Demographic, Life Style and Job-Related Determinants of Quality of Life of Industrial Manufacturing Employees: An Application of Multilevel Latent Class Regression on a Large Cross-Sectional Study

BACKGROUND: Employees are one of the key elements of an organization and measure the quality of life (QoL) provides reliable assessment of health and wellbeing in this population. This study aimed at investigating the QoL in a large sample of Iranian industrial manufacturing employees and its determinants.METHODS: In a cross-sectional study conducted was in 2015, 3063 people were selected among 16000 Esfahan Seal Company's employees using multistage cluster sampling. QoL was evaluated by EQ-5D questionnaire, mental health by GHQ-12, physical activity by IPAQ, job stress by Effort–Reward Imbalance questionnaire. Self-report questionnaire was used for gathering demographic characteristics. Multilevel latent class regression analysis was used for data analysis using R (3.4.3).RESULTS: The mean (SD) age of the study participants was 36.74 (7.31), and 91.5% of them were males. The mean (SD) sleep duration was 7.11 (1.17), and 95.4% of the participants had normal mental health. Latent class analysis classified employees into two classes (high (82.4%) and low QoL (17.6%)). Also employees’ job categories classified into high and low QoL classes (79.55% and 20.45%, respectively). Latent class regression showed that lower age (OR=0.93; P< 0.0001), being male (OR=1.75; p=0.009), lower levels of education (OR=2.1; P< 0.0001), normal mental health (OR=12.4; P< 0.0001), higher sleep duration (OR=1.2; P< 0.0001) and lower BMI (OR=0.96; P=0.016) were significant predictors of being in high QoL class.CONCLUSION: Our study provides data about the QoL of industrial manufacturing employees along with its significant determinants. The findings picture the ways for improving QoL, finally increasing the efficiency and productivity of workforce by directing health policies appropriately.

Parenteral immunonutrition in patients with acute pancreatitis: A systematic review and meta-analysis

Background & aims: Acute pancreatitis is a systemic immunoinflammatory response to auto-digestion of the pancrease and peri-pancreatic organs. Patients with acute pancreatitis can rapidly develop nutritional deficiency; hence nutritional support is important and critical. Sometimes parenteral nutrition (PN) is inevitable in acute pancreatitis. Due to immunosuppressive and inflammatory nature of the disease, it seems that immunonutrients like glutamine and omega-3 fatty acids (u-3 FAs) added to parenteral formulas may improve the conditions. We conducted a meta-analysis to evaluate the effects of parenteral immunonutrition on clinical outcomes (infectious complications, length of hospital stay (LOS) and mortality) in patients with acute pancreatitis. Methods: A computerized literature search on four databases (PubMed, Cochrane, ISI Web of Science, and Iran Medex) was performed to find all the randomized controlled trials (RCTs) assessed the effects of parenteral immunonutrition in acute pancreatitis. Necessary data were extracted and quality assessment of RCTs was performed with consensus in the study team. Fixed effects model was used to conduct the meta-analysis. Results: One hundred and ninety four references were found via our search in which 7 articles matched our criteria for enrolling the meta-analysis. Parenteral immunonutrition significantly reduced the risk of infectious complications (RR ¼ 0.59; 95% CI, 0.39e0.88; p 0.05) and mortality (RR ¼ 0.26; 95% CI, 0.11 e0.59; p 0.001). LOS was also shorter in patients who received immunonutrition (MD ¼ 2.93 days; 95% CI, e4.70 to 1.15; p 0.001). Conclusion: Immunonutrients like glutamine and u-3 FAs added to parenteral formulas can improve prognoses in patients with acute pancreatitis. © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved. 1

The Impacts of Hinged and Solid Ankle-Foot Orthoses on Standing and Walking in Children with Spastic Diplegia

How to Cite This Article: Dalvand H, Dehghan L, Feizi A, Hosseini SA, Amirsalari S. Iran J Child Neurol. 2013 Autumn; 7(4):12-19.AbstractObjective The purpose of this study was to examine the impacts of hinged and solid anklefoot orthoses (AFOs) on standing and walking abilities in children with spastic diplegia.Materials & MethodsIn a quasi-experimental design, 30 children with spastic diplegia, aged 4-6 years were recruited. They were matched in terms of age, IQ, and level of GMFCS E&R. Children were randomly assigned into 3 groups: a hinged AFO group (n=10) plus occupational therapy (OT), a solid AFO group (n=10) plus OT, a control group who used only OT for three months. Gross motor abilities weremeasured using Gross Motor Measure Function (GMFM).ResultsWe obtained statistically significant differences in the values between baseline and after treatment in all groups. The groups were also significantly different in total GMFM after intervention. Furthermore, there were differences between hinged AFOs and solid AFOs groups, and between hinged AFOs and control groups.ConclusionWe concluded that gross motor function was improved in all groups; however, hinged AFOs group appears to improve the gross motor function better than solid AFOs and control groups.ReferencesMiller F. Cerebral palsy. 1st ed. New York: Springer Science & Business Media; 2005.Wren TL, Rethlefsen S, Kay RM. Prevalence of specific gait abnormalities in children with cerebral palsy: Influence of cerebral palsy subtype, age, and previous surgery. J Pediat Orthoped 2005;25(1):79-83.Knutosn L, Clark D. Orthotic devices for ambulation in children with cerebral palsy and myelomeningocele. Phys Ther 1991;71:947-60.Figueiredo EM, Ferreira GB, Maia Moreira RC, Kirkwood R, Fetters L. Efficacy of Ankle-Foot Orthoses on Gait of Children with Cerebral Palsy: Systematic Review of Literature. Pediat Phys Ther 2008; 20(3):207-23.Brehm MA, Harlaar J, Schwartz M. Effect of ankle-foot orthoses on walking efficiency and gait in children with cerebral palsy. J Rehabil Med 2008;40(7):529-34.Abel MF, Juhl GA,Vaughan CL, Damiano DL. Gait assessment of fixed ankle-foot orthoses in children with spastic diplegia. Arch Phys Med Rehabil 1998;79(2):126-33.Balaban B, Yasar E, Dal U, Yazicioglu K, Mohur H, Kalyon TA. The effect of hinged ankle-foot orthosis on gait and energy expenditure in spastic hemiplegic cerebral palsy. Disabil Rehabil 2007;29(2):139-44.Wilson H, Haideri N, Song K, Telford D. Ankle-foot orthoses for preambulatory children with spastic diplegia. J Pediat Orthoped 1997;17(3):370-6.Romkes J, Hell AK, Brunner R. Changes in muscle activity in children with hemiplegic cerebral palsy while walking with and without ankle-foot orthoses. Gait Posture 2006;24(4):467-74.Radtka SA, Skinner SR, Dixon DM, Johanson ME. A comparison of gait with solid, dynamic, and no ankle-foot orthoses in children with spastic cerebral palsy. Phys Ther 1997;77(4):395-409.Radtka SA, Skinner SR, Johanson ME. A comparison of gait with solid and hinged ankle-foot orthoses in children with spastic diplegic cerebral palsy. Gait Posture 2005;21:303-10.Hayek S, Hemo Y, Chamis S, Bat R, Segev E, Wientroub S, et al. The effect of community prescribed ankle–foot orthoses on gait parameters in children with spastic cerebral palsy. J Children’s Orthoped 2007;1(6):325-32.Burtenr PA, Woollactt MM, Qualls C. Stance balance control with orthoses in a group of children with spastic cerebral palsy. Dev Med Child Neurol 1999;41(11):748-57.Bjornson KF, Schmale GA, Adamczyk-Foster A, McLaughlin J. The effect of dynamic ankle foot orthoses on function in children with cerebral palsy. J Pediat Orthoped 2006;26(6):773-6.Hassani S, Ferdjallah M, Reiners K, Johnson C, Smith P, Harris G. Motor performance comparison of the hinged and dynamic ankle-foot orthotics. Dev Med Child Neurol 2002;44(91):4.Smith PA, Hassani S, Graf A, Flanagan A, Reiners K. Brace evaluation in children with diplegic cerebral palsy with a jump gait pattern. J Bone Joint Surg Am 2009;91(2):356-65.Zhang J, Wang Y, Yang Z. Comparison of dynamic and solid ankle-foot orthosis configurations for cerebral palsy children with spastic diplegia. Chine J Rehabil Med 2009;24(1):45-8.Case Smith J. Occupational therapy for children. 5th ed. Michigan: Elsevier Mosby; 2005.Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997; 39(4):214–23.Wood E, Rosenbaum P. The gross motor function classification system for cerebral palsy: a study of reliability and stability over time. Dev Med Child Neurol 2000;42(5):292-6.Dehghan L, Dalvand H, Abdolvahab M, Bagheri H, Faghih zade S. Inter rater reliability of Persian version Gross Motor Function Classification System Expanded & Revised in patients with cerebral palsy. Bimonthly Official Publication Medical Daneshvar 2011;18(91):2-8.Russell DJ, Rosenbaum PL, Avery LM, Lane M. Gross Motor Function Measure (GMFM’66&GMFM’88) user’s manual. 1st ed: London; Mac Keith Press; 2002.Russell DJ, Goster JW. Assessing functional differences in gross motor skills in children with cerebral palsy who use an ambulatory aid or orthoses: can the GMFM-88 help? Dev Med Child Neurol  2005;47(7):462-7.Drouin LM, Malouin F, Richards CL, Marcoux S. Correlation between the gross motor function measure scores and gait spatiotemporal measures in children with neurological impairments. Dev Med Child Neurol 1996;38(11):1007-19.Buckon CE, Thomas SS, Jakobson-Huston S, Sussman M, Aiona M. Comparison of three ankle-foot orthosis configurations for children with spastic hemiplegia. Dev Med Child Neurol 2001;43(6):371-8.Middleton EA, Hurley GRB, McIlwain JS. The role of rigid and hinged polypropylene ankle-foot-orthoses in the management of cerebral palsy: A case study. Prosthetics and Orthotics International 1988;12(3):129-35.Rethlefsen S, Kay R, Dennis S, Forstein M, Tolo V. The effects of fixed and articulated ankle-foot orthoses on gait patterns in subjects with cerebral palsy. J Pediat Orthoped 1999;19(4):470-4.Neumann DA. Kinesiology of the musculoskeletal system foundations for physical rehabilitation. 1st ed. Michigan: Mosby; 2002.Buckon CE, Thomas SS, Jakobson-Huston S, Moor M, Sussman M, Aiona M. Comparison of three ankle-foot orthosis configurations for children with spastic diplegia. Dev Med Child Neurol 2004;46(9):590-8.Rodda JM, Graham HK, Carson L, Galea MP, Wolfe R. Sagittal gait patterns in spastic diplegia. J Bone Joint Surg Br 2004;86(2):251-8

Assessing Awareness Level about Warning Signs of Cancer and its Determinants in an Iranian General Population

The present study was aimed at investigating the awareness level about warning signs of cancer and its determinants in an Iranian general population. This cross-sectional interview-based survey investigated 2,500 people aged 18 years and over, as a representative sample of Tehran population. Latent class regression was applied for analyzing data. A small (18.8%) proportion of the respondents had high level of knowledge, and 54.5% had moderate awareness, and 26.7% had low level of awareness. Most effective predictors for awareness were educational attainment, sex, and marital status. The findings suggest that the overall level of knowledge about warning signs of cancer among the public is low, particularly about some specific signs. Accordingly, educational and intervention programmes, with special attention placed on particular at-risk populations, to increase awareness about the disease leading to its early diagnosis are needed

The effect of synbiotic supplementation on body composition and lipid profile in patients with NAFLD: A randomized, double blind, placebo-controlled clinical trial study

Background: Regarding the growing prevalence of non-alcoholic fatty liver disease, concentrating on various strategies for its prevention and management seems necessary. Objectives: This study aimed to assess the effects of synbiotic administration on body composition and lipid profile in patients with NAFLD. Methods: Eighty patients with NAFLD participated in this randomized, double-blind, placebo-controlled clinical trial (from March to July 2014) in Iran. Based on AST and ALT as main variables of the study, 34 patients were required in each group (power 80% and α = 5%). Considering a 20% sample loss, 80 patients were enrolled. Synbiotic supplement in form of a 500 mg capsule (containing 7 species of probiotic bacteria and Fructooligosaccharides) was administrated to patients in the intervention group and those in the placebo group received 1 placebo capsule daily for 8 weeks. At the baseline and the end of the study, body composition and lipid profile were evaluated. Results: A significant reduction was observed in weight (P = 0.001), body fat (P = 0.02), and total cholesterol (P = 0.04) within the synbiotic group. Onthe other hand,WC(P = 0.02), total cholesterol, and LDL-c (P = 0.04 and P = 0.001, respectively) were significantly increased in the placebo group. TG, HDL-c, and FBG levels remained statistically unchanged in both groups. Significance betweengroup differences were seen in total cholesterol (P = 0.01), LDL (P = 0.01), weight, WC, and body fat after adjustment for energy intake (P = 0.05). Conclusions: Synbiotic supplementation may improve lipid profile and body composition in patients with NAFLD and might be useful in prevention of the disease progression

PERSONALITY TRAITS ARE DIFFERENTLY ASSOCIATED WITH DEPRESSION AND ANXIETY: EVIDENCE FROM APPLYING BIVARIATE MULTIPLE BINARY LOGISTIC REGRESSION ON A LARGE SAMPLE OF GENERAL ADULTS

Background: The purpose of this study was to explore the association of five factors personality traits, as predictor variables, with the anxiety and depression as joint dependent variables in an Iranian adult population. Subjects and methods: A total of 3175 subjects living in Isfahan participated in this cross-sectional population-based “study (SEPAHAN) and completed self-administered questionnaires about demographic, life style, gastrointestinal disorders, personality traits, social support, and psychological problems. Data was analyzed using bivariate multiple binary logistic regression in R Free statistical software. Results: The results indicated high scores of neuroticisms increase the risk of anxiety and depression after adjustment for the potential confounders in total sample (OR (95% CI): 1.22 (1.19-1.24) and 1.19 (1.17-1.21), respectively) as well as in both male and female. In contrast, joint inverse associations were found between anxiety and depression with high extraversion (OR (95% CI): 0.90 (0.88-0.92) and 0.91 (0.89-0.92), respectively), agreeableness (0.93 (0.91-0.96) and 0.94 (0.92-0.96) respectively) and conscientiousness scores (0.95 (0.93-0.97) and 0.95 (0.94-0.97) respectively) as well as in both male and female. Furthermore, higher scores of openness had significant inverse association with depression in male. Conclusion: The present study indicated that higher scores of neuroticism, however lower extraversion, conscientiousness and agreeableness scores are risk factors for both anxiety and depression in Iranian adult population. It is suggested to perform family studies or twin and genetic association studies with considering combinations of personality traits (personality styles), and also measuring personality traits at the facet level

Mutations of Dual Oxidase 2 (DUOX2) Gene among patients with Permanent and Transient Congenital Hypothyroidism

Objective: The prevalence of congenital hypothyroidism (CH) is high in Isfahan, Iran. In addition, it has different etiologies compared with other countries. The rate of parental consanguinity is also high in the city. Moreover, DUOX2 gene is effective in transient CH and permanent CH due to dyshormonogenesis. Therefore, the aim of this research was to investigate the mutations of DUOX2 gene in patients with transient CH and permanent CH due to dyshormonogenesis. Methodology: In this descriptive, prospective study, patients diagnosed with transient and permanent CH due to dyshormonogenesis during CH screening program were selected. Venous blood samples were obtained to determine the 3 mutations (Q36H, R376W, and D506N) of DUOX2 gene using polymerase chain reaction (PCR) method by specific primers and complementary methods such as restriction fragment length polymorphism (RFLP) and singlestrand conformation polymorphism (SSCP). Results: In this study, 25 patients with transient CH and 33 subjects with permanent CH due to dyshormonogenesis were studied. In addition, 30 children were studied as the control group. We did not find any mutations of the 3 mentioned mutations of DUOX2 gene. Conclusion: Considering the findings of the current study, further studies with other methods are required to evaluate other gene mutations such as pendrin, sodium-iodide symporter (NIS) and thyroglobuli

Dietary sodium and potassium intake and their association with blood pressure in a non-hypertensive Iranian adult population: Isfahan salt study

Aim: The association of sodium (Na) and potassium (K) intake with blood pressure (BP) is an ongoing debate, especially in central Iran. We aimed to examine the mean Na and K intake, major sources of Na and the relationship between BP and dietary and urinary Na and K. Methods: This cross-sectional study was performed in central Iran in 2013-2014. A total of 796 non-hypertensive adults aged >18years were randomly recruited. The semi-quantitative food frequency questionnaire was used to assess dietary Na and K intake. Moreover, 24-hour urine samples were collected to measure 24-hour urinary Na (UNa) and K (UK) as biomarkers. BP was measured twice on each arm using a standard protocol. Results: The mean Na and K intake were 4309.6±1344.4 and 2732.7±1050.5mg/day, respectively. Table and cooking salt were the main sources of Na. Odds ratio (OR) (95% confidence interval (CI)) of the crude model in the highest quartile of UNa indicated a significant association with the higher risk of prehypertension (OR (95% CI): 2.09 (1.09-4.05); P for trend=0.007). After adjustment for potential confounders, prehypertension was significantly associated with increasing dietary Na/K ratio (OR (95% CI): 1.28 (1.01-1.57); P for trend=0.046) and UNa/UK ratio (OR (95% CI): 2.15(1.08-4.55); P for trend=0.029). Conclusions: Increasing dietary and urinary Na/K ratios and UNa were associated with elevated BP and prehypertension occurrence. These findings support the necessity of developing a salt reduction programme in our country. © 2016 Dietitians Association of Australia

Effects of vitamin D-fortified low fat yogurt on glycemic status, anthropometric indexes, inflammation, and bone turnover in diabetic postmenopausal women: a rando...

Background & aims: Low levels of serum 25-hydroxy vitamin D (25(OH)D) are common in type 2 diabetic patients and cause several complications particularly, in postmenopausal women due to their senile and physiological conditions. This study aimed to assess the effects of vitamin D-fortified low fat yogurt on glycemic status, anthropometric indexes, inflammation, and bone turnover in diabetic postmenopausal women. Methods: In a randomized, placebo-controlled, double-blind parallel-group clinical trial, 59 postmenopausal women with type 2 diabetes received fortified yogurt (FY; 2000 IU vitamin D in 100 g/day) or plain yogurt (PY) for 12 weeks. Glycemic markers, anthropometric indexes, inflammatory, and bone turnover markers were assessed at baseline and after 12 weeks. Results: After intervention, in FY group (vs PY group), were observed: significant increase in serum 25(OH)D and decrease of PTH (stable values in PY); significant improvement in serum fasting insulin, HOMA-IR, HOMA-B, QUICKI, and no changes in serum fasting glucose and HbA1c (significant worsening of all indexes in PY); significant improvement in WC, WHR, FM, and no change in weight and BMI (stable values in PY); significant increase of omentin (stable in PY) and decrease of sNTX (significant increase in PY). Final values of glycemic markers (except HbA1c), omentin, and bone turnover markers significantly improved in FY group compared to PY group. Regarding final values of serum 25(OH)D in FY group, subjects were classified in insufficient and sufficient categories. Glycemic status improved more significantly in the insufficient rather than sufficient category; whereas the other parameters had more amelioration in the sufficient category. Conclusions: Daily consumption of 2000 IU vitamin D-fortified yogurt for 12 weeks improved glycemic markers (except HbA1c), anthropometric indexes, inflammation, and bone turnover markers in postmenopausal women with type 2 diabetes