The researchers conclude that the Persian version of the FOUR score is a reliable and valid scale to assess unconscious patients with traumatic brain injury and can be substituted for the GCS.

Quantile regression is an efficient method for predicting and estimating the relationship between explanatory variables and percentile points of the response distribution, particularly for extreme percentiles of the distribution. To study the relationship between urbanization and cancer morbidity, we here applied quantile regression. This cross-sectional study was conducted for 9 cancers in 345 cities in 2007 in Iran. Data were obtained from the Ministry of Health and Medical Education and the relationship between urbanization and cancer morbidity was investigated using quantile regression and least square regression. Fitting models were compared using AIC criteria. R (3.0.1) software and the Quantreg package were used for statistical analysis. With the quantile regression model all percentiles for breast, colorectal, prostate, lung and pancreas cancers demonstrated increasing incidence rate with urbanization. The maximum increase for breast cancer was in the 90th percentile (β=0.13, p-value<0.001), for colorectal cancer was in the 75th percentile (β=0.048 ,p-value<0.001), for prostate cancer the 95th percentile (β=0.55, p-value<0.001), for lung cancer was in 95th percentile (β=0.52, p-value=0.006), for pancreas cancer was in 10th percentile (β=0.011, p-value<0.001). For gastric, esophageal and skin cancers, with increasing urbanization, the incidence rate was decreased. The maximum decrease for gastric cancer was in the 90th percentile(β=0.003, p-value<0.001), for esophageal cancer the 95th (β=0.04, p-value=0.4) and for skin cancer also the 95th (β=0.145, p-value=0.071). The AIC showed that for upper percentiles, the fitting of quantile regression was better than least square regression. According to the results of this study, the significant impact of urbanization on cancer morbidity requirs more effort and planning by policymakers and administrators in order to reduce risk factors such as pollution in urban areas and ensure proper nutrition recommendations are made.

Introduction: Spirituality is one of human capabilities providing problem solving and coping strategies; in addition, it creates a sense of meaning, against disaster and confusion, as a social support resource. Spiritual well-being is a state of health expressing emotions, behaviors, and positive cognitions of self-, others, nature, and a super entity communication. Elderly is an undeniable evolutionary period of human being. Getting older, elderlies would undergo several physical and mental problems including cancer. Knowledge of cancer may influence several life aspects among elderlies, the most important of which may include death anxiety and life satisfaction. Life satisfaction indicates the individual positive attitude to the world where he lives. It is inclusively related to the individual needs. With the knowledge of cancer, there would be an inconsistency between the individual's needs and natural tendencies leading to life dissatisfaction among the patients suffering from cancer. Purpose: The present research is conducted to study the correlation between spiritual well-being with life satisfaction and death anxiety among patients enduring cancer at major hospitals in Tehran. Given the increased population of elderlies, high prevalence of cancer and its malicious effect, and regarding cancer incidence in recent decades influencing different life aspects including life satisfaction and death anxiety; and otherwise, the effect of life satisfaction and death anxiety on cancer progression, the present research is significant considered as national research priorities. Research methodology: This is a descriptive-correlation study. Research statistical population included Iranian elderlies enduring cancer at major hospitals in Tehran in 2016. 185 research samples were selected based on inclusion criteria through convenience sampling method using a demographic questionnaire, spiritual well-being scale (Ferry and Dollman), satisfaction with life scale (SWLS; Diener), and death anxiety scale (Templler). Research data were analyzed through SPSS 20 using multiple linear regression analysis, independent t-test, and analysis of variance (ANOVA). Further, the correlation between the two variables was tested by Pearson correlation coefficient at significance level 0.05. Findings: The research showed that there is a positive significant relationship between spiritual well-being and life satisfaction (at 0.05). In other word, spiritual well-being can predict satisfaction with life in understudied elderlies. In addition, there was seen a significant inverse relationship between death anxiety and spiritual well-being. As a result, the individuals with higher spiritual well-being would experience less death anxiety. Conclusion: Spiritual well-being is of effective factors of death anxiety and satisfaction with life among elderlies suffering from cancer. Spirituality and meeting spiritual needs are considered as nursing care priorities for elderlies. Paying attention to the elderlies' spirituality by nurses may shie...

Background: Health literacy (HL) could influence self-care behaviors and further affect HbA1c values. Understanding the mechanism relationships between HL, self-care behaviors and HbA1c could provide the valuable knowledge for developing evidence-based interventions in diabetic patients. In this study, we hypothesized that HL and its subscales would be related to self-care behaviors and that HL would be indirectly related to glycemic control (HbA1c) via relations with self-care behaviors among diabetes patients. Methods: This cross-sectional study was performed on 300 patients with type 2 diabetes referred to five educational hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2018. The Persian version of Functional, Communicative, and Critical Health Literacy (FCCHL) questionnaire and the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire were used. Also, recent HbA1c values were extracted from patients’ medical records. Structural equation modeling (SEM) was also used to investigate the relationships between the variables. Results: The SEM results showed the direct standardized path of the total HL score, functional HL, communicative HL and critical HL on HbA1c were nonsignificant in the model with mediator. While the indirect effect of the total HL score (β = −0.24, P =0.042), functional HL (β = −0.15, P =0.01), communicative HL (β = −0.16, P =0.01) and critical HL (β = −0.22, P =0.03) on HbA1c through the mediation of self-care behaviors were significant. Conclusion: The results of this study indicated that HL and particularly critical HL are significant factors in reducing HbA1c in patients with type 2 diabetes through the mediation of self-care behaviors.

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