Validity and reliability of the Persian version of the Gastroesophageal Reflux Disease Health-Related Quality of Life questionnaire.

OBJECTIVE: The Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) is one of the most widely used questionnaires for assessing typical gastro-oesophageal reflux disease (GORD) symptoms. It is simple, concise, and treatment responsive, yet it has not been validated in the Persian language. This study aimed to translate the GERD-HRQL questionnaire into Persian and assess its validity and reliability. DESIGN: In this cross-sectional validation study, a team of gastroenterologists, general surgeons, and professional translators conducted the forward-backward translation. A gastroenterologist interviewed 10 patients with GORD to insure understandability of the questionnaire. Fifty-four patients with GORD and 60 patients with gastrointestinal complaints other than GORD were enrolled using convenience sampling method. To assess concurrent validity, patients with GORD completed the Persian GERD-HRQL and the WHO Quality of Life Brief Version (WHOQOL-BREF) questionnaires. To assess discriminant validity, GERD-HRQL scores were compared between GORD and non-GORD patients. After 2 weeks, the patients with GORD completed the GERD-HRQL questionnaire again to assess test-retest reliability. The internal consistency was measured using Cronbach's alpha. RESULTS: The mean age of the GORD participants was 36.90±10.44, and the majority were women (78%). All GERD-HRQL domains and total scores exhibited significant negative correlations with WHOQOL-BREF domains (ranging from -0.28 to -0.97). The GERD-HRQL scores were significantly different in GORD and non-GORD patients (p<0.001). Test and retest scores did not show any significant differences (p=0.49). Cronbach's alpha was 0.85. CONCLUSION: The Persian GERD-HRQL questionnaire is valid and reliable and can effectively assess the GORD symptoms in Persian-speaking individuals.

Association between socioeconomic status and Parkinson's disease: findings from a large incident case-control study.

Introduction: The association between socioeconomic status (SES) and Parkinson's disease (PD) has been investigated in few studies. To our knowledge, SES measurement based on wealth index and perceived SES in PD patients has not been investigated in any study. Also, the simultaneous measurement of objective and perceived SES and their association with PD has not been conducted yet. This study aimed to determine the association between various SES indicators and PD. Methods: This incident case-control study was conducted on 508 patients with PD and 1015 controls randomly selected from the general population in Iran in 2021-2022. A telephone interviewing method was used for data collection. The wealth index and educational level were used to measure objective SES. Perceived SES was also recorded. Multiple logistic regression was used to calculate the adjusted OR (AOR). Results: A significant association based on the wealth index was found, where the intermediate category had lower odds of developing PD than the deprived category (AOR 0.75 (95% CI 0.58 to 0.99)). The odds of PD was significantly higher in the people with academic education compared with illiterate and primary-level education (AOR 2.17 (95% CI 1.58 to 2.99). Additionally, the odds of PD were significantly lower in the intermediate (AOR 0.26 (95% CI 0.13 to 0.52)) and affluent (AOR 0.21 (95% CI 0.11 to 0.40)), compared with the deprived categories based on perceived SES. Similar results were obtained in the analysis by sex. Conclusion: This study demonstrated that lower wealth index, a lower perceived SES and academic education are associated with increased the odds of PD.

Association between the Dietary Inflammatory Index with gallstone disease: finding from Dena PERSIAN cohort.

OBJECTIVE: The Dietary Inflammatory Index (DII) is a documented nutritional tool for assessing diet-induced inflammation that has been linked to various diseases/outcomes. The association between DII and gallstone disease (GSD) is yet to be explored. The objective of this study was to examine the association between DII and GSD. DESIGN: This cross-sectional study was conducted using the baseline phase data of the Dena PERSIAN cohort. The analysed data included demographic information, lifestyle variables, body mass index, diabetes and fatty liver history, and laboratory test results. The 113-item Food Frequency Questionnaire was used to estimate the dietary intake of participants and quantify the inflammatory potential of the individual's diet. DII score was analysed as a continuous and quartiles variables. Univariable and multivariate logistic regressions were used to investigate the relationship between GSD and DII scores . RESULTS: Out of 3626 individuals entering the study, 173 (4.77%) had GSD. The median DII was -0.08 (IQR=0.18). In the unadjusted model, the odds of having GSD were significantly higher in the first and second quartiles of DII (anti-inflammatory diet) than in higher quartiles (proinflammatory diet). In the adjusted model, the odds of having GSD in the third and fourth quartiles of DII scores compared with the first quartile were OR=0.59 (95% CI 0.36 to 0.95) and OR 0.51 (95% CI 0.30 to 0.84), respectively. CONCLUSION: The results of this study suggest that a proinflammatory diet is associated with a reduced chance of GSD. However, longitudinal studies are needed to examine the causal association.

The Effect of Month of Birth on Multiple Sclerosis: A Sase-Control Study in Northeast Iran.

BACKGROUND: Multiple sclerosis (MS) is an autoimmune and multi-factorial (e.g. environmental, genetic) disease. We conducted a case-control study of month and season of birth (MOB and SOB) and multiple sclerosis (MS) risk in the east of Iran. METHODS: The MS patients registered in Mashhad and Torbat Heydariyeh MS Society until 20 March 2018 was compared with the MOB and SOB in the healthy population during 1988 to 2018. Case group was matched for age, sex and place of residence with the control group. Differences in the distributions of MOB and SOB between the patients and the control groups were assessed using the chi-square test. RESULTS: There were 2,160 MS patients in case group and 2,245 in control group. There was a significant relationship between MOB ans SOB with the risk of MS (P less than 0.05). Analysis showed a significant (p less than 0.01) peak in the MOB during Mar-Apr (OR is equal to 1.60), May-Jun (OR is equal to 1.30) and Aug-Sep (OR is equal to 2.42). CONCLUSION: The findings show a relationship between MOB and SOB as risk factor for MS in Northeast Iran. Further studies are needed to confirm this result. Keyword: Multiple sclerosis, Month of Birth, seasonality, case-control, Iran.

Temporal trends of incidence and prevalence of multiple sclerosis in Razavi Khorasan Province, Northeast Iran.

OBJECTIVES: The prevalence of multiple sclerosis (MS) in the Persian Gulf countries has been significantly increasing during the past decades. This study was conducted for investigating the prevalence and incidence of MS in Northeast Iran (Khorasan Razavi province). METHODS: This cross-sectional study was conducted during 1 January 1988 and 23 September 2018. All patients with a clinically definite diagnosis of MS according to the McDonald criteria (2005) and MRI along with the medical diagnosis, recorded in the Khorasan MS society, were considered for calculation of crude and age-standardized prevalence, and incidence rates of MS. The periodic incidence rates were calculated based on the year of onset of MS. Also, we calculated gender ratios for prevalence and incidence rates. RESULTS: The mean age-standardized prevalence and incidence rates of MS in the Khorasan Razavi were 8.69 (95% CI 8.05-9.41) per 100,000 (3.99 (95% CI 3.39-4.74) for males, 13.49 (95% CI 12.37-14.76) for females). Age-standardized prevalence was 48.87 (95% CI 48.37-49.35) per 100,000 (22.47 (95% CI 22.01-22.93) for males, 75.65 (95% CI 74.80-76.51) for females). Also, the mean incidence and prevalence for Mashhad County as capital of province were 11.38 and 59.09 per 100,000 populations, respectively. The female/male ratio was 3.33 for all age groups. CONCLUSION: Our results showed that this region is a high-risk area for MS like central region of Iran. Our results revealed that the prevalence and incidence of MS in the study area have increased during the recent decades with a sharp slope.

Socioeconomic determinants of global distribution of multiple sclerosis: an ecological investigation based on Global Burden of Disease data.

BACKGROUND: Socioeconomic factors may be involved in risk of multiple sclerosis (MS), either indirectly or as confounding factors. In this study two comprehensive indicators reflecting socioeconomic differences, including the Human Development Index (HDI) and Prosperity Index (PI), were used to assess the impact of these factors on the worldwide distribution of MS. METHODS: The data for this global ecological study were obtained from three comprehensive databases including the Global Burden of Disease (as the source of MS indices), United Nations Development Programme (source for HDI) and the Legatum Institute Database for PI. MS indices (including prevalence, incidence, mortality, and disability-adjusted life years) were all analyzed in the form of age- and sex-standardized. Correlation and regression analyses were used to investigate the relationship between HDI and PI and their subsets with MS indices. RESULTS: All MS indices were correlated with HDI and PI. It was also found that developed countries had significantly higher prevalence and incidence rates of MS than developing countries. Education and governance from the PI, and gross national income and expected years of schooling from the HDI were more associated with MS. Education was significantly related to MS indices (p < 0.01) in both developed and developing countries. CONCLUSION: In general, the difference in income and the socioeconomic development globally have created a landscape for MS that should be studied in more detail in future studies.

Copper concentration in multiple sclerosis: a systematic review and meta-analysis.

BACKGROUND: A wide range of risk factors, from genetic to environmental, have been identified to play role in the etiology of multiple sclerosis. However, the role of trace element remains mostly unknown. We sought to combine all available evidence to assess the association between copper concentration and multiple sclerosis. METHODS: This systematic review and meta-analysis was conducted based on PRISMA guidelines. PubMed, Scopus, Embase, and Web of Science were searched since inception till July 2020. Observational studies that assessed copper as exposure in serum, plasma, whole blood, and cerebrospinal fluid were included. Standardized mean differences (SMD), comparing the mean of copper concentration in multiple sclerosis patients versus healthy controls, were considered as the measure of association. The fixed-effect model with inverse variance weighting was used to combine the findings. RESULTS: Twenty studies inclusive of 797 multiple sclerosis cases and 875 healthy controls were included in the meta-analysis (all case-control studies). The combined SMDs were 1.25 (95% confidence interval [CI] 0.95 to 1.55, number of included studies [n]=4) in plasma, 0.45 (CI 0.22 to 0.68, n=4) in whole blood, 0.19 (CI 0.06 to 0.33, n=12) in blood serum and 1.23 (CI 0.83 to 1.64, n=4) in cerebrospinal fluid. CONCLUSIONS: We found a higher concentration of copper in multiple sclerosis patients than healthy controls. The possible causal nature of the observed associations warrants further investigation with prospective data.

Efficacy of complete rings (MyoRing) in treatment of Keratoconus: a systematic review and meta-analysis.

PURPOSE: We aimed to systematically review the existing evidence and determine the efficacy of MyoRing as a novel method for treatment of keratoconus using meta-analysis. METHODS: Online electronic search of Medline, ISI Web of Science, Embase, Scopus, and Cochrane Library databases was performed with reference lists of relevant articles for pre-post trials published through August 2017. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere, cylinder, spherical equivalent (SE), maximum, minimum, and mean keratometry were considered as the visual acuity outcomes. Weighted mean difference (WMD) with 95% confidence interval was used as pooled estimation of intervention efficacy using random-effects meta-analysis. Heterogeneity was measured with the Cochran Q statistic and quantified with the I2 statistic using Stata software. RESULTS: Of the 47 potentially related studies, 21 eligible studies were included in the meta-analysis. The mean of uncorrected distance visual acuity (UDVA) based on LogMAR in patients with keratoconus had a significant change 3 months after implantation/embedding of the complete ring (WMD =  - 0.73 (CI = - 0.88 to - 0.58), I2 = 79.9%, p < 0.001). Results support a statistically significance improvement in CDVA, SE, sphere, cylinder, and maximum keratometry after surgical intervention. Range of reported safety index, stability, and efficacy index by included studies was 1.7-2.7, 74-100%, and 0.9-1.96, respectively. CONCLUSIONS: MyoRing is an appropriate treatment option for keratoconus. Findings of this meta-analysis demonstrated that main visual outcomes have been improved 3, 6, and 12 months after the implantation of the complete ring (MyoRing).

Epidemiology of Multiple Sclerosis in Torbat-e Heydarieh (Northeast of Iran) during 1982-2016.

It was believed that the risk of multiple sclerosis (MS) is associated with latitude gradient. Due to the increasing prevalence of MS in some areas around the equator such as Iran, this theory has been criticized in recent years. Since the distribution of MS in Iran is not uniform, this study was designed to describe the prevalence and incidence of MS in the northeastern area of Iran. The patients were registered in the MS center of Torbat-e Heydarieh County and all of them were living in this county during the study period (during 1 January 1982 to 31 December 2016). Data of the patients were extracted from their files in the MS center. Because of the long-term span of this study, we used different diagnosis criteria according to the files of the patients to proven case missing. In addition, population data were obtained from the website of Statistical Centre of Iran. The total number of the MS patients during the study period was 110 cases. The prevalence of the disease at the beginning and end of the research period was 0.33 (95% CI, 0.008-1.85) and 30.48 (95% CI, 25.25-37.03) patients per 100,000 persons, respectively. The incidence of the disease in this 36-year period was 1.41 (95%CI, 1.15-1.69) patients per 100,000 persons. The average age of the patients was 35.01 (95% CI, 33.37-36.65) years and the female to male ratio was 2.8:1. The prevalence of MS has been increased in the 36-year period in Torbat-e Heydarieh, especially for women. More epidemiological studies are needed to determine the factors affecting this increasing trend.

Mutual benefits in academic-service partnership: An integrative review.

BACKGROUND: Academic and service institutions involve with many challenges. Partnership programs are a golden opportunity to achieve mutual benefits to overcome these challenges. Identifying mutual benefits is the cornerstone of forming a successful partnership and guarantee to its continuity. There are definitions and instances of mutual benefits in the literature related to partnership programs, but there is no coherent evidence and clear picture of these benefits. OBJECTIVE: This study is conducted to identify mutual benefits in academic-service partnership by analyzing the definitions and instances of it in the literature. DESIGN: An integrative review of key papers regarding mutual benefits in academic-service partnership was undertaken. This review was guided by the framework described by Whittemore and Knafl. DATA SOURCES: Search of the following databases was conducted: MEDLINE, ERIC, Google Scholar, Emerald Insight and Science Direct. The search terms were mutual benefits, mutual gains, mutual interest, mutual expectations, mutual goals, mutual demand, partnership, collaboration, academic-service partnership and academic service collaboration. REVIEW METHODS: Cooper's five-stage integrative review method was used. Quality evaluation of articles was conducted. Data were abstracted from included articles. The analysis was conducted based on the qualitative content analysis of the literature suggested by Zhang and Wildemuth. RESULTS: 28 articles were included in this review. Mutual benefits are described in four categories include: synergy in training and empowerment of human resources, education improvement, access to shared resources, facilitate production and application of beneficial knowledge into practice. CONCLUSION: Mutual benefits in the academic-service partnership include a range of goals, interests, expectations, and needs of partner organizations that is achievable and measurable through joint planning and collaboration. We suggest academic and service policymakers to consider these benefits in the planning and evaluating partnership programs.

Wrist circumference as a novel predictor of obesity in children and adolescents: the CASPIAN-IV study.

Background Recent studies have discussed the application of wrist circumference as an easy-to-use predictor of general and abdominal obesity. The aim of the current study is to evaluate the association of wrist circumference with generalized and abdominal obesity and to determine its sex- and age-specific optimal cutoff points in association with generalized and abdominal obesity in a national sample of pediatric population. Methods This nationwide survey was conducted among 14,880 students, aged 6-18 years, selected through a multistage, random cluster sampling method from rural and urban areas of 30 provinces in Iran from 2011 to 2012. Anthropometric indices (weight, height, wrist circumference, waist circumference [WC], hip circumference [HC]) were measured by standard protocols using calibrated instruments. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. By considering the area under the curve (AUC) of the receiver operator characteristic (ROC) curves, we evaluated the association of wrist circumference with obesity indices and determined its sex- and age-specific optimal cutoff points in association with obesity. AUC: 0.5, AUC: 0.5-0.65 and AUC: 0.65-1.0 were interpreted as equal to chance, moderately and highly accurate tests, respectively. Results Overall, 13,486 children and adolescents with a mean age of 12.47±3.36 years completed the study (participation rate of 90.6%). In both genders, wrist circumference had a significant correlation with anthropometric measures including weight, height, BMI, WC, HC and WHtR. In all age groups and both genders, wrist circumference performed relatively well in classifying individuals into overweight (AUC: 0.67-0.75, p<0.001), generalized obesity (AUC: 0.81-0.85, p<0.001) and abdominal obesity (AUC: 0.82-0.87, p<0.001). Conclusions Wrist circumference is suggested to be a useful index for assessing excess weight in the pediatric age group. Its easy measurement without the need of calculation ratios might make it as a routine measurement in daily clinical practice and in large epidemiological studies.

Antecedents and consequences of workplace violence against nurses: A qualitative study.

AIMS AND OBJECTIVES: To explore Iranian nurses' perceptions of and experiences with the antecedents and consequences of workplace violence perpetrated by patients, patients' relatives, colleagues and superiors. BACKGROUND: Workplace violence against nurses is a common problem worldwide, including in Iran. Although many studies have reviewed the antecedents and consequences of workplace violence, limited information is available on this topic. An understanding of the predisposing factors for violence and the consequences of violence is essential to developing programs to prevent and manage workplace violence. DESIGN: Qualitative descriptive design. METHODS: In this qualitative study, 22 unstructured, in-depth interviews were conducted with registered nurses who had experienced workplace violence and who were selecting using purposive sampling in nine hospitals. Inductive content analysis was used to analyse the data. RESULTS: Five categories emerged as predisposing factors: unmet expectations of patients/relatives, inefficient organisational management, inappropriate professional communication, factors related to nurses and factors related to patients, patients' relatives and colleagues. Individual, familial and professional consequences were identified as outcomes of workplace violence against nurses. CONCLUSIONS: Workplace violence by patients/their relatives and colleagues/superiors is affected by various complicated factors at the individual and organisational levels. In addition to negatively affecting nurses' individual and family lives, workplace violence may lead to a lower quality of patient care and negative attitudes towards the nursing profession. RELEVANCE TO CLINICAL PRACTICE: Identifying factors, which lead to workplace violence, could help facilitate documenting and reporting such incidents as well as developing the necessary interventions to reduce them. Furthermore, native instruments must be developed to predict and monitor violence.

Does the socioeconomic status affect the prevalence of psychiatric distress and violent behaviors in children and adolescents? The CASPIAN-IV study.

BACKGROUND: This nationwide study aims to investigate the prevalence of psychiatric distress and violent behaviors in a nationally-representative sample of Iranian children and adolescents according to the socioeconomic status (SES) of their living region. METHODS: In this study, 14,880 school students, aged 6-18 years, were selected from 30 provinces in Iran. The World Health Organization Global School-based Health Survey questionnaire was used. Data were compared at national and subnational levels according to the SES of the living region. RESULTS: Overall, 13,486 students (49.2% girls) with mean (SD) age of 12.47 (3.36) years completed the study. At national level, the prevalence of psychiatric distress ranged between 9 to 38%; the most and least prevalent psychiatric distresses were angriness (37.73%, 95% CI: 36.5-38.99) and confusion (8.65%, 95% CI: 8.04-9.29), respectively. Students living in regions with highest SES experienced angriness (41.24%, 95% CI: 38.94-43.59) more than in those from the regions with lowest SES (31.18%, 95% CI: 26.71-36.02). The prevalence of bullying, being bullied and physical fight was 17.56% (95% CI: 16.73-18.42), 27.36% (95% CI: 26.34-28.42), and 39.94% (95% CI: 38.69-41.20), respectively. The prevalence of violent behavior did not differ significantly in various regions of Iran. CONCLUSIONS: The relatively high prevalence of psychiatric distress in Iranian children and adolescents necessitates paying more attention to mental health of this vulnerable age group. Differences in the prevalence of such disorders according to the SES of the living area should be considered in planning evidence-based preventive programs and in international comparisons.

Human dignity and professional reputation under threat: Iranian Nurses' experiences of workplace violence.

Workplace violence against nurses is a challenging problem in both developed and developing countries. Because the concept of violence bears some cultural load, nurses' understanding is region-specific. This study explores Iranian nurses' perceptions of workplace violence. Using qualitative content analysis, 22 registered nurses underwent unstructured, in-depth interviews. The main themes of threats to human dignity and professional reputation emerged, plus four categories: physical violence, psychological violence, honor insults, and ethnic-religious insults. The term "honor insults," as a unique finding, was used instead of "sexual harassment." These findings may help to redefine workplace violence based on cultural background, design strategies for supporting nurses, and prevent and manage such violence.

Determinants of Tobacco and Hookah Smoking in a Nationally Representative Sample of Iranian Children and Adolescents: The CASPIAN-IV Study.

BACKGROUND: The consumption of tobacco through a hookah is growing in popularity, especially among children and adolescents, but little is known about the determinants of hookah smoking. OBJECTIVES: The current study aimed to assess the determinants of tobacco smoking and hookah smoking in a nationally representative sample of Iranian children and adolescents. PATIENTS AND METHODS: This study was conducted as part of the fourth cross-sectional survey of a national school-based program. Using a cluster random sampling method, a validated questionnaire was completed anonymously by 14,880 students who were aged 6 - 18 years and living in urban and rural areas of 30 provinces in Iran. RESULTS: The final study group consisted of 13,486 children and adolescents (participation rate of 90.6%), of whom 49.2% were girls and 75.6% were urban residents. The mean age was 12.47 ± 3.36 years. According to the self-reports of the students, 2.6% (3.5% of boys and 1.7% of girls) were current tobacco smokers, 5.9% (7.5% of boys and 4.2% of girls) were ever tobacco smokers, and 1.8% (2.49% of boys and 1.14% of girls) were current hookah smokers. Based on a multiple logistic regression (MLR) model, the following factors increased the risk of current smoking: age, number of days spent with friends per week, hookah smoking or cigarette smoking by the father, hookah smoking by siblings, hookah smoking by other members of the family, and screen time. The age, number of days spent with friends, hookah or cigarette smoking by the father, hookah smoking by siblings, and screen time increased the risk of hookah smoking. Female gender and living in rural areas decreased the risk of current tobacco and hookah smoking. CONCLUSIONS: Preventive measures against tobacco use should be underscored for Iranian families. The preparation of strategies on the promotion of a healthy lifestyle should be considered a health priority.

Physical violence against health care workers: A nationwide study from Iran.

BACKGROUND: Workplace violence is a serious and problematic phenomenon in health care settings. Research shows that health care workers are at the highest risk of such violence. The aim of this study was to address the frequency of physical violence against Iranian health personnel, their response to such violence, as well as the contributing factors to physical violence. MATERIALS AND METHODS: A cross-sectional study was conducted in 2011, in which 6500 out of 57,000 health personnel working in some teaching hospitals were selected using multi-stage random sampling. Data were collected using the questionnaire of "Workplace Violence in the Health Sector" developed by the International Labor Organization, the International Council of Nurses, the World Health Organization, and the Public Services International. RESULTS: The findings revealed that 23.5% of the participants were exposed to physical violence in the 12 months prior to the study. Nurses were the main victims of physical violence (78%) and patients' families were the main perpetrators of violence (56%). The most common reaction of victims to physical violence was asking the aggressor to stop violence (45%). Lack of people's knowledge of employees' tasks was the most common contributing factor to physical violence (49.2%). CONCLUSIONS: Based on the results, legislating appropriate laws in order to prevent and control violence in the workplace is necessary. Moreover, developing educational programs to manage the incidence of physical violence should be on health centers' agenda.

Level of physical activity and screen time among Iranian children and adolescents at the national and provincial level: The CASPIAN-IV study.

Background: There are few epidemiological reports on adherence to physical activity (PA) and screen-time (ST) recommendations among Iranian children and adolescents at the provincial level. We used nationally representative data to provide recent prevalence estimates of Iranian children who met the recommendations for PA and ST. Methods: This nationwide study was conducted among 14,880 students aged 6-18 years from 30 provinces of Iran. The frequency of the recommended level for PA (>1 hours/week) and ST (<2 hours/day) and different combinations of PA and ST was determined in the studied population. Results: In this study, 13,486 students (response rate: 90.6%) were studied. Overall, 18.62%, 34.11%, 50.66% and 9.63% of the students reported high ST, low level of PA, high TV watching and high computer working, respectively. The frequency of the recommended level of PA and ST was 53.92%. Of the studied population, 6.63% had low PA and high ST. Paradox combinations of low PA and low ST and moderate/high PA and high ST was prevalent among 27.47% and 6.26% of the children and adolescents. The lowest and highest frequency of recommended level of PA and ST was 38.9% and 65%, respectively. The lowest and highest frequency of low PA and high ST was 1.87% and 13.77%, respectively. Conclusion: The results of this study revealed that the frequency of low PA was high and that approximately 46% of the students did not meet the recommended level of PA and ST. The findings indicated that preparing facilities for improving PA level among children should be the main priority in our future interventions in this field.

Weight disorders and anthropometric indices according to socioeconomic status of living place in Iranian children and adolescents: The CASPIAN-IV study.

BACKGROUND: Excess weight in children and adolescents is a multi-factorial phenomenon and associated with earlier risk of obesity-related diseases. This study aims to assess the prevalence of weight disorders and the mean values of anthropometric indices according to regional, socioeconomic, and urban-rural variations among Iranian children and adolescents. MATERIALS AND METHODS: This nationwide study was performed in 2011-2012 among a representative multi-stage cluster sample of 14,880 Iranian students aged 6-8 years. The World Health Organization (WHO) reference curves were used to define weight disorders. Abdominal obesity was defined as the waist-to-height ratio (WHtR) of more than 0.5. Iran was classified into four regions according to the socioeconomic status (SES). RESULTS: The mean (95% confidence interval) of body mass index (BMI), waist circumference (WC), and hip circumference (HC) was 18.8 (18.7, 18.9) kg/m(2), 67.0 (66.7, 67.3) cm, and 80.8 (80.3, 81.2) cm, respectively. The prevalence of underweight was 12.2%. A total of 9.7%, 11.9%, and 19.1% of students overweight, obese, and abdominally obese, respectively. The highest mean of BMI, WC, wrist circumference, HC, and WHtR were related to the second high SES (North-northeast) area (19.2 [18.8, 19.5], 68.3 [67.3, 69.4], 14.8 [14.7, 15.0], 82.6 [81.1, 84.0], and 0.464 [0.460, 0.468]). In contrast, the lowest SES (Southeast) region had the lowest mean of these anthropometric indices (17.6 [17.1, 18.2], 63.2 [61.7, 64.8], 14.5 [14.2, 14.8], 76.9 [74.9, 79.0], and 0.439 [0.434, 0.444]). CONCLUSION: We found considerable differences in the prevalence of anthropometric measures throughout the country by SES of the region. Health policy making and implementing health strategies should consider SES of regions.

The Frequency, Contributing and Preventive Factors of Harassment towards Health Professionals in Iran.

BACKGROUND: There are high levels of sexual harassment in health care systems. Also, workplace violence occurs against ethnic and racial minorities. This study aimed to identify the frequency of and the factors contributing to and preventing sexual and racial harassment in the workplace towards health professionals in Iran. METHODS: This cross-sectional study was conducted on 6500 out of 57000 health workers who were selected by multistage random sampling from some teaching hospitals in Iran. Data were collected using the questionnaire of "workplace violence in the health sector" developed by the International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. RESULTS: According to the findings, the frequencies of sexual harassment and racial harassment were, respectively, 4.7% and 12% for the 12 months prior to the study (2011). Among healthcare workers, nurses reported the highest rate of violence. The most important contributing factors in sexual and racial harassment were lack of security facilities (45.8%) and people's ignorance of employees' tasks (55.7%). The presence of security force, safety measures in the wards, and guards were noted as the most important preventive factor to harassment. CONCLUSION: Based on the results, the frequency of sexual and racial harassment is low, which can be attributed to underreporting due to cultural sensitivity or fear. So, identifying the reasons for refusal to report harassment, developing a clear mechanism for reporting and providing the necessary trainings to health workers are essential in order to deal with harassment.

Psychological violence in the health care settings in iran: a cross-sectional study.

BACKGROUND: Psychological violence is the most common form of workplace violence that can affect professional performance and job satisfaction of health care workers. Although several studies have been conducted in Iran, but there is no consensus regarding current status of such violence. OBJECTIVES: This study aimed to investigate the prevalence of psychological violence among healthcare workers employed at teaching hospitals in Iran. PATIENTS AND METHODS: In this cross-sectional study, 5874 health professionals were selected using multistage random sampling. Data were collected using a self-administered questionnaire developed by the International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. Descriptive statistics were used to analyze the data. RESULTS: It was found that 74.7% of the participants were subjected to psychological violence during the past 12 months. Totally, 64.5% of psychological violence was committed by patients' families, but 50.9% of participants had not reported the violence, and 69.9% of them believed that reporting was useless. CONCLUSIONS: The results are indicative of high prevalence of psychological violence against healthcare workers. Considering non-reporting of violence in more than half of participants, use of an appropriate reporting system and providing training programs for health professionals in order to prevent and manage workplace violence are essential.