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Background: Training needs assessment is the process of recognizing educational needs. This study aimed to apply a community-based nutrition education needs assessment to revise the nutrition course plan in the curriculum of the doctorate of medicine and that of the baccalaureate of nursing. Methods: The study was designed in 2 phases: (1) nutritional needs assessment; (2) community-based revision of nutrition course plan. In the first phase, 13 nutrition professionals working in the region set out 5 priorities of nutrition-related health problems in the community by a training need assessment based on a survey and scoring system. Then, an expert panel determined the priorities of behavioral and nonbehavioral causes of the nutrition-related health problems by the nominal group technique (NGT). The results of the first phase were used to review the topics of nutrition course plans up to 20%. Results: The priorities identified in Abadan, Khorramshahr, and Shadegan were obesity and type 2 diabetes mellitus in adults as well as anemia in pregnant women, respectively. Also, wrong eating habits and insufficient nutrition knowledge were among the most important behavioral causes of nutrition-related health problems in the target community. These results were applied to a community-based review of nutrition course plans for medical and nursing students. Conclusion: The use of nutritional needs assessment approaches by a survey and nominal group technique with a group of professionals provided an opportunity for a community-based review of the nutrition course plan for medical and nursing students as a first phase in the development of a community-based nutrition course plane.
RESUMO
Objective: Based on the results of previous studies, the effects of N. sativa on some of the non-alcoholic fatty liver disease's (NAFLD) biomarkers were positive; however, there were conflicting results regarding other variables. Therefore, the present systematic review of clinical trials was designed to clarify whether N. sativa effectively prevents the progression of NAFLD. Materials and Methods: A search of four databases (Scopus, PubMed, Medline, and Google scholar) was conducted to identify the clinical trials that assessed the effects of N. sativa supplementation on NAFLD. The outcome variables of interest were biomarkers of hepatic steatosis, liver enzymes, insulin resistance, and inflammation. Results: Overall, four randomized clinical trials (RCTs) were included. In three studies, hepatic steatosis grade decreased significantly after N. sativa supplementation. Serum levels of liver enzymes reduced significantly in three of four included trials. In the only study that examined the effect of N. sativa on insulin resistance parameters, all variables related to this factor were significantly reduced. In two included studies that measured biomarkers of inflammation, the serum levels of tumor necrosis factor α (TNF-α), high-sensitive C-reactive protein (hs-CRP), and interleukin 6 (IL-6) decreased significantly after intaking N. sativa supplements. Conclusion: Although the efficacy of N. sativa on liver enzymes and the grade of hepatic steatosis was reported in some of the included studies, more well-designed clinical trials are needed to determine the definitive effects of N. sativa on NAFLD. The present study provides suggestions that help to design future studies in this field.
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The main goal of bariatric surgery (BS) in patients with morbid obesity is reducing body mass and fat mass (FM). However, body mass loss is systematically accompanied by a decline in fat-free mass (FFM). We aimed to examine the time-course effect of BS on FFM and body FFM percentage (FFM%) in individuals with morbid obesity by conducting a systematic review and meta-analysis of controlled adult human trials. We searched PubMed, Scopus, Embase, Institute for Scientific Information Web of Science, and Cochrane databases within the period from October 2002 to May 2021, with no restriction in the English language, to find studies assessing the effect of BS on FFM and FFM% in patients with morbid obesity. A meta-analysis of 122 studies carried out on data of 10,758 patients with morbid obesity after BS showed that BS was associated with a substantial decrease in FFM at 1 (-3.47 kg [95% confidence interval [CI]: -3.88, -3.07]), 3 (-5.59 kg [95% CI: -6.01, -5.17], 6 (-6.61 kg [95% CI: -7.25, -5.98]), and 12 (-8.34 kg [95% CI: -9.04, -7.63]) months after the surgery; however, the FFM% increased at 3 (6.51% [95% CI: 5.00, 8.02]), 6 (8.56% [95% CI: 6.81, 10.31], and 12 (11.29% [95% CI: 8.94, 13.64]) months after the surgery. BS was associated with sustained declines in FFM and increases in FFM% from 1-12 months with no indication of plateau phase postoperatively. These findings emphasize that postbariatric care should focus more on FFM loss during the first year after surgery.