Metabolic Syndrome in Celiac Disease: What Does Following a One-Year Gluten-Free Diet Bring?

Background: Metabolic syndrome (MetS) is a set of conditions that occur together and increase the risk of cardiovascular disease. Previous studies have linked a gluten-free diet (GFD) to obesity and MetS in some populations. However, others have suggested that weight gain is usually regulated only in underweight individuals with celiac disease (CD). Owing to the lack of sufficient data and the importance of GFD in controlling cardiovascular disease, we surveyed the prevalence of MetS and its components before and after a year of GFD in patients referred to the main celiac clinic in southern Iran. Methods: This was a repeated cross-sectional study conducted on 69 patients with a definite diagnosis of cardiovascular disease who were on follow-up and registered at the Shiraz Celiac Clinic. Demographic, anthropometric, and laboratory measurements at the time of diagnosis and one year after the GFD were extracted from their medical records. Results: The participants' mean age was 35.53, and 68.1% were women. The prevalence of MetS increased from 5.8% to 11.6% after a year of the GFD; however, this increase was not statistically significant. Waist circumference (WC) and serum triglyceride levels were significantly elevated during the study period. Conclusion: A GFD may contribute to the development of MetS in patients with cardiovascular disease; however, the rate of MetS is still lower than that in the general population. It is critical to educate patients about these potential risks and encourage them to have a healthy lifestyle that includes a balanced diet and physical activity.

Iranian University students' stressors and coping strategies: A qualitative study.

BACKGROUND: Although a certain amount of stress is essential, excessive stress can adversely influence the physiological and mental health. Hence, this study aims to assess common stressors and coping strategies among university students. MATERIALS AND METHODS: This qualitative study was conducted from October to November 2019 in Iran. Twelve students were recruited based on purposeful sampling to participate focus group discussions (FGD). Transcripts of three sessions of FGD were analyzed applying Graneheim and Lundman (2004) approach, and a thematic network was applied to illustrate the findings. RESULTS: The finding emerged 78 codes, 14 subthemes, and 4 main themes. Stressors were classified in two main themes, including individual stressors and the social ones. Behavioral strategies and the cognitive ones were among two categories of coping strategies. According to the thematic network, a full stress student affecting the precious stressors and the social, cultural, and the economic context may manage his/her stress applying the coping strategies. CONCLUSION: The findings revealed that university students experienced different kinds of stress, and usually, they do not apply right coping strategies. It is important to establish stress counseling programs for university students. Besides, it is proposing to provide 1st year university students with workshops about the cause of stress and effective coping strategies.

An investigation of depression, anxiety, and stress and its relating factors during COVID-19 pandemic in Iran.

BACKGROUND: The COVID-19 (SARS-CoV-2) is an emerging epidemic caused by the new Coronavirus. It has affected more than 200 countries, infected 5,939,234 people, and killed 367,255 in the world until 1 June 2020. While the disease epidemic could affect population mental health, this study aimed to investigate stress, anxiety, and depression during the Corona pandemic in Iran. METHODS: An online survey was designed using the depression, anxiety, and stress scale (DASS-21) questionnaire. The questionnaire was available for all Iranian population from 18 to 28 April 2020. Finally, 1498 participants filled the questionnaire using snowball sampling. Data were analyzed using multivariate regression models. RESULTS: Findings showed that most participants had experienced a normal level of stress (36.6%), anxiety (57.9%) and depression (47.9%). About 2.5% of respondents report an extremely severe level of stress. This amount of anxiety and depression was 6.3 and 7.9%, respectively. Regression model showed being female (CI: - 1.299; - 0.248), living with a high risk family member (CI: 0.325; 1.400), health status (CI: - 0.857; - 0.595), economic status (CI: - 0.396; - 0.141), social capital (CI: - 0.475; - 0.244), risk of disease (CI: 0.081; 0.729), and following COVID-19 news (CI: 0.111; 0.551) have a relation with stress level. Education level (CI: - 0.252; - 0.017), living with a high risk family member (CI: 0.0301; 1.160), health status (CI: - 0.682; - 0.471), social capital (CI: - 0.236; - 0.048), risk of disease (CI: 0.154; 0.674), and following COVID-19 news (CI: 0.046; 0.401) have a relation with anxiety score. Depression score was in relation with education level (CI: - 0.263; - 0.022), having a high-risk family member (CI: 0.292; 1.155), health status (CI: - 0.687; - 0.476), social capital (CI: - 0.235; - 0.048), risk of disease (CI: 0.144; 0.667), and following Covid-19 news (CI: 0.053; 0.408). CONCLUSIONS: Most of the factors related to depression, anxiety, and stress are related to COVID-19, such as having a vulnerable person in the family, risk of disease, and following COVID-19 news. The findings suggest the factors that should be taken into consideration for improving population mental health during pandemics.

The effects of mobile apps on stress, anxiety, and depression: overview of systematic reviews.

OBJECTIVES: Despite a large number of mobile apps in the field of mental health, it is difficult to find a useful and reliable one, mainly due to the fact that the effectiveness of many apps has not been assessed scientifically. The present study aimed to assess the effects of mental health apps on managing the symptoms of stress, anxiety, and depression. METHODS: A comprehensive literature search was conducted in PubMed, Scopus, EMBASE, Cochrane, and Web of Science databases for the papers published from 2000 to 2019. Studies were included if they reviewed articles or mobile apps for their effectiveness in stress, anxiety, and depression. The reviews that had considered mobile apps or web-based mobile applications as an intervention or part of intervention were included, as well. RESULTS: A total of 4,999 peer-reviewed articles were identified, out of which nine systematic reviews met the inclusion criteria. Seven systematic reviews measured depression outcomes, three measured stress, and five systematic reviews measured anxiety symptoms. The applications that used behavior change strategies, such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Behavioral Activation, reported significant effects on depression, anxiety, and stress. CONCLUSION: It seems that mental health apps can be promising media for reducing depressive symptoms. This field is an emerging area of mobile health, and further research should be done in future in order to reach conclusive evidence.

Efficacy of a web application for stress management among Iranian college students during COVID-19 outbreak: a study protocol for randomized controlled trials.

BACKGROUND: The prevalence of mental health disorders is increasing globally, and the prevalence of COVID-19 has made it worse. Evidence has indicated a major mental health burden and elevated anxiety associated with the new coronavirus outbreak in the general population. This study aims to evaluate an evidence-based web application (Naranj) for stress management among Iranian college students. METHODS AND DESIGN: This study aims to present a protocol related to a randomized controlled trial among Iranian college students. The study will be conducted on 100 students from two colleges of Shiraz University of Medical Sciences in Iran. The participants will be randomly assigned to the intervention and control groups. The intervention group participants will be provided with a web application, whereas the control group ones will be provided with an app unrelated to stress management. The primary outcome for this study will be the Perceived Stress Scale, and the two groups will be compared with respect to stress level and sleep quality. DISCUSSION: A web application will be developed according to psychological theories and will be scientifically approved for managing college students' stress and improving their sleep quality during the COVID-19 outbreak. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20160427027647N2 . Registered on 14 May 2020.

Web-based health Information Seeking and eHealth Literacy among College students. A Self-report study.

OBJECTIVES: This study aimed to assess web-based health information seeking and eHealth literacy among Iranian college students. METHODS: The study was conducted in five colleges of the Shiraz University of Medical Sciences in Iran during 2018. The data were collected by a researcher-made questionnaire consisting of seven questions on a 4-point Likert-type scale, with scores ranging from 7 to 28. These questions were: 'I know how to use the Internet to answer my questions about health', 'I think there is enough information about health-related issues on the Internet', 'I know the vocabulary used in health issues on the Internet', 'I can tell high-quality health resources from low-quality health resources on the Internet', 'I know how to use the health information I find on the Internet to help me', 'I feel confident in using information from the Internet to make health decisions', and 'Searching for health-related information on the Internet will increase my knowledge in this field'. High eHealth literacy level is defined as above the total mean score and low eHealth literacy level is defined as lower than the total mean score. RESULTS: In all, 386 college students participated in the study. The results showed that the mean score of eHealth literacy was 19.11 out of 28; 205 participants (54.4%) had low eHealth literacy. In addition, the students used the Internet to search for information regarding diseases symptoms (70%), physical illnesses (67.1%), existing treatments (65%), and diagnosis (63.1%). CONCLUSIONS: The results showed that participants in this study usually searched for illnesses, symptoms, and treatments after they got sick and paid little attention to other aspects related to integral health.

Web-based health Information Seeking and eHealth Literacy among College students. A Self-report study

Objective. This study aimed to assess web-based health information seeking and eHealth literacy among Iranian college students. Methods. The study was conducted in five colleges of the Shiraz University of Medical Sciences in Iran during 2018. The data were collected by a researcher-made questionnaire consisting of seven questions on a 4-point Likert-type scale, with scores ranging from 7 to 28. These questions were: 'I know how to use the Internet to answer my questions about health', 'I think there is enough information about health-related issues on the Internet', 'I know the vocabulary used in health issues on the Internet', 'I can tell high-quality health resources from low-quality health resources on the Internet', 'I know how to use the health information I find on the Internet to help me', 'I feel confident in using information from the Internet to make health decisions', and 'Searching for health-related information on the Internet will increase my knowledge in this field'. High eHealth literacy level is defined as above the total mean score and low eHealth literacy level is defined as lower than the total mean score. Results. In all, 386 college students participated in the study. The results showed that the mean score of eHealth literacy was 19.11 out of 28; 205 participants (54.4%) had low eHealth literacy. In addition, the students used the Internet to search for information regarding diseases symptoms (70%), physical illnesses (67.1%), existing treatments (65%), and diagnosis (63.1%). Conclusion. The results showed that participants in this study usually searched for illnesses, symptoms, and treatments after they got sick and paid little attention to other aspects related to integral health.

Objetivo. Evaluar la búsqueda de información de salud en línea y el nivel de alfabetización en eSalud entre los estudiantes universitarios iraníes. Métodos. El estudio se realizó en cinco colegios de la Universidad de Ciencias Médicas de Shiraz, Irán, durante 2018. Los datos se recopilaron con la ayuda de un cuestionario realizado por los investigadores que consta de 7 afirmaciones con opciones de respuesta tipo Likert de 4 puntos, con un rango de puntaje de 7-28 puntos: 1. "Sé cómo usar Internet para responder mis preguntas sobre salud"; 2. "Creo que hay suficiente información sobre problemas relacionados con la salud en Internet"; 3. "Conozco el vocabulario utilizado en temas de salud en Internet"; 4. "Puedo distinguir en Internet los recursos de salud de alta calidad de los que son de baja calidad"; 5. "Sé cómo usar la información de salud que encuentro en Internet para ayudarme"; 6. "Me siento seguro al usar la información de Internet para decisiones de salud", y 7. "Buscar en Internet información relacionada con la salud aumentará mi conocimiento en este campo". Se estableció que se tenía alfabetización en eSalud alta si el puntaje estaba por encima de la media total y alfabetización en eSalud baja si este puntaje era inferior a la puntuación media. Resultados. 386 estudiantes universitarios participaron en el estudio. La puntuación media de alfabetización en eSalud fue de 19,11 de los 28 puntos máximos posibles. 205 participantes (54.4%) tenían baja alfabetización en eSalud. Además, los estudiantes utilizaron Internet para buscar información sobre síntomas de enfermedades (70%), enfermedades físicas (67.1%), tratamientos existentes (65%) y diagnóstico (63.1%). Conclusión. Los resultados mostraron que los participantes de este estudio buscaban generalmente información en Internet acerca de enfermedades, síntomas y tratamientos después de enfermarse y prestaban poca atención a otros aspectos relacionados con la salud integral.

Objetivo. Este estudo teve como objetivo avaliar a busca de informações sobre saúde on-line e o nível de alfabetização em eSaúde entre estudantes universitários iranianos. Métodos. O estudo foi realizado em cinco faculdades da Universidade de Ciências Médicas de Shiraz, Irã, durante 2018. Os dados foram coletados com a ajuda de um questionário conduzido pelos pesquisadores, composto por 7 declarações com opções de resposta tipo Likert de 4 pontos, com uma faixa de pontuação de 7-28 pontos. Essas perguntas foram: 'Eu sei como usar a Internet para responder às minhas perguntas sobre saúde', 'Eu acho que há informações suficientes sobre problemas relacionados à saúde na Internet', 'Eu conheço o vocabulário usado nas questões de saúde na Internet', 'Eu posso distinguir em Recursos de saúde de alta qualidade na Internet que são de baixa qualidade ',' Eu sei como usar as informações de saúde encontradas na Internet para me ajudar ',' Sinto-me seguro ao usar informações da Internet para decisões de saúde 'e' A busca de informações relacionadas à saúde na Internet aumentará meu conhecimento neste campo '. Foi estabelecido que havia alta alfabetização em eSaúde se a pontuação estivesse acima da média total e baixa literacia em eSaúde se essa pontuação fosse menor que a média. Resultados 386 universitários participaram do estudo. A pontuação média em alfabetização em eSaúde foi 19,11 dos 28 pontos máximos possíveis. 205 participantes (54,4%) tinham baixa alfabetização em eSaúde. Além disso, os estudantes usaram a Internet para buscar informações sobre sintomas da doença (70%), doenças físicas (67,1%), tratamentos existentes (65%) e diagnóstico (63,1%). Conclusão. Os resultados mostraram que os participantes deste estudo geralmente buscavam informações na Internet sobre doenças, sintomas e tratamentos após adoecer e prestavam pouca atenção a outros aspectos relacionados à saúde integral.

Critical Appraisal of Mental Health Applications.

BACKGROUND: Using mobile applications in health is progressing rapidly; hence, assessing them is essential to ensure their quality and standards. The present study was designed to critically evaluate the quality of existing applications in the field of mental health. METHODS: In this is review the related keywords "Health and Mental health" were used in Persian and English to search in 4 application platforms: App Store, Google Play, Bazar (Persian version of Google Play), Sib app (Persian version of App Store). Inclusion criteria for the applications were either in Persian or English language and compatible with Android or IOS. The exclusion criteria were any application downloaded less than 100 times and those that were one dimensional such as only focusing on sleep disorder. A team of researchers reviewed each app in terms of two sets of criteria: 1) Mobile App Rating Scale (MARS) subdomain scores for reviewing engagement, functionality, esthetics, and information; and 2) personalization level. RESULT: The search resulted in 958 apps, of which 61 had the inclusion criteria. Most of them (n=59, 97%) were rated as appropriate for all age groups and only two were designed for children. In MARS score, thirty-three percent (n=5) of the Persian apps received the rating of 2.5 or higher, while this score was 53 percent (n=27) for English applications. Eight application (13%) used dialogue boxes for personalization and 11 (18%) had feedback capability. None of the Persian apps could be personalized. CONCLUSION: Although numerous apps are available, there are only few apps with personalization features, which should be considered as one of the key features when developing this type of apps.