Association between lipid profiles and cigarette smoke among adults in the Persian cohort (Shahedieh) study.

OBJECTIVES: Exposure to cigarette smoke introduces a large amount of nicotine into the bloodstream through the lungs. So, smoking can be a risk factor for many diseases. The present study was conducted to investigate the effect of active and passive cigarette smoke on the blood lipid profile and dyslipidemia. METHODS: This cross-sectional study was performed on 5052 individuals who participated in the recruitment phase of the Shahedieh cohort study. A logistic regression model was used to investigate the relationship between smoking exposure status and lipid profiles. RESULTS: The prevalence of abnormal low-density lipoprotein-cholesterol (LDL-C), abnormal HDL-C, abnormal total cholesterol (TC), abnormal triglyceride (TG), and dyslipidemia were 254 (5.00%), 562 (11.10%), 470 (9.30%), 1008 (20.00%), and 1527 (30.20%), respectively. Adjusting for confounders, it was observed that current smokers had higher odds of having abnormal HDL-C [OR (95% CI), 2.90 (2.28-3.69)], abnormal TG [OR (95% CI), 1.71 (1.38-2.13)] and dyslipidemia [OR (95% CI), 1.86 (1.53-2.25)]. Ex-smokers also had greater odds of abnormal HDL-C [OR (95% CI), 1.51 (1.06-2.16)] compared to non-smokers who were not exposed to cigarette smoke. CONCLUSIONS: The findings indicated that current smokers had higher TG and lower HDL. So, necessary measures should be taken to reduce smoking. The findings also showed that the prevalence of abnormal TG and HDL in ex-smokers was lower than in current smokers. Therefore, the existence of incentive policies to quit smoking seems necessary.

Agreement between ten-years cardiovascular disease risk assessment tools: An application to Iranian population in Shahedieh Cohort Study.

Background and aim: Cardiovascular risk-prediction models are efficient primary prevention tools to detect high-risk individuals. The study aims to use three tools to estimate the 10-year risk of developing cardiovascular disease (CVD) and investigate their agreement in an Iranian adult population. Methods: The current cross-sectional study was carried out on 8569 adults between 35 and 70 who participated in the first phase of the Shahedieh cohort study in Yazd, Iran, and were free of CVDs (cardiac ischemia or myocardial infarction or stroke). World Health Organization/International Society of Hypertension (WHO/ISH) chart, Laboratory-Based (LB) and Non-Laboratory-Based (NLB) Framingham Risk Score (FRS) were used to predict the 10-year risk of developing CVD. The agreement across tools was determined by Kappa. Results: WHO/ISH chart indicated the highest prevalence of low CVD risk for males (96.10%) and females (96.50%), while NLB Framingham had the highest prevalence of high CVD risk for males (19.40%) and females (5.30%). In total, there was substantial agreement between both FRS models (Kappa = o.70), while there was a slight agreement between WHO/ISH and both FRS tools. For under 60 years males and females, substantial agreements were observed between FRS methods (kappa = 0.73 and kappa = 0.68). For males and females over 60 years, this agreement was moderate and substantial, respectively (kappa = 0.54 and kappa = 0.64). WHO/ISH and LB Framingham model had substantial agreement for over 60 years females (kappa = 0.61). Conclusions: Framingham models classified more participants in the high-risk category than WHO/ISH. Due to the lethality of CVDs, categorizing individuals based on FRS can ensure that most of the real high-risk people are detected. Remarkable agreement between FRS methods in all sex-age groups suggested using the NLB Framingham model as a primary screening tool, especially in a shortage of resources condition.

Sleep Quality and Cancer-Related Fatigue in Patients with Cancer.

Introduction: Sleep problems and fatigue are common symptoms reported by cancer patients. In this study, the researchers used a specialized tool to measure fatigue in cancer patients and its relationship with sleep quality in Yazd, Iran. Methods: This descriptive correlational study included 149 cancer patients (age range: over 18 years) referred to Shahid Sadoughi Hospital in Yazd, Iran. Data were collected by the Pittsburgh Sleep Quality Index (PSQI) and Cancer-Related Fatigue Questionnaire. A PSQI score of ≥5 indicated a poor sleep. Data were analyzed using SPSS Statistics for Windows, version 13.0 (SPSS Inc., Chicago, IL, USA), Pearson's correlation, t test, analysis of variance (ANOVA), and linear regression. Results: The mean (SD) PSQI score of patients was 13 (4.85) out of 21. About 69.3% of patients had a poor sleep quality. While the mean (SD) of sleep duration was 5.57 (0.54) hours, it was 69.44 (46.58) minutes for sleep latency. Also, with increasing the mean of sleep quality, the mean of fatigue significantly increased (P < 0.001, R=0.63). Conclusion: According to the results, there was a relationship between the sleep quality and fatigue in cancer patients, so that patients with better sleep quality had less fatigue.

Construction and Validation of Breast Cancer Awareness Scale in Iranian Women.

Introduction: Application of a single valid and reliable questionnaire in future studies in the area of Iranian women's awareness of breast cancer provides the health policymakers with a comprehensive view over the issue. In designing the current questionnaires in Iran, the prior researchers neither explained about the design procedure, nor calculated the validity and reliability of the questionnaire completely. In this regard, researchers decided to design a standard questionnaire to examine women's awareness about the symptoms and risk factors of the breast cancer. Methods: This methodological study was conducted on 250 women in Yazd. Data were collected by a researcher-made questionnaire. The reliability was determined using the Cronbach's alpha and test-retest method. Factor analysis was used to determine the construct validity in SPSS version 21. Results: The face validity of the questionnaire was evaluated by the target population. The results of the impact score indicated that all questions had a score equal or greater than 1.5. The qualitative content validity of the questionnaire was evaluated by the expert panel. Content validity ratio (CVR) and content validity index (CVI) obtained close to one for questionnaire. Construct validity was confirmed by performing factor analysis and dimensions of the questionnaire were determined. Cronbach's alpha coefficient for all dimensions was higher than 0.8. Also, intraclass correlation coefficient (ICC) for all dimensions was close to one and was between 0.84-0.95. Conclusion: Validity and reliability of designed questionnaire in this study for Iranian women are acceptable and suitable.

The comparison of depression and anxiety between fertile and infertile couples: A meta-analysis study.

BACKGROUND: Depression and anxiety are the most common reaction in infertile couples. Several studies have been conducted to examine the psychiatric disorders among infertile and fertile couples. OBJECTIVE: This meta-analysis was conducted to compare the depression and anxiety in fertile and infertile couples in various studies. MATERIALS AND METHODS: The authors searched articles published in multiple databases including World Health Organization, PubMed, Cochrane Library, Scopus, Science Direct, Medline EMBASE and Persian databases including Scientific Information Database (SID) and IranMedx between 2005 and 2017. The main keywords used for searching the databases were: depression, anxiety, infertility, and fertility. Statistical analyses were performed using Comprehensive Meta-Analysis/2.0 software. RESULTS: The authors found 42 related articles after searching the databases. 11 articles entered the meta-analysis after considering the inclusion and exclusion criteria. Finally, eight articles were chosen for the comparison of depression and anxiety, two published articles for the comparison of depression, and one published article to compare anxiety in fertile and infertile couples. The results of the heterogeneity test showed a significant heterogeneity among all articles that were analyzed in this meta-analysis in the field of depression and anxiety. The results showed that depression (p = 0.0001; Hedges'g = 1.21; 95% CI 0.63-1.78) and anxiety (p = 0.00001; Hedges'g = 0.63; 95% CI 0.54-0.73) were higher in infertile couples than fertile couples and that the possibility of a publication bias does not exist in this study. CONCLUSION: The analysis of articles used in this meta-analysis showed that depression and anxiety scores in infertile couples were higher than fertile couples.

Clinical education stressors in medical trainees in Shahid Sadoughi University of Medical Sciences, Yazd.

INTRODUCTION: Stress is an important factor in the educational process. Teaching and learning are stressful processes. This stress can affect one's ability and change his/her performance. The purpose of this study was to investigate stressors of clinical education from the perspective of medical students in Yazd University of Medical Sciences. METHODS: This descriptive-analytic study was conducted in Yazd University of Medical Science during year 2014-2015. The sample size was 170 medical students who were selected randomly. The data were collected by a questionnaire including four components: interpersonal relationship, educational environment, clinical experience and the unpleasant emotions. A significance level of 0.05 was considered for analysis. The statistical analyses included descriptive statistics, ANOVA and T-tests, using SPSS software, version 14. RESULTS: The results showed that the highest domain score belonged to interpersonal relationship (3.33±0.3) followed by unpleasant emotions domain (3.3±0.3). The lowest domain score of clinical education stressors was educational environment (3.12±0.1). The results showed that the mean score of interpersonal relationship domain was more in women than in men (p<0.05). CONCLUSION: The relationship between teachers and students is an effective factor in all dimensions of clinical education stressors. So proper measures such as the promotion of scientific awareness of teachers and educational staff about factors that lead to stress and the best way to communicate with students should be taken to reduce the students' stress.

Construction and Validation the Lifestyle Questionnaire Related to Cancer.

BACKGROUND: Healthy lifestyle is a significant factor in cancer etiologic and prevention of cancer. There are instruments to measure a healthy life style, but the lifestyle questionnaires only examine one or a few more aspects of lifestyle. OBJECTIVES: The purpose of this study was to construct a comprehensive instrument to examine all aspects of lifestyle related to cancer. MATERIALS AND METHODS: This study was a cross-sectional study that was conducted in Yazd city in Iran. A questionnaire was designed to assess and measure various aspects of lifestyle related to cancer using similar studies. Researchers used the Cronbach's alpha and test-retest method to determine the reliability. Also, construct validity was determined using the factor analysis method in SPSS 16 software. RESULTS: Face validity was examined using a panel of experts. Cronbach's alpha for the whole scale was appropriate (α = 0.87). Also, Cronbach's alpha for all dimensions of questionnaire was acceptable (perfect score). Test-retest method was used to determine the reliability. The results indicated that ICC was in the range of 0.84 to 0.94. Based on the obtained results of factor analysis method, 8 dimensions of the questionnaire were extracted (physical health, physical activity and exercise, mental health, drug and alcohol avoidance, balanced consumption of food, environmental pollutants and harmful substances, weight control and nutrition, and reproductive health). CONCLUSIONS: This study showed that the present questionnaire can be used as a valid and reliable tool for collecting data about the lifestyle of people related to cancer.

Effect of Carrot Intake in the Prevention of Gastric Cancer: A Meta-Analysis.

PURPOSE: Gastric cancer is the third leading cause of cancer-related mortality, with the incidence and mortality being higher in men than in women. Various studies have shown that eating carrots may play a major role in the prevention of gastric cancer. We conducted a meta-analysis to determine the relationship between carrot consumption and gastric cancer. MATERIALS AND METHODS: We searched multiple databases including PubMed, Cochrane Library, Scopus, ScienceDirect, and Persian databases like Scientific Information Database (SID) and IranMedx. The following search terms were used: stomach or gastric, neoplasm or cancer, carcinoma or tumor, and carrot. Statistical analyses were performed using Comprehensive Meta Analysis/2.0 software. RESULTS: We retrieved 81 articles by searching the databases. After considering the inclusion and exclusion criteria, 5 articles were included in this study. The odds ratio (OR) obtained by fixed effects model showed that a 26% reduction in the risk of gastric cancer has been associated with the consumption of carrots) OR=0.74; 95% confidence interval=0.68~0.81; P<0.0001). According to funnel graph, the results showed that the possibility of a publication bias does not exist in this study. CONCLUSIONS: The findings of this study showed an inverse relationship between the consumption of carrots and the risk of gastric cancer.

Five year survival of women with breast cancer in Yazd.

BACKGROUND: Cancer is a non-communicable disease that is considered deadly in many cases. In recent years, the mortality rates from breast cancer have increased with increasing incidences. The present study was conducted to determine five year survival of women with breast cancer in Yazd, in the central region of Iran. MATERIALS AND METHODS: In a prospective study, data were obtained from the patient's medical records with breast cancer that were referred to the Shahid Sadoughi hospital and radiotherapy center from 2002-2007 and followed up for 5 years. The data collected were analyzed by SPSS/16 and Kaplan-Meyer test and log-rank test and Cox proportional hazard model was used. RESULTS: The mean age of breast cancer diagnosis was 48.3±11.7 years. The 1-, 2-, 3-, 4- and 5-year cumulative survivals for breast cancer patients were 95%, 86%, 82%, 76% and 70%, respectively. There were significant differences with age distribution (p=0.006). A significant decrease in the 5-year survival in patients with involvement of lymph nodes was lso observed. CONCLUSIONS: Education for early diagnosis in women must be considered and these findings support the need for breast cancer screening programs.

Health belief model and reasoned action theory in predicting water saving behaviors in yazd, iran.

BACKGROUND: People's behaviors and intentions about healthy behaviors depend on their beliefs, values, and knowledge about the issue. Various models of health education are used in deter¬mining predictors of different healthy behaviors but their efficacy in cultural behaviors, such as water saving behaviors, are not studied. The study was conducted to explain water saving beha¬viors in Yazd, Iran on the basis of Health Belief Model and Reasoned Action Theory. METHODS: The cross-sectional study used random cluster sampling to recruit 200 heads of households to collect the data. The survey questionnaire was tested for its content validity and reliability. Analysis of data included descriptive statistics, simple correlation, hierarchical multiple regression. RESULTS: Simple correlations between water saving behaviors and Reasoned Action Theory and Health Belief Model constructs were statistically significant. Health Belief Model and Reasoned Action Theory constructs explained 20.80% and 8.40% of the variances in water saving beha-viors, respectively. Perceived barriers were the strongest Predictor. Additionally, there was a sta¬tistically positive correlation between water saving behaviors and intention. CONCLUSION: In designing interventions aimed at water waste prevention, barriers of water saving behaviors should be addressed first, followed by people's attitude towards water saving. Health Belief Model constructs, with the exception of perceived severity and benefits, is more powerful than is Reasoned Action Theory in predicting water saving behavior and may be used as a framework for educational interventions aimed at improving water saving behaviors.