Journal of Health System Research
Year:2011 | Volume:7 | Issue:1|Papers Count:17

Background: Cardiovascular disease (CVD) is the most important cause of human mortality in the world.Higher intakes of choline and betaine are indicated to be associated with lower plasma homocysteine levels. This study aimed to review the evidence of the relationship between dietary intakes of choline and betaine and the traditional/novel CVD risk factors.Methods: The PubMed was searched from 1990 to 2009, with the use of "dietary choline and betaine, cardiovascular disease, metabolic syndrome, inflammation" as the search engine. The cross-sectional and prospective studies together with clinical trials were recruited in this investigation.Findings: Dietary intakes of choline/choline and betaine were not significantly associated with CVD risk, but the higher intakes of choline and betaine were associated with higher serum concentrations of CRP, IL-6 and TNF-a. Individuals with a high plasma choline levels were obese and had elevated plasma triglycerides, HDL and non HDL cholesterol levels, whereas high plasma betaine levels were inversely associated with these biochemical markers. Both choline and betaine supplementation resulted in the increased blood lipid profiles.Conclusion: Although dietary intakes of choline and betaine were not significantly associated with CVD incidence, the long term consumption of these nutrients is shown to prevent CVD mortality by decreasing inflammation and the other risk factors.

Background: Although several studies have assessed the relationship between dietary energy density and obesity, limited data are available in this regard in Iran. This study aimed to assess the association between dietary energy density and general and abdominal obesity among female students of School of Public Health, Isfahan University of Medical Sciences, Iran.Methods: In this cross-sectional study, 90 female students of School of Public Health were selected proportionally to size by cluster random sampling method. Usual dietary intakes were evaluated by the use of a 168-item semi-quantitative food frequency questionnaire. Weight, height and waist circumference were assessed. General obesity was defined as having body mass index³30 kg/m2 and abdominal obesity as having waist circumference³80 cm.Findings: Mean BMI, dietary energy density and total energy intake of participants were 21.1 kg/m2, 87.0 kcal/g and 2122 kcal, respectively. General and abdominal obesity were prevalent among 9% and 8.9% of students, respectively. A significant negative association was found between dietary energy density and BMI (b=-4.9, P=0.03), even after adjustment for potential confounders (b=5.4, P=0.04).Waist circumference was not associated with dietary energy density.Conclusion: Although the prevalence of obesity was not different between tertiles of dietary energy density, it seems that BMI is significantly associated with this variable.

Background: Nowadays obesity is considered as a worldwide issue. Although genetics is one of the factors associated with obesity, but the predisposing factors are nutrition and environmental factors. There are several studies conducted regarding the relationship between nutritional factors and general obesity and central adiposity. Therefore the purpose of this study was to determine the relationship between the dairy products consumption and prevalence of obesity and central obesity in the young female university students.Methods: This cross sectional study was conducted on 236 healthy female university students aged between 18 to 30 years old who were selected randomly from the university students of Isfahan University of Medical Science, Iran. A previously validated semi quantitative food questionnaire was used to assess the entire dietary component intakes. Physical activity was assessed by recording the daily physical activities.Findings: The prevalence of obesity, central adiposity and overweight was 1.7, 0.9 and 8.1% respectively. The mean value of the body mass index (BMI) and the waist circumference were respectively 21.54 kg/m2 and 70.37 cm. The mean value of the dairy product consumption was 444.24 g/day. There was not any significant relationship between the diary product consumption, the calcium intake and the weight and the waist circumference as well as the obesity and central adiposity and overweight prevalence (P>0.05).Conclusion: There was not any significant relationship between the dairy product consumption, the calcium intake and overweight, obesity and central adiposity among the young female university students.However the importance of the study was reporting of the prevalence of obesity, central adiposity and over weight as well as the mean values of BMI and waist circumference.

Background: Obesity is growing rapidly in our country. Nutrition is an important associate of obesity. The aim of this study was to determine the association between fruit and vegetable intake with the waist circumference and the body mass index (BMI) among young female university students.Methods: This cross sectional study was conducted on 236 healthy female university students aged between 18 to 30 years old, who were selected randomly from the university students of Isfahan University of Medical Sciences. A previously validated semi quantitative food frequency questionnaire was used to assess the entire dietary component intake. Physical activity was assessed by recording the physical activities daily.Findings: The prevalence of obesity, central adiposity and overweight was 1.7, 0.9 and 8.1% respectively.The mean value of BMI and the waist circumference was 21.54 kg/m2 and 70.37cm respectively. There was inverse association between the fruit and vegetable intake and body weight (r=-0.1, P=0.03) as well as BMI (r=-0.1, P=0.04) and also there was inverse association between the fruit intake and body weight (r=-0.1, P=0.01) and BMI (r=-0.1, P=0.01). There was no significant association between fruit and vegetable as well as fruit or vegetable separately with the waist circumference.Conclusion: There were significant associations between fruit and also fruit and vegetable and body weight and BMI among female university students. There were no significant associations between fruit and vegetable as well as fruit or vegetable separately with waist circumference.

Background: Soy milk replacement in the diet may have beneficial effects on anthropometric and blood pressure values in overweight and obese individuals. Therefore, in this study the effects of soy milk replacements on the weight, waist circumference and blood pressure are examined among overweight and obese youth females.Methods: This was a cross-over randomized clinical trial on 23 overweight and obese female subjects. All patients were on a weight reducing diet. There were two trial periods for six weeks (soy milk period and caw's milk period) and a wash-out period for 3 weeks. In the soy milk period only one glass of soy milk (240 cc) was replaced by one glass of caw’s milk (240 cc).Findings: The mean age of the patients was 22±2 years. The mean BMI was 28.1±0.5 kg/m2. Weight and waist circumference did not changed significantly after soy milk period compared to the caw's milk period (mean percentage change in soy milk period for weight: -3.6±0.4 vs -2.2±0.3 in the caw's milk period, P=0.82 and for waist: -0.8±0.2 vs -1.0±0.2, P=0.11). The systolic blood pressure reduced significantly following the soy milk period (mean percentage change in soy milk period: -4.0±0.9 vs -1.7±0.5 in the caw's milk period, P<0.05). The diastolic blood pressure also reduced in the soy milk period (-0.4±0.1 vs 0.4±0.1, P<0.05).Conclusion: Soy milk replacement could reduce both systolic and diastolic blood pressure among overweight and obese youth females. However, this replacement had no significant results on the weight and the waist circumference.

Background: This study was performed to evaluate the impact of factors and the total citations of ISI-indexed on nutrition journals in the last 10 years.Methods: To perform this retrospective study, the impact factor and the total citation data were collected through Journal Citation Reports of Thomson Scientific Corporation Web of Knowledge. Five highly cited journals in "nutrition and dietetics" category were selected for the analysis. These journals include Annual Reviews in Nutrition (ANNU REV NUTR), American Journal of Clinical Nutrition (AJCN), Progress in Lipid Research (PROG LIPID RES), Journal of Nutrition (J NUTR) and International Journal of Obesity (INT J OBESITY).Findings: All five selected journals were ranked as one of the top ten nutrition and dietetics journals between 1999 and 2008 in ISI category. Most of the selected journals' impact factor have upward trend during the 10 years period with fluctuation in some cases. Am J Clin Nutr had consistently the highest total citation trend during these years.Conclusion: Impact factor is a useful yardstick to compare quality of nutrition journals and also to compare the performance of the top journals in this category.

Background: The live oil- rich diet may decrease the risk of cardiovascular disease through declining plasma lipid profiles as a source of MUFA (mono unsaturated fatty acid). The purpose of this study was to assess the effects of olive oil-rich diet on plasma lipids and glucose levels in overweight women.Methods: This cross-section randomized clinical trial was performed among 20 healthy overweight (BMI=25-29.9 kg/m2) women aged between 20 and 50 years old. Subjects were randomly assigned to receive a usual energy-restricted diet (-500 kcal) [51% carbohydrate, 15% protein, 34% fat, 16% SFA (saturated fatty acid), 10% PUFA (poly unsaturated fatty acid), 8% MUFA] or an olive oil-rich energy restricted diet [51% carbohydrate, 15% protein, 34% fat, 8% SFA, 10% PUFA, 16% MUFA]. All participants followed the diet for six weeks. Two weeks wash-out period was done before following the phase 2 diets. After completing the first phase, subjects changed their diet to the one not used in the first phase. At the beginning and the end of each phase, fasting plasma glucose and lipid levels were measured.Findings: Both diets instructions resulted in a reduction of plasma lipid and glucose levels. Reductions by the olive oil-rich diet were greater than that by the usual diet, however, there was not any significant difference.Conclusion: Using the olive oil-rich diet is led to a non-significant reduction in the plasma lipids, cholesterol, triglyceride, LDL, HDL comparing to the usual diet.

Background: Several studies showed that the macronutrient intake of the food basket of imposed veterans with war injuries is lower than the recommended daily adequate (RDA). Consequently, veterans are at risk of nutritional imbalances. The aim of this project was to assess the intake of macronutrients and body composition of veterans with war injuries in Isfahan, Iran.Methods: This research was a cross-sectional study. The number of subjects studied was 106 individuals with over 10% percent disability in Isfahan city. Data collection was made using a general details questionnaire and a two-day dietary recall. The data review was conducted with N4 nutritional software and data analysis was done with SPSS10 statistical software.Findings: This project examined the average intake of macronutrients and mean anthropometric indices in veterans with war injuries. Also, a comparison was made between the mean macronutrients and RDA and comparing the mean of anthropometric indices with standard values. The relationship between the amount of intake of macronutrients and anthropometric indices was established.Conclusion: According to the findings of the study, the pattern found in food of veterans is necessary to be corrected. Intake of some amounts of macronutrients was higher than RDA.The findings related to anthropometric indices and body composition in this group indicated that the total amount of fat is more than normal and it was determined that the regular physical activity plays an important role in promotion of health in these people.

Background: More than 80% of pregnant women suffer from vomiting and nausea during weeks 4-7 of pregnancy after the last menstrual period (LMP). These problems are mostly resolved at week 20 of pregnancy. Hyperemesis gravidrun (HG) is a severe form of vomiting and nausea occurring in one out of every 200 pregnant women. HG has some symptoms and signs such as nausea, vomiting, dehydration, weight loss, ketonurea, hypocalcaemia, esophagus disorder, pneumthorax, peripheral neuropathy, fetal growth disorder and increased mortality rate. Recent studies showed Helicobacter pylori (H. pylori) to have a possible role in occurrence of vomiting, nausea and also HG during pregnancy. The current study assessed the immunoglobulin G (IgG) and immunoglobulin M (IgM) titer to H. pylori in pregnant women with nausea, vomiting and HG in Ilam, Iran.Methods: This case-control study used non-probability quota sampling to select 100 pregnant women (including 50 subjects with severe vomiting and nausea as the case group, and 50 without the symptoms as the control group) from those attending "Mostafa Khomeini" hospital and other clinics in Ilam. After collecting the data through interview and filling questionnaires, the IgG and IgM titers against H. pylori were measured by ELISA method. Data analysis was performed using chi-square test, Mann-Whitney U test, and T-test in SPSS (ver.16). The significant level of the test was consideredα=5%.Findings: The mean IgG titers in the case (45.2±5) and the control (25.8±4) groups differed significantly (P=0.04). There was also a significant difference (P=0.01) between the mean IgM titers in the case (19.6±7.2) and the control groups (11.8±6.9). In addition, a significant correlation was observed between severe nausea and vomiting (more than three times ad day) and increased IgM titer values in the case group (P=0.02), while no significant correlation was found between IgG, nausea and vomiting (P=0.08).Conclusion: H. pylori can cause nausea, vomiting and HG during pregnancy and therefore detection and treatment of this infection in pregnant women is suggested to cure the problem.

Background: Emotional intelligence is a social skill which includes understanding one's own feelings for suitable decision-making, application of feelings in communication and the ability to lead other people.This descriptive study has been conducted with the aim of investigating and determining emotional intelligence among students of medical sciences universities in western Iran. It also tried to compare this feature among male and female students.Methods: All 303 participants of the study have been students of medical sciences universities in west of Iran, who were selected using stratified random sampling. Bar-On emotional intelligence test was used as an instrument for data collection. Descriptive statistics including mean, mode, standard deviation, frequency was used to analyze the data. Non-parametric statistical test of Mann–Whitney U has been used to examine the hypotheses.Findings: The results of this study show that 83.2 percent of respondents have high levels of sympathy and empathy. Most of the respondents (63.5) had a medium flexibility in dealing with changes and situations. Also, there was a significant difference between male and female students regarding some components of emotional intelligence including problem solving, level of independence, emotional self consciousness, optimism, and sympathy.Conclusion: The results of the present study indicate that among students, especially females, emotional intelligence regarding indexes and subtests of impulse control, flexibility, realism, stress tolerance and self-expression lies in a medium level. Training students in these aspects of emotional intelligence, as a part of life skill learning program, is suggested.

Background: Maintaining a balance between cost-effectiveness and the delivery of quality patient care is a continual challenge to modern health care systems. In addition to negative effects on the patient and his family's quality of life, readmission after major surgeries imposes substantial adverse economic effects on the health care delivery system. Therefore, causes of readmission to Alzahra hospital were determined.Methods: This cross sectional study was conducted on medical records of 161 patients who were admitted during the first half of 2006 in Alzahra hospital, Iran and readmitted to the same hospital within a three month period. The data was analyzed by SPSS and using chi-square and Mann-Whitney U tests.Findings: The main reasons of readmission to Alzahra hospital included follow up (36.6%), recurrence of the disease (20.5%), a new disease (18%), canceling an operation (5.6%), complications of surgery (4.3%), infection (3.1%), treatment failure (2.5%), post surgery infection (1.5%), discharge without the physician's order (1.2%) and wrong diagnosis (1.2%).Conclusion: Since Among the several factors that contribute to readmission of the patients, 3 most important groups are personal factors, clinical factors and hospital-related factors.

Background: Influenza A (H1N1) pandemic is recently threatening the health of world's population. Nonpharmaceutical measures are important to prevent the spread of influenza A (H1N1) and to prevent a pandemic. Effective influenza pandemic management requires understanding of the factors influencing preventive behavioral changes. This study determined the status of preventive behaviors regarding H1N1 (swine) influenza pandemic based on protection motivation theory (PMT) among female high school students in Isfahan, Iran.Methods: In a cross-sectional survey, multiple-stage randomized sampling was used to select 300 female students in Isfahan who completed a questionnaire during December 2009. The questionnaire was developed by the researchers based on PMT. The obtained data was analyzed using descriptive and deductive statistics in SPSS 14.Findings: The mean age of participants was 15.62 (SE=1.1) years. A majority of participants were informed regarding H1N1 (swine) influenza pandemic (87.3%, 262 out of 300). There were significant positive correlations between preventive behaviors and perceived susceptibility, perceived severity, and self-efficacy (P<0.01). PMT's coping appraisal component of self-efficacy and response efficacy, and PMT's threat appraisal variables of perceived sensitivity and perceived severity had a significant positive relation with preventive behavior and predicted 11% of the behavior.Conclusion: A high perceived threat of influenza A was found in this research. Therefore, public health educators and planners are required to implement pandemic prevention interventions. In addition, since mass media was reported as the major information source, new policies must be developed to improve the knowledge of students by different and more scientific information sources.

Background: Having a very sensitive and non-developed immune system, immunization seems to be the most effective and most economical means available for health promotion in children and infants. This study evaluated the attitudes of mothers towards the vaccination of children under one year. It measured two components of the health belief model (perceived susceptibility and perceived severity) in 2009.Methods: This cross-sectional study used cluster sampling to include 350 mothers with children under one year who referred to health centers in the cities of Ardebil and Boukan, Iran. For data collection a questionnaire consisting of 20 questions, divided into three parts of demographic information, perceived susceptibility, and perceived severity, was used. Qualitative and quantitative analyses of the data were performed in SPSS17.Findings: The mean age of mothers in the study was 26 years.90% of mothers mentioned the vaccines as highly effective, and 7% believed that vaccinations were ineffective. Perception of mothers in connection with the sentence "My child is as sensitive against diseases as other children." was measured and the majority of mothers (58.3%) disagreed. Most mothers (70.9%) agreed that "Vaccines are more suitable for weaker children. A significant difference (P=0.001) was also observed among mothers.Conclusion: Parental attitudes toward vaccination were favorable in general. But offering advice and information about the importance of vaccines is essential. More efforts should be done to educate parents about real and unreal contraindications.

Background: The aim of this study was to determine the impact of a 6-month lifestyle change using the health belief model (HBM) on cardiovascular risk factors in sedentary, postmenopausal women of Ahvaz, Iran.Methods: This study started in June 2007 and completed in May 2008. A total of 67 healthy and sedentary postmenopausal women were assigned into two groups, namely exercise (38) and control (29).Over the six months of follow-up, the intervention (exercise) group attended five educational sessions about physical activity according to the HBM (the first session and the one at the end of the 3rd month included face to face education, three lecture-discussion classes with educational aids such as slide demonstrations, on weekends in the first month). In addition, a pamphlet containing information about menopause and the effects it has on the cardiovascular system along with the benefits of physical activity in cardiovascular disease prevention was prepared based on the HBM and handed to all participants. Every participant also received five exercise-reminding telephone calls at the end of each month. Pre- and post intervention measurements of health belief and anthropometric components including blood pressure, blood lipids and physical activity were conducted. Paired and independent t-tests and repeated measure test were used to analyze the data in SPSS15.Findings: Compared to the control group, women in the exercise group experienced significant decrease in their low density lipoprotein levels (-15 mg/dl, P<0.05), fasting blood sugar (-7.4 mg/dl, P<0.05), and an increased physical activity (272 minutes/week, P=0.02). All components of HBM, except for knowledge, improved significantly in the exercise group compared to the control group (P=0.001).Conclusion: Lifestyle change intervention using the HBM can be an effective means of reducing cardiovascular risk in obese and sedentary postmenopausal women.

Background: Considering the effect of socioeconomic factors on the appearance of chronic diseases, and also the importance of this issue for policy makers of health care services, we tried to assess the role socioeconomic factors have in diabetes complications. This survey may have some benefits in prevention and control of diabetes.Methods: This cross-sectional study was conducted on 384 diabetic patients who referred to a diabetes center in Isfahan. The subjects were selected using simple random sampling. A questionnaire with 42 questions was used in order to measure the outcomes of type 2 diabetes and its relation with socioeconomic status. Chi-square and Fisher's statistical tests were performed in SPSS software to analyze the data.Findings: Study population consisted of 52.1% male and 47.9% female subjects. There was a statistically significant association between diabetes complications and age group, education level, job status, type of communication with family members, number of visits and the security level provided by the family, type of leisure time activities, health status, years with diabetes, smoking, type of treatment, fried food consumption and income group (P<0.001), sense of security and communication in living environment (P<0.002) and daily use of vegetable groups (P<0.02).Conclusion: Findings demonstrated that some socioeconomic factors had effects on the outcomes of type 2 diabetes. Employing supportive strategies and resources for chronic disease sufferers seems very important. Empowerment strategies can induce basic changes in order to increase positive expectations, hope, self-esteem and self- confidence in patients. This is the exact strategy which must be used to efficiently control diabetes and its complications among patients.