Journal of Research in Health Sciences
Volume:22 Issue: 1, Winter 2022

Suicide is a significant public health problem and one of the leading causes of death worldwide. The effect of religion on suicidal behaviors (i.e., ideation, plan, attempt, and death) is an important issue worthy of consideration.

Major electronic databases, including MEDLINE, Web of Science, and Scopus, were searched for the articles published until 26 April 2021. Reference lists were also screened. Observational studies addressing the associations between religion and suicidal behaviors were also examined. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The probability of publication bias was explored using the Begg and Egger tests, as well as trim-and-fill analysis. The effect size was expressed as odds ratio (OR) with 95% confidence intervals (CIs) using a random-effects model.

Out of 11,389 identified studies, 63 articles were eligible, involving 8,053,697 participants. There was an inverse association between religion and suicidal ideation OR=0.83 (95% CI: 0.78, 0.88; P<0.001), suicidal plan OR=0.93 (95% CI: 0.83, 1.04; P=0.200), suicide attempt OR=0.84 (95% CI: 0.79, 0.89; P<0.001), and completed suicide OR=0.31 (95% CI: 0.14, 0.72; P=0.006). There was a no evidence of publication bias.

The results of this meta-analysis support the notion that religion can play a protective role against suicidal behaviors. Nonetheless,  the effect of religion on suicidal behaviors varies across countries with different religions and cultures. Although this association does not necessarily imply causation, an awareness of the relationship between religion and suicide risk can be of great help in suicide prevention policies and programs.

Bullying is a widespread violence type that threatens adolescents' well-being in family, school, and neighborhood. This study aimed to estimate the percentages of the last 12 months of bullying behavior types among Greek adolescents and identify the associations of these behaviors with adolescents' aggression and mental health-behavioral problems. Study Design: A cross-sectional study.

The sample consisted of 1934 adolescents attending the second grade of 45 randomly selected public and private high schools and senior high schools of the Greater Athens Metropolitan Area, Greece. Bullying involvement was examined by four questions, evaluating the occurrence and type of bullying. The adolescents' aggression and their mental health-behavioral problems were estimated using the Buss-Perry aggression questionnaire, as well as the strength and difficulties questionnaire, respectively. Moreover, information about adolescents' individual and family characteristics was collected.

Overall, 18.4% of participants reported bullying involvement at school as a victim (11.0%), a bully (5.0%), or both (2.4%), while verbal bullying was the most common type. Compared to uninvolved participants, victims were more likely to report emotional symptoms and peer problems, and bullies were highly likely to report physical aggression, bully-victims physical aggression, hostility, and lower prosocial behavior.

Approximately, 20% of adolescents were involved in bullying in the past year at school, reporting aggressive behaviors, emotional problems, and/or social difficulties. Further longitudinal research would increase the understanding of the mechanisms of bullying involvement that may lead to preventative interventions promoting positive peer interactions in schools.

Food and beverage advertisements on television play a significant role in food preferences, especially among children and adolescents. This study aimed to evaluate foods and beverages advertised on television and purchased by adolescents or their families using the World Health Organization (WHO) nutrient profiling model. Study Design: A cross-sectional study.

This cross-sectional study was performed on 2,699 students (1,380 males and 1,319 females) aged 11-16 in Ankara, Turkey, in 2015. Socio-demographic characteristics, television-viewing habits, and the tendency to purchase foods and beverages under the influence of TV advertisements were recorded. The body weight and height were measured by the researchers. All reported food and beverage items (n=284) were evaluated and classified as permitted or not permitted to advertise, according to the WHO nutrient profile model (2015).

The majority (69.8%) of students were underweight/normal weight, whereas 13.3% and 16.9% were classified as overweight and obese, respectively. A total of 69.6% of adolescents declared that they were influenced by food advertisements, and 66.4% bought those foods. The most purchased products included cakes and sweet biscuits (63.8%), chocolate and confectionery (44.9%), savory snacks (39.6%), and soft drinks (25.4%). Only 8.5% of all the advertised products (n=284) were permitted to be advertised, according to the WHO nutrient profile model (2015). Dairy products, meat products, grains, fruits and vegetables, soup, and some traditional Turkish foods (e.g., cig kofte and Turkish pizza) were permitted. The permitted products were preferred by only 13.6% of the adolescents.

Unhealthy foods are advertised on television for adolescents, and food advertisement management may be an essential strategy to provide healthy food choices.

The prevalence of tobacco smoking and its burden on societies is not homogenous at the national and district levels. This nationwide study aimed to investigate current inequalities in the prevalence of smoking at the district level and the association of smoking behaviors with gender, wealth, education, and urbanization in Iran. Study design: A cross-sectional study.

This study was conducted by analyzing the data of the STEPS survey 2016 with 30,541 participants. The small-area estimation method using the Bayesian spatial hierarchical multilevel regression model was employed to generate district-level prevalence of all types of smoking by gender. The inequalities between the groups by wealth, education, and urbanization were investigated via concentration index.

The prevalence rates of current daily cigarette smoking were found to be at the range of 4.6-40.9 and 0-4.5 among men and women, respectively. Current daily cigarette smoking was higher in men than in women: 19.0 (95% CI: 9.5-28.7) vs 0.7 (95% CI: 0-6.9). Women with lower wealth, education, or urbanization were more likely to smoke tobacco or be exposed to secondhand smoking. On the other hand, men with higher wealth or education indices were more likely to smoke tobacco. Men with lower wealth, education, or urbanization were more likely to be exposed to secondhand smoking.

The smoking behavior varied significantly at the district level in Iran. Gender, wealth, education, and urbanization were determinants of smoking prevalence.

The suicide incident has had an increasing trend in Iran over the past years. This study mainly aimed to investigate and visualize the spatial variations of registered suicide cases at the province level. A two-step modeling approach was employed in order to estimate the relative risks and model the age of fatal suicide across provinces in Iran. Study design: An applied ecological study.

This study used the suicide death data recorded by the Iranian forensic medicine organization from March 21, 2016, to March 20, 2018. Furthermore, a Bayesian spatial approach- Besag, York, and Mollie's (BYM) model- was applied to estimate the relative risk of suicide across provinces in Iran.

This risk was found to be significantly higher than the average in both men and women in the west of Iran. For women, higher population density (mean: 0.003; 95% CrI: 0.001-0.005) and lower urbanization rate of provinces (mean: -0.025; 95% CrI: -0.038, -0.012) were associated with increased relative risk of suicide. Based on the log-normal model fitted to the data, the overall mean age of the fatal suicide at the national level was 34 years.

The magnitude of gender and age differences was quantified, and many spatial variations were identified in suicide mortality across provinces in Iran. Given the heterogeneity in suicide mortality risk among different subgroups of age and gender, our findings point to the urgent need in developing gender- and age-specific suicide prevention strategies. Moreover, efficient allocation of healthcare resources for suicide prevention can be attained by targeting provinces with higher risk.

Identification of the predictors of coronavirus disease 2019 (COVID-19)-related death in hemodialysis patients plays a key role in the management of these patients. In this regard, the present study aimed to evaluate the predictors of death among COVID-19 infected hemodialysis patients in Hamadan province, Iran. Study design: A cross-sectional study.

This cross-sectional study investigated 50 COVID-19 infected hemodialysis patients who were confirmed by PCR test and referred to hemodialysis wards of hospitals located in Hamadan province, Iran, from March 2019 and January 2020. In order to compare the demographic characteristics and clinical variables between survived and deceased patients, the independent student t-test and chi-square test were applied.

Out of 50 confirmed COVID-19 hemodialysis patients, 27 (54%) cases were male, 38 (76%) subjects were urban residents, and 4 (8%) individuals were smokers. A significant relationship was observed between patients' gender, age, acute respiratory distress syndrome (ARDS) status, and body mass index (BMI) with the treatment outcome (P<0.05). A significantly higher level of serum albumin was observed in the survived patients (3.49±0.37 vs. 3.17±0.42, P=0.030). Moreover, in terms of lactate dehydrogenase (LDH) level, a significantly higher level of LDH was observed in the patients who died (1471.1±1484.89 vs. 670.86±268.85, P=0.005).

It can be concluded that some demographic characteristics of the patients, including age, gender, ARDS status, BMI, co-morbidities, and laboratory signs and symptoms are associated with disease outcomes in COVID-19 infected hemodialysis patients. Therefore, awareness about the predictors of death in these patients can help make better and direct clinical decisions and inform health officials about the risk of COVID-19 mortality among hemodialysis patients.

Ethiopia is ranked as the fifth of heavy under-five death burdened countries with the highest burden in its rural areas. This study aimed to identify the determinants of under-five deaths in rural parts of Ethiopia. Study Design: A population-based cross-sectional study.

The data for this study was extracted from the 2016 Ethiopian Demographic and Health Survey. Descriptive analysis, non-parametric estimation, and Cox proportional hazards regression model were used to examine the determinants of under-five mortality.

A total of 7,301 under-five eligible children from rural areas were involved in this survey, and 6.5% of the cases were passed away before reaching their fifth birthday. Male children’s death accounted for 59.7% of the death rate in the participants. An estimated median survival time was 31 months [95% CI: 30-32]. About 83% of children’s death occurred among children delivered at home. Cox proportional hazard regression model revealed that gender, delivery-place, family-size, mother’s education, number of children, contraceptive use, and source of drinking water had significant effects on survival time of under-five children. Under-five mortality was significantly fewer in female children (HR=0.728; 95% CI: 0.606-0.875, P=0.001), children delivered at health facilities (HR=0.738; 95% CI: 0.572-0.951, P=0.019), and those from secondary and above educated mothers (HR=0.464; 95% CI: 0.301-0.714, P=0.001), compared to the reference category.

Significant risk factors were associated with under-five mortality in rural areas. Delivering in health facilities, uses of contraceptives, mother’s education, and improvement of infrastructures should be areas of concern to decrease under-five children’s deaths.

Brucellosis runs rampant endemically with sporadic outbreaks in Algeria. The present study aimed to provide insights into the epidemiology of brucellosis and compare the performance of some prediction models using surveillance data from Tebessa province, Algeria. Study design: A retrospective study

Seasonal Autoregressive Integrated Moving Average (SARIMA), Neural Network Autoregressive (NNAR), and hybrid SARIMA-NNAR models were developed to predict monthly brucellosis notifications. The prediction performance of these models was compared using root mean square error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE).

Overall, 13,670 human brucellosis cases were notified in Tebessa province from 2000-2020 with a male-to-female ratio of 1.3. The most affected age group was 15-44 years (56.2%). The cases were reported throughout the year with manifest seasonality. The annual notification rate ranged from 30.9 (2013) to 246.7 (2005) per 100,000 inhabitants. The disease was not evenly distributed, rather spatial and temporal variability was observed. The SARIMA (2,1,3)(1,1,1)12, NNAR(12,1,6)12, and SARIMA(2,0,2)(1,1,0)12-NNAR(5,1,4)12 were selected as the best-fitting models. The RMSE, MAE, and MAPE of the SARIMA and SARIMA-NNAR models were by far lower than those of the NNAR model. Moreover, the SARIMA-NNNAR hybrid model achieved a slightly better prediction accuracy for 2020 than the SARIMA model.

As evidenced by the obtained results, both SARIMA and hybrid SARIMA-NNAR models are suitable to predict human brucellosis cases with high accuracy. Reasonable predictions, along with mapping brucellosis incidence, could be of great help to veterinary and health policymakers in the development of informed, effective, and targeted policies, as well as timely interventions.