Dietary Fiber Intake and Related Factors in Community-Based Iranian's Elderly.

Background: There are considerable documents suggesting that inadequate fiber intake (FI) is a key risk factor for various chronic diseases. The aim of this study was to investigate Dietary FI in the Persian elderly. Methods: This descriptive-analytic study was performed to investigate FI in a sample of the elderly who received free services from healthcare centers in Karaj, Iran. For sampling method: at first, the names of 36 centers were written on small pieces of paper and poured into a container, then another person was asked to randomly select the names of 10 centers, then referring to each of the centers and preparing a list of elderly people, the study subjects were selected, The study was conducted between September 2018, and April 2019Several questionnaires were used to collect data regarding DF: characteristics, daily FI , knowledge, SE (self-efficacy), perceived benefits, and barriers towards FI as well as stage of readiness of FI. t-test and ANOVA were used to compare independent mean values. Data were checked for normality before analysis by using Kolmogorov-Smirnov (K-S) test to check data normality. Results: Totally of 400 elderly individuals entered the study with the average amount of fiber per day. The data analysis indicated they did not know the recommended intake of at least 25 gr each day. feeling less hungry and fiber's price was the most frequent perceived benefits and barriers towards FI , respectively. Gastrointestinal diseases ( P < 0.001), smoking (P < 0.001), and perceived barriers (P < 0.001), were statistically significant independent positive predictors of FI. Conclusion: The findings of the current study indicated that FI among elderly people in Iran was very low and varied a great by gender, education, marital status, income level, employment status, smoking, stage of change, and gastrointestinal disease.

Predictors of Perceived Stress and Quality of Life among Women during the COVID-19 Outbreak: A Cross-sectional Study from Karaj, Iran.

Background: The emergence of the coronavirus disease of the 2019 (COVID-19) pandemic in Iran has markedly affected lives and taken a toll on Iranians' mental health, especially in women. The current study investigated factors that contributed to both perceived stress and quality of life (Qol) among women during the COVID-19 pandemic in Karaj, Iran. Methods: A cross-sectional online survey study was conducted between November 30, 2020, and January 30, 2021. A researcher-made questionnaire with 4 subscales, including information seeking, social support, primary appraisal, and secondary appraisal, was used. Perceived Stress Scale (PSS-10), and 36-Item Short Form Survey (SF-36) questionnaires were also applied. A total of 581 participants completed the study. The convenience sampling method was used in this study. Multiple mediation analyses were applied using pathway analysis. Results: The mean age ± SD of the participants was 38.57±7.68 years, and 40.8% had a higher education than a high school diploma. Based on the final fitted model, higher perceived stress had a direct impact on mental QoL (ß = 0.47). The Comparative Fit Index (CFI), Incremental fit index (IFI), and Goodness of Fit Index (GFI) were calculated as 1, and χ2/df was 4.87. Educational level and social support from both the direct and indirect pathway affected QoL. Social support affected both information-seeking behavior and secondary appraisal (ß = 0.50: 95% CI, 0.38-0.59). Furthermore, information-seeking behavior and secondary appraisal affected perceived stress. Perceived stress followed by educational level had the strongest and primary appraisal had the poorest indirect association with mental QoL. Conclusion: In conclusion, primary appraisal, secondary appraisal, social support, educational level, perceived stress, and information-seeking behavior were correlated with higher levels of mental QoL among women. Social support and improving the situation appraisal can provide appreciated support to manage stress induced by the COVID-19 pandemic. Further assessment is needed to determine the vulnerable groups such as illiterate people.

Investigation flipped classroom effectiveness in teaching anatomy: A systematic review.

BACKGROUND: In the Filliped Classroom (FC), the educational environment changes from a large place to an individual learning space and presents curriculum content outside the classroom, engaging learners. PURPOSE: Several preliminary studies have been conducted to evaluate the effectiveness of the FC in anatomy curricular, there are discrepancies between their results. Therefore, the present study was conducted to determine the efficiency of FC in anatomy courses using systematic review. METHODS: In the current systematic review, all documents related to the FC in the anatomy teaching were searched using validated MeSH terms and their synonyms including "Flipp*", "Backwards Classroom", "Reverse Instruction", "Reverse Teaching", "Anatomy" in the Embase, ProQuest, Scopus, PubMed, Web of science (WoS). Google Scholar search engine and two local resources of Scientific Information Database (SID), MagIran, were also searched. The records were considered without time limitation until April 2021. RESULTS: A total of 1169 articles were found and after removing duplicate articles in different databases or unrelated to the inclusion criteria, finally 26 articles with a total sample size articles of the FC group of 2401 people were included in the study. According to the included studies the FC increases the level of self-confidence, improves academic achievement and students' interest and satisfaction, engages students in the learning and interactive activities, longevity and increases overall performance in anatomy curricular. CONCLUSION: The results of this systematic review show that FC is generally perceived positively, and it has some advantages including increasing self-confidence, academic achievement, interest, learning activity, interaction, satisfaction, and overall performance in anatomy curricular. Therefore, it is suggested that this method be considered as one of the methods in teaching anatomy curricular.

Social networks and internet emotional relationships on mental health and quality of life in students: structural equation modelling.

BACKGROUND: Social networks and relationships create a sense of belonging and social identity; hence, can affect mental health and the quality of life, especially in young people. The present study was conducted to determine the predicting role of social networks and internet emotional relationships on students' mental health and quality of life. METHODS: The present cross-sectional study was conducted in 2021 on 350 students at Alborz University of Medical Sciences selected by convenience sampling. Data were collected using five questionnaires: socioeconomic status, social networks, internet emotional relationships, stress, anxiety, depression scale (DASS-21), quality of life, and a checklist of demographic details. Data were analyzed in SPSS-25, PLS-3, and Lisrel-8.8. RESULTS: According to the path analysis, the DASS-21 score had the most significant positive causal association with internet emotional relationships in the direct path (B = 0.22) and the most negative association with socioeconomic status (B = - 0.09). Quality of life had the highest negative causal association with the DASS-21 score in the direct path (B = - 0.26) and the highest positive association with socioeconomic status in the indirect path (B = 0.02). The mean duration of using social networks (B ≈ - 0.07) and internet emotional relationships (B ≈ - 0.09) had the highest negative association with quality of life. CONCLUSION: The use of the internet and virtual networks, internet emotional relationships, and unfavorable socioeconomic status were associated with higher DASS-21 scores and reduced quality of life in the students. Since students are the future of countries, it is necessary for policymakers to further address this group and their concerns.

Psychometric adequacy of the Persian adapted version of the Tilburg pregnancy distress scale (P-TPDS).

BACKGROUND: Pregnancy distress is a combination of anxiety, stress, and depression during pregnancy. The first step in preventing pregnancy distress is to identify women at risk. The present study assessed adaptation and psychometric adequency of the Persian Adapted Version of Tilburg Pregnancy Distress Scale (P-TPDS). METHODS: By Brislin's translation guidelines, TPDS was translated to Persian. This was followed by determining the face validity of P-TPDS and evaluating construct validity using exploratory and confirmatory factor analyses. The Cronbach's alpha coefficients and intra-class correlation coefficient (ICC) were used to estimate reliability. RESULTS: A final 16-item scale was loaded on four distinct constructs jointly accounting for 59.62% of variance. The factors were labelled as delivery-related worries, partner involvement, pregnancy-related worries, and social-related worries. The alpha coefficients for P-TPDS subscales ranged from 0.85 to 0.91 and ICC ranged from 0.70 to 0.77. All comparative indices of the model including CFI, IFI, NFI, and NNFI were above 0.9 showing the goodness of fit for the data with a RMSEA of 0.04, lower bound: 0.038. CONCLUSIONS: The Persian adapted version of TPDS (P-TPDS) is a reliable and valid scale for assessing pregnancy distress among pregnant women in Iran.

Investigating preventive health behaviors against COVID-19 in elementary school students' parents: A cross-sectional study from Tehran - Capital of Iran.

BACKGROUND: Parents act as a role model for children in showing health behaviors. This study investigated factors affecting the preventive behavior in elementary school students' parents based on protection motivation theory (PMT). MATERIALS AND METHODS: This cross-sectional study was conducted in Tehran (Iran) in 2020. Multistage sampling was used to choose 660 elementary school students' parents. The data collection instrument was a multi-sectional questionnaire, including sections on demographic characteristics, PMT constructs, self-reported health, and information sources related to COVID-19. In this study, descriptive statistics (mean and standard deviation) and analytical statistical methods (Pearson correlation and path analysis) were used to analyze the data. The range of Cronbach's alpha of the study instrument varied from 0.71 to 0.97. RESULTS: The results of the current study revealed significant association between all PMT constructs and preventive behaviors. Knowledge from both direct and indirect paths was related to preventive behaviors (B = 0.76). Preventive behaviors had the strongest, direct relationship with age (B = 0.76). Based on the final fitted model, knowledge had the greatest impact on preventive behaviors through indirect and direct routes. CONCLUSION: Knowledge was the most important variable which influenced preventive behavior, and it should be noticed in prevention programs.

An asthmatic pregnant woman with COVID-19: A case report study.

BACKGROUND: COVID-19 represents with various clinical symptoms and infects the respiratory tract, throat, nose, and lung involvement can lead to severe lung disease and death., among asthmatic patients, infections can lead to deterioration. The severity, and prognosis of this disease are likely to be devasted in pregnant women with underlying diseases such as asthma. CASE PRESENTATION: We present an Asthmatic pregnant woman who infected with SARS-CoV-2 admitted to two hospitals in Iran. The patient's symptoms were dry coughs, dyspnea, and inability to speak, numbness, and fatigue. The initial examination indicated a body temperature of 37.9 °C, oxygen saturation (SPO2) 91%, partial pressure of oxygen (Pao2) was 25 mm Hg, respiratory rate (RR) of 20 breaths/minute (b/m), blood pressure of 100/60 mmHg, and pulse of 80 bpm (beat/minute) and fetal heart rate (FHR) = 167/min. The pregnancy terminated by Caesarean Section (C/S) due to fetal tachycardia, a healthy baby with normal range. Anthropometric characteristics were born. Our case had leukopenia and also revealed, elevated C-reactive protein and erythrocyte sedimentation rate. Our case received supportive care and antibiotic & antiviral therapy and was discharged within 8 days with a good general condition. CONCLUSIONS: The patient's condition improved after 8 days of hospitalization and the patient underwent appropriate clinical outcome in spite of underlying disease and infection with SARS-CoV-2.

The relationship among fear and anxiety of COVID-19, pregnancy experience, and mental health disorder in pregnant women: A structural equation model.

INTRODUCTION: Coronavirus pandemic causes stress and anxiety for pregnant women worldwide. The present study was conducted for the path analysis of the relationship among fear and anxiety caused by coronavirus, pregnancy experience, and the mental health of pregnant women. METHODS: This cross-sectional study was conducted on 222 pregnant women who were referred to Kamali Hospital in Alborz province in 2020. The eligible individuals entered the study through convenience sampling, and data were collected using five questionnaires including the Fear of COVID-19 Scale, the Anxiety of COVID-19 Scale, the pregnancy experiences Scales, Depression Anxiety Stress scale, and demographic checklist. The obtained data were then analyzed using SPSS-16 and Amos software. RESULTS: According to results of the path analysis, the anxiety of COVID-19 and concerns during pregnancy were variables that were positively and significantly correlated with mental health only through one path, which was direct, and anxiety of COVID-19 had also the highest positive direct correlation among them (B = 0.32). The next variable was the happiness during pregnancy experiencing, which had a significantly negative and direct correlation with mental health disorder (B = 0.29). Moreover, fear of COVID-19 through the mediating concerns of pregnancy experiences was shown to have a significant positive relationship with mental health through an indirect path (B = 0.05). CONCLUSION: Based on the result of this study, it is necessary to pay more attention to the mental health of pregnant women during a pandemic. In addition, it is recommended to provide a virtual training group to reduce anxiety caused by coronavirus and pregnancy concerns, as well as emphasizing the feeling of enjoying happiness caused by pregnancy experience during a pandemic.

A predictive model of the sunscreen use in the paddy workers based on the health action process approach model: a path analysis.

BACKGROUND: Skin cancer is considered as one of the most common cancers in the world. There is little information about identifying factors affecting sunscreen use among paddy workers and their protective behavior. The present study aimed to determine a predictive model of the sunscreen use in the paddy workers based on the health action process approach model (HAPA). METHODS: This cross-sectional study was conducted on 177 paddy workers who engaged in agricultural work in the north of Iran in 2018. Convenience sampling methods was used. Inclusion criteria were being a farmer for 5 years, working under the sunshine more than 2 h per day, and above the age of 30 years. A multi-sectional questionnaire (intention, risk perception (RP), outcome expectation (OE), action self-efficacy (ASE), action planning (AP), coping planning (CP), coping SE (CSE), self-monitoring (SM), and sunscreen use) was used for data collection. Data were analyzed with SPSS-21 and Lisrel-8.8 software. RESULTS: The mean age of participants was 47.78 ± 12.66 years. The final path model fitted well (comparative fit index (CFI) = 0.98, RMSEA = 0.000), only coping self-efficacy (CSE) from both direct and indirect paths had an impact on sunscreen use (B = 0.73). Among the variables which are influenced only in one direction, coping planning (CP) had the most direct influence (B = 0.30) on behavior, and action planning had the lowest influence (B = 0.24). CONCLUSION: Coping self-efficacy was the most important factor which had influence on the use of sunscreen, and it should be considered when designing interventional programs related to sunscreen use among paddy workers.

How to increase community participation capacity in food environment policymaking: Results of a scoping review.

Background: Food environment plays a major role in health outcomes. A growing interest in community-based participatory research (CBPR) has led to its application in the improvement of the food environment. This scoping review aims to compile and map the literature and identify key strategies used for increasing community participation capacity in the food environment policymaking process. Methods: The scoping review of peer-reviewed articles on community participation and food environment policymaking followed the framework suggested by Arksey and O'Malley (2005). Scopus, PubMed, and Web of Science were searched. A charting table was developed to extract the key information of each identified study. A directed content analysis approach was used to assign retrieved codes into categories proposed by Foster-Fishman. Results: A total of 28 studies were included in this review. Most studies used the CBPR approach to involve the community at least in the problem identification step of the policymaking process (n=12) and 7 studies reported their involvement in all the steps of policymaking. In 15 out of 28 studies, the level of community participation was at "involvement" and in 8 studies it was at "empowerment". Strategies for increasing relational capacity, member capacity, programmatic capacity, and organizational capacity of community participation were reviewed. Conclusion: To improve food environment using the community-participation approach, identifying different strategies and adjusting them based on the social and political context of each society is of high importance.

Popular water pipe smoking, medical sciences students' awareness, perceptions, and motivations.

OBJECTIVES: This study was done to investigate popularity, awareness, perceptions, and motivations regarding water pipe smoking (WPS) among medical sciences students in 2017. METHODS: This cross sectional study was done among 385 medical sciences student in 2017.The systematic random sampling was used to recruit subjects. Multidimensional questionnaire (demographic characteristics, awareness, perceptions, action, and water pipe motivators) was used. t-test, ANOVA, X2, and logistic regression was used to analyze the data by SPSS. RESULTS: The mean ages of participants were 22 ± 2.64 and 89% were male. The majority of the study sample was from health school. Most participants reported having smoked before. Family entertainment was found to be the most common motivator for WPS. The second one was to be fun. WPS use was significantly associated with age (odds ratio [OR], 0.17; 95% Confidence Interval [CI], 0.04-0.61); awareness (OR, 1.55; 95% CI, 1.35-1.78); and perception (OR, 0.71; 95% CI, 0.65-0.78). CONCLUSIONS: Results show that WPS is very popular among Iranian youth. In designing public health programs, policy makers should consider the motivators for inclination to WPS. Intervention should focus on addressing students' perception and awareness regarding WPS.

Perspectives of adolescents regarding the sexual and reproductive health self-care: a theory-based qualitative research.

OBJECTIVES: It is widely accepted that sexual and reproductive health in adolescents are among the health priorities in the world that affects health aspects and the formation of beliefs and socioeconomic development in the community. However, achieving goals related to sexual and reproductive health is not possible without awareness and participation of the adolescents. On the other hand, proper knowledge about such issues can prevent many problems in this regard. METHODS: This qualitative study was carried out for one month in schools of Alborz University of Medical Sciences using content analysis. Data were collected from semi-structured, individual and in-depth interviews with female students. In addition, data analysis was performed using guided qualitative content analysis (theory-based). RESULTS: Analysis of the data led to the extraction of 11 primary codes classified in six categories of protection motivation constructs (perceived sensitivity, perceived severity, response efficiency, response cost, self-efficacy, and internal rewards) and two additional categories (communications and social contexts). CONCLUSION: All interviewees found themselves exposed to sexually transmitted diseases and emphasized sexual self-care even though the majority of these individuals had inadequate self-efficacy.

Investigation E-health literacy and correlates factors among Alborz medical sciences students: a cross sectional study.

BACKGROUND: Health literacy is one of the goals of public health and the key challenge of health education in the 21st century. This study aimed to determine E-health literacy and correlates among medical sciences students in Karaj, Iran 2017. METHODS: This cross-sectional study was performed on a thousand students of Alborz University of Medical Sciences. A multi-sectional questionnaire was used to collect data. The first section included age, major, marital status; educational grade, mother and father education, socioeconomic status, health status, membrane in social network and the second compromised a validated Persian version of the E-health literacy. We used t-test and analysis of variance (ANOVA) to compare the mean of variables and for categorical variables x2 was used with SPSS version 19. RESULTS: The mean age of the subjects was 25.5 ± 5.6 years, of which 65.3% were male. The medical students constituted the most number of participants (28.6%). Mean eHEALS score was 26.11 ± 6.6 years. There was a significant difference between female and male regarding E-health literacy (P = 0.04). Internet was the most commonly used sources for health information (67%), the majority of the students were members of one of the social networks (77.7%) that telegram and Instagram were among the most popular networks. CONCLUSION: Improving search skills and assessing of health resources in students, especially in medical and Para-medical sciences, is recommended. Social networks can be used as channels for the transmission of the health messages due to high usage among students.

Factors affecting the quality of life in women with gestational diabetes mellitus: a path analysis model.

BACKGROUND: Quality of life (QoL) is the most important indicator for assessing the status of health care in chronic diseases. The present study aimed to determine the pathway determinants model of QoL in patients with gestational diabetes mellitus (GDM). METHODS: This cross-sectional study was conducted on 329 women with GM referred to health care centers in Qom, Iran during 2018. Convenience sampling methods was used. Inclusion criteria were: afflicted by GM and received pregnancy care services from health center. Several questionnaires (Knowledge, attitude, self-efficacy (SE), social support (SS), pregnancy distress, self-management(SM) and QoL) were used for data collection. Data were analyzed with SPSS-21 and Lisrel-8.8 software using statistical path analysis. RESULTS: The mean age of participants was 30.93 ± 5.42 years. The final path model fitted well (CFI =1, RMSEA = 0.0003) and showed that, only age variable from both direct and indirect path had an impact on QoL (B = 0.51). Among variables that directly affected the QoL, SS had the highest effect (B = 1.02) and SE (B = 0.01) had the lowest effect. In the indirect path, only the knowledge variable by affecting the SE had an impact on the QoL (B = 0.0045). CONCLUSION: SS had the greatest impact on the QoL. Obviously, providing all the requirements to support patients can help them overcome problems and improve their QoL. Distress negatively affects the QoL through SM and it should be noticed in interventional studies.

Cultural adaptation and psychometric adequacy of the Persian version of the physical activity scale for the elderly (P-PASE).

OBJECTIVE: This cross sectional study was conducted to investigate cultural adaption and validation of the Persian version of the PASE among the elderly community dwellers in Iran. Out of 278 elderly people, 65% of them were female. After translation and cultural adaption, the PASE was evaluated with respect to the validity and reliability. Regarding the construct validity, the concurrent validity was assessed between the PASE and ADL, IADL, self-rated health, and TUG test. RESULTS: The mean score of P-PASE was equal to 153.73 ± 48.47. P-PASE scores were significantly and negatively correlated with TUG (r = - 0.691, P < 0.001) and age (r = - 791, P > 0.001), and were also significantly correlated with ADL (r = 0.775, P < 0.001), and IADL (r = 0.161, P < 0.001). The ICC was obtained as 0.92 (95% CI 0.90-0.94), 0.86 (95% CI 0.82-0.87), and 0.91 (95% CI 0.90-0.94) for the leisure time activity, household activity, and work-related activity scores, respectively. The Cronbachs̓ alpha coefficient was equal to 0.74, 0.74, and 0.79, respectively for leisure time activity, household activity, and work-related activity domains.

Perspectives of paddy workers regarding the use of sunscreen: a theory-based qualitative research.

BACKGROUND: Skin cancer is one of the most frequent types of cancer. This study aims to clarify farmers' perspectives regarding the use of sunscreen according to Health Action Process Approach. METHOD: Twenty-seven farmers were recruited an interviewed. The samples were classified according to their age, sex, and education. The data were collected through a deep and semi-structure interview during one-month period. Questions were asked based on Health Action Process Approach (HAPA) and were continued until the saturation stage. RESULTS: The data were classified into six categories (intention, risk perception, outcome expectation, self-efficacy, perceived barriers and action planning). Most of the interviewees did not use sunscreen and did not intend to use it either. They indicated some threats of sunlight, such as burn and rash, redness, itching, soreness and darkness of skin. The participants pointed to some physical outcome expectation of the sunscreen and mentioned some perceived barriers such as time limitation, low income, non-familiarity with sunscreen, the notion that sunscreen is only for women and the farmers prioritize farming and believed that sunscreen is not required in all seasons. CONCLUSIONS: Risk perception, outcome expectation and perceived barriers should be considered designing appropriate interventions. The education of protection behaviors should be considering during interventional strategies.

Effect of education based on protection motivation theory on adolescents' reproductive health self-care: a randomized controlled trial.

BACKGROUND: Adolescents should be empowered to improve their reproductive and sexual health needs. The present study aimed to investigate effects of protection motivation theory-based education on student girls' reproductive and sexual health self-care. METHODS: This randomized controlled trial was conducted in parallel on 90 female students living in dormitories of the Alborz University of Medical Sciences in Iran. The data collection lasted from January 2017 to May 2018. Convenience sampling was performed, and samples were put into intervention and control groups by block randomization. The intervention group received six educational sessions based on the protection motivation theory(PMT). The data collection tool of this research consisted of the protection motivation theory and reproductive health self-care questionnaires. RESULTS: There was no significant difference between control and intervention groups in demographic characteristics. The results of the repeated measures test indicated that the reproductive health self-care variable had a significant change (p = 0.000), and there was a significant difference between groups (p = 0.000). The total score of the Protection Motivation Theory Questionnaire was not changed over time (p = 0.54) and there was no significant difference between groups (p = 0.51) according to results of the repeated measures test. CONCLUSION: According to effects of an educational intervention based on the protection motivation theory, it is suggested to utilize this model as an educational framework for adolescents' reproductive and sexual health by healthcare providers, schools and universities as well as holding periodic courses educating adolescents within short-term intervals in order to achieve the higher sustainability of the educational results.

The Impact of Demographic Factors and Blood Sugar Control on the Incidence of Urinary Tract Infections in Khorramabad in 2013.

BACKGROUND: Diabetes is one of the most serious metabolic disorders to affect different organs in the body. Patients with diabetes are hence at risk of developing other problems. Urinary tract infections (UTI) are one of the problems that occur more commonly in diabetic patients than in others. There are several risk factors that lead to the incidence of UTI in diabetic patients. OBJECTIVES: We conducted this study to determine the effect of different factors on the incidence of UTI in diabetic patients in order to decrease the incidence of this problem. PATIENTS AND METHODS: In this cross-sectional study, data concerning 233 patients who were referred to the largest diabetes center in Khorramabad, Lorestan province, Iran, were recorded. The relationships between various factors and the incidence of UTI in these patients were evaluated using SPSS version 16. We used chi-square and logistic regression to analyze the data. A P < 0.05 was considered to be statistically significant. RESULTS: The incidence of UTI increased significantly with increasing age (P = 0.009). The incidence of UTI was higher among females than among males, and it was higher among unemployed people than among those in other occupations. The prevalence of UTI among patients who control their diabetes through diet and exercise was lower than that among those undergoing other types of treatment; however, no significant relationship was found between the different types of oral medication and the incidence of UTI. We did not find any relationship between the incidence of UTI in diabetic patients and other factors such as literacy, marital status, BMI, addiction, history of hospitalization, and level of HbA1c. CONCLUSIONS: We found that age, gender, occupation, and the type of medication used are all risk factors for the incidence of UTI in diabetic patients. Other factors such as literacy, marital status, addiction, and history of hospitalization did not have any significant association with the incidence of UTI in diabetic patients.

Is Routine Iron Supplementation Necessary in Pregnant Women With High Hemoglobin?

BACKGROUND: Iron supplementation is a chief component in prenatal care, with the aim of preventing anemia; however, extreme maternal iron status may adversely affect the birth outcome. Given the negative consequences of high maternal iron concentrations on pregnancy outcomes, it seems that iron supplementation in women with high hemoglobin (Hb) should be limited. OBJECTIVES: The aim of this study was to examine the effect of iron supplementation on iron status markers in pregnant women with high Hb. PATIENTS AND METHODS: In a randomized, double-blind, placebo-controlled trial, 86 pregnant women with Hb > 13.2 g/dL and ferritin > 15 µg/l in the 16th - 20th week of pregnancy were randomized into experimental and control groups. From the 20th week until the end of pregnancy, the experimental group received one ferrous sulfate tablet containing 50 mg of elemental iron daily, while the control group received a placebo. Hb and ferritin levels at 37 - 39 weeks of pregnancy were evaluated and compared. In addition, after delivery the birth weight was measured in two groups and compared. RESULTS: There were statistically significant differences between the two groups in Hb (p = 0/03) and ferritin (p = 0/04) levels at the end of pregnancy, but the incidence of anemia exhibited no difference in either group (p < 0/001). In addition, the mean of birth weight in experimental group and control group were 3391/56 ± 422, 3314/06 ± 341, respectively and it was not significant difference (p = 0.2). CONCLUSIONS: Not using iron supplementation did not cause of anemia in women with Hb concentrations greater than 13.2 g/dL during pregnancy; thus, the systematic care and control of iron status markers without iron supplementation is recommended for these women.

Social support and dairy products intake among adolescents: a study from Iran.

BACKGROUND: Adequate daily milk and dairy products intake seems to an important for adolescents' health. This study aimed to identify the high-risk group adolescents who did not meet the recommended daily serving milk and dairy products and indeed to find out associated factors relating to their nutrition behaviors. METHODS: This cross sectional study was carried out on 7th grade students, in Tabriz, East Azerbaijan province, Iran. An anonymous self-administrated questionnaire including items on perceived social support, physical activity, and sedentary behaviors was administered. In addition a valid food frequency questionnaire (FFQ) measuring daily milk products serving intake as a main outcome measure was completed for each respondent. Logistic regression analysis was applied to examine the association between milk and dairy products consumption and independents variables. RESULTS: In all 402 students (51.5 % female) participated in the study. The mean age of students was 12.9 (SD = 0.49) years. The average daily intake of milk and dairy products was 1.64 (SD = 0.78) servings per day. Overall 14.2 % of adolescents (18.8 % of girls, and 9.2 % of boys, p = 0.006) reported consumption of the recommended daily milk and dairy products serving per day. The results indicated that gender boys (OR for boys = 2.41, 95 % CI = 1.25-4.67), mother age (OR for age group 40-55 years = 2.52, 95 % CI = 1.18-5.38), poor perceived emotional family support, (OR = 1.10, 95 % CI = 1.05-3.61), and poor perceived practical family support (OR = 2.04, 95 % CI = 1.18-4.17) were the most significant contributing factors to low level milk and dairy products intake in adolescents. CONCLUSION: The findings indicated that adolescents did not take the recommended daily amount of milk and dairy products and this appeared to be strongly related to low perceived family support. To achieve the recommended daily milk and dairy products serving consumption, family involvements in any programs that specifically address emotional and practical support for promoting daily milk and dairy products intake among adolescents are suggested.