The burden of HMPV and influenza associated hospitalizations in adults in New Zealand, 2012-2015.

BACKGROUND: Unlike influenza, information on the burden of human metapneumovirus (HMPV) as a cause of hospitalizations in adults with acute respiratory illness (ARI) is limited. METHODS: We compared the population-based incidence, seasonality, and clinical characteristics of these two viral infections among adults aged 20 years and over with ARI hospitalisations in Auckland, New Zealand, during 2012-2015 through the Southern Hemisphere Influenza Vaccine Effectiveness Research and Surveillance (SHIVERS) project. RESULTS: Of the 14,139 ARI hospitalisations, 276 (4.3%) of 6484 tested positive for HMPV and 1342 (19.1%) of 7027 tested positive for influenza. Crude rates of 9.8 (95% CI: 8.7-11.0) HMPV and 47.6 (95% CI: 45.1-50.1) influenza-associated ARI hospitalisations were estimated for every 100,000 adult residents annually. The highest rates for both viruses were in those aged 80 years or older, of Maori or Pacific ethnicity, or living in low socioeconomic status (SES) areas. HMPV infections were more common than influenza in those with chronic medical conditions. CONCLUSIONS: Although HMPV infections accounted for fewer hospitalisations than influenza in adults aged 20 years and over, HMPV-associated ARI hospitalisation rates were higher than influenza in older adults, Maori and Pacific people and those of low SES. This highlighted a need for vaccine/antiviral development.

Separation and identification of snuff constituents by using GC-MS and ICP-OES as well as health risk assessment of some existing heavy metals.

The identification of volatile organic components in snuff was accomplished using GC-MS analysis in this study. The findings of the GC-MS analysis revealed the presence of nicotine, its derivatives, and several other toxic chemicals that are hazardous to human health. Furthermore, the content of 34 elements in four brands of snuff consumed in Neyshabur City was determined by ICP-OES analysis (with five repetitions). The health hazards of measured heavy elements were examined from two perspectives: carcinogenic (7 heavy elements were checked) and non-carcinogenic (4 heavy elements were checked). The investigation of non-carcinogenic hazards from inhalation was based on the computation of the hazard quotient (HQ) factor, and the results indicated that inhaling five heavy metals, Cu, Pb, Ni, Zn, and Cd, does not represent a substantial health risk ((HQ < 1). In contrast, the computed HQ factors for Cr and As were relatively high (1 < HQ < 10), indicating a substantial health risk from breathing these two elements. The carcinogenic factor (CR value) results revealed that the degree of carcinogenic risk for Cd was very low (CR value less than 1 × 10-6) and did not pose a concern to the consumer population. However, the risk of As, Cr, and Ni exposure is considerable in the carcinogenic risk range (CR values between 1 × 10-6 and 1 × 10-4).

Socioeconomic inequality in depression and anxiety and its determinants in Iranian older adults.

BACKGROUND: Older adults with lower socioeconomic status are more vulnerable to stressful life events and at increased risk of common mental health disorders like anxiety and depression. This study investigates the socioeconomic inequality in depressive symptoms and anxiety. METHODS: The data were from 7462 participants of the Neyshabur longitudinal study of ageing registered during 2016-2018. The outcome variables were anxiety and depressive symptoms. Anxiety was defined by the "Hospital Anxiety and Depression scale Questionnaire", and depressive symptoms was defined and measured by the "short-term form of the Epidemiological Center Questionnaire." The socioeconomic status was defined using principal component analysis of home assets. The Concentration Index (C) was used to measure socioeconomic inequality in anxiety and depressive symptoms. Concentration index was decomposed to its determinants to determine the role of the independent variables on inequality. RESULTS: The prevalence of depressive symptoms and anxiety was 12.2% (95% CI: 11.4, 12.9) and 7.0% (95% CI: 6.4, 7.5), respectively. Moreover, the C for anxiety was -0.195 (95% CI: -0.254, -0.136) and for depressive symptoms was -0.206 (95% CI: -0.252, -0.159), which indicate a considerable inequality in favor of high socioeconomic group for anxiety and depressive symptoms. Decomposition of the concentration Index showed that education, unemployment and male sex were the most important positive contributors to the observed inequality in anxiety and depressive symptoms, while age and number of grandchildren were main negative contributors of this inequality. CONCLUSION: Low socioeconomic groups were more affected by anxiety and depressive symptoms. Any intervention for alleviation of inequality in anxiety and depression should be focus on education and employment of people, especially in younger elderly.

Metabolic Syndrome and Body Composition Among People Aged 50 Years and Over: Results from The Neyshabur Longitudinal Study on Ageing (NeLSA).

There are few studies regarding body composition and metabolic syndrome (MetS) association in older adults. To evaluate the association between MetS and body composition indices in a large-scale population of subjects with an age of 50 and up. This study was based on the data from Neyshabur Longitudinal Study on Ageing (NeLSA) in a total of 7462 people of Neyshabur city in IRAN. The best cut-off scores and AUC value of body composition variables for having association with likelihood of MetS were determined by using a receiver operating curve analysis. Each unit increase in the Waist/Hip ratio, the odds of having MetS increase 3-6 times (OR: 4.937, 95%CI: 3.930, 6.203 in men; OR: 3.322, 95%CI: 2.259, 4.884 in women). In addition, in the case of BMI (OR: 1.256, 95% Cl: 1.226, 1.286 in men; OR: 1.104, 95% Cl: 1.086, 1.121 in women) and BFM (OR: 1.119, 95% Cl: 1.105, 1.133 in men; OR: 1.050, 95% Cl: 1.041, 1.060 in women), the chance of having MetS increases with increasing these variables. Totally, BMI and BFM showed the best AUC values. The optimal cut-off values for BMI in men was 26.45 and in women was 27.35 and for BFM in men was 23.35 and in women was 26.85. These results suggest that adiposity measures such as BMI and BFM are associated with likelihood of having MetS in subjects with an age of 50 and up, and that avoiding high adiposity is important to prevent MetS incidence.

Longitudinal assessment of the health-related quality of life among older people with diabetes: results of a nationwide study in New Zealand.

BACKGROUND: The current work examined experiences of Health-Related Quality of Life (HRQOL) among older adults with a diagnosis of Diabetes Mellitus (DM) over time compared to those without a diagnoses DM. METHODS: The sample was drawn from six biennial waves of the New Zealand Health, Work and Retirement survey, a prospective population-based cohort study of older adults 55-70 years at baseline. Data on sociodemographic factors, health behaviours, chronic disease diagnoses and physical and mental HRQOL (SF-12v2) were obtained using six biennial surveys administered 2006-2016. Generalised Estimating Equation models, adjusted for time-constant and -varying factors, were employed to compare HRQOL and its determinants over time for older adults with and without a diagnosis of DM. RESULTS: DM was negatively associated with physical HRQOL [ß (95% CI) - 7.43 (- 8.41, - 6.44)] with older adults affected by DM reporting scores 7.4 points lower than those without DM. Similarly, the mean Mental HRQOL score was lower among those affected by DM [ß = - 4.97 (- 5.93, - 4.01)] however, scores increased over time for both groups (p < 0.001). Greater age, more chronic conditions, sight and sleep problems, obesity, lower annual income, and fewer years of education were predictors of poorer HRQOL among older adults. CONCLUSIONS: Older adults affected by diabetes experienced poorer physical and mental HRQOL compared to those not affected when controlling for a range of sociodemographic and health related indices. A management aim must be to minimise the gap between two groups, particularly as people age.

Influenza-Associated Outcomes Among Pregnant, Postpartum, and Nonpregnant Women of Reproductive Age.

BACKGROUND: Pregnant women are prioritized for seasonal influenza vaccination, but the evidence on the risk of influenza during pregnancy that is used to inform these policies is limited. METHODS: Individual-level administrative data sets and active surveillance data were joined to estimate influenza-associated hospitalization and outpatient visit rates by pregnancy, postpartum, and trimester status. RESULTS: During 2012-2015, 46 of 260 (17.7%) influenza-confirmed hospitalizations for acute respiratory infection and 13 of 294 (4.4%) influenza-confirmed outpatient visits were among pregnant and postpartum women. Pregnant and postpartum women experienced higher rates of influenza-associated hospitalization than nonpregnant women overall (rate ratio [RR], 3.4; 95% confidence interval [CI], 2.5-4.7) and by trimester (first, 2.5 [95% CI, 1.2-5.4]; second, 3.9 [95% CI, 2.4-6.3]; and third, 4.8 [95% CI, 3.0-7.7]); the RR for the postpartum period was 0.7 (95% CI, 3.0-7.7). Influenza A viruses were associated with an increased risk (RR for 2009 pandemic influenza A[H1N1] virus, 5.3 [95% CI, 3.2-8.7]; RR for influenza A(H3N2) virus, 3.0 [95% CI, 1.8-5.0]), but influenza B virus was not (RR, 1.8; 95% CI, .7-4.6). Influenza-associated hospitalization rates in pregnancy were significantly higher for Maori women (RR, 3.2; 95% CI, 1.3-8.4), compared with women of European or other ethnicity. Similar risks for influenza-confirmed outpatient visits were not observed. CONCLUSION: Seasonal influenza poses higher risks of hospitalization among pregnant women in all trimesters, compared with nonpregnant women. Hospitalization rates vary by influenza virus type and ethnicity among pregnant women.

Respiratory syncytial virus hospitalisations among young children: a data linkage study.

We aimed to provide comprehensive estimates of laboratory-confirmed respiratory syncytial virus (RSV)-associated hospitalisations. Between 2012 and 2015, active surveillance of acute respiratory infection (ARI) hospitalisations during winter seasons was used to estimate the seasonal incidence of laboratory-confirmed RSV hospitalisations in children aged <5 years in Auckland, New Zealand (NZ). Incidence rates were estimated by fine age group, ethnicity and socio-economic status (SES) strata. Additionally, RSV disease estimates determined through active surveillance were compared to rates estimated from hospital discharge codes. There were 5309 ARI hospitalisations among children during the study period, of which 3923 (73.9%) were tested for RSV and 1597 (40.7%) were RSV-positive. The seasonal incidence of RSV-associated ARI hospitalisations, once corrected for non-testing, was 6.1 (95% confidence intervals 5.8-6.4) per 1000 children <5 years old. The highest incidence was among children aged <3 months. Being of indigenous Maori or Pacific ethnicity or living in a neighbourhood with low SES independently increased the risk of an RSV-associated hospitalisation. RSV hospital discharge codes had a sensitivity of 71% for identifying laboratory-confirmed RSV cases. RSV infection is a leading cause of hospitalisation among children in NZ, with significant disparities by ethnicity and SES. Our findings highlight the need for effective RSV vaccines and therapies.

Prospective Epidemiological Research Studies in Iran (the PERSIAN Cohort Study): Rationale, Objectives, and Design.

Noncommunicable diseases (NCDs) account for 76% of deaths in Iran, and this number is on the rise, in parallel with global rates. Many risk factors associated with NCDs are preventable; however, it is first necessary to conduct observational studies to identify relevant risk factors and the most appropriate approach to controlling them. Iran is a multiethnic country; therefore, in 2014 the Ministry of Health and Medical Education launched a nationwide cohort study-Prospective Epidemiological Research Studies in Iran (PERSIAN)-in order to identify the most prevalent NCDs among Iran's ethnic groups and to investigate effective methods of prevention. The PERSIAN study consists of 4 population-based cohorts; the adult component (the PERSIAN Cohort Study), described in this article, is a prospective cohort study including 180,000 persons aged 35-70 years from 18 distinct areas of Iran. Upon joining the cohort, participants respond to interviewer-administered questionnaires. Blood, urine, hair, and nail samples are collected and stored. To ensure consistency, centrally purchased equipment is sent to all sites, and the same team trains all personnel. Routine visits and quality assurance/control measures are taken to ensure protocol adherence. Participants are followed for 15 years postenrollment. The PERSIAN study is currently in the enrollment phase; cohort profiles will soon emerge.

Prevalence of musculoskeletal disorders in Azar cohort population in Northwest of Iran.

Musculoskeletal disorders (MSDs) are considered as major public health problems. The purpose of this study was to determine the prevalence of MSDs in Azar cohort population in northwest of Iran. Azar cohort study is a state level of a national cohort project (PERSIAN) which began in 2014. All adults over 35 years old in Khamene city in East Azarbaijan province were recruited for the pilot phase of the Azar cohort. For the purpose of the current study, a total of 952 subjects age range of 35-70 who completed the Community Oriented Program for the Control of Rheumatic Disease (COPCORD) questionnaire as supplementary were included. 299 subjects had MSDs and were introduced to the rheumatologist, only 237 of them referred for further assessment. 33.4% of subjects had MSDs within the past 7 days. The most frequent complaint was pain and the most common sites of complaints were knee, lumbar spine, and shoulder, respectively. Osteoarthritis was the most common rheumatic disease (53.2%) and the knee was the most common region affected (47.7%) followed by low back pain (28.2%). Osteoarthritis and knee osteoarthritis were present in 56.1 and 51.8% of females and 46.6 and 38.4% of males, respectively. Furthermore, low back pain was present in 32.9% of males and 26.2% of females. Peri-arthritis was more prevalent in males (12.3%), whilst fibromyalgia, psychologic pain, and heel spur were prevalent among females (9.1, 5.1, and 1.2%, respectively). Rheumatoid arthritis was observed in 1.4% of males and 1.8% of females, respectively. Prevalence of MSDs is very high in this area. Therefore, it calls for action by heath officials and professionals to plan for appropriate programs of prevention and management of MSDs in society.

Cryptosporidium infection in children with cancer undergoing chemotherapy: how important is the prevention of opportunistic parasitic infections in patients with malignancies?

Cryptosporidiosis is a relatively uncommon disease in healthy individuals but could be potentially worrisome in immunocompromised patients. This study aimed to evaluate Cryptosporidium infection in children with cancer undergoing chemotherapy. A case-control study was conducted in 132 children with cancer undergoing chemotherapy and 132 non-cancer controls. The modified Ziehl-Neelsen (MZN) staining and polymerase chain reaction methods were used for the detection of Cryptosporidium parasite. All positive isolates were sequenced for phylogenetic analysis. Statistical analysis was performed using the SPSS version 16 and Fisher exact test. The rate of cryptosporidiosis in children with cancer undergoing chemotherapy was 3.8%, which was higher than that of the control group. Other intestinal parasites detected in patients with cancer included Giardia lamblia (3%), Entamoeba coli (1.5%), and Chilomastix mesnili (0.8%). In the control group, only two (1.5%) cases were positive for G. lamblia. No significant difference was observed between the gender, age, residency, contact with domestic animals, stool appearance, neutropenia, chemotherapy period, and type of malignancy with regard to cryptosporidiosis. Phylogenetic analysis revealed that Cryptosporidium parvum isolates in this study relied on a branch that represents similar sequences from Iran and other countries. Although the rate of Cryptosporidium infection was relatively higher in children with cancer undergoing chemotherapy compared to the control group, any statistically significant difference has not been found between them. These findings should not be contrary to the need for healthcare to prevent opportunistic parasitic infections in malignant and immunocompromised patients.

Human cryptosporidiosis in Iran: a systematic review and meta-analysis.

Cryptosporidiosis caused by Cryptosporidium spp. is an important parasitic disease that can be life-threatening for children and immunocompromised patients. This systematic review and meta-analysis was designed to determine the prevalence rate of Cryptosporidium infection and related risk factors among the Iranian general population. We searched electronic databases including Google Scholar, PubMed, Science Direct, Scopus and Proquest for articles in English and SID, Magiran, IranMedex, and IranDoc for articles in Persian. Out of 4816 studies identified in the electronic search, 94 articles were eligible for inclusion in the systematic review and meta-analysis. The prevalence rate of cryptosporidiosis by using the random effect model among children, healthy people, and gastroenteritis and immunocompromised patients in Iran was estimated as 3.65, 2.94, 1.29, and 4.54%, respectively. Findings of a phylogenetic analysis inferred by gp60 and 18S ribosomal RNA markers indicated that most of the infection rate belonged to C. parvum (particularly subtype IIaA15G2R1) and C. hominis among understudied groups. The present study is the first systematic review and meta-analysis providing a comprehensive view of the prevalence of human cryptosporidiosis and its related risk factors in Iran. It seems that the awareness of Cryptosporidium prevalence, risk factors, and disease complications may be required for developing effective strategies to prevent infection.

Is poor sleep quality associated with lipid profile in elderly population? Finding from Iranian Longitudinal Study on Ageing.

BACKGROUND: Abnormal lipid profile as one of reversible cardiovascular disease risk factors might be affected by poor sleep quality. AIM: This study aimed to assess the association between poor sleep quality and serum concentration of lipid profile in Iranian elderly population. METHODS: The study was performed on a representative sample of 3452 Iranian older people (≥60 years) who contributed in the Iranian Longitudinal Study on Ageing (IRLSA). Sleep quality was measured through the validated Persian version of Pittsburgh Sleep Quality Index (PSQI). Fasting blood samples were collected from the participants to measure plasma levels lipid profile. We used multiple linear regression model to evaluate the independent association of poor sleep quality with lipid profile. RESULTS: The mean age of participants was 68.0±6.7 years and 52.5% of them were male. In total, 52.4% of study population reported poor sleep quality (PSQI>5). Mean serum concentration of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) was 143.2±74.2 mg/dl, 195.6±43.2 mg/dl, 112.9±31.0 mg/dl, and 57.3±12.4 mg/dl, respectively. Poor sleep quality was significantly associated with serum levels of TG (ß=17.85; P=0.006), LDL-C (ß=5.45; P=0.039) and HDL-C (ß=-2.13; P=0.039) after adjusting for studied covariates. CONCLUSION: Our study illustrates that poor sleep quality is a risk factor for poorer lipid profile. Therefore, early behavioral or pharmacological interventions that improve sleep quality are necessary to modify lipid profile in elderly population.

Association Between Metabolic Syndrome and Health-Related Quality of Life in Older Adults: Findings from the IRanian Longitudinal Study on Ageing.

Objectives: There are some studies without consensus on the association between metabolic syndrome (MetS) and health-related quality of life (HRQoL) and few studies among elderly participants; therefore, the aim of this study is evaluating the association between MetS and HRQoL between elderly participants after adjusting for possible confounding factors. Methods: A cross-sectional analysis was conducted with the data from baseline phase of the IRanian Longitudinal Study on Ageing. The MetS diagnosis was conducted based on the National Cholesterol Education Program Adult Treatment Panel III guidelines. The participants were 3452 subjects aged ≥60 years with and without MetS. The Prospective Epidemiological Research Studies in Iran version of the SF-12 questionnaire was used to examine subjects' perspectives on their well-being and general health level. The association between MetS and HRQoL was evaluated through multivariable linear regression model after adjusting for possible covariates. Results: MetS independently had an inverse association with subscales of HRQoL including physical functioning, physical problems, general health, social functioning, and emotional problems, even after fully adjusting for studied confounding factors. An inverse association was also observed between MetS and both mental component summary and physical component summary in the fully adjusted model. Conclusion: Older adults with MetS had a relatively worse physical and mental HRQoL in comparison with individuals without MetS. Independent of any underlying factors, the inverse association of MetS with HRQoL emphasizes the necessity of routine screening and treatment of MetS in older populations.

Impact of the COVID-19 related border restrictions on influenza and other common respiratory viral infections in New Zealand.

BACKGROUND: New Zealand's (NZ) complete absence of community transmission of influenza and respiratory syncytial virus (RSV) after May 2020, likely due to COVID-19 elimination measures, provided a rare opportunity to assess the impact of border restrictions on common respiratory viral infections over the ensuing 2 years. METHODS: We collected the data from multiple surveillance systems, including hospital-based severe acute respiratory infection surveillance, SHIVERS-II, -III and -IV community cohorts for acute respiratory infection (ARI) surveillance, HealthStat sentinel general practice (GP) based influenza-like illness surveillance and SHIVERS-V sentinel GP-based ARI surveillance, SHIVERS-V traveller ARI surveillance and laboratory-based surveillance. We described the data on influenza, RSV and other respiratory viral infections in NZ before, during and after various stages of the COVID related border restrictions. RESULTS: We observed that border closure to most people, and mandatory government-managed isolation and quarantine on arrival for those allowed to enter, appeared to be effective in keeping influenza and RSV infections out of the NZ community. Border restrictions did not affect community transmission of other respiratory viruses such as rhinovirus and parainfluenza virus type-1. Partial border relaxations through quarantine-free travel with Australia and other countries were quickly followed by importation of RSV in 2021 and influenza in 2022. CONCLUSION: Our findings inform future pandemic preparedness and strategies to model and manage the impact of influenza and other respiratory viral threats.

Uptake of liquid-based cytology as an adjunct to conventional cytology for cervical screening in NSW, Australia: a cross-sectional and population-based cohort analysis.

BACKGROUND: Cervical screening is currently recommended every two years in sexually active women aged 18-20 to 69 years in Australia. Direct replacement of conventional cytology with liquid-based cytology (LBC) for cervical screening was rejected for public funding on grounds of cost-effectiveness, first in 2002 and again in 2009, but LBC is performed as an adjunct to conventional cytology in women who elect to pay. The objective of this study was to describe prevalence and predictors of use of LBC in Australia's most populous state, New South Wales (NSW). METHODS: We performed cross-sectional and population-based cohort analyses using data from the state Pap Test Register in NSW. We calculated the age-adjusted proportion of women aged 20-69 years electing to have adjunctive LBC over the period from 2006-2010. We also calculated the fully-adjusted odds ratios for the association between subsequent LBC use and age, socioeconomic status, place of residence, previous cytological history and provider type in a cohort of 360,247 women who had an index cervical cytology test in 2006-8. RESULTS: Uptake of LBC varied between 29.7% (95% Confidence Interval (CI): 29.5-30.0%) in 2006/7 and 26.6% (95% CI: 26.4-26.9%) in 2009/10. LBC was more likely to be used in women aged 30-44 years, if it had been used previously (OR13.58, 95% CI: 13.33-13.84), if the previous test result was abnormal (OR2.62, 95% CI:2.53-2.72) or unsatisfactory (OR2.37, 95% CI:2.27-3.47), or if a gynaecologist requested the test (OR1.50, 95% CI:1.46-1.54). Uptake was least for women in remote/very remote areas (OR0.68; 95% CI:0.57-0.80 referenced to those in major cities) and in lower socioeconomic groups (OR 0.41, 95% CI:0.40-0.42 for lowest versus highest SES quintile). CONCLUSION: In the current environment in NSW, Australia, in which public funding for LBC has not been available, adjunctive uptake of LBC depends strongly on a woman's age, her screening history and socioeconomic factors. These findings provide important context for a current review of technologies used in the National Cervical Screening Program in Australia.

Impact of organised cervical screening on cervical cancer incidence and mortality in migrant women in Australia.

BACKGROUND: Organised cervical screening, introduced in 1991, appears to have reduced rates of cervical cancer incidence and mortality in women in Australia. This study aimed to assess whether cervical cancer rates in migrant women in the state of New South Wales (NSW) showed a similar pattern of change to that in Australian-born women after 1991. METHODS: Data from the NSW Central Cancer Registry were obtained for females 15+ years diagnosed with invasive cervical cancer from 1973 to 2008 (N=11,485). We used joinpoint regression to assess annual percent changes (APC) in cervical cancer incidence and mortality before and after the introduction of organised cervical screening in 1991. RESULTS: APC in incidence fell more rapidly after than before 1991 (p<0.001) amongst women from seven groups defined by country of birth (including Australia). There was only weak evidence that the magnitude of this incidence change varied by country-of-birth (p=0.088). The change in APC in mortality after 1991, however, was heterogeneous by country of birth (p=0.004). For Australian and UK or Ireland-born women the mortality APC fell more rapidly after 1991 than before (p=0.002 and p=0.001 respectively), as it did for New Zealand, Middle East, North Africa and Asian-born (p≥0.05), but in other European-born and women from the 'Rest of the World' it appeared to rise (p=0.40 and p=0.013 respectively). CONCLUSIONS: Like Australian-born women, most, but not all, groups of migrant women experienced an increased rate of fall in incidence of cervical cancer following introduction of organised cervical screening in 1991. An apparent rise in mortality in women in a 'Rest of the World' category might be explained by a recent rise in migration from countries with high cervical cancer incidence and mortality rates.

Gender Differences in Psychological Distress in Patients with Colorectal Cancer and Its Correlates in the Northeast of Iran.

PURPOSE: Colorectal cancer has a significant impact on patients' physical, psychological, and social aspects. This study aimed to examine the gender difference in anxiety and depression and its relationship with some of the characteristics of the disease and demographic in the northeast of Iran. METHODS: In this cross-sectional study, patients with colorectal cancer aged over 18 years who were admitted to hospitals, without considering the disease stage and type of treatment, were enrolled during 2014-2016. The Hospital Anxiety and Depression Scale (HADS) Questionnaire was completed via interview. RESULTS: A total of 303 survivors of colorectal cancer were included in the current analysis, of whom 55.1% (167) were male. The overall frequency of depression was 44.9%, and it was 38.3% and 32.9% for men and women, respectively. The overall frequency of anxiety was 53.4% (50.3% and 57.4% for men and women, respectively). The results showed that compared to men, women (52%) were more likely to report depression (OR = 0.48, 95% CI = 0.22-1.04, P = 0.065); in contrast, men (12%) were less likely than women to report anxiety (OR = 0.88, 95% CI = 0.38-2.03, P = 0.779), which was less than 12% in men. Among other variables, education and employment were identified as independent and strong predictive variables for depression and anxiety. CONCLUSIONS: The frequency of anxiety and depression is high among colorectal cancer survivors, especially in women. Therefore, screening for psychological distress is recommended in clinical settings and there is a need to pay attention to women.

Sex-specific prevalence of metabolic syndrome in older adults: results from the Neyshabur longitudinal study on aging, Iran.

Purpose: The prevalence of metabolic syndrome (MetS) and associated diseases grows as the population ages. This study aimed to investigate sex differences in the prevalence of MetS and its components among people aged 50 years and older in Iran. Methods: Data were drawn from the Neyshabur Longitudinal Study on Ageing (NeLSA), which is an ageing component of the Prospective Epidemiological Research Studies in IraAn (PERSIAN). The NCEP ATP III and IDF criteria were used to identify the prevalence of MetS among 3383 men and 3873 women aged 50 years and older. Sociodemographic information, lifestyle and clinical factors were collected via an interview-based questionnaire. Weight and height, waist circumferences and blood pressure were measured. Laboratory measures such as fasting blood sugar, triglycerides and high-density cholesterol were also assessed. Results: The overall prevalence of the MetS according to the NCEP ATP III and IDF definitions were 45% and 47%, respectively. The prevalence of the MetS in men and women was 37% and 63% according to the NCEP ATP III definition, 33% and 67% by the IDF definition, respectively. The prevalence of MetS components was significantly higher in women than in men. Conclusion: In the current study, the prevalence of MetS and its components was significantly higher among women than men. We also observed good concordance between IDF and NCEP ATP III criteria.

The concurrent accuracy of the modified telephone interview for cognitive status and mini-mental state examination tools in detection of cognitive impairment among older adults.

Due to the need for face-to-face administration of many cognitive screening tests, it is not always feasible to screen large-scale samples. Objective: This study aimed to assess the discriminant validity of the Persian version of Telephone Interview for Cognitive Status (P-TICS-m) and Mini-Mental State Examination in the middle-aged Iranian population. Methods: The P-TICS-m and MMSE were administered to 210 randomly selected middle-aged community-dwelling adults who had been registered in the Neyshabur Longitudinal Study on Ageing. Participants also underwent psychological examination by two neurologists to assess cognitive impairment based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. To evaluate the discriminant validity of P-TICS-m and MMSE with DSM-V criteria, the sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (LR+ and LR-) were calculated. Results: The mean age of the participants was 59.6±6.8 years. The TICS and MMSE were highly correlated (r=0.635, p<0.001). The sensitivity, specificity, PPV, NPV, LR+, and LR- to discriminate cognitive impairment were, respectively, 83%, 92%, 68%, 96%, 10, and 0.182 for MMSE and 100%, 13%, 19%, 100%, 1.16, and 0 for TICS-m. The receiver operating characteristic curve analysis results showed no statistically significant differences between P-TICS-m and MMSE. Conclusions: Our findings indicate that the TICS-m test can be used as a screening tool instead of the MMSE. Due to the low specificity and low PPV of the TICS-m compared to MMSE, the diagnosis should be confirmed using definitive diagnostic tests when a subject is classified as having cognitive impairment.

Diante da necessidade de administração face a face de muitos testes de triagem cognitiva, nem sempre é viável rastrear amostras em grande escala. Objetivo: O objetivo deste estudo foi avaliar a validade discriminante da versão persa do Telephone Interview for Cognitive Status (TICS-m) e do Miniexame do Estado Mental (MMSE) na população iraniana de meia-idade. Métodos: A versão persa do TICS-m (P-TICS-m) e do MMSE foi administrada a 210 adultos de meia-idade residentes na comunidade e selecionados aleatoriamente, que haviam sido registrados no Neyshabur Longitudinal Study on Ageing. Os participantes também foram submetidos a exame psicológico por dois neurologistas para serem avaliados quanto ao comprometimento cognitivo com base nos critérios do Manual de Diagnóstico e Estatística de Transtornos Mentais (DSM-V). Para avaliar a validade discriminante do P-TICS-m e do MMSE com os critérios do DSM-V, foram calculados a sensibilidade, a especificidade, os valores preditivos positivo e negativo (PPV e NPV) e a razão de verossimilhança positiva e negativa (LR+ e LR-). Resultados: A média de idade dos participantes foi de 59,6±6,8 anos. O TICS e o MMSE foram altamente correlacionados (r = 0,635, p <0,001). A sensibilidade, a especificidade, o PPV, o NPV, a LR+ e a LR- do MMSE para discriminar comprometimento cognitivo foram 83, 92, 68, 96%, 10, 0,182; e, para TICS-m, foram 100, 13, 19, 100%, 1,16 e zero, respectivamente. Os resultados da análise da curva característica de operação do receptor (ROC) não mostraram diferenças estatisticamente significativas entre P-TICS-m e MMSE. Conclusões: Nossos achados mostram que o teste TICS-m pode ser utilizado como ferramenta de triagem em vez do MEEM. Por causa da baixa especificidade e do baixo PPV do TICS-m em relação ao MMSE, o diagnóstico deve ser confirmado por meio de testes diagnósticos definitivos quando um indivíduo é classificado como portador de comprometimento cognitivo.