Noise-induced Hearing Loss: Continuous versus Impact/impulse Noise.

Background: Impact/impulse and continuous noise are two main causes of noise-induced hearing loss (NIHL) in workplaces. The aim of this study was to compare the effects of impulse/impact noise and continuous noise on hearing status. Methods: In this study, 259 workers referred to the occupational medicine clinic of Shahid Rahnemoun hospital, Yazd, Iran, entered the study and were divided into two groups: with exposure to impact/impulse noise and with exposure to continuous noise. Hearing thresholds were measured and compared between the two groups by pure-tone audiometry (PTA). The frequency of hearing loss and audiometric notch according to the results of PTA was compared between the two groups. Data were analyzed by SPSS (ver. 16) using Student's t-test, Chi-square test, and Mann-Whitney U test. Results: Hearing thresholds were significantly higher at all frequencies in the impact noise group. The hearing threshold at 6000 Hz was higher than other frequencies in both groups. The frequency of hearing loss at high frequencies was higher in the impact group. The frequency of audiometric notch was not significantly different between the two groups. Conclusions: The results of this study showed that hearing loss after exposure to impact/impulse noise is probably more frequent and more severe than exposure to continuous noise, but the pattern of hearing loss is similar in both types of noise exposure.

The experiences of preparation and engagement of educators in teaching e-portfolio.

INTRODUCTION: A teaching e-portfolio is used to organize the collation and presentation of documents about teaching for the development and evaluation of educators. The current study was aimed at describing teaching e-portfolio components at Shahid Sadoughi University of Medical Sciences. As well, we examined the performance and experience of educators in engaging in the teaching e-portfolio. MATERIALS AND METHODS: This study was conducted at Shahid Sadoughi University in 2018-2022 in three main stages: (1) Development of the teaching e-portfolio; (2) Implementing teaching e-portfolio, and evaluating teaching documentation quantitatively; and (3) Exploration of educators' experiences by a conventional content analysis introduced by Graneheim and Lundman. The teaching e-portfolio was developed from the perspective of the components, domains, and criteria of scholarship of teaching and learning. The teaching e-portfolio documented the educational activities of educators in 12 areas, including philosophy of education (1 activity), curriculum planning (4 activities), evaluation (7 activities), teaching and learning (1 activity), e-learning (1 activity), professional development in education (1 activity), scholarly activities (2 activities), mentoring and counseling (3 activities), educational leadership (2 activities), education research (6 activities), education reform project (1 activity), and production of scholarship of teaching and learning (13 activities). The educators recorded the documentation of educational activities in their teaching e-portfolio. Their documentation was reviewed by two peers. The reviewers delivered constructive feedback to improve the educators' performance. The quantitative performance of educators in different activities in teaching e-portfolio was examined by descriptive tests (frequency and percentage). The experiences of educators were explored by the conventional content analysis approach which was introduced by Graneheim and Lundman. RESULTS: In the present study, 148 educators registered in the teaching e-portfolio. A total of 1488 documents of educational activities were registered in the e-portfolio from 2018 to 2022, and 55.24% of the activities received feedback in the peer review process. The experience of participants was categorized into a theme "fear and hope in utilizing teaching e-portfolio". This theme consisted of three categories: "motivational roadmap for personal and professional development in the future", "concern about the consequences of continuous monitoring", and "restriction of resources and capability as resistance sources". CONCLUSION: The current study showed that the participation of educators in a teaching e-portfolio was at an acceptable level. Support systems and educational policies played an effective role in guiding educators to participate in educational development activities. The educators perceived the teaching e-portfolio as a two-faceted tool. Teaching e-portfolio can provide a road map for their personal and professional development to achieve excellent teaching. As well, the teaching e-portfolio was recognized as a tool for continuous performance monitoring and detection of the inefficiency of teaching quality activities. This perception, along with limited resources such as time, weak technological literacy, and difficulty in working with electronic devices and systems, led to resistance from educators to involve in teaching e-portfolio.

Spirometric Parameters in Waterpipe Smokers, Cigarette Smokers, and Non-smokers of Shahedieh Cohort Study.

Background: Different kinds of smoking tobacco may affect pulmonary function and reduce some spirometric parameters. This study aimed to assess the relationship between smoking cigarettes and waterpipe and spirometric parameters. Methods: This was a cross-sectional study on 1543 middle-aged individuals, as a sub-study of the Shahedieh cohort study in Yazd. The participants were randomly selected from the Shahedieh cohort population and were divided into 6 groups according to their smoking habits: non-smokers (n=455), cigarette smokers (n=139), waterpipe smokers (n=287), ex-cigarette smokers (n=131), concurrent waterpipe and cigarette smokers (n=121), and cigarette or waterpipe passive smokers (n=410). Spirometry was performed on all participants and spirometric parameters were compared between different groups. The data were analyzed by SPSS (version 20) using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. Findings: FEV1 %, FEV1/FVC, and PEF25-75% were significantly lower in cigarette smokers, compared to waterpipe smokers and non-smokers. The measures were not significantly lower in waterpipe smokers in comparison to non-smokers. The frequency of obstructive pattern and small airway diseases was significantly higher in cigarette smokers compared to waterpipe smokers and non-smokers. Conclusion: The results of this study showed that in the middle-aged population, spirometric parameters related to airway obstruction (FEV1, FEV1/FVC, and FEF25-75%) were significantly lower in cigarette smokers than in non-smokers and waterpipe smokers, but these parameters were not significantly different between waterpipe smokers and non-smokers.

Association between occupational noise exposure and diabetes: A systematic review and meta-analysis.

BACKGROUND: In addition to the well-known risk factors of diabetes, evidence is accumulating on the negative role of environmental and occupational factors such as noise exposure. We conducted a systematic review and meta-analysis on the association between long-term occupational noise exposure and diabetes. METHODS: We systematically searched evidence in PubMed, Scopus, and Web of Science (until August 2022) according to the PRISMA protocol. Risk of bias was assessed using the Newcastle-Ottawa scale. Random-effects meta-analysis was applied separately for risk ratio (odds ratio, relative risk) and hazard ratio. We evaluated the heterogeneity and publication bias. We applied meta-regressions to identify sources of heterogeneity. The overall body of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. RESULTS: Of 533 retrieved articles, twelve studies (11 on non-gestational, and one on gestational diabetes) on total 106,045 population (23,996 diabetic cases) met our inclusion criteria; of which eight studies were cross-sectional, three were cohorts, and one was case-control. Only 40% of papers (five out of 12) had fair, good or very good quality, and most of the papers had poor or very poor quality in terms of risk of bias. We observed a non-significant increased risk of diabetes in association with occupational noise exposure (combined risk estimates: 1.16, 95% confidence interval [CI]: 0.97: 1.34; I2 = 57.7%). Doing separate meta-analyses on cohort and rest of studies, we found similar findings (cohort studies (n = 3): combined risk estimate: 1.17; 95% CI: 0.84: 1.50; I2 = 79%; cross-sectional studies (n = 8): combined risk estimate: 1.26; 95% CI: 0.93: 1.58; I2 = 50.4%). We found no indication of publication bias. CONCLUSIONS: The overall evidence on the association between occupational noise exposure and diabetes is heterogeneous, limited, and mostly with low quality. More robust studies in terms of population selection, exposure and outcome assessment, and adjustment for confounders are necessary.

Effective components of teachers' professionalism in viewpoints of various stakeholders.

BACKGROUND: The teacher must conduct educational responsibilities in the best way by observing the ethical principles to meet students' educational needs. The aim of the study was to investigate the main factors of professionalism among faculty members from the viewpoints of various stakeholders including learners, peers, and educational officials, as well as the components were assessed from the viewpoints of the stakeholders. MATERIALS AND METHODS: This was a descriptive analytical study conducted in two phases. In the first phase, a questionnaire was developed and validated to assess the professional behavior of faculty members. In the second phase, the evaluation of the teachers' professional behavior was done from the viewpoint of various stakeholders, including learners, middle and senior education managers and peers. The participants were faculty members from 10 schools enrolled in the study by census (n = 427). To extract the factors that constitute professional behavior in faculty members, exploratory factor analysis was used. Data were summarized using descriptive indices (mean, standard deviation, and percent). Exploratory factor analysis (EFA) was used to extract the factors that constitute professional behavior in faculty members. Data was analyzed by using SPSS software (version 23.0). RESULTS: In the first phase, the questionnaire with 11 items was developed. The validity and reliability of the tool was confirmed. The mean (SD) of the faculty members' scores was 4.54(±0.34), with a minimum score of 2.33 and a maximum score of 5.00. The highest scores of faculty members were reported in the items of "altruism to colleagues and students" and the lowest scores were related to "feedback seeking and feedback acceptance". Professional behavior was categorized under two domains: accountability to professional duties and adherence to professional values. Fifty percent of the participants followed the adherence to professional values (P = 0.22), but less than 50% of the individuals followed the adherence to professional duties significantly (P = 0.002). CONCLUSION: The results of the present study showed that adherence to professional duties was low in faculty members. Assessment of individuals' adherence in these two domains showed that faculty members' compliance in the domain of accountability to professional duties was significantly lower.

Association between different patterns of shift work and liver function tests: A cross-sectional analysis of Shahedieh PERSIAN cohort data, Iran, 2020.

BACKGROUND: Recent studies suggest that shift work may cause liver dysfunction. OBJECTIVE: This study aimed to examine the relationship between different patterns of shift work and elevated level of liver enzymes. METHODS: In this cross-sectional study, 1910 workers aged 35 to 70 years were selected with simple random sampling from 9978 participants of the recruitment phase of Shahedieh PERSIAN cohort study. Level of serum liver enzymes (ALT, AST, ALP, and GGT) and ALT/AST ratio was compared between shift workers and non-shift workers, and among employees working in different patterns of shift work. Data were analyzed by SPSS (version 21.0) using Student's T test, Mann-Whitney U test, chi-square test, Kruskal Wallis test, and logistic regression. RESULTS: Among 1347 males (71%) and 563 females (29%) with a mean age of 40.4±7.4 years, 469 were shift workers. Fixed evening type shift was the most common (30.3%) and fixed night-shift was the least common (0.9%) type of shift work. The mean blood levels of liver enzymes was not significantly different between shift workers and non-shift workers. In comparison between different patterns of shift work, the mean serum level of GGT was significantly higher in individuals with slow rotating shifts than those with fixed evening shifts, rapid rotating, split and fixed 24 hour shifts (p≤0.001). After adjusting for confounding factors only elevated AST was significantly higher in shift workers. CONCLUSION: There was only a significant association between shift work and elevated AST, and no relationship was found with ALT, ALP, GGT, and ALT/AST ratio.

The relationship between noise-induced hearing loss and cognitive function.

INTRODUCTION: NIHL may affect some domains of cognitive function. This study was conducted to assess the relationship between NIHL and working memory, attention and response time. MATERIALS AND METHODS: This was a cross-sectional study on 154 textile workers with exposure to noise higher than 85dBA in a textile factory. The participants were divided into two groups: with and without NIHL and some domains of cognitive function were compared between two groups. Wechsler working memory test and Stroop color-word test were used to measure working memory, selective attention and response time. Data were analyzed by SPSS (ver. 24) using student's T test, and multiple linear regression model. RESULTS: Totally, 154 workers entered the study (77 with NIHL and 77 without NIHL). All participants were males. Working memory score and response time were higher and interference score was lower in NIHL group, although only the difference in working memory was significant. Due to the significant difference of age and work history between case and control groups, cognitive parameters were compared between two groups after adjusting for these two variables, but the significance was not changed. CONCLUSION: This study showed that noised-exposed middle-aged males with NIHL had probably a lower working memory span than their counterparts without NIHL.

Development of an interprofessional task-based learning program in the field of occupational health: a content validity study.

OBJECTIVE: One of the duties of the educational system is to provide situations in which students learn the tasks corresponding to their future careers in an interprofessional team. This study was designed to develop an interprofessional task-based training program. METHODS: This was a curriculum development study conducted by content validity methodology in two stages: 1) 'framework development' which resulted in the creation of the framework items; and 2) 'evaluation of the framework' (judgment and quantification). The first stage consisted of task identification, generation of sub-tasks, and assimilation of items into a usable format. The second stage consisted of the judgment -quantification of the content validity of items and the framework. After that, the framework of the tasks of the occupational health team was finalized in the expert panel. After explaining the tasks, a matrix for task-expected roles in the occupational health team and a matrix for task-required skills to perform each task were developed. The next step determined the appropriate teaching and assessment methods for each task. Finally, an expert panel reviewed and approved the components of the interprofessional task-based training program. RESULTS: Integrating the interprofessional education strategy with task-based learning was considered innovative in occupational health team training. In the development stage, 48 items were extracted, and then 35 tasks were generated in the step of identification of tasks. In the second step, 174 sub-tasks were developed. The tasks and sub-tasks were categorized into seven areas. After the stage of evaluation of the framework, 33 tasks were categorized into seven main areas, including "assessment and identification of workplace hazards" (n = 10), "control of occupational hazards" (n = 4), "determining the appropriate job position for each person" (n = 3), "occupational health examinations" (n = 6), "management of occupational/work-related diseases" (n = 5), "inter-organizational and inter-disciplinary relations, and legal judgment" (n = 3) and "education and scholarship in occupational health services" (n = 2). CONCLUSION: The results of the present study can be used in developing the use of the interprofessional strategy and task-based training as two appropriate strategies for the purposeful development of learners' abilities in the fields involved in providing occupational health services in their future careers.

The association between dietary patterns derived by three statistical methods and type 2 diabetes risk: YaHS-TAMYZ and Shahedieh cohort studies.

Findings were inconsistent regarding the superiority of using recently introduced hybrid methods to derive DPs compared to widely used statistical methods like principal component analysis (PCA) in assessing dietary patterns and their association with type 2 diabetes mellitus (T2DM). We aimed to investigate the association between DPs extracted using principal component analysis (PCA), partial least-squares (PLS), and reduced-rank regressions (RRR) in identifying DPs associated with T2DM risk. The study was conducted in the context of two cohort studies accomplished in central Iran. Dietary intake data were collected by food frequency questionnaires (FFQs). DPs were derived by using PCA, PLS, and RRR methods considering. The association between DPs with the risk of T2DM was assessed using log-binomial logistic regression test. A total of 8667 participants aged 20-70 years were included in this study. In the multivariate-adjusted models, RRR-DP3 characterized by high intake of fruits, tomatoes, vegetable oils, and refined grains and low intake of processed meats, organ meats, margarine, and hydrogenated fats was significantly associated with a reduced T2DM risk (Q5 vs Q1: RR 0.540, 95% CI 0.33-0.87, P-trend = 0.020). No significant highest-lowest or trend association was observed between DPs derived using PCA or PLS and T2DM. The findings indicate that RRR method was more promising in identifying DPs that are related to T2DM risk compared to PCA and PLS methods.

The Effect of Water-Pipe and Cigarette Smoking on Exhaled Nitric Oxide.

Context: Fractional exhaled nitric oxide can be used as a biomarker of some respiratory diseases. Aims: This study was conducted to compare exhaled nitric oxide in cigarette and water-pipe smokers with nonsmokers. Methods: This cross-sectional study was conducted on 549 adult subjects as a sub-study of Shahedieh cohort in Yazd. Participants were divided into 5 groups according to their smoking habits: non-smokers (n = 202), cigarette smokers (n = 121), water-pipe smokers (n = 129), cigarette ex-smokers (n = 58), water-pipe and cigarette smokers (n = 39). The smokers were also categorized into heavy and light smokers. Fractional exhaled nitric oxide was compared between the groups. Statistical Analysis Used: The data were analyzed by SPSS (ver. 20) using Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. Results: Fractional exhaled NO was lower in all smokers than nonsmokers, but cigarette smokers showed the least level of NO than other groups. Fractional exhaled NO was not significantly lower in water-pipe smokers than nonsmokers. Conclusions: Cigarette smoking significantly affect fractional exhaled NO, but water-pipe smoking did not significantly affect exhaled NO level.

Health risk assessment of inhalational exposure to heavy metals in drivers working in an urban desert city in the Middle East.

Heavy metals are threatening the lives of people around the world. This study aims to quantify the adverse health risks of seven heavy metals, including arsenic, cadmium, cobalt, chromium, lead, manganese, and nickel in taxi drivers in an urban desert city, Yazd, Iran. The exposure concentrations were determined through air sampling in the breathing zone of 40 randomly selected intercity taxi drivers, 20 in winter and 20 in summer, in 2019. An ICP-MAS spectrometer was applied to measure the elements. Target hazard quotient (THQ) and excessive cancer risk (ECR) indices were applied to calculate the non-cancer and cancer risks based on the United States Environmental Protection Agency (USEPA) guidelines, respectively. The results showed that arsenic and lead had the highest exposure concentrations among the seven measured heavy metals while cobalt and chromium metals had the lowest concentrations. Arsenic, cadmium, manganese, and nickel would probably cause some adverse non-carcinogenic health problems (THQ > 1) in the drivers over their working life. The percentile 95% ECR of measured heavy metals was 1.3E - 03 in total, which is much higher than the value of 1E - 06. The concentration of arsenic and nickel was higher in winter than in summer. Taxi drivers in Yazd city are at considerable health risk; therefore, swift and serious controlling measures should be taken by responsible authorities. Besides, the taxi drivers should be educated about heavy metals' health effects and their protective behaviors.

Exposure to greenspace and cancer incidence, prevalence, and mortality: A systematic review and meta-analyses.

We conducted a systematic review and meta-analysis of the available literature on the association between greenspace exposure and all-sites and site-specific cancer incidence, prevalence, and mortality in adults. We searched PubMed, Scopus, and Web of Science for original articles published, without language restriction until September 2021. We assessed the risk of bias in each study and the overall quality of evidence for exposure-outcome pairs that were reported in two or more studies. Out of the 18 included studies, cross-sectional studies were the most common study design (n = 8), and most of the studies were conducted in Europe (n = 8). In terms of risk of bias, the majority of cohorts (four out of six) and case-control studies (three out of four) were of good or very good quality, and cross-sectional studies were mostly (five out of eight) of poor quality. Outcomes (incidence, prevalence, mortality) on different cancer sites were reported: lung cancer (n = 9), prostate cancer (n = 4), breast cancer (n = 4), skin cancer (n = 3), colorectal cancer (n = 2), all-sites cancer (n = 2), brain cancer (n = 1), mouth and throat cancer (n = 1), and esophageal cancer (n = 1). The meta-analyses for the breast, lung, and prostate cancer incidence did not show statistically significant associations (for example for breast cancer: hazard ratio = 0.83; 95% confidence interval: 0.47-1.48). For skin cancer, the available evidence suggests that greenspace could be a potential risk factor. For the other cancers, the evidence was non-conclusive. The overall quality of evidence of all of the exposure-outcome pairs was very low. Given the wide confidence interval of the pooled estimates and very low quality of evidence, the findings should be interpreted with caution. Future large and longitudinal studies are needed to assess the potential association of greenspace exposure with cancers, considering types and quality of greenspace, evaluation of cancer sub-types, and adjustment for a sufficient set of covariates.

Greenspace exposure and children behavior: A systematic review.

We systematically reviewed the existing evidence (until end of November 2021) on the association between long-term exposure to greenspace and behavioral problems in children according to the PRISMA 2020. The review finally reached 29 relevant studies of which, 17 were cross-sectional, 11 were cohort, and one was a case-control. Most of the studies were conducted in Europe (n = 14), followed by the USA (n = 8), and mainly (n = 21) from 2015 onwards. The overall quality of the studies in terms of risk of bias was "fair" (mean quality score = 5.4 out of 9) according to the Newcastle-Ottawa Scale. Thirteen studies (45%) had good or very good quality in terms of risk of bias. The strength and difficulty questionnaire was the most common outcome assessment instrument. Exposure to the greenspace in the reviewed studies was characterized based on different indices (availability, accessibility, and quality), mostly at residential address locations. Association of exposure to different types of greenspace were reported for nine different behavioral outcomes including total behavioral difficulties (n = 16), attention deficit hyperactivity disorder (ADHD) symptoms and severity (n = 15), ADHD diagnosis (n = 10), conduct problems (n = 10), prosocial behavior (n = 10), emotional symptoms (n = 8), peer-relationship problems (n = 8), externalizing disorders (n = 6), and internalizing disorders (n = 5). Most of the reported associations (except for conduct problems) were suggestive of beneficial association of greenspace exposure with children's behaviors; however, the studies were heterogeneous in terms of their exposure indicators, study design, and the outcome definition.

Effect of shift work on working memory, attention and response time in nurses.

Objective. The present study aimed to investigate the relationship between shift work and cognitive performance in nurses. Methods. The present before-after study included 35 female nurses 25-40 years old with similar mental and physical workload. Working memory, response time and attention were assessed using Wechsler and Stroop tests. The variables were measured at the beginning and the end of three working shifts (morning, afternoon and night). An interval of 3 days was considered for performing an after-shift test to eliminate the learning effect. Data were analyzed using repeated-measures analysis of variance (ANOVA). Results. At the end of all three shifts, nurses' working memory (p = 0.039) and interference score (p = 0.04) were significantly decreased, but their response time was not significantly affected during a shift. The decrease in working memory after the night shift was significantly higher than after the morning and evening shifts (p < 0.001). Conclusion. The results of this study showed that shift work can affect some aspects of cognitive function (working memory and attention) in nurses, and this effect was more prominent after a night shift.

A comparison of principal component analysis, partial least-squares, and reduced-rank regressions in the identification of dietary patterns associated with hypertension: YaHS-TAMYZ and Shahedieh cohort studies.

Limited data exist on the advantage of data reduction hybrid methodologies for evaluating the relationship between dietary patterns (DPs) and chronic diseases and they have led to inconsistent results. This study aimed to investigate the association between DPs extracted using principal component analysis (PCA), partial least-squares (PLS), and reduced-rank regressions (RRRs) in identifying DPs associated with hypertension (HTN) risk. The current study was conducted in the context of two cohort studies accomplished in Iran. DPs were generated using PCA, PLS, and RRR methods. Log-binomial logistic regression test was used to assess the association between DPs and the risk of HTN. From a total of 12,403 included participants aged 20-70 years, 507 incident cases of confirmed HTN were identified. The PCA-DP2 was associated with HTN in the fully adjusted model (T3 vs. T1: RR: 0.737, 95% CI: 0.57-0.93, P trend = 0.013). The PLS-DP2 and HTN risk were inversely associated in the multivariate model (T3 vs. T1: RR: 0.704, 95% CI: 0.54-0.91, P trend = 0.013). The RRR-DP2 was associated with an increased risk of HTN (T3 vs. T1: RR: 1.412, 95% CI: 1.11-1.80, P trend = 0.007). Our findings suggest that the RRR method reveals stronger results in association with HTN risk. However, further investigations are required to confirm the association between DPs derived by PLS and RRR methods by incorporating biomarkers related to HTN as the response variables.

The Comparison of The Efficacy of Photobiomodulation and Ultrasound in the Treatment of Chronic Non-specific Neck Pain: A Randomized Single-Blind Controlled Trial.

Introduction: Chronic neck pain is a common complaint among office workers. The aim of the present study was to compare the efficacy of a high-intensity laser and physiotherapy in office workers who were diagnosed with chronic non-specific neck pain. Methods: This study was a single-blind randomized controlled trial, with parallel allocation. Sixty office workers with chronic neck pain, aged between 25 and 55 years, participated in the study. The participants were randomly divided into two groups: photobiomodulation (by a high-level laser) and physiotherapy. Visual analogue scale (VAS), Neck Disability Index (NDI), Neck Pain and Disability Scale (NPDS) and Bournemouth Questionnaire (BQN) were completed on three occasions (before, immediately and 2 weeks after the intervention) to assess and compare the efficacy of the high-intensity laser and physiotherapy in neck pain. Data were analyzed by SPSS 23 software using the chi-square test, Student's t test, multivariate tests, and Fisher's exact test. Results: The mean age of the participants was 37.53±9.52 and 41.16±7.85 years in physiotherapy and laser therapy respectively. The VAS score and NDI scores decreased after both kinds of interventions, and the effect of photobiomodulation was significantly higher than physiotherapy (P < 0.001). Both treatment modalities significantly affect different aspects of chronic neck pain assessed by NDPS and BQN questionnaires and the effect of photobiomodulation was more prominent than physiotherapy. Conclusion: The findings of this study showed that photobiomodulation and physiotherapy can reduce chronic neck pain and its different aspects and the effect of laser therapy was significantly higher than physiotherapy.

Nationwide Prevalence of Diabetes and Prediabetes and Associated Risk Factors Among Iranian Adults: Analysis of Data from PERSIAN Cohort Study.

INTRODUCTION: Over the past decades prevalence of diabetes has increased in Iran and other countries. This study aimed to update the prevalence of diabetes and prediabetes in Iran and to determine associated sociodemographic risk factors, as well as diabetes awareness and control. METHODS: This is a nationally representative cross-sectional survey that included 163,770 Iranian adults aged 35-70 years, from different ethnic backgrounds, between 2014 and 2020. Diabetes was diagnosed at fasting blood sugar of ≥ 6.99 mmol/L (126 mg/dL), or receiving blood glucose-lowering treatment. Multivariable logistic regression was applied to detect determinants associated with prevalence of diabetes and prediabetes, as well as predictors of diabetes awareness and glycemic control. RESULTS: Sex- and age-standardized prevalence of diabetes and prediabetes was 15.0% (95% CI 12.6-17.3) and 25.4% (18.6-32.1), respectively. Among patients with diabetes, 79.6% (76.2-82.9) were aware of their diabetes. Glycemic control was achieved in 41.2% (37.5-44.8) of patients who received treatment. Older age, obesity, high waist to hip ratio (WHR), and specific ethnic background were associated with a significant risk of diabetes and prediabetes. Higher awareness of diabetes was observed in older patients, married individuals, those with high WHR, and individuals with high wealth score. Moreover, glycemic control was significantly better in women, obese individuals, those with high physical activity, educational attainment, and specific ethnic background. CONCLUSIONS: The prevalence of diabetes and prediabetes is increasing at an alarming rate in Iranian adults. High proportion of uncontrolled patients require particular initiatives to be integrated in the health care system.

Developing a Competency Framework of Interprofessional Occupational Health Team: A First Step to Interprofessional Education in Occupational Health Field.

OBJECTIVE: The present study aimed to develop a competency framework for interprofessional collaboration in an occupational health team. METHODS: This study was carried out in three stages. In the first stage, the viewpoints of different stakeholders on the essential competencies of interprofessional team members in occupational health services (OHS) were assessed. In the second stage, extracted codes were converted into competencies in expert panels. After that, the extracted items were categorized by inductive content analysis approach into competency framework. In the third stage, the content validity of interprofessional competencies in OHS was evaluated. RESULTS: The competency framework was finalized in six competency domains including prevention, occupational disease management, occupational health assessments, inter-disciplinary and interprofessional collaboration, education, and evidence-based practice and professionalism. CONCLUSION: The framework could be developed in interprofessional education in OHS based on competency-based education approach.

Prevalence, comorbidity, and predictors of obsessive-compulsive disorder in Iranian children and adolescents.

BACKGROUND AND OBJECTIVES: Obsessive-compulsive disorder (OCD) is a disease that causes personal distress or social dysfunction, especially in childhood. The present study aimed to provide the prevalence, comorbidity, and predictors of OCD among children and adolescents. METHODS: This was a cross-sectional national project conducted on 29,858 children and adolescents using the multi-stage cluster random sampling in Iran. There were both genders in each cluster and three age groups (6-9, 10-14, and 15-18 years) within each cluster. The tools used in this research included a demographic questionnaire and K-SADS-PL. To analyze the data, logistic regression and cross-tab tests were used. RESULTS: According to the results, the prevalence of OCD in children and adolescents was 3.1 in boys and 3.8 in girls. Also, gender, age, place of residence, and history of psychiatric hospitalization of parents could predict OCD. OCD had comorbidity with behavioral disorders (OR = 0.60, 95%CI: 0.39-0.92), elimination disorders (OR = 0.50, 95%CI: 0.30-0.83), mood disorders (OR = 2.92, 95%CI: 1.43-5.94), and smoking and alcohol disorders (OR = 4.33, 95%CI: 1.28-14.63). CONCLUSION: In the development of the obsessive-compulsive disorder, other disorders and symptoms also environmental factors can play a role and are important. Based on our findings, given the prevalence rate of OCD was higher in the age groups of 10-14 and 15-18 years, are one of the most important stages of development for the prevention and treatment of mental disorders, especially OCD, clinical specialists can design appropriate clinical trials or modify existing interventions based on the results of such research.