Journal of Health System Research
Year:2019 | Volume:15 | Issue:3|Papers Count:10

Background: Fatty liver is a common metabolic disorder that results in abnormal liver function due to the excessive accumulation of fat in the liver cells. Vitamin D can play a role in the improvement of fatty liver symptoms due to its anti-inflammatory, anti-fibrotic, and insulin-sensitizing roles. In this regard, the present study aimed to summarize the data obtained from clinical trials on the effect of vitamin D supplement on various parameters associated with nonalcoholic fatty liver disease. Methods: Published studies during 1990 and 2018 were extracted through searching the scientific databases, including PubMed, Google Scholar, ScienceDirect, Scopus, and Web of Science, using the keywords of NAFLD, Nonalcoholic Fatty Liver Disease, Nonalcoholic Steatohepatitis, Vitamin D, Cholecalciferol, 1, 25 (OH) 2D3, and Calcitriol. Findings: It seems that Vitamin D can improve the symptoms of nonalcoholic fatty liver disease by decreasing the fat content of the liver, levels of alanine transaminase and aspartate transaminase enzymes, pre-inflammatory cytokines, such as nuclear factor kappa-light-chain-enhancer of activated B cells and tumor necrosis factor-α , and level of a high-sensitivity C-reactive protein as an inflammatory factor. In addition, vitamin D can positively affect the symptoms of nonalcoholic fatty liver disease through the improvement of insulin resistance. It can also have positive effects on oxidative stress by the reduction of the level of malondialdehyde and increase of antioxidant capacity. Conclusion: Vitamin D can play an important role in the prevention and improvement of nonalcoholic fatty liver through various mechanisms.

Background: Noncommunicable disease prevention is an important issue in promoting health services and its training is possible through health education models and theories. The present study aimed to determine the effect of education based on the health belief model on the knowledge and attitude of health care workers towards colon cancer screening in Yazd, Iran. Methods: In this quasi-experimental study, all 28 health care workers working at the Health Center of Yazd, Iran, were selected for the study. For the purpose of data collection, a questionnaire comprising of two sections was used. 1) Demographic items. 2) knowledge-related items, including perceived sensitivity, perceived severity, perceived benefits, perceived barriers, self-efficacy, and perceived behavior. A three-session educational intervention was provided. The collected data were analyzed in SPSS (version 20) software and Kolmogorov-Smirnov test, Paired t-test, and Wilcoxon tests were used in the current study. Findings: The results of the present study showed that after the educational intervention, the mean score of the health care workers' knowledge about colon cancer screening significantly increased (P=0. 013). In addition, the mean scores of the perceived sensitivity (P=0. 047), perceived severity (P=0. 324), perceived benefits (P<0. 001), self-efficacy (P=0. 003), and perceived behavior (P<0. 001) increased after the educational intervention. However, the mean score of perceived barriers decreased after the intervention (P=0. 746). Conclusion: Health belief model constructs can be used as an appropriate framework for designing colon cancer screening interventions to improve the health-promoting behaviors of health care workers.

Background: Body composition changes affect different physical, motor, and mental aspects of individuals. Self-concept weakness poses a serious problem for both overweight children and children with developmental coordination disorder. In this regard, the present study aimed to assess the effect of play-based exercises on the self-concept of overweight children with developmental coordination disorder. Methods: This semi-experimental study was conducted on a total number of 50 children aged 8-10 years which were selected from elementary schools using the targeted sampling method and based on entry criteria. Following the pre-test, the participants were randomly assigned to the experimental group (n = 30) and control group (n = 20). In pre-test and post-test, the Movement Assessment Battery for Children (MABC-2) was used to measure the coordination disorder of subjects, and their physical self-concept was assessed using Wilson questionnaire. The experimental group underwent training for 3 months. In post-test, the data were analyzed in SPSS software (version 21) using a one-way analysis of covariance (ANCOVA) at a significant level of 0. 05. Findings: As evidenced by the obtained results, a significant difference was detected between the scores of self-concept and subscales, including coordination, desirability, self-esteem, flexibility, and appearance between the two groups. Nonetheless, no significant difference was observed in the components of strength, endurance, physical activity, and health. Conclusion: Childhood is one of the important stages in the formation of self-concept. Based on the results, games can exert beneficial effects on the social and psychological development of overweight children with coordination disorders who are more exposed to emotional problems.

Background: Chronic diseases, such as diabetes mellitus, are among the healthcare issues in new communities. Diabetes, like any other chronic and debilitating diseases, poses some problems for the patients, especially the children, thereby affecting all aspects of their daily life. The purpose of this study was to evaluate the effectiveness of cognitive-behavioral therapy in social anxiety among children with type I diabetes mellitus. Methods: The present quasi-experimental study was conducted using a pretest-posttest design with a control group and follow-up. The study population corresponded to a group of 25 children aged 8 to 13 years with type I diabetes as diagnosed by an endocrinologist. The participants were selected using purposive sampling technique and then randomly assigned into control and intervention groups. The intervention group received 8 cognitive-behavioral therapy sessions of 45 min within 2 months. On the other hand, the control group was placed on the waiting list. The subjects completed the Social Anxiety Scale for Children-Revised (La Greca & Stone, 1993) at the pre-test and post-test stages, as well as after 45 days of follow-up. The data were analyzed using repeated measures ANOVA. Findings: The results of this study showed a significant difference among the mean scores of social anxiety obtained at the pre-test, post-test, and follow-up (P<0. 01). In addition, there was a significant difference between the intervention and control groups regarding the mean scores of social anxiety dimensions (P <0. 05). Conclusion: As the results of this study indicated, cognitive-behavioral therapy was considered an effective intervention in reducing social anxiety in children with type I diabetes mellitus, and the treatment effects were maintained until follow-up.

Background: In addition to chemical contaminants, the air we breathe may contain various microorganisms that can cause infectious and allergic diseases. This study aimed to evaluate the concentration of bioaerosols in indoor and outdoor air of school and kindergarten buildings in Andimeshk, Iran. Moreover, the indoor-to-outdoor concentration ratios (I/O) were calculated to identify the sources of contamination during winter 2016. Methods: In this cross-sectional descriptive study, 216 air samples were taken from the indoor and outdoor of the school and kindergarten buildings during winter 2016 (i. e., January, February, and March) in Andimeshk, Iran. The sampling was performed using an Andersen single-stage impactor containing a culture medium and an SKC Pump based on the methods recommended by the American Conference of Governmental Industrial Hygienists. Bacterial samples were incubated at 37° C for 2 days and fungal samples were stored at room temperature for 3 to 5 days. Subsequently, the colonies were counted and reported as the colony counts per cubic meter (CFU/m3). Findings: The school No. 4 obtained the highest mean of indoor (1504 CFU/m3) and outdoor (1295 CFU/m3) bacterial concentration. Moreover, kindergartens No. 4 and 3 obtained the highest mean of indoor (249. 6 CFU/m3) and outdoor (323. 3 CFU/m3) fungal concentration, respectively. In addition, the lowest mean of indoor (513. 5 CFU/m3) and outdoor (221. 6 CFU/m3) bacterial concentration were related to school No. 6 and kindergarten No. 5, respectively. In the same line, kindergarten No. 5 obtained the lowest and highest mean of indoor (147. 6 CFU/m3) and outdoor (174. 3 CFU/m3) fungal concentration. The highest mean (46. 2 CFU/m3) of indoor fungal concentration (i. e., Aspergillus fumigatus) was related to school No. 1, and the lowest mean (4. 61 CFU/m3) in this regard was observed in kindergarten No. 3. Conclusion: Based on the results, the mean amount of indoor bacteria concentration at all buildings understudy was greater than that proposed by the World Health Organization (500 CFU/m3). This can be the cause of respiratory diseases and a threat to children's health. A study of I/O in elementary schools and kindergartens showed that the sources of bacterial and fungal contaminations were mostly indoor and outdoor, respectively. Therefore, there is a need for continuous monitoring and developing prevention management programs.

Background: Disease-related malnutrition exerts adverse effects on the treatment process. This problem can increase infection, inflammatory factors, oxidative stress, recovery delay, length of hospital stay, hospital costs, and mortality, especially in the elderly and patients with malignant diseases admitted to intensive care units. Alpha Lipoic Acid (ALA) is an eight-carbon sulfur-containing compound with antioxidant properties which may be suitable for these patients. The present study aimed to investigate the effects of ALA supplementation on malnutrition, oxidative stress, length of hospital stay, and length of ventilator connection. Methods: This study was a randomized, double-blind, placebo-controlled clinical trial in which 80 patients (18-80 years) were randomly assigned to two groups, including intervention and control groups. The intervention group received ALA (600 mg daily) and the control group received a placebo for 8 weeks. Antioxidant capacity (TAC), malnutrition, waist circumference, arm circumference (MAC), the thickness of skin fat (TSF) were measured before and after the intervention. The present study was performed in the general and neurosurgical ward of Loghman Hakim Hospital affiliated to Shahid Beheshti University of Tehran. Dietary data were assessed using N4 software and statistical analysis was performed using SPSS software (version 20). Quantitative data were considered as mean± SD. A p-value less than 0. 05 was considered statistically significant. Findings: The intervention and placebo groups were comparable in terms of initial characteristics (P<0. 05). Nonetheless, after the intervention, significant changes were observed in TAC (P=0. 538), TSF (P=0. 350), malnutrition (P=0. 184), MAC (P=0. 525), waist circumference (P=0. 343), and length of stay (P=0. 343). There was no difference between the two groups regarding mechanical ventilation time (P=0. 094). Conclusion: As evidenced by the obtained results, 8-week supplementation with 600 mg ALA exerted no significant effect on TAC, malnutrition, waist circumference, MAC, TSF, mechanical ventilation time, and length of hospital stay in ICU patients.

Background: The gradual increase in the concentration of heavy metals in soil poses serious hazards to human health and other living organisms. Accordingly, the current study aimed to assess the optimal operating conditions of phytoremediation of soils contaminated with zinc by Spinaciaoleracea L. plant. Methods: In this experimental study, different concentrations of zinc chloride (0, 100, 250, 500, 1000, 1500, and 2000 μ M) were applied to Spinaciaoleracea L. plant in the four-leaf stage in hydroponic culture medium for four weeks. Thereafter, the growth and physiologic parameters, as well as the amount of the zinc accumulated on the root and aerial organs of the plants were measured. The experiment was carried out with a completely randomized design at three treatment levels. Findings: In Spinaciaoleracea L. plant, the increase in the concentration of zinc chloride in nutrient solutions led to a significant decrease in the biomass of the root and aerial part, chlorophyll a, total chlorophyll, and leaf surface, with the highest reduction being related to the treatment with 2000 μ M zinc chloride. In the aerial part of Spinaciaoleracea L. plant, proline accumulation increased significantly with elevated zinc concentration. This being the case, the zinc accumulation rate in treatment with 2000 μ M zinc was 2. 57 times higher than the control treatment. In addition, the zinc accumulation rate in treatment with 2000 mM was measured at 324. 02 and 355. 46 mg/kg of dry weight in aerial and root sections, respectively. Conclusion: As evidenced by the obtained results, Spinaciaoleracea L. plant can be used to refine zinc-contaminated soil since it is resistant to low concentrations of zinc in terms of indices of growth, chlorophyll a, total chlorophyll, carbohydrates, and leaf surface. The other underlying rationales include the relatively short growth period and high performance of this plant.

Background: Lack of physical activity is one of the risk factors for cardiovascular diseases. During manual working, the most important performance of hand is gripping and force exertion. Various factors affect physical activity. Moreover, grip strength as an index to measure total muscle strength may be related to physical activity. Regarding the importance of the issue and the absence of research carried out in this field in Iran, the present study aimed to investigate the relationship between grip strength and physical activity (PA). Methods: This descriptive-analytic and cross-sectional study was carried out on a total number of 120 Municipality workers. Dynamometer, pinch gauge, and Iranian version of International Physical Activity (IPQA) were used for the measurement of grip strength, pinch strength, and PA, respectively. Data were analyzed in SPSS software (version 20) using Spearman and Pearson correlations. A P-value less than 0. 05 was considered statistically significant. Findings: In the current study, Mean of grip, pinch, and PA were measured at 36, 8. 5 kgf, and 3830 MET, respectively. Furthermore, the results of Spearman's test revealed no significant relationship between PA and hand strength (P˃ 0. 05). Conclusion: Physical activity is one of the important influential factors affecting chronic diseases. In the current study, the mean score of workers' physical activity was reported to be high. Since no research has been carried out in this field in Iran (except for the present study), it is recommended that further studies be conducted on this issue.

Background: Consumption of trans fatty acids (TFAs) is a major risk factor of cardiovascular diseases. In Iran, similar to other countries in the world, food manufacturers seek to minimize the amount of this compound in food. The current study aimed to modify wafer cream formulations by mixing hydrogenated oil (HO), canola oil (CO), and texturizers in order to achieve optimum physicochemical and texture properties with a minimum of TFAs. Methods: In the present study, 11 samples of wafer cream were prepared using a different percentages of HO and CO, as well as starch and carboxy methyl cellulose (CMC) as texturizing agents. Changes in formulation were compared using a two-way analysis of variance (ANOVA) performed in SPSS21 with a 95% confidence level. Findings: The obtained results indicated that with the increasing rate of HO replacement with CO, the moisture was constant. Compared with control sample, the anisidin value was reduced as well as acidity, peroxide and TBA increased, whereas the stifness of texture decreased. Moreover, it was observed that TFAs and saturated fatty acid amount decreased, while the amount of mono-and polyunsaturated acids increased. Nonetheless, no significant difference was observed in the kind of texturizing agents and examined properties. Conclusion: The most optimal formulation was obtained by replacing 20% HO with CO and achieving 1% of TFAs. Accordingly, this formulation is recommended to be used by industrially food manufacturers in the production of wafer cream.

Background: Chlorpyrifos and deltamethrin are organophosphorus and pyrethroid agents respectively, which can produce reactive oxygen species and oxidative stress. On the other hand, Rosemary and Salvia extracts contain antioxidants that play a protective role against free radicals. In this regard, the present study aimed to investigate the reduction effect of Rosemary and Salvia extract on the oxidative damage caused by the exposure to chlorpyrifos and deltamethrin. Methods: A total of 54 male Wistar rats weighing approximately 200-220 g were used in this study. The rats were randomly divided into nine groups (six rats in each group). The rats were weighed and sacrificed after 30 consecutive days of exposure, and serum samples were collected to examine the changes of malondialdehyde and glutathione peroxidase. Findings: Results of statistical tests showed that chlorpyrifos and deltamethrin significantly changed the levels of glutathione peroxidase activity and malondialdehyde in the exposed rat serums, compared to those in the control group. Moreover, simultaneous exposure to chlorpyrifos with Rosemary extract and deltamethrin with Salvia extract significantly decreased the levels of glutathione peroxidase and malondialdehyde and reduced the damage caused by these toxicants. Conclusion: According to the obtained results of this study, Rosemary and Salvia extracts can reduce the oxidative stress induced by chlorpyrifos and deltamethrin in Wistar rats. In addition, these extracts can be used to mitigate the consequences of poisoning caused by the pesticides of interest.