Health Subjects Research Articles

Features of natural population movement in the Siberian Federal District during the coronavirus pandemic

The pandemic of a new corona virus infection (NCVI) has worsened the already unfavorable demographic situation in the Russian Federation. Aim of the study was to assess the changes in the demographic situation in the country and the Siberian Federal District and the causes contributing to them. Material and methods. Statistical data of the Ministry of Health of the Russian Federation, Rosstat, regional ministries of health of subjects belonging to the Siberian Federal District, and literature on the problems of demography were used. The following methods were used: analytical, historical, statistical, including statistical observation, summary and grouping of materials, absolute and relative statistical values, sampling. Results and discussion. The pandemic period of the new coronavirus infection in RF and SFD is characterized by a substantial increase in the mortality rate, which became the maximum in the newest history of Russia, i.e. since 1991. The structure of the main causes of death has changed. Diseases of the circulatory system, neoplasms, diseases of the digestive organs and external causes, accounted for 76.6 % of all causes in 2019, in 2021 they accounted for only 60.1 %, with NCVI taking second place among causes of death (19.1 %). The birth rate remains at a low level, and in 2021 was 9.6 per 1000 population, which is 16.5 % lower than in 2017, due to which the natural decline in population has significantly increased (to –6.3 in Russia and to –7.0 per 1000 population in SFD) and the average life expectancy has decreased. Conclusions. All of the foregoing points to the ineffectiveness of measures to prevent and forestall the adverse effects of the pandemic, which is practically inevitable in the case of new, poorly studied infectious diseases. The measures taken to organize medical care to the population in the conditions of the pandemic have not been adequate. This is evidenced by the higher rates of total mortality of the population, compared to the probable ones (caused by the increase in mortality from NCVI), a significant increase in natural population decline and a reduction in life expectancy.

Impact on quality of life caused by vitamin D deficiency in bariatric patients: a literature review

Introduction: Bariatric surgery is a procedure performed to control obesity and its associated morbidities. Surgeries with malabsorptive and mixed techniques cause a deficit in the absorption of micronutrients, including vitamin D. Objective: The objective of this literature review was to investigate studies that verified the impact of vitamin D deficiency on the preand postoperative quality of life of individuals undergoing bariatric surgery. Methods: The search strategy was carried out in the virtual databases PubMed, Scielo, LILACS, Scopus, Web of Science, Embase, and the Virtual Health Library, in addition to gray literature such as Google Scholar, OpenGrey, Ibict/BDTD (Brazilian digital library of theses and dissertations) and ProQuest using the Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS) descriptors with Boolean logical operators (AND, OR and NOT. The studies considered potentially eligible were those that presented in the same article the levels of vitamin D in the pre and postoperative period of the individuals, as well as the effect generated on their quality of life from where the data collection and analysis of the main outcomes found were made. Results: The online search resulted in 197 studies located in the virtual bibliographic databases and 115 in the gray literature. After removing the duplicates, 235 articles remained that were read by title and abstract, and 12 articles were chosen for reading the full text, leaving 7 that met the inclusion criteria. In most of the included studies, vitamin D deficiency was higher preoperatively than postoperatively in bariatric individuals. Better levels of 25(OH)D were correlated with reduced body weight, decreased BMI, and improved glycemic profile. Conclusion: Combating obesity remains an important issue in Public Health, with bariatric surgery being a safe way to reduce overweight since vitamin D levels are lower in the postoperative period of bariatric individuals, however, it is suggested to choose the appropriate technique to maintain ideal vitamin indices.

Digital health literacy in schools: new tools, empirical findings and implications for interventions

Abstract Children and youth are important populations to receive education and training on digital health literacy, while digital health literacy has recently increased attention as an important determinant of child and adolescent health. Albeit schools are the best equipped settings to enhance health-related competencies and digital literacy capacities of children and adolescents, the uptake of digital health literacy by European schools is still in its infancy and progresses somewhat slowly. Reasons are that digital health literacy is a relatively new topic in education, an overcrowded curriculum, lacking training opportunities for teachers on the subject, economic constraints and poor digital health policies for the education sector, and limited knowledge about the digital health literacy needs of schoolchildren, teachers, and schools, as well as missing evidence needed to inform these issues. A new project on digital health literacy in schools in Germany seeks out to close some of these gaps by conducting two large-scale surveys among secondary schoolchildren and teachers. New measurement tools have been developed and used to generate first time data on digital health literacy in schools, not only assessing personal capacities of schoolchildren and teachers but of learning opportunities and instructions concerning digital health literacy teaching and learning provided in schools. These findings will inform future tailored educational programs, public health interventions, and health and education policies in order to enable the uptake of digital health literacy in education, schools, and teacher training.

Lead Exposure Survey Tool (LEST): A methodological approach to highlight the invisible lead poisoning

Lead is the most common heavy metal found in the Earth's crust. Lead has been widely dispersed and incorporated in the natural world since prehistoric times. In the majority of wealthy countries, the amount of lead entering the atmosphere has been significantly reduced. Acute lead exposure becomes relatively low, but chronic lead exposure remains a substantial public health hazard. Disadvantaged people, are developing and industrializing countries in the Middle East and North Africa (MENA). Between 1981 and 2018, a comprehensive literature search was undertaken in the PubMed and Scopus databases. All studies were evaluated equally based on predetermined inclusion and exclusion criteria. The Delphi method was used to identify numerous resources of lead pollutants. The Mixed Method Appraisal Tool (MMAT) was used to evaluate the quality of identified papers for inclusion in the systematic review synthesis. The studies and sources of lead toxicology were further evaluated using a scale of evidence to establish the degree of evidence based on SIGN & GRADE standards. There were 14 genres and 82 subgenres identified. Through a comprehensive analysis, our cohort developed an exposure survey tool that takes into account the local sociocultural aspects of MENA countries, which will serve as a resource forresearchers,medical toxicologists, and public health professionals in the MENA region to enhance early detection of potential subjects, conduct further studies and implement exposure prevention strategies.•There is no single tool available to detect the invisible lead poison. Lead poisoning is a serious public health problem that can have devastating consequences.•The tool, called the Lead Exposure Survey Tool (LEST), uses a combination of but not limited to data sources, including blood lead levels, environmental lead levels, and demographic information, to identify subjects who are at risk of lead poisoning. LEST is a powerful tool that can help to improve early detection and prevention of lead poisoning.•The development of LEST is a major breakthrough in the fight against lead poisoning. This tool has the potential to save lives and improve the health of high risk subjects around the world.

Digitalization of Prenatal Healthcare System with SMS Notification for the Health Centers in Negros Occidental

The main objective of this study was to develop a web-based, mobile-responsive information management system for the health centers in the province of Negros Occidental (Western Visayas, Philippines). For this purpose, the constructive research approach was used, including data collection methods such as face-to-face interviews, observation of the current workflow, and analysis of the existing records, forms, and other relevant references. Rapid Application Development (RAD) guided the development process. The system is focused on providing an information management system including the following features: record management, report generation, SMS notification, and user account management. After the development, the system was assessed by three experts. The results showed that the system allowed the subject health centers to have a prenatal check-up record management, report generation module, personal prenatal journals, and a check-up schedule reminder. The overall score of the evaluation was 2.55, which implies that the system performs acceptably under the eight factors used to evaluate the system performance.

Comparison of immunoexpression of dendritic cells, mast cells and blood vessels in periodontal disease between adults and elderly.

The aim of this study was to compare, in adults and elderly individuals, the immunoexpression of immature and mature dendritic cells (DCs), mast cells, and blood vessels in healthy and diseased gingival tissues. The expressions of immunohistochemical markers, including CD1a (immature dendritic cells), CD83 (mature dendritic cells), tryptase (mast cells) and CD34 (blood vessels), were analyzed in gingival biopsies from elderly (n = 27) and adult (n = 127) patients presenting health, gingivitis and periodontitis. Positive cells for each specimen and marker were counted. There were no differences in the immunostaining of DCs, mast cells and the amount of blood vessels among gingival biopsies with health, gingivitis and periodontitis in adult and elderly subjects (p > 0.05). Immature DCs were more frequent in tissues with gingivitis and periodontitis in elderly patients, when compared to adults (p < 0.05). Furthermore, degranulated mast cell counts were higher, whereas the number of microvessels was lower in gingivitis in the elderly, when compared to adults (p < 0.05). Diseased periodontal sites in the elderly present an overall significant overexpression of immature DCs and degranulated mast cells, in relation to those of adults. Furthermore, gingivitis in elderly is associated with decreased microvessel growth. These immunoinflammatory differences between elderly and adults may have implications in periodontal tissue breakdown in the late adulthood. Further studies should be performed to elucidate this hypothesis. Understading the relationship between aging and changes in immune cells during periodontal inflammation may lead to therapeutic targets for the future management of periodontal diseases.

Associations between maternal health literacy, neonatal health and breastfeeding outcomes in the early postpartum period.

Maternal health literacy is a social skill that is relevant to successful postnatal newborn adaptation, neonatal feeding, and neonatal health outcomes, given the importance of maternal health literacy in newborn healthcare. The study aims to identify and assess the associations between maternal health literacy, neonatal health, and breastfeeding outcomes during the early postpartum period. Five hundred women who gave birth to full-term newborns at Vilnius University Hospital were invited to the study from 1 May to 30 September 2022. The 47 questions of the European Health Literacy Questionnaire (HLS-EU-Q47) were used to assess maternal health literacy on days 2 and 3 after birth. Each subject's health literacy indices were divided into four categories: inadequate, problematic, sufficient, and excellent. The neonatal health indicators were birth weight and height, along with the APGAR score and the outcomes of feeding either exclusively with breast milk or with adapted formula in addition to breastfeeding. Most women who participated in the survey had insufficient or problematic health literacy (69%). The study showed that women's higher health literacy is associated with a lower risk of obesity, a healthier diet, regular physical activity, and a higher birth weight and height of their newborns (p<0.05). Mothers with inadequate/problematic health literacy were more likely to feed their newborns with adapted formula in addition to breastfeeding. Women's health literacy is a factor that affects women's healthy lifestyle choices before and during pregnancy and is significant for newborns' health indicators.

Daily consumption of galactooligosaccharide gummies ameliorates constipation symptoms, gut dysbiosis, degree of depression and quality of life among sedentary university teaching staff: A double-blind randomized placebo control clinical trial.

Functional constipation affects approximately 10% of the Indian population and may reduce the quality of life (QOL)and increase gut dysbiosis. PURPOSEOF STUDY: The study aimed at assessing the impact of galactooligosaccharide (GOS) gummy supplementation on gut health, depression status and QOL of constipated subjects. A double-blind placebo control clinical trial (CTRI/2021/10/037474) was conducted on sedentary constipated adults (n = 35), who were split into an experimental group (n = 17) and a control group (n = 18), supplemented with 10g GOS and sugar gummies, respectively, for 30days. Relative abundance of fecal gut microbes, including Bifidobacterium, Lactobacillus, Clostridium and Bacteroides and phyla Bacteroidetes and Firmicutes using real-time polymerase chain reaction and short-chain fatty acids, was analyzed pre and post supplementation. Constipation profile was studied using Rome IV criteria and the Bristol stool chart. Depression status was studied using the Becks Depression Inventory. TheQOL was assessed using patient assessment of constipation. GOS gummy supplementation increased Bifidobacterium and Lactobacillus by 1230% and 322%, respectively, (p < 0.001; p < 0.01) with reduced Clostridium by 63%, phylum Firmicutes by 73% and Bacteroidetes by 85% (p < 0.01). The GOS-supplemented group demonstrated a higher F/B ratio (4.2) indicating improved gut health (p < 0.01) with reduced gut dysbiosis and constipation severity. GOS gummies enhanced acetic acid and butyric acid levels compared to the control group (p < 0.01; p < 0.001). Post supplementation, there was 40% reduction in depression (p < 0.01) and 22% improvement in QOL (p < 0.05). This research validates the predicted beneficial benefits of short-term GOS consumption on constipation profile, gut microflora, depression status and quality of life of constipated subjects.

Post-COVID-19 cholangiopathy: Systematic review.

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on global health, primarily characterized by severe respiratory illness. However, emerging evidence suggests that COVID-19 can also lead to secondary sclerosing cholangitis (SC), referred to as post-COVID-19 cholangiopathy. To synthesize currently reported cases to assess the current state of knowledge on post-COVID-19 cholangiopathy. Medical Subject Headings and Health Sciences Descriptors were used to retrieve relevant studies, which were combined using Boolean operators. Searches were conducted on electronic databases including Scopus, Web of Science, and MEDLINE (PubMed). Studies published in English, Spanish, or Portuguese were included, with no restrictions on the publication date. Additionally, the reference lists of retrieved studies were manually searched. Simple descriptive analyses were used to summarize the results. Then the data were extracted and assessed based on Reference Citation Analysis (https://www.referencecitationanalysis.com/). The initial search yielded a total of 192 articles. After screening, 85 articles were excluded due to duplication, leaving 107 articles for further review. Of these, 63 full-length articles met the inclusion criteria and were included in the analyses. Most of the patients were male and exhibited elevated liver function tests (93.8%). Magnetic resonance imaging revealed duct thickening with contrast enhancement (47.7%), as well as beading of the intrahepatic ducts (45.7%) with peribiliary contrast enhancement on diffusion (28.7%). Liver biopsy results confirmed SC in most cases (74.4%). Sixteen patients underwent liver transplantation, with three experiencing successful outcomes. Post-COVID-19 cholangiopathy is a serious condition that is expected to become increasingly concerning in the coming years, particularly considering long COVID syndromes. Although liver transplantation has been proposed as a potential treatment option, more research is necessary to establish its efficacy and explore other potential treatments.

Citrus Extract High in Flavonoids Beneficially Alters Intestinal Metabolic Responses in Subjects with Features of Metabolic Syndrome.

The objective of this study was to investigate the effects of a citrus extract rich in citrus flavonoids on intestinal metabolic responses in subjects with features of metabolic syndrome, in an in vitro colon fermentation system (TIM-2) and fecal samples obtained from human subjects in an in vivo trial. In the TIM-2 system inoculated with fecal samples of volunteers with features of metabolic syndrome, continuous citrus extract supplementation (500 mg/day) resulted in increased cumulative short-chain fatty acid (SCFA) levels compared to the control condition, which was mainly due to increased production of butyrate, acetate, and valerate. In human volunteers, 12 weeks of daily supplementation with 500 mg citrus extract resulted in a significant shift in the SCFA profile towards more butyrate (p = 0.022) compared to the placebo group. Furthermore, there was a trend towards a reduction in fecal calprotectin levels, a marker for intestinal inflammation, compared to the placebo (p = 0.058). Together, these results suggest that citrus extract intake may have a positive effect on intestinal metabolic responses and through this, on host health in subjects with features of metabolic syndrome. Further research is needed to provide more insight into the potential underlying mechanisms and to study effects on clinical parameters.

The immediate impact of a balanced, very low-calorie diet on the metabolic health of Indian subjects - A prospective longitudinal study

Problems consideredGlobal challenges posed by obesity, type 2 diabetes mellitus (T2DM), hypertension, and related metabolic diseases necessitate effective interventions. Pharmacotherapy often falls short, leading to a demand for innovative approaches. This study delves into the effects of an organized diet featuring a readily available food substitute blend over an eight-week span. MethodsThe study implemented a low-calorie diet (800–830 calories), comprising three shakes, non-starchy vegetables, soups, reduced buttermilk, and limited fat. Assessments covered NCDs like T2DM, hypertension, dyslipidemia, and non-alcoholic fatty liver disease. WHO STEPS protocol guided anthropometric measures and blood pressure readings, while INBODY 230 Analyser determined body composition. SPSS 16 software facilitated analysis of baseline and two-month follow-up data. ResultsParticipants with an average baseline BMI of 31.9 kg/m2 witnessed substantial improvements. Weight, BMI, waist and hip circumferences, neck, arm, and thigh circumferences, and body fat percentage registered significant decreases. Positive changes were observed in diabetes indicators, including reduced HbA1c (7.2%–6.1%) and fasting/post-prandial blood glucose (p < 0.001). Noteworthy enhancements extended to blood pressure, triglycerides, and NAFLD markers (p < 0.001), indicating favorable shifts in obesity-related markers and metabolic irregularities. ConclusionThe study underscores the potential of reversal diet in real-world clinical settings, offering promise in ameliorating metabolic disorders linked to obesity. Intriguingly, these benefits extended to individuals of South Asian region, accentuating its broad relevance. However, sustaining these improvements necessitates further exploration through extended interventions with larger participant cohorts. The findings kindle optimism in addressing mounting burden of metabolic diseases on a global scale.

Health effects of 100% fruit and vegetable juices: evidence from human subject intervention studies.

The health effects of 100% fruit and vegetable juices (FVJ) represent a controversial topic. FVJ contain notable amounts of free sugars, but also vitamins, minerals, and secondary compounds with proven biological activities like (poly)phenols and carotenoids. The review aimed to shed light on the potential impact of 100% FVJ on human subject health, comprehensively assessing the role each type of juice may have in specific health outcomes for a particular target population, as reported in dietary interventions. The effects of a wide range of FVJ (orange, grapefruit, mandarin, lemon, apple, white, red, and Concord grapes, pomegranate, cranberry, chokeberry, blueberry, other minor berries, sweet and tart cherry, plum, tomato, carrot, beetroot, and watermelon, among others) were evaluated on a series of outcomes (anthropometric parameters, body composition, blood pressure and vascular function, lipid profile, glucose homeostasis, biomarkers of inflammation and oxidative stress, cognitive function, exercise performance, gut microbiota composition and bacterial infections), providing a thorough picture of the contribution of each FVJ to a health outcome. Some juices demonstrated their ability to exert potential preventive effects on some outcomes while others on other health outcomes, emphasising how the differential composition in bioactive compounds defines juice effects. Research gaps and future prospects were discussed. Although 100% FVJ appear to have beneficial effects on some cardiometabolic health outcomes, cognition and exercise performance, or neutral effects on anthropometric parameters and body composition, further efforts are needed to better understand the impact of 100% FVJ on human subject health.

Cardiometabolic benefits of Lacticaseibacillus paracasei 8700:2: A randomized double-blind placebo-controlled trial

Modulating microbial metabolism via probiotic supplementation has been proposed as an attractive strategy for the prevention of cardiometabolic diseases. Recently, Lacticaseibacillus paracasei (L.paracasei) was reported to alleviate metabolic disorders in murine models, however, its beneficial effects in humans remain to be determined. This study evaluated whether L.paracasei supplementation could improve endothelial function and cardiometabolic health in subjects with metabolic syndrome (MetS). In this randomized, double-blind and placebo-controlled trial among 130 participants with MetS, subjects were randomly assigned to placebo or L.paracasei 8700: 2 (10 billion CFU) daily for 12 weeks. Endothelial function was measured by flow-mediated slowing, and cardiometabolic health was determined by both components and severity of MetS. Ideal compliance was defined as consumption no less than 70% of the capsules. 130 individuals (mean [SD] age, 45.97 [7.11] years; 95 men [73.1%]) were enrolled and randomized to L.paracasei (n=66) or placebo control (n=64). Compared to placebo, L.paracasei supplementation led to a greater reduction in remnant cholesterol (-0.16mmol/L, 95%CI:-0.29mmol/L to-0.02mmol/L; P=0.024). Such a reduction in remnant cholesterol was significantly associated with improvement in endothelial function (r=-0.23, P=0.027). In subjects with an ideal compliance with trial protocol, L.paracasei treatment additionally lowered triglycerides, alleviated MetS severity and delayed weight gain. On the contrary, no obvious effect on insulin sensitivity or pancreatic beta-cell function was observed after L.paracasei intervention. Moreover, regarding safety and tolerability, no significant between-group difference in protocol-specified adverse events of interest was observed. L.paracasei supplementation enhanced endothelial function potentially through downregulating remnant cholesterol levels. Our study provides a feasible and safe strategy for the prevention of cardiometabolic diseases in subjects with severe dyslipidemia and endothelial dysfunction. Under ClinicalTrails.gov identifier NCT05005754.

Primary school Physical Education (PE) specialist teachers’ experiences of teaching Health Education and Physical Education

The purpose of this paper was to extend understanding of the studied phenomenon: primary school Physical Education (PE) specialist teachers’ experiences of teaching Health Education and Physical Education within the Learning Area Health and Physical Education (HPE) in their schools. Figurational sociology guided the research, which employed an explanatory sequential mixed methodology consisting of an online survey with 94 participants, followed by semi-structured interviews with 11 purposively sampled participants. Survey data indicated participants perceived their students undertook approximately one hour of HPE each week, except for Kindergarten students, who completed just over 40 minutes. This is less than the notional 80 hours a year recommended for delivering the subjects Health Education (HE) and Physical Education (PE) within the Australian Curriculum. Participants perceived HPE delivery in their primary schools was predominantly PE focused, and therefore, HE was ‘falling between the cracks’. Thematic analysis of the interview data led to the identification of themes reflecting specialist teachers’ perceptions of HE being the remit of class teachers, marginalised due to a crowded curriculum and lack of collaboration between PE specialists and classroom teachers. There is significant scope for HE not to be taught or not be taught well in the primary schools represented in the data provided by participants in this study. Improved collaboration between class teachers and PE teachers, increased support and prioritisation from senior staff (e.g. principals) and increased HE professional learning opportunities for class teachers are required.

Deciphering the human urine matrix: a new approach to simultaneously quantify the main ions and organic compounds by ion chromatography/mass spectrometry (IC-MS).

Analyzing the composition of (human) urine plays a major role in the fields of biology and medicine. Organic molecules (such as urea, creatine) and ions (such as chloride, sulfate) are the major compounds present in urine, the quantification of which allows for the diagnosis of a subject's health condition. Various analytical methods have been reported for studying urine components and validated on the basis of known and referenced compounds. The present work introduces a new method able to simultaneously determine both major organic molecules and ions contained in urine, by combining ion chromatography using a conductimetric detector with mass spectroscopy. The analysis of organic and ionized compounds (anionic and cationic) was achieved in double injections. For quantification, the standard addition method was used. Human urine samples were pre-treated (diluted and filtered) for IC-CD/MS analysis. The analytes were separated in 35 min. Calibration ranges (0-20 mg.L-1) and correlation coefficients (> 99.3%) as well as detection (LODs < 0.75 mg.L-1) and quantification (LOQs < 2.59 mg.L-1) limits were obtained for the main organic molecules (lactic, hippuric, citric, uric, oxalic acids, urea, creatine, and creatinine) and ions (chloride, sulfate, phosphate, sodium, ammonium, potassium, calcium, and magnesium) contained in urine. The intra- and inter-day accuracies of the analytes consistently ranged from 0.1 to 5.0%, and the precision was within 4.0%. For all analytes, no significant matrix effects were observed, and recoveries ranged from 94.9 to 102.6%. Finally, quantitative results of analytes were obtained from 10 different human urine samples.

Effect of Resistance Exercise in Postmastectomy Breast Cancer Survivors: A Systematic Review

Background: Breast cancer (BC) impacts over 1.2 million individuals every year worldwide and is the most frequently diagnosed illness in women. Medical treatment options have increased chances of survival, but these procedures frequently have side effects that can negatively impact health status and quality of life (QoL) over the long term QoL. Given that resistance exercise has a special anabolic effect; it may be useful for addressing the effects of BC and its therapy. Materials and Methods: This is an integrative literature review study that includes data search from PubMed, MEDLINE, Scopus, Google Scholar, and the physiotherapy evidence database databases for articles and also crossing English descriptors indexed in the medical subject headings and health sciences descriptors, respectively. The present review is based on the Whittemore and Knafl methodology. Results: A total of 842 patients from 13 studies were included. There was no aggravation subjectively reported or objectively evaluated lymphedema symptoms. Adverse effects were uncommon, mostly of a musculoskeletal in nature, and were successfully handled using conservative methods. The studies we looked at indicate that women who had BC surgically treated can benefit from resistance exercise in terms of their clinical and health outcomes. Results demonstrate that in cancer survivors, pain, physical and emotional functioning, fatigue, depression, and aerobic capacity have improved. Conclusion: It is necessary to conduct rigorously constructed randomized controlled trials (RCTs) that recommend targeted resistance exercise regimens at various stages of BC treatment. To demonstrate the effectiveness of this intervention for the posttreatment care of BC patients and survivors as a method of enhancing health status and QoL, RCTs with complete, standardized reporting of interventions, and adverse events are necessary.

Mediterranean diet and psychological well-being intervention to reverse metabolic syndrome in Chile (CHILEMED trial)

Psychosocial status and lifestyle are key risk factors of non-communicable diseases (NCDs), which, in turn, are main drivers of healthcare costs and morbimortality worldwide, including Chile. Mediterranean diet (MedDiet) is one of the healthiest dietary patterns under study. However, its impact on high-risk conditions, such as metabolic syndrome (MetS), and NCDs outside the Mediterranean Basin remains mostly unexplored. Even though Central Chile has an environment, food production, and culinary traditions comparable to those present in Mediterranean countries, few studies -some with significant methodological limitations- have evaluated the effect of MedDiet on health and/or disease in Chilean subjects. Importantly, a Mediterranean lifestyle is a modus vivendi that integrates physical health with mental and social well-being. Psychological well-being (PWB) is associated with healthy behaviors, positive health outcomes, and longevity, thereby emerging as a novel healthcare goal. We report here an ongoing randomized controlled clinical trial in Chilean patients with MetS seeking to test whether (1) a PWB theory-based intervention facilitates induction to and increases long-term adherence to a locally adapted MedDiet, and (2) a MedDiet intervention -implemented alone or combined with well-being promotion- is more effective at reversing MetS compared to individuals following a low-fat diet without psychological support. The CHILEan MEDiterranean (CHILEMED) diet intervention study is a 1-year trial including patients with MetS living in Chile. Participants will be assigned randomly by a computer-generated random number sequence to one of the three intervention arms: a) low-fat diet as control group, b) MedDiet alone, and c) MedDiet plus well-being support. Patients will be followed-up by individual and/or group online nutritional sessions or phone cal as well as 6- and 12-month in-person re-assessment of medical history, medication use, food intake, PWB, anthropometrics/physical exam, and blood collection for laboratory analysis. The primary outcome of the trial will be the effect of the MedDiet -with or without PWB intervention- on overall reversal of MetS compared to low-fat diet alone. Based on a statistical superiority trial, expected impact, and patient loss, the estimated study sample is 339 subjects (113 individuals per arm in 3 equal-sized groups). Currently, we have enrolled 179 patients, predominantly women, evenly distributed by age (group means ranging from 45.7 to 48,9 years-old), 3/4 are obese with almost all of them showing abdominal obesity, 70% are hypertensive, whereas <10% exhibit diabetes. If findings turn out as expected (e.g., MedDiet -with or without PWB intervention- is better than the low-fat diet for reversion of MetS at 1-year follow-up), CHILEMED will provide further beneficial evidence of the MedDiet on NCD risk conditions beyond the Mediterranean region.

High-risk Behaviors in Sex-Reassigned Trans-sexual People in Tehran, Iran

Background: Abundant high-risk behaviors in trans-sexual people make it necessary to investigate. Objectives: This study aimed to describe the frequency of high-risk sexual behaviors in sex-reassigned trans-sexual people in Tehran, Iran. Materials and Methods: This study was cross-sectional. Ninety-six sex-reassigned transsexual individuals of both genders presenting to Salamat Bonyan Psychology Clinic were enrolled in the study. The scales included a demographic characteristic form and a researcher-made questionnaire to evaluate high-risk behaviors and sexual health of sex-reassigned transsexual subjects. Results: According to the results, 96 individuals completed hormone therapy, of whom 43 underwent sex-reassignment surgery. Also, 73 persons were female-to-male, and 23 persons were male-to-female. In this study, 62.5% of the participants did not receive hepatitis B vaccine (CI: 0.52 - 0.72), and 95.83% of the participants did not receive human papillomavirus vaccine (CI: 0.92 - 0.99). Moreover, 87.09% of the participants did not take a human infection virus (HIV) test (CI: 0.68 - 0.85), and 97.9% had a Pap smear test (CI: 0.95 - 0.99). In addition, 96% of the participants were never screened for prostate cancer (CI: 0.89 - 0.99), and 91.66% were never screened for breast cancer (CI: 0.86 - 0.97). Oral sex was the most common sexual act (93.75%), and 72.91% of the subjects never used condoms (CI: 0.68 - 0.77). Finally, 30% of the participants smoked hookah and cigarettes and used alcohol (CI: 0.20 - 0.39). Conclusions: Considering high-risk behaviors and sexually risky behaviors in this group, it is necessary to carry out preventive interventions.

Evaluation of brewers’ spent grain on cardiovascular disease risk factors in adults: Lessons learned from a pilot study

The beer industry generates large amounts of leftover barley called brewers’ spent grain (BSG). Fiber-rich grains like barley are associated with ameliorating cardiovascular disease (CVD) risk factors. This randomized pilot study investigated the influence of daily BSG consumption for 8 weeks on lipid profiles, inflammation, and metabolic functions in healthy adults. Subjects (n = 37, 26 ± 4 y; BMI 23 ± 3 kg/m2) received muffins containing 8.3 g BSG or 0 g BSG daily for 8 weeks. Body composition, blood pressure, and fasting blood were collected at baseline and week 8. Gastrointestinal symptoms and Bristol stool scale ratings remained stable throughout the study in both groups. Dietary fiber intake increased in the BSG group (5 g/day; 26%; p = 0.003); however, there were no significant between-group effects on blood lipids, glucose, insulin sensitivity, C-reactive protein, body composition, or blood pressure. Consuming 8.3 g BSG for 8 weeks is well tolerated and improves dietary fiber intake but does not significantly impact CVD risk factors in this sample of healthy adults. Subject health status, sample size, and BSG flour substitution rate may support the lack of effect in the current study. Larger controlled trials are needed to understand the potential of BSG as a value-added ingredient and its impact on human health.

Efficacy of Stress Inoculation Training on General Health of the Mothers of Blind Children

ABSTRACT The aim of the current study was to investigate the influence of stress inoculation training (SIT) on the general health of mothers of children with visual impairments. The study population included the mothers of children with visual impairments aged 33–45 years during 2018–2019 academic year in Isfahan city. The participants were 34 mothers selected by convenient sampling method from Shahid Samani and Shahid Abedi schools. They were randomly divided into experimental (n = 17) and control (n = 17) groups. The experimental group received SIT in 10 sessions, while the control group did not. The instrument of study was General Health Questionnaire (Goldberg and Hiller, 1979). Data were analysed by using MANCOVA. The results indicated that the SIT had a significant effect on post-test scores of general health (P < 0.0001) in subjects. Based on these findings, SIT plays a critical role in the general health of the mothers of children with visual impairments.