A survey of the impact of proper breastfeeding education on blood sugar levels of healthy term infants in the public hospital of Shahid Rajai in Gachsaran in 1392

مقدمه و هدف: هیپوگلیسمی نوزادی به دلیل ایجاد عوارض مغزی در نوزاد نیاز به توجه جدی دارد .با توجه به احتمال افت قند خون در نوزادان ترم سالمی که تغذیه نا مناسب دارند،این مطالعه با هدف تعیین تأثیرآموزش روش صحیح شیردهی بر میزان قند خون نوزادان ترم سالم انجام شده است. روش مطالعه: این مطالعه یک کارآزمایی بالینی است که بر روی 85 زن باردار واجد شرایط انجام شد. نمونه ها به صورت تصادفی در دو گروه آزمایش وکنترل قرارگرفتند.برای گروه آزمایش3 جلسه‌ی 45 دقیقه‌ای کلاس آموزشی تئوری و عملی هفته‌ای یک بار در 1ماه آخربارداری برگزار شد. پس از زایمان میزان قند خون نوزادان در 3 زمان 1،3و 6 ساعت پس از تولد کنترل و ثبت گردید. داده های این مطالعه با نرم افزار spss و تست های آماری تی مستقل،کای‌اسکور، ضریب همبستگی پیرسون، فیشر وanova مورد تجزیه وتحلیل قرارگرفتند. یافته‌ها: یافته های پژوهش رابطه معنی داری را بین آموزش روش صحیح شیردهی ومیزان قند خون نوزادان درتمامی زمان های مورد پژوهش در دو‌گروه مورد مطالعه نشان داد. بیشترین میانگین قند خون در گروه آزمایش وکمترین میانگین قند خون درگروه کنترل بود. بیشترین میزان هیپوگلیسمی در ساعات اول و ششم پس از تولد و درگروه کنترل دیده شد. طبق تجزیه و تحلیل های آماری بین متغیّرهای کیفی و کمی جمعیت شناختی با میزان قند خون نوزادان رابطه معنی داری دیده نشد. متغیّرقد نوزاد در ساعت اول پس از تولد (با کنترل اثر سایر متغیّرها) در سطح خطای کوچکتر از 05/0 با هیپوگلیسمی رابطه معنی داری نشان داد(003/0 =pvalue) و این رابطه بصورت منفی می باشد به این معنی که افزایش یک سانتی متری قد نوزادان شانس ابتلا به هیپوگلیسمی را به اندازه 40 کاهش می دهد. نتیجه‌گیری: شیوه‌ی صحیح شیردهی به طورمعناداری سبب افزایش میزان قندخون نوزادان ترم سالم وکاهش شیوع هیپوگلیسمی در آنها می شود بنابراینبا وجود آموزش های جاری شیردهی، نیاز به آموزش های بیشتر و تبلیغات وسیعتر در مورد شیوه ی صحیح شیردهی در مادران باردار و نخست زا احساس می شود و پیشنهاد می گردد به افت قندخون متعاقب عدم تغذیه مناسب با شیر مادر، در نوزادان ترم سالم توجه بیشتری شود

Autoimmune PaneLs as PrEdictors of Toxicity in Patients TReated with Immune Checkpoint InhibiTors (ALERT)

Background: Immune-checkpoint inhibitors (ICI) can lead to immune-related adverse events (irAEs) in a significant proportion of patients. The mechanisms underlying irAEs development are mostly unknown and might involve multiple immune effectors, such as T cells, B cells and autoantibodies (AutoAb). Methods: We used custom autoantigen (AutoAg) microarrays to profile AutoAb related to irAEs in patients receiving ICI. Plasma was collected before and after ICI from cancer patients participating in two clinical trials (NCT03686202, NCT02644369). A one-time collection was obtained from healthy controls for comparison. Custom arrays with 162 autoAg were used to detect IgG and IgM reactivities. Differences of median fluorescent intensity (MFI) were analyzed with Wilcoxon sign rank test and Kruskal–Wallis test. MFI 500 was used as threshold to define autoAb reactivity. Results: A total of 114 patients and 14 healthy controls were included in this study. irAEs of grade (G) ≥ 2 occurred in 37/114 patients (32%). We observed a greater number of IgG and IgM reactivities in pre-ICI collections from patients versus healthy controls (62 vs 32 p < 0.001). Patients experiencing irAEs G ≥ 2 demonstrated pre-ICI IgG reactivity to a greater number of AutoAg than patients who did not develop irAEs (39 vs 33 p = 0.040). We observed post-treatment increase of IgM reactivities in subjects experiencing irAEs G ≥ 2 (29 vs 35, p = 0.021) and a decrease of IgG levels after steroids (38 vs 28, p = 0.009). Conclusions: Overall, these results support the potential role of autoAb in irAEs etiology and evolution. A prospective study is ongoing to validate our findings (NCT04107311)

Anthropometric Index and Diet Pattern of Fasting Men in Khvormuj

Background: In the month of Ramadan, the type and amount of received food, sleep patterns, and fluid intake change which could have various effects on people’s health status. To design a proper diet pattern during Ramadan, the exact changes in dietary pattern should be investigated. We aimed to determine the anthropometric index and food pattern after Ramadan of fasting men in Khvormuj. Methods: We included 70 men who decided to fast in the whole month of Ramadan were selected from those who referred to the mosques of Khvormuj to pray before Ramadan. To determine their diet status, the 24-hour dietary recall questionnaire for three days before Ramadan and three days after Ramadan was applied. Their body mass index (BMI) and waist circumference (WC) were measured before and after Ramadan. In order to analyze the diet pattern, NUT4 software and for statistical analysis, SPSS 16 software were used. Results: Mean weights and BMIs of participants before Ramadan were 73.58±11.06 kg, and 23.84±3.51 kg/m2, respectively which reduced to 72.53±11.01 kg, and 23.50±3.46 kg/m2after Ramadan (both P<0.001). The mean WC decreased from 89.45±10.46cm to 88.60±10.66 cm (P=0.004). Mean calorie intake decreased from 2758±547 to 2575±587 Kcal (P=0.16). Also, mean values of protein, fat, and oil decreased and the higher percentage of the total food was obtained from carbohydrates (P=0.001). There were significant changes in consumption pattern of most vitamins and minerals. Conclusion: The changes in the dietary pattern indicate the necessity of educating people about the food groups to prevent overeating

The effect of almonds on anthropometric measurements and lipid profile in overweight and obese females in a weight reduction program: A randomized controlled clinical trial

Background: Due to the wholesome benefits of nuts increased consumption of them has been recommended. However, because of nut′s high energy density, the role of them in the treatment of overweight and obesity is vague. This current clinical trial study aims to investigate the effects of a balanced hypocaloric almond-enriched diet (AED) (almond group) in comparison to a balanced hypocaloric nut-free diet (NFD) (nut-free group) on body weight and cardiovascular disease risk factors in women with body mass index (BMI) >25 for 3-month. Materials and Methods: A total of 108 overweight and obese women were assigned in our 3-month randomized controlled trial. The subjects were randomly divided into two groups regarding a balanced hypocaloric diet with or without almond. The planned reduced calorie diets for both groups were identical except for the almond group who consumed 50 g of almonds daily. Anthropometric and laboratory measurements of the participants who completed the study were made prior to and at the end of the study. Results: A total of 100 subjects completed the study. Weight, BMI, waist circumference, waist to hip circumference ratio, total cholesterol, and triglyceride, total: High density lipoprotein-cholesterol (HDL-C), fasting blood sugar and diastolic blood pressure decreased significantly in the almond group compared to the nut-free group (P > 0.001). Greater reduction in low density lipoprotein-cholesterol (P > 0.002) and systolic blood pressure (P > 0.001) and greater increase in HDL-C (P = 0.001) were found in the nut-free group. Conclusion: The balanced hypocaloric AED in comparison to the balanced hypocaloric NFD led to a greater weight-loss and overall better improvements in studied cardiovascular disease risk factors

The effect of Home Visit during the first six weeks of postpartum on the quality of life of primiparous women referred to Shiraz health centers of Shiraz University of Medical Sciences

Objective. To evaluate the effect of home visitation programs during the first six weeks of postpartum on the quality of life of primiparous women. Methodology. Controlled clinical trial. The 52 primiparous women who were referred to healthcare centers of the University of Shiraz (Iran) were randomly assigned to either an intervention group (n = 26) or a control group (n = 26). An instrument was applied including demographic information and the Specific Postnatal Quality of Life (SPQOL) scale (30 items with Likert-type response options ranging from 0 to 4, the higher the score the better the quality of life). The intervention conducted during the first six weeks of postpartum consisted of an educational program developed during four sessions from 30 minutes to one hour, dealing with topics of nutrition, physical support, ways of having appropriate relations with the spouse, and exercises for the postpartum. During weeks 0 and 6, the SPQOF was applied in both study groups. Results. Both groups were similar regarding the socio-demographic variables. The difference between SPQOL scores from the first and second evaluations was 39.6 in the intervention group versus 6.2 in the control group (p < 0.001). Conclusion. The results from this study indicate that the home visitation program was related to improved quality of life of primiparous women during the first six weeks of postpartum.Objetivo. Avaliar o efeito da visita domiciliária nas seis primeiras semanas de pós-parto na qualidade de vida de mulheres primíparas. Metodologia. Ensaio clinico controlado. As 52 mulheres primíparas que foram remetidas aos centros de saúde da Universidade de Shiraz (Irã) foram atribuídas em forma aleatória ao grupo de intervenção (n=26) ou ao de controle (n=26). Aplicou-se um instrumento que incluía informação demográfica e a escala Specific Postnatal Quality of Life �SPQOL- (30 itens com opções de resposta tipo Lickert que vão de 0 a 4, a maior pontuação major qualidade de vida). A intervenção foi realizada durante as primeiras seis semanas de pós-parto; consistiu num programa educativo desenvolvido em quatro sessões de 30 minutos a uma hora, no que se trataram os temas de nutrição, apoio físico, forma de ter uma apropriada relação com o esposo e exercícios para o pós-parto. Nas semanas 0 e 6 se aplicou a SPQOF nos dois grupos de estudo. Resultados. Ambos grupos foram similares com respeito às variáveis sócio-demográficas. A diferença entre as pontuações de SPQOL da primeira e segunda avaliação foi 39.6 no grupo de intervenção contra 6.2 no grupo controle (p<0.001). Conclusão. Os resultados deste estudo indicam que o programa de visita domiciliária se relacionou com a melhoria na qualidade de vida das mulheres primíparas nas primeiras seis semanas de pós-parto.Objetivo. Evaluar el efecto de la visita domiciliaria en las seis primeras semanas de postparto en a calidad de vida de mujeres primíparas. Metodología. Ensayo clínico controlado. Las 52 mujeres primíparas remitidas a los centros de salud de la Universidad de Shiraz (Irán) fueron asignadas en forma aleatoria al grupo de intervención (n=26) o al de control (n=26). Se aplicó un instrumento que incluía información demográfica y la escala Specific Postnatal Quality of Life �SPQOL- (30 ítems con opciones de respuesta tipo Lickert que van de 0 a 4, a mayor puntaje major calidad de vida). La intervención fue realizada durante las primeras seis semanas de posparto, la cual consistió en un programa educativo desarrollado en cuatro sesiones, de 30 minutos a una hora, en el que se trataron los temas de nutrición, apoyo físico, forma de tener una apropiada relación con su cónyuge y ejercicios para el posparto. En las semanas 0 y 6 se aplicó la SPQOF en los dos grupos de estudio. Resultados. Ambos grupos fueron similares con respecto a las variables sociodemográficas. La diferencia entre los puntajes de SPQOL de la primera y segunda evaluación fue 39.6 en el grupo de intervención versus 6.2 en el grupo control (p<0.001). Conclusion. Los resultados de este estudio indican que el programa de visita domiciliaria se relacionó con la mejoría en la calidad de vida de las mujeres primíparas en las primeras seis semanas de posparto

The effect of Home Visit during the first six weeks of postpartum on the quality of life of primiparous women referred to Shiraz health centers of Shiraz University of Medical Sciences Efecto de la visita domiciliaria en las seis primeras semanas de postparto en la calidad de vida de las mujeres primíparas Efeito da visita domiciliária nas seis primeiras semanas de pós-parto na qualidade de vida das mulheres primíparas

Objective. To evaluate the effect of home visitation programs during the first six weeks of postpartum on the quality of life of primiparous women. Methodology. Controlled clinical trial. The 52 primiparous women who were referred to healthcare centers of the University of Shiraz (Iran) were randomly assigned to either an intervention group (n = 26) or a control group (n = 26). An instrument was applied including demographic information and the Specific Postnatal Quality of Life (SPQOL) scale (30 items with Likert-type response options ranging from 0 to 4, the higher the score the better the quality of life). The intervention conducted during the first six weeks of postpartum consisted of an educational program developed during four sessions from 30 minutes to one hour, dealing with topics of nutrition, physical support, ways of having appropriate relations with the spouse, and exercises for the postpartum. During weeks 0 and 6, the SPQOF was applied in both study groups. Results. Both groups were similar regarding the socio-demographic variables. The difference between SPQOL scores from the first and second evaluations was 39.6 in the intervention group versus 6.2 in the control group (p < 0.001). Conclusion. The results from this study indicate that the home visitation program was related to improved quality of life of primiparous women during the first six weeks of postpartum.<br>Objetivo. Evaluar el efecto de la visita domiciliaria en las seis primeras semanas de postparto en la calidad de vida de mujeres primíparas. Metodología. Ensayo clínico controlado. Las 52 mujeres primíparas remitidas a los centros de salud de la Universidad de Shiraz (Irán) fueron asignadas en forma aleatoria al grupo de intervención (n=26) o al de control (n=26). Se aplicó un instrumento que incluía información demográfica y la escala Specific Postnatal Quality of Life -SPQOL- (30 ítems con opciones de respuesta tipo Lickert que van de 0 a 4, a mayor puntaje major calidad de vida). La intervención fue realizada durante las primeras seis semanas de posparto, la cual consistió en un programa educativo desarrollado en cuatro sesiones, de 30 minutos a una hora, en el que se trataron los temas de nutrición, apoyo físico, forma de tener una apropiada relación con su cónyuge y ejercicios para el posparto. En las semanas 0 y 6 se aplicó la SPQOF en los dos grupos de estudio. Resultados. Ambos grupos fueron similares con respecto a las variables sociodemográficas. La diferencia entre los puntajes de SPQOL de la primera y segunda evaluación fue 39.6 en el grupo de intervención versus 6.2 en el grupo control (p< 0.001). Conclusion. Los resultados de este estudio indican que el programa de visita domiciliaria se relacionó con la mejoría en la calidad de vida de las mujeres primíparas en las primeras seis semanas de posparto.<br>Objetivo. Avaliar o efeito da visita domiciliária nas seis primeiras semanas de pós-parto na qualidade de vida de mulheres primíparas. Metodologia. Ensaio clinico controlado. As 52 mulheres primíparas que foram remetidas aos centros de saúde da Universidade de Shiraz (Irã) foram atribuídas em forma aleatória ao grupo de intervenção (n=26) ou ao de controle (n=26). Aplicou-se um instrumento que incluía informação demográfica e a escala Specific Postnatal Quality of Life -SPQOL- (30 itens com opções de resposta tipo Lickert que vão de 0 a 4, a maior pontuação major qualidade de vida). A intervenção foi realizada durante as primeiras seis semanas de pós-parto; consistiu num programa educativo desenvolvido em quatro sessões de 30 minutos a uma hora, no que se trataram os temas de nutrição, apoio físico, forma de ter uma apropriada relação com o esposo e exercícios para o pós-parto. Nas semanas 0 e 6 se aplicou a SPQOF nos dois grupos de estudo. Resultados. Ambos grupos foram similares com respeito às variáveis sócio-demográficas. A diferença entre as pontuações de SPQOL da primeira e segunda avaliação foi 39.6 no grupo de intervenção contra 6.2 no grupo controle (p<0.001). Conclusão. Os resultados deste estudo indicam que o programa de visita domiciliária se relacionou com a melhoria na qualidade de vida das mulheres primíparas nas primeiras seis semanas de pós-parto

The Effect of an Educational Program Based on Protection Motivation Theory on Pap Smear Screening Behavior among Women Referring to Health Centers in Fasa

Background and Objectives: Despite the importance of pap smear in reducing the incidence of cervical cancer and its death, this cancer is still one of the leading causes of death among women around the world. Accordingly, in this study, we aimed to determine the effect of an educational program based on the protection motivation theory on Pap smear screening behavior. Materials and Methods: This quasi-experimental study was conducted on 200 women referring to Fasa health centers, Fasa, Iran. The participants were randomized into experimental and control groups (n=100 per group). The data collection tool, which consisted of demographic data and protection motivation theory constructs, was completed by both groups before and 2 months after the intervention. For the experimental group, the educational program was implemented during 4 sessions using group discussions and educational pamphlets. To analyze the data, chi-square test, independent t-test, and paired t-test were run in SPSS, version 22. Results: After the intervention, the mean scores of protection motivation theory constructs significantly increased in the experimental group compared to the control group (P<0.001). However, no significant difference was noted between the two groups regarding the response efficacy construct at the post-intervention stage (P=0.552). In addition, after the intervention, the rate of conducting Pap smear test significantly incremented in the experimental group (58%). Conclusions: The study results revealed the effectiveness of the educational intervention based on protection motivation theory in promoting Pap smear screening behavior. Therefore, we recommend designing educational interventions based on this theory to promote public health, especially in women

Prediction of positive social behaviors based on norm-activation model in female students

Keeping order in the classroom, modifying students’ behavioral problems, and implementing regulations codified at schools are among the issues in education involving the minds of headmasters and teachers. Following adolescence appropriate behavioral patterns plays a key role in bringing about the adolescents’ positive social behavior. This study aimed to investigate the predictors of adolescents’ positive social behavior using the Norm Activation Model (NAM). This study was conducted on 200 female students between 12 and 13 years old studying in the third educational district of Shiraz, Iran, that were selected through cluster random sampling method. The study data were collected as self-report using a questionnaire composed of demographic items and items measuring positive social behavior based on NAM. The findings showed that among the NAM constructs, personal norm was the strongest predictor of positive social behavior followed by awareness of consequences and ascription of responsibility. The relation of awareness of consequences to birth order, ascription of responsibility to father’s occupation and birth order, personal norm to father’s occupation, number of brothers, and birth order, and positive social behavior to number of brothers, birth order, non-classmate friends, and number of intimate non-classmate friends was statistically significant. It was concluded that NAM could be utilized to predict the factors affecting positive social behavior. Moreover, the results can be used by authorities and policymakers to develop appropriate plans and behavioral interventions

The effects of teaching stress management skills on the quality of life in ICU nurses

Introduction: Job stress is one of the main factors in decreasing productivity in organizations and the leading cause of psychosomatic disorders in personnel. Since job stress of nurses working in Intensive Care Units (ICUs) is considered as an important segment in health and medical systems, it significantly affects the quality of care and the nurse’s quality of life. To this end, the purpose of this research is to examine the effects of teaching stress management skills on the quality of life of the nurses working at ICU of the hospitals affiliated to Shiraz University of Medical Sciences. Methods: The subjects of the study consisted of 60 ICU nurses with the average stress score in Osipow job stress exam working at the hospitals affiliated to Shiraz University of Medical Sciences. The subjects were randomly assigned to two groups (30 in the case and 30 in the control group). The intervention was performed as a teaching stress management workshop for eight hours throughout two-days (four hours per day), and the nurses were followed up for two months. The data were collected through a two part questionnaire including demographic characteristics and WHO Quality of life BREF and were analyzed in SPSS software using paired t test, and t-test. Results: The findings showed that the nurses of both the case and control groups were homogeneous considering the demographic data such as age, sex, marital status, number of children, shift position, job satisfaction, number of working hours per week, work experience and the amount of income. Moreover, there was no significant difference between the mean score of the life quality before the intervention in both groups. But after the intervention, a significant increase was revealed in the mean score of the life quality of the case group as compared to that of the control group (P<0.0001). Conclusion: The findings revealed the efficacy of the stress management workshop in improving the life quality of ICU nurses. During one and two months after the intervention, the mean score of the quality of life had a significance increase compared to the stage before the interventio

Application of Seemingly Unrelated Regression in Medical Data with Intermittently Observed Time-Dependent Covariates

Background. In many studies with longitudinal data, time-dependent covariates can only be measured intermittently (not at all observation times), and this presents difficulties for standard statistical analyses. This situation is common in medical studies, and methods that deal with this challenge would be useful. Methods. In this study, we performed the seemingly unrelated regression (SUR) based models, with respect to each observation time in longitudinal data with intermittently observed time-dependent covariates and further compared these models with mixed-effect regression models (MRMs) under three classic imputation procedures. Simulation studies were performed to compare the sample size properties of the estimated coefficients for different modeling choices. Results. In general, the proposed models in the presence of intermittently observed time-dependent covariates showed a good performance. However, when we considered only the observed values of the covariate without any imputations, the resulted biases were greater. The performances of the proposed SUR-based models in comparison with MRM using classic imputation methods were nearly similar with approximately equal amounts of bias and MSE. Conclusion. The simulation study suggests that the SUR-based models work as efficiently as MRM in the case of intermittently observed time-dependent covariates. Thus, it can be used as an alternative to MRM