Health Care Centers In Tehran Research Articles

Support Needs of Family Caregivers of Older Patients With Cancer in Iran:A Qualitative Study

Objectives Family members have a significant role in caregiving for older patients with cancer. These caregivers are exposed to a significant caregiving burden. Therefore, it is necessary to support them. In this regard, it is important to know their needs. The present study aimed to explore the support needs of family caregivers of older patients with cancer in Iran. Methods & Materials This descriptive qualitative study was conducted during 2020–2022. Thirty-one participants including family caregivers of older patients with cancer, family members of family caregivers, and healthcare providers were purposefully recruited from healthcare centers in Tehran, Iran. Data were collected through semi-structured interviews until data saturation. Data analysis was performed using Graneheim and Lundman’s content analysis method. Lincoln and Guba’s criteria were used to evaluate the trustworthiness of the data. Results The analysis led to the identification of six main themes, including the need for informational support, the need for physical support, the need to get rid of psychological insecurity, the need for improve spirituality, the need for practical support and the need for the help of a care team. Conclusion Considering the multiple support needs of family caregivers of older patients with cancer in Iran, policymakers, healthcare planners, and healthcare providers should design and implement various interventions based on these needs by using a caregiver-centered approach to support these caregivers.

Evaluation of the Relationship Between Meal-Based Dietary Anti-Oxidant Quality Score with Obesity in Apparently Healthy Adults Attended to Health Care Centers in Tehran.

Studying the dietary antioxidant quality (DAQ) score as a modifiable factor to lessen the negative effects of obesity on health is vital due to the rising global trend of obesity. Therefore, this study aimed to determine how adult obesity and meal-based DAQ scores correlate. A cross-sectional study including 850 men and women in Tehran was conducted. Three 24-hour dietary recalls were used to evaluate dietary consumption. Based on the design of DAQs, the meal-based DAQ score was evaluated. Higher scores indicate better DAQ. The overall DAQ score varied from 0 to 5. To investigate the relationship between DAQs and obesity in each meal, logistic regression analysis was utilized. There was no correlation between a higher breakfast DAQ score and being overweight or obese (for overweight: OR = 0.69; 95% CI: 0.38-1.24/for obesity: OR = 0.65; CI 95%: 0.31-1.37). In the basic model, a higher lunch DAQ score was inversely related to probabilities of being overweight (OR: 0.62; 95% CI: 0.39-0.99) Such a connection remained significant after relevant confounders were considered (OR: 0.48; 95% CI: 0.27-0.84). In both the raw and fully adjusted models, there was no discernible correlation between the meal DAQ score and overweight or obesity. We discovered that a higher DAQ score for lunch was substantially associated with a lower risk of being overweight but not obese. To verify our findings, additional prospective research in various populations is required.

Changes in menstrual cycles among Iranian women during the COVID-19 pandemic: A cross-sectional study.

Some women experienced alterations in their menstrual cycles during the Coronavirus disease 2019 (COVID-19) pandemic. This study aimed to evaluate the changes in menstrual cycles among Iranian women during the COVID-19 pandemic. This cross-sectional study included 1500 women of childbearing age referred to healthcare centers in Tehran, Iran from April-November 2022. Participants were selected using the stratified sampling method. Data were collected via a questionnaire covering information on menstrual cycle, COVID-19 infection, and COVID-19 vaccination status. The study's outcomes focused on menstrual changes by evaluating cycle regularity, duration, and symptoms based on participant-reported observations. The findings revealed that the pattern of menstrual change during the pandemic occurred in the form of a shorter interval in 8.6%, and longer interval in 8.9%, shorter duration in 10.4%, longer duration in 9.4%, heavier bleeding in 12.3%, lighter bleeding in 14.7%. The chance of menstrual changes in women who were infected with COVID-19 was 54% higher than that of women who were not infected, and the chance of menstrual changes in women who received 3 doses of COVID-19 vaccine was 1.5 times higher than women who had not been vaccinated. Our research revealed a high incidence of menstrual changes among Iranian women of childbearing age during the COVID-19 pandemic. Healthcare providers should be knowledgeable about the menstrual changes associated with COVID-19 infection and vaccination to provide information and support to affected women.

Factors influencing support provision to the family caregivers of elderly patients with cancer: A qualitative study

PurposeFamily caregivers (FCs) play a significant role in providing care to elderly patients with cancer (PWC). Meanwhile, they face a wide range of challenges and are considered hidden patients who require special attention and support. Nonetheless, they do not receive adequate support. This study aimed at exploring the factors influencing support provision to the FCs of elderly PWC. MethodThis descriptive qualitative study was conducted in 2020–2022. Thirty-one FCs and family members of elderly PWC and healthcare providers were purposefully recruited from various healthcare centers in Tehran, Iran. Data were collected through semi-structured interviews and analyzed using Graneheim and Lundman's conventional content analysis approach. Trustworthiness was ensured through Lincoln and Guba's criteria. ResultsFactors influencing support provision to the FCs of elderly PWC came into three main categories, namely the potential for supporting elderly PWC and FCs, complexity of family and social support, and support-related challenges of the healthcare system. ConclusionsIdentifying the factors influencing support provision to the FCs of elderly PWC can assist healthcare policymakers and authorities in developing more effective strategies to support these groups.

Comparison of habitual and meal-specific dietary patterns identified by latent class analysis and confirmatory factor analysis in adults: A cross-sectional study

ObjectiveThe aim of this study was to compare characteristics of habitual and meal-specific dietary patterns identified by latent class analysis (LCA) and confirmatory factor analysis (CFA). MethodsParticipants included 778 adults selected for the present cross-sectional study from local health care centers in Tehran, Iran. Three 24-h dietary recalls evaluated dietary intake. LCA was used to group study participants into exclusive subgroups of individuals with similar patterns of dietary intake. CFA was applied to identify patterns of habitual and meal-specific dietary intake. Analysis of variance was used to compare the average scores of habitual and meal-specific CFA-derived dietary patterns across classes identified by LCA. ResultsUsing habitual dietary intake, CFA grouped correlated food items into three major factors: fruits and vegetables, mixed, and Western dietary patterns. LCA grouped study participants with similar patterns of habitual intake into four subgroups of individuals: fruits and vegetables, mixed, Western, and low consumer classes. LCA-fruits and vegetables, LCA-Western, and LCA-mixed classes had, respectively, higher mean scores of CFA-fruits and vegetables, CFA-Western, and CFA-mixed dietary patterns compared with other classes (P < 0.001). Similar findings were observed for meal-specific dietary intake, where classes identified by LCA had the highest mean scores of their corresponding dietary pattern identified by CFA. ConclusionHabitual and meal-specific classes identified by LCA were well characterized by the dietary patterns derived by CFA, suggesting that LCA may be an appropriate statistical approach to classify study participants with similar patterns of intake into exclusive subgroups of individuals.

Reasons for high prevalence of contraceptive withdrawal in Tehran, Iran

This study explores reasons for withdrawal use that is highly prevalent in Iran. A face-to-face semi-structured survey questionnaire was designed and 79 married women aged 15–49, who were only using withdrawal when attending five primary healthcare centers in Tehran during September–October 2021 were interviewed. Results showed that withdrawal mostly was chosen by the couple (67%), and partly by the woman alone (19%) or by the husband alone (14%). Participants evaluated withdrawal positively that has no side effect and cost, is easy to use and accessible, and increases sexual pleasure and intimacy. Most women agreed that husbands use withdrawal to protect their wife's health (76%). Women obtained contraceptive information primarily from gynecologists (42%), the internet (21%), midwives in public health centers (19%), and social networks (18%). "Side effects of modern methods" (37%), "fear of side effects" (16%), and "reduction in sexual pleasure" (14%) were the major reasons reported for using withdrawal. While 'side effects' was given mostly by women who alone or with their husband chose withdrawal (52%, 38%), 'reduction in sexual pleasure' and 'fear of side effects' were mostly reported by women whose husband was the sole decision maker in choosing withdrawal (28%, 25%). The 'fear of side effects' was reported mostly by women who had lower education (21%), used the internet for contraceptive information (23%), and whose husband alone chose withdrawal (25%). Cost of modern methods was a trivial reason for using withdrawal. Most withdrawal users (75%) would not switch to modern methods even if they were freely accessible. More educated women and their husbands would be less likely to switch to modern methods even they were provided freely (OR 0.28, CI 0.10–0.80; OR 0.20, CI 0.07–0.59). However, women who were using modern methods before, and those who alone chose withdrawal would be more likely to switch to modern methods (OR 6.4, CI 2.0–20.2; OR 3.4, CI 1.1–11.2). Access to regular contraceptive counselling and public health campaigns could help women to deal with fears of side effects of modern methods, learn their proper use, and to receive education on how to use withdrawal more effectively to avoid unintended pregnancies.

No association between dietary magnesium intake and body composition among Iranian adults: a cross-sectional study

PurposeObesity is becoming more prevalent worldwide. Magnesium (Mg) intake may play a role in the regulation of energy metabolism and body weight. Therefore, in this cross-sectional study, we aimed to investigate the association between dietary Mg intake and body composition among healthy adults.MethodsA total of 778 adult men and women aged 18–59 years who attended health care centers in Tehran, Iran, entered the final analysis. Dietary intake was assessed with a validated and reliable food frequency questionnaire with 168 items and the dietary Mg intake was estimated using Nutritionist IV software. Anthropometric measurements and blood samples were collected and body composition was evaluated employing the Body Mass Index (BMI), A Body Shape Index (ABSI), Body Adiposity Index (BAI), Body Roundness Index (BRI), Visceral Adiposity Index (VAI), Lipid Accumulation Index (LAP), and Triglyceride-Glucose index (TyG). Multiple linear regression analysis was used to determine the association of the dietary Mg intake with body composition indices.ResultsThe mean daily dietary Mg intake was 294 ± 140 mg in men and 262 ± 112 mg in women. Unadjusted linear regression showed that dietary magnesium intake is significantly associated with a waist to hip ratio (WHR) and total cholesterol (TC) in men, and hip circumference (HC) in women. After adjusting for potential confounders including age, education, marriage, occupation and smoking, total energy intake, and activity score, there remained no significant association between dietary Mg intake and any of the body composition indices including BMI, ABSI, BAI, BRI, VAI, LAP, and TyG neither in men nor women.ConclusionHigher Mg intake was not associated with anthropometric indices in Iranian adults, according to our findings. Additional observational studies would be beneficial in clarifying the existing findings.

A Comparison Study of the Tehran Norms to the Reference Norms on Children Performance of the Bayley III

ObjectivesThe Bayley Scales of Infant and Toddler Development (3rd ed.; Bayley III) are widely used to assess cognitive, language, and motor development of children aged 1–42 months. It is unclear whether or not the reference norms of the Bayley III are acceptable for use in other populations or lead to over- or underestimating the developmental status of target children. This study aimed to compare the Tehran norms to the reference norms.Materials & MethodsWe used Bayley III norms to assess cognitive, language, and motor development of 1,674 healthy children from health care centers in Tehran. Differences between the scaled scores were calculated based on the Tehran and reference norms. A one-sample multivariate analysis of variance (MANOVA) was used to control the mean difference scores over all subtests. When MANOVA showed significant differences between the scaled scores based on the Tehran and reference norms, we used univariate analysis to see which subtest and age group led to these significant differences. Finally, the proportions of children with low scores (scaled scores <7 or -1 SD and <4 or -2 SD) based on 2 norms were compared using the McNemar test to determine the over- or underestimation of developmental delay. ResultsThe scaled scores based on the Tehran norms varied across values based on the reference norms in all subtests. The mean differences were significant in all 5 subtests (p < .05) with large effect sizes for receptive and expressive communication, fine and gross motor subtests of .20, .23, .14, and .25, respectively, as well as with a small effect size for the cognition subtest of .02. Large effect sizes for all age groups were found for cognition, expressive communication, and fine motor subtests. More children scored below 1 and 2 SD using the Tehran norms. Using the reference norms resulted in underestimation of developmental delay regarding cognitive, receptive and expressive communication, and fine and gross motor skills.ConclusionPopulation-specific norms should be used to identify children with low scores for referral and intervention. The Tehran norms differed from the reference norms for all subtests, and these differences were clinically significant.

A Comparison Study of the Tehran Norms to the Reference Norms on Children Performance of the Bayley III.

ObjectivesThe present study aimed to compare the performance of Iranian Azeri-speaking children based on Iran and the reference of the Bayley Scales of Infant and Toddler Development Third Edition (Bayley III) norms. Materials & MethodsThe total sample included 248 infants and toddlers aged 16 days to 42 months and 15 days. The Iranian version of the Bayley III scale was used in this study. The scaled scores and composite scores in cognitive, language, and motor domains were compared based on Iran and reference Bayley III norms. Then, the proportions of children scoring < -1 standard deviation (SD) and < -2 SD were compared based on the two norms.ResultsThe scaled scores of the study group were higher based on the reference norms in receptive communication, fine motor, and gross motor subtests. The scaled scores were variable in expressive communication and cognitive subtests. The differences were significant for receptive communication and fine motor subtests (P<0.05). Using the reference norms instead of Iran norms resulted in under-referral regarding receptive communication and fine motor subtests. More children scored below 1 and 2 SD using Iran norms in comparison to those reported for using the reference norms. ConclusionIran norms differ significantly from the reference norms over two subscales. It is recommended to use population-specific norms to identify children with developmental delay and early intervention.

Healthy eating index and anthropometric status in young children: A cross-sectional study.

Weight status and growth during childhood are indicative of healthy development throughout the lifespan. Thus, understanding the influence of overall quality of diet and dietary patterns on anthropometric measures during childhood is critical to inform dietary recommendations. The current study used an updated version of the healthy eating index (HEI) to evaluate the association between overall diet quality and measures of childhood development in six-year-old children. This cross-sectional study was conducted across 788 six-year-old children referred to healthcare centers in Tehran, Iran. Anthropometric indices and dietary intake were evaluated using standard protocols and food frequency questionnaires, respectively. The HEI-2015 was used to evaluate participant diet quality. The total HEI-2015 score ranged from zero to 100 using the sum of thirteen food score components. Children in the highest tertile of HEI score had higher nutrient intakes and HEI-related food groups (p<0.05). Children within the highest tertile of HEI score compared to those within the lowest tertile were more likely to be overweight (OR: 1.45; 95% CI=1.01; 2.08). Findings presented in this study showed that HEI was not associated with a greater likelihood of obesity, underweight, severe underweight, and stunting. However, children in the highest tertile of HEI score were more likely to be overweight.

Comparison of various aspects of women\u2019s lives between infertile and women with and without tubal ligation: a comparative cross-sectional study

BackgroundThe aim of this study is to compare anxiety, depression, body image, self-esteem, sexual function, and quality of life (QoL) between infertile women and control fertile women undergoing tubal ligation (TL) and using condom.MethodsThis cross-sectional study was conducted on 600 women in three groups of infertile and control fertile women with or without TL (200 women in each group), who met the inclusion criteria. They were selected from Royan Institute and a number of health care centers in Tehran (Iran) from May 2017 to February 2019. The subjects were asked to fill out the Short Form Health Survey (SF-12), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale (HADS), Body Image Concern Inventory (BICI), and Rosenberg’ Self-Esteem Scale (RSES). One-way ANOVA was used to identify the possible statistical differences between the three groups of participants.ResultsThe mean scores of all FSFI domains were lower in the control TL women, and the differences between the three groups in all dimensions were statistically significant. In addition, the TL group had more female sexual dysfunction (FSD) comparing to the infertile and condom group (22.43 ± 5.30, 24.79 ± 4.74, and 28.03 ± 3.29, respectively P < 0.001). There was a significant difference between the three groups in SF-12 scores (76.59 ± 13.14, 68.49 ± 14.47, and 78.87 ± 12.62, respectively P < 0.001). Also there was a significant difference between the three groups in anxiety, depression, and total scores of HADS (P < 0.001). Furthermore, infertile women had lower body image (P < 0.05) and the TL group had lower self-esteem comparing to the two other groups (P < 0.05).ConclusionsThe findings revealed the adverse effects of using TL on the anxiety, depression, sexual life, body image, and QoL of women. It is recommended that health-care professionals should increase their awareness and knowledge regarding the side-effects of using TL on women’s lives and share this information with the patients.

How Much Iranian Parents Know of and How Well They Practice Regarding Antibiotics?

Irrational use of antibiotics as a global health concern has led to excessive treatment costs, failure of treatments, and antimicrobial resistance. Parents’ knowledge of and practice regarding antibiotics are two important factors contributing to the (ir) rational use of antibiotics. This study aimed to evaluate ill children’s parents’ knowledge and practice of prescribed antibiotics. Our subjects included only parents with children up to 12 (inclusive) years of age in Tehran, Iran’s capital. A prospective cross-sectional survey was conducted at 203 health care centers in Tehran. Parents’ knowledge was evaluated using a 37-item researcher-made questionnaire, and their practice about antibiotics was measured with a self-stated questionnaire, followed by an observational method to gain a real insight into their practice. SPSS 22 was used to analyze the data. A total of 401 randomly selected parents were enrolled in the study. The average score of parents’ knowledge of antibiotics regarding administration, indications, storage, and antimicrobial resistance was found to be 9.72 out of 17.00. In the self-stated method, an appropriate practice of antibiotic use was reported in 49.4% of participants who also got an average score of 3.95 points out of a total 8. In the observational method, most parents’ practice (68.4%) regarding antibiotic use was found to be acceptable; their average score was 5.93 points out of a total of 10. The findings of this study showed that half of the parents had adopted an acceptable practice regarding antibiotic use.

Knowledge, Attitude, and Practice Regarding Cardiovascular Diseases in Adults Attending Health Care Centers in Tehran, Iran.

BackgroundStudies on knowledge, attitude, and practice (KAP) can be valuable for public health to help in developing targeted educational programs and assessing the effectiveness of interventional programs.ObjectivesThis study was designed to determine the level of current knowledge, attitude, and practice (KAP) regarding cardiovascular diseases (CVDs), CVD risk factors and symptoms in adults attending health care centers in Tehran province.MethodsA cross-sectional study was performed using a self-administered questionnaire with score of 0 - 100 on adults aged > 20 years attending ten health care centers in Tehran province, Iran. Descriptive and multivariate logistic regression analyses were used in data analysis.ResultsA total of 300 adults (51.3% females) with a mean age of 39.71 ± 12.1 years participated in this study. The median (IQR) score for knowledge about CVD was 91.7 (16.7); approximately 80% of respondents’ awareness was highly satisfactory and hypertension was the commonest identified risk factor followed by obesity. Furthermore, the median (IQR) score for attitude was 89 (18); 70% of respondents had a highly satisfactory attitude about CVD. Regarding physical activity and nutrition/smoking behaviors, just 10.7% and 32% had highly satisfactory behavior, respectively. In the multivariate logistic regression analysis, attending university education and age ≥ 40 years were independent factors of a better level of CVD knowledge; attending university education, and having a family history of chronic disease were independent factors of a better level of CVD attitude. Regarding a higher physical activity behavior, being a man, and for a better nutrition & smoking behavior, attending university education were the only independent factors.ConclusionsAlthough more than half of the current study participants had high knowledge and attitude about CVD, their behaviors is not satisfactory. Therefore, it is necessary to establish more effective educational interventions aimed at promoting positive health behaviors and explaining to the public that knowledge and action regarding the reduction of risk factors are linked to reduced CVD and mortality.

A Preliminary Survey of Autism Knowledge and Attitude among Health Care Workers and Pediatricians in Tehran, Iran.

Autism spectrum disease (ASD) is not a common diagnosis for children presenting with neurodevelopmental delay before 36 months in Iran. Although recent years have witnessed improvements in diagnosis of pediatrics psychological disorders the role of referral system starting with health care workers (HCW) is not clear. Therefore, we aimed to investigate the common concepts about ASD among pediatricians and HCW. Pediatricians were randomly selected from four teaching hospital of Tehran University of Medical Sciences, Tehran, Iran in 2012-13. HCW were randomly selected from 3 urban health care centers in Tehran, Iran. DSM-IV TR criteria for ASD was used to assess knowledge. Participants were asked to rate sixteen statements on beliefs about autism to assess attitude. Overall, 122 pediatricians and 90 HCWs with mean ± SD age of 36±4.7 yr and 76.4% being female recruited. Pediatricians had significantly higher encounter with autistic patients (18% vs. 10%, P-value=0.06) and parents of autistic child (17% vs. 12%, P-value=0.07). But generally, 209 participants (98.6%) declared that they were familiar with autism. There was no statistically significant difference between study groups in rating DSM-IV TR criteria for ASD as "necessary for diagnosis". Age, gender and working experience, did not differ between pediatricians or HCW answers (all P-values >0.05). Among HCW participants, higher educational level was associated with higher disagreement about "autistic children is schizophrenic" (P=0.01). Moreover, HCW with higher working experience had higher agreement rate with "autistic children needs special education" statement (P= 0.04). There are still misconceptions about ASD regarding developmental, cognitive and emotional features in both HCW and pediatricians needed to be educated through national program.

Complications following Bacille Calmette-Guérin Vaccination in Children under the Age of 18 Months: A Multi-center Study

Background: The BCG vaccine, used since 1921 to prevent tuberculosis (TB), considered the world's most widely used vaccine. This study aimed to investigate the frequency and the type of complications associated with Bacillus Calmette-Guerin (BCG) vaccination in Iranian children. Materials and Methods This cross-sectional study conducted for 6months among children aged up to 18 months who presented to primary health care centers in Tehran (under supervision of all three Medical Universities of Tehran) for their routine vaccinations. All children had received BCG vaccination at birth. We investigated the occurrence of BCG complications through history taking from the parents and physical examination by the study physician. Complications categorized into four major groups: local, regional, remote, and generalized and the rate of occurrence compared between the two genders. Results: Finally, 14,095 children enrolled during the study period; 574 patients (4%) had experienced at least one complication following BCG vaccination. The most common complications were local side effects observed in 304 children (2.1%); followed by lymph node involvement detected in 270 children (1.9%). Lymph node involvement was more common in males (P<0.001) and axillary lymph nodes were the most common site of involvement. There was a significant increase in the frequency of lymph node involvement at age 18 months in comparison to 2 month old infants (odds ratio=7.76, P<0.001). Conclusion: We found local adverse reactions as the most common complication following BCG vaccination and age was an independent predictor for the time of presentation of post vaccination lymph node involvement. Disseminated BCG and Osteitis not observed among vaccinated children.

Development and validation of a knowledge, attitude, and practice questionnaire on nutrition-related cancer prevention for Iranian women.

Background:Designing cancer prevention programs needs information on knowledge, attitude, and practice of the community. Unfortunately, this information is not available in Iran.Materials and Methods:We developed a questionnaire (NUTCANKAPQ) to assess the knowledge, attitude, and practice of Iranian women regarding cancer prevention dietary habits. We recruited women who had referred to public health-care centers in Tehran, Iran. To assess validity, we applied face, content, and construct validity methods. We performed test–retest approaches to assess reliability, and internal consistency of the questionnaire was assessed through Cronbach's alpha and intraclass correlation coefficients (ICCs).Results:Qualitative content validity was carried out by an expert panel, and internal consistency was deemed satisfactory (Cronbach's alpha, >0.6). We also observed high reliability in the questionnaire (ICC = 0.85). The mean (± standard deviation) scores for knowledge, attitude, and practice of study participants were 28.3 (±14.1), 67.1 (±18.9), and 53.7 (±8.3), respectively. The result of exploratory factor analysis, Kaiser–Meyer–Olkin (KMO), implied that the model was reasonably fit (KMO > 0.6). The final questionnaire included seventy items.Conclusion:NUTCANKAPQ is a valid and reliable tool for the assessment of cancer-related nutrition knowledge, attitude, and practice among the Iranian population. Application of NUTCANKAPQ may provide important clues for policy-making and improvement of cancer prevention programs among the Iranian population.

Effectiveness of a Multi-Dimensional Group Counseling Program Based on the GATHER Approach on the Quality of Life in Surgically Menopausal Women.

ObjectivesSurgical menopause can influence women's quality of life in many aspects. This study was designed to assess the effectiveness of a multi-dimensional group counseling program based on the great clients, ask clients, tell clients, help clients, explain how to use, return for follow up (GATHER) approach, on quality of life in the surgically menopausal women.MethodsThis randomized clinical trial was conducted using two groups. The study comprised 78 women meeting inclusion criteria who had visited 4 healthcare centers in Tehran from December 2017 to September 2018. The participants were selected through simple random sampling (39 in each group). The intervention group underwent 6 consecutive weekly group counseling sessions based on GATHER approach, whereas the control group received no interventions. Data were collected using the Menopause-specific Quality of Life questionnaire at 4 time-points (i.e., baseline, immediately after the intervention, 1 month after the intervention, and 3 months after the intervention).ResultsThe trend of changes at four time-points obtained on the basis of repeated measures test results showed significant betweengroup differences in vasomotor (P = 0.001), psychosocial (P = 0.025), and physical (P = 0.001) domains. Friedman test showed significant between-group differences in the mean score trend of changes at 4 time-points in sexual (P = 0.002) and overall quality of life (P = 0.004) domains.ConclusionsOn the basis of the study results, implementation of this approach with less expenditure in healthcare centers aimed at improving quality of life in surgically menopausal women is highly recommended.

Lactating Mothers and Infants Residing in an Area with an Effective Salt Iodization Program Have No Need for Iodine Supplements: Results from a Double-Blind, Placebo-Controlled, Randomized Controlled Trial

The necessity of iodine supplementation in lactating mothers residing in countries with sustained salt iodization programs for iodine sufficiency of breast-fed infants remains unclear. The aims of this study were to investigate the effect of iodine supplementation on iodine status and growth parameters of lactating mothers and breast-fed infants and to compare these data with that of formula-feeding mothers and their infants during the first year of infancy. In this multicenter, double-blinded, randomized clinical trial conducted in four healthcare centers in Tehran (Iran), healthy lactating mothers and their term newborns aged 3-5 days were randomly assigned to treatment groups: placebo, 150 μg/day iodine, or 300 μg/day iodine. They were followed up for 12 months. Formula-fed infants aged 30-45 days and their mothers were randomly selected from the same centers. The primary outcomes were maternal and infant urinary iodine concentrations (UICs), breast-milk iodine concentrations (BMICs), and infant growth parameters, measured at 1, 2, 4, 6, 9, and 12 months during routine health visits. The formula-fed group was assessed at 2, 4, 6, 9, and 12 months of age. Analysis was by per protocol principle using mixed-effects models. Mother-newborn pairs (n = 180) in treatment groups and partially/exclusively formula-feeding mother-infant pairs (n = 60) participated between October 2014 and January 2016. Median baseline UICs in the treatment groups were 84 μg/L (interquartile range [IQR] 41-143 μg/L) in mothers and 208 μg/L (IQR 91-310 μg/L) in their infants. The values in the formula-fed group were 76 μg/L (IQR 40-144 μg/L) in mothers and 121 μg/L (IQR 66-243 μg/L) in infants. The 300 μg/day iodine group showed significantly higher UICs and BMICs than did the other treatment groups; infant UICs in the 150 μg/day iodine, placebo, and formula-fed groups were similar. Infants in all groups showed iodine sufficiency (median UIC ≥100 μg/L) throughout the study period. Anthropometric measurements were similar between the treatment and formula-fed groups over the study period, except at the last follow-up visit at 12 months. Supplementation of breast-feeding mothers with either 300 or 150 μg/day iodine improved their iodine status. However, the iodine status of infants in all groups studied indicated iodine sufficiency during the first year of infancy, demonstrating that in countries with effective salt iodization program, iodine supplementation for lactating mothers is unnecessary.

Psychometric Properties of a Developed Questionnaire to Assess Knowledge, Attitude and Practice Regarding Vitamin D (D-KAP-38).

The aim of this study was to develop a valid and reliable questionnaire to assess vitamin D-related knowledge, attitude and practices in Tehranian adults, who may be at increased risk of vitamin D deficiency. This study was conducted on 572 individuals, aged ≥20 years from public health care centers in Tehran, Iran. Based on results of a literature review and in-depth interviews, the 38-item vitamin D-related KAP questionnaire (D-KAP-38) with four subscales was developed: (1) general knowledge; (2) nutritional knowledge; (3) attitudes; (4) behaviors. Validity of the D-KAP-38 questionnaire was assessed, utilizing face, content, and construct validity methods. Internal consistency was calculated to assess reliability of the current developed questionnaire. A total of 572 (54.1% female) adults, aged 30.2 ± 7.9 years, participated in the study. All items were perceived as relevant and comprehendible by participants. Content validity was confirmed by a panel of experts. The internal consistency, as measured by Cronbach’s alpha coefficients, exceeded the minimum reliability standard of 0.60 for four subscales. Exploratory factor analysis suggested a four-factor construct and the results of the confirmatory factor analysis indicated acceptable fit indices for the proposed model. No ceiling effects were observed except for general knowledge (1.2%). Floor effects detected were 0%, 1.1%, 2.4%, and 8.7% for practice, attitude, general knowledge, and nutrition knowledge, respectively. General knowledge had the highest score (79.59 ± 14.52) and nutrition knowledge had the lowest (42.58 ± 20.40), among the four sub-scales. Results confirm the initial validity and reliability of D-KAP-38 questionnaire. Further investigations in different populations are recommended.

Effect of Acupressure on Early Complications of Menopause in Women Referring to Selected Health Care Centers.

Background:Menopausal period is accompanied by numerous disorders and complications. Nowadays, hormone therapy is the most effective existing method to treat these complications, but many women cannot undergo that due to the known potentiality of risk. So, the present study aimed to investigate the effect of acupressure on early complications of menopause.Materials and Methods:This is a blind random clinical trial conducted on 70 menopaused women referring to selected health care centers in Tehran who were qualified to enter the study. The subjects were randomly assigned to study (wearing a special acupressure wrist brace, three times a week for 15 min, in both bands on Shenmen and Sanyinjiao acupoints, in addition to receiving conventional menopausal care) and placebo (wearing a special acupressure wrist brace, three times a week for 15 min, but in a counter wise way, in addition to receiving conventional menopausal care) groups. Length of intervention was 4 weeks. Early complications of menopause were evaluated before intervention and 2 and 4 weeks after intervention in both groups. Data were analyzed by descriptive and inferential statistical methods.Results:The findings revealed a significant reduction in the number and severity of hot flashes, the number of night sweats, and state–trait anxiety severity (P < 0.001), but with regard to the severity of night sweats and trait anxiety, there was no significant difference between groups.Conclusions:With regard to the obtained results on the effect of acupressure on reduction of early menopausal complications, acupressure along with conventional menopausal care is suggested as one of the complementary medicine methods to improve the complications of this period.