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Introduction. Cognitive disorders and chronic diseases such as diabetes are common problems of aging. The aim of this study was to determine and compare the cognitive status of diabetic and non-diabetic elderly in the past ten years in primary health care in Iran. Method: This cross-sectional study was performed on people aged 60 years and older in Kerman, Iran in 2020. In total, this study was performed on 200 patients (100 diabetic and 100 non-diabetic) meeting inclusion criteria. The Short Mental Status Questionnaire (MMSE) and The Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) were used to assess cognitive function. The validity and reliability of the questionnaires were confirmed in this study. Data were analyzed using Chi-square, T-test, and ANOVA analysis in SPSS 21 software. Results. The results showed that there was a statistically significant difference between diabetic and non-diabetic groups in the current cognitive status and cognitive status in the last ten years. The mean scores of cognitive function from the short mental status questionnaire in the diabetic group were lower than in the non-diabetic group (p = 0.001). The mean scores of the cognitive deficit screening questionnaire in diabetic elderly were higher than in non-diabetic elderly (p < 0.001). Conclusion. Based on the results of this study, health care providers and family physicians should focus on controlling diabetes and identifying any cognitive impairment in the early stages of comprehensive care of diabetic patients.

Social capital is one of the sociological factors that has received increasing attention in the past few decades as a potential determinant of health and well-being among older populations across countries and cultures. This study aimed to examine the social capital among Iranian older adults based on a population-based survey. It was an ecological cross-sectional study covering 22 districts and 368 neighborhoods in Tehran, Iran, using secondary data from: (1) the second round of the Urban Health Equity Assessment and Response Tool (Urban HEART-2) survey, which was a large population-based study of 15 069 older adults, and (2) the results of the official report of Tehran’s Center of Studies and Planning based on the 22 Tehran districts which was used for assessing the determinants of the neighborhood level. The multiple linear regression analyses revealed that duration of residence, transportation costs, social dysfunction, food security, green spaces, perceived societal security, clean days, road traffic rate, and physical activity were significantly related to social capital. Community and neighborhood conditions are important determinants of social capital among older adults. Social policies such as providing more green space and clear air, more perceived safety, and better transportation make the elderly feel more secure and create reliable surroundings, help older adults join the community’s mainstream, and be a rich source for their society. Also, interventions targeting social capital are in need, specifically those reinforcing neighborhood social cohesion and diminishing neighborhood physical disorder and negative social support of older adults.

Pragmatic language ability denotes the ability to use language in a social context. There is a lack of research that has compared children's pragmatic skills with hearing loss with those of hearing peers. This study questioned whether children with a cochlear implant would show better pragmatic skills than children with hearing aids. 52 children were included in three groups: cochlear implant (n = 16), hearing aid (n = 16), and normal hearing (n = 20). The participants' pragmatic skills were evaluated using the Persian version of the children's communication checklist. Of the 52 participants recruited, 22 (42.3%) were males, and 30 (57.7%) were females. The mean age of the CI, HA, and NH group participants was 75.19 ± 10.80, 72.19 ± 8.68, and 68.90 ± 6.78 months, respectively (P > 0.05). There was a significant difference between the mean scores of Speech Output and Syntax between the groups (CI, HA and NH) (P

Objectives: Low media literacy and exposure to media-produced content during the Coronavirus Disease 2019 (COVID-19) pandemic can affect the health of people in the community. This study aims to investigate the psychological effects of media use on the mental health of community-dwelling older adults. Methods & Materials: In this descriptive-analytical study with a cross-sectional design, 200 elderly people aged ≥60 years participated who were selected from daycare rehabilitation centers and retirement centers in Kerman, Iran in 2020 using a convenience sampling method. Data were collected using a demographic form (Surveying age, gender, education, occupation, marital status, income, and media use), and the 12-item General Health Questionnaire. Results: The mean age of participants was 66.60 ± 5.08 years. More than three-quarters of them were following the latest COVID-19 news via media (Local radio and television). Most of them (77.4%) had poor mental health status. Higher educational level (P

Background: The spreading of health-related rumors can profoundly put society at risk, and the investigation of strategies and methods can efficiently prevent the dissemination of hazardous rumor is necessary, especially during a public health emergency including disease outbreaks. In this article we review the studies that implicated the surveillance system in identifying rumors and discuss the different aspects of current methods in this field. Methods: We searched PubMed, EMBASE, Scopus, and Web of Science databases for relevant publications in English from 2000 to 2020. The PICOS approach was used to select articles, and two reviewers extracted the data. Findings were categorized as a source of rumors, type of systems, data collection, and data transmission methods. The quality of the articles was assessed using the Mixed Method Appraisal Tool (MMAT) checklist. Results: Five studies that presented the methods used for rumor detection in different outbreaks were included in the critical appraisal process. Findings were grouped into four categories: source of rumors, type of systems, data collection, and data transmission methods. The source of rumors in most studies was media, including new social and traditional media. The most used data collection methods were human-computer interaction technique, and automatic and manual methods each were discussed in one study. Also, the data transmission method was asynchronous in the majority of studies. Conclusion: Based on our findings, the most common rumor detection systems used in the outbreaks were manual and/or human-computer methods which are considered to be time-consuming processes. Due to the ever-increasing amount of modern social media platforms and the fast-spreading of misinformation in the times of outbreaks, developing the automatically and real-time tools for rumor detection is a vital need.

Introduction: This study was conducted aimed to determine the relationship between a healthy lifestyle, self-esteem and subjective vitality of the elderly in Sirjan in 2020.Method: In this descriptive-analytical study, 200 elderly people aged 60 years and older were selected from comprehensive health centers in Sirjan by two-stage random sampling method. The data were collected using validated Healthy Lifestyle Questionnaire among Iranian Elderly, Rosenberg Self-Esteem Scale and validated Subjective Vitality Scale.Results: The mean and standard deviation of healthy lifestyle score was 134.42±13.78, 36.34±4.62 for self-esteem and 21.80±2.85 for subjective vitality. A direct and significant relationship was between healthy lifestyle and self-esteem (p Conclusion: A direct and significant relationship was between healthy lifestyle, self-esteem and subjective vitality of the elderly. Therefore, the elderly should take care of their health and benefit from self-esteem and vitality by selecting a healthy lifestyle.

Objectives: Physical disability to perform daily living activities is one of the major causes of depression in the elderly people. On the other hand, depression is associated with loss of interest in daily activities and lack of independence. The present study aimed to assess the relationship of depression with the ability to perform Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) in older adults in Iran. Methods & Materials: This cross-sectional study was performed on 148 elderly people aged ≥60 years who were selected by multi-stage cluster sampling method. Data were collected by using ADL, IADL, and 15-item Geriatric Depression Scale (GDS-15) questionnaires and were then presented by using descriptive statistics and analyzed by Chi-square test, Pearson correlation coefficient, and regression analysis. Results: Participants were 86 female (58.1%) and 62 male (41.9%); 109 (73.6%) aged 60-75 years, and the rest were older than 75 years; 71 (48%) had moderate or severe depression; 4(2.7%) and 61(41.2%) were dependent or in need of help performing ADL and IADL, respectively. Statistical analysis showed that depression has a significant negative correlation with ADL (r= -0.304, P0.01); i.e. by increasing one of them, the depression decreases. Conclusion: The ability of the elderly people to perform ADL and IADL can be a good predictor of depression in them. With early assessment of their health and ability by health teams and family members, it is possible to prevent the development of their disability and depression.

Introduction: Medication adherence is regarded as one of the most important factors in caring for hypertension. This study aimed to investigate the effect of intervention based on the theory of planned behavior (TPB) on medication adherence and its influencing factors on the elderly with hypertension in a rural area, Kerman province, Iran. Methods: This quasi-experimental study of the pre and post-control type was conducted on 109 elderly patients with hypertension. Data were collected using a multistage random sampling and a valid questionnaire based on the TPB. The intervention was an educational program based on TPB constructs using educational videos, pamphlets and booklets approved by the Ministry of Health. The collected data were analyzed by the SPSS 22 using parametric tests (Independent t-test, paired t-test, and regression analysis). Results: The average score of the attitudes , perceived behavioral control, as well as medication adherence behavior constructs increased significantly after the intervention in the intervention group compared to the control group (p < 0.001). Multivariate regression analysis in intervention group after intervention showed that 76% of variations in intention were explained by the model. Attitude, subjective norms and perceived behavioral control were independent predictors of intention. The association between subjective norms and intention was of marginal significance (B = 0.89). Conclusion: The results of this research showed that an educational program based on TPB can affect medication adherence on elderly rural patients suffering from hypertension.

Background: Head and Neck (H and N) cancers include malignant tumors of the nasal cavity, pharynx, paranasal sinuses, oral cavity, larynx and salivary glands. Opium use might be related to these cancers. The aim of this study was to investigate the relation between Opium and its Derivatives (O and D) use and the incidence of H and N cancers. Methods: In this case-control study conducted in Kerman, 140 patients with HandN cancers and 280 healthy controls (matched for age, gender, and place of residence) were included. Information about their use of OandD, cigarette smoking, alcohol and diet were collected using a structured questionnaire. Conditional logistic regression was used to investigate the relation between variables. Results: The use of opioids was associated with an increased risk of HandN cancers (Adjusted OR: 8.13; CI: 4.08-16.2). A significant dose-response relation between OandD use was observed, with high use Adjusted OR=8.91; 95 CI: 4.03-19.65 and low use Adjusted OR=6.52; 95 CI: 3.18-13.36. This dose-response association was stronger in patients with laryngeal cancer and opioids use, with high use Adjusted OR = 11.17; 95 CI=4.48-28.09 and low use Adjusted OR = 9.46; 95 CI= 3.97-22.52. Conclusion: The results show that opium use can be considered as an important risk factor for H and N cancers. Also in Iran, opium seems to play a more important role than cigarette smoking. © 2020, Asian Pacific Organization for Cancer Prevention.

Background The COVID-19 pandemic has affected the use of integrated geriatric care services for the elderly. This study aimed to evaluate and compare the status of using integrated geriatric health care services for the elderly before and after the COVID-19 pandemic. Materials and Methods This cross-sectional study was performed in Kerman, Iran, and consisted of two phases. In the first phase, information on the use of services through the secondary data of the integrated health services system was collected. The second phase was a cross-sectional study conducted among the elderly in Kerman in 2021, and the dimensions of the integrated geriatric health care process were surveyed through a researcher-made semi-structured questionnaire. The study population (n = 200) was selected using systematic random sampling. Results Under the influence of COVID-19, the number of older adults who received services from the primary health care system, especially the elderly in the age group of 60 to 70 years, decreased. Care services received due to high blood pressure and diabetes increased, but those in balance assessment showed a significant decrease. The mean of risk screening (P = 0.001) and self-care (P = 0.03) increased significantly in the COVID-19 pandemic compared to those before the onset of the COVID-19 crisis. There was no significant difference (P = 0.025) in health education compared to that before the crisis and the mean of case management and medication dimension was not significantly different. Conclusion Considering the decrease in the use of geriatric care during the COVID-19 crisis, policymakers should take the necessary measures, especially for the post-crisis period, emphasizing the dimensions of integrated geriatric care.

Introduction: One of the most important factors affecting the increase of clients’ satisfaction is how health care providers (HCP) communicate with clients. On the other hand, different factors can hinder proper communication and thus education, which is one of the main tasks of HCP. Therefore, the purpose of this study was to investigate communication barriers to education to referrals from the perspective of referrals to health centers (RHC) and HCP. Method: This descriptive-analytical study was conducted on RHC and HCP in Kerman in 2021. Using a multi-stage sampling method, 162 HCP and 414 RHC were included in the study. The data collection tool was two researcher-made questionnaires. Data were analyzed using SPSS 16. Findings: From the perspective of RHC and HCP, most communication barriers were related to environmental and then socio-cultural factors. Among the demographic variables of HCP, level of education showed a significant relationship with the physical-psychological, verbal-non-verbal, and informational domains. And in relation to RHC, a significant relationship was found between education and job in the socio-cultural field and environmental barriers ( p < 0.05). Conclusion: HCP face a variety of barriers in educating people, most of which are related to environmental factors. Given the cost-effectiveness of education to the public, it is essential that planners and policymakers use strategies to eliminate environmental factors as well as the placement of indigenous HCP in health facilities to reduce communication barriers.

Aims Diabetes mellitus type 2 (DMT2) is a major chronic condition that also common in older people, and associated with an increased risk of falling. This study aimed to determine the risk factor of fall in elderly with DMT2. Methods In this cross-sectional study, 220 elderly diabetic patients who had referred to diabetes center in Kerman were chosen via convenience sampling method. To collect data, Semi-structured Fall Risk questionnaire and the Pittsburgh Sleep Quality Index (PSQI) were used. Findings The mean age was estimated to be 69.82 (SD: 9.9) years. Among the participants, 38.5% suffered falls in the past one year. Good sleep quality (OR = 0.45, 95% CI = 0.1–0.85) and appropriate environment (OR = 0.6, 95% CI = 0.1–0.77) were significantly associated with a lesser odd of having recurrent falls. Gait problem (OR = 1.8, 95% CI = 1.1–4.9), balance difficulties (OR = 2.1, 95% CI = 1.24–7.12), hypotension (OR = 1.7, 95% CI = 1.2–5.6), and medication above three medicine (OR = 1.55, 95% CI = 1.12–6.34) were significantly associated with a greater odd of having recurrent falls. Conclusion It would therefore appear that older diabetic patients would be a suitable target group for a strategy aimed at preventing falls. Early recognition of the multiple causes of falls in the older diabetic patient and prompt referral of this group of patients to a specialist falls clinic is recommend.

Objective The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of mobile health (m-health) interventions on lipid profiles among patients with metabolic syndrome and related disorders. Methods Cochrane Library, EMBASE, PubMed, and Web of Science databases were searched to indentify the relevant randomized clinical trials published up April 30th, 2018. Two reviewers examined study eligibility, extracted data, and assessed risk of bias of included clinical trials, individually. Heterogeneity was measured using I-square (I2) statistic and Cochran's Q test. Data were pooled the standardized mean difference (SMD) effect size by the random-effect model. Results 18 trials of 1681 citations were identified to be appropriate for the current meta-analysis. Findings random-effects model indicated that m-health interventions significantly decreased total- (SMD −0.54; 95% CI, −1.05, −0.03) and LDL-cholesterol levels (SMD −0.66; 95% CI, −1.18, -0.15). M-health interventions had no significant effect on triglycerides (SMD −0.14; 95% CI, −0.56, 0.28) and HDL-cholesterol levels (SMD −0.35; 95% CI, −0.81, 0.11). Conclusion Overall, the current meta-analysis demonstrated that m-health interventions resulted in an improvement in total- and LDL-cholesterol, but did not affect triglycerides and HDL-cholesterol levels.

Background Brain cancer is a rare and deadly malignancy with a low survival rate. The present study aims to evaluate the epidemiology of brain cancer and its relationship with the human development index (HDI) worldwide. Methods This is an ecological study. The data on cancer incidence and cancer mortality was extracted from the World Bank for Cancer in 2018 (GLOBOCAN 2018). The incidence, mortality rate, and brain cancer distribution maps were drawn for different countries. We used correlation and regression tests to examine the association of incidence and mortality rates of brain cancer with HDI. The statistical analysis was carried out by Stata-14 and a significance level of 0.05 was considered. Results According to the results of Global Cancer Registry in 2018, there were 18,078,957 registered cases of cancer in both sexes, of which 29,681 were related to brain cancer. The highest incidence (102,260 cases, 34.4%) and mortality (77,815 cases, 32.3%) belonged to very high HDI regions. Results showed that incidence (r = 0.690, P r = 0.629, P r = 0.346, P r = 0.64, P r = 0.66, P r = 0.667, P r = 0.28, P r = 0.591, P r = 0.624, P r = 0.605, P Conclusion The results of the study showed that the incidence and mortality of brain cancer in countries with higher HDI levels is higher than countries with lower HDI levels, so attention to risk factors and action to reduce it in countries with higher HDI levels in controlling this cancer in this Countries are effective.

Summary Introduction Older adults are significant consumers of health care, and ageist stereotypes against them have a crucial impact on the equality of life in aging. This study investigated ageism among health care professionals and nurses. Methodology In this cross-sectional study, 145 health care professionals and 200 nurses were selected using a stratified sampling method in Kerman, Iran. Data collection tools included: a sociodemographic questionnaire and Kogan's attitudes toward older adults. Results The mean age of health care workers and nurses was 41.06 ± 28.61 and 35.80 ± 8.03 years, respectively. The scores of staff's attitude towards aging indicated that most of both groups had a positive attitude towards aging. Discussion It is necessary to pay attention to improving the attitude of health care workers towards aging to facilitate the change of professional behaviours, which improve the quality of health care for the elderly.

The aim of this study was to investigate the prevalence of elder abuse and associated factors among community-dwelling older adults Kerman province, Iran. In this cross-sectional descriptive study, 200 elderly people in Kerman were included using multi-stage sampling. 51.4% of the elderly reported abuse. 17.5% reported physical abuse, 20.9% reported verbal abuse, and 26.4% reported non-verbal abuse. Also, 11.5% reported self-neglect and 6.5% were neglected by others. 11.4% of the elderly reported abandonment and 14.9% reported financial abuse. There was a significant relationship between economic stress and neglect (P = .01), the risk of abuse in the elderly with a very good health status was about 50% less than that in others (P < .001). Elderly experience different types of abuse. Therefore, proper knowledge of elder abuse, especially emotional abuse and its related factors, including economic stress and health status, can increase knowledge and sensitivity of society, in order to avoid this dilemma.

Introduction: Depression and cognitive impairment are common mental health problems among elderly, although few studies have examined their co-occurrence in aging population. So the aim of this study was to determine the relationship between depression and cognitive impairment in older adults. Methods: This cross-sectional population-based study was conducted on 506 older adults were presented to the health centers of the municipality of Tehran, Iran. Data were collected using the sociodemographic questionnaire, Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS). Data were analyzed by using SPSS-17 with correlation analysis and logistic regression. Results: The mean age of the participants was 65.71 years. Older people (> 75 years) had more twice risk (95% CI 1.01- 4.90) for cognitive dysfunction. There was a significant correlation between MMSE and GDS. Elderly with collegiate education had 85% (95% CI 0.1- 0.5) and employed elderly had 56% (95% CI 0.04- 0.74) lower risk for cognitive dysfunction. Elderly with severe depression had twice risk (95% CI 1.41- 4.8) for cognitive dysfunction. Conclusion: Findings suggest there is a relationship between depression and cognitive impairment among the elderly. These findings emphasis on assessing cognitive impairment and depression in geriatric assessment in elderly.

Objectives Malnutrition is a clinical disorder and a common risk factor in older patients with diabetes that may impact their health. This study aimed to assess nutritional status and associated factors in elderly with diabetes in Kerman City, Iran. Methods & Materials This was a cross-sectional study conducted in Kerman in which 190 older patients with diabetes were included. Their nutritional habit was measured using the MNA. Data analysis was done using descriptive statistics and correlation among variables, analyzed by the Chi Square, T-test, and One Way ANOVA. Results The findings showed that 5.3% of elderly patients were suffering from malnutrition, and in 51.6% nutritional status was normal. Also, there was a statistically significant association between nutritional status and gender (P=0.036). There was a significant negative relationship between duration of diabetes and nutritional status in the elderly (r=0.192, P=0.008). Conclusion It is necessary to maintain and improve the status of elderly diabetic patients with malnutrition by administering normal nutritional status and special attention

Although all age groups are at risk of contracting Covid-19 disease, older people are facing the highest risk due to ageing and underlying health conditions. According to the US Centers for Disease Control and Prevention report, 8 out of 10 deaths reported in the US have been of adults 65 years old and older. Therefore, the global recommendation for older populations includes social isolation, which involves staying at home and avoiding contact with other people, possibly for an extended period of up to three or four months. Such distancing presents serious challenges to the health and well-being of older adults, more so those who are frail or have multiple chronic conditions.brbr.

Background: The physiological changes and muscle problems can lead to balance disorder and increased risk of falling among the elderly. Therefore, it is necessary to evaluate the factors associated with balance in the elderly, to increase their awareness of the falling risks and to provide them with appropriate assistive devices.. Hence, this study was carried out to investigate the relationship between some gait parameters and static and dynamic balance in the elderly. Methods: In this quasi-experimental study, 44 men and women in two groups (22 per group) participated as the study sample. The measured values included step length, stride length, step width, rotating angle of toes, and static and dynamic balance. The static balance was measured with Romberg test and dynamic balance with TUGTU test. Data were analysed by SPSS-15 software using t-test and Pearson correlation coefficient. Results: There was a significant relationship between step length and stride length with static and dynamic balance and between step width and dynamic balance (p0/05). But no significant relationship was reported between step width and static balance and between rotating angle of toes with static and dynamic balance among the elderly. Conclusions: the elderly balance can be improved by decreasing the step length and increasing the stride length, thereby reducing the possibility of their falling.

This survey examined association between social support and self-efficacy with self-care in elderly with diabetes. A total of 374 subjects were identified in Kerman city, Iran who responded to questionnaires on self-care, social support, and self-efficacy. Data were analyzed by using SPSS. Along with customary descriptive statistics, we also determined group difference for self-care, and Pearson correlation, and prediction value of various variables by using hierarchical multiple regression. And 67.37% of subjects were classified as poor adherence to self-care; 55.9% patients reportedly had good foot care habits, while 68.4% patients were not taking adequate physical activity. There was a significant correlation between self-care with social support and self-efficacy. Independent variables accounted for 44.3% of the variance in self-care. Diabetes care programs should aim to implement (a) weekly free-of-cost mass physical activity programs, (b) mass education adapted for gender- and age-based needs, and (c) informal social cohesion and companionship among general public.

Aims Diabetes is a common problem in older adults, as they increasingly comprise a larger proportion of patients newly diagnosed with diabetes. The evidence on the prevalence and distribution of type 2 diabetes (DT2) and its related factors among older adults in Iran is sparse. The aim of the present study was to determine the prevalence of DT2 among Iranian older adults aged ≥60 years. Materials and methods The study was part of a comprehensive survey (Urban HEART-2) which was a large population-based cross-sectional study. A multistage cluster random sampling method was used to select the participants in Tehran in 2011. All the participants were interviewed by trained personnel using a standard questionnaire on diabetes as well as a socio-demographic checklist. Logistic regression and chi-square were used to investigate the association between diabetes and the demographic characteristics. Results A total of 15069 older adults were included in this analysis. The mean age of the participants was 68.93 ± 7.27 years (SE: 0.059) and the mean of BMI was 26.21 ± 4.40 kg/m2 (SE: 0.036). Prevalence of DT2 was 14.4% among Iranian older adults. Factors such as age, being female, high BMI, and education were significantly associated with DT2. Conclusion Given the high prevalence of diabetes among older people, more population based research is needed to quantify the ramifications of diabetes, and to monitor the effects of prevention and health system strengthening strategies on the prevalence, treatment, and control of DT2.

Introduction Diabetes is one of the most common chronic diseases among the elderly and is also a very serious health problem. Adopting theory-based self-care behaviors is an effective means in managing such diseases. This study aimed to determine the predictors of diabetes self-care in the elderly in Kerman based on a social cognitive theory. Material and methods In this cross-sectional study, 384 elderly diabetic patients who had referred to health screening centers in Kerman were chosen via cluster sampling. To collect information about self-care and its predictors, Toobert Glasgow's diabetes self-efficacy scale as well as a questionnaire was used which was based on social cognitive theory constructs. The validity and reliability of the questionnaire was confirmed. The data were analyzed using Pearson correlation and linear regression analysis in SPSS software 17. Findings Among the subjects, 67.37% (252) had poor self-care ability; 29.14% (109) had average ability, and 3.40% (13) enjoyed a proper level of self- care ability. There was a significant relationship between the constructs of the social cognitive theory (knowledge, self- efficacy, social support, outcome expectations, outcome expectancy and self-regulation) and the self-care score. Furthermore, the mentioned constructs could predict 0.47% of the variance of the self-care behaviors. Conclusion self-care behaviors in this study were poor. Therefore, it is necessary to develop an educational intervention based on cognitive theory constructs with the goal of properly managing diabetes in the elderly patients.

Background: This study was conducted to compare the rate of discharge by personal wishes and its causes in older and younger patients. Methods: This descriptive analytical study was conducted on 35549 patients discharged from Shahid Beheshti Hospital Complex in Kashan, Iran, from April 2014 to April 2015. The patients discharged by their own wishes were divided into the older group (60 years old and above) and the younger group (age 20-59). and the reasons for their discharge were assessed and compared. And then in each group, the reasons for their discharge were assessed and then results compared in two group.Results: The rate of hospital discharge by personal wishes was 4.81% in the study population, with 28.11% of cases pertaining to older patients and 71.88% of cases to younger patients. Conclusions: According to the results obtained, marital status, education, duration of hospitalization and admission department can affect discharge by personal wishes in both older and younger patients. Certainty about recovery is one of the factors associated with discharge by personal wishes in both older and younger patients.

Background: According to the direct connection between congenital hypothyroidism and iodine deficiency in pregnant women, also relatively high incidence of congenital hypothyroidism in some areas of Kerman province, especially Raver district located in North of Kerman province, this study was performed to determine and compare the urinary iodine concentration (UIC) in pregnant women referring to health centers. Methods: This cross-sectional study was done during March 2014 and May 2015. Inclusion and exclusion criteria to be considered and UIC were measured by spectrophotometry in 384 and 374 pregnant women in Ravar and Kerman cities, Iran. Sampling method for this study was all of pregnant women in Ravar and random stratified sampling in Kerman. data were collected using a structured questionnaire. All statistical analyses were performed using SPSS Software, version 20.0 (IBM SPSS, Armonk, NY, USA). Chi-square test, Pearson's correlation coefficient and Logistic regression were used for associations and differences. Results: The mean UIC was 200.21 µg/L in pregnant women of Ravar and 238.79 µg/L in pregnant women of Kerman. 22.7% of pregnant women were with low concentrations of iodine, 57.8% within the normal range and 19.5 percent were with high iodine concentrations in Ravar. While 5.3 percent of pregnant women were with low concentrations of iodine, 54.5% were within the normal range and 40.1% were with high UIC in Kerman. There were no significant differences between demographic variables and UIC in the two regions (P> 05/0). Multivariate regression models showed significant connections between the residence and UIC pregnant women (P< 0.001). Conclusion: The results of this study showed that UIC in pregnant women of Ravar was significantly lower than Kerman and the place of living can be considered as a predictor of UIC in pregnant women.

Background: Colorectal cancers (CRCs) including colon, rectum and anal cancers are the third most prevalent cancers in the world. There are strong evidence showing the risk of the cigarette smoking, alcohol use, low physical activity and some types of diets in CRCs; however, few studies explored the relationship between opium use and CRCs. This study aimed to investigate the association between opioid use and the incidence of CRCs. Methods: In a population-based matched case-control study in Kerman, Iran, 175 patients with colorectal cancers and 350 healthy controls (matched for age, sex, and place of residence) were interviewed from Sep 2014 to Nov 2014. Opium and its derivatives, cigarette, alcohol, and diet use were collected using a valid and reliable questionnaire. Conditional logistic regression was used to estimate odds ratios with 95% confidence intervals. Results: The use of opioids was associated with an increased risk of CRCs (adjusted odds ratio= 4. 5, 95% CI: 2. 4-8. 7). In addition, a dose-response relationship was observed between the cumulative use of opioids and the incidence of CRCs (with low use OR=3. 7; 95% CI: 1. 5-8. 6 and high use OR= 8. 0; 95% CI: 2. 9-21. 7). This dose-response relationship was also strong in patients with colon cancers, with OR= 3. 9 (95% CI: 1. 5-9. 9) and 9. 4 (95% CI: 3. 3-27. 0) for the low and high uses of opioids, respectively. Conclusion: Opioid use can lead to an increased risk of CRCs. Therefore, it is necessary to implement preventive policies to control the use of opioids.