Examination of influence of social media education through mobile phones on the change in physical activity and sedentary behavior in pregnant women: a randomized controlled trial.

BACKGROUND: Nowadays because of some necessities and demands for virtual and remote education, a new model of health approach through mobile-phones is widely used to deal with improving physical activity and its beneficial effect on pregnancy. There are a small number of studies for showing this importance and the efficacy of such methods, so this study was aimed to determine the influence of social networking through mobile phones on changing the physical activity behavior in pregnant women. METHODS: This randomized controlled trial was conducted with parallel groups on 90 pregnant women referring to Urmia health centers in 2018-2019. The participants from various social and economic backgrounds were included. The participants were randomly assigned to a control and a treatment group. Demographic and Pregnancy Physical Activity Questionnaire (PPAQ) questionnaires were filled. In addition to routine cares, the treatment group received educational intervention through social network within 16 training sessions related to physical activity and nutrition in 8 weeks. RESULTS: The mean weight in both control and treatment groups changed significantly during the study, but in different trends (P < 0.001, Mean Difference (MD) = 4.43). At the beginning of the study, control and treatment groups were not different in terms of daily physical activity level (P = 0.17, MD = 0.62), meanwhile, there was a statistically significant difference at the end of intervention in the level of daily physical activity (P < 0.001, MD = 0.69). Comparison of both groups, based on different categories of activity level at the end of the treatment, showed a non-significant difference in sedentary activities (P = 0.89, MD = 0.46), but the intervention led to a significant difference based on the other level of activities; light (P < 0.001, MD = 51.94), moderate (P < 0.001, MD = 46.87), and sever (P = 0.05, MD = 1.07). CONCLUSION: Educational intervention based on social networks through mobile phones had an effective role in behavior change in physical activity during pregnancy. TRIAL REGISTRATION: IRCT20151004024340N15, Registration date05/06/2020.

Do the patient education program and nurse-led telephone follow-up improve treatment adherence in hemodialysis patients? A randomized controlled trial.

BACKGROUND: End-Stage Renal Disease (ESRD) is the final and permanent stage of Chronic Kidney Disease (CKD). Hemodialysis (HD) is the most common treatment for CKD. To have desirable therapeutic outcomes, patients have to adhere to a specific therapeutic regimen that reduces the hospitalization rate and side-effects of HD. The present study aimed to determine the effects of the patient education program and nurse-led telephone follow-up on adherence to the treatment in hemodialysis patients. METHODS: This is a randomized controlled trial in which a total of 66 patients were recruited using convenience sampling and then randomly assigned to two groups of control (n = 33) and intervention (n = 33). Data were collected using a demographic questionnaire, the laboratory results record sheet, and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), which included four dimensions of HD attendance, medication use, fluid restrictions, and diet recommendations. The intervention group received a patient education program and nurse-led follow-up services through telephone communication and the Short Message Service (SMS) for 3 months. All participants filled in the questionnaire before and after the intervention. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). RESULTS: The results showed a significant difference in the mean scores of HD attendance, medication use, fluid restrictions, and diet recommendations between the two groups immediately, 1 month, and 3 months after the intervention (p < .001). The results also indicated a significant difference in the mean scores of four dimensions during the four-time points of measurement in the intervention group (P < 0.0005). Therefore, the level of treatment adherence in the intervention group was higher than in the control group. Moreover, there was a significant difference in the mean score of laboratory values between the two groups after the intervention, except for the level of serum sodium (P = 0.130). CONCLUSION: Implementation of the patient education program and nurse-led follow-up can lead to better adherence to hemodialysis in four dimensions of HD attendance, medication use, fluid restrictions, and dietary recommendations in HD patients. TRIAL REGISTRATION: IRCT registration number: IRCT20190127042512N1 ; Registration date: 2020-09-12; Registration timing: retrospectively registered: Last update: 2020-09-12.

Socioeconomic - related inequalities in overweight and obesity: findings from the PERSIAN cohort study.

BACKGROUND: Overweight and obesity are major health concerns worldwide, with adverse health consequences during the life span. This study measured socioeconomic inequality in overweight and obesity among Iranian adults. METHODS: Data were extracted from 129,257 Iranian adults (aged 35 years and older) participated in the Prospective Epidemiologic Research Studies in IrAN (PERSIAN) in 14 provinces of Iran in 2014. Socioeconomic-related inequality in overweight and obesity was estimated using the Concentration Index (Cn). The Cn further decomposed to find factors explaining the variability within the Socioeconomic related inequality in overweight and obesity. RESULTS: Of the total number of participants, 1.98, 26.82, 40.76 and 30.43% had underweight, normal weight, overweight and obesity respectively. The age-and sex standardized prevalence of obesity was higher in females than males (39.85% vs 18.79%). People with high socioeconomic status (SES) had a 39 and 15% higher chance of being overweight and obese than low SES people, respectively. The positive value of Cn suggested a higher concentration of overweight (0.081, 95% confidence interval [CI]; 0.074-0.087) and obesity (0.027, 95% CI; 0.021-0.034) among groups with high SES. There was a wide variation in socioeconomic-related inequality in overweight and obesity rate across 14 provinces. The decomposition results suggested that SES factor itself explained 66.77 and 89.07% of the observed socioeconomic inequalities in overweight and obesity among Iranian adults respectively. Following SES, province of residence, physical activity, using hookah and smoking were the major contributors to the concentration of overweight and obesity among the rich. CONCLUSIONS: Overall, we found that overweight and obesity is concentrated among high SES people in the study population. . Accordingly, it seems that intersectional actions should be taken to control and prevent overweight and obesity among higher socioeconomic groups.

Socioeconomic gradient in physical activity: findings from the PERSIAN cohort study.

BACKGROUND: The level of socioeconomic-related inequality in physical activity in Iran is largely unknown. This study investigates socioeconomic-related inequality in poor-physical activity (PPA) among Iranian adults. METHODS: A total of 129,257 adult participants enrolled in the PERSIAN (Prospective Epidemiological Research Studies in IrAN) Cohort were included in this study. Physical activity of adults was measured using metabolic equivalent rates (METs). Physical activity less than 41 METs/hour/day was considered PPA. The Concentration index (C) was used to quantify socioeconomic-related inequality in PPA. Moreover, the C was decomposed to identify the relative contribution of explanatory variables to inequality in PPA. RESULTS: There were significant regional variations in physical activity level among Iranian adults (29.8-76.5%). The positive value of C (0.098, 95% CI = 0.092 to 0.104) suggested that the higher concentration of PPA among higher socioeconomic status (SES) adults in Iran which was consistently observed in all cohort sites. CONCLUSIONS: The higher prevalence of PPA among Iranian adults, especially, women and older adults, warrant further public health attention. Since PPA is concentrated more among the high-SES population in Iran, strategies for the promotion of physical activity should focus more on economically well-off population.

Serum vitamin D level and its relation to thyroid hormone, blood sugar and lipid profiles in Iranian sedentary work staff.

INTRODUCTION: the sedentary lifestyle is related to the incidence of various diseases and metabolic disorders. The aim of the current study was to understand the link between serum vitamin D levels, thyroid hormones and lipid profiles among Iranian sedentary staff. MATERIAL AND METHODS: in this cross-sectional study, 300 healthy subjects with normal body mass index (BMI) and age between 18 and 65 years, with sedentary lifestyles, were included. Serum levels of 25-hydroxyvitamin D, thyroid stimulating hormone (TSH), fasting blood sugar, plasma total cholesterol, and high-density lipoprotein (HDL) and triglycerides (TG) were measured with qualified laboratory methods. Low-density lipoprotein (LDL) concentration was calculated based on the Friedewald equation. A self-made questionnaire with different questions was used to assess physical activity. RESULTS: the means of BMI and age were 25.63 ± 10.25 and 36.69 ± 7.14 years, respectively. The prevalence of vitamin D deficiency was 65.7%. Results showed significant differences for TG, HDL, and thyroxine (T4) between subgroup categories. Serum levels of 25-hydroxyvitamin D had a negative significant correlation with triiodothyronine (T3) and T4, and a positive correlation with HDL. Linear regression analysis showed a significant association of 25-hydroxyvitamin D concentrations with HDL and T4 after adjustments based on the sex. CONCLUSION: finally, the results of this study show that with the improvement in vitamin D status, the decrease in the levels of TG, T3 and T4, with an increase in HDL can be expected. So, verification and detection of true causality through the interventional studies will be valuable, scientifically.

Non-diabetic Hyperglycemia and Some of Its Correlates in ICU Hospitalized Patients Receiving Enteral Nutrition.

INTRODUCTION: Hyperglycemia is a common occurrence in critically ill patients, and its prevalence in patients receiving nutritional support is much higher than in other patients. The non-diabetic form is associated with more undesirable outcomes. This study was performed to determine the prevalence of non-diabetic hyperglycemia and its correlates in patients receiving enteral nutrition. MATERIAL AND METHODS: This cross-sectional study was performed between March and December 2015. Seven hundred forty eight (748) patients were reviewed to see if they met the inclusion criteria. After random sequence numbering, 414 patients who were eligible for further assessment and data gathering were selected. Hyperglycemia was defined as the blood glucose levels higher than either 126 mg/dL, in the fasting state, or 180 mg/dL, in a random state. Blood glucose was measured by an ACCU-CHECK glucometer (Roche diagnostics, Mannheim, Germany) three times, after ICU admission, in both fasting and random state. A pre-prepared form was used to extract data from hospital records. Data analysis was performed by SPSS 21 software. RESULTS: In this group of hospitalized patients, the prevalence of non-diabetic hyperglycemia was 14/49 (60/414). In the hyperglycemic subgroup, mean FBS was 228.00±36.42, mean random BS was 183.19±43.94 and mean blood sugar on the first day of hospitalization was 203.60 ± 60.79. The mean age of patients was 56.64±19.79 years and the mean duration of hospitalization was 19.24±15.33 days. There was no significant relationship between enteral nutrition feeding volume and hyperglycemia. Majorly, patients aged above 60 years were hyperglycemic. The prevalence was higher in men than in women. Most patients were internal cases, but with the highest prevalence of hyperglycemia in surgical patients. CONCLUSIONS: Since among different studied variables just diagnosed disease and the level of provided calorie showed significant differences between subgroup categories, so it can be suggested that designing on-time appropriate management programs based them can be effective on the administration of non-diabetic hyperglycemia and its undesirable consequences in such patients.

Food intake, plate waste and its association with malnutrition in hospitalized patients.

BACKGROUND: Hospital malnutrition is a worldwide dilemma and challenge. High levels of plate waste contribute to malnutrition-related complications in hospital. We investigated the association between the levels of plate waste, food intake and patient satisfaction with nutritional risk and malnutrition prevalence in three hospital settings. METHODS: The sample population of 120 patients, aged 18-65 year, admitted consecutively over a 12 month period to 3 different educational university hospitals was included. For all the patients, diet history, anthropometric measurements, body mass index and patient satisfaction with the hospital food service was evaluated. Weight plate waste for all daily meals was done and actual intakes computed individually for each day. Nutrition risk screening (NRS)-2002 (≥ 3) tool was used for estimating the nutritionally at-risk population. Results: From one hundred twenty non-critically ill patients with a mean 8.9 ± 3.5 day length of hospital stay, 40.8% (49) were men and 59.2% (71) were female. Mean energy and protein requirements were 2,030.3 ± 409.03 kcal/day and 76.13 ± 15.33 g/day respectively. Mean intakes were 1,326 ± 681.44 kcal/day and 66.81 ± 31.66 g/day respectively. The mean percent of plate waste for lunch and dinner were 37.7 ± 29.88 and 30.4 ± 23.61 respectively. In the total population, 25% of patients were satisfied and 75% patients were unsatisfied with hospital foods. Based on BMI (< 20), unintentional weight loss (> 10%), malnutrition prevalence was 12.5% and 14.2% respectively during hospitalization. The prevalence of nutritionally at-risk population was 30% at admission time and reached 33.3% at discharge. CONCLUSION: Plate waste and hospital malnutrition were highly prevalent in accompanying with increasing nutritionally risk progression. So it should be addressed as an important health issue and appropriate strategies for stimulating governmental policies should be adopted.

Seasonal variations of vitamin D and its relation to lipid profile in Iranian children and adults.

BACKGROUND: Vitamin D has a multitude of functional properties and acts like a hormone in the body. Its effect on the lipid profile is one of the proposed mechanisms for its relationship with many disorders during its deficiency. But, this relationship is still conflicting and debatable, so this study was conducted to determine the association between serum level of vitamin D and lipid profiles, including serum concentrations of cholesterol, triglyceride (TG), HDL, and LDL in healthy subjects. METHODS: In this cross-sectional study, 541 volunteers with age of 5-60 years from normal and healthy subjects were selected via random sampling. Demographics and history of daily or weekly sunlight exposures were recorded. Measuring vitamin D was done in two consecutive seasons: winter and summer. Ten milliliters of peripheral venous blood sample was withdrawn after an overnight fasting. Serum levels of 25(OH) D (25, hydroxy vitamin D3) were measured using the enzyme-linked immunosorbent assay (ELISA), and the Confirmatory test was done by high-performance liquid chromatography (HPLC). RESULTS: Mean age in the total mixed population was 30.83 ± 14.02 years. Subjects were 50.5% male and 49.5% female. Mean 25(OH) D in the total population for winter and summer were 45.8 ± 24.26 ng/ml and 55.24 ± 37.47 ng/ml respectively. In the total population, 38.08% were vitamin D deficient. Comparing serum lipid levels in the summer and winter showed a significant difference for cholesterol, LDL, and HDL, but no significant effect was found for TG. Analysis for the comparison of lipid profiles between the two genders in winter showed that there were significant differences in all lipid profiles except for LDL, while such analysis for summer revealed significant difference just for TG. In multivariate analysis, there was a significant mean difference only for LDL in subgroups with vitamin D insufficiency and deficiency. There was no correlation between Vitamin D and lipid profiles. CONCLUSIONS: Vitamin D is different between the two seasons regardless of gender variations. Its status showed some significant relationship with some lipid profiles (cholesterol, LDL, and HDL) during the two seasons. There were different results among winter and summer based on the gender.

Effects of Appropriate Nutrition Training in Small Groups on Laboratory Parameters in Hemodialysis Patients from Iran.

INTRODUCTION: Adherence to appropriate nutrition and fluid intake is one of the essential parts of chronic renal failure treatment for achieving the desirable results among the patients with hemodialysis. Among various training methods, the "small groups' method", as an advanced method, can be performed by nurses in achieving desirable therapeutic results. The present study was aimed to investigate the effect of appropriate nutrition training in small groups on laboratory parameters in hemodialysis patients. MATERIAL AND METHODS: In this clinical trial, 64 patients who met the inclusion criteria were randomly selected and divided into an intervention group and a control group. Subsequently, an appropriate nutritional training program, including lectures along with appropriate nutrition pamphlets in three one hour question and answer sessions were performed. Thirty two patients in each group were assigned to intervention groups of five. Then, the laboratory indicators for each patient were measured in each group one month after training. Thereafter, data analysis was performed using descriptive and analytical statistics (statistical tests including independent t-test, paired t-test, repeated measures, and ANOVA) in SPSS V.16 software. RESULTS: The mean age of the patients was 50.1 ± 13.1 years; 47.5% of them had undergone dialysis due to hypertension and 55.7% had a history of 1-5 years of hemodialysis. There was a significant difference in post-intervention levels of urea, creatinine, sodium, potassium, calcium, and phosphorus between the two groups. CONCLUSIONS: Appropriate nutrition training via small-group method for patients on hemodialysis can impose positive effects on laboratory parameters.

Social Determinant Factors and their Relationship with Nutritional Pattern in Cardiovascular Patients after Hospital Discharge.

INTRODUCTION: Several evidences suggest that it will be possible to reduce the risk of cardiovascular diseases by modifying its risk factors. Current study designed for identifying some social determinant factors and their relationship with nutritional pa! ern in cardiovascular patients a" er hospital discharge. METHODS: This cross-sectional study was conducted on 385 cardiovascular discharged patients from an university specialized heart educational hospital. Patients were included by simple sampling methods. Data collected via interview and a preset questionnaire with two diff erent sections; demographic and nutrition evaluation section one. Collected data was analyzed by SPSS 20 software. RESULTS: The results showed a signifi cant relationship between nutritional pa! erns and age, location, job, marital and educational status. There was no signifi cant relationship between nutritional pa! ern and sex, income, and housekeeping status. CONCLUSION: Some social factors are eff ective on nutritional pa! ern in patients with cardiovascular diseases that they can be used in diff erent fi elds for investment, including nursing education and management services.