Iranian Adolescents Research Articles

The relationship between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status in adolescents with overweight and obesity: results from a cross-sectional study in Iran.

Few studies investigated the association between Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and metabolic health status, particularly among adolescents. The present study was designed to investigate the association of MIND diet with metabolic health status in Iranian adolescents with overweight/obesity. This cross-sectional study was done among 203 adolescents with overweight/obesity (12-18 years) in Isfahan, Iran. A validated FFQ was applied to collect dietary intakes. Anthropometric indices and blood pressure were also measured by standard procedures. Fasting blood samples were obtained to determine serum insulin, glucose and lipid profile. To categorise participants as being with metabolically healthy overweight/obesity (MHO) or metabolically unhealthy overweight/obesity (MUO), two methods including International Diabetes Federation (IDF) criteria and IDF plus Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) were applied. Participants had a mean age of 13·98 years and 50·2 % of them were girls. In fully adjusted models, participants with highest MIND diet adherence had lower odds of MUO status based on IDF (OR = 0·20; 95 % CI 0·08, 0·51) and IDF/HOMA-IR (OR = 0·22; 95 % CI 0·08, 0·59) criteria. Stratified analyses revealed that this association was stronger among girls and was only significant among individuals with overweight. An inverse association was also found between MIND diet score and odds of hyperglycaemia and insulin resistance (IR). Higher MIND diet adherence was associated with lower odds MUO in adolescents with overweight/obesity. Inverse associations were also found between MIND diet and odds of hyperglycaemia and IR. Future longitudinal prospective studies are necessary to confirm our results.

Sensory Processing Measure Tools for Adolescents Aged 12 to 21 Years

Background and Objectives: Impairment in the way of sensory information by the central nervous system can cause functional problems in all areas of an adolescent’s activities, including education, self-care, social participation, and leisure. Therefore, in the presence of problems in such activities, it is necessary to evaluate and screen for sensory processing. In the present study, the sensory processing assessment tools that cover the adolescent age group were investigated. Methods: In this review, PubMed, Science Direct, Google, OTseeker, and Google Scholar databases were searched, and articles published between 2000 and 2022 on sensory processing assessment tools in adolescents and their psychometrics were selected. Keywords used included sensory integration dysfunction (SID), sensory processing disorder (SPD), adolescence, adolescent, assessment, measurement, reliability, validity, psychometry, environment, scale, and instrument. Results: The assessment tools identified to evaluate sensory processing in the adolescent age group include the “adolescent/adult sensory profile” (AASP), “Glasgow sensory questionnaire” (GSQ), “sensory processing measure (SPM)”, “sensory response in autism spectrum” (SR-AS) questionnaire, “sensory processing scale” (SPS), and “SPM-second edition” (SPM-2). Conclusion: The environment was considered as a factor that needs to be evaluated only in the second version of the SPM among the selected tools. The results of this review also showed that the only tool available in Persian in this field is the AASP, which does not seem to be a suitable tool for use in adolescence because the population studied in the psychometric evaluation of the Persian version was elderly people with dementia. Therefore, it seems necessary to prepare the Persian version and psychometric evaluation of an appropriate assessment tool for evaluating the sensory processing of Iranian adolescents.

Effect of malocclusion severity on oral health and its correlation with socioeconomical status in Iranian adolescents

BackgroundThis study aimed to assess the effect of malocclusion severity according to the Index of Treatment Need (IOTN) on oral health (dental caries and gingivitis), and its correlation with socioeconomic status (SES) in Iranian adolescents.MethodsThis descriptive cross-sectional study was conducted on adolescents between 10 and 16 years in Tehran city, who underwent clinical dental examination. The Dental Health Component (DHC) of the IOTN was used to assess the severity of malocclusion. The DMFT index was calculated to assess dental caries, and the gingival index (GI) was calculated for gingival health assessment. For oral hygiene assessment, the Oral Hygiene Index-Simplified (OHI-S) was calculated, and a questionnaire was used.ResultsTotally, 306 adolescents participated in this study. The frequency of IOTN grades was 88 (28.8%), 89 (26.1%) ,49 (16%), 60 (19.6%), and 29 (9.5%) for grades 1 to 5, respectively. The multinomial logistic regression showed that by an increase in OHI-S score, the odds of having IOTN grade 4 compared to grade 1 increased. Postgraduate parental level of education decreased the odds of having IOTN grade 4 compared to grade 1. Furthermore, there was an inverse correlation between oral hygiene practice and the odds of having IOTN grade 5 compared to grade 1.ConclusionsMalocclusion may hinder oral hygiene practice, and resultantly increase plaque accumulation. This risk may be amplified in children with lower SES, highlighting the need for preventive and educational oral health programs.

Evaluation of the death anxiety beliefs and behaviors scale in Iranian adolescents

Numerous tools assess death anxiety, but many have questionable psychometric properties. The Death Anxiety Beliefs and Behaviors Scale (DABBS) addresses these shortcomings, assessing death-related maladaptive affect, beliefs, and behaviors that could be foundational to fears associated with death. We translated the DABBS into Persian and examined its psychometric properties among Iranian adolescents (n = 598, M age = 14.80, range = 12-18 years old). Confirmatory factor analyses supported the intended three-factor structure that comprises death-related affect, beliefs, and behaviors. Furthermore, the DABBS demonstrated good internal consistency, as well as expected associations with other measures of death anxiety and psychopathology measures, except that the Behaviors subscale unexpectedly did not relate to theoretically relevant constructs. Our findings indicate that the DABBS affect and belief subscales have strong psychometric properties among Iranian adolescents. However, further research is needed to elucidate whether the overall DABBS score demonstrates improved validity when used with other populations.

Association of macronutrient intake, physical activity, anxiety, and depression with sleep quality among Iranian male adolescents

BackgroundAdolescence is a unique stage of life accompanied by physiological and psychological modifications, along with stress, confusion, and depression.Materials and methodsThe present descriptive-analytical cross-sectional research was done on 267 male adolescents who studied at high schools in Zanjan, Iran. Demographic characteristics questionnaires, a 48-item food frequency questionnaire, a short version of the International Physical Activity Questionnaire (IPAQ), the Depression Anxiety Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data.ResultsThe mean ± standard deviation (SD) of age, weight, height, and sitting time was 15.94 ± 0.91 years, 68.53 ± 15.28 kg, 1.75 ± 0.06 m, and 449.25 ± 322.06 min, respectively. The study results showed that students with poor sleep quality showed a higher rate of depression than those with good sleep quality in the high and low physical activity groups (p < 0.05). The stress, depression, and anxiety scores significantly correlated with sleep quality in the physical activity groups (p < 0.05). The structural equation model analysis results showed that mental health directly affected sleep quality; this association was significant in the low physical activity group.ConclusionWe found that sleep quality was independently related to mental health in young Iranian men. However, dietary intake was not a significant predictor of mental health or sleep quality. More studies are required to evaluate the association between dietary intake and sleep quality in adults.

Exploring the efficacy of memory specificity training on depression among Iranian adolescents: a comparative analysis of online vs. in-person delivery

Depression in adolescence is common worldwide, with the burden being highest in low- and middle-income countries. This study assessed the efficacy of in-person Memory Specificity Training (MeST) and computerized MeST (c-MeST) as cognitive training programs aimed at addressing depression among Iranian adolescents. A secondary aim was to evaluate the efficacy of MeST and c-MeST on autobiographical memory specificity, emotion regulation and cognitive control. Ninety Iranian male adolescents (aged 13–18 years) with depression were randomly assigned to three groups; MeST group (n = 30), c-MeST group (n = 30) and the non-active control group (n = 30). Participants completed the Beck Depression Inventory-II, Autobiographical Memory Test, Cognitive Emotion Regulation Questionnaire, Wisconsin Card Sorting Test and Stroop Color and Word Test. The groups underwent either MeST and c-MeST. All the assessments were re-conducted after the intervention (post-intervention) and at 1-month post-intervention (follow-up). The in-person MeST group exhibited significantly higher autobiographical memory specificity at post-intervention and follow-up compared to the c-MeST group. Both groups demonstrated significantly lower levels of depression at post-intervention and follow-up. Both groups showed improvements in emotion regulation and cognitive control, which were found to mediate improvements in depression symptomatology. c-MeST and MeST appear promising brief interventions for the treatment of depression among adolescents in Iran.

Psychometric properties of the farsi version of the international trauma questionnaire -child and adolescent version (ITQ-CA) in a sample of iranian children and adolescents exposed to trauma

BackgroundThe International Trauma Questionnaire-Child and Adolescent Version (ITQ-CA) is a self-report measure for post- traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD), corresponding to the diagnostic criteria in the International Classification of Diseases, 11th Revision (ICD-11). While in the meantime the original English version of the ITQ-CA is available in different languages such as traditional and simplified Chinese, German, or Spanish, the Farsi was missing so far. ObjectiveThe purpose of this study was to evaluate the psychometric properties of the Farsi International Trauma Questionnaire-Child and Adolescent version (ITQ-CA) in a sample of Iranian children and adolescents objectively exposed to a traumatic event. MethodA total of 130 participants completed the Farsi form of the ITQ-CA and the Farsi Child and Adolescent Trauma Screen (CATS) for comparison. For the psychometric evaluation, we used confirmatory factor analysis (CFA) and bivariate correlations. ResultsThe Farsi version of ITQ-CA self-report form yielded scores with robust reliability (internal consistency ranging from 0.83 to 0.91, and the Intraclass correlation coefficients (ICC) varied from 0.74 to 0.92 with moderate, good, and excellent results) and adequate convergent validity (correlations with the CATS ranging from 0.49 to 0.77). CFA supported ICD-11 CPTSD symptom structure as a two-factor higher order model with PTSD. We found that the two-factor model fit the data better than the other measurement models (χ2/df = 43.492/37=1.175, RMSEA = 0.038, CFI = 0.994, TLI = 0.989, SRMR = 0.04.( ConclusionThe Farsi version of the ITQ-CA showed very good and satisfactory psychometric properties. As such, the Farsi ITQ-CA appears to be a valid and reliable self-rating measure to assess PTSD and DSO in Farsi-speaking children and adolescents exposed to traumas.

Psychological strains after the crisis: evaluating separation anxiety among Iranian children and adolescents in the post-COVID-19 era

ObjectivesThe objective of this study was to specifically investigate Separation Anxiety Disorder (SAD), as one of the noteworthy disorders within the spectrum of anxiety disorders, among children and adolescents, after overcoming the crises caused by the Coronavirus Disease 2019 (COVID-19) pandemic. Efforts were also made to identify socio-demographic factors that could be associated with changes in SAD level and also to assess the effect of different constituting dimensions of SAD on the severity of this disorder.MethodsIn this cross-sectional study, face-to-face interviews were conducted with the parents of 317 (7-13-year-old) Iranian students, who were selected through a multi-stage random sampling method in the city of Shiraz. During the interviews, socio-demographic data were collected, and subsequently, SAD symptoms and dimensions were assessed using the Separation Anxiety Assessment Scale (Parent Version) (SAAS-P) questionnaire. Later, employing the Partition Around Medoids (PAM) statistical method, the participants were categorized into two groups with low and high levels of SAD. Also, to understand the interaction between the different dimensions of SAD, the network analysis method was employed. Finally, univariate analysis and logistic regression were utilized, with a significance level of 0.05, to determine potential associating factors with the level of SAD.ResultsThe sample included 128 girls and 189 boys with a mean age of 9.63 ± 2.63 and 9.63 ± 1.95 years respectively. Based on the PAM method, 51.1% of the participants presented a high level of SAD. According to network analysis, it was demonstrated that the “fear of abandonment” dimension plays a central role in high levels of SAD. Based on logistic regression, female gender, age ≥ 10 years, parents’ unacademic educational background, mother’s employment, and child’s history of physical/mental problems were significantly associated with the high level of SAD.ConclusionsA considerable number of the participants in this study presented a high level of SAD with the “fear of abandonment” being a key influential dimension of elevated levels of this disorder. Maternal employment, female gender, child’s history of health issues, and low parental education were identified as important contributors to the high SAD level. Considering these factors allows for more effective diagnostic and therapeutic interventions. However, the need for further studies remains crucial.

Occupational Therapy Assessment Tools for Children and Adolescents in Iran: A Scoping Review.

Assessment tools are essential in occupational therapy for providing client-centered care, clinical decision-making, evidence-based documentation, and defining expected outcomes. This study investigated available occupational therapy assessment tools for children and adolescents in Iran. A comprehensive search was conducted in MEDLINE, PubMed Central, Web of Science, Embase, Scopus, SID, Magiran, and Google Scholar from their inception until May 24, 2022. Two reviewers screened records and applied inclusion criteria focused on peer-reviewed articles in English or Persian, covering children and adolescents aged 0-18 years old in Iran. The methodological quality of each study and the evidence quality of each measurement tool was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias Checklist, and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. A review of 66 articles published between 2010 and 2021, identified 51 assessment tools. The majority of tools (70.7%) targeted typically developing children and those with cerebral palsy, with limited options for adolescents (n=5) and infants (n=1). These tools primarily focused on assessing body functions (47.06%), particularly sensory-motor functions. While numerous tools demonstrated good reliability (66.67%) and significant content validity (31.37%), there was a paucity of high-quality evidence supporting other psychometric properties. This study identified 51 occupational therapy assessment tools for Iranian children and adolescents. However, the present research identified some concerning trends, such as lack of tools available for specific populations, an overreliance on translated tools, and a predominant focus on body functions. Moreover, there were concerns about the methodological quality of studies using these tools.

Effects of E-learning for Postural Education in Music Students (El-Poems): A Randomized Controlled Trial Among Iranian Adolescents.

Musculoskeletal (MSK) pain represents a major health problem facing music students worldwide. There is some evidence that posture education could be effective in reducing pain and disability among music students. The aim of this study was to assess the effective¬ness of E-learning for posture education in music students (El-Poems) on the presence of MSK pain, MSK pain intensity, as well as postural behavior. This was a matched-pair, two-arm parallel randomized controlled trial. Participants were music students (aged 12-18 yrs), randomized to intervention (n=134) and control (n=133) groups. The education program included four online sessions of the risks of incorrect posture and the necessary skill for correct postural behavior. A numeric rating scale (NRS) and the Nordic body map were used to evaluate the primary outcomes (MSK pain intensity, presence of MSK pain, and location). A secondary outcome (postural behavior) was assessed using the Rapid Entire Body Assessment checklist. Data were collected at two points, baseline and 6-month follow-up. ANOVA and Wilcoxon tests were performed to assess the time x group interaction effect. A total of 267 music students participated this study. Of these, 150 (56.2%) reported at least one symptomatic region over the previous week. A significant reduction was found from baseline to 6-month follow-up in mean scores in the intervention group for MSK pain prevalence (from 55.2% to 43.3%, Z=-2.71, P=0.004, etap2=0.07), MSK pain intensity (from 2.21±2.51 to 1.94±2.47, F263=32.27, P<0.001, etap2 = 0.11), and postural behavior (from 6.99±2.97 to 6.65±2.72, F263=27.35, P<0.001, etap2=0.09). The results demonstrated that the E-learning postural education program was associated with a decrease in the prevalence of MSK pain, a reduction in pain intensity, and improved postural behavior. Iranian Registry of Clinical Trials: reg. no. IRCT20180528039885N2, Nov-09-2021.

Correction: Enhancing childhood obesity management: implementing an obesity registry for Iranian children and adolescents

Correction: Enhancing childhood obesity management: implementing an obesity registry for Iranian children and adolescents

Glucose and lipid-related indicators in relation to elevated alanine aminotransferase in a pediatric population.

To determine the associations between various glucose and lipid-related indicators with elevated alanine aminotransferase (ALT) in pediatric population. We analyzed the cross-sectional data of 3,771 Iranian children and adolescents aged 7-18 years using the fifth survey of a national school-based surveillance program. The predictive power of 11 different glucose and lipid-related indicators for predicting elevated ALT was examined using receiver operating characteristic (ROC) curve. In the total sample non-HDL-C, non-HDL-C/HDL-C, and TC/HDL-C showed the largest area under the curve (AUC) for elevated ALT detection, with 0.731 (cut-off, 129.5 mg/dL), 0.706, and 0.706, respectively. In girls, non-HDL-C had the highest predictive value (AUC, 0.741, cut-off, 129.5 mg/dL). Among boys, non-HDL-C/HDL-C and TC/HDL-C showed the largest AUC of 0.753 with optimum cut-off values of 2.63 and 3.63, respectively. The findings of this study suggest that non-HDL-C, non-HDL-C/HDL-C, and TC/HDL-C can be predictors of elevated ALT in the pediatric population. These indices can be useful in large population-based studies for predicting children and adolescents at risk of fatty liver.

Enhancing childhood obesity management: implementing an obesity registry for Iranian children and adolescents

Enhancing childhood obesity management: implementing an obesity registry for Iranian children and adolescents

Differential Impacts of Maternal and Paternal Attachments on Adolescent Delinquency: Implications for Counselling

Delinquency among adolescents is a growing concern in Iranian society. Research on the role of maternal and paternal attachments, particularly in the Iranian context, has received limited attention. This correlational study aims to concurrently investigate the predictive capacity of both maternal and paternal attachment on delinquent behaviours among Iranian adolescents. The sample included 528 students aged 15 and 17 from 10 government high schools in Tehran who were selected using multi-stage cluster sampling. Participants completed self-administered questionnaires using two established instruments. The findings highlighted a significant association between high parental attachment scores and low adolescent delinquent activity. Secure attachments to mothers and fathers were found to reduce engagement in delinquency. Adolescent age, fathers’ educational level, and maternal attachment emerged as significant predictors of delinquency. Adolescents with insecure maternal attachments and older adolescents with educated fathers showed greater susceptibility to delinquent behaviour. The study also emphasises the vast contribution of mothers to adolescent development, suggesting the need for further exploration of paternal influence on internal dynamics and delinquency in future research. In a broader sense, understanding the differential impacts of these attachments on adolescent delinquency may help counsellors to effectively address these issues and provide appropriate interventions.

Effectiveness of forgiveness education with adolescents in Iran: Increasing the positive psychology of empathy, altruism, and willingness to forgive

ABSTRACT The aim of the current study was to investigate the effect of forgiveness education on positive psychology variables (empathy, altruism and willingness to forgive) in Iranian adolescents. Two hundred twenty-four (Persian, Azeri, and Kurdish) male and female students in eighth grade participated. Schools were randomly assigned to experimental (N=123) and control (N=101) groups. Measures include the Toronto Empathy Questionnaire, Altruistic Personality Scale, and Willingness to Forgive Scale, administered at pre-test, post-test, and follow-up. The experimental group was presented with 15 weekly sessions of teaching forgiveness programs by classroom teachers. The results showed that the experimental group improved more in degrees of empathy, altruism, and willingness to forgive compared to the control group, and also at follow-up. It seems that forgiveness education programs can contribute to human flourishing with the increase of positive psychology in students, particularly in empathy, altruism, and willingness to forgive.

Identifying the challenges of policy content related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in adolescents

BackgroundThis study aims to identify policy content challenges related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in Iranian adolescents.MethodsThis qualitative study analyzed high-level and national documents pertaining to adolescent health, high-risk sexual behaviors, stimulant, and alcohol consumption in adolescents. The documents, which were published by public organizations between January 1979 and February 2023 and publicly available, were complemented by interviews with policymakers and executives. The study involved reviewing 51 papers and conducting interviews with 49 policymakers and executives at the national, provincial, and local levels who were involved in addressing adolescent behaviors related to high-risk sexual behaviors, stimulant, and alcohol consumption. The data collected was analyzed using conventional content analysis.ResultsThe study’s results involved examining policy content and identifying challenges related to policy content. The analysis revealed that from the beginning of the Iranian revolution in 1979 until the late 1990s, the dominant approach in Iran was to deny the existence of high-risk behaviors among adolescents. However, in the early 2000s, the country began to adopt a new approach that acknowledged the social harms and ineffectiveness of previous strategies. As a result, a new policy framework was introduced to address high-risk behaviors among adolescents. The study’s interviews with policymakers and executives identified 12 challenges related to policy content, including parallel programs, lack of institutional mapping, lack of evidence-based policymaking, lack of integrated approach regarding training, late parent training, lack of consideration of all occurrence reasons in adolescents’ high-risk behaviors policymaking, and the existence of many abstinence policies regarding high-risk behaviors.ConclusionsThe study’s findings suggest that high-risk behaviors among adolescents in Iran are primarily a health issue, rather than a social or ideological one. Unfortunately, ideological approaches, stigma, and policymaking based on anecdotes rather than evidence have had a significant impact on this area. To improve policymaking in this domain, it is crucial to address these challenges by tackling stigma, adopting an integrated and holistic approach, and implementing evidence-based policies that consider all relevant aspects, including adolescents’ subcultures and policy audiences. Such an approach can also be useful for other countries facing similar conditions.

Cognitive, Metacognitive, Motivational, and Emotional Predictors of the Intensity of Internet Gaming Disorder among Adolescents.

Internet gaming disorder (IGD) is multifaceted and can have significant negative consequences. The present study examined the contribution of cognitive, metacognitive, motivational, and emotional factors as predictors for IGD severity. In a cross-sectional study, 703 Iranian adolescents (36.8% females, mean age = 16.98years [SD = 1.23]) completed an online survey. Hierarchical regression analysis showed that the cognitive, metacognitive, motivational, and emotional factors predicted 7.8%, 17.4%, 1.4%, and 1.9% of the variance in IGD symptoms, respectively. The findings indicated that the cognitive factors including some maladaptive cognitions, such as cognitive salience, regret, and perfectionism, and metacognitive factors including some maladaptive metacognitions (negative metacognitions regarding the uncontrollability of online gaming and negative metacognitions regarding the dangers of online gaming) were significant predictors of IGD severity, highlighting their importance in understanding and predicting problematic gaming behaviors. Although contributing to the variance in IGD, motivational factors (escape, coping, and skill development) and emotional factors including emotion regulation (especially reappraisal) played relatively smaller roles compared to cognitive and metacognitive factors. Of the examined predictive factors, metacognitions were the most important predictor of IGD severity. Exploratory moderator analyses showed significant interactions between three predictors of IGD (reappraisal, negative metacognitions, and cognitive salience) with loneliness, stress, anxiety, and depressive symptoms. Reappraisal was the most frequent predictor and had a significant interaction with these variables. Other predictors independently impacted IGD irrespective of the level of loneliness, stress, anxiety, or depressive symptoms. Based on these findings, special attention to metacognitive, cognitive, emotional, and motivational factors is suggested in the treatment of IGD.

The Association Between CYP2R1 rs10741657 Polymorphisms and Bone Variables, Vitamin D, and Calcium in Iranian Children and Adolescents: A Cross-Sectional Study.

Osteoporosis is a common disorder with a strong genetic component. Bone mineral density (BMD), vitamin D, and calcium levels declining are a main contributor of osteoporosis and fragility fractures. This cross-sectional study designed to explore the possible link between CYP2R1 rs10741657 polymorphism and BMD of the total hip, lumbar spine and femoral neck, vitamin D, and calcium in Iranian children and adolescents. 247 children and adolescents (127 girls and 120 boys) between 9 and 18 years old from Kawar (an urban area located 50 km east of Shiraz, the capital city of the Fars province in the south of Iran) were randomly selected based on age-stratified systematic sampling and recruited for genetic analysis. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used for genotyping CYP2R1 rs10741657. Anthropometric, biochemical, and bone mineral density (BMD) parameters were also measured. The results specified that in the dominant [P < 0.0001, -2.943 (-4.357-1.529)] and over-dominant [P < 0.0001, 2.789 (1.369-4.209)] models, vitamin D concentration significantly differed between genotypes. The highest vitamin D levels were displayed for participants carrying the rs10741657 AG genotype (16.47 ng/ml). In regard to calcium, in a dominant model [P = 0.012, 0.194 (0.043-0.345)] and over-dominant model [P = 0.008, 0.206 (-0.357-0.055), there was a significant association. AG genotype displayed the highest (9.96 mg/dl) and GG genotype the lowest (9.75 mg/dl) calcium values. This study reported the association of CYP2R1 rs10741657 polymorphisms with calcium and vitamin D levels in Iranian children and adolescents.

The burdens attributable to primary headache disorders in children and adolescents in Iran: estimates from a schools-based study

BackgroundWe recently found headache disorders to be highly prevalent among children (aged 6–11 years) and adolescents (aged 12–17) in Iran (gender- and age-adjusted 1-year prevalences: migraine 25.2%, tension-type headache 12.7%, undifferentiated headache [UdH] 22.1%, probable medication-overuse headache [pMOH] 1.1%, other headache on ≥ 15 days/month [H15+] 3.0%). Here we report on the headache-attributed burden, taking evidence from the same study.MethodsIn a cross-sectional survey, following the generic protocol for the global schools-based study led by the Global Campaign against Headache, we administered the child and adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) structured questionnaire in 121 schools, purposively selected to reflect the country’s diversities. Pupils self-completed these in class, under supervision. Headache diagnostic questions were based on ICHD-3 criteria but for the inclusion of UdH (defined as mild headache with usual duration < 1 h). Burden enquiry was across multiple domains.ResultsThe analysed sample (N = 3,244) included 1,308 (40.3%) children and 1,936 (59.7%) adolescents (1,531 [47.2%] male, 1,713 [52.8%] female). The non-participating proportion was 3.4%. Mean headache frequency was 3.9 days/4 weeks, and mean duration 1.8 h. Estimated mean proportion of time in ictal state was 1.1% (1.4% for migraine, 16.5% for pMOH). Symptomatic medication was consumed on a mean of 1.6 days/4 weeks. Lost school time averaged 0.4 days/4 weeks overall (2%, assuming a 5-day week), but was eleven-fold higher (4.3 days; 22%) for pMOH. For most headache types, days of reported limited activity were several-fold more than days lost from school (45% for pMOH, 25% for other H15+). Almost one in 12 parents (7.9%) missed work at least once in 4 weeks because of their son’s or daughter’s headache. Emotional impact and quality-of-life scores reflected these measures of burden.ConclusionsHeadache, common in children and adolescents in Iran, is associated with symptom burdens that may be onerous for some but not for most. However, there are substantial consequential burdens, particularly for the 1.1% with pMOH and the 3.0% with other H15+, who suffer educational disturbances and potentially major life impairments. These findings are of importance to educational and health policies in Iran.

Validity and reliability of the Persian version of food preferences questionnaire (Persian-FPQ) in Iranian adolescents

The assessment of dietary intakes and habits using reliable and youth-specific measurement tools during adolescence is essential. The aim of the present study was to culturally adapt and investigate the psychometric properties of the Persian version of the food preferences questionnaire (Persian-FPQ) among Iranian adolescents. This methodological cross-sectional study was conducted among 452 Persian-speaking adolescents, living in Isfahan, Iran. Translation of the FPQ was performed using forward–backward method. Intra Class Correlation (ICC) and Cronbach’s α were used to assess test–retest reliability and internal consistency, respectively. Construct validity was investigated by using exploratory factor analysis (EFA). Divergent validity was determined using correlation analysis with Kessler Psychological Distress Scale (K-10). Known-group validity was assessed based on differences in mean food preference score between boys and girls and different categories of body mass index (BMI). The internal and external reliabilities for the Persian-FPQ were in the range of good to excellent in all domains (Cronbach’s α: 0.76–0.96 and ICCs: 0.982–0.998). Boys had higher scores of food preferences than girls, indicating good known-group validity. Construct validity evaluated by EFA led to extraction of seven factors (“Vegetables”, “Fruit”, “Dairy”, “Snacks”, “Meat/Fish”, “Starches” and “Miscellaneous foods”), explaining 37.8% of the variance. Divergent validity revealed significant negative correlations between five sub-scales of the Persian-FPQ and psychological distress. The Persian version of the FPQ is a reliable and valid instrument with applicability in a broad range of the population of Persian-speaking adolescents for assessing food preferences in community-based research projects.