Scant evidence exists to support the association of opium use with head and neck cancer, limited to the larynx and oral cavity. In a multicenter case‐control study—Iran Opium and Cancer study, we recruited 633 cases of head and neck squamous cell carcinoma (HNSCC) (254 lip and oral cavity, 54 pharynx, 327 larynx and 28 other subsites within the head and neck) and 3065 frequency‐matched controls from April 2016 to April 2019. Odds ratios (ORs) for opium use and 95% confidence intervals (95% CIs) were obtained using mixed‐effects logistic regression because of heterogeneity among centers. The adjusted OR (95% CI) for regular opium use was 3.76 (2.96‐4.79) for all HNSCC combined. Strong dose‐response effects were observed by frequency or amount of use, and duration of use. Regular opium uses significantly increased the risk of HNSCC of the pharynx, larynx and other subsites within the head and neck with OR (95% CI) of 2.90 (1.40‐6.02), 6.55 (4.69‐9.13) and 5.95 (2.41‐14.71), respectively. The observed associations were significant even among never tobacco smokers (including cigarette and water‐pipe smoking). Moreover, by the multiplicative interaction scale, the effect of opium use could be varied by cigarette smoking on HNSCC, 8.16 (6.20‐10.74). For the first time, the current study showed opium users have an increased risk of several anatomic subsites of HNSCC.

This study aims to examine the relative contribution of religious identity, social support, social connectedness, and perceived discrimination on psychological well-being (PWB) among Middle Eastern (ME) migrants in Australia. This cross-sectional study was conducted within Queensland, Australia. A total of 382 first-generation young adult ME migrants, aged 20–39 years, filled out a self-administered questionnaire. The hypothesized model was tested using a 2-step process: measurement and structural model testing. First, confirmatory factor analysis was performed to test the fitness of the measurement model, and reliability and validity indices were calculated. Structural equations modeling was then applied to test the structural model. The mediation analyses were tested using a bootstrapping method. Social support had the largest total effect on PWB through both a direct and an indirect effect via perceived discrimination and social connectedness with ethnic community (SCETH). Religious identity demonstrated both a direct and an indirect effect on PWB through social support, perceived discrimination, SCETH, and social connectedness with mainstream community (SCMN). Perceived discrimination showed a direct and an indirect effect on PWB, mediated by SCMN. The SCETH and SCMN had only direct effects on PWB. Developing interventions that assist religious institutions/networks in offering support and/or strategies to provide support to ME migrants through religious organizations could be helpful in increasing their PWB. Protecting ME migrants against discrimination based on their religious affiliation is a main area of action. Interventions that promote ME migrants’ interaction with others could result in their better mental health outcomes.

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BACKGROUND: In the event of an epidemic outbreak, the mental health of medical staff, including nurses who serve on the frontlines of hospitals, can be affected; thus, the identification of factors affecting nurses’ mental health is of importance. OBJECTIVE: This study aimed to examine the association between moral distress and the mental health of nurses working at four selected hospitals in Iran during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A cross-sectional questionnaire survey was conducted on 296 nurses working at the selected hospitals in Bushehr and Shiraz (south of Iran) at the time of the COVID-19 outbreak. The collected data were analyzed via logistic regression analysis. RESULTS: The mean scores for nurses’ moral distress were low (54.31±24.84). The results of this study indicated more symptoms of mental issues among nurses (73.60%). Moreover, a significant association was observed between mental health and moral distress. Among the examined demographic variables, only gender had a significant association with mental health (p-value = 0.014). CONCLUSION: The results of this study indicated that an increase in moral distress would lead to a significant increase in mental health issues of the examined nurses. Nurse managers and hospital policymakers should develop strategies to enhance nurses’ level of mental health, as well as providing adequate emotional and family support for nurses. Considering the intensifying role of gender in this association, timely interventions are necessary to reduce the negative effects of workplace pressure/stress on female nurses.

Background: There is evidence of an inverse association between yoghurt intake and risk of colorectal cancer (CRC). We aimed at investigating the association between the intake of yoghurt and other dairy foods consumed in Iran and CRC risk. Methods: Our analysis included 4070 subjects within the IROPICAN (Iran Study of Opium and Cancer) study. Detailed information was collected by the use of validated questionnaires. We estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between the intake of total dairy products, and, separately, of yoghurt, milk, cheese, kashk, dough, cream, ice cream, and other milk products, and CRC using unconditional logistic regression analyses. The intake was categorized in tertiles. Results: Overall, we analyzed 865 cases and 3205 controls. Total dairy products intake was not associated with CRC. The OR for one tertile increase (OR_T) in yoghurt intake was 0.97 (95% CI 0.87–1.08) for CRC and 0.66 (95% CI 0.52–0.84) for proximal colon cancer. Cream intake was associated with CRC (OR_T3 = 1.33, 95% CI 1.08–1.64), colon (OR_T3 = 1.37, 95% CI 1.03–1.81), and proximal cancer (OR_T3 = 1.29, 95% CI 1.04–1.61). The OR of distal colon cancer for ice cream intake was 0.59 (95% CI 0.43–0.82). Other dairy products were not associated with CRC risk.

Background: In recent years, lung cancer (LC) incidence has increased in Iran. The use of opium and its derivatives (O&D) has increased as well. The aim of this study was to investigate the association between the use of O&D and LC incidence. Methods: In this case-control study conducted in Kerman, Iran; 140 patients with lung cancer and 284 healthy controls matched by age, sex, and place of residence were included. Data including O&D use, cigarette smoking, alcohol use, and diet were collected using a structured questionnaire. The relation between the use of O&D and LC was evaluated using conditional logistic regression test. Results: The use of opium was associated with an increased risk of LC (Adjusted Odds Ratio (AOR) = 7.95, 95% CI: 3.78 -16.73). A significant dose-response relation between the use of opium and its derivatives was observed (low use AOR = 7.47, 95% CI: 2.33-23.98 and high use AOR = 11.57, 95% CI: 2.25-59.49). Also, there was a relation between starting to use O&D at lower ages and an increased risk of LC (AOR = 5.78, 95 % CI: 2.36 - 14.14). Conclusion: The results of this study support that opium use could be considered as a strong risk factor for LC. Thus, it is highly suggested that tailored policies to be applied in order to reduce use of opium.

Background: Bladder cancer is one of the common cancers. Currently some studies found an association between opium use and incidence of bladder cancer, however, underreporting and detection bias was high in the previous studies and also some of them did not adjust their results for confounding variables and had small sample size, various and unclear definition of opium use, and lack of data on starting age, duration, dose, and route of opium consumption. In this study we investigated the association between opium use and incidence of bladder cancer, overcoming previous studies limitations and doing sensitivity analyses for underreporting bias. Methods: We performed a population-based case-control study, including 300 cases diagnosed with bladder cancer and 600 controls (matched for age, sex, and place of residence) between 2013-2015. We used conditional logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI). Results: Overall, 200 cases (64.9%) and 172 controls (27.9%) reported regular use of opium, resulting in an adjusted OR (95% CI) of 4.4 (2.9-6.5). Dose response relationship was seen and the adjusted OR for low and high dose consumption groups were 4.2 (95% CI 2.6-6.8) and 4.5 (95% CI 2.9-7.2) respectively. The association between opium use and bladder cancer was statistically significant even after controlling for underreporting bias. Conclusion: This study confirmed that opium use was associated with the bladder cancer incidence. We suggest primary prevention and early detection for bladder cancer, especially in the high risk groups.