Kamiar Kouzekanani

Assessing the mediating role of breast conflict on cognitive factors associated with adopting mammography

ABSTRACT Breast conflict may represent a woman’s unpleasant feelings toward her breasts, which may adversely affect her decision to undertake the procedures for an early detection of breast cancer. The purpose of the present study was to examine the mediating role of breast conflict in cognitive factors, as suggested by the Health Belief Model (HBM), for adopting mammography. In this explanatory cross-sectional study, multistage cluster sampling was employed to recruit 738 women in the age range of 40 to 69 years in Iran. Champion’s revised HBM Scale for mammography adoption and the Women’s Breast Conflict Scale were used to measure the variables of interest. Generalized structural equation modeling and hierarchical logistic regression were used for data analysis. Breast conflict was negatively associated with perceived barriers of mammography. Perceived barriers were inversely related to self-efficacy, which was positively related to mammography, suggesting the mediating role of perceived barriers and self-efficacy, connecting breast conflict to mammography indirectly. The mediating role of breast conflict in perceived barriers and self-efficacy suggests an indirect link between breast conflict and mammography. Clinicians and public health-care providers must pay attention to women’s feelings in formulating and delivering appropriate interventions and consultations.

Efficacy of pharmacological and non-pharmacological interventions on low sexual interest/arousal of peri- and post-menopausal women: a meta-analysis

ABSTRACT The aim of our study was to investigate the therapeutic efficacy of pharmacological and non-pharmacological interventions on low sexual interest/arousal of peri- and post-menopausal women. In this systematic review and meta-analysis, randomized clinical trials (RCTs) that published up to 22 June 2016 were retrieved from several online electronic databases, including Cochrane Library, PubMed, Ovid, Scopus, Medline, CINHAL, and EBSCO. Fifty-seven studies were included in the meta-analysis. The results showed that both pharmacological interventions (mean difference (MD) = –0.86, 95% confidence interval (CI) = –1.49 to –0.90, p = 0.0001) and non-pharmacological interventions (MD = –0.92, 95% CI = –1.35 to –0.49, p = 0.0001) had statistically significant effects on improving sexual interest/arousal. Among pharmacological interventions, hormone therapy with dehydroepiandrosterone, testosterone, tibolone and estrogen in combination with progesterone, estrogen in combination with testosterone as well as estrogen in combination with progesterone and testosterone were found to be effective. Non-hormonal medications including flibanserin and sildenafil as well as herbal medicines were also shown to be effective. However, due to high heterogeneity of the findings and scarcity of the studies in certain domains, there is uncertainty of their true effect. So, further well-designed RCTs with larger samples are required to ascertain the long-term effects of studies.

The interaction effect of body mass index and age on fat-free mass, waist-to-hip ratio, and soft lean mass

Background: Research has shown that body mass index (BMI) does not take into consideration the gender and ethnicity. The primary purpose of this study was to examine the interaction effect of the BMI and age on fat-free mass (FFM), waist-to-hip ratio (WHR), and soft lean mass (SLM). The secondary purpose was to evaluate the practical significance of the findings by examining effect sizes. Materials and Methods: The study was comparative in nature and employed a factorial design. Due to nonexperimental nature of the investigation, no causal inferences were drawn. The nonprobability sample consisted of 19,356 adults. Analysis of the data included factorial analysis of variance, analysis of simple effects, calculation of mean difference effect sizes, and data transformation. The Statistical Package for the Social Sciences version 22 was employed for the purpose of data manipulation and analysis. Results: The BMI by age interaction effects on FFM, F (10, 19,338) = 28.26, P < 0.01, on WHR, F (10, 19,338) = 18.46, P < 0.01, and on SLM, F (10, 19,338) = 14.65, P < 0.01, was statistically significant and ordinal in nature. Analysis of the effect sizes, ranging from 0.30 to 1.20, showed that the BMI and age influenced the WHR but their interaction effects on FFM and SLM, ranging from 0.04 to 0.36 and 0.03 to 0.33, respectively, were mainly negligible. Conclusion: Based on the examination of the statistical and practical significance of the results, it is concluded that the BMI and age together can influence the WHR but their interaction effect on the FFM and SLM is questionable.

Subgrouping High School Students for Substance Abuse–Related Behaviors A Latent Class Analysis

The aim of the current study was to characterize the prevalence of latent groups in terms of smoking, hookah, and alcohol in a sample of Iranian high school students. In this cross-sectional study, 4,422 high school students were assessed in East Azerbaijan Province, Iran. Latent class analysis was applied to determine the subgroups and prevalence of each class using the procLCA in SAS 9.2 software. The prevalence of hookah smoking was the highest among the other substances and had the greatest abuse among males than females. Nearly 86%, 9.5%, and 4.6% of the participants were low risk, tobacco experimenter, and high risk, respectively. The odds ratio indices of membership in each class, compared with the first class, associated with the independent variables. A fair number of students, males in particular, were identified as high risk-takers. Considering the simultaneous incidence of multiple high-risk behaviors, interventions must cover multiple aspects of the issue at the same time.