and suggest the direction of future studies.

Methods: We analyzed 11 meta-analysis studies based on AMSTAR-2 criteria by collecting documents related to suicidal thoughts using seven electronic databases (DBPia, Scholar, KISS, KCI, RISS, KoreaEmbase, and National Assembly Electronic Library) from Jan 1, 2000 to Dec 3, 2022.

Results: Among the 142 papers searched, we analyzed the final 11 selected studies. Not all analyzed meta-analysis studies conducted quality assessment and these studies omitted the list of excluded references and the adequacy of the literature search. Moreover, 54.5% of the analyzed studies (six out of eleven studies) did not present the effect of publication bias. Consequently, SOMETHING was critically low due to omissions in critical domains.

Conclusion: In all 11 studies analyzed, 2 or more of 7 critical domains were omitted, and the quality level was confirmed to be critically low. Therefore, future meta-analysis studies on suicidal ideation will have to include quality assessment and improve the quality of meta-analysis, such as testing bias effects.

Background: This study reviewed cervical cancer policies implemented in developing countries that adhered to WHO standards. Despite long being known as a preventable disease, cervical cancer is still one of the leading causes of mortality among women. Nine out of ten cervical cancer deaths occurred in less-developed countries, suggesting that the preventive and control approaches in these countries might differ from those in developed nations.

Methods: Cervical cancer policies in six developing countries from each WHO region were selected while related data from the Cervical Cancer Country Profiles 2021 by WHO were retrieved for comparison.

Results: The cervical cancer policies that were included in this review were from Malaysia, Thailand, Iran, Kenya, Argentina, and Ukraine. According to the latest guidelines on the management of cervical cancers, WHO recommendations have been elaborated on primary, secondary, and tertiary prevention. A comparison of policies among these selected countries showed variation in each level of prevention. The cancer burden in each country was also found to determine the progression of cervical cancer prevention and policy controls in these countries.

Conclusion: This review emphasizes the dissimilarities of cervical cancer policies in six developing countries compared to recommendations by the WHO. Identifying these discrepancies could help policymakers in developing nations to recognize the pressing issues surrounding cervical cancer prevention and establish more effective prevention and control approaches.

Background: Didactic lecture is most commonly used method to teach medical students in Family and Community Medicine. However, considering its demerits and the need to integrate theoretical knowledge into practice, the objective of this paper is to review the contribution of role play in medical education and to propose it’s applications to deliver healthcare services in community more effectively.

Methods: Research studies on role play were searched in PubMed, Google scholar, Google using terms role play, medical education, community medicine, family medicine, health promotion, awareness during the period between January 2000 up to December 2021 to evaluate the potential and contribution of role play in medical education and health promotion.

Results: Review of role play and related researches were included to analyze the outcome. The outcomes of different studies analyzed were showing several teaching methodologies used in medical field. Several studies have tested role play in other medical specialities and have found it to be a powerful educational tool. However, not many studies have tested its effectiveness to educate students in Family and Community Medicine although it could have immense practical applications like demonstrating and creating awareness in the community about the importance of cancer screening, breast feeding, immunisation, food fortification, genetic screening, premarital counselling, ante natal checkups, danger signs in pregnancy.

Conclusion: Role play simulates real scenarios enabling students to apply their skills and knowledge into practice in real time. It can integrate theory concepts into practice. Hence, it must be introduced in medical curriculum to achieve the objectives of teaching and learning more effectively.

Background: Physical and chemical factors of workplace, either alone or in combination, contribute to oxidative stress that is harmful to the body. The combined impact of physical and chemical components of the work environment on oxidative stress was examined in this research.

Methods: Research articles published from 2000 to 2021 on this topic in reliable national and international databases were collected and analyzed. Based on the preliminary screening, 120 articles were selected for the first stage. The relevance and quality of 85 suitable papers were found appropriate and evaluated by examining the purpose of the study in the next phase.

Results: The data collected and presented from the articles cover simultaneous exposure to physical risk factors such as noise, radiation, and chemicals such as metal solvents, as well as different types of oxidative stress parameters like MDA, GHS, LOP, 8-OHdG, SOD, CAT, ROS, and other parameters such as research site, co-exposure effects, and target organ. Investigating the combined effect of physical and chemical variables on oxidative stress in the target organs, as well as the interaction of multiple effects on each other, was one of the key goals of the articles (synergistic, reinforcing, additive or antagonistic).

Conclusion: Most of the findings of theses researches generally highlight the synergistic impact of concurrent exposure to chemical and physical risk factors on oxidative stress.

Background: Since most of nursing students lack clinical reasoning competency, for effective handover education, it is necessary to include a strategy to improve the clinical reasoning competency in the practical training course of the nursing department.

Methods: This study used a quasi-experimental research design using a non-equivalent control group pretest-posttest design to verify the effectiveness of the practice education program using the OPT model and SBAR. The subjects were 73 third-year students participating in clinical practice or clinical alternative practice in Korea.

Results: The experimental group showed significantly better communication clarity (t=-12.262, P<.001), communication confidence (t=-12.486, P<.001), problem-solving processes (t=-13.100, P<.001), and team efficacy (t=-6.197, P<.001) compared to before the intervention. However, there was no significant difference between the pre- and post-intervention scores of the control group.

Conclusion: In a situation where clinical practice is difficult for nursing students, the handover education program using the OPT model and SBAR can helps improve their communication clarity, communication confidence, problem- solving process, and team efficacy.

Background: As the most convenient and commonly used for clinical diagnosis, cancer biomarker has been widely used in the auxiliary diagnosis of tumors, the observation of curative effect, the judgment of prognosis, and the monitoring of the disease.

Methods: Pan-cancer analysis was used to validate the value of Dehydrogenase/Reductase 2 (DHRS2) as a tumor prognostic marker in various tumors. The relationship of DHRS2 to TMB and MSI was used to explain the effect of DHRS2 on genomic instability. Online cbioportal was used to analyze DHRS2 mutations in tumors. Finally, 33 clinical tumor samples were collected in 2021 who were enrolled into the Affiliated Lianyungang Oriental Hospital of Xuzhou Medical University, to verify the expression and diagnostic prognostic value of DHRS2.

Results: The expression of DHRS2 was up-regulated in a variety of tumors and had adverse effects on the overall survival, disease-free interval, and progression-free interval of tumor patients. DHRS2 was associated with tumor genome instability, confirming that DHRS2 was correlated with tumorigenesis. In addition, DHRS2 had different mutation sites in various tumors. DHRS2 was up-regulated and was a poor prognosis biomarker in clinical tumor samples.

Conclusion: DHRS2 was aberrantly expressed in tumors and has diagnostic prognostic value.

Background: Women undergo an array of menstrual symptoms, depending on the menstrual cycle period. This study aimed to gain a more objective understanding of the impact of menstruation by examining differences in menstrual symptoms, menstrual attitude, physical stress, and psychological stress across the menstrual cycle.

Methods: This study was conducted from Apr to Jun 2021 in the Gyeonggi Province of Korea. Women aged ≥20 yr were divided into premenstrual (n=17), menstrual (n=8), and postmenstrual periods (n=23). Menstrual symptoms and menstrual attitudes were assessed using questionnaires. Quantitative electroencephalography was used to assess the physical stress indices (left and right), and the psychological stress indices (left and right), with brainwave parameters quantified by frequency series power spectrum analysis. Data were compared using the non-parametric tests.

Results: More menstrual symptoms were experienced in the menstrual period than in the premenstrual period (Z=2.16, P=.031). Menstrual attitudes did not significantly differ among menstrual periods (Z=1.20, P=.231). Physical stress indices were high (≥10 μV) throughout the menstrual cycle and there were significant differences among the three periods (left: χ²=4.00, P=.035, right: χ²=5.78, P=.046). Psychological stress indices were >1 μV during the premenstrual and menstrual periods.

Conclusion: Women experience more severe and diverse menstrual symptoms in the menstrual period than in other periods. Objective investigations are needed to inform an effective approach for addressing negative menstruation-related experiences. 

Background: Esophageal squamous cell carcinoma (ESCC), a widely known esophageal disease, severely affects people's health. Numerous investigations demonstrated that long non-coding RNAs (lncRNAs) performed key jobs inside a wide scope of organic cycles and stand out in malignant growth. Our study planned to investigate the roles and mechanisms of linc01614 in ESCC.

Methods: A Total of 60 ESCC tissue samples including 30 patients with cisplatin sensitivity and 30 patients with cisplatin resistance, who received DDP-based treatment, were obtained from Zhuhai People's Hospital, Zhuhai City during 2021. These tissues were frozen and saved in a -80 ℃ ultra-low temperature freezer. We performed CCK-8, clone formation, flow cytometry assays to determine the effect of linc01614 on ESCC progression, and explored the specific mechanism of linc01614 in ESCC cell proliferation, apoptosis, and chemotherapy resistance.

Results: linc01614 expression was upregulated in ESCC tissues and cells compared with non-tumor tissues and human normal esophageal epithelial cells (Het-1A). Knockdown of linc01614 repressed cell expansion, chemotherapy opposition, and advanced cell apoptosis in ESCC. Besides, linc01614 regulated the expression of miR-4775 as a competitive endogenous RNA (ceRNA).

Conclusion: The linc01614/miR-4775 axis played an important role in ESCC progression and drug resistance, revealing that linc01614 is a promising target in ESCC treatment.

Background: Elevated blood pressure (BP) is one of the leading causes for developing major cardiovascular events and still represents a major public health challenge worldwide. We aimed to provide data on predictors of poor adherence to medication in hypertensive patients in Serbia.

Methods: Observational, analytical study was undertaken at a group of 388 patients who refilled their medications in the Pharmacy Institution, “Apoteka Kragujevac”, Kragujevac, Serbia between Jan and Mar 2019. Afterward, we conducted a case-control study to evaluate the influence of the variables associated with the adherence. We used a self-developed questionnaire and SF-36 to assess the influence of the quality of life on medication adherence.

Results: Results revealed four independent predictors of non-adherence: increased number of medications, living in a city, forgetfulness of the dosing regimen and low energy. The odds of non-adherence were the highest among the participants living in the city and the low energy was the only factor inversely associated with the level of non-adherence.

Conclusion: Many factors were associated with the non-adherence to medication. Further studies are needed to find the most appropriate protocol to promote adherence. The four risk factors (increased number of medications, living in a city, forgetfulness of the dosing regimen and low energy) are associated with non-adherence in adult hypertensive patients.

Background: We aimed to establish the cut-off value of weight-for-height for preschool children in China, and to explore the influence of overweight and obesity on the physical performance of preschool children.

Methods: Data from 31 provinces in China monitored in 2010 and 2014, the standard deviation unit curves of WFH were established by using GAMLSS (generalized additive model for location, scale, and shape) method preschool children in China, and then the cut-off values of normal weight, overweight and obesity were divided. The research group tested 5 physical performance indicators of 5154 preschool children from April 2018 to June 2019 in Beijing and Zhejiang in China. We then compared physical performance differences between the normal-weight group and the overweight-obesity group.

Results: A smooth and effective standard deviation unit curve of WFH was established. The overweight and obesity of Chinese preschool children were at a high level. Being overweight and obese reduced preschool children's relative strength, speed, sensitivity, coordination, and balance ability, but did not reduce preschool children's flexibility. In general, the physical performance of preschool children in the normal weight group was better than that in the overweight and obesity group.

Conclusion: It is suggested to use the WFH criteria in this study to evaluate overweight and obesity in Chinese preschool children, and strengthen physical activity and take in energy substances properly of preschool children, to control the spread of overweight and obesity， to improve physical performance level.

Background: Breast cancer is the most common malignancy among women worldwide. We aimed to know the past trends of age-specific breast cancer incidence rates in Faisalabad city.

Methods: A retrospective study was designed at Allied Hospital Faisalabad (AHF), Pakistan from 2014-2018. Overall, 12742 cancer patients presented throughout these years, out of which 3390 were breast cancer cases. Descriptive statistics were computed and the results were presented as counts and percentage for categorical variables. Means and standard errors were computed for the continuous variables. For testing the association among categorical variables, a chi-square test of independence was used and the p-values less than 0.05 are reported as significant.

Results: 84.70% patients were diagnosed with invasive breast carcinoma and 15.30% were all other types reported in the Allied Hospital Faisalabad. The incidence of breast cancer was outrageous in the 40-49 year-old age group (1021 patients, 30.12%) and the mean age is 45 in all years. An increase of 34.86% was observed from 2014 to 2018. The comprehensive four-year data (2015 to 2018) were further analyzed for histology, surgery, staging and grading pattern as 2014 files data was insufficient to discuss. The stage III and grade III were most common throughout the years from 2015 to 2018 with 33.9% and 55.71% respectively.

Conclusion: Breast cancer is diagnosed more commonly in women than in any other type of cancers in Faisalabad city. There is a need to upgrade the existing hospital facilities to make the women diagnose the cancer at an earlier stage.

 Background: We aimed to assess the effect of life-cycle management on the satisfaction and health outcomes of children with chronic diseases and their parents, as well as the career benefits of healthcare workers.

Methods: Participants were children with chronic diseases who received long-term treatment at the Three Gorges Hospital Affiliated to Chongqing University from January 2021 to November 2022. From the first admission, compare the children's disease onset, satisfaction and professional benefits of medical staff among "Medical and Nursing Integration" + "Internet plus"-based life cycle management group (n = 221, the experimental group), the routine management group (n = 53, the control group 1) and the "Medical and Nursing Integration" group (n = 67, control group 2).

Results: The overall satisfaction of children in the experimental group (100 %) was higher than that in the control group 1 (98.11%) and control group 2 (98.51%). The times of second admission and third admission of patients in the experimental group were significantly lower than those in control group 1 were (both P<0.001) and control group 2 (both P<0.01). Nurses' sense of professional benefit, professional identity, and doctor's satisfaction with nurses in the experimental group were significantly higher than those in control group 1 (P<0.05, P<0.01, P<0.001) and control group 2 (all P<0.05).

Conclusion: The application of "Medical and Nursing Integration" + "Internet plus"-based life cycle management in chronic disease nursing management can effectively improve the management on pediatric chronic diseases.

Background: Domestic violence is defined as the combined pattern of physical, psychological, economic and/or sexual violence against a family member. Intimate partner violence is the most common form. We aimed to present the basic characteristics of the Montenegrin families and family members affected by domestic violence, with the intent to inform the global mosaic of differences related to cultural specificities.

Methods: A cross-sectional study was performed using 323 cases judicially processed and officially judged according to Criminal Act from 2015-2017 in Montenegro. Socioeconomic characteristic were investigated followed by analysis of many variables.

Results: Demographic characteristics, socio-economic status, and other characteristics of the perpetrators and the victims, as well as characteristics of violent act with posible risk factors, are presented. The results of case-control analyisis of intimate-partner relationships are given, too.

Conclusion: A typical example of domestic violence in Montenegro shows an intimate couple with a violent male and a victimized female partner, living in a rented residence in the suburbs, with both partners in the fourth decade of their lives. The most frequent income level was poor, with half of the batterers and nearly three quarters of the victims unsatisfied with their marriage. The increased presence of such factors (both modifiable and unmodifiable) in the partiarchical families suffering from domestic violence should spark interest in public health and government authorities regarding domestic violence screening adapted for patriarchical societies.

Background: Bladder cancer (BCa) is one of the most common urinary tract malignancies. Our study aimed to provide promising biomarkers for BCa screening and prognosis.

Methods: BCa samples were obtained from Gene Expression Omnibus (GEO) datasets. Differentially expressed genes (DEGs) were analysed by GO/KEGG analysis. Univariate Cox hazard analysis and Kaplan Meier Curve clarified the relevance of DEGs and survival. Receiver operating characteristic (ROC) curve showed the discrimination ability of DEGs in BCa patient outcome prediction. RT-PCR was used to validate gene expression.

Results: Overall, 61 common up regulated and 170 common down-regulated genes in BCa were obtained. DEGs were mainly enriched in proliferation and metastasis processes. CDC20, COL14A1, SPARCL1, TMOD1, RHOJ, FXYD6 and MFAP4 had clinical relevance to survival with high accuracy. CDC20, SPARCL1 and TMOD1 are promising biomarkers of BCa. CDC20, SPARCL1 and TMOD1 are involved in cancer immune infiltration.

Conclusion: CDC20, SPARCL1 and TMOD1 are promising biomarkers of bladder cancer. In addition, CDC20, SPARCL1 and TMOD1 are involved in cancer immune infiltration, which provides new targets in immune therapy in bladder cancer.

Background: We aimed to determine the level of hope in breast cancer patients along with the influence of sociodemographic characteristics on the expressed level of hope.

Methods: A descriptive cross-sectional study was conducted on the sample size of 72 female patients with breast cancer diagnosis. The study was conducted at the University Clinical Center of Kragujevac, Serbia from November 2020 until March 2022. Data were collected from the patients in a form of the Sociodemographic Variables Questionnaire (Q-SV). The Herth Hope Index (HHI) was used in assessing the level of hope.

Results: The value of the total HHI score was ranging from 14 to 48, whereas the mean value of the HHI score was 40.00±5.92. The significantly higher level of hope was reported in female patients who: searched the Internet for gathering information on their disease (39.24±6.23; P=0.047), were religious (38.77±6.13; P=0.003), believed in God (38.45±5.51; P=0.004), had no formal medical education (38.44±5.75; P=0.036) and after therapy (38.76±6.49; P=0.022).

Conclusion: Hope is an existential internal resource possibly affecting the manner in which female patients perceive their own health state and future as well. A better understanding of the meaning of hope during treatment can be of great value in supporting cancer patients.

Background: Message framing is a low-cost and effective intervention method to improve diabetics’ health behaviors. The study aimed to investigate the impacts of positive and negative message framing interventions on the self-management activities and self-efficacy of patients with type 2 diabetes mellitus (T2DM).

Method: Overall, 102 T2DM patients from Jinhua People’s Hospital of China were recruited and divided into three groups: positive and negative message framing intervention groups and a control group. A 12-week experiment was implemented on the first two groups. Then, the differences of the patients’ self-management activities and self-efficacies were analyzed between the experimental and control groups. Finally, the mediating effect of self-efficacy between two types of message framing interventions and patients’ self-management activities was investigated.

Results: Both positive and negative message framing interventions could significantly improve the T2DM patients’ self-management activities in diet, blood glucose testing, foot care, and medication taking (P<0.05), meanwhile significantly improving their self-efficacies along the nutrition, physical exercise and weight, medical treatment, blood sugar, and feet check (P<0.05). Results of the difference analysis for both within-group and inter-group showed that, compared with the positive messaging framing intervention, the negative one had more significant effects on enhancing the patients’ self-management activities and self-efficacy. Self-efficacy had only a mediating effect between negative messaging framing intervention and self-management activities (β = 0.94, 95% CI: 0.0934 – 0.456).

Conclusion: Negative messaging framing intervention could better enrich T2DM patients’ diabetes knowledge through offering threatening information, thereby enhancing their self-efficacies, and ultimately improve their self-management activities.

Abstract

Background: We aimed to investigate the latent smoking classes in men and their association with health-related quality of life (HRQoL) of themselves, their wives and offspring.

Methods: Using Tehran Lipid and Glucose Study (TLGS), 1781 men with marital stability and 8-18-year-old offspring were followed for 15 years (1999-2014). Latent class growth modeling (LCGM) was used to identify men's smoking patterns in 1139 men with at least three non-missing measurements of cigarettes per day (CPD); they had 1908 children (8-18 years at baseline). HRQoL and its physical and mental component summaries (PCS and MCS) was measured at the last follow-up using the SF-12v2 questionnaire. The associations of men's smoking classes with HRQoL of the family members were examined using generalized linear model.

Results: LCGM revealed four trajectories for men's smoking patterns; non/rare smokers, decreasing light, persistent moderate smokers, and persistent heavy smokers. Persistent smoking men, regardless of the amount of smoking (light or heavy), had lower scores in general health (ß= -7.80 for moderate and ß= -10.71 for heavy class) but not overall PCS. Al three trajectories of smoker men had poorer overall MCS than non/rare smokers. Living with persistent heavy smoker men was associated with decreased overall MCS in women (ß= -4.20), in particular role emotional (ß= -8.82) and mental health (ß= -9.42). No significant association was detected between fathers' smoking patterns and offspring HRQoL in young adulthood.

Conclusion: Our results show men's heavy and persistent smoking worsens their own and their spouses' HRQoL, mainly in mental health dimensions.

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Background: One approach to reducing the burden of diseases can be to identify socioeconomically vulnerable groups. We aimed to estimate the socioeconomic inequality of in-hospital deaths using relative and absolute indices of socioeconomic inequality.

Methods: In this retrospective cohort study on Covid-19 patients; age, gender, marital status, education level, date of admission, diagnostic method, and final condition were measured. Socioeconomic inequality in in-hospital death was assessed using three approaches. We used the relative index of inequality (RII) to measure relative inequality. We used two approaches to evaluate absolute inequality: the slope index of inequality (SII) and the concentration index (ci).

Results: Overall, 587 patients’ data were collected and 42 (7.2%) of these patients died in the hospital. There were statistically significant differences between the case-fatality rates of different levels of education (P<0.001). In addition, all the inequality indices showed that the distribution of COVID-19-related deaths was higher among the lower education levels. Accordingly, after controlling the effect of age, gender, and comorbidities the RII indicated that the case fatality rate in the lowest education level was 9.42 (95% CI: 2.23 to 39.01, P<0.001) times compared to the case fatality rate in the highest level of education.

Conclusion: The results of all three approaches indicate considerable education inequality in CFR in favor of groups of high education levels. These results can improve the prioritization and impact of public health interventions, including prevention and diagnosis of Covid-19 in favor of vulnerable groups.

Background: We aimed to investigate the relationship between air pollution and the Infant mortality rate (IMR) during nearly ten years in Tehran, Iran.

Methods: This study is a retrospective cohort case using time series analysis. Air pollution monitoring data during the study period (2009-2018) were collected from the information of 23 Air Quality Control Centers in different areas of Tehran. For this purpose, the daily measures of PM10, PM2.5, O3, CO, SO2, NO2 were obtained. Data on infant mortality was obtained from the National Statistics Office of Iran and mortality registered in Tehran's main cemetery during the study period. Distributed lag linear and non-linear models were used.

Results: A total of 23,206 infant deaths were reported during the study period. Following an increase of 10 ug/m3 in PM10 in an early day of exposure, the risk of mortality increased significantly (RR=1.003, 95%CI:1.001-1.005). There is a pick on lag 5-10 that shows a very strong and immediate effect of cold temperature which means that cold temperatures increase the risk of mortality at an early time. At cold temperate, (var=0 and lag 0) risk of infant mortality was significantly higher than reference temperature (19˚C) (RR=1.1295, %CI: 1.01-1.25).

Conclusion: The results show the adverse effects of PM10 exposure on infant mortality in Tehran, Iran. Accordingly, a steady decline in PM10 levels in Tehran may have greater benefits in reducing the Infant mortality rate.

Background: Adolescence obesity and its health consequent on adulthood is affected by various environmental factors. Recently, dishware size or color is considered as a probable critical point to manage intake and weight. We investigated visual perception effects of plate size and color on fullness sensation regarding the Body Mass Index (BMI) for age percentiles in Tehran, Iran in 2019.

Methods: A cross sectional study conducted on 408 students aged 13-18 year from both sexes with different socioeconomic status through convenience sampling method. Anthropometric characteristics were measured to determine BMI for Age categories based on the WHO protocol. Visual analog scale (VAS) was used to assess participants’ perceived satiety when faced to images of different plate’s size and color with the same food volume. SPSS 21 was used to statistical analyze.

Results: 41.2% of student were on >85th percentile of BMI for age. Mean of score of VAS for medium red plate was significantly lower than medium and large white plates in both sexes (P<0.001), while mean of score of VAS for small white plate was significantly lower than large white plates only in girls (P<0.001). The adolescents who were on >85th percentile of BMI for age, gave higher score to large white plate than medium white plate and to medium white plate than medium red plate, significantly (P<0.001), while the scores given by the adolescent on 5th percentile of BMI, were not significant.

Conclusion: Considering dramatic trend of obesity in adolescents in Iran, there is an urgent need to make supportive policies. Manipulating food containers seems to be an effective and simple approach to control feeling satiety. It may be a cost-effective approach to prevent obesity in adolescents before progressing to adulthood.

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