EVALUATION OF REPEATED MEASURES OUTCOMES IN EPIDEMIOLOGY

Ph.DDOCTOR OF PHILOSOPH

Clustering and Combining Pattern of High-Risk Behaviors among Iranian University Students: A Latent Class Analysis

Background: High-risk behaviors are increasing among young adults worldwide. We aimed to identify university students’ subgroups on the basis of high-risk behaviors and to assess the role of age, living alone, religious beliefs, and parental support in the membership of specific subgroups. Study design: A cross-sectional study Methods: The study was conducted in Bushehr (the south of Iran) from November to December 2016. The sample included 977 university students selected through random sampling. The data were collected using a self-administered questionnaire. Then, latent class analysis was used to classify the students. Results: Totally, five latent classes were identified as follows: low risk, high risk, somewhat low risk, hookah user, and very high risk. Notably, 7.7% and 2.5% of the students belonged to high risk and very high risk classes, respectively. The results suggested the protective effect of familial support and religiosity on high-risk behaviors. Conclusions: This study indicated the co-occurrence of high-risk behaviors. The findings can be used to plan and evaluate interventions by considering risk factors and protective factors in universities

The evaluation of breakfast intake pattern and short-term memory status in junior secondary school students in Shiraz 2007

زمینه و هدف: یادگیری، حافظه و پیشرفت تحصیلی کودکان در مدرسه تحت تاثیر عوامل مختلف تغذیه ای و از جمله صبحانه قرار دارند. مواد مغذی اعم از ویتامین های نیاسین (B3)، فولیک اسید (B9)، کوبالامین (B12)، آهن، ید و غیره بر حافظه کوتاه مدت موثرند. از آنجا که صبحانه از عادات مطلوبی است که بر حافظه کودکان موثراست. لذا این مطالعه با هدف بررسی الگوی صبحانه دریافتی و وضعیت حافظه کوتاه مدت دختران دانش آموزان مدارس راهنمایی شهر شیراز صورت گرفت. روش بررسی: در این مطالعه توصیفی-تحلیلی 150 نفر از دختران دانش آموز مدارس راهنمایی شیراز به روش تصادفی چند مرحله ای انتخاب شدند. اطلاعات دموگرافیک اجتماعی-اقتصادی با پرسشنامه والگوی صبحانه با پرسشنامه بسامد و یادآمد صبحانه 3 روزه جمع آوری و از هر فرد یک تست حافظه وکسلر به عمل آمد. داده ها با استفاده از آزمون های آماری همبستگی پیرسون و ANOVA تجزیه و تحلیل شد. یافته ها: بین شغل و تحصیلات والدین، وضعیت تحصیلی، سن و حافظه‌ رابطه‌ معنی داری وجود نداشت. طی بررسی تغذیه ای بین مصرف پیریدوکسین (ویتامینB6 )، B12، ید، کالری، پروتیین، چربی یا کلسترول و نمره ی حافظه رابطه‌ی معنی داری وجود نداشت (05/0P>)، اما بین مصرف ویتامین B3، کربوهیدرات و آهن در صبحانه و نمره ی حافظه رابطه ی معنی دار و همبستگی از نوع مستقیم وجود داشت (05/0

Risk factors for COVID-19 severity and mortality among inpatients in Southern Iran

Introduction: COVID-19 is a highly contagious respiratory disease and many factors can affect its severity and mortality. This study aimed to investigate the risk factors associated with the severity and mortality of COVID-19. Methods: In this study, 311 cases with COVID-19 approved by the CORONA database in the Center for Disease Control and Prevention (CDC) of Shiraz University of Medical Sciences were selected using a random systematic sampling method. The study data were collected through interviews and phone calls. Results: The mean age of the participants was 45.82±17.92 years, and the male to female ratio was 1.57:1. In addition, the Case Fatality Rate (CFR) was 4.50%, and the disease was severe in 47.5% of the cases. The most common clinical symptoms were cough (39.22%), fever (31.83%), and dyspnea (24.76%). The severity of COVID-19 was significantly associated with age and history of Cardiovascular Disease (CVD). Besides, the mortality of COVID-19 was significantly related to age, gender, hypertension, CVD, and Chronic Kidney Disease (CKD). The mean interval between the onset of the first symptom and referral to health center was 3.02±2.82 days. Additionally, the mean interval between the referral to health centers and testing was 0.88±2.20 days. Conclusion: Older patients and those who had CVD needed more careful healthcare and early intervention to prevent the exacerbation of COVID-19. Furthermore, the interval between the onset of the first symptom and testing was relatively long. Overall, early diagnosis, isolation, and treatment of patients were found to be essential to control COVID-19

Estimativa populacional da prevalência pontual e periódica de infecções sexualmente transmissíveis com base no sistema de vigilância de sintomas iranianos

Sexually transmitted diseases (STDs) are of greate international concerns. The aim of this study was to measure the point and period prevalence of reportable STDs in Iran based on syndromes defined by the Iranian STDs surveillance system. In that regard, the population of Marvdasht, the second largest county of Fars province, was selected. This is a population based cross-sectional study, which was conducted among urban and rural residences of Marvdasht county in 2017. In total, among 11763 randomly sampled individuals, 3879 eligible participants in urban and rural areas of Marvdasht county were interviewed. The participants were on average 33 years old. Overall about 33 percent of men and 70 percent of women reported that, since the age of 15 years, they experienced at least one of the symptoms of selected STDs defined by the Iranian center for disease control (CDC) for surveillance of sexually transmitted infections (STIs). Moreover, %9.7 of men and %28.7 of women were suffering from at least one of the defined symptoms at the time of interview. Regardless of the etiology of the detected syndromes, the results highlight the importance of access to diagnostic and medical services to achieve on time diagnosis and treatment of the patients. Also, sexual health education is needed to be provided to the rural and urban sexually active population of Iran.Las enfermedades de transmisión sexual (ETS) son de gran preocupación internacional. El objetivo de este estudio fue medir la prevalencia de punto y período de las ETS notificables en Irán según los síndromes definidos por el sistema de vigilancia iraní de ETS. En ese sentido, se seleccionó la población de Marvdasht, el segundo condado más grande de la provincia de Fars. Este es un estudio transversal basado en la población, que se llevó a cabo entre las residencias urbanas y rurales del condado de Marvdasht en 2017. En total, entre 11763 individuos de muestra aleatoria, se entrevistaron 3879 participantes elegibles en áreas urbanas y rurales del condado de Marvdasht. Los participantes tenían en promedio 33 años. En general, alrededor del 33 por ciento de los hombres y el 70 por ciento de las mujeres informaron que, desde la edad de 15 años, experimentaron al menos uno de los síntomas de las ETS seleccionadas definidas por el centro iraní para el control de la enfermedad (CDC) para la vigilancia de las infecciones de transmisión sexual ( ITS). Además, el% 9,7 de los hombres y el 28,7% de las mujeres sufrían al menos uno de los síntomas definidos en el momento de la entrevista. Independientemente de la etiología de los síndromes detectados, los resultados resaltan la importancia del acceso a los servicios médicos y de diagnóstico para lograr el diagnóstico y el tratamiento a tiempo de los pacientes. Además, es necesario proporcionar educación sobre salud sexual a la población sexualmente activa rural y urbana de Irán.As doenças sexualmente transmissíveis (DSTs) são de grandes preocupações internacionais. O objetivo deste estudo foi medir a prevalência pontual e periódica de DST notificáveis no Irã com base em síndromes definidas pelo sistema de vigilância de DSTs iranianas. A esse respeito, a população de Marvdasht, o segundo maior condado da província de Fars, foi selecionada. Trata-se de um estudo transversal de base populacional, realizado em residências urbanas e rurais do condado de Marvdasht em 2017. No total, dentre 11763 indivíduos amostrados aleatoriamente, foram entrevistados 3879 participantes elegíveis nas áreas urbana e rural do município de Marvdasht. Os participantes tinham em média 33 anos de idade. No geral, cerca de 33% dos homens e 70% das mulheres relataram que, desde os 15 anos, tiveram pelo menos um dos sintomas das DSTs definidas pelo Centro Iraniano de Controle de Doenças (CDC) para vigilância de infecções sexualmente transmissíveis (DSTs). Além disso, % 9.7 de homens e% 28.7 de mulheres sofriam de pelo menos um dos sintomas definidos no momento da entrevista. Independentemente da etiologia das síndromes detectadas, os resultados destacam a importância do acesso aos serviços médicos e diagnósticos para alcançar o diagnóstico e tratamento oportuno dos pacientes. Além disso, é necessário fornecer educação em saúde sexual para a população rural e urbana sexualmente ativa do Irã

Adverse Effects of Sit and Stand Workstations on the Health Outcomes of Assembly Line Workers: A Cross-sectional Study

Introduction: Sitting and standing workstations can affect individual's health outcomes differently. This study aimed to assess the effects of sit and stand workstations on energy expenditure and some blood parameters, musculoskeletal symptom/pain and discomfort, fatigue, and productivity among workers of assembly line of a belt factory. Methods: This cross-sectional study was conducted on 47 male assembly line workers (24 workers in sitting workstation and 23 workers in standing workstation) with at least one year of working experience. Data were gathered via demographic/occupational characteristics, Fitbit system, medical records, Persian version of the Nordic Musculoskeletal Questionnaire (P-NMQ), Persian version of the Numeric Rating Scale (P-NRS), Persian version of the Swedish Occupational Fatigue (P-SOFI), and Persian version of the Health and Work Questionnaire (P-HWQ). Results: The findings of the present study revealed that the energy expenditure, blood glucose/triglyceride there are not statistically differences between in sitting and standing groups. In addition, the prevalence of the MSs in the neck, lower back, knees, and ankles/feet in standing group was significantly higher than the sitting group. Generally, occupational fatigue was higher among the standing group compared to sitting group. About productivity, the ‘concentration/focus’ and ‘impatience/irritability’ subscales in sitting group were higher than the standing group. Contrariwise, other subscales of the productivity, including ‘productivity’, ‘supervisor relations’, ‘non-work satisfaction’, ‘work satisfaction’ in the standing group were higher than the sitting group. Conclusions: To reduce the adverse effects of sitting and standing workstations on individual's health outcomes, planning to use sit-stand workstations is recommended. &nbsp

Prevalence of Zinc Deficiency in Obese Adults with Increased Appetite in Shiraz, Iran

Background: Low serum zinc concentration is associated with obesity,and its deficiency has been linked to many pathogenesis aspects of obesity. The present study was designed to evaluate the prevalence of zinc deficiency in the obese adults with increased appetite in Shiraz,Fars province, south of Iran. Furthermore, we aimed to evaluate the serum zinc correlation with some demographic and anthropometric indices. Methods: In this study, 260 adults with the ages ranged from 25 to 55 years old were selected for serum zinc concentration. Age, sex, job, education level, physical actively, weight, height, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist to hip ratio (WHR) were also recorded for each participants. Using calorimeter method, we considered the serum level of zinc less than 70µg/dL as deficient. Results: Mean serum level of zinc was 96.37 ± 18.24 µg/dL. The prevalence rate of zinc deficiency was 8%, which was more prevalent among female participants than male ones with no significant difference (9.8% and 4.6%, respectively, Pvalue = 0.14). The participants’ characteristics were not statistically different between normal and deficient groups, and serum zinc concentration had no correlation with age, sex, height, weight, BMI, WC, HC, and WHR. Conclusions: Zinc deficiency in obese adults living in Shiraz is as prevalent as other population groups, and also other regions of Iran. Zinc deficiency is considered as a possible risk factor for obesityrelated diseases, and requires more investigations. Keywords: Zinc, Deficiency, Prevalence, Obesity, Iran

Prevalence of Zinc Deficiency in Obese Adults with Increased Appetite in Shiraz, Iran

Background: Low serum zinc concentration is associated with obesity,and its deficiency has been linked to many pathogenesis aspects of obesity. The present study was designed to evaluate the prevalence of zinc deficiency in the obese adults with increased appetite in Shiraz,Fars province, south of Iran. Furthermore, we aimed to evaluate the serum zinc correlation with some demographic and anthropometric indices. Methods: In this study, 260 adults with the ages ranged from 25 to 55 years old were selected for serum zinc concentration. Age, sex, job, education level, physical actively, weight, height, body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist to hip ratio (WHR) were also recorded for each participants. Using calorimeter method, we considered the serum level of zinc less than 70µg/dL as deficient. Results: Mean serum level of zinc was 96.37 ± 18.24 µg/dL. The prevalence rate of zinc deficiency was 8%, which was more prevalent among female participants than male ones with no significant difference (9.8% and 4.6%, respectively, Pvalue = 0.14). The participants’ characteristics were not statistically different between normal and deficient groups, and serum zinc concentration had no correlation with age, sex, height, weight, BMI, WC, HC, and WHR. Conclusions: Zinc deficiency in obese adults living in Shiraz is as prevalent as other population groups, and also other regions of Iran. Zinc deficiency is considered as a possible risk factor for obesityrelated diseases, and requires more investigations. Keywords: Zinc, Deficiency, Prevalence, Obesity, Iran

The Effect of Musculoskeletal Problems on Fatigue and Productivity of Office Personnel

Introduction: Work-related musculoskeletal disorders (WMSDs) can be affective on the fatigue and productivity of office workers. This study aimed to survey of the effect of musculoskeletal problems on fatigue and productivity in office personnel.Methods: In this study, 101 Iranian office workers participated. Data was gathered through demographic questionnaire, Nordic Musculoskeletal Questionnaire, Numeric Rating Scale, Persian version of Multidimensional Assessment of Fatigue Scale, and Persian version of Health and Work Questionnaire.Results: The results revealed that the highest prevalence rates of musculoskeletal symptoms in the past week were related to the neck (41.6%), lower back (41.6%), and shoulders (40.6%). The mean score of discomfort/pain in the neck, lower back, and shoulders were 1.67, 1.55, and 1.31, respectively. The severity of discomfort/pain in neck, shoulders, lower back, and thighs were correlated with total fatigue. The severity of discomfort/pain in the neck, lower back, buttock, and thighs were correlated with concentration/focus sub-scale of productivity.Conclusions: Improvement of working conditions is suggested for reducing musculoskeletal problems, fatigue decrement, and productivity increment

The Effect of Radiation on Secondary Sex Ratio among Radiologists in Shiraz, Iran

Environmental and occupational exposure may play a role in gender offspring. This study aimed to investigate the effect of radiation on gender ratio in the offspring of radiologists and technicians. This cross-sectional study was conducted on 262 participants with a total of 354 children. A data collection form including age, years spent in radiology practice, number of children, sex of each child, observance of radiation protection principles, and intensity of exposure based on International Commission Radiological Protection was completed. Male to female ratio was calculated 0.85 in fathers and 0.75 in mothers in comparison to this ratio estimated in Iran demographic statistics sex ratio which is 1.03. Highly-exposed parents (Prevalence ratio [PR]: 1.67, 95% confidence interval [CI]: 1.67, 95% confidence interval [CI: 1.11-2.52), as well as fathers (PR: 2.72, 95%CI: 1.56-4.72), had a significant propensity to have female offspring. However, this criterion in female radiologists was not found to be significant (P= 0.57). Moreover, in fathers a significant relationship was found between the years spent in radiology field up to the time of the child’s birth or age of the parents’ at child’s conception with offspring gender (4-6 year: PR: 2.07, 95% CI: 1.15-3.72; ≥7 year: PR:1.81, 95%CI: 1.18-2.78). Highly-exposed radiology male personnel, as well as those exposed to radiation 4 years or more before the offspring’s birth, were more likely to have daughters than sons. Although no exact mechanism has been identified for this preponderance, further animal studies are required to evaluate whether x ray is an influential factor in offspring gender