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Abstract Background Severe mental illness (SMI) imposes a substantial worldwide burden of disability, highlighting the need for comprehensive and adaptable mental health services. This study aims to assess the efficacy and cost-effectiveness of community-based mental health services (CBMHS) in reducing relapse and rehospitalization rates among individuals with SMI in Iran. Method A systematic review and meta-analysis were conducted. Medline, EMBASE, ISI, SCOPUS, and ProQuest were searched until December 2022. We focused on randomized controlled trials, quasi-experimental studies, or economic studies related to individuals with SMI. Out of 127 articles, 17 were selected for a full-text review. The primary outcomes were the severity of psychopathology, rehospitalization rates, and the mental health of caregivers. We also examined community-based interventions and their impact on various outcomes. Data extraction and risk of bias assessment were performed, and critical appraisal was conducted using JBI checklists. Meta-analysis was carried out using STATA software. (PROSPERO registration. CRD42022332660). Result Rehospitalization rates among patients who received CBMHS were significantly lower, with an odds ratio of 2.14 (95% CI: 1.44 to 3.19), indicating a 2.14 times lower likelihood than those who received treatment as usual. A reduction in psychopathology accompanied this, SMD: -0.31, 95% CI: -0.49 to -0.13, I2 = 40.23%). Moreover, there was a notable improvement in social skills (SMD: -0.7, 95% CI: -0.98 to -0.44, I2 = 0.00%). The burden on caregivers also decreased (SMD: -0.55, 95% CI: -0.99 to -0.1, I2 = 63.2). The Incremental Cost-Effectiveness Ratio (ICER) for QUALY was acceptable, albeit with a wide range of 613 to 8400 Dollars. Conclusion CBMHS has demonstrated effectiveness and efficiency in Iran as a developing country. Additionally, it shows promise in mitigating the shortage of acute psychiatry beds. Using multiple data collection tools poses a limitation regarding data consolidation and conducting a meta-analysis.

Abstract Aim To estimate the effect size of distance education on the readmission of patients with heart failure. Design This study was a systematic review and meta‐analysis. Method Both Persian and English interventional studies focused on investigating the effectiveness of any form of distance education interventions on the readmission of patients with heart failure were retrieved from the main databases: Embase, PubMed, Scopus, Web of Science, SID, and Google Scholar. Two independent teams screened the articles for eligibility. The Cochrane Risk of bias tool was implemented to evaluate the studies' quality. A random‐effects model was applied to pool the effect sizes, I2 was calculated to examine heterogeneity, and Meta‐regression was used to investigate the source of heterogeneity. The proposal was registered in the PROSPERO database (no. CRD42020187453). Results Articles 8836 were retrieved, and 11 articles were selected. Nine studies investigated the effect of distance education on readmission with

Abstract Background Recent reports suggested that circulating exosomal microRNAs (exomiRs) may serve as non-invasive prediction biomarkers in gastrointestinal (GI) cancers, yet their clinicopathological and prognostic values need to be more clarified. Hence, the present meta-analysis was aimed to quantitatively assess the evidence regarding the association between circulating exomiRs and prognosis in GI cancer patients. Methods A comprehensive search was carried out in prominent literature databases, including PubMed, ISI Web of Science, Scopus, and Embase. Odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were gathered to evaluate the strength of the association. The quality assessment was investigated through the Newcastle-Ottawa Scale (NOS) and publication bias via Eggers’ test and funnel plots. Results A total of 47 studies, comprising of 4881 patients, were considered eligible for this meta-analysis. Both up-regulated and down-regulated circulating exomiRs are significantly associated with differentiation (HR = 1.353, P = 0.015; HR = 1.504, P = 0.016), TNM stage (HR = 2.058, P

Background and Objective: Pregnancy under the fear of Covid-19 may bring numerous maternal and neonatal consequences. The present study aimed to investigate the relationship of COVID-19-related fear and self-care behaviors with pregnancy outcomes during the Covid-19 pandemic. Materials and Methods: In this descriptive cross-sectional study, the sampling was performed on 300 pregnant mothers who were referred to at Akbarabadi Educational-Medical Center in Tehran during the Covid-19 pandemic from June to September 2021. The research instruments included demographic and pregnancy information questionnaires, Carvalho's Covid-19-related self-care questionnaire, Fear of COVID-19 Scale, and maternal-neonatal outcomes questionnaires. Data were analyzed using SPSS software version 20. Results: The mean age of 300 subjects was reported as 29.35±5.60 years. The gestational age of 266-278 days had the highest frequency (36%). Furthermore, the mean gestational age for all participants was 262.11±18.76 days. Moreover, 1% and 3.6% of subjects had the most and least severe COVID-19-related fear, respectively. Maternal outcomes were positively and significantly correlated with fear of COVID-19. Higher mean scores of fear were associated with more maternal outcomes; nonetheless, there was no relationship between neonatal outcomes and COVID-19-related Fear. Self-care behaviors were not correlated with maternal outcomes; however, they were related to neonatal consequences. Conclusion: Fear of Covid-19 was associated with an increase in the adverse consequences of pregnancy; therefore, it is necessary to raise mothers' awareness of Covid-19 and reduce their fear by training them on correct self-care behaviors and health protocols.

Abstract Objective and background Mental health is a widespread field that entails variables such as the presence of positive feelings like satisfaction with life and lack of negative emotions like depression, anxiety, and stress. This research aimed to study the prevalence of depression, anxiety, stress, and satisfaction with life as dimensions of adolescent girls’ mental health in Tehran. Methodology The population considered in this cross-sectional study consisted of adolescent girls in the last grade of high school in Tehran. Research samples were selected using multi-stage sampling. The sample size in this study was 491 and the research tools used were standardized questionnaires. Descriptive and inferential statistics included Spearman, ANOVA, and regression tests were used. Findings More than half of the adolescents experienced common symptoms of depression, anxiety, and stress. About 30% of adolescents were dissatisfied with life to some extent. Satisfaction with life was negatively correlated with age, depression, anxiety, and stress. Age and depression were predictor variables of life satisfaction based on the regression model. Conclusion A considerable percentage of adolescents suffered some form of depression, anxiety, and stress symptoms and were notably dissatisfied with life. Regarding the importance of satisfaction with life in having a joyful life and its role in initiating depression, anxiety, and stress, our findings highlight the need for interventions to prevent depression, anxiety, and stress and enhance life satisfaction among adolescents.