Prevalence of Suicidal Ideation and Suicide Attempts after Disaster and Mass Casualty Incidents in the World: A Systematic Review and Meta-Analysis

Objective: After accidents and disasters, people suffer from mental disorders due to physical, economic and social injuries. These include anxiety, stress, depression, suicidal ideation, and suicide attempts. Due to the fact that some of these measures can endanger a person’s life, it is important to pay attention to these psychological factors. Accordingly, the present study was conducted to investigate prevalence of suicidal ideation and suicide attempts after disasters in the world. Method: The present study was a systematic review and meta-analysis of the prevalence of suicidal ideation and suicide attempt after disaster in the world. Accordingly, all articles published English-language from the beginning of 2000 to the end of 2020 were extracted from Scopus, Web of Science, PubMed, Psych Info, Science Direct and Google scholar and evaluated. Statistical analysis of data was performed using the fixed and random effects model in meta-analysis and Cochran test. Results: A total of 33 studies with a sample size of 61,180 people entered the meta-analysis process. Accordingly, the prevalence of suicidal ideation was estimated at 12.9% (CI95%: 10.3% -15.5%) in the whole population, 10.6% (CI95%: 6.1% - 15.0%) in males and 15.8% (CI95%: 10.0% - 21.6%) in females. Moreover, prevalence of suicide attempt after disasters was estimated at 8.8% (CI95%: 6.6% - 11.0%). Conclusion: Based on the findings of the present study, prevalence of suicidal ideation and suicide attempt is high and prevalence of Suicide idea in women was about three times higher than in men.

Care Burden in Informal Caregivers of Hemodialysis Patients: A systematic review and meta-analysis study

Background: Correct assessment of care burden in informal care providers to hemodialysis patients such as family members has a crucial role in promoting their physical and mental health, so this study was conducted to determine care burden in informal caregivers of hemodialysis patients. Methods: This systematic review and meta-analysis was performed based on the systematic review meta-analysis and reporting system. To access relevant studies in the field, databases of Medline via PubMed, SCOPUS, ProQuest, SID, Embase and Magiran databases were searched with keywords assigned and using AND & OR operators until 1th August, 2019. After eliminating duplicates and primary and secondary screening of the articles, finally 8 studies entered the meta-analysis process. Cochran test and I2 index were used to determine the heterogeneity of the studies. Random Effects Model was used to estimate pooled mean. Egger's tests were used to evaluate diffusion bias. Results: The level of care burden in informal caregivers of hemodialysis patients varied from 1.7 to 54.01 in 8 studies with a sample size of 651. The majority of caregivers were spouses of patients and their mean age ranged from 32 to 51 years. Based on the cumulative graph, the mean total effect for care burden index in caregivers of hemodialysis patients in the studies was estimated to be 8.918 (14.3-454.381) with 95% confidence interval based on random effect model. Conclusion: Considering the care burden in caregivers of hemodialysis patients and its adverse effects, it is recommended to pay more attention to the health of caregivers as hidden patients and appropriate strategies should be considered to improve their quality of life.

The Effect of Exercise on the Older Adult’s Blood Pressure Suffering Hypertension: Systematic Review and Meta-Analysis on Clinical Trial Studies

Background. Senescence refers to spontaneous and progressive irreversible degenerative changes in which both the physical and psychological power diminish significantly. Hypertension is the most common cardiovascular disease in the elderly. Several studies have been conducted regarding the effect of exercise on reducing the blood pressure of the elderly, which have found contradictory results. One of the uses of meta-analysis study is responding to these assumptions and resolving the discrepancies. Accordingly, the aim of the present study is to determine the impact of exercise on the blood pressure of older adults. Method. In this research, in order to find electronic published papers from 1992 to 2019, the papers published in both domestic and foreign databases including SID, MagIran, IranMedex, IranDox, Gogole Scholar, Cohrane, Embase, Science Direct, Scopus, PubMed, and Web of Science (ISI) were used. Heterogeneity index between the studies was determined based on Cochran test Q(c) and I2. Considering existence of heterogeneity, random effects model was employed to estimate the standardized subtraction of the mean exercise test score for reduction of blood pressure in the older adults across the intervention group before and after the test. Results. In this meta-analysis and systematic review, eventually 69 papers met the inclusion criteria. The total number of participants was 2272 in the pre- and postintervention groups when examining the systolic changes and 2252 subjects in the pre- and postintervention groups when inspecting the diastolic changes. The standardized mean difference in examining the systolic changes before the intervention was 137.1 ± 8.09 and 132.98 ± 0.96 after the intervention; when exploring the diastolic changes, the pre- and postintervention values were 80.3 ± 0.85 and 76.0 ± 6.56, respectively, where these differences were statistically significant (P<0.01). Conclusion. The results of this study indicated that exercise leads to significant reduction in both systolic and diastolic blood pressure. Accordingly, regular exercise can be part of the treatment plan for hypertensive elderly.

Reference Change Values for Immature Red Blood Cell Parameters in Under-20 Soccer Players

Introduction: Immature red blood cell parameters compose of the anti-doping programs of several sports, including soccer. The biological variability of reticulocytes is not well defined in young athletes. Our aim was to calculate biological variation and reference change values (RCV) for immature red blood cell parameters in young soccer players.Methods: Samples from 19 male soccer players (mean age, 18 ± 1 years) were collected before the start of training (C0) and after two (C1) and four weeks of training. Blood samples were collected in tubes with K3-EDTA Vaccuete® (Greiner Bio-One). Red blood cell parameters were analyzed on Sysmex XE-5000®. The e-Check Sysmex® 2 levels were used to obtain the coefficient of analytical variation (CVA). Homogeneity of variance was verified using the Cochran test. The within-subject (CVI) and between-subject biological variation (CVG) was calculated according to the mean and standard deviation from the athletes’ results. ANOVA with repeated measures was used to compare the means at the significance level of p<0.05. RCV95% was calculated using the Fraser’s formula: RCV=21/2 x1.96x(CVA2 + CVI2)1/2. Graph Pad Prism 6.0 and Matlab 7.0 were used to perform statistical analyzes.Results: Mean corpuscular volume, RDW, and reticulocyte hemoglobin content (Ret-He) had significant increases during the training period. The Ret-He were higher in C1 (32.4±1.1 pg) and C2 (32.3±1.3 pg) compared to C0 (31.9±1.2 pg) (p<0.05). It was not possible to calculate RCV for Ret-He because of heterogeneous variances. The RCV of reticulocytes (29.1%) and IRF (48.8%) were higher than Hgb (5.5%) and Hct (6.7%).Conclusion: Reticulocytes are highly variable in different athletes’ and the RCV obtained from young soccer players would contribute to monitor training adaptation and to diagnose sports anemia. The Ret-He behavior in our study suggests that this parameter can detect an early increase of iron for hemoglobin synthesis in response to training, this makes it an interesting biomarker to assess anemia and suspicion of doping by rhEPO.

The Effectiveness of Cananga Aromatherapy with Warm Compress in Reducing Premenstrual Syndrome (PMS) Amongst Teenage Girls

<p align="center"><strong><em>Abstract</em></strong></p><p><em>Premenstrual Syndrome (PMS) appears 7-10 days before the menstrual period and can cause an uncomfortable feeling and pain with mild to severe symptoms that eventually can disturb the activities and quality of life of teenage girls. Prolonged use of chemical medication can cause several side effects. However, there is the option to use complementary therapy, such as Cananga aromatherapy with a warm compress, which is considered to be safer than chemical medication and has no side effects. The purpose of this research is to investigate the effectiveness of Cananga aromatherapy with a warm compress in reducing PMS in teenage girls. This research is a quasi experimental, pretest and posttest with control group design. Consecutive sampling was used to generate 68 respondents from teenage girls who were then divided into two groups - the intervention group that was given Cananga aromatherapy with a warm compress and the control group who did not receive the intervention. The bivariate analysis in the experimental group after the intervention, using the Cochran test, showed that the Cananga aromatherapy with a warm compress is effective in reducing PMS amongst teenage girls (p=0,000 &lt; ? = 0,05). Another analysis using the Kolmogorov-Smirnov test showed that </em>there is a difference in the level of PMS<em> between the experimental and the control group (p=0,002 &lt; ? = 0,05). It is therefore recommended that Cananga aromatherapy with a warm compress be used as a complementary therapy to reduce PMS amongst teenage girls.</em></p><p><em> </em></p><p><em>Key words: </em><em>Premenstrual Syndrome; PMS, Cananga Aromatherapy; Warm Compress; Teenage Girls</em></p>

Impact of cutoff points on adolescent sedentary behavior measured by accelerometer

The aim of this study was to analyze the impact of cutoff points in defining sedentary behavior (SB) time and prevalence, measured by accelerometers in adolescents from Northeastern Brazil. This is a cross-sectional study with adolescents aged between 10 and 14 years from public schools in João Pessoa, Paraíba state, conducted in 2014. SB was measured by an accelerometer (ActiGraph GT3X+) and the following cutoff points were applied: Evenson (≤ 25 counts/15sec), Puyau (< 800 counts/60sec), Vanhelst (≤ 400 counts/60sec), Hänggi (< 3 counts/1sec) and Romanzini (≤ 180 counts/15sec), along with the 20 and 60-minute accelerometer nonwear time. To compare the average and prevalence of excessive SB time (≥ 8 hours/day) between cutoff points, one-way ANOVA for repeated measures (Bonferroni post hoc) and the Cochran test, respectively, were used. There were significant differences in average SB between the cutoff points analyzed (p > 0.05), ranging from 37.44 min/day (Romanzini: 547.37 min/day vs. Vanhelst: 584.81 min/day) to 370.44 min/day (Hänggi: 310.51 min/day vs. Puyau: 680.95 min/day) for the 20-minute nonwear criterion; and from 81.52 min/day (Evenson: 502.41 min/day vs. Romanzini: 583.93 min/day) to 361.94 min/day (Hänggi: 354.58 min/day vs. Puyau: 716.52 min/day) for the 60-minute criterion. The prevalence of excessive SB varied from 3.3% (Hänggi) to 99.3% (Puyau). Average daily SB and the prevalence of excessive SB in the adolescents showed marked differences between the cutoff points assessed.

Analysis of Lavender Aroma and Guided Imagery on Insomnia in Lansia in Technical Specific Unit Social Tresna Wherda Glenmore District Banyuwangi

Naturally the elderly is experiencing a decline both in terms of physical, biological and mental and this is not independent of economic, social and cultural issues. Sleep disorders is one of the health problems often faced by the elderly. The elderly require good sleep quality to improve health and restore the condition of the illness. There are several ways to deal with insomnia can be done in 2 ways: pharmacology and non pharmacology. The purpose of this study was to determine the effect of lavender and guided imagery on insomnia in elderly in Technical Implementation Unit (UPT) of Social Tresna Werdha Glenmore Sub-district of Banyuwangi Regency. In this research, the research design used is True experimental research design. The population of the study were all elderly people who experienced insomnia of 36 people and sample of 33 people by using simple random sampling. Data collection using checklist sheet then analyzed using Cochran test. The results showed that significant probability value of Cochran test of 0,032 <0,05 means there is significant difference between giving of lavender scent, guided imagery and control group to insomnia. While the treatment before and after the lavender scent there is a significant influence on insomnia (p: 0.008 <0.05). Treatment before and after guided imagery there is a significant effect on insomnia (p: 0,016 <0,05). Treatment before and after the control group there was no significant effect on insomnia (p: 0,500> 0,05). Based on the results of this study non pharmacology treatment can be maintained and continued for better sleep quality. Whether using aroma therapy or guided imagery lavender because it has been proven to reduce insomnia.

Ideal Fertility in Iran: A Systematic Review and Meta-analysis

Objectives: This study was conducted to estimate the mean ideal number of children and to determine the overall prevalence of childlessness, one child, two children, as well as three children and more as the ideal number of children in Iran. Further, the study investigated the effect size of the relationship between social factors and ideal fertility. Materials and Methods: To this end, a systematic review and meta-analysis was conducted on all studies on ideal fertility that were published from January 2000 to February 2018. Totally, 37 qualified papers and two national surveys were selected with a total sample size of 37,079 women. The degree of correlation between the ideal fertility and variables was calculated using Spearman’s correlation, Pearson’s correlation coefficient, and r by using MedCalc 17 software. Results: The pooled mean ideal fertility by the random effect was 2.25 in Iran. The results of the Cochran test and I2 statistics showed considerable heterogeneity regarding the prevalence of the ideal number of children (Q=1722.0911, P<0.0001, and I2 =97.62%). In addition, the proportions of childlessness, 1 child, 2 children, along with 3 children and more as the ideal parity were 0.83, 15.99, 56.092, and 22.26, respectively. The pooled correlation coefficients demonstrated that age, actual fertility, and the economic costs of children are the most important predictors of ideal fertility. Conclusions: Despite the differences in the actual fertility level in different regions of Iran, two children is the the predominant pattern of the number of desired children. This result implies a convergence of fertility ideals in Iran. If desirable conditions for childbearing are provided, fertility could be maintained at the replacement level.

Survival Rate of Patients with Acute Leukemia in Iran: A Systematic Review and Meta-analysis

Background: Leukemia is the fifth most common cancer among both genders. The prevalence of this type of cancer has been increasing in Iran. According to the Iranian Cancer Registry SYSTEM, leukemia is among the first four cancer cases in terms of causing mortality. Considering the importance of survival rate of patients with acute cancers in Iran, this study aimed to study survival of patients with acute adult leukemia in Iran systematically. Methods: In this study, all articles on the survival rate of patients with acute leukemia were searched throughout the Google scholar,web of science, PubMed, Scopus, Cochrane of science, Cochrane, Magiran, Irandoc, IranMedex and SID websites. Our search included the articles published up toJune 2017. Using the keywords of Iran, ، Leukemia, ، Survival rate, blood cancer, life expectancy and their compositions. The search process was completed by two researchers independently. Then, all the reviewed articles and theses that met our inclusion criteria were examined. The data were analyzed using a comprehensive meta-analysis software and by running the Cochran test. Results: We investigated eight studies with a sample of 1219 people in our meta-analysis. The findings showed that the 1-year survival rate for adults with acute leukemia was 61 % and the 5-year survival rate was 48 %. Conclusion: According to the research findings, the survival rate of patients with acute leukemia in Iran is the same as other countries. Key words: Iran, Leukemia, Survival rate, meta-analysis, Systematic study.

Immature to Total Neutrophil (I/T) Ratio sebagai penunjang Diagnosis Sepsis Neonatorum

Early diagnosis of neonatal sepsis plays an important role in the management of patients. Blood culture, currently used as thegold standard, has several limitations such as time consuming and low positive rate. For this reason, a rapid and accurate diagnosticmethod is required. Manual differential count is a practical, inexpensive method and can support the diagnosis of bacterial infections.A shift to the left in differential white count with a raised immature neutrophil count has been documented in patients with bacterialinfections. This led to the use of I/T ratio as a indicator towards bacterial infections. The aim of this study is to obtain the diagnosticvalue of I/T ratio in diagnosing neonatal sepsis. The study was a prospective and cross-sectional. The subjects were enrolled consecutively,consisting of newborn babies (from birth to 30-days old) admitted to the Neonatal Intensive Care Unit (NICU) of the Dr. SoetomoHospital, Surabaya. Forty and three samples, consisting of 13 sepsis samples and 30 nonsepsis as controls samples were examined. I/Tratio are a ratio between immature neutrophils against total neutrophils in blood smear preparation. For the determination of the whitecell differential count, a total of 100 white cells (granulocytes) were counted. I/T ratio > 0.2 showed an abnormality that suggestaninfection process occur. Blood smear evaluations were done by three (3) independent observers. The result from three (3) observerswere as follows: sensitivity and specificity of I/T ratio in the diagnosis of neonatal sepsis were 69.2%, 92.3%, 61.5% and 50%, 50%,63.3%, respectively. Positive and negative predictive values were 37.50%, 44.44%, 42.10% and 78.94%, 93.75%, 79.16%, respectively.According to Cochran test there was no difference found between the 3 observers (p = 0.086). However, using Kappa test no agreementbetween I/T ratio and sepsis (p = 0.051) differences were found. from this study so far, the value in the diagnosis of neonatal sepsis theI/T ratio showed a low diagnostic.