Background: The basic reproduction number ( R 0 ) has a key role in epidemics and can be utilized for preventing epidemics. In this study, different methods are used for estimating R 0 's and their vaccination coverage to find the formula with the best performance. Materials and Methods: We estimated R 0 for cumulative cases count data from April 18 to July 6, 2009 and 35-2017 to 34-2018 weeks in Canada: maximum likelihood (ML), exponential growth rate (EG), time-dependent reproduction numbers (TD), attack rate (AR), gamma-distributed generation time (GT), and the final size of the epidemic. Gamma distribution with mean and standard deviation 3.6 ± 1.4 is used as GT. Results: The AR method obtained a R 0 ( 95% confidence interval [CI]) value of 1.116 (1.1163, 1.1165) and an EG (95%CI) value of 1.46 (1.41, 1.52). The R 0 (95%CI) estimate was 1.42 (1.27, 1.57) for the obtained ML, 1.71 (1.12, 2.03) for the obtained TD, 1.49 (1.0, 1.97) for the gamma-distributed GT, and 1.00 (0.91, 1.09) for the final size of the epidemic. The minimum and maximum vaccination coverage were related to AR and TD methods, respectively, where the TD method has minimum mean squared error (MSE). Finally, the R 0 (95%CI) for 2018 data was 1.52 (1.11, 1.94) by TD method, and vaccination coverage was estimated as 34.2%. Conclusion: For the purposes of our study, the estimation of TD was the most useful tool for computing the R 0 , because it has the minimum MSE. The estimation R 0 > 1 indicating that the epidemic has occurred. Thus, it is required to vaccinate at least 41.5% to prevent and control the next epidemic.
Background: A patient experiences high pain and anxiety during laceration healing. One of the non-pharmacological methods of pain and anxiety relief is using music. Objectives: This study was outlined to examine the impact of music therapy on the pain and anxiety levels of patients experiencing wound healing by suturing in the emergency wards. Methods: The study population for this randomized controlled clinical trial was all patients aged 18 - 65 years who were referred to the Emergency Ward of Imam Khomeini and Buali Sina hospitals, Sari, Iran, to suture the hand or foot. Thirty people were included from each group in the study. In the intervention group, traditional Iranian wordless music (Peyk Sahar track) was played with headphones from when the patient was placed on the bed for suturing to the end, and the duration was recorded. In the control group, sutures were made according to the usual procedure. The pain level was measured by a visual analog scale in two stages before washing and immediately after the anesthetic injection. Moreover, the anxiety level was assessed in three steps, before washing the wound, after the end of the anesthetic injection, and immediately after suturing. Data were analyzed by the SPSS software version 22. Descriptive statistics, including mean and standard deviation, and inferential statistics, such as Exact Fisher’s test, Mann-Whitney test, and Wilcoxon, were used to describe and analyze the variables. Results: The mean pain before washing the wound (before music therapy) and after the end of the anesthetic injection was not significantly different between the intervention group (5.38 ± 1.31 and 3.71 ± 1.98, respectively) and the control group (5.31 ± 1.69 and 4.60 ± 2.31, respectively) (P = 0.27 and 0.057, respectively). The mean anxiety before washing the wound, after the end of anesthesia injection, and immediately after finishing the suture was 3.37 ± 0.89, 2.73 ± 1.23, and 1.27 ± 0.52in the intervention group, and 3.50 ± 0.97, 3.07 ± 1.33, and 2.07 ± 1.14 in the control group, respectively. The mean anxiety at all three times was significantly different between the two groups (P < 0.001). Conclusions: The study results indicated that music therapy lowered pain without a statistically significant difference. However, music therapy significantly reduced anxiety. Therefore, it is recommended to use music therapy to reduce pain and anxiety in patients.
Background and objectives: Premenstrual syndrome includes physical and mental symptoms occurring cyclically during the secretory phase. The present study aimed to specify the association between neuroticism and the severity of premenstrual syndrome symptoms. Method: This cross-sectional study was conducted on 223 students of Kerman University of Medical Sciences in 2019 November 17. Chi-square and Fisher’s exact tests were used to analyze the relationship between qualitative variables; stepwise logistic regression was employed to assess the factors affecting the syndrome symptoms, and Mann–Whitney U test was used to compare the scores of the Daily Record of Severity of Problems chart in two groups. Findings: 223 female students completed the first stage information. The mean score of the questionnaire was 151.72±100.11. Moreover, 77.6% of the students had the syndrome. The severity of symptoms was mild, moderate, severe, and highly severe in 53.6, 42, 3.6, and 0.7%, respectively. There was a significant relationship between premenstrual syndrome and neuroticism scores. Students with PMS had higher scores in all of the subscales (neuroticism including anxiety, stress, despair,..) (P<0.001). Conclusion: It seems that there is a relationship between neuroticism (anxiety, stress, despair) and the severity of PMS symptoms. Therefore, it is recommended that therapists and counselors consider these factors to treat and mitigate the severity of PMS symptoms.
Background: The prevalence of the Coronavirus disease 2019 (COVID-19) pandemic, as one of the biggest global health threats, has had psychological impacts on healthcare workers (HCWs) and all aspects of their mental health, particularly resilience. Objectives: This study aimed to investigate the relationship between mental health and resilience in prehospital emergency medical services (EMS) practitioners. Methods: This descriptive/analytical cross-sectional study was conducted in 2020 using a web-based questionnaire, wherein the data were collected from a total number of 115 EMS practitioners working in 115 EMS stations in Golestan province, northern Iran, selected using convenience sampling. The data collection tools were also the General Health Questionnaire-28 (score range: 0 - 84) and the Connor-Davidson Resilience Scale (score range: 0 - 100). The relationship between both questionnaires was then examined by structural equation modeling via maximum likelihood estimation. In addition, multiple linear regression (MLR) was applied to reflect on the factors affecting the resilience mean score. Results: The mental health and resilience mean scores in the EMS practitioners were 25.73 ± 8.90 and 72.25 ± 12.63, respectively. Furthermore, 43.5% and 49.6% of the subjects had good and mild mental health conditions, respectively. The correlation coefficient between both questionnaires (-0.51) revealed that mental health deterioration diminished resilience in the EMS practitioners. Additionally, the type of employment and mental health mean score had a significant effect on the resilience mean value (R2 in MLR = 0.54). Conclusions: The study results demonstrated that more than half of the EMS practitioners had moderate mental health status, and their resilience mean score was high. Therefore, it is suggested to evaluate the prevalence of other common types of mental problems, such as anxiety, depression, and sleep disorders, in HCWs during the COVID-19 pandemic at the national level in future studies.
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