International Journal of Preventive Medicine最新文献

Background: Fampridine is the only drug approved by the US Food and Drug Administration (FDA) for people with multiple sclerosis (MS) to improve their movement and has exhibited a clinically significant improvement in gait function in a subset of MS patients with Expanded Disability Status Scale (ESDSS) from 4 to 7. Nevertheless, this drug has been reported to possess some adverse effects (AEs) like seizure because of its pharmacological features. The aim of this study was to evaluate the incidence rate of post-medication side effects (SEs) of fampridine in MS patients.

Methods: This prospective cohort study includes MS patients aged between 18 and 65 years, referred to the neurology clinic of Kashani Hospital from April 2022 to October 2022, all with administration of fampridine (10 mg tablet twice daily according to the product specifications). Safety in these patients was monitored through monthly SEs checklist questions during 6 months of screening. SPSS version 18 was used to analyze the data of this study.

Results: From 319 participants screened at baseline, 254 patients with MS, including 127 relapsing-remitting multiple sclerosis (RRMS), 101 secondary progressive multiple sclerosis (SPMS), and 26 primary progressive multiple sclerosis (PPMS), were included in the study. The most observed AEs in SPMS and RRMS patients were dry mouth (13.9% vs. 15%) and insomnia (12.9% vs. 11%), respectively. Urinary tract infection (UTI) (11.5%) and stomachache (11.5%) were the most common SEs in PPMS patients. The most severe complication of the patients was back pain, while digestive complications were less severe. Also, insomnia and UTI were the patients' most persistent SEs.

Conclusions: The drug seems to be safe and well tolerated, as the SEs were mild and transient and they were consistent with most of the previous studies focusing on this medication.

Background: The present study is a systematic review and meta-analysis aiming to investigate the effects of alcohol consumption on male sex hormones in humans.

Methods: We conducted searches on PubMed, Scopus, Science Direct, and Google Scholar from June 2020 to June 2022. We included observational studies (cohorts, case-controls, and cross-sectional studies) comparing FSH, LH, or testosterone levels in alcohol consumers versus non-consumers. Subgroup analysis based on alcohol intake levels was conducted to explore potential heterogeneity sources. The meta-analysis was done by STATA version 11. Seventeen studies met the criteria.

Results: Combining data from these studies, the standardized mean differences for FSH, LH, and testosterone in alcohol-exposed versus non-exposed groups were -0.00 (95% CI: -0.099-0.099), 0.04 (95% CI: 0.00-0.12), and 0.03 (95% CI: -0.11-0.16), respectively, showing no statistical significance. Subgroup analysis indicated a significant difference in FSH levels between moderate/high and low alcohol consumption groups (-0.04, 95% CI: -0.08 to -0.00). Similarly, compared to non-exposed individuals, testosterone levels differed significantly in groups with moderate (0.22, 95% CI: 0.12-0.32) and low (0.19, 95% CI: 0.04-0.35) alcohol intake. Given the notable alterations observed in testosterone levels among individuals with alcohol use disorder and the associated feedback changes in LH levels, it has been concluded that alcohol overuse should be recognized as a factor with destructive effects.

Conclusions: It is suggested that future research includes comprehensive studies to investigate the changes in the hypothalamus-pituitary-testis axis induced by alcohol consumption.

Background: An accurate assessment of food intake is necessary to monitor nutritional status. However, differences in cultures and dietary habits between communities make it necessary to create culturally specific tools to evaluate food intake. This study aimed to develop and validate a short food frequency questionnaire (SH-FFQ) in Iranian adults.

Methods: This perspective longitudinal study was conducted during four months. A total of 135 healthy adults over 18 years (both of sex) were included. The 24-hour dietary recalls (24-HDRs) (three times per month: A total of 12 numbers) were collected as reference for validation of SH-FFQ. Participants completed two SH-FFQ, once at the end of the fourth month for validity, and the second one week after the first administration for reliability assessing.

Results: Reliability analysis showed that the mean difference between the two SH-FFQs was not statistically significant (P > 0.05). None of the correlation coefficients (r_s) were less than 0.4. There was a substantial or perfect correlation (r > 0.6) in 85.1% and a moderate correlation (r = 0.4-0.6) in 14.9% of food items. For validity assessment, the average values of two SH-FFQ1 and SH-FFQ2 (SH-FFQ) were compared with the average values of 24-HDRs. All of the intraclass correlation coefficients (ICCs) of between SH-FFQ and 24-HDRs were equal to or greater than 0.4 (except one item). Moderate correlation (ICC = 0.4-0.6) and substantial or perfect correlation (ICC > 0.6) were observed in 38.3% and 59.6% of food items, respectively.

Conclusions: The current study showed that the developed SH-FFQ is reliable and valid in Iranian adults. This developed SH-FFQ can be used in nutritional assessments.

Background: Work-family balance has emerged as one of the influencing factors for the physical and mental health of working mothers and their children.

Aims: The present study aimed to understand the experiences and perspectives of working mothers on maternity leave and return to work after childbirth. This cross-sectional survey was conducted in three major cities in southeastern Iran.

Methods: Working mothers who had at least one live birth during the 3 years prior to the survey, aged between 18 and 49 years, and living with their husbands were enrolled using a consecutive sampling method. The sampling framework consisted of all government workplaces that had at least 30 female employees. Using a validated anonymous questionnaire consisting of demographic and attitude variables, we assessed the working mothers' experiences and perspectives regarding the quantity and nature of the last maternity leave and how supportive their workplace was. Descriptive statistics with frequencies and percentages were used. To compare categorical variables between groups, the Chi-square test was used. A P value of less than 0.05 was considered significant. Statistical analysis was done using SPSS version 22.

Results: A total of 900 female employees were invited to participate in the study, and finally, 741 valid questionnaires were analyzed. More than 21% of them reported that the office had changed their position or type of work after returning to work. Women with higher position jobs reported a higher husband's support for baby care (P = 0.03). Almost 51% of mothers agreed their workplace allowed them to use breastfeeding breaks, which was less evident in nurses (P = 0.001). Nearly 86% of them stated that mothering duties are much more important than job-related responsibilities.

Conclusions: Our study identified areas of consideration for investing in family-friendly workplace policies in Iran.

Background: Aging is caused by the progressive accumulation of various changes in the body, which is associated with an increase in free radicals and oxidative stress (OS). The aim of this study was to investigate the potential of caloric restriction (CR) and quercetin (QUER) in alleviating OS in aging and the involvement of the NAD (P) H quinone oxidoreductase 1 (NQO1)/SIRT1 signaling pathway in these effects.

Methods: Two age groups of male Wistar rats (eight and 20 weeks of age) were included in the study and subdivided into normal diet (ND), ND with QUER (15 mg Kg^-1, IP), ND with CR, and ND with QUER and CR groups. The activities of catalase (CAT), paraoxonase (PON1), liver enzymes and lipid profiles, and the expression of SIRT1 and NQO1 genes were analyzed using the desired methods.

Results: We showed higher liver enzymes (aspartate aminotransferase [AST], alanine transaminase [ALT], and alkaline phosphatase [ALP]), increased atherogenic lipids, and reduced PON1 activity in 20-week-old rats compared with eight-week-old rats, and the administration of QUER and CR restored these values to the normal range. The expression of NQO1 and SIRT1 is also affected by CR and QUER. CR alone and in combination with QUER significantly raised the expression of the NQO1 and SIRT1 genes. This effect was notable in SIRT1.

Conclusions: QUER and CR together improved the detrimental effects of aging by modulating antioxidant signaling pathways, suggesting this combination is a complementary therapeutic regime for aging and age-related diseases.

Background: Climate change poses significant threats to the health and safety of communities worldwide. Extreme weather events can disrupt critical infrastructure and overwhelm emergency medical services (EMS) systems. As the frequency and intensity of these climate-related disasters continue to increase, it is essential that EMS organizations develop robust strategies to enhance their resilience. One important step in building climate-resilient EMS systems is the development of comprehensive assessment tools. Developing a comprehensive tool for assessing the resilience of EMS in the face of climate change.

Methods: This research employs an applied, mixed-methods approach to investigate the development and validation of the Emergency Medical Services Resilience Assessment (EMSRA) tool. The study will be executed across four key phases: (a) A scoping review will be conducted to identify the global dimensions and components of EMS systems that demonstrate resilience to the impacts of climate change. (b) A qualitative study, involving semistructured interviews, will be undertaken to explore the specific dimensions and components of EMS resilience within the Iranian context. (c) Based on the findings from the scoping review and qualitative inquiry, assessment items related to EMS resilience in climate change will be extracted and synthesized to develop a pilot version of the EMSRA tool. (d) The pilot EMSRA tool will undergo a rigorous process of quantitative and qualitative validation, including an evaluation of its psychometric properties, to assess the resilience of EMS systems in the face of climate-related challenges.

Conclusions: The development of EMSRA tool will enable the assessment and enhancement of climate change resilience within the national and provincial EMS systems, providing critical data to inform evidence-based strategies and plans for strengthening EMS against the impacts of severe climate changes.

Background: Vitamin D (VD) deficiency and insulin resistance (IR) increase the risk of non-alcoholic fatty liver disease (NAFLD), but few studies have explored the potential mechanisms by which IR mediates the association between VD and the pathogenesis of NAFLD at the genetic level using publicly available databases.

Methods: This is a cross-sectional study, and we utilized the National Health and Nutrition Examination Survey (NHANES) dataset, as well as data from GSE200765 obtained from the Gene Expression Omnibus (GEO) website. A total of 723 individuals who had completed liver ultrasound examination and the detection of VD levels were included in the final analysis. A gene expression dataset, GSE200765, was also downloaded from the GEO website, to explore the potential mechanism of VD and NAFLD.

Results: In the NHANES data, covariates significantly differed in four VD categories, and the controlled attenuation parameter (CAP), vibration-controlled transient elastography-liver stiffness measurement (VCTE-LSM), and IR were reduced with an increase in VD levels. Mediation analysis revealed that IR mediated the association between VD and both CAP and LSM, and the estimated mediation effects were 29.0% and 39.8%, respectively. Bioinformatics analysis showed that seven differentially expressed genes (DEGs) (solute carrier family 2 member 2 [SLC2A2], protein phosphatase 1 regulatory subunit 3E [PPP1R3E], CAMP responsive element binding protein 3-like 3 [CREB3L3], Interleukin-6 [IL-6], peroxisome proliferator-activated receptor gamma coactivator 1-alpha [PPARGC1A], nuclear factor kappa B inhibitor alpha [NFKBIA], and phosphoenolpyruvate carboxykinase 2 [PCK2]) were enriched in the IR pathway in comparison groups (VD group vs. lipid group), suggesting that VD improved NAFLD via changed IR.

Conclusions: VD deficiency and IR were the risk factors for NAFLD, and increased VD levels improved the status of NAFLD. The underlying mechanism may be that elevated VD levels reduced IR, which improved the expression of DEGs involved in the IR pathway.

Background: Evaluation of scientific productions to attract, maintain, and promote faculty members is one of the necessary processes of academic societies and is of interest to policy makers in the field of higher education. This study aimed to provide a uniform and native framework for evaluating the scientific productions of researchers in the fields of science and health in Iran.

Methods: The current research used the single-stage fuzzy Delphi technique and AHP. The research community comprised 50 top scientific experts and researchers from the country. The data collection tool was a researcher-made checklist obtained from the review of literature and laws and regulations of Iranian universities and research institutions.

Results: Data analysis led to the identification, prioritization and weighting of eleven criteria and 124 items for the intended framework, which are, respectively, author's authority (scientific leaders) (15 items); database used in calculating the index (3 items); Innovation and technological impact (18 items); Gaining rank in national and international festivals related to the specialized field (6 items); Citations (7 items); subject area (3 items); level of cooperation (15 items); Types of scientific productions (54 items); scientific age (3 items); Evaluating, refereeing and monitoring of research, technology and innovation activities (2 items) Author`s role and position (1 item).

Conclusion: The final framework obtained for evaluating Iranian researchers has 11 criteria and 124 items that can be used to compile an author-centered and native scientometrics index that leads to the same evaluation of health and science researchers.

Background: Older adults with frailty have an increased risk of multiple negative health outcomes, such as disability, falls, and morbidity when exposed to physical stressors. The present study investigated the prevalence of frailty and associated risk factors among community-dwelling Indonesian older adults in several districts in Jakarta, Indonesia.

Methods: This cross-sectional study was done in several urban villages in Jakarta, Indonesia. It involved community-dwelling Indonesian older adults aged 60 and over. Sociodemographic and multiple health data were assessed and measured by a trained interviewer. Frailty was evaluated using Fried's criteria.

Results: The data analysis found a 14.7% prevalence of frailty among 518 participants. Multivariate analysis showed that frailty was independently associated with females (OR 3.62, 95% CI: 1.73-7.55), having multimorbidity (OR 2.01, 95% CI: 1.21-3.35), and clinical depression (OR 2.13, 95% CI: 1.24-3.65).

Conclusions: Early interventions in younger older adults, especially women in their early 50s or 60s, might decrease frailty risk over age 60. Controlling chronic disease and better mental education and support to reduce depression risk could reduce frailty risk.

Background: Depression literacy has notable advantages in the early identification and treatment of depression. The current study was conducted with the aim of translating and investigating the validity and reliability of the Depression Literacy Questionnaire (D-Lit) in Iranian young adults.

Methods: The current study entailed a descriptive-analytical study in which the translation, validation, and preparation of the Persian version of D-Lit were conducted. It had two stages: translation and validation. In order to check the composite reliability, the statistical population consisted of Iranian adults in the city of Mashhad, and 300 people participated in this study in the form of a census. The content validity ratio (CVR) and content validity index (CVI) indices were used for content validity.

Results: The results of the content validity evaluation of this questionnaire indicated that both the CVR and CVI indices have higher-than-average coefficients (0.78 and 0.83). Furthermore, the Cronbach's alpha value for the components of the D-Lit was found to be higher than 0.70. In the present study, the questionnaire's reliability was assessed using the intra-cluster correlation coefficient (ICC), and the difficulty coefficient for the whole questionnaire and its sub-components was at a favorable level. Out of 22 questions, 17 questions of this questionnaire were retained and questions 1, 17, and 22 were removed due to low CVR and CVI in the validity stage, and questions 5 and 13 were removed due to common factor load in the factor analysis stage.

Conclusion: According to the content validity and reliability in this study, this tool can be used to identify underlying factors, etiology, and treatment of depression.