Trend of stunting, overweight and obesity among children under five years in a rural area in Northern Iran, 1998–2013: Results of three cross-sectional studies

Background: Obesity is a common health problem in the world and the purpose of this study was to identify the trend of overweight, obesity and stunting among children under five from 1998 to 2013 that was carried out in three stages in the villages of Golestan province in the northern Iran (south east of the Caspian Sea). Methods: Three cross-sectional studies with sample sizes of 7575, including 2339, 2749 and 2487 cases were carried out in 1998, 2004 and 2013, respectively. Among 118 villages, 20 were chosen by random sampling and all of the under-five-children in these villages were assessed. For all subjects, a questionnaire was completed and anthropometric indices were measured. Z-score was used for body index classification with following categories: Z ≤ 2SD=Normal or under-nutrition; >2SD Z ≤3SD = Overweight and Z>3SD = Obesity. P-value under 0.05 indicated significance. Results: In 1998, 2004 and 2013, the prevalence of overweight was 8.5% (95% Cl; 7.3–9.6), 3.3% (95% Cl; 2.7–4.0) and 5.2% (95% Cl; 4.2–6.1), that of obesity was 4.6%(95% Cl; 3.8–3.5), 1.2% (95% Cl; 0.8–1.6) and 3.5% (95% Cl; 2.8–4.3), and that of stunting was 32.8% (95% Cl; 31.0–34.6), 13.4% (95% Cl; 12.2–14.6) and 15.7% (95% Cl;14.3–17.2), respectively. In boys, the mean of height was significantly different in all age groups while the mean of weight was significant only at ages 13–24, 37–48 and 49–60 months (P< 0.005 for all). In girls, the mean of height significantly different from 36 months age (P < 0.01) whereas weight difference was significant only at age of 37–48 months (P = 0.002). Conclusion: A heterogenic trend was seen in stunting, overweight and obesity. Although short stature was the main cause of obesity in 1998, extra weight was its major cause in 2013. Renewed increase of obesity among children under-five is considerable in the northern Iran. © 2016, Academy of Medical Sciences of the I.R. Iran

Possibilities to Improve the Therapy of the Patients with Ureteral Concretions

The aim of the given study was to improve the results of treatment of patients with concretions of the upper third of the ureter.Materials and methods. The clinical trial was carried out as a non-interventional open, controlled, in two groups of patients with baseline control. The inclusion criteria concerned the patients with concretions of the upper third of the ureter 0.7-0.9 mm in size, which had one session of an extracorporeal shock-wave lithotripsy (ESWL), and after the procedure the size of the concretions fragments was up to3 mm. The study involved 60 patients, all patients in the main group (n = 30) were treated using phytotherapy, within 1 month starting with basic therapy under hospital conditions and continuing with preventative treatment in an outpatient setting. The control group (n = 30) received baseline therapy (up to 10 days) at the stationary stage. Results and discussion. In patients of the main group, fragments of concretions came out significantly faster, namely: in the main group, the fragments came out in 21 patients (70.0 %), while in the control group in 15 patients (50.0 %) (p1- p2, p &lt;0.05) to the 7th day, and in the main group, the fragments came out in one patient more than 14 days, and in the control group – in 5 patients, p &lt;0.05. The "stone path" in the bottom third of the ureter was in 1 patient (3.3 %) of the main group and in 3 patients (10.0 %) in the control group (p1-p2, p &lt;0.05). The "stone path" departure time in patients of the main group was 2 days, and in patients of the control group it was 4.1 days from the time of its formation (p1-p2, p &lt;0.05). Bacteriuria was observed in the main group on the 10th day 6.6 % less relative to the control group.Conclusion. At comparing the obtained results in patients of both groups in 1 month it was noted that high efficacy of the treatment was registered in 6 (20 %) patients of the main group and in 3 patients (10 %) of the control group (p &lt;0.05), moderate efficiency was registered in 23 (76.7 %) patients of the main group and in 22 (73.3 %) patients of the control group respectively, low efficacy was registered in 1 (3.33 %) patient in the main group and 5 (16.7 %) patients of the control group (p &lt;0,05), which points to the effectiveness of Urolesan capsules use in complex therapy of patients with concretions of the one third of ureter

The effect of individual counseling, line follow-up, and free nicotine replacement therapy on smoking cessation in the samples of Iranian smokers: Examination of transtheoretical model

Background: According to transtheoretical model(TTM), Stage matched interventions are more effective in quitting. The objective of current study was to investigate the effect of individual counseling, line follow-up, and free nicotine replacement therapy(NRT) on smoking cessation in smokers who are in preparation stage of smoking. Materials and Methods: In a randomized clinical trial design, through sending the short message system, potential participants in preparation stage of smoking were recruited and divided into control(n=60)and treatment(n=50) groups. The treatment group received an in-person counseling, line follow-up, and free NRT. TTM variables trend; pros and cons of smoking, behavioral and experiential processes, temptation, were assessed at baseline, 3 and 6months follow-up along with point prevalence and continuous abstinence. Results: Continuous abstinence at 6-month follow-up were 3.3%(n=2) in control group and 46%(n=23) in the treatment group(x 2 = 34.041, P &lt; 0.001). Time � group analyses indicated that except cons of smoking (P &gt; 0.05), all TTM constructs had significantly changed; temptation(F=36.864, P&lt;0.001), pros (F=12.172, P&lt;0.001), experiential processes(F=3.377, P&lt;0.001), and behavioral processes(F=11.131, P&lt;0.001). Conclusion: Interventions based on TTM variables increased the quite rate in prepared and motivated people. Our findings suggest that interventions through individual counseling along with free NRT and line follow-up in people who prepare for quitting are beneficial for our country

Knowledge, attitude and practice of urban and ruarl households towards principles of nutrition in Iran: results of NUTRIKAP Survey.

Background: The aim of this study was to assess knowledge, attitude and practice of urban and rural households toward principles of nutrition in Iran. Methods: The study population was Iranian households who live in rural and urban areas in all provinces of the country. The sampling method at households’ level in each province was single stage cluster sampling with equal size clusters. The incumbent data was collected by a structured questionnaire and through the interview with the eligible subject in each household. Results: A total of 14,136 Iranian households were selected as total sample size, 9,149 urban households, and 4,987 rural households. Around 57.2% of urban and 49.5% of rural households was aware of food groups. Respectively in urban and rural households, about 35.1% and 39.7% had correct knowledge toward roles of food groups. Approximately 41.5% and 39.9% of households had accurate knowledge about reason of food eating in urban and rural areas, respectively. The results showed that 79.6% of them had favorable attitudes. The most of the households consumed red meat and poultry weekly whereas fish was eaten rarely. Fruits, vegetables and dairy were consumed daily in the most of households. Sugar intake was daily in the most of households and cream and butter intake was weekly. Conclusion: The most of households had moderate knowledge and good attitudes. Practice of families about food consumption was good. The results of this study can be used for proper intervention for improving of health society

Determinants of physical activity promotion by smoking cessation advisors as an aid for quitting: Support for the Transtheoretical Model

Objectives: Physical activity (PA) can reduce cigarette cravings and aid quitting but little is known about its promotion by smoking cessation advisors. This study aimed to: (1) determine the extent to which smoking cessation advisors promote PA; and (2) examine the relationship between PA promotion as a cessation aid and advisor characteristics and cognitions, within the Transtheoretical Model (TM) framework. Methods: Self-report surveys assessing PA promotion, TM variables, advisors’ own PA levels and demographics were completed by 170 advisors in England and Scotland. Results: Advisors reported spending 29 minutes promoting PA over a 6/7-week clinic. Those in later stages of readiness for promoting PA as a cessation aid and those spending more time promoting PA held more positive beliefs regarding pros and cons, self-efficacy, outcome efficacy and importance of PA within smoking cessation. Time spent promoting PA and stage of readiness were strongly associated. There was a trend for the more physically active advisors to promote PA more often. Conclusions: About half the advisors promoted PA and TM variables predicted this variability. Practice Implications: PA promotion among smoking cessation advisors may be facilitated by enhancing self-efficacy, outcome efficacy and pro and con-beliefs related to PA promotion

Equalities in Scotland’s Growth Economic Sectors: Final Report

Aims The purpose of the study was to examine equality issues in Scotland’s growth sectors since baseline research carried out in 2009, focusing on trends in the following protected characteristics: gender; age; disabilities; ethnic minorities; gender reassignment; marital and civil partnership status; maternity and pregnancy; religion and belief; and sexual orientation. Scotland’s growth sectors are identified as: creative industries; energy; financial and business services; food and drink; life sciences; tourism; universities; chemical sciences; construction; engineering; and ICT and digital technologies. Methods The methodology primarily consisted of analysis of a range of datasets, including the Annual Population Survey, (APS) to establish the representation of individuals with protected characteristic in each growth sector; the FAME database, to establish the representation of women, young people and older people among company directors; data from Skills Development Scotland and the Scottish Funding Council on the supply of labour into the growth sectors from the protected characteristics, in terms of Modern Apprenticeship starts, college enrolments and university entrants; and key research published since 2010 on the representation of protected characteristics in the growth sectors and, where available, the factors that are driving this. Information was also collated from a small number of organisations that work with individuals with protected characteristics in order to supplement the desk-based research where there was no or limited data or literature available. Findings The report suggests that no overarching trends can be identified. The representation of individuals with some protected characteristics in the workforce is increasing, but it is declining for others. It also indicates mixed findings on a sector-by-sector basis, with sectors often making progress on the representation of some equalities groups within their workforce whilst experiencing a decline in others. The recession is highlighted as a key factor as, due to the issues faced by many protected characteristics in relation to the labour market, groups such as young people, disabled people and ethnic minorities have experienced disproportionate decreases in employment and increases in unemployment. The creative industries was found to be the sector that is most open to individuals with protected characteristics, while, with the exception of older workers, all groups were found to be underrepresented in the energy sector. Recommendations The report notes that, as the representation of individuals from equalities groups varies across growth sectors, there is a need to customise responses by sector. It is also suggested that in order that individuals from protected characteristics are able to access the good quality employment opportunities that the growth sectors offer, efforts must be made to tackle underrepresentation where it exists and that a key element of this must be to ensure better representation of individuals with protected characteristics on Modern Apprenticeships, and on college or university courses, that lead to careers in these sectors. The report argues that increasing the representation of protected characteristics within the sector is not sufficient, however, and efforts must also be deployed to tackling pay gaps, occupational segregation and the lack of progression into management and leadership roles

Access to HIV care in the context of universal test and treat: challenges within the ANRS 12249 TasP cluster-randomized trial in rural South Africa

Introduction: We aimed to quantify and identify associated factors of linkage to HIV care following home-based HIV counselling and testing (HBHCT) in the ongoing ANRS 12249 treatment-as-prevention (TasP) cluster-randomized trial in rural KwaZulu-Natal, South Africa. Methods: Individuals ]16 years were offered HBHCT; those who were identified HIV positive were referred to cluster-based TasP clinics and offered antiretroviral treatment (ART) immediately (five clusters) or according to national guidelines (five clusters). HIV care was also available in the local Department of Health (DoH) clinics. Linkage to HIV care was defined as TasP or DoH clinic attendance within three months of referral among adults not in HIV care at referral. Associated factors were identified using multivariable logistic regression adjusted for trial arm. Results: Overall, 1323 HIV-positive adults (72.9% women) not in HIV care at referral were included, of whom 36.9% (n488) linked to care B3 months of referral (similar by sex). In adjusted analyses (n1222), individuals who had never been in HIV care before referral were significantly less likely to link to care than those who had previously been in care (B33% vs. 42%, pB0.001). Linkage to care was lower in students (adjusted odds-ratio [aOR] 0.47; 95% confidence interval [CI] 0.240.92) than in employed adults, in adults who completed secondary school (aOR0.68; CI 0.490.96) or at least some secondary school (aOR0.59; CI 0.410.84) versus 5 primary school, in those who lived at 1 to 2 km (aOR0.58; CI 0.440.78) or 25 km from the nearest TasP clinic (aOR0.57; CI 0.410.77) versus B1 km, and in those who were referred to clinic after ]2 contacts (aOR0.75; CI 0.580.97) versus those referred at the first contact. Linkage to care was higher in adults who reported knowing an HIV-positive family member (aOR1.45; CI 1.121.86) versus not, and in those who said that they would take ART as soon as possible if they were diagnosed HIV positive (aOR2.16; CI 1.134.10) versus not. Conclusions: Fewer than 40% of HIV-positive adults not in care at referral were linked to HIV care within three months of HBHCT in the TasP trial. Achieving universal test and treat coverage will require innovative interventions to support linkage to HIV care

Highlights of Fifteenth Day Enrollment for the Spring Term 2020

This item contains information on student enrollment. It includes information on such topics as enrollment by campus, credits per student, and enrollment by student demographics

Health Expenditure Scenarios in the New Member States – Comparative Report on Bulgaria, Estonia, Hungary, Poland and Slovakia. ENEPRI Research Reports No. 43, 19 December 2007

The objective of this comparative report is to present the model of future health care system revenues and expenditures in selected Central and Eastern European countries which are now the new EU member states, and to discuss projection assumptions and results. Health expenditure analysis and projections are based on the ILO social budget model, a part of which is the health budget model. The model covers health care system revenues and expenditures. It is suitable for the analysis of impact exerted by demography (especially ageing) on health care system revenues and expenditures. The objective of AHEAD project is to examine those factors. Up to date, data and information sources in new member states that could be used for the long-term comparative projections have been limited

A Fibreoptic Endoscopic Study of Upper Gastrointestinal Bleeding at Bugando Medical Centre in Northwestern Tanzania: a Retrospective Review of 240 Cases.

Upper gastrointestinal (GI) bleeding is recognized as a common and potentially life-threatening abdominal emergency that needs a prompt assessment and aggressive emergency treatment. A retrospective study was undertaken at Bugando Medical Centre in northwestern Tanzania between March 2010 and September 2011 to describe our own experiences with fibreoptic upper GI endoscopy in the management of patients with upper gastrointestinal bleeding in our setting and compare our results with those from other centers in the world. A total of 240 patients representing 18.7% of all patients (i.e. 1292) who had fibreoptic upper GI endoscopy during the study period were studied. Males outnumbered female by a ratio of 2.1:1. Their median age was 37 years and most of patients (60.0%) were aged 40 years and below. The vast majority of the patients (80.4%) presented with haematemesis alone followed by malaena alone in 9.2% of cases. The use of non-steroidal anti-inflammatory drugs, alcohol and smoking prior to the onset of bleeding was recorded in 7.9%, 51.7% and 38.3% of cases respectively. Previous history of peptic ulcer disease was reported in 22(9.2%) patients. Nine (3.8%) patients were HIV positive. The source of bleeding was accurately identified in 97.7% of patients. Diagnostic accuracy was greater within the first 24 h of the bleeding onset, and in the presence of haematemesis. Oesophageal varices were the most frequent cause of upper GI bleeding (51.3%) followed by peptic ulcers in 25.0% of cases. The majority of patients (60.8%) were treated conservatively. Endoscopic and surgical treatments were performed in 30.8% and 5.8% of cases respectively. 140 (58.3%) patients received blood transfusion. The median length of hospitalization was 8 days and it was significantly longer in patients who underwent surgical treatment and those with higher Rockall scores (P < 0.001). Rebleeding was reported in 3.3% of the patients. The overall mortality rate of 11.7% was significantly higher in patients with variceal bleeding, shock, hepatic decompensation, HIV infection, comorbidities, malignancy, age > 60 years and in patients with higher Rockall scores and those who underwent surgery (P < 0.001). Oesophageal varices are the commonest cause of upper gastrointestinal bleeding in our environment and it is associated with high morbidity and mortality. The diagnostic accuracy of fibreoptic endoscopy was related to the time interval between the onset of bleeding and endoscopy. Therefore, it is recommended that early endoscopy should be performed within 24 h of the onset of bleeding