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Aim: Prediabetes is a strong predictor for type 2 diabetes mellitus (T2DM). However, the possible effects of other factors on the above association are unknown. This study aimed to determine factors associated with the progression of prediabetes to T2DM. Materials and methods: In the present prospective cohort study, 757 individuals with prediabetes included in the Fasa cohort study were identified and followed for 5 years in order to diagnose T2DM. The baseline demographic, medical, and clinical records of participants were surveyed. Latent class analysis (LCA) and Cox regression model were applied to evaluate potential factors affecting the rate of progression of prediabetes to T2DM. p values less than 0.05 were considered significant. Results: The annual cumulative incidence rate of diabetes was 124.1 per 1000 population. A total of 3 different latent classes were among participants including fatty liver & DII class (FLDc), with 18.58%, metabolic syndrome class (MSc), with 31.44%, and high-risk class (HRc), with 49.98% of the participants. Based on the results of Cox multivariate regression analysis, the risk of progression to T2DM was significantly raised with the presence of FLDc (HR = 2.37, 95% CI: 1.19, 4.74). Conclusion: Our findings show that the cumulative diabetes incidence was alarmingly high in Iran. Also, the cooccurrence of factors such as high fatty liver index, high DII score, metabolic syndrome, and waist-to-hip ratio increased the risk of diabetes in prediabetic individuals. These results point out the importance of applying effective preventive interventional programs for prediabetic individuals. [ABSTRACT FROM AUTHOR]

Background: the present study aimed to investigate gender difference in the perceived cause (intrinsic or extrinsic) of falls leading to fracture (FLF) and its association with selected social, health, and environmental factors. Methods: All patients aged 60 years or older who were admitted to two referral hospitals due to FLF from August 1, 2018, to the end of May 2019, were included in the study. An interview-administered questionnaire was used to collect the required data from 300 participants (136 men and 164 women). Results: When compared to men, women were less physical active, were less smoker, had lower education, had more vision problems, used more sedatives, and were more satisfied with their life (P less than 0.05 for all). No statistical difference was observed between men and women about the perceived cause of Fall. Conclusion: Although women and men were the same in the perceived cause of fall, they had considerably riskier lifestyles and lower health status. These factors include education, vision condition, physical activity, occupation, and taking sleeping pills. On the other hand, men were more smoker and alcohol user. [ABSTRACT FROM AUTHOR]

Introduction: The expansion of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic has been considered a serious issue globally, and the disease is currently a major contributing factor to morbidity and mortality rates in many developing countries. This study aimed to investigate survival rate of HIV-positive patients, and its' contributing factors among individuals receiving antiretroviral therapy in Southern Iran. Material and methods: A prospective cohort study was conducted among 1,327 HIV patients, who started antiretroviral therapy (ART) between June 2000 and March 2021. Kaplan-Meier analysis and Cox proportional hazard regression analyses were applied to define the survival rate of patients. Results: In this study, of 1,327 registered HIV/AIDS patients who were under ART, 30.6% died during the study period. The 1-, 2-, 5-, and 10-year survival rates of the patients were 90%, 87%, 78%, and 67%, respectively. Based on the results of multivariate Cox regression analysis, older age (HR≥40/<40 = 1.48), occupation (HRunemployment/employment = 1.29), history of addiction (ORyes/no = 1.64), route of transmission (HRIDU/sexual = 0.48), baseline CD4+ < 200 (HR< 200/> 500 = 2.91), clinical stage IV (HRIV/I = 1.70), ART adherence (HRadherence/non-adherence = 0.37), time on ART > 5 (HR> 5/< 1 = 0.06), and anemia (HR yes/no = 1.58) were directly associated with the survival in patients. Conclusions: Mortality in adults HIV-positive patients on antiretroviral therapy is relatively high in Iran. Age, history addiction, WHO clinical stage, low CD4+ count, and anemia are associated with poor survival in HIV patients. Concerned stakeholders should focus on early detection, timely ART onset, and adherence to treatment. [ABSTRACT FROM AUTHOR]

Introduction: Although combination of antiretroviral therapy (cART) has been successful in improving health outcomes of people living with HIV (PLWH), optimal treatment adherence is required to maintain the benefits. This study aimed to determine factors associated with treatment non-adherence among PLWH in Iran. Material and methods: In this cohort study, we included 988 PLWH (1997-2017) living in Southern Iran, Fars Province. Required demographic and clinical data was collected from patients' files. Non-adherence was defined by a physician of the center as skipping a visit or less than 90% intake of prescribed medicines (antiretroviral drugs) in the month preceding to the date of data collection. Results: Of the 988 participants, 70.54% were males. Mean (SD) age of the participants was 35.80 (SD = 8.58) years and treatment non-adherence was found in 17.81% of patients (n = 176). Multiple regression model showed that injection drug use (IDU) (AOR = 2.53, 95% CI: 1.11-5.74%), and history of incarceration (AOR = 4.20, 95% CI: 1.65-10.66%) increased the likelihood of treatment non-adherence, while taking medications for pneumocystis pneumonia (AOR = 0.34, 95% CI: 0.22-0.52%), duration of being under ART (AOR = 0.13, 95% CI: 0.08-0.21%) for 1-5 years, and (AOR = 0.06, 95% CI: 0.02-0.16%) for more than 5 years, decreased the likelihood of treatment non-adherence. Conclusions: These findings show that one in five PLWH did not adhere to cART. On the other hand, the likelihood of non-adherence was directly associated with IDU and incarceration history. Based on the results, tailored programs should be developed to improve adherence among individuals with a history of IDU or incarceration. [ABSTRACT FROM AUTHOR]

Child abuse is a problem that needs to be addressed worldwide. This is a cross‐sectional study to estimate the prevalence of child abuse among children aged 3 to 6 years and its associated factors in southern Iran. In total, 5142 participants were selected using multi‐stage random sampling. The estimated prevalence rates of neglect and physical and verbal/emotional abuse among children were 26.4% (95% confidence interval [CI] 25.2–27.6), 59.4% (95% CI 58.1–60.6), and 63.9% (95% CI 62.6–65.1), respectively. The results of logistic regression models showed that the child's sex was associated with physical abuse (odds ratio [OR]boy/girl 1.25; 95% CI1.11–1.41) and verbal abuse (ORboy/girl 1.17; 95% CI 1.04–1.32). However, parents living together was inversely associated with physical abuse (OR 0.45; 95% CI 0.25–0.80), verbal abuse (ORboy/girl 0.46; 95% CI 0.25–0.84), and neglect (ORboy/girl 0.53; 95% CI 0.31–0.88). Mother's education (ORuniversity degree/illiterate 0.58; 95% CI 0.35–0.98) was also inversely associated with physical abuse. The prevalence of child abuse in southern Iran is significantly higher than in several other countries in the region and other parts of the world. Social and family factors, including mother's education and parents living together, are important in reducing child abuse and its related mental and physical disorders during childhood. It is essential to train parents of young children about abuse and its negative effects on the health and social performance of children. [ABSTRACT FROM AUTHOR]

Background: Compassionate care is emphasized within professional ethics codes for nursing and is a key indicator of care quality. The purpose of the present study is to develop and assess the psychometric properties of a compassionate care instrument for nurses. Methods: This methodological study was carried out in two phases -qualitative and quantitative-from February 2016 to October 2018. In the qualitative stage of the study, a content analysis approach was used to establish the concept of compassionate care through interviews with nurses, patients, and family caregivers. The initial draft of the questionnaire was developed based on the qualitative findings and a subsequent review of the literature. In the second phase, the psychometric properties of the questionnaire were assessed for validity and reliability. Data analysis was performed using descriptive and inferential statistics in SPSS v.16. Results: From the results of the qualitative phase and review of literature, 80 items were extracted. In the quantitative phase, after evaluation of the face and content validity, 40 items were kept. After measurement of the construct validity, 28 items whose factor loading was above 0.4 were retained. Measurement of convergent validity showed a moderate correlation between the questionnaire and the nurses' caring behaviors scale (r = 0.67, P = 0.01). The reliability of the 28-item questionnaire was tested by measuring its Cronbach's alpha coefficient and intra-class correlation coefficient which were found to be 0.91 and 0.94 for the whole questionnaire, respectively. Conclusion: The questionnaire has enough validity and reliability to be used for measuring the nurses' compassionate care. Therefore, the instrument can be used to measure and record the quality of nursing care. [ABSTRACT FROM AUTHOR]

Background: Compassion is the core of nursing care and the basis of ethical codes. Due to the complex and abstract nature of this concept, there is a need for further investigations to explore the meaning and identify compassionate nursing care. Objectives: The purpose of this study was to identify and describe compassionate nursing care based on the experiences of nurses, patients, and family caregivers. Research design: This was a qualitative exploratory study. Data were analyzed using the conventional content analysis method. Participants and research context: Nurses, hospitalized patients, and family caregivers in different educational hospitals in an urban area of Iran were selected from February 2016 to December 2017 using a purposeful sampling method (n = 34). In-depth and semi-structured interviews, focus group interviews, and field notes were used for data collection. Ethical considerations: The study was approved by the University's Ethics Committee. The participants were informed about the aim and method of the study, reasons for recording the interviews, confidentiality of data, and voluntary nature of participation in this study. Findings: Data from interviews and filed notes were analyzed and classified into three themes: "effective interaction," "professionalism," and "continuous comprehensive care." Discussion and conclusion: Emerged themes of this study involved holistic care in the current literature on nursing with an emphasis on effective interaction and professionalism. Nurses can understand patients' and family caregivers' comprehensive needs through interaction skills. In addition, clinical proficiency, maintaining professional ethics' standards along with holism, and continuity in care are examples of compassionate care. Education program about compassionate care can enhance the quality of nursing care. [ABSTRACT FROM AUTHOR]

Background: It has been found that the new coronavirus can affect various parts of the cardiovascular system. Cardiovascular complications caused by coronavirus disease 2019 (COVID-19) are often serious and can increase the mortality rate among infected patients. This study aimed to investigate the prevalence of cardiovascular complications in COVID-19 adult patients. Methods: A systematic review and meta-analysis of observational studies published in English were conducted between December 2019 and February 2021. A complete search was performed in PubMed (PubMed Central and MEDLINE), Google Scholar, Cochrane Library, Science Direct, Ovid, Embase, Scopus, CINAHL, Web of Science, and WILEY, as well as BioRXiv, MedRXiv, and gray literature. A random effect model was used to examine the prevalence of cardiovascular complications among COVID-19 patients. The I² test was used to measure heterogeneity across the included studies. Results: A total of 74 studies involving 34,379 COVID-19 patients were included for meta-analysis. The mean age of the participants was 61.30±14.75 years. The overall pooled prevalence of cardiovascular complications was 23.45%. The most prevalent complications were acute myocardial injury (AMI) (19.38%, 95% CI=13.62-26.81, test for heterogeneity I²=97.5%, P<0.001), arrhythmia (11.16%, 95% CI=8.23-14.96, test for heterogeneity I²=91.5%, P<0.001), heart failure (HF) (7.56%, 95% CI=4.50-12.45, test for heterogeneity I²=96.3%, P<0.001), and cardiomyopathy (2.78%, 95% CI=0.34-9.68). The highest pooled prevalence of cardiac enzymes was lactate dehydrogenase (61.45%), troponin (23.10%), and creatine kinase-myocardial band or creatine kinase (14.52%). Conclusion: The high prevalence of serious cardiovascular complications in COVID-19 patients (AMI, arrhythmia, and HF) necessitates increased awareness by healthcare administrators. [ABSTRACT FROM AUTHOR]

Background: Detection of Hepatitis C virus (HCV)-infected people in each community assists with infection prevention and control. This study aims to evaluate the prevalence of HCV infection among high risk groups in Kohgiloyeh and Boyerahmad Province, Southwest Iran. Methods: This was a cross-sectional study conducted from 2009-2010 in Kohgiloyeh and Boyerahmad Province. High risk groups for HCV were the subjects of this study. Blood samples were taken from 2009 individuals at high risk for HCV that included inmates, injecting drug users (IDUs), health care workers, patients on maintenance hemodialysis, hemophilic patients, and those with histories of blood transfusions. Patients were residents of Yasuj, Gachsaran, and Dehdasht (3 main townships in the province). Samples were analyzed by ELISA for anti-HCV antibodies. Demographic features of participants were recorded by a questionnaire during sample collection. Data were analyzed by SPSS version 13 software. Results: Of 2009 subjects, HCV antibodies were detected in 172 (8.6%). Rate of infection was higher in males (11.4%) compared to females (3.2%). Rate of infection in inmates was 11.7% while this rate was 42.4% in IDUs, 4.2% in health care workers, and 6.1% in thalassemic patients. Significant correlation was found between HCV infection, history of imprisonment, and thalassemia. Conclusion: Results of this study have provided epidemiologic features of HCV and its risk factors in Kohgiloyeh and Boyerahmad Province, Southwest Iran. This information may assist in preventing the spread of HCV infection in this and other similar settings in the region. The findings of this study may help in improving surveillance and infection control in the community through management and monitoring of infected individuals. [ABSTRACT FROM AUTHOR]