Journal of research in health sciences最新文献

Background: Behavioral modification programs have improved body composition, dietary behavior (DB), and physical activity (PA). However, there is limited evidence on the effectiveness of these programs among overweight high school students in rural areas of Thailand. Therefore, this study aimed to examine the effects of a school-based behavioral modification (SBM) program on these factors among high school students with overweight. Study Design: This study employed a randomized controlled trial.

Methods: The study was conducted from November 2022 to May 2023 among overweight high school students. A total of 100 overweight students were randomly assigned to either an intervention (n=50) or a control (n=50) group. The intervention group received an SBM, while the control group received the usual educational program. The chi-square test, independent-samples t-test, Mann-Whitney U test, ANOVA, and Cochran's Q test were used to analyze data.

Results: Both groups were female (72.0%), with a mean age of 17.03 years. At the follow-up, the intervention group demonstrated significant improvements in DB and PA and a reduction in sedentary behavior compared to the control group (P<0.05). Additionally, statistically significant differences were observed between the intervention and control groups regarding biceps (P=0.001), triceps (P=0.031), and waist circumference (P<0.001).

Conclusion: The SBM effectively increased students' PA, improved DBs, decreased sedentary behavior, and resulted in changes in body composition. These findings indicated that SBM programs are useful for healthcare providers or teachers to promote healthy behaviors among students and can be applied in related research in different contexts and situations.

Background: Sleep quality is crucial in heart failure (HF) patients, yet its associations with clinical, demographic, and psychosocial factors remain underexplored. This study examined these relationships to identify predictors of poor sleep quality. Study Design: A cross-sectional study.

Methods: This cross-sectional was conducted on 354 HF patients at Shahid Chamran Heart Hospital, Isfahan, Iran (September 2023-2024). Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) were used to evaluate sleep quality, anxiety, and depression, respectively. Random forest (RF) modeling and ordinary least squares (OLS) regression identified predictors of poor sleep quality.

Results: Poor sleep quality (PSQI>7) was observed in 18% of patients who were older (70.00±6.30, P<0.001) and had lower ejection fraction (EF) (23.75±12.79%, P<0.001). This group also had higher systolic blood pressure (BP 140.67±12.50 mmHg, P=0.014). Complex medication regimens, including angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and diuretics, were associated with poor sleep (P<0.001). Moreover, depression (HADS-depression: 5.36±0.70, P<0.001) and anxiety (HADS-anxiety: 4.84±1.32, P<0.001) were correlated with poor sleep. The RF model had an area under the curve of 0.79, and OLS regression (R²=0.280) highlighted New York Heart Association (NYHA) class and medication type as significant predictors.

Conclusion: Overall, poor sleep quality in HF patients was related to older age, reduced cardiac function, higher blood pressure (BP), complex medication regimens, and increased anxiety and depression. Accordingly, multidimensional management strategies are needed to improve sleep outcomes.

Background: Anemia is a common blood disorder in developing countries and is associated with diseases such as diabetes, as well as cardiovascular and pulmonary diseases. This study aimed to investigate the relationship between anemia and anthropometric profiles in the Tabari cohort population. Study Design: A case-control study.

Methods: In this study, we used a subset of data collected during the first phase of the Tabari cohort study (TCS). All participants who had anemia were included in the case group (1352 individuals) using the census method. The control group (1352 individuals) consisted of participants who did not have anemia and were randomly selected from the remaining participants. The case and control groups were matched for age and gender. Anthropometric indices, including body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR), were measured by qualified and trained persons. Hematological indices were measured, and data were analyzed using the chi-square test and independent t test. A multiple logistic regression analysis was used to adjust for possible confounding variables.

Results: The place of residence, education level, socioeconomic status, WC, BMI, and WHR were significantly different between the case and control groups (P<0.05). Anthropometric indices, including BMI (adjusted OR=0.75; 95 % CI 0.61, 0.91), WC (adjusted OR=0.86; 95 % CI 0.74, 1.00), and WHR (adjusted OR=0.75; 95 % CI 0.64, 0.88), were significantly different between the case and control groups (P<0.05).

Conclusion: Anthropometric indices were associated with anemia, and participants with higher BMI, WC, and WHR were less likely to develop anemia.

Background: This study was conducted to investigate the trend of some tuberculosis (TB) indices and identify existing gaps in addressing this important public health issue in Hamadan province over a long time period. Study Design: A registry-based cross-sectional study.

Methods: In this study, we examined the trend of 10 TB indicators separately in males and females, including the incidence rates of smear-positive pulmonary TB (SPPT), extra-pulmonary TB (EPT), and smear-negative pulmonary TB (SNPT), co-infection with AIDS, relapse rate, smear conversion rate two months after treatment initiation, TB mortality rate, diagnosis rate of pulmonary TB with a smear grade of 3+, treatment success rate, and TB diagnosis rate by the private sector in Hamadan province during 2011-2022. The trend analysis of TB was conducted using Joinpoint regression model, and the annual percentage change (APC) and the average annual percentage change (AAPC) were calculated.

Results: A total of 481 females and 554 males were eligible for analysis. The incidence of SPPT in females showed a decreasing trend (AAPC: -7.72; 95% CI: -15.63, -1.10; P=0.008). The rates of EPT and treatment success showed a significant downward trend in both genders. In contrast, the recurrence rate among females exhibited a notable upward trend during the specified time period (AAPC: 18.45; 95% CI: 3.23, 46.47; P=0.0002).

Conclusion: The findings of this study suggest that the epidemiological profile of TB has exhibited a relatively favorable trend in some of the examined indicators since 2011, with declines observed in both SPPT and EPT.

Background: Integrated trauma systems (ITS) have shown potential in reducing traffic crash-related injuries and mortality, although their structure and impact can vary. This study assessed the effectiveness of ITS in Guilan, Iran. Study Design: A retrospective observational study.

Methods: Utilizing a cross-sectional analysis, this descriptive-analytical study was conducted in Northern Iran from 2015 to 2019 to compare road traffic crash (RTC) data in Guilan (with ITS) against Mazandaran (without ITS), considering weather as a confounder. The study involved pre- and post-ITS intervention analyses to evaluate changes in RTC, injury, and mortality rates.

Results: Before ITS implementation, Guilan's daily RTC mean was 38.4 (SD=16.7), which significantly decreased to 30.8 (SD=13.7) after the intervention. Conversely, in the control province of Mazandaran, the daily average number of RTCs increased from 37.29 (SD=14.1) to 42.55 (SD=16.4) post-ITS implementation in Guilan. Furthermore, the mortality rate in Guilan showed a marginal decline from 27.74 (SD=12.6) pre-ITS to 26.60 (SD=11.9) post-ITS, indicating the positive impact of the ITS. In contrast, Mazandaran demonstrated a significant increase in mortality from 32.16 (SD=14.5) to 51.75 (SD=15.7). The statistical analysis confirmed a significant reduction in mortality and injury incidence in Guilan at the time of the intervention, with a marked decrease observed post-intervention (P<0.001).

Conclusion: The findings revealed that RTC prevention is feasible in Iran, with ITS in Guilan significantly reducing RTCs, injuries, and mortalities, underscoring the importance of ongoing efforts to expand ITS components nationally.

Background: Breast cancer (BC) is the most common cancer in women, and it is important to identify models that can accurately predict mortality in patients with this cancer. The aim of the present study was to use the elastic net regression and artificial neural network (ANN) models in diagnosing and predicting factors affecting BC mortality. Study Design: A cross-sectional study.

Methods: The data of 2,836 people with BC during 2014-2018 were analyzed in this study. Information was registered in the cancer registration system of Kerman University of Medical Sciences. Death status was considered the dependent variable, while age, morphology, tumor differentiation, residence status, and residence place were regarded as independent variables. Sensitivity, specificity, accuracy, area under the receiver operating characteristic curve (AUC), precision, and F1-score were used to compare the models.

Results: Based on the test set, the elastic net regression determined factors affecting BC mortality (with sensitivity of 0.631, specificity of 0.814, AUC of 0.629, accuracy of 0.792, precision of 0.318, and F1-score of 0.42) and ANN did so (with sensitivity of 0.66, specificity of 0.748, AUC of 0.704, accuracy of 0.738, precision of 0.265, and F1-score of 0.37).

Conclusion: The sensitivity and AUC of the ANN model were higher than those of the elastic net regression, but the specificity, accuracy, precision, and F1-score of the elastic net were higher than those of the ANN. According to the purpose of the study, two models can be used simultaneously. Based on the results of models, morphology, tumor differentiation, and age had a greater effect on death.

Background: Prediabetes is a golden period because the blood sugar levels can be lowered to normal levels, unlike diabetes mellitus. Studies on risk factors of prediabetes in Indonesia have never been conducted before, especially with cohort study design. The purpose of this study was to identify risk factors associated with prediabetes in Indonesia based on a cohort study conducted in Bogor, Indonesia. Study Design: A retrospective cohort study.

Methods: This study was conducted using data from the Bogor Cohort Study done by the Ministry of Health of Indonesia, which included individuals aged more than 25 years. Individuals who had impaired fasting glucose (IFG) (100-125 mg/dL) and/or impaired glucose tolerance (IGT) (140-199 mg/dL) at baseline screening were excluded from the study. Demographic characteristics, risk factors, and clinical observations were extracted using a questionnaire. Cox regression was used for data analysis.

Results: The cumulative incidence of prediabetes in Bogor was 50.3%. Factors associated with prediabetes were old age (RR: 1.33; 95% CI 1.19, 1.47), female gender (RR: 1.32; 95% CI 1.18, 1.48), overweight (RR: 1.17; 95% CI 1.01, 1.36), obesity (RR: 1.26; 95% CI 1.08, 1.46), central obesity (RR: 1.17; 95% CI 1.02, 1.34), high cholesterol levels (RR: 1.11; 95% CI 1.00, 1.22), and hypertension (RR: 1.27; 95% CI 1.14, 1.42).

Conclusion: Age is a dominant risk factor for prediabetes. Therefore, it is important to stick to a healthy lifestyle by doing more physical activities and maintaining a balanced diet since young age to prevent prediabetes.

Background: Despite the decrease in prevalence from 18.5% in 2013 to 12.3% in 2018, diarrhea presents a major public health challenge in Indonesia which leads to significant mortality. This study investigated factors influencing diarrhea among children under five years of age in underdeveloped regions of Indonesia, where disparities from other regions are significant. Study Design: A cross-sectional study.

Methods: This study obtained data from National Basic Health Research conducted in 2018. Sixty underdeveloped regions of Indonesia, with a total of 9243 children aged 0-59 months, were included. Chi-square, bivariate, and multivariate analyses were conducted to determine factors influencing the prevalence of diarrhea in children under 5 years of age.

Results: Multivariate analysis revealed that the age categories of 12-23 months (OR: 1.73; 95% CI: 1.48, 2.02) and 24-35 months (OR: 1.31; 95% CI: 1.11, 1.53), awareness of a nearby hospital (OR: 0.74; 95% CI: 0.63, 0.86), and history of acute respiratory infection (ARI) in the past month (OR: 1.99; 95% CI: 1.66, 2.40) were associated with diarrhea in children under the age of five in underdeveloped regions of Indonesia. In contrast, the environmental factors analyzed further in the study were not significantly associated with the prevalence of diarrhea in children under five years of age in underdeveloped regions of Indonesia.

Conclusion: These findings suggest that the child's age, the child's history of ARI, and household awareness of nearby hospitals are critical factors associated with the child's diarrhea in underdeveloped regions of Indonesia.

Background: Hypertension (HTN) elevates blood pressure (BP) in the arteries. It is defined as systolic BP (SBP)>140 mm Hg and/or diastolic BP (DBP)>90 mm Hg. This study aimed to identify determinant risk factors of longitudinal change of SBP and DBP with time to first remission of hypertensive patients. Study Design: A retrospective cohort study.

Methods: A descriptive and inferential analysis was employed to explore the determinant risk factors, and a multivariate joint model was applied to test the significant association of the possible risk factors.

Results: Of all 369 patients, 235 (63.7%) had first remission with a median survival time of five months. The patients demonstrated shorter first remission time when they had no history of comorbidity, resided in urban areas, took a combination of drugs, and were younger. Similarly, residence, age, treatment, history of diabetes mellitus (DM), history of stroke, and observation time were determinant risk factors of SBP. On the other hand, age, treatment, history of DM, chronic kidney diseases, and observation time were identified as determinant risk factors of DBP. The result revealed a strong positive association between changes in SBP and DBP (P=0.9923). In addition, a significant association was observed between the value of SBP and time to first remission (γ_1=-0.0693, HR=0.993).

Conclusion: Having good follow-ups, receiving control of comorbidity, and taking a combination of drugs show several opportunities for decreasing BP. Consequently, this compels patients to experience the first remission early.

Background: Poor sleep quality in the elderly is a prevalent issue that can significantly impact overall health and quality of life. This study aimed to assess the prevalence of sleep disorders and the factors contributing to poor sleep quality among older adults in Western Iran. Study Design: This is a cross-sectional study.

Methods: This study involved 403 elderly people. The following tools were employed to collect data: the Pittsburgh Sleep Quality Index (PSQI), the Leisure and Pleasure Activities Database (a quality-of-life tool), the standardized Depression, Anxiety and Stress Scale (DASS-21), and the Abbreviated Mental Test (AMT)for cognitive assessment. A backward stepwise selection method was employed to finalize the variables for multiple logistic regression analysis.

Results: The overall prevalence of poor sleep quality was 44.7%. With each one-point increase in stress, the likelihood of experiencing poor sleep quality increases significantly (adjusted OR: 1.09, P<0.001). The number of children in the household was found to have a protective effect against poor sleep quality (adjusted OR=0.63, P=0.008). Furthermore, elderly individuals working as housekeepers had higher odds of poor sleep quality than those employed elsewhere (adjusted OR=7.45, P=0.005).

Conclusion: A significant association was observed between elevated stress levels and poor sleep quality. Interestingly, the presence of children in the household appeared to offer a protective effect. Conversely, individuals in household management roles faced a dramatically increased risk of poor sleep quality. These findings offer preliminary evidence for the potential effectiveness of early interventions and prevention strategies designed to improve sleep quality and reduce social frailty in the elderly.