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Introduction COVID-19, caused by the SARS-CoV-2, emerged as a lethal infectious disease with viral pneumonia-like symptoms, and was first identified in Wuhan, China, in December 2019. This study aimed to compare the epidemiological characteristics and clinical manifestations of COVID-19 between elderly and non-elderly adult populations in Kermanshah Province, Iran. Methods This retrospective study included 20,943 COVID-19 patients diagnosed between March 2020 and July 2021. Data were collected from the Medical Care Monitoring Center (MCMC) and comprised demographic information, comorbidities, clinical symptoms, hospitalization duration, and outcomes (discharge or mortality). Statistical analyses were performed using chi-square tests, Kaplan–Meier survival analysis, and multivariate Cox regression. Results Of the 20,943 patients, 7,174 (34.3%) were aged 65 years or older. Elderly patients exhibited a higher prevalence of comorbidities such as diabetes (11.5% vs. 6.5%), heart disease (11.7% vs. 3.6%), and COPD (1.8% vs. 0.7%) compared to younger adults ( P  < 0.001). Additionally, elderly patients had a significantly higher mortality rate (19.4% vs. 6.0%) and shorter median survival time (18 days vs. 36 days) ( P  < 0.001). Severe symptoms, including hypoxemia (SpO2 < 93%) and altered mental status, were also more common in the elderly. Conclusion This study showed that elderly COVID-19 patients are at a higher risk of severe illness and mortality compared to younger adults. The presence of comorbidities and more severe clinical manifestations in this age group led to increased hospitalization duration and mortality. These findings underscore the importance of targeted clinical management and public health policies for the elderly population in the context of COVID-19.

Background Long-term hemodialysis significantly impacts the lives of patients and their families, creating a range of psychosocial and economic challenges. Social support and resilience are critical in enabling patients to navigate these difficulties and restore balance. This study investigated the relationship between perceived social support and resilience in patients undergoing hemodialysis. Methods This inferential cross-sectional study was conducted from April to July 2022, involving patients undergoing hemodialysis at two major centers in western Iran. Three hundred patients were selected through convenience sampling based on specific inclusion and exclusion criteria. Data were gathered using a demographic information form, the Multidimensional Scale of Perceived Social Support, and the Connor-Davidson Resilience Scale. The data were analyzed using SPSS version 24 software, employing descriptive and analytical statistical methods. Results The results indicated a significant positive correlation between perceived social support and patients’ resilience ( r  = 0.391, p  = 0.001). Multivariable linear regression analysis revealed that resilience was significantly associated with perceived social support (β = 0.384, p  = 0.001), educational level (β = 0.151, p  = 0.018), marital status (β = 0.139, p  = 0.036), gender (β = 0.134, p  = 0.014), and income level (β = 0.128, p  = 0.025). Conclusion The study findings demonstrate a strong positive correlation between perceived social support and resilience in patients undergoing hemodialysis. Therefore, health professionals are recommended to enhance resilience through psychosocial interventions (e.g., support groups and counseling) and family empowerment models. Clinical trial number Not applicable.

Tourette Syndrome (TS) is a disorder in which the patient has a history of multiple motor and vocal tics. Depression and anxiety are common in these patients. The results of the studies show different prevalence of these disorders in patients with TS. So, the objective of the present study was to liken the prevalence of depression and anxiety in patients with TS by systematic review and meta-analysis. The present study was conducted according to PRISMA guidelines during 1997–2022. The articles were obtained from Scopus, Embase, PubMed, Web of Science (WoS) and Google Scholar databases. I 2 was used to investigate heterogeneity between studies. Data were analyzed by comprehensive meta-analysis software (Version 2). Finally, 12 articles with a sample size of n  = 3812 were included in the study. As a result of combining the results of the studies, the total estimate of the prevalence of depression and anxiety in patients with TS was 36.4% (95% confidence interval: 21.1–54.9%) and 53.5% (95% confidence interval: 39.9–66.6%), respectively. The results of meta-regression showed that by increasing mean age (9–31.5 years), the prevalence of depression and anxiety in patients with TS increased significantly ( P <0.001). The results of the present study showed that the prevalence of depression and anxiety was high in patients with TS. Therefore, it is suggested that health officials and policy makers design measures to prevent and control these disorders.

Background Oral health is an integral part of the overall health of the elderly, significantly impacting their physical, social, and psychological well-being. This study aimed to synthesize, summarize, and standardize the results of primary studies, resolve inconsistencies, examine the influence of potential factors, and estimate the global prevalence of dental caries in the elderly through a systematic review and meta-analysis. Methods The systematic review and meta-analysis covered studies published from 1991 to November 2024. Relevant articles were identified through searches in international databases, including Embase, PubMed, Scopus, and Web of Science (WoS), using appropriate keywords. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) checklist. Heterogeneity among studies was evaluated using the I 2 statistic. Data were analyzed using Comprehensive Meta-Analysis software, version 2. Results The initial search yielded 20,374 studies, of which 31 articles with a total sample size of 26,703 individuals met the inclusion criteria for the meta-analysis. The global prevalence of dental caries in the elderly was estimated at 60.7% (95% confidence interval: 54.6%–66.4%). The highest prevalence was observed in the Americas at 79.6% (95% CI: 34.8%–96.6%). Meta-regression analysis revealed that the prevalence of dental caries decreased with larger sample sizes, higher study quality, and older age, while it increased over time (P < 0.05). Conclusion The findings indicate a high prevalence of dental caries among the elderly, particularly in the Americas, with an upward trend in recent years. It is recommended that health policymakers prioritize prevention and control measures for this condition.

Background Organ donation following brain death has become an important way of supplying organs for transplantation in many countries. This practice is less common in Iran for different reasons. Therefore, this study aims to explore the obstacles to organ donation following brain death in Iran. Methods This qualitative research was conducted following the conventional content analysis method. The study population consisted of individuals with a history of brain death among their blood relatives who refused to donate the organs. Snowball sampling was employed to select the participants. In-depth semi-structured interviews were conducted for data gathering. Theoretical saturation was achieved through 20 interviews. Data analysis was done following the steps proposed by Graneheim and Lundman. Lincoln and Guba’s criteria were used to ensure data rigor and transferability of the study. Results Data analyses revealed 185 codes, 23 categories, and seven themes including, poor knowledge about brain death and organ transplantation from a dead body, cultural beliefs, religious beliefs, deficiencies of requesting process, fear and concerns, inability to make a decision, and social learning. Conclusion There were several factors in families’ reluctance to donate organs of a brain-dead patient. Through improving knowledge and changing cultural beliefs in society, it is possible to take large steps towards promoting organ donation from brain-dead patients.

Background Telenursing facilitates access to efficient care and acceptance and compliance with treatment at home. Given wide complications of lack of compliance with treatment in causing complications and progression of diabetes and role of the family in attending the patient, this study aimed to investigate the effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2. Methods This was a randomized controlled clinical trial. The study population was patients with diabetes mellitus type 2 referred to Alzhara hospital at Gilan Gharb in 2019, of which 60 individuals out of them were classified randomly into two groups of intervention and control. Eight 30-min sessions of family-centered training were held through telenursing for the intervention group. Data were gathered before and after the intervention by standard questionnaire of Mudanlo in both groups and was analyzed using SPSS software version 22. Results There was no significant difference among the two intervention and control groups before the study regarding demographic variables ( p  > 0.05). The scores of subscales of making effort for treatment, intention to take the treatment, adaptability, integrating illness into life, stick to the treatment, indecisiveness for applying treatment, and total score of compliance were significantly increased after training intervention ( p  = 0.001). Conclusions Results of the study indicates positive effects of performing family-centered empowerment pattern using telephone call follow-up on increasing compliance with diet regimen in patients. Therefore, it is recommended to perform family-centered patterns in health policy-makings and also hospitals and other diabetic patients.

Background One of the main elements that help students in research projects and composing dissertations is the student-supervisor relationship. A valid and reliable tool to measure this seems essential and it is the objective of the present study to validate and assess the psychometric properties of a questionnaire on supervisor-doctoral student interaction (QSDI) in Iran. Methods Before starting the study, a permission from the developer of the tool was secured. Then the tool was forward-backward translated. After preparing the Farsi version of the tool, content validity was confirmed through qualitative and quantitative methods. To examine construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted with participation of 218 and 410 MD, MSc, and PhD students of medical sciences, respectively. To check reliability of the tool, correlation coefficient was used. To examine internal consistency of the tool, Cronbach’s alpha was used. Data analyses were done in SPSS (v.25) and LISREL (v.8). Results The EFA and CFA results revealed eight factors and 39 items. The value of R-square for the model was equal to 0.99, which means 99% of changes in the dependent variable (supervisor-student interaction) is attributed to the independent variable (41 items). That is, 99% of the dependent variable changes is due to the independent variables. The main indices of the model based on factor analyses were supported (0.9<), which indicated goodness of fit of the model (χ2/df = 1.76, CFI, NFI, TLI = 0.98 GFI = 0.91, RMSEA = 0.043, R-square = 0.99). The significance level for correlation coefficient was below 0.05. Reliability of the tool was supported based on internal correlation (Cronbach’s alpha) equal to 0.943 for the whole tool and in 0.89–0.97 range for the subscales. Conclusion In general, the results showed that the Farsi version of QSDI (eight factors and 39 items) had acceptable and applicable indices and it can be used as a valid tool in different fields for higher education students of medical sciences.

Background Depression and cardiovascular disease (CVD) by the end of 2030 will be among the major causes of disability worldwide. Meanwhile, medication adherence is an important factor in predicting clinical outcomes in patients with CVD. Further, lack of medication compliance is affected by depression. Thus, this study aimed to explore the relationship between depression and medication adherence among older patients with CVD. Materials and Methods The search was done across eight databases of PubMed/MEDLINE, Google Scholar, Embase, Scopus, APA Psycinfo, CINAHL/ebsco, ProQuest, and Web of Science. For the selection of included studies, there were no constraints regarding publication language. All studies available in each of the databases were searched up to December 9, 2021. Risk of bias assessment was done based on the Joanna Briggs Institute scale. The final result was estimated using a random effects model. The data were analyzed by CMA 2 software. Results Seven studies and 10,153 elderly suffering from CVD were identified. Most included studies had reported an inverse association between depression and medication adherence. There was a small effect between depression and medication adherence among these older patients (combined odds ratio 0.603, 95% confidence interval 0.252–1.442). Thus, having depression would reduce medication adherence by 40%. Conclusion Depression has a considerable effect on medication adherence among older patients with CVD. Thus, it is suggested that considering the importance of depression and lack of medication adherence in increasing the negative outcomes of this disease in these patients, primary studies be conducted in this regard to achieve conclusive results in subsequent systematic reviews and meta‐analyses.

BACKGROUND: Hemodialysis patients suffer from mental disorders such as anxiety and depression. One of the known nonpharmacological methods to eliminate these disorders is music therapy. The present study aimed to investigate the effect of instrumental music on state depression and anxiety in hemodialysis patients. MATERIALS AND METHODS: This study was a clinical trial. The population was hemodialysis patients in Hamedan in 2017 and 50 patients were selected and randomly divided into experimental and control groups. The duration each time of the instrumental music intervention for the experimental group was 3 weeks, 3 times a week for 20 min. Data were measured by beck depression inventory and SpeilBerger State-Trait Anxiety Inventory-Y1 before the intervention and immediately after the last intervention and analyzed using Yates correction, Chi-square test, Mann-Whitney U-test, independent t-test, and Wilcoxon test. RESULTS: No significant difference between the intervention and control groups was observed before the study in terms of demographic variables (P > 0.05). In the intervention group, the mean and standard deviation of the depression score before the intervention was 8.99 ± 23.68 and after the intervention reached 7.54 ± 14.88, which shows that the variable was significant (P = 0.001); however, no significant difference was observed in the control group. In the intervention group, the mean of state anxiety before the intervention was 10.05 ± 53.76 and after the intervention reached 9.76 ± 42.48, which was statistically significant (P = 0.004), while no significant difference was observed in the control group. CONCLUSION: The results indicate the positive effect of instrumental music on reducing anxiety and depression in hemodialysis patients. It is recommended that this therapy be used as a nursing method to reduce state anxiety and depression in hemodialysis patients.

Background In recent years, around 30% of all mortalities worldwide has been related to cardiovascular disease (CVD). The most important predictor solution of cardiovascular events is enhancing medication adherence. Meanwhile, the main reason behind development of physical disorders among the elderly is depression. In this regard, the present research was performed to determine the relationship between depression and medication adherence among the elderly suffering from CVD. Methods A cross‐sectional study was done via an analytical approach on 188 elderlies fulfilling the inclusion criteria. The participants were chosen through convenience nonrandomized sampling from March to July 2022. The data were collected through demographic and healthcare information form plus Madanloo chronic disease medication adherence and geriatric depression scale. The analysis of the data was done by SPSS 26 plus Stata 14.2. Results The mean depression score was 5.6(4.3) and the mean score of medication adherence in the elderlies was 168.03(23.85). The prevalence of depression was higher in women than in men (p = 0.015), and the elderlies differing from heart failure reported the minimum extent of medication adherence. The findings obtained from analysis of variance showed that age, level of education, and monthly level of income were among the effective demographic factors in the extent of depression and medication adherence (p < 0.05). Meanwhile, 26% of changes in medication adherence can be attributed to depression. Further, the results of the multiple linear regression model reported that depression, age, and polypharmacy are among the predictors of medication adherence. Discussion and Conclusion A weak to moderate relationship existed between depression and medication adherence among these elderlies. Given the growing elderly population, the importance of depression, and lack of medication adherence in incidence of CVD events, it is recommended to train the healthcare team to monitor the elderly regarding depression symptoms.