How can the results of a qualitative process evaluation be applied in management, improvement and modification of a preventive community trial? The IHHP Study

BACKGROUND: This study reports the results of the qualitative process evaluation (PE) of the Isfahan Healthy Heart Program (IHHP), an integrated community-based trial for prevention and control of non-communicable diseases in Iran. METHODS: The study explored the overall quality of program implementation. The participants, including designers of IHHP, stakeholders and community members (n = 60) were purposefully recruited from the intervention areas. Data collected from semi-structured interviews and field notes were analyzed using a modified thematic analysis. RESULTS: Four main themes were identified. Our findings highlighted the key role of the resources as both facilitating and hindering factors. IHHP directors faced incompatibilities arising from negative perceptions/attitudes which resulted in decreased adherence to the program. Hence various strategies were used to motivate, strengthen and organize the human workforce implementing the program. CONCLUSION: Recommendations arising from evaluation of the program were used in subsequent stages of implementation. Qualitative research is an important component of community trials which can improve their implementation

Gender Differences in Obesogenic Behaviour, Socioeconomic and Metabolic Factors in a Population-based Sample of Iranians: The IHHP Study

This study investigated the gender differences in association of some behavioural and socioeconomic factors with obesity indices in a population-based sample of 12,514 Iranian adults. The mean body mass index (BMI), waist circumference (WC), and the waist-to-hip ratio (WHR) were significantly higher in women than in men. Current and passive smoking had an inverse association with BMI among males whereas current smoking, transportation by a private car, and longer duration of watching television (TV) had a positive association with BMI among females. Current and passive smoking, cycling, and Global Dietary Index (GDI) had an inverse association with WC among males. Higher consumption of fruits and vegetables, current and passive smoking, duration of daily sleep, and GDI had an inverse association with WC among females. Using a private car for transportation had a significant positive association with WHR among both males and females. Living in an urban area, being married, and having a higher education level increased the odds ratio of obesity among both the genders. Non-manual work also increased this risk among males whereas watching TV and current smoking increased this risk among females. Such gender differences should be considered for culturally-appropriate interventional strategies to be implemented at the population level for tackling obesity and associated cardiometabolic risk factors

Effect of Lactobacillus casei on the production of pro-inflammatory markers in streptozotocin-induced diabetic rats.

It has been demonstrated that probiotic supplementation has positive effects in several murine models of disease through influences on host immune responses. This study examined the effect of Lactobacillus casei strain Shirota (L. casei Shirota) on the blood glucose, C-reactive protein (CRP), Interleukin-6 (IL-6), Interleukin-4 (IL-4), and body weight among STZ-induced diabetic rats. Diabetes mellitus was induced by streptozotocin (STZ, 50 mg/kg BW) in male Sprague–Dawley rats. Streptozotocin caused a significant increase in the blood glucose levels, CRP, and IL-6. L. casei Shirota supplementation lowered the CRP and IL-6 levels but had no significant effect on the blood glucose levels, body weight, or IL-4. Inflammation was determined histologically. The presence of the innate immune cells was not detectable in the liver of L. casei Shirota-treated hyperglycemic rats. The probiotic L. casei Shirota significantly lowered blood levels of pro-inflammatory cytokines (IL-6, CRP) and neutrophils in diabetic rats, showing a lower risk of diabetes mellitus and its complications

Effect of Patellar Electrocautery Neurectomy on Postoperative Pain among Patients Referred for Total Knee Arthroplasty

Background: Anterior knee pain is a major problem in total knee arthroplasty (TKA). It is accepted that anterior knee pain (AKP) often contributes to a patellofemoral etiology; however, its etiology or treatment is not understood completely. Disabling pain receptors by electrocautery could theoretically lead to anterior knee area denervation. The present study aimed to evaluate the pain post-patellar denervation (PD) with electrocautery in TKA. Materials and Methods: Clinical results for 92 patients who underwent TKA (58 women, 34 men; mean age 67.5 years) were analyzed. In addition to removal of all osteophytes, PD by electrocautery was performed on patella of treatment group (n = 46) and debridement alone including removing of all osteophytes was performed on the control group (n = 46). Knee Society System (KSS) score, patella score (PS), and visual analog scale (VAS) were used to determine pre- and post-operative AKP. Results: The follow-up duration was 10 months. No revision or reoperations were performed. There were no patellar fractures. On all parameters (KSS score, PS, and VAS), there was a statistically significant pre- to post-operative difference in favor of the denervation group only 3 weeks after operation; however, there was no statistically difference postoperation on other follow-ups (3, 6, and 10 months). Conclusions: PD with electrocautery could reduce AKP in TKA without patellar resurfacing only in a short-term period postoperation

Light ballast concrete containing foam-glass

I Sverige tillverkas betong normalt med glaciofluviala grusavlagringar(naturgrus). På senare år har tillgång på naturgrus blivit starkt begränsade i vissa regioner och man vill av miljöskäl minska förbrukningen av det som återstår. Återvinnig av material som kan ersätta detta är både bra av miljöaspekt samt öppnar väg för produktion av betong med nya egenskaper. Med lättballastbetong avses betong i vilken ballastmaterialet helt eller delvis består av någon typ av lättballast som har en partikeldensitet som är markant mindre än vad som är normalt för normala bergartsmaterial såsom granit, gnejs eller kalksten. Lättballast är porös, dvs innehåller hålrum, och får därför lägre hållfasthet än normalballast. I lättballastbetong bestämmer lättballastpartiklarna många av betongens egenskaper, såsom hållfasthet, elasticitetsmodul och krympning. Examensarbetets inledande del är en state-of-the-art rapport som omfattar tillverkning av lättballastbetong i allmänhet, både i färsk och hårdnade tillstånd, samt dess beståndsdelar med fokus på skumglas som lättballast. Arbetets följande del beskriver praktiskt laborationsarbete som inleds med proportionerig av betongblandningar med lättballast av skumglas. Ballasten förbereddes genom krossning och siktning. Betongkuber tillverkades för tryckprovning och för studie av betongblandningarnas struktur i hårdnat tillstånd. Resultaten visar att tryckhållfastheten hos lättballastbetong med skumglasballast beror på ballastens styvhet och att högre tryckhållfasthet än motsvarande C 28/35 inte är att förvänta för denna typ av betong. Slutligen ges praktiska rekommendationer för användning och tillverkning av den provade typen av lättballastbetong.Production of concrete in Sweden is normally based on glaciofluvial gravel storages (natural gravel). Since the access to natural gravel has become remarkably limited in some parts of the country in resent years, the environmental considerations demand a reduction in consumption of natural gravel. Recycled materials that can replace natural gravel are environment friendly and will open the way for production of a concrete with new characteristics. Lightweight concrete is defined as concrete whose ballast materials are totally or partially made of light ballast whose density is significantly less than what is normal for rock materials such as granite, gneiss or limeston. Light ballast is porous and therefore has lower strength than normal ballast. In light ballast concrete, the ballast particles play a decisive role for the resulting quality and characteristics of the concrete, such as strength, elasticity and shrinkage. The first part of this master project is a state-of-the-art report, which deals with production of light ballast concrete in general, both in fresh and hardened forms. It is also covers information about the various components of light ballast concrete, with focus on foam-glass as ballast. The following part presents laboratory work that first deals with the composition of concrete mixes containing foam-glass. The ballast was crushed and sorted prior to mixing. Concrete cubes were cast for the following compressive tests and for studies of the structure of the hardened concrete. The results show that the compressive strength of the light ballast concrete with foam-glass depends on the stiffness of the ballast and that higher strength than corresponding to C 28/35 is not to be expected in this case. Finally, practical recommendations for the use and manufacturing of the tested type of light ballast concrete are given

Effects of Lactobacillus Casei Consumption on Inflammation Biomakers and Histological Changes in Selected Organs in Normal and Diabetic Rats.

The severity of diabetes mellitus often manifested by a progressive inflammatory biomarkers. Reducing the rate of the inflammation progression is one of the many measures to reduce complication of the disease. Many established evidences have suggested the beneficial effect of probiotic consumption on the progression of inflammatory bowel syndrome (IBS). In the present study, possible benefit of probiotics on inflammatory progression of diabeties mellitus (DM) is investigated. The present study employed two different approaches to induce hyperglycemia in adult Sprague-Dawley rats. The initial approach using high fructose diet (HFD), (21% w/v), was unable to induce satisfactorily hyperglycemia in the animal. Chemical induction using streptozotocin (STZ), ( 50 mg/ kg body weight) induced hyperglycemia in all animals injected. Rats in both batches were divided into groups. A non-diabetic group (ND), a non-treated group with a standard diet (NT) and two diabetic groups which were treated with 109 cfu/ml/day (LCI/DLCI) and 1011 cfu/ml/day (LC2/DLC2) of self-cultured Lactobacillus casei strain Shirota. The pribiotic L.cS was gavaged for three consecutive weeks. Blood was collected through the orbital venous plexus to measure circulating C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-4 (IL-4) as the inflammatory biomarkers. The results have shown no significant difference in blood glucose level of L.cS fed rats compared with non-treated group (p>0.05). Both doses of L.cS were observed to induce lower CRP production after three weeks of administration compared to the diabetic control group. Interleukin-6 was found to be decreased but only at higher dose (1011 cfu/ml) of the L.cS which was comparable with the level that was observed in the non-diabetic group at the end of the study duration. Interleukin-4 level was found to be significantly decreased in all treated and the diabetic control group, but was observed to be higher in the normal group. Data from the three inflammatory biomarkers suggested that probiotic L.cS has the potential to improve inflammatory status among STZ-induced rats. Histological study of the pancreas showed a huge damage of the Langerhans islets in STZ induced rats. In addition, foamy cells were found in the kidney cortex of the STZ induced rats. Colon condition was similar among all groups. Inflammatory invasion was evidenced in the liver where the presence of neutrophils could be clearly seen in the non-treated group. Treatment with the L.cS observed a significant reduction in the invasiveness of the neutrophils which highly indicates decreased levels of inflammation by the probiotics. The results of this study indicate that Lactobacillus casei strain Shirota, possess an ability to reduce inflammatory biomarkers hence complication caused by inflammation in DM

Using the Mouse to Model Human Diseases: Cognitive Impairment in Systemic Lupus Erythematosus

Cognitive impairment (CI) is one of the most prevalent neuropsychiatric syndromes. In Systemic Lupus Erythematosus (SLE) Patients often report CI as the most bothersome disease-related manifestation with a great impact on their quality of life. Nevertheless, studies focusing on CI remain scarce and no effective targeted therapy has been identified. We herein present murine models of CI in lupus with insights into the pathogenesis of this condition as well as the role of the renin angiotensin system in microglial activation. We will discuss the role of neuroimaging as a useful objective assessment tool describing our experience in previous and ongoing clinical trials of CI in SLE patients

Numerical comparison of streamflow drought index (SDI) and standardized streamflow index (SSI) for evaluation of Isfahan drought status

ABSTRACTHydrological droughts are the most serious and alarming variation of droughts due to their numerous long-term negative impacts on natural ecosystems, agricultural capacities, and the water regime of a specific region. Isfahan province, in Iran, is highly prone to this type of drought, and its arid climate has already made the efficient water management in this area a challenging task. Due to the lack of a uniform method for drought evaluation, various indices have been suggested by different researchers over the last few decades. The streamflow drought index (SDI) and standardized streamflow index (SSI) are the two primary hydrological drought indices that have been used in many regions with similar climatic conditions to Isfahan province. Their reliability in previous case studies and the easy computational process have made them suitable drought measurement tools for Isfahan. In this study, these two indices are calculated based on the obtained data from 10 hydrometric stations in Isfahan, for the timeframe (1988–2018). The analysis of SSI and SDI in this region shows consistent and station-specific drought patterns, with moderate drought conditions prevailing. These findings offer valuable insights for regional water resource management and climate adaptation, guiding policies to mitigate the impact of droughts

MicroRNA Expression Relating to Dietary-Induced Liver Steatosis and NASH

Health issues associated with excessive caloric intake and sedentary lifestyle are driving a modern “epidemic” of liver disease. Initially presenting in the clinic as an excessive accumulation of fat within hepatocyte cells (steatosis), the progression to more severe non-alcoholic steatohepatitis (NASH) in which liver damage and inflammation are overt features, is becoming increasingly common. Often developing as a sequela of obesity, non-alcoholic fatty liver disease (NAFLD) arises in almost one-third of people initially carrying excess hepatic fat and is likely the result of the liver’s limited capacity to cope with the modern-day levels of dietary fatty acids circulating in the blood. While routine imaging can readily assess the presence and level of “extra-hepatic fat”, a proper diagnosis of disease progression to NASH is currently only possible by liver biopsy. A general reluctance to undergo such screening means that the prevalence of NASH is likely to be under reported and, thus, risk assessment for future metabolic syndrome (MetS) markedly compromised. The seemingly inevitable progression to overt insulin resistance that characterizes MetS may in part be the consequence of the body’s attempt to cope with NAFLD by driving systemic insulin sensitivity and, thus, fatty acid breakdown. The potential significance of miRNAs in both physiological homeostasis and pathogenesis is increasingly appreciated and in the liver may contribute specifically to the regulation of lipid pathways and NAFLD progression. As such, they may have utility as molecular indicators for the accurate profiling of both initial risk and disease progression from simple steatosis to NASH, and further to fibrosis/cirrhosis