PSYCHOMETRICS AND VALIDATION OF THE IRANIAN VERSION OF THE DIABETES HEALTH LITERACY ASSESSMENT QUESTIONNAIRE

Background: Assessing the health literacy of diabetic patients requires the availability of a tool specific to this group. The Diabetes Health Literacy Assessment Questionnaire (LAD) is one of the tools used to measure the health literacy of diabetic patients. The present study was conducted with the aim of translating and validating the Persian version of the LAD questionnaire. Methods: The present study aimed to determine the validity and reliability of the Persian version of the Health Literacy Assessment Questionnaire for diabetic patients on 300 patients with diabetes in 1398, by sampling. Stages of study: First: Translation and preparation of the Persian version of the health literacy questionnaire in order to design and select items and their qualitative evaluation by the second group: Quantitative evaluation of narrative features using the opinions of the third group of experts: Formal narrative evaluation (comprehensibility) and The reliability of the questionnaire was assessed by a small group of the target population in a fourth experimental study: analysis of items, validity assessment and reliability of the final questionnaire. Results: In the analysis of organizational structure items, the effects of roof and floor were not observed. The highest averages were for items 8 and 12 and the lowest averages were for items 6. According to the Skewness Index, no deviation was observed in the items. Based on the results, the instrument had acceptable internal stability. Detective factor analysis identified two factors for the Diabetes Health Literacy Questionnaire: one was individual understanding and the second was social support. Conclusion: The results of exploratory factor analysis, Diabetes Health Literacy Questionnaire (LAD) have good validity and reliability and can be used to measure the health literacy of diabetic patients. Keywords: Validity, Reliability, Initial Validation, Health Literacy Assessment Questionnaire For Diabetic Patient

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

The Effect of Exercise Program on the Quality of Life in Shahrekord Elderly People

Objectives: the proportion of older adults in the population continues to increase in the developing countries. In addition, in elderly persons decrease quality of life because of several factors such as low physical activity and impairment in mobility. This study was performed to assess the effect of exercise program on the quality of life in Shahrekord elderly people. Methods & Materials: This quasi-experimental study was conducted older adults in 2007. In this study 60 elderly persons were randomly divided into two groups; experimental (30) with mean age 68.63&plusmn;6.96 and control (30) with mean age 68.03&plusmn;10.65. this groups can doing Exercise and Daily activity without Depends to other and without any systematic disease and restrictive. Exercise program was administrated to the individual of experimental group for 60sessions; subsequently using Leipard questionnaire, the level of quality of life was measured in the two groups at the beginning and the end of the study. The data was analyzed, using, chi-square, Manwitny and t tests. Results: Using exercise program, mean level of quality of life in different were increase statically significant (P<0.05), whereas in the control group these parameters were unchanged. Conclusion: According to the result of this research that showed using a regular and prolong exercise program, and good acceptance toward geriatrics can increase the level of quality of life in older adult in different dimension, and showed that healthy way of living for them

Magnetohydrodynamics Flow and Heat Transfer Around a Solid Cylinder Wrapped With a Porous Ring

The problem of the effect of an external magnetic field on fluid flow and heat transfer characteristics is relevant to several physical phenomena. In this paper, flow and heat transfer of an electrically-conductive fluid around a cylinder, wrapped with a porous ring and under the influence of a magnetic field, is studied numerically. The ranges of the Stuart (N), Reynolds (Re), and Darcy (Da) numbers are 0-7, 1-40, and 10 À8 -10 À1 , respectively. The Darcy-Brinkman-Forchheimer model was used for simulating flow in the porous layer. The governing equations provide a coupling between flow and magnetic fields. The governing equations, together with the relevant boundary conditions, are solved numerically using the finite-volume method (FVM). The effect of the Stuart, Reynolds, and Darcy numbers on the flow patterns and heat transfer rate are explored. Finally, two empirical equations for the average Nusselt number were suggested, in which the effect of a magnetic field and the Darcy numbers are taken into account. It was found that in the presence of a magnetic field, the drag coefficient and the critical radius of the insulation increases, while the wake length and Nusselt number decrease

A numerical study of flow and temperature fields in circular tube heat exchanger with elliptic vortex generators

The two-dimensional fluid flow and heat transfer in a circular tube heat exchanger with two elliptic obstacles at the back is studied numerically. The computational domain consists of a circular tube and two elliptic obstacles that are situated after the tube, such that the angle between their centerlines and the direction of free coming flow is 45 degrees. The numerical solution is achieved by numerical integration of full Navier-Stokes and energy equations over the computational domain, using finite volume method. The fluid flow is assumed to be laminar, incompressible and steady-state with constant thermo-physical characteristics. In this study major thermo-fluid parameters such as temperature, pressure and velocity fields as well as Nusselt number and friction factor variations are computed and some results are presented in the graphs. It is shown that using of elliptic obstacles leads to an increase in the average Nusselt number and also pressure.