Modeling trend changes in percent of under five-year-old children with malnutrition amongst 39 Asian countries from 1987 to 2016 via growth mixture model

Purpose Malnutrition is an important public health issue and the main cause of child morbidity and mortality, especially in developing countries. The present study aimed to model trend changes in percentage of the malnourished children under 5 among 39 Asian countries during 1987 to 2016. Methods Information about percentage of the malnourished under 5 years children based on under-weight (weight for age) malnutrition for 39 Asian countries were extracted from Gapminder web site during 1987 to 2016. To cluster Asian countries based on trend changes, Growth Mixture Model (GMM) was implemented. All the statistical analyses were performed in Mplus 7.4 software and P < 0.10 in likelihood ratio test (LRT) was considered as statistically significant. Results Based on P-value of LRT, the model with 3 clusters was selected. Although, cluster 3 with 9 countries had higher intercept in 1987 and the worst situation in malnutrition, they gained a sharp decrease (- 0.93) in percentage of malnourished children under five annually. The slope of - 0.64 for cluster 1 countries indicate a moderate decrease annually in percent of children with malnutrition. The other 20 countries with slope of - 0.29 in their linear trend belonged to cluster 2 which shows slow decrease in the percentage of children with malnutrition. Conclusion The investments in public health and education programs, as well as political commitment and government proper response in line with needs and demands are crucial to promote food security, nourishing diets and improving child nutrition. Certainly, most of them are still a long way from eradicating malnutrition

The Prediction Of Alexithymia Using Depression, Anxiety, Stress, And Demographics In Undergraduate Students

Aims: Alexithymia is a psychiatric disorder in which people become emotionally frustrated. This study aims to model the role of depression, anxiety, and stress in alexithymia prediction. Materials and Methods: In this cross-sectional study, 260 undergraduate students were selected via multi-stage cluster sampling. The Toronto Alexithymia Scale (TAS-20) and depression, anxiety and stress scale have been used to collect data. The association between qualitative variables was examined using Chi-square test and LASSO logistic regression was fitted for alexithymia prediction. Results: The mean± SD of participants’ age was 20.7± 3.2 years. Of all, 197 (75.8%) students were female and 236 (90.8%) were single. According to the cutoff point for TAS-20, 30.8% of the students displayed signs of alexithymia. The rate of alexithymia was significantly higher among males (42.9% versus 26.9%, P=0.02) and among nursing (45.9%) and anesthesia (44.8%) students than other undergraduate students. The proportion of students with anxiety, depression, and stress were 45.0%, 15.8%, and 9.2%, respectively. 51.2% of the depressed students had alexithymia, while only 26.9% of non-depressed students were alexithymic (P=0.002). LASSO logistic regression showed that odds of alexithymia was significantly higher among male students (OR=1.40, 95% CI=1.03, 1.90), students with depression (OR=1.73, 95% CI=1.18, 2.54), students who had anxiety (OR=1.42, 95% CI=1.07, 1.89), and nursing students (OR=1.62, 95% CI=1.07, 2.45). Conclusion: The results of this study indicate the importance role of anxiety and depression in predicting alexithymia. Due to the high prevalence of alexithymia among college students, we suggest the routine evaluation of college students for alexithymia

Regression of nonalcoholic fatty liver disease detected by sonography: Results of a four years prospective adult population-based study

Background: Today, nonalcoholic fatty liver disease (NAFLD) has become a major health problem owing to its high prevalence. Literature evidence about regression of NAFLD are not as high as its development or progression. Objectives: This cohort study was conducted to reveal the factors influencing the regression of the NAFLD. Methods: A population-based study conducted in Shiraz, Iran. Adults older than 18 years were recruited by multistage randomized sampling in 2012, and then in 2017. Demographic, anthropometric, nutritional, and medical characteristics of each interviewee were entered into a valid and reliable questionnaire. Interviewees were categorized into three groups according to the changing of their NAFLD status between two stages of this study; no change, regressed and progressed. Results: Of the 537 participants, 163 (30.3%) showed regression of their NAFLD compared to 93 (17.3%) that their NAFLD was progressed. Multinomial regression showed that each unit of decrease in BMI (∆ BMI=-1 kg/m2 ) augmented the relative risk (RR) of improvement of NAFLD by 13.3% (RR: 0.867; 95% CI: 0.776-0.969; P = 0.012) and reduced the relative risk of NAFLD deterioration by 14.3% (RR: 1.143; 95% CI: 1.009-1.294; P = 0.035). Conclusions: A significant portion of patients showed regression of their NAFLD by decreasing their BMI. Therefore, BMI as a modifiable variable should be regarded in the management of NAFLD patients Keywords: Non-Alcoholic Fatty Liver, Regression, Progression, Cohort Stud

Clustering time trends of breast cancer incidence in Africa: A 27-year longitudinal study in 53 countries

Background: Breast cancer is the most common, frequently diagnosed cancer with the highest incidence among female worldwide. Although the incidence is decreasing in developed countries, it is on increase in most of the African countries. Objective: This study aimed to identify different time trends of breast cancer incidence among African countries using latent mixture approach. Methods: The information includes newly diagnosed breast cancer patients per 100,000 women for 53 African countries in a period of 1990-2016. Latent mixture modeling was performed in Mplus 7.4 software. Results: The overall trend of breast cancer in Africa was increasing. Latent mixture model with 5 clusters was estimated as the best using fit indices and linear growth trajectories were specified for each cluster. Nigeria was the only country which belongs to a cluster with negative slope indicating a slow decrease in the breast cancer incidence; also, Seychelles was the only country that showed a sharp increase over time. 31 countries belonged to a cluster with a slope of 0.08, indicating that the incidence of breast cancer is almost constant over time. Cluster 3 including Algeria, Angola, Botswana, Central African Republic, Cote d�lvoire, Equatorial Guinea, Lesotho, Libya, Namibia, Somalia, Sudan, Swaziland, Uganda and Zimbabwe and cluster 2 including Gabon, Mauritius, Morocco, South Africa, Tunisia and Congo showed a slow and moderate increase in the incidence of breast cancer, respectively. Conclusion: Providing health education programs is essential in African countries with rising trend of breast cancer during the last decades

The Effectiveness of a Sequential Helicobacter Pylori Eradication Regimen on the Severity of Clinical Symptoms in Children with Chronic Gastritis: A Randomized Clinical Trial

Background: The effectiveness of eradicating Helicobacter pylori infection in improving the symptoms of chronic gastritis has been examined; however, the results of the studies have been contradictory, especially in childhood. This study aimed to compare the clinical effectiveness of sequential Helicobacter pylori eradication treatment and proton pump inhibitor alone in children with chronic Helicobacter pylori-positive gastritis.Methods: This randomized double-blinded clinical trial was conducted on 84 children aged 5 to 15 years suffering from Helicobacter pylori-associated active chronic gastritis. The patients in the experimental group received sequential therapy including omeprazole, amoxicillin, clarithromycin, and metronidazole; and those in the control group only received omeprazole. Before the intervention, and 2 and 4 months after it, the severity of clinical symptoms was assessed.Results: After therapeutic regimens, the intervention group was found to have a significantly higher decrease in the severity grades of some symptoms including heartburn, gastroesophageal reflux, and abdominal pain in the epigastric area as compared to the control group (P<0.05). The assessment of the frequency of clinical symptoms in the intervention and control groups also indicated a greater reduction in epigastric pain in the group treated with Helicobacter pylori eradication as compared to the control group (P<0.05).Conclusion: Prescribing a sequential Helicobacter pylori eradication regimen can lead to reducing the severity of clinical symptoms in children suffering from chronic gastritis

Measurement Invariance and Psychometric Analysis of Oxford Happiness Inventory Scale across Gender and Marital Status

Background: The Oxford Happiness Inventory (OHI) is a self-report tool to measure happiness. A brief review of previous studies on OHI showed the lack of evaluation of OHI fairness/equivalence in measuring happiness among identified groups. Methods: To examine the psychometric properties and measurement invariance of the OHI, responses of 500 university students were analyzed using item response theory and ordinal logistic regression (OLR). Relevant measures of effect size were utilized to interpret the results. Differential test functioning was also evaluated to determine whether there is an overall bias at the test level. Results: OLR analysis detected four items across gender and two items across marital status to function differentially. An assessment of effect sizes implied negligible differences for practical considerations. Conclusions: This study was a significant step towards providing theoretical and practical information regarding the assessment of happiness by presenting adequate evidence regarding the psychometric properties of OHI

Determinant components of newly onset versus improved metabolic syndrome in a population of Iran

This study aimed to determine the risk factors related to regression and progression of metabolic syndrome, in a 4-year cohort study. A total of 540 individuals (≥ 18 years old) participated in both phase of the study. Participants were categorized into 3 categories of regressed, progressed and unchanged metabolic syndrome (MetS). Demographic, anthropometric and biochemical parameters were assessed for each individual in both phase. Variables differences (delta: Δ) between the two phase of study were calculated. Unchanged group was considered as baseline category. Based on IDF, MetS had been regressed and progressed in 42 participants (7.7%) and 112 (20.7%) participants respectively, in the second phase. More than 47% of people, whose MetS regressed, experienced also NAFLD regression. Results of multiple variable analysis revealed that increased age, positive Δ-TG, and Δ-FBS, significantly increased the odds of MetS progression based on IDF and ATP III definitions, while negative Δ-HDL and Δ-neutrophil to lymph ration increased the odds of progression. On the other hand, negative Δ-TG and positive Δ-HDL significantly increased the odds of Mets regression based of both IDF and ATP III. Management of hypertriglyceridemia, hyperglycemia, and HDL is a critical, non-invasive and accessible approach to change the trend of Met

Determination of the Level of Happiness among Students of Shiraz University of Medical Sciences, Iran

Introduction and Objective: The purpose of this study is to determine the level of happiness and vitality as one of the effective factors on increasing students' success in education and spiritual well-being. Materials and Methods: The present study is a descriptive cross-sectional study. Five hundred and seven students from Shiraz University of Medical Sciences were selected by stratified random sampling and responded to the Oxford Happiness Questionnaire. Data were analyzed using "SPSS 19" software, descriptive and inferential statistics. Results: The results indicate that mean of happiness among participants was 40.9 +/- 13.1 (ranged from 2 to 87) which was moderate. Also mean score of happiness among males was significantly higher than females (43.5 +/- 15.0 and 40.1 +/- 12.4, p=0.01). Moreover there was no difference in the level of happiness between difference status such as marital (married/single), residence (dormitory/home), field of study (medicine/pharmacology/medical laboratory sciences, and occupational health), and academic degree (bachelor/master/doctorate). Conclusion: If academic places such as universities include a happy and vital environment, they will have a very influential role in improving the students' educational and cultural level

The Correlation between Using Social Networks and the General Health of Multiple Sclerosis Patients

Background. Multiple sclerosis (MS) threatens the patients' independency and ability to effectively participate in the society. The aim of this study was to determine the correlation between using social networks on the general health of multiple sclerosis patients.Methods. This study was performed on 80 MS patients referring to Shiraz University of Medical Sciences, Chamran, and Imam Reza Hospital in 2017, whose condition had improved and were treated by a specialist physician. Tools for data collection were general health questionnaire (GHQ-28) and social networks use questionnaires.Results. Amongst the 80 individuals with MS, 65 (81.3%) were female and 15 (18.8%) were male. Our results suggest that patients with higher levels of education had higher levels of health (P=0.01). Telegram and WhatsApp, respectively, had a positive correlation with general health (P=0.007,P=0.007), anxiety (P=0.003,P=0.028), and social dysfunction (P=0.007,P=0.007). WhatsApp with 33.64% was the most popular application among MS patients. The correlation between general health and duration of using social networks was not statistically significant (r=0.22,P=0.06). Also, no significant correlation was found between the duration of using social networks and the general health (P=0.62).Conclusion. Our findings suggest that social networks, especially Telegram and WhatsApp, had a positive correlation with general health, anxiety, and social dysfunction of patients. Therefore, the use of social networks can be considered as a suitable option in reducing the aforementioned concerns among patients with MS. On the other hand, general health and mood status might as well influence the use of social network in MS patients

RELATIONSHIP BETWEEN SELF-ESTEEM AND FIELD OF STUDY AND ITS EFFECT ON ACADEMIC BURNOUT IN STUDENTS OF SHIRAZ UNIVERSITY OF MEDICAL SCIENCES

Medical students are prone to burnout due to high volume and stressful courses and also attending medical centers. Therefore, the present study aimed to investigate the relationship between self-esteem and field of study and its effect on academic burnout in students of Shiraz University of Medical Sciences. This cross-sectional study was conducted on 600 students of Shiraz University of Medical Sciences selected by multi-stage cluster sampling in 2018. Data were analyzed by SPSS (R) software. The mean score of self-esteem in men was higher than that of women and the mean score of burnout in men was lower than that of women, but this difference was not statistically significant. There was no significant difference in the mean of self-esteem among single and married students. Also, the level of academic burnout was significantly lower among married students than single students. There was a significant negative correlation between self-esteem and academic burnout. The results of the regression analysis showed that academic burnout is the only predictor of student self-esteem. The precise and principled planning for medical and paramedical students who are prone to severe academic burnout due to their very difficult educational situation can play an important role in increasing self-esteem in these student