Iranian Journal of Public Health
Year:2023 | Volume:52 | Issue:3|Papers Count:25

Background: Chronic hepatitis B virus (CHB) infection is one of the most common liver infections worldwide. Approximately 240 million patients are diagnosed with CHB. The objective of this meta-analysis was to identify the effect of CHB on the affected patients’,health-related quality of life and com-pare with the control group. Methods: A comprehensive search was conducted through PubMed, Medline, ProQuest, Cochrane Central Register of Controlled Trials, Clinicaltrials. gov, and Web of Science databases up to Jul 2022. Results: Five primary observational studies using SF-36 and WHOQOL surveys with 1135 participants (646 with CHB and 489 healthy individuals) included in the meta-analysis. We evaluated the scores of phys-ical and mental component summaries. HRQoL was comparable in both groups. The disease's impact ap-pears to slightly affect the mental component summary than the physical component summary. Conclusion: The HRQoL in CHB patients is mainly reflected in the impairment of the mental aspect. It is vital to focus on optimally managing care, family and social support, stress management.

Background: Work-related musculoskeletal diseases (WMSDs) have a greater negative impact on nurses' physical and men-tal health. However, the epidemiologic characteristics of nurse WMSDs are unclear, and the reported prevalence of WMSDs varies widely. The aim of this meta-analysis was to provide a quantitative synthesis of WMSDs’,prevalence in nurses and estimate the pooled prevalence of its. Methods: The PubMed, ScienceDirect, Web of Science, Cochrane Library, EMBASE, CINAHL, Ovid, WANFANG, VIP, China Knowledge Integrated, and CBM databases were searched for relevant studies. The retrieval period extended from database initiation to Mar 2022. After data extraction and quality assessment, a meta-analysis was performed using the Stata 16. 0 software package. Results: Overall, 42 articles were included, yielding a total sample size of 36, 934. The annual prevalence of WMSDs among nurses was found to be 77. 2% (95% confidence interval: 0. 725-0. 819). The three anatomical areas with the highest preva-lence of WMSDs among nurses were the lower back (at 59. 5%), neck (at 53. 0%) and shoulder (at 46. 8%). Nurses in devel-oped countries have a higher prevalence of WMSDs than those in developing countries. Conclusion: There was currently moderate evidence to suggest a high prevalence of WMSDs in nurses. National policies should aim to reduce their prevalence in this population.

Background: Menopause is a natural phase in a woman's aging process. Menopause leads to the decrease of the estrogen levels, and in consequence the functionality worsening. Physical exercise can improve the function-ality of postmenopausal woman. This review aimed to assess the effect of whole-body vibration exercise (WBVE) on the functionality of postmenopausal women. Methods: PRISMA guideline were used. Only English language were considered. Searches were conducted using relevant keywords for papers prior to Sep 16th, 2021, in Embase, Pubmed, The Cochrane Library, PED-ro, SPORTDiscus, Scopus, Web of Science and CINAHL databases. Results: Eight articles were selected to be in this systematic review. The mean score of methodological quality was moderate, the risk of bias was low for two studies, high for four studies, and unclear for two studies. The level of evidence of the studies was II. Improvements on muscle strength, jump, balance and maximum trunk flexion strength in the post menopause woman were reported. Conclusion: This systematic review demonstrated the functionality increase in postmenopausal women through WBVE. WBVE has been recommended as a non-pharmacological option relevant to postmenopausal management, helping to control the decline in bone density and symptoms related to osteoporosis and sarcope-nia. However, further studies are needed to reinforce these findings.

Background: White noise (WN), because of its unique behavior and characteristics, has different applications in different sciences. Nevertheless, the results of studies and reviews of the literature on occupational safety and health found that this type of noise is often used as a noise source to assess the effects of hearing and its physi-cal characteristics. Its possible applications in this area have not received as much attention. The present review study aimed to answer the question, "Can WN be used as a means of promoting occupational safety and health at the workplace? ". Methods: In this review, we reviewed the articles published in reputable databases from 1990 to 2020. Our study included 33 articles from 120 that were searched in full text and followed the inclusion and exclusion cri-teria. Results: Various applications were examined, including noise masking, white noise therapy, cognitive functions, and sleep. WN can enhance the work environment and meet occupational safety and health objectives based on the study's results. The results of this study will provide a basis for continuing research into the use of WN in the workplace as an engineering and management control method. Conclusion: WN is being used in various fields that may hold promise for its application in occupational health sciences and maintaining the well-being of workplace workers.

Background: The present research aimed to assess the effects of oral health intervention programs at school level on students’,oral hygiene in developing countries. To this aim, a systematic review and meta-analysis ap-proach was employed. Methods: The present research was done by surfing electronic databases with MEDLINE Ovid (Embase Ovid, Scopus), Web of Science from 2000 to Mar 2020. The data were collected using a standard type of data collection including specific studies to observational ones, and the data entered RevMan 2014. The eligibility criteria were individually randomized controlled trials (RCTs) or cluster-RCTs including quasi-experimental papers with oral health interventions. The RevMan 2014 package was used for a meta-analysis done through random-effects mod-els. Results: Meta-analyses revealed statistically significant divergences in terms of knowledge (SMD 3. 31, 95% CI 2. 52 to 4. 11,I2 = 98,P<0. 001), attitude (SMD 1. 99, 95% CI 0. 43 to 3. 54,I2 = 99,P<0. 001), behavior (SMD 4. 74, 95% CI 3. 70 to 5. 77,I2 = 99,P<0. 001), plaque index (SMD-1. 01, 95% CI-1. 50 to-0. 51,I2 = 97,P<0. 001) and Gingival index (SMD 0. 33, 95% CI-0. 36 to 1. 02,I2 = 98,P=0. 34) in the case of students who received educational interventions versus those with ordinary care. Conclusion: The present findings attested to the effectiveness of the educational interventions in improving oral health knowledge, attitudes, behaviors, and so on which can presumably contribute to a better oral hygiene, lower incidence of oral diseases, and lower costs of the treatments imposed by oral diseases.

Background: This descriptive study investigated the effects of sleep quality and depression on somatization symptoms in middle-aged women with cardiovascular risk factors. Methods: Data were collected from outpatients who visited three general hospitals and one private hospital in Korea between May 2017 and December 2018. Questionnaires and anthropometric data were used to analyze 144 middle-aged women (45–, 65 years) with at least one cardiovascular risk factor. SPSS and WIN 21. 0 soft-ware were used for statistical analysis. To test the mediating effects, the relationships between independent variables and somatic symptoms were compared using the t-test, analysis of variance, and χ, ²,-test, and correla-tions were analyzed using Pearson’, s correlation coefficient. Finally, multiple linear regression and the Sobel test were used to identify predictors. Results: Somatic symptoms showed a positive correlation with depression (r=46, P<0. 001) and a strong nega-tive correlation with sleep quality (r=-52, P<0. 001). Depression and sleep quality explained 37% of somatic symptom variance in a multiple linear regression analysis after correcting for age (R², =0. 37, F=41. 53, P<0. 001). The Sobel test showed a sleep quality Z-value of 3. 78, demonstrating that it was a mediating variable. By add-ing sleep quality to depressive symptoms, the absolute value of β, , which shows the effect’, s strength, decreased from. 49 to. 32, confirming a partial mediating effect. Conclusion: Depression and sleep quality were predictive of somatic symptoms in middle-aged women with cardiovascular risk factors, and sleep quality had a partial mediating effect on somatic symptoms. To reduce somatic symptoms, strategies that alleviate depression by improving sleep quality are required.

Background: The age of 6-12 yr show different degrees of learning adaptability problems. We aimed to ex-plore the influence of comprehensive psychological intervention on the psychological behavior problems and learning adaptability of students at age of 6-12 yr old. Method: In March 2022, 768 students were selected from two primary schools in Harbin of China, and divid-ed into control and observation groups. The changes in the scores of Achenbach Child Behavior Checklist (CBCL) for parent use and Mental Health Rate Scale for Pupil (MHRSP), and self-cognitive ability and learning adaptability level before and after the intervention were compared between the two groups. Results: After the intervention, the discipline violation, hostility, compulsion, immaturity, evil communication, schizoid personality, and physical symptom scores in the observation group (boys) were reduced compared with those before the intervention. In comparison with the situation before the intervention, the cruelty, ag-gression, immaturity, depression and withdrawal, physical symptom, anxiety, and compulsion scores in the ob-servation group (girls) were reduced, and the CBCL scores were improved better than those in the control group (P<0. 05). In comparison with the situation before the intervention, the scores of MHRSP, self-cognitive ability, and learning adaptability score and level in the observation group were elevated after the intervention, and the above scores were improved obviously to a greater extent than those in the control group (P<0. 05). Conclusion: Comprehensive psychological intervention can effectively improve the psychological behavior problems of children at the age of 6-12 yr, and enhance their self-cognitive ability and learning adaptability.

Background: Osteoporosis is a chronic disease that results in microarchitectural changes to the bone, thereby reduc-ing its density and increasing the risk of fractures. This retrospective cross-sectional study aimed to examine the link between the risk of major osteoporotic fractures and hip fractures with the age of menopause onset, as well as the impact of menopause duration on fracture incidence. Methods: This retrospective cross-sectional study was conducted at the Special Hospital for Rheumatic Diseases, Novi Sad, Serbia. The data required for meeting the study objectives were obtained from patients’,medical records spanning the 2015-2018 period. The sample for the study comprised of 985 postmenopausal women aged ≥,50 yr who underwent bone mineral densitometry examination and received a FRAX score for major osteoporotic fractures and hip fractures with and without bone mineral density. The obtained FRAX scores were compared across the sub-jects with respect to the age of menopause onset and menopause duration. Results: The group that entered into menopause before the age of 45 had a high risk of hip fracture (OR: 1, 652,95% CI: 1, 138-2, 399,P<. 01) and a higher mean FRAX score for hip fracture compared to women in whom meno-pause started after the age of 45 (Me=1. 60 vs. 1. 30, P<. 004). FRAX scores were also correlated with menopause du-ration, and the difference between the groups with the longest (over 20 yr) and the shortest (1–, 10 yr) duration was statistically significant at P<. 001. Conclusion: As menopause duration could contribute to the prediction of fracture risk, its inclusion in the FRAX algorithm should be considered, while also taking into account the age of menopause onset.

Background: The role of γ,-aminobutyric acid receptor (GABR) in breast cancer (BC) is unknown. Methods: The expression of different GABR subunits between BC and adjacent normal tissues was com-pared using transcriptome data set. The clinical and prognostic importance of the various GABR subunit genes in BC was determined using clinical and survival data (Data downloaded from TCGA, May 2022). Only GABRD was discovered to be substantially expressed and strongly related to the prognosis of BC cases. Results: Compared with normal tissues, GABRD expression was increased in all subgroups of breast can-cer tissues. Knockdown of GABRD inhibited the growth of BC cells. Mechanistically, the function of GABRD may be attributed to its effect on major pathways such as oxidative phosphorylation, Parkinson disease, and cell cycle. GABRD deletion significantly blocked the G2/M phase in BC cells. Conclusion: Overall, GABRD might be a novel prognostic predictor of BC, providing clues for further studies on GABRD.

Background: Although sleep problems are prevalent among people with chronic obstructive pulmonary disease (COPD), many research gaps exist in this area. The aims of this study were to identify sleep duration and sleep difficulty in people with COPD and to determine factors influencing these sleep variables. Methods: This cross-sectional study employed data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES) performed in 2019. A total of 408 people with COPD were included in the study. Individuals’,sociodemographic, COPD-related, and psychological characteristics were examined to determine factors affecting their sleep duration and sleep difficulty. Results: Of 408 study subjects, almost 95% had mild or moderate COPD. The mean sleep duration of the subjects was 6. 73 hours per day, indicating short sleep duration. Subjects with elementary school or no education, middle indi-vidual income, unmarried status, or depression were more likely to have shorter sleep duration than those with middle or high school education, low individual income, married status, or no depression. In addition, over 54% of subjects experienced mild to severe sleep difficulty. Female gender, low family income, and more perceived stress were signifi-cantly associated with greater sleep difficulty. Conclusion: Among the study subjects, over 40% had short sleep duration or mild to severe sleep difficulty. Although COPD severity was not significantly associated with sleep duration or sleep difficulty, sociodemographic disparities in sleep health were observed.

Background: Polarization of macrophages and miR-7 have been reported to greatly influence the progress of chronic obstructive pulmonary disease (COPD). However, the interaction is unclear. We aimed to investigate the role of miR-7 in the serum exosome of COPD, thus further revealing the underlying mechanism of COPD. Methods: The study was conducted in 2022 in The Affiliated Changzhou No. 2 People’, s Hospital of Nanjing Medical University, Changzhou, China. COPD mouse model was established. Macrophages were sorted by flow cytometry assay. ELISA kits were used to detect the levels of TNF-α,and IL-6. Exosomes were identified by confocal microscopy and PKH67 staining. RT-qPCR and western blot assay were performed to determine the mRNA and protein expressions. H&E staining assay was used to assess the tissue injury. CCK-8 assay was applied to evaluate cell viability. Luciferase reporter assay was used to confirm the binding between PIM1 and miR-7. Results: The exosomes derived from the COPD mice serum exerted high level of miR-7, which induced M1 differentiation of macrophages and increased the secretion of proinflammatory factors in vivo and in vitro. The effects of exosomes from COPD mice could be inhibited by miR-7 inhibitor. Bioinformatic prediction, lucifer-ase reporter assay, and western blot assay showed an interaction between miR-7 and PIM1. Further examina-tion showed that miR-7 regulated macrophage activation and differentiation to M1 via PIM1 in vitro. Conclusions: miR-7 from serum exosomes might exacerbate COPD by stimulating macrophage differentia-tion to M1, supplying a potential therapeutic target for COPD treatment.

Background: Fatalism is an important parameter that affects individuals' understanding of health. In addition, stress and economic status, such as fatalism, are important factors that affect an individual's understanding of health. In this context, there may be an important link between stress, economic situation and fatalism. This study was conducted to determine whether health fatalism levels and styles of coping with stress are affected by poverty. Methods: This cross-sectional field study involved participants consisted of 382 individuals living in the two-Family Health Center regions in Turkey in 2018. The data collection phase continued for approximately three months. Collecting the data were used, namely demographic introduction form, Health Fatalism Scale, Styles of Coping with Stress Scale, and Individual Poverty Index. The data were analysed using SPSS 22 package program. Results: The difference between the average health fatalism score in poor and non-poor individuals was statistically significant (P<0. 05). There was a weak, positive, and significant relationship between health fatalism score and optimistic, helpless, and submissive approach scores in both poor and non-poor individuals (P<0. 05). Conclusion: While individuals' health fatalism level was affected by poverty, their style of coping with stress was not affected. Still, there was a significant relationship between health fatalism level and their style of coping with stress.

Background: We aimed to construct enteral nutrition nursing management system under medical alliance mode, and to explore the clinical application effect. Methods: Based on the training project of enteral nutrition nursing team of Chinese Association of Parenteral and Enteral Nutrition, the enteral nutrition nursing management system was constructed in June 2021. Using the convenient sampling method, 850 cases of enteral nutrition clinical practice were selected from medical alli-ance hospitals before and 6 months after the implementation of the system. The process indicators of enteral nutrition nursing quality were checked, and the reported outcome indicators were compared. Results: After the implementation, the implementation rate of enteral nutrition risk screening, the implementa-tion rate of nutritional status assessment, and the correct rate of nursing measures of nurses in medical alliance hospitals were significantly improved (P<0. 001). The frequency of aspiration, diarrhea and unplanned extuba-tion was notably decreased (P<0. 05). The mastery rate of enteral nutrition knowledge and the satisfaction rate of nursing work of patients were significantly higher than before (P<0. 001). Conclusion: The established enteral nutrition nursing management system under the medical alliance model was effective and feasible, which was helpful to improve the level of enteral nutrition nursing management and the quality of enteral nutrition nursing in the medical alliance hospitals.

Background: If the mother is immune to measles, the infant is protected against measles infection after birth with maternal immunity. Therefore, the mother's immunity to measles is the most important factor in protecting the baby from measles in the first year. This study aimed to investigate measles seroprevalence and related factors in women between Oct 2019 and Jun 2021. Methods: The cross-sectional study was conducted on women aged 15-49 yr in Mersin city. Overall, 400 people were included in the study. NovaLisa Measles IgG ELISA (NovaTec Immunodiagnostica GmbH®, ) kit was used to measure measles IgG antibodies in serological analyses. The research was conducted between Oct 2019 and Jun 2021. In the analysis of the data,descriptive statistics, chi-square analysis, and binary logistic regression anal-ysis were used. The statistical significance level was accepted as P≤, 0. 05. Results: Measles seropositivity was detected in 103 (25. 7%) of the women. This rate was found 5. 5% in the 15-19 yr age group, 20. 0% in the 20-24 yr age group, 14. 5% in the 25-29 yr age group, 23. 0% in the 30-34 yr age group, 42. 3% in the 35-39 yr age group, 42. 3% in the 40-44 yr age group and 37. 5% in the 45-49 yr age group. In the logistic regression analysis, the rate of seropositivity was compared to those in the 15-19 yr age group,it was found to be 4. 33 times (P=0. 03) at the age of 20-24 yr, 12. 71 times (P<0. 001) at the age of 40-44 yr, and 10. 40 times (P<0. 001) at the age of 45-49. Conclusion: Three out of every four babies born in our region are not adequately protected against measles.

Background: The desire to attain ideal body dimensions determined by the society causes internal pressure and negative emotional intensity in young people, and this leads to mood disorders. It was aimed to examine the relationship between university students' perceived body weights and their depression, anxiety, and stress levels. Methods: This cross-sectional, descriptive study was conducted with 950 university students at Uskudar University in Istanbul, Turkey during the 2021-2022 academic year. The Information Form and the De-pression, Anxiety and Stress Scale (DASS-42) were administered online through a structured questionnaire created in Google Forms. IBM SPSS v26®,software was used in the analysis of the data. Results: 74. 4% of the students were female. The mean age was 19. 17±, 1. 11 years, and the mean body mass index (BMI) was 22. 12±, 3. 87 kg/m2. The prevalence of participants’,mood disorders as ‘, severe’,and ‘, ex-tremely severe’,depression was 91. 2%, anxiety was 62. 2% and stress was 62. 3%. According to BMI, 26. 1% of ‘, underweight’,students and 31. 5% of ‘, overweight’,students perceived themselves as normal weight. And also, 23. 8% of the students misjudged their body weight. Students who misjudged their body weight had higher depression levels (P=0. 008). Conclusion: There was a strong relationship between perceived body weight and depression, 1 of every 4 students misjudged their body weight. Body perception of participants who were ‘, underweight’,according to BMI was in the perceptional direction of obesity and who were ‘, overweight’,was in the perceptional direction of thinness. Students who were ‘, normal weight’,according to BMI have a healthier body image.

Background: This study aimed to investigate human papillomavirus (HPV) type prevalence in our region and the relationship between uterine cervical HPV types and squamous cell carcinoma (SCC)/intraepithelial lesions. Methods: HPV test results were obtained from patient file archives of the Gynecology and Obstetrics Clinic. Pathol-ogy report results were obtained from the digital records of the Pathology Laboratory and the patient file archives of the Gynecology and Obstetrics Clinic in 2018. Results: The most frequently detected was HPV16 (29. 2%), followed by HPV51 (13. 1%), HPV56 (11%), HPV31 (9. 2%), HPV52 (8. 4%), and HPV68 (8. 2%). HPV16 was positive in 50% of patients diagnosed with SCC, 54. 9% of patients with HSIL, 27% of patients with LSIL, and 25% of cases diagnosed as benign (P<0. 001). HPV18 was posi-tive in 25% of patients diagnosed with SCC, 11% of patients with HSIL, 4. 7% of patients with LSIL, and 5. 2% of cases diagnosed as benign (P=0. 019). Conclusion: The most frequent hrHPV genotype was HPV16, followed by HPV51, HPV 56, and HPV 31. There is an increase in the frequency of HPV51 and HPV56. HPV51, not included in HPV vaccines and is the second most frequent, should be included in these vaccines. In addition, although the frequency of HPV18 has decreased, HSIL and SCC generation is still high together with HPV16.

Background: In recent years, the biosorption of heavy metals by Lactobacillus strains has received attention from researchers. We aimed to remove of heavy metals lead and cadmium from L. fermentum 6b exopolysaccha-ride in 2021. Methods: Extracellular exopolysaccharide was first extracted from selected probiotic strain, and then the effect of variables such as pH, the extracted exopolysaccharide adsorbent dose, contact time, heavy metal concentra-tion, and temperature on the adsorption rate was investigated. The adsorption isotherms of Langmuir and Freundlich were also examined. Pseudo-first and pseudo-second-order kinetics equations were also investigated for the desired surface adsorption. Results: The adsorption process at pH=6. 5, contact time=80 min, pollutant concentration=100 mg. L-1, adsor-bent dose (extracted exopolysaccharide) =1500 mg. L-1, temperature=35°, C for cadmium,pH= 6, contact time=60 min, contaminant concentration of 100 mg. L-1, adsorbent dose (extracted exopolysaccharide) =1500 mg. L-1 temperature=of 35 °, C for lead had optimum condition. The adsorption process corresponded to Freundlich isotherm with R2=0. 958 and R2=0. 988, and pseudo-second-order kinetic with R2=0. 99 and R2=0. 85 for cadmium and lead, respectively. Conclusion: The exopolysaccharide extracted from L. fermentum 6b isolate can have an acceptable removal po-tential for lead and cadmium heavy metals.

Background: One of the most important endogenous factors causing genomic instability in human cells is L1s retrotransposons. In this study, we assume that increased activity of L1 retrotransposons (specifically L1 ex-pression) might be induced by hyperglycemia and hyperinsulinemia in neuroblastoma cell line. Methods: Two different cell lines (BE (2)-M17 and HEK293) were treated with insulin and its PI3K signaling pathway inhibitor under three conditional media including hyperglycemic and retinoic acid treatment in the department of Medical Genetics, Tehran University of Medical Sciences, Tehran, Iran in 2018. The expression of L1 ORF1, as well as genes involved in insulin signaling pathway and neuronal stress and structure were measured at RNA level. Results: Insulin could significantly down regulate the expression of L1 ORF1 and NEFM genes. Hyperglyce-mia result in severe decrease in expression of all candidate genes in control neuroblastoma but not HEK293 cells. Retinoic acid as the concentration used in this study cause increase stemness in neuroblastoma but not HEK293 cells. We could not find significant correlation between expression pattern of other genes tested in our study and L1 ORF1 expression. Conclusion: Total regulatory effect of insulin on L1 ORF1 RNA expression as well as NEFM markedly in BE (2)-M17 cell line. Although these results could not be interpreted as L1 retrotransposition, expression of L1 RNA during stress conditions might be considered following inhibition of the insulin pathway. The result of this study also confirms the impotence of insulin on human evolution.

Background: We aimed to estimate the prevalence of domestic violence against women at Reproductive Age (WARA) and its visibility in southeast of Iran. Methods: Adopting a modified time-location sampling, we recruited 933 WARA in the city of Kerman, Iran from Aug to Dec 2019. Domestic violence (DV) was divided into three main categories: Physical, psychological, and sexual. Data were obtained by direct and Network Scale-Up (NSU) methods through self–, administered questionnaires. Generalized Estimating Equations (GEE) was used to determine the association between socio-economic variables and the violence experience. Visibility was defined as the ratio of NSU over direct estimates. Results: Using the direct method, the annual prevalence of psychological violence was estimated at 60. 9%. Cor-responding figures for physical and sexual violence were 34. 7% and 37. 7%, respectively. NSU estimates were about one-third of the direct estimates. Divorced and widowed, self-employed, and less educated women were more likely to experience DV. Conclusion: While the average DV was as high as 44%, its visibility was as low as 33%. Nearly two-thirds of domestic violence against women remains undisclosed. This indicates a high level of stigma perceived around this type of violence.

Background: Little is known about the relationship between renal insufficiency and time after cancer diagnosis. Methods: The data of 71, 302 individuals (aged 19 to 79 yr) that participated in the 2007–, 2019 Korean National Health and Nutrition Examination Surveys were subjected to analysis. Renal insufficiency was defined as an esti-mated glomerular filtration rate of < 60 ml/min/1. 73 m2. Odds ratios of renal insufficiency were estimated using multivariate logistic regression models adjusted for potential covariates. Results: Of the 71, 302 study subjects, 3. 7% were cancer survivors and 2. 2% were long-term (≥,5 yr) survivors. Renal insufficiency was significantly more prevalent among short-term survivors, but not among long-term survi-vors, than among subjects without cancer. Conclusion: A cancer history of ≥,5 yr is not an independent risk factor of renal insufficiency.

Despite the evidence of the relationship between cognitive and motor functions in Alzheimer's dis-ease (AD), there are gaps in the literature about the association of this disease with handgrip strength (HGS) decline, and the factors associated with HGS in elderly people with AD have not been widely assessed. We evaluated HGS in individuals with AD and its relationship with the Clinical Dementia Rating (CDR) and the Mini Nutritional Assessment (MNA), in 2016, in Campinas-SP-Brazil. This study included 43 elderly patients aged 65 years and over, 65. 1% (n=28) being female, with AD. A control group (CG) was formed with 51 patients (78. 3±, 7. 8 years) and similar socio-cultural condi-tions, without cognitive complaints and without neurological or psychiatric diseases. . .

Neural tube defects (NTDs) are one of the most common fetal malformations of the central nerv-ous system (CNS) and are object of study in eve-ry pregnancy because they occur in the early stag-es of fetal development. Although some of them are compatible with life, they represent a signifi-cant social problem for the family and society. Malformations are due to improper closure of the neural tube and can occur sporadically or as a syndrome. Their etiology is multifactorial, related to demographic, exogenous and endogenous ma-ternal factors. . .

Faced with specific emotional stimuli, such as fear, fright, or worry, some people may experience the so-called vasovagal syncope (SVV), a secondary reflex responsible for hypotension and bradycardia, which constitutes about 30% of syncopes (1). From an epidemiological point of view, SVV is a frequently occurring phenomenon in the general population. The prevalence of the first syncopal episode is particularly high in patients between 10 and 30 yr of age, reaching about 47% in females and 31% in males around 15 yr of age (2). This reaction is therefore particularly experienced by adolescents and young adults. The characteristic symptoms of SVV are nausea, tremor, sweating, weakness, and vision impairment (3). Among the various activities in which SVV manifests itself there is a particularly delicate activity involving health called venous sampling. During the sampling, it is necessary to be careful because the person might faint and fall unconscious on the floor (in the context of transient loss of consciousness [T-LOC]), resulting in negative consequences. Although this reaction occurs rapidly, is short-lived, and has spontaneous recovery, such episodes can lead to a lot of anxiety and concern in the people who experience it. Some may stop taking blood samples, compromising the need test them which could have a potentially major impact on disease prevention. Fainting because of sampling has been studied mainly from a medical point of view so far. The mechanisms that are physiologically activated during syncope are well understood. However, the causes responsible for SVV have not yet been clarified, although it is known that hypo-tension and bradycardia are associated with transient inhibition of the sympathetic system and activation of the vagal system (4). The few psychophysical studies conducted have deepened the relationship between emotion and genetics. For example, it was found that disgust and fear can facilitate the onset of vasovagal syncope (5), while a sense of disgust towards the needle is related to needle phobia but is completely absent among people who are not afraid of the needle. Our research stems from the need to explore the experience of people who have undergone SVV. With this this scope, we conducted an exploratory survey on a sample of 68 subjects diagnosed with pre-syncope or SVV of both sexes (28 males, 40 females), aged between 14 and 24 yr, with an average age of 22. 18 yr, who underwent venous blood sampling at an outpatient clinic in Italy and reported having experienced one or more episodes of fainting. The study objectives concern the description of the sampling experience. Narrative interviews were used as the research methodology and were conducted at acquiring the description of the interactions within the hospital due to which the fainting could have occurred. Informed consent was taken from the patients before the study. The narrations provided by the participants al-lowed us to highlight the ways in which they shape some fundamental aspects of this experience, allowing for some reflections that could be codified in guiding principles. A majority of the respondents focused on the relational and inter-active aspects, considering them decisive in contributing in generating fear. First, the hospital was represented in an unfriendly context as a detached and a cold place, which is professional but creates a lot of distance between those in need and those who care. Many interviewees spoke of it as an environment that arouses "anxiety and fear". These sensations increase during the wait when the more the time passes, the more the worry grows. This, according to several respondents, feeds the fear. In fact, some said they thought about giving up the withdrawal and some even left the hospital. The non-reception is also due to a too large an environment, a bare, aseptic and depersonalized room, which makes them feel like "a number". Second, interactions with operators are considered crucial: the hasty attitude of the operators was considered by the patients as a sign of lack of attention or disorganization. Another aspect that was stressful is the silence by the operators in charge of the sample, which comes across as cold, detached, and unsympathetic towards the uncomfortable situation of the patient. On the other hand, participants expressed that they would greatly appreciate an operator to speak and ask questions in everyday language, showing availability, distracting them, instilling confidence in them, and contributing in creating a serene environment. These data confirm what Hughes et al (6) had found on the importance of welcoming patients and making them familiar with the practices implemented in order to help them manage their worry and anxiety. All these findings brought out the need to train sampling staff to implement a more welcoming and comforting relationship and communication with patients. We hope that these data can help improve the environment and operators’,behavior to allow for a rapid change in experience of sample collection for young citizens. This will ensure their good health (7) and that of the entire community to which they belong.

In a survey on the status of the Korean conven-ience industry in 2019, the number of convenience stores in Korea surpassed 42, 000 at the end of 2019. There was one convenience store per 1, 350 population, which was far greater compared to one convenience store per 2, 250 population in Ja-pan (1). As such, the Korean convenience store market is continuously growing, known to be de-rived from consumption behavior pursuing sub-stance, simplicity, convenience, increase in one-person households, and consumption culture change, including a small amount purchase pattern (2). Convenience stores fall in line with the consump-tion pattern of those in their 20s, seeking conven-ient dietary options due to such merits as conven-ient accessibility and 24-hour operations. Also, having a meal in a convenience store is gradually on the rise. The dietary lifestyles of people in their 20s feature irregular mealtime and inappropriate healthcare, although individual interest in health is apparently huge. In fact, the ratio of those who think that their dietary life value is merely eating or meeting hunger is rising (3). In a situation where the patronization frequency in convenience stores among Korean people in their 20s (those who exhibit many dietary lifestyle prob-lems) increases, a probability to negatively affect dietary life and healthcare according to the use of convenience stores is high, and social attention promoting concern about such a situation is grow-ing. This study, a fact-finding analysis on the conven-ience store use of Korean university students in their 20s, along with the accompanying health var-iables, aimed to present a sound direction on con-venience store use and consumption and provide baseline data for public health study that is neces-sary for healthy dietary life management. This study targeted 199 students among Namseoul University located in Cheonan City, Chungcheong Province, students in their 20s in Korea with the WMA Declaration of Helsinki, using convenience stores once or more. The weekly mean use fre-quency of convenience stores, status of using con-venience meals, distance between convenience store and residence, and effects on distance, upon using convenience stores, and on dietary habit, gaining weight, drinking, and late night meal (snack) according to the use of convenience stores were surveyed. Also, a questionnaire survey on the status of checking nutritional contents and calories upon purchasing foods was carried out. A fre-quency analysis on the measured questionnaire survey details was conducted by means of SPSS 23. 0 Windows (IBM Corp., Armonk, NY, USA), and the sampling error was ±, 1. 09% at 95% confi-dence level. According to the study results, the mean use fre-quency of convenience stores was 1-2 times a week (51. 7%), 3-4 times (31. 5%), 5-6 times (7. 9%), and 7 times (8. 9%). In the question on whether they use convenience stores often, 40. 4% of the participants said “, Yes, ”,30. 0% said “, Moderate, ”,and 29. 6% said “, No. ”,On the distance between convenience stores and residence, 20. 1% of the to-tal participants said within 100m, 37. 2% said 100m-500m, 31. 6% said 500m-1000m, and 11. 1% said over 1km. In the question on whether dis-tance affects the use of convenience stores, 58. 1%, 24. 1%, and 17. 7% said “, Yes, ”,“, Moderate, ”,and “, No, ”,respectively. In the question on whether convenience store use affects dietary life, 68. 5%, 23. 2%, and 8. 3% said “, Yes, ”,”, Moderate, ”,and “, No, ”,respectively. In the question on whether convenience store use affects gaining weight, 36. 5% responded “, Yes, ”,30. 9% re-sponded “, Moderate, ”,and 33. 5% responded “, No. ”,33. 5%. In the question on whether convenience store use affects drinking, 25. 7% said “, Yes, ”,22. 7% said “, Moderate, ”,and 51. 7% said “, No. ”,In the question on whether convenience store use affects late night meal (snack), 43. 9%, 25. 6%, and 30. 5% said “, Yes, ”,“, Moderate, ”,and “, No, ”,each. Lastly, in the question on whether the participants checked nutritional contents upon purchasing foods sold at convenience stores, 14. 8%, 20. 2%, and 65. 1% said “, Yes, ”,“, Moderate, ”,and “, No. ”,In the question on whether the participants checked calories upon purchasing foods at convenience stores, 21. 8% said “, Yes, ”,23. 8% said “, Moderate, ”,and 54. 4% said “, No. ”,This study examined the situations of convenience store use among Korean university students in their 20s, along with their health variables. They were affected by distance in using convenience stores, and their dietary habit and late night meal (snack) were affected by the use of convenience stores. In addition, the participants did not check nutritional contents and calories upon purchasing foods at convenience stores. The study results can provide new vision and in-formation to a public health study necessary to es-tablish consumption culture, considering health variables upon convenience store use, as well as to a study on the situation of convenience store use of university students (in their 20s) in many coun-tries, including Korea.

Despite increasing interest in evidence–, based interventions and a growing body of evidence for effectiveness of this approach, health educators and health promoters continue to do their routine practice due to complexity and barriers to apply evidence –, based interventions. With the movement toward best practices, intervention mapping (IM) as a systematic process of intervention development highly recommended by researchers (1, 2). The authors pointed health educators and promoters must have the knowledge and skills to develop effective interventions to help individuals and communities change health risk behavior and initiate health-promoting behavior. To prevent the health problem and malaria prevention among international students, implication of health-related intervention required. To addressing the barriers that affect public health practice, we discuss IM approach for developing evidence-based interventions. The protocol of IM consist of six fundamental steps: 1) Conduct the needs assessment, and assess community capacity among the participatory planning group. Moreover, set specify program goals for health and quality of life improvement of international student regarding preventing and control malaria. 2) Create matrices of change objectives through specifying performance and behavior change objectives, it is important and changeable determinants based on collected information were selected to create the matrix of change objectives. 3) Selecting theory-based intervention methods and practical applications, after consult with the planning group. During the meeting, the planning group, discussed appropriate theoretical methods, designed practical applications and what needs to change regarding behavioral outcomes. 4) Intervention program through organizing methods and applications into the health–, related intervention. First, representatives of international students and implementers were consulted. Second, the program themes, scope, sequence of activities and material list were formed. Then, draft of program protocol and materials were prepared. Finally, pretest program protocol. 5) Specifying adoption and implementation plans, after identifying potential adopters and implementers, specify determinants for adoption and implementation health-related intervention. At