Journal of Education and Health Promotion

Abstract BACKGROUND: Type 2 diabetes mellitus (DM) is a multifactorial disease and can be described as a
noncommunicable disease of epidemic magnitude. Little is known about the predictors of depression
in this population, especially among the Indian population. This study explores the predictors for
depression in patients with type 2 DM.
MATERIALS AND METHODS: A cross‑sectional study was performed for a period of 7 months
during 2018–2019. The data were collected from 250 subjects at the diabetic clinic and psychiatry
outpatient department of a tertiary care teaching hospital. T2DM with an age group of 18–60 years
were included. Exclusion criteria were clinical evidence of any significant Axis I psychiatric disorder
according to the International Classification of Diseases‑10 Diagnostic Criteria for Research other
than depression and substance use disorders. Data were analyzed with multiple linear regression
analysis using SPSS‑23 version.
RESULTS: Male and female patients were 127 (50.80%) and 123 (49.20%), respectively. The
prevalence of depression was 49.20% among 250 patients with T2DM. Female patients had higher
depression than male patients. We found age (P = 0.013), female gender (P = 0.041), locality of the
patient (P = 0.021), body mass index (BMI) (P = 0.018), and fasting blood sugar (FBS) (P = 0.045)
as significant predictors of depression among T2DM patients.
CONCLUSIONS: The study concludes that females and elderly patients were more affected by
depression. The predictors of depression were age, gender, locality, BMI, and FBS among diabetic
patients. The findings indicate to screen the patients of T2DM for depression, predominantly female
and elderly patients, at regular intervals as per clinical demand.

Abstract BACKGROUND: The pediatric hospital is an environment with a high level of stress for most parents.
Parents experience high levels of stress if their children are hospitalized due to the fear for the loss
of their child’s life.
OBJECTIVE: The objective of this study was to evaluate stress factors in parents of hospitalized
children.
MATERIALS AND METHODS: This study was conducted from January to July 2019 at the General
Pediatrics Department of Fieri Regional Hospital. The study sample was composed of 200 parents,
of which 86 (43.3%) were males and 114 (56.7%) were females. The parents chosen as our sample
had their children hospitalized for at least 5 days.
RESULTS: Our results showed that 80% of the sample was stressed out by waiting at the hospital,
whereas 42% of them felt stressed also by their child’s oral problems. Parents of hospitalized
children (83%) felt stressed about the painful techniques applied to their children. Nearly 65% of
them were stressed out by the hospital environment; child's sleep bruxism was considered another
stressor by 39% of the sample.
CONCLUSION: This study claims that parents of hospitalized children experience stress from different
stressors such as dental visits, waiting for the diagnosis, and sleep bruxism. There are other factors
which do not influence parental stress including residence, divorced parents, and  hospital conditions.

Abstract Background and Objectives: Breast cancer is a major threat to women’s health. Evaluation
of the changes in trend of the incidence rate provides valuable information for the assessment
and planning of development indicators of each country. The aim of the present study was to
apply the JoinPoint regression model for determining changes in the trend of the breast cancer
incidence rate in Isfahan. Materials and Methods: In this cross‑sectional study, 3640 women
with breast cancer referring to oncology and radiotherapy departments of Seyed‑al‑Shohada
and Milad cancer treatment centers of Isfahan during 2001–2010 were studied and sampling
was not done. Joinpoint regression model was used to investigate the pattern of breast
cancer incidence rate. Response and independent variables were the natural logarithm of the
age‑standardized incidence rates and year of diagnosis of breast cancer, respectively, in which
various levels of cancer tumor characteristics (P < 0.05) were analyzed. Results: The incidence
rates increased annually in the age groups of 40–44 years (6.2%), 45–49 years (5.3%), and
55–59 years (5.3%). The trend of incidence rates in women with tumor size ≤2 cm (18.2%),
well (moderately) differentiated tumor grade [8% (10.2%)], positive estrogen (progesterone)
hormone receptor status [10.5% (6.9%)], and the proportion of positive lymph node to surgery
node ≤25% (nonsignificant) was upward. Conclusion: The trend of incidence rates with tumor
size ≤2 cm, well‑differentiated tumor grade, moderately differentiated tumor grade, and positive
estrogen and progesterone hormone receptors was upward. The pattern of breast cancer can
help in cancer prevention and prognosis, and in selecting the best type of surgery.