Prevalence of and demographic factors associated with domestic violence among Iranian older adults: the results of Urban HEART-2

This study aimed to determine the prevalence of and demographic factors associated with domestic violence among Iranian older adults based on the Urban HEART-2 project in Tehran, Iran. The study was a part of the second round of the Urban Health Equity Assessment and Response Tool (Urban HEART-2) project, which was a large, populationbased, cross-sectional study. Individuals aged ≥ 60 years were selected randomly through a multistage, cluster sampling method from 368 neighborhoods of 22 districts of Tehran. A total of 15,069 older adults, 79% married and 45.22% female, were included in the study. The mean age of the par ticipants was 68.93 ± 7.27 years. The overall prevalence of physical domestic violence was 2.32%. Factors such as age, gender, schooling, and having a disability were significantly associated with domestic violence (p < .05). These results are likely to be an underestimate of what really happens in the community, as many authors have mentioned previously. Therefore, it is necessary to broaden our perspectives on the phenomenon of domestic violence against the elderly, especially in the fields of public health and nursing.This study aimed to determine the prevalence of and demographic factors associated with domestic violence among Iranian older adults based on the Urban HEART-2 project in Tehran, Iran. The study was a part of the second round of the Urban Health Equity Assessment and Response Tool (Urban HEART-2) project, which was a large, populationbased, cross-sectional study. Individuals aged ≥ 60 years were selected randomly through a multistage, cluster sampling method from 368 neighborhoods of 22 districts of Tehran. A total of 15,069 older adults, 79% married and 45.22% female, were included in the study. The mean age of the par ticipants was 68.93 ± 7.27 years. The overall prevalence of physical domestic violence was 2.32%. Factors such as age, gender, schooling, and having a disability were significantly associated with domestic violence (p < .05). These results are likely to be an underestimate of what really happens in the community, as many authors have mentioned previously. Therefore, it is necessary to broaden our perspectives on the phenomenon of domestic violence against the elderly, especially in the fields of public health and nursing

Predicting quality of life based on mental health state: A machine learning approach using Urban-HEART 2

Introduction: Quality of life (QoL) is a complex and multifaceted concept often used as an indicator in evaluating public policy. This study aimed to predict QoL based on mental health state using a machine learning approach. The analysis was conducted using data from the Urban Health Equity Assessment and Response Tool (Urban-HEART 2) survey conducted in Tehran, Iran. Methods: This secondary analysis utilized data from the second round of the Urban-HEART 2 survey, which included 117,839 participants. Various machine learning (ML) algorithms were employed, including Random Forest, Decision Tree, Support Vector Machine (SVM), Naive Bayes, and Logistic Regression. Additionally, an unsupervised learning method, specifically k-means clustering, was used. Results: Following data preparation, the k-means clustering algorithm identified five clusters based on mental health features. ML algorithms were then utilized to predict each participant's QoL label through distinct scores. The top-performing ML algorithms based on high scores were found to be Random Forest (0.994), Decision Tree (0.991), SVM (0.990), Naive Bayes (0.935), and Logistic Regression (0.934), respectively. Conclusions: By implementing k-means clustering, we identified distinct clusters based on mental health features and assigned labels to each participant accordingly. Machine learning models accurately predicted the QoL label for each participant. All models achieved high scores (above 0.93), indicating that mental health features can reliably predict QoL labels with high accuracy

Spoken and Written Narrative in Persian-Speaking Students Who Received Cochlear Implant and/or Hearing Aid

Objectives To compare narrative skills between fourth and fifth grades of Persian-speaking students with hearing impairments and typical hearing students of the same grade and also to evaluate the effects of group, sex, hearing age, and educational grade of the students on their spoken/written narrative performance. Methods The subjects were 174 students aged 10–13 years, 54 of whom wore cochlear implants, 60 suffered from moderate to severe hearing losses and wore hearing aids, with the remaining 60 students being typical hearing in terms of the sense of hearing. The micro- and macrostructure components of spoken and written narrative were elicited from a pictorial story (The Playful Little Elephant) and then scored by raters. Results Compared to the typical hearing, the students with hearing impairments had significantly lower scores in all of the microstructure components of narratives. However, the findings showed no significant difference among different groups in macrostructure components of narratives. It was also revealed that the students had equal performance in spoken and written narrative. Finally, factor analysis manifested that group, sex, hearing age, and educational level of children might alter the outcome measures in various interactions. Conclusion Although cochlear implantation was more effective than hearing aid on spoken and written narrative skills, the Persian-speaking students with hearing impairments were seen to need additional trainings on microstructure components of spoken/written narrative

Comparison of Online Sexual Activity Among Iranian Individuals With and Without Substance Use Disorder: A Case-Control Study

The most important practical concerns in addiction medicine are the non-substance addiction and related addictive behaviors among individuals with substance use disorder. On the other hand, technological advances, and easy access have increased the frequency of online sexual activities (OSAs) as one of these behaviors. This study aimed to compare the prevalence of OSAs, based on the Internet Sex Screening Test (ISST) scores, among 60 patients with substance use disorder referred to Iran Psychiatric Hospital and 60 non-dependent individuals. The results showed significant negative correlations between the ISST scores and age, age at the onset of substance use, and substance use duration. There was a significant difference between the ISST scores of the case and control groups (P = 0.001). Patients who start using substances at an early age and have a great duration of substance use are more likely to engage in other addictive behaviors such as OSAs. Therefore, it is critical to consider OSAs and other addictive behaviors in patients with substance use disorder to provide better care for this vulnerable community

Dysphagia and upper airway obstruction in COVID-19 without pulmonary complications

Dysphagia and upper airway obstruction may be post-acute complication of COVID-19. The studied case showed that in people newly infected with SARS-CoV-2, the two mentioned clinical complications probably occur due to the strong immune response and cytokine storm in the throat which can be prevented from oropharynx obstruction by using corticosteroids and antihistamines

Factors associated with pharmacological and psychotherapy treatments adherence in patients with borderline personality disorder

BackgroundBorderline personality disorder is a major mental illness characterized by sustained relationship instability, impulsive behavior, and intense affects. Adherence is a complex behavior, from minor refusals to abandonment of treatment, which can be affected by various factors. Therefore, the present study aimed to investigate the factors affecting pharmacological and psychotherapy adherence, patients' attitude toward medication, and assessing medication and treatment adherence in patients with borderline personality disorder referred to an outpatient referral clinic in Tehran, Iran.MethodsThe study was a cross-sectional study. The files of patients with borderline personality disorder referred to the outpatient clinic of the Tehran Psychiatric Institute were reviewed as the first step. Data were collected using the Drug Attitude Inventory-10 (DAI-10) questionnaire and a questionnaire to determine the attitude of patients toward pharmacological and psychotherapy treatment as well as therapeutic adherence. After collecting data, patients' therapeutic adherence was divided into poor, partial, and good compliance.ResultsNinety-four patients were involved in the study, and fifty-four were women. Findings of DAI showed that 54 (57.4%) participants had negative attitudes toward medication, while 38 (40.4%) participants showed a negative attitude toward psychotherapy treatment. Additionally, the percentage of patients with good psychotherapy adherence (44.7%) was higher than that of patients with good medication adherence (31.9%). The most common reasons for discontinuation of treatment were medication side effects (53.1%), dissatisfaction with the therapist (40.3%), and then fear of medication dependence (40%). Patients with higher education levels and a positive history of hospitalization in a psychiatric ward had better adherence to psychotherapy (P < 0.05).ConclusionResults of the current study show that attitude toward psychotherapy is more favorable than pharmacotherapy among patients with BPD. The rationale may be that medications are mainly prescribed for comorbid conditions and do not have substantial effects on the BPD symptoms, resulting in low medication adherence

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Use of multidimensional item response theory methods for dementia prevalence prediction : an example using the Health and Retirement Survey and the Aging, Demographics, and Memory Study

Background Data sparsity is a major limitation to estimating national and global dementia burden. Surveys with full diagnostic evaluations of dementia prevalence are prohibitively resource-intensive in many settings. However, validation samples from nationally representative surveys allow for the development of algorithms for the prediction of dementia prevalence nationally. Methods Using cognitive testing data and data on functional limitations from Wave A (2001-2003) of the ADAMS study (n = 744) and the 2000 wave of the HRS study (n = 6358) we estimated a two-dimensional item response theory model to calculate cognition and function scores for all individuals over 70. Based on diagnostic information from the formal clinical adjudication in ADAMS, we fit a logistic regression model for the classification of dementia status using cognition and function scores and applied this algorithm to the full HRS sample to calculate dementia prevalence by age and sex. Results Our algorithm had a cross-validated predictive accuracy of 88% (86-90), and an area under the curve of 0.97 (0.97-0.98) in ADAMS. Prevalence was higher in females than males and increased over age, with a prevalence of 4% (3-4) in individuals 70-79, 11% (9-12) in individuals 80-89 years old, and 28% (22-35) in those 90 and older. Conclusions Our model had similar or better accuracy as compared to previously reviewed algorithms for the prediction of dementia prevalence in HRS, while utilizing more flexible methods. These methods could be more easily generalized and utilized to estimate dementia prevalence in other national surveys

Global mortality from dementia : Application of a new method and results from the Global Burden of Disease Study 2019

Introduction Dementia is currently one of the leading causes of mortality globally, and mortality due to dementia will likely increase in the future along with corresponding increases in population growth and population aging. However, large inconsistencies in coding practices in vital registration systems over time and between countries complicate the estimation of global dementia mortality. Methods We meta-analyzed the excess risk of death in those with dementia and multiplied these estimates by the proportion of dementia deaths occurring in those with severe, end-stage disease to calculate the total number of deaths that could be attributed to dementia. Results We estimated that there were 1.62 million (95% uncertainty interval [UI]: 0.41–4.21) deaths globally due to dementia in 2019. More dementia deaths occurred in women (1.06 million [0.27–2.71]) than men (0.56 million [0.14–1.51]), largely but not entirely due to the higher life expectancy in women (age-standardized female-to-male ratio 1.19 [1.10–1.26]). Due to population aging, there was a large increase in all-age mortality rates from dementia between 1990 and 2019 (100.1% [89.1–117.5]). In 2019, deaths due to dementia ranked seventh globally in all ages and fourth among individuals 70 and older compared to deaths from other diseases estimated in the Global Burden of Disease (GBD) study. Discussion Mortality due to dementia represents a substantial global burden, and is expected to continue to grow into the future as an older, aging population expands globally