The association between night eating syndrome and GERD symptoms among university students at An-Najah National University in Palestine: a cross-sectional study.

BACKGROUND: Night eating syndrome (NES) is a kind of eating disorder. NES association with gastroesophageal reflux disease (GERD) symptoms among university students is still not fully understood. We aimed to determine the relationship between NES and the presence of GERD symptoms among university students at An-Najah National University in Palestine. METHODS: This study involved undergraduate students from An-Najah National University. The data were collected through online surveys from November to December 2023. The sampling frame involved voluntary sampling, as the data were collected using a structured questionnaire to collect data on sociodemographic variables, medical history, lifestyle habits, nutritional status, GERD risk, and NES. The GERD questionnaire (GerdQ) was used to assess symptoms, while the Arabic version of the validated Night Eating Questionnaire (NEQ) was used to assess night eating. Physical activity was assessed using the short form of the International Physical Activity Questionnaire (SF-IPAQ), and adherence to a Mediterranean diet was assessed using the validated Arabic version of the MEDAS. Both univariate and multivariate analyses were also conducted to assess the study hypotheses. RESULTS: The study involved 554 participants, 59.9% female. A total of 33.4% reported GERD symptoms, with 10.3% having NES. A strong association was observed between GERD and NES and between GERD and physical activity. Night eating syndrome (AOR = 2.84, CI = 1.07-3.19), high physical activity (AOR = 0.473, CI = 1.05-3.19), and non-smoking (AOR = 0.586, CI = 1.27-7.89) were identified as independent predictors of GERD symptoms. CONCLUSION: This study revealed that 33.4% of undergraduate students were at risk of GERD, with night eaters having a greater risk. GERD risk was negatively associated with physical activity level and smoking status. No associations were found between GERD risk and weight status, Mediterranean diet adherence, sociodemographic factors, or sleep disturbances.

Identification and prediction of association patterns between nutrient intake and anemia using machine learning techniques: results from a cross-sectional study with university female students from Palestine.

PURPOSE: This study utilized data mining and machine learning (ML) techniques to identify new patterns and classifications of the associations between nutrient intake and anemia among university students. METHODS: We employed K-means clustering analysis algorithm and Decision Tree (DT) technique to identify the association between anemia and vitamin and mineral intakes. We normalized and balanced the data based on anemia weighted clusters for improving ML models' accuracy. In addition, t-tests and Analysis of Variance (ANOVA) were performed to identify significant differences between the clusters. We evaluated the models on a balanced dataset of 755 female participants from the Hebron district in Palestine. RESULTS: Our study found that 34.8% of the participants were anemic. The intake of various micronutrients (i.e., folate, Vit A, B5, B6, B12, C, E, Ca, Fe, and Mg) was below RDA/AI values, which indicated an overall unbalanced malnutrition in the present cohort. Anemia was significantly associated with intakes of energy, protein, fat, Vit B1, B5, B6, C, Mg, Cu and Zn. On the other hand, intakes of protein, Vit B2, B5, B6, C, E, choline, folate, phosphorus, Mn and Zn were significantly lower in anemic than in non-anemic subjects. DT classification models for vitamins and minerals (accuracy rate: 82.1%) identified an inverse association between intakes of Vit B2, B3, B5, B6, B12, E, folate, Zn, Mg, Fe and Mn and prevalence of anemia. CONCLUSIONS: Besides the nutrients commonly known to be linked to anemia-like folate, Vit B6, C, B12, or Fe-the cluster analyses in the present cohort of young female university students have also found choline, Vit E, B2, Zn, Mg, Mn, and phosphorus as additional nutrients that might relate to the development of anemia. Further research is needed to elucidate if the intake of these nutrients might influence the risk of anemia.

Comparison of premenstrual symptoms, psychological well-being, and nutritional status between Palestinian women with and without polycystic ovarian syndrome: a case-control study.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is a widely seen reproductive and endocrinological disorder. PCOS can exert substantial effects on many aspects of an individual's life, including reproductive health and psychological well-being. The objective of this study was to assess the nutritional status, premenstrual syndrome, and mental health of women affected by PCOS in comparison to women without PCOS. METHODOLOGY: A case-control observational study in Palestine included 100 PCOS patients and 200 healthy women. The collected data included socio-demographic information, medical history, premenstrual syndrome, mental health, nutritional status, and lifestyle. Anthropometric measurement and the Mediterranean Diet Adherence Screener (MEDAS) were used to evaluate the nutritional status. The General Health Questionnaire (12-GHQ) was used to evaluate the state of mental health. Premenstrual syndrome (PMS) severity was evaluated using a validated Arabic premenstrual syndrome questionnaire. RESULTS: The study's findings indicated that there was a statistically significant increase in the three dimensions of PMS among participants with PCOS, p < 0.05. Similarly, PCOS patients demonstrated elevated ratings across all aspects of mental health, p < 0.05. In terms of the other variables, it has been observed that PCOS patients have a notably greater prevalence of perceived sleep disturbances and decreased adherence to the Mediterranean diet. Regression analysis revealed that PCOS is associated with mental health problems indicated by a higher GHQ score (OR: 1.09; 95% CI: 1.03; 1.16, p < 0.05), lower adherence to the MD diet (OR: 0.86; 95% CI: 0.76; 0.98, p < 0.05), and pre-menstrual syndrome, especially the physical symptoms (OR: 1.06; 95% CI: 1.003; 1.12, p < 0.05) after adjusting for age, smoking, waist-hip ratio, and body mass index (BMI). CONCLUSION: The study has linked polycystic ovary syndrome to negative mental health outcomes and an increased severity of premenstrual syndrome (PMS). Additional investigation is required in order to establish a causal association between polycystic ovary syndrome (PCOS) and lifestyle behaviors within the Palestinian population. Intervention and instructional studies are necessary to investigate the efficacy of management strategies in alleviating the effects of polycystic ovary syndrome (PCOS) on both physical and mental well-being.

The relationship between nutrition literacy and nutrition information seeking attitudes and healthy eating patterns among a group of palestinians.

INTRODUCTION: Nutrition literacy is crucial because it gives people information and drives them to take responsibility for their eating habits. Prior research on three categories of nutrition literacy among Palestinians was lacking: functional literacy (FNL), interactive literacy (INL), and critical literacy (CNL). AIMS: (1) Describe three types of nutrition literacy-FNL, INL, and CNL-among a group of Palestinians was one of the study's primary objectives. (2) To investigate the connections between various nutrition literacy levels, eating habits, and the habit of seeking out nutrition-related information. METHODS: 149 Palestinians were chosen at random to take part in the study in the fall of 2020. Data on sociodemographic variables were gathered through an online survey that was disseminated across social and educational internet sites. Nutrition literacy data was gathered using a translated questionnaire, while diet behavior data was gathered using the Short Format of the Diet Health and Knowledge Survey (SFDHKS). The data were examined using SPSS 21. RESULTS: This study included young people (20.4 ± 4.9 years old), 78% of whom were female. The majorities of participants had bachelor's degrees or were already enrolled in school to obtain them. FNL had a mean of 2.8 ± 0.5, INL of 3.3 ± 0.5, and CNL of 3.6 ± 0.5. The connection between CNL and INL was significant (p 0.05). Significant correlations were found between many aspects of diet behavior, the usage of food labels, and nutrition literacy. CONCLUSION: Participants from the Palestinian community are willing to learn about and comprehend nutrition facts and how it relates to diet behavior in 2021.

Mental illness stigma as a moderator in the relationship between religiosity and help-seeking attitudes among Muslims from 16 Arab countries.

BACKGROUND: Determining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries. METHOD: The current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 ± 10.80 years, 77.1% females). RESULTS: Bivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta = .005; p < .001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes. CONCLUSION: Our findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities.

Cross-cultural comparison of mental illness stigma and help-seeking attitudes: a multinational population-based study from 16 Arab countries and 10,036 individuals.

BACKGROUND: There is evidence that culture deeply affects beliefs about mental illnesses' causes, treatment, and help-seeking. We aimed to explore and compare knowledge, attitudes toward mental illness and help-seeking, causal attributions, and help-seeking recommendations for mental illnesses across various Arab countries and investigate factors related to attitudes toward help-seeking. METHODS: We carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries among participants from the general public. RESULTS: More than one in four individuals exhibited stigmatizing attitudes towards mental illness (26.5%), had poor knowledge (31.7%), and hold negative attitudes toward help-seeking (28.0%). ANOVA tests revealed a significant difference between countries regarding attitudes (F = 194.8, p < .001), knowledge (F = 88.7, p < .001), and help-seeking attitudes (F = 32.4, p < .001). Three multivariate regression analysis models were performed for overall sample, as well as Palestinian and Sudanese samples that displayed the lowest and highest ATSPPH-SF scores, respectively. In the overall sample, being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes. The same results have been found in the Palestinian sample, while only stigma dimensions helped predict help-seeking attitudes in Sudanese participants. CONCLUSION: Interventions aiming at improving help-seeking attitudes and behaviors and promoting early access to care need to be culturally tailored, and congruent with public beliefs about mental illnesses and their causations.

Effect of cognitive behavioral therapy program on mental health status among medical student in Palestine during COVID pandemic.

BACKGROUND: The COVID-19 pandemic had a profound psychological influence on everyone in society, and the impact it had on students, particularly medical students, cannot be underestimated. The main purpose of this study is to (1) determine the prevalence of mental disorders among medical students and their associated factors, and (2) examine the effectiveness of cognitive behavior therapy on mental health problems among medical students. METHODS: Between March and May 2021, we conducted a randomized controlled study on two phases among medical students at An-Najah National University. Data were collected using an online questionnaire and the Arabic version of the 12-item General Health Questionnaire (GHQ-12). We also used the MEDAS tool to assess their Mediterranean Diet (MD) adherence. In the second phase, sixty-six students were recruited and assigned randomly to control and intervention groups. Intervention impact was assessed using 12-item General Health Questionnaire at two-time points; baseline, and 8 weeks post-intervention. The interventional model used was cognitive behavioral therapy, and the control group received no treatment. RESULTS: A total of 329 students were included in the analysis of the first phase of the study. Approximately 28% of students had mental health problems. We found a significant relationship between good mental health status with a higher level of physical activity level, longer sleeping hours, and shorter entertainment time (p < 0.05). In the second phase of the study, a total of 91 students were included. Overall, using the CBT program showed a significant improvement in the outcome measures. At 8 weeks post-intervention, students had lower scores on total GHQ-12, depression, anxiety, and social dysfunction. CONCLUSION: These findings propose that adequate attention must be paid to the mental health of medical students and that CBT programs can be used for the management of mental health problems among medical students.

Palestinian nurses' knowledge, attitudes, and practices regarding enteral nutrition: Cross-sectional study.

BACKGROUND: Enteral nutrition support plays a key role in minimizing malnutrition in critically-ill patients, and its provision is originally a nurse's responsibility. Thus, nurses need to have a sufficient knowledge and a positive attitude with regard to enteral nutrition. In Palestine, literature regarding nurses' knowledge, practices, and attitudes of enteral nutrition is rare. OBJECTIVE: This study aimed to investigate Palestinian nurses' knowledge, practices, and attitudes regarding enteral nutrition. METHOD: Interview based pre-tested questionnaire was used during data collection procedure. Cronbach Alpha was also used to determine the reliability of knowledge, attitude and practice questionnaire. Descriptive statistics, independent t-test, and ANOVA were performed. RESULTS: A total of 325 registered nurses were involved in the final analysis. The mean of the knowledge score is (9.6 ± 2.8) out of 20. It was confirmed that sociodemographic characteristics has no influence on nutrition knowledge score among nurses. The findings also reveal that certain aspects of enteral nutrition practices were consistent with the current guidelines such as flushing the tube and backrest elevation. On the other hand, certain practices showed inconsistency and differences with international guidelines such as checking gastric residual volume. Results also showed that nurses attitudes were positive towards enteral nutrition. CONCLUSION: It was found that nurses' have inadequate knowledge regarding enteral nutrition. The findings also showed that enteral nutrition practices among nurses were somewhat incongruent with best current evidence. However, it was noted that they have positive attitudes towards enteral nutrition. Promoting research utilization is highly needed as well as establishing evidence-based guidelines.

Prevalence of premenstrual syndrome and its association with psychosocial and lifestyle variables: a cross-sectional study from Palestine.

BACKGROUND: Premenstrual Syndrome (PMS) is a very common problem with symptoms that can negatively affect normal daily life. This cross-sectional study aimed to investigate the prevalence of PMS symptoms and their relationship with psychosocial status and lifestyle of female students at An-Najah National University in Palestine. A sample of 398 female students was randomly selected to participate in the study. Arabic Premenstrual Scale (A-PMS) was used for PMS assessment. Psychosocial variables were determined using the DASS-21 Arabic version, and dietary habits were measured using a 24 item self-reported questionnaire. Data was analyzed by one-way ANOVA and Chi-square tests using SPSS software version 23. RESULTS: The 398 participants (100%) suffered from some kind of PMS symptoms; 398 (100%) had physical symptoms, 397 (99.7%) had psychological symptoms, and 339 (85.2%) had behavioral PMS symptoms. All PMS symptoms were significantly associated with student psychosocial status (p < 0.01). Preferring a certain type of food during menstruation was significantly related to psychological PMS symptoms (p < 0.001), and physical symptoms (p < 0.01). Following a diet was significantly related to physical symptoms (p < 0.05) and behavioral symptoms (p < 0.001). Moreover, drinking herbal tea was significantly related to physical symptoms (p < 0.001) and behavioral symptoms (p < 0.05). CONCLUSION: The findings of the study revealed a relatively high prevalence of PMS syndrome with a significant relationship with dietary habits and psychosocial status.

Prevalence and correlates of malnutrition among hemodialysis patients at hebron governmental hospital, Palestine: cross-sectional study.

BACKGROUND: Malnutrition is a usually observed condition among patients on hemodialysis and is considered one of sturdiest indicators of mortality and morbidity. OBJECTIVES: The current study was performed to assess the prevalence of malnutrition, to verify whether functional status is associated with malnutrition, and to explore the probable factors related to malnutrition among a sample of hemodialysis patients at Hebron Governmental Hospital in West Bank, Palestine. METHODS: A cross-sectional study was conducted on hemodialysis patients in Hebron Governmental Hospital at Hebron city/Palestine. An interview-based questionnaire was used to obtain information related to socio-demographics, dialysis, medical history, lifestyle, anthropometric measurements, dietary data, and functional status. Renal inpatient screening tool (renal iNUT) was also utilized to screen hemodialysis patients for malnutrition. Furthermore, biochemical tests were obtained during the study period from medical files of the studied patients. RESULTS: A total of 153 patients, having a mean age of 50.1 ± 16.6 years, were involved in the final analysis. The results indicated that the prevalence of high risk of malnutrition (45.4 %). Moreover, high risk of malnutrition was significantly associated with occupation, and walking. It was further found that patients with high risk of malnutrition are more likely to had osteoporosis, unable to ambulate, didn't feel that the amount of food they eat is enough. Our findings also figured out that some complications during hemodialysis session (e.g., headache, nausea, hypotension) and some hemodialysis side effects (e.g., itching, access site complication) were significantly correlated to malnutrition. CONCLUSIONS: A high prevalence of malnutrition was revealed among hemodialysis using renal iNUT screening tool. Improving nutritional assessment methods for patients on hemodialysis is highly needed. Findings reveals that risk of malnutrition is associated with multiple factors such as osteoporosis, occupation, walking, ability to ambulate, certain complication during hemodialysis session, and some hemodialysis side effects. Further studies are highly recommended.

Successful aging among community-dwelling palestinian older adults: Prevalence and association with sociodemographic characteristics, health, and nutritional status.

BACKGROUND: Aging population and life expectancy are increasing globally, to cope with this trend, successful aging (SA) attracted the attention of gerontology research to determine its prevalence, risk factors, and its correlates. However, the published research about SA and older adult's health are sparse in Palestine. OBJECTIVES: This study aimed to determine the prevalence and correlates of SA, normal aging, and mild cognitive impairment (MCI) among Palestinian older adults in Hebron governorates. METHODS: A cross-sectional study was conducted during March 2018-May 2018 among a total of 185 participants selected by stratified random sampling from five different areas in Hebron governance. SA was defined based on the multidimentional model; absence of chronic diseases, normal functional status with complete independency, maintains normal cognitive and psychological function and social engagement. Sociodemographic data, nutrition, and health status were also collected and analyzed. RESULTS: The prevalence of SA among older Palestinians (22.2%), usual aging (58.9%), and the MCI (18.9%), with no significant difference in the prevalence between men and women P <0.05. The most prevalent subdomain is independent living skill (77.8%) and the lowest is the absence of chronic diseases (30.8%). SA was associated with younger older age (60-70 years), still working, and well-nourished participants. CONCLUSION: The results of this study revealed, successful aging is associated with younger age, still working and good nutritional status. Further research with appropriate methodology different parts of Palestine is required.

Factors associated with motoric cognitive risk syndrome among low-income older adults in Malaysia.

BACKGROUND: Motoric cognitive risk (MCR) syndrome is characterized by slow gait and memory complaints that could be used to predict an increased risk of dementia. This study aims to determine the MCR syndrome and its risk factors among low-income (B40) older adults in Malaysia. METHODS: Data from TUA cohort study involving 1366 older adults (aged 60 years and above) categorized as low-income were analysed, for risk of MCR syndrome based on defined criteria. Chi-square analysis and independent t test were employed to examine differences in socioeconomic, demographic, chronic diseases and lifestyle factors between MCR and non-MCR groups. Risk factors of MCR syndrome were determined using hierarchical logistic regression. RESULTS: A total of 3.4% of participants fulfilled the criteria of MCR syndrome. Majority of them were female (74.5%, p = 0.001), single/widow/widower/divorced (55.3%, p = 0.002), living in rural area (72.3%, p = 0.011), older age (72.74 ± 7.08 year old, p <  0.001) and had lower years of education (3.26 ± 2.91 years, p = 0.001) than non-MCR group. After adjustment for age, gender and years of education, participants living in rural area (Adjusted OR = 2.19, 95% CI = 1.10-4.35, p = 0.026), with obesity (Adjusted OR = 3.82, 95% CI = 1.70-8.57, p = 0.001), diabetes (Adjusted OR = 2.04, 95% CI = 1.01-4.11, p = 0.046), heart disease (Adjusted OR = 2.50, 95% CI = 1.00-6.20, p = 0.049) and cancer (Adjusted OR = 6.57, 95% CI = 1.18-36.65, p = 0.032) were associated with increased risk of MCR syndrome. CONCLUSION: Only 3.4% of older adults from low-income group were identified as having MCR syndrome. Women, those living in rural areas, had obesity, diabetes, heart disease and cancer were more likely to have MCR syndrome. Further investigation on MCR as a predementia syndrome will help in development of preventive strategies and interventions to reduce the growing burden of dementia, especially among individuals with low socioeconomic status.

Nutritional Management in Enterocutaneous Fistula. What is the evidence?

The management of Enterocutaneous fistula (ECF) is challenging. It remains associated with morbidity and mortality, despite advancements in medical and surgical therapies. Early nutritional support using parenteral, enteral or fystuloclysis routs is essential to reverse catabolism and replace nutrients, fluid and electrolyte losses. This study aims to review the current literature on the management of ECF. Fistulae classifications have an impact on the calories and protein requirements. Early nutritional support with parenteral, enteral nutrition or fistuloclysis played a significant role in the management outcome. Published literature on the nutritional management of ECF is mostly retrospective and lacks experimental design. Prospective studies do not investigate nutritional assessment or management experimentally. Individualising the nutritional management protocol was recommended due to the absence of management guidelines for ECF patients.

Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study.

The aim of this study is to determine the prevalence of taste alterations (TAs) during chemotherapy and their association with nutritional status and malnutrition. In addition to the associated factors with TA, including sociodemographic health-related factors and clinical status, and to investigate coping strategies to manage TA. A multicenter cross-sectional design study was conducted on 120 cancer patients aged at least 18 who had been undergoing at least one round of chemotherapy. TAs were evaluated using the chemotherapy-induced taste alteration scale (CiTAS), the malnutrition universal screening tool (MUST) was used for nutritional screening, the antineoplastic side effects scale (ASES) was used for subjective assessment of chemotherapy side effects, and the Charlson comorbidity index (CCI) was used for comorbidity assessment. SPSS21 software was used to analyze the data, and the independent T-test and one-way ANOVA test were used to determine the association between TAs and a variety of related variables. The prevalence of TAs was 98.3%. Among participants, 48.3% were at low risk of malnutrition, 20% at medium risk, and 31.7% at high risk. Malnutrition risk was associated with taste disorders (p<0.05). Patients' age, gender, educational level, and physical status were associated with TAs (p<0.05). Type of cancer, chemotherapy regimen, and number of chemotherapy cycles were also associated with TAs (p<0.05). A variety of antineoplastic side effects were associated with TAs (p<0.05), including nausea, vomiting, dry mouth, sore mouth and throat, excessive thirst, swallowing difficulty, appetite changes, weight loss, dizziness, lack of energy, disturbed sleep, anxiety, and difficulty concentrating. TAs were associated with an increased number of comorbidities, and individuals with diabetes, pulmonary diseases, and hypertension were associated with TAs (P<0.05). Patients in this study rarely practice self-management strategies to cope with TAs. A high prevalence (98.3%) of TAs in cancer patients receiving chemotherapy was found, and it was linked to a variety of negative outcomes. Chemotherapy-induced TAs are an underestimated side effect that requires more attention from patients and health care providers.

Knowledge and handling practices for raw hen's eggs during purchase, preparation, storage, and consumption: a cross sectional study.

The study aimed to assess the hen's eggs knowledge, handling practices, and consumption among Palestinian consumers using the cross-sectional survey design. Online questionnaire was sent via social media platforms including well-known Facebook and WhatsApp groups in West bank, Gaza and Jerusalem, along with an invitation explaining the research objectives and the voluntary participation. The online questionnaire consisted of three main sections: socio demographic, knowledge and practices for hen's eggs during purchase, preparation, storage, and consumption. The items were developed based on previous literature and international guidelines for hen's eggs purchase and handling, and subjected to content validity process, followed by a pilot study to determine the reliability of the questionnaire using Cronbach's alpha test. The final data were analysed based on the dichotomous Rach model for knowledge and polytomous Rasch model for practices using Winsteps version 5.1.3. The Rasch SPSS output interval data files were used in the inferential analyses tests (one-way ANOVA test and independent samples t-test). The Rasch analysis showed that on average the participants had quite low level of knowledge of hen's eggs consumption safety, (person ability Mean 0.10 logit). The item difficulty measures ranged between + 1.65 (most difficult) and - 2.24 logit (easiest). It was not easy for the participants to endorse the items pertaining their practices in handling the hen's eggs during purchase, preparation, storage and consumption, (person ability Mean - 0.11 logit). The item difficulty measures ranged between + 2.68 logits (most difficult) to - 2.45 logit (easiest). In addition, female participants significantly outperformed males in knowledge scores; and the level of hen's eggs hygiene practices and storage during purchase depended on participants' knowledge level. The research recommended interventional programs to enhance Palestinians' awareness and knowledge about hen's eggs knowledge, handling practices, and consumption. Further quantitative and qualitative research studies were also recommended.

Development and validation of food frequency questionnaire screener software for sodium intake among palestinian population.

BACKGROUND: High sodium intake has been linked to negative health effects, including cardiovascular and renal diseases. Traditional dietary sodium assessment methods are time-consuming and subjected to errors. Using technology may increase the efficiency and accuracy of dietary assessment. The objective of this study is to develop and validate a food frequency questionnaire (FFQ) screener using software to assess sodium intake among the Palestinian population. METHODOLOGY: The study was conducted in four phases. In Phase 1, Palestinian foods were categorized and subcategorized according to their mode of consumption, sodium content, and food groups. The sodium content values were calculated from Palestinian food composition database. Content validity was done in Phase 2, while in Phase 3, a pilot study was conducted to determine test-retest reliability. In Phase 4, the criterion validity of the screener was assessed by comparing the results of sodium intake from the FFQ screener with the results from a 24-hour urinary sodium test and a 3-day diet recall. Correlations between the sodium intake values from the three methods were analyzed using Pearson correlation tests, and the difference was assessed using the Bland-Altman test. RESULTS: The developed FFQ screener sodium screener included 41 food items categorized into nine groups, with photo-based portion size estimation and frequency of consumption. The reliability test showed a Pearson correlation coefficient of 0.7, p < 0.01 using test and retest. For criterion validity, the correlation coefficient between dietary sodium intake using the FFQ screener software and the 24-hour urine sodium test was (0.6, p < 0.000). The correlation coefficient between dietary sodium intake using the FFQ screener software and dietary sodium intake using a 3-day recall was (0.3, p < 0.000). Sodium intake was significantly correlated with preferences for low-sodium food and previous salt reduction, p < 0.05. CONCLUSIONS: Using the FFQ screener software was a valid and reliable method for assessing dietary sodium intake. Using the photo-based method to estimate portion size improved precision and accuracy in diet assessment.

Intradialytic eating practices and health outcomes among hemodialysis patients, cross-sectional study.

BACKGROUND AND AIMS: Intradialytic eating practices is a subject of debate among hemodialysis patients and is associated with a variety of clinical implications. This study aimed to investigate eating practices during hemodialysis and their influence on health outcome, including various symptoms experienced during dialysis, intradialytic hypotension, dialysis adequacy, and malnutrition. METHODS: A cross-sectional study was conducted on hemodialysis patients. A structured questionnaire was used to collect information related to sociodemographic, medical history, lifestyle, dialysis, and eating practices. The occurrence of intradialytic hypotension was determined according to the patients' blood pressure measured at the beginning and end of the session, and dialysis adequacy was determined based on the ultrafiltration rate of the patients. Malnutrition was evaluated using renal inpatient screening tool (renal iNUT), and biochemical data was recruited from the patient's hospital records. RESULTS: A total of 260 hemodialysis patients participated in this study. The mean age was 51.29 ± 15.92, and half of the participants were females. The findings showed no significant association between intradialytic eating practices and symptoms developed during dialysis session, intradialytic hypotension, or malnutrition (p > 0.05). According to Chi-square test, a statistically significant association was found between eating practices and dialysis adequacy (p = 0.037), hemoglobin level (p < 0.001), and phosphorous level (p = 0.003). CONCLUSION: Eating practices were not associated with symptoms that developed during dialysis sessions, intradialytic hypotension, or malnutrition, according to our findings. However, findings reveal that it is possible that eating practices may affect the adequacy of dialysis.

Machine Learning Approach for Predicting the Impact of Food Insecurity on Nutrient Consumption and Malnutrition in Children Aged 6 Months to 5 Years.

BACKGROUND: Food insecurity significantly impacts children's health, affecting their development across cognitive, physical, and socio-emotional dimensions. This study explores the impact of food insecurity among children aged 6 months to 5 years, focusing on nutrient intake and its relationship with various forms of malnutrition. METHODS: Utilizing machine learning algorithms, this study analyzed data from 819 children in the West Bank to investigate sociodemographic and health factors associated with food insecurity and its effects on nutritional status. The average age of the children was 33 months, with 52% boys and 48% girls. RESULTS: The analysis revealed that 18.1% of children faced food insecurity, with household education, family income, locality, district, and age emerging as significant determinants. Children from food-insecure environments exhibited lower average weight, height, and mid-upper arm circumference compared to their food-secure counterparts, indicating a direct correlation between food insecurity and reduced nutritional and growth metrics. Moreover, the machine learning models observed vitamin B1 as a key indicator of all forms of malnutrition, alongside vitamin K1, vitamin A, and zinc. Specific nutrients like choline in the "underweight" category and carbohydrates in the "wasting" category were identified as unique nutritional priorities. CONCLUSION: This study provides insights into the differential risks for growth issues among children, offering valuable information for targeted interventions and policymaking.

Investigating the Association between Nutrient Intake and Food Insecurity among Children and Adolescents in Palestine Using Machine Learning Techniques.

Food insecurity is a public health concern that affects children worldwide, yet it represents a particular burden for low- and middle-income countries. This study aims to utilize machine learning to identify the associations between food insecurity and nutrient intake among children aged 5 to 18 years. The study's sample encompassed 1040 participants selected from a 2022 food insecurity household conducted in the West Bank, Palestine. The results indicated that food insecurity was significantly associated with dietary nutrient intake and sociodemographic factors, such as age, gender, income, and location. Indeed, 18.2% of the children were found to be food-insecure. A significant correlation was evidenced between inadequate consumption of various nutrients below the recommended dietary allowance and food insecurity. Specifically, insufficient protein, vitamin C, fiber, vitamin B12, vitamin B5, vitamin A, vitamin B1, manganese, and copper intake were found to have the highest rates of food insecurity. In addition, children residing in refugee camps experienced significantly higher rates of food insecurity. The findings emphasize the multilayered nature of food insecurity and its impact on children, emphasizing the need for personalized interventions addressing nutrient deficiencies and socioeconomic factors to improve children's health and well-being.

Factors associated with positive body image among Palestinian university female students, cross-sectional study.

Background: Studies suggested that body image is influenced by biological, psychological, historical, individual, cultural, and social factors. This study aimed to investigate the relationship between body image, lifestyle, social pressure, and social media in Palestinian female university students. Method: A sample of 905 female undergraduate students (mean age: 20 ± 1.55 years old) from Palestinian universities were included in this cross-sectional study. In this study, the Body Appreciation Scale (BAS-2) was used for measuring body appreciation. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 28. One-way ANOVA, independent t-test, Cohen's d and Partial Eta Square, Pearson's correlation, and simple linear regression tests were performed. In addition, a mixed regression model was used to identify the predictors of Body Appreciation. Results: It was found that higher BMI, following models and celebrities on social media, following models/celebrities' nutritional advice, self-perceived family and friends pressure, previous dieting, and longer daily phone time were associated with lower body appreciation among female university students. While physical activity was associated with higher body appreciation. Conclusion: Body appreciation was significantly associated to lifestyle, social pressure, and social media use in the study sample. A higher BMI, following models and celebrities on social media, family and friend pressure, dieting, and daily phone use time decreased body appreciation. While being more physically active was linked to a higher body appreciation.