Family Physicians’ satisfaction with factors affecting the dynamism of the urban family physician program in the Fars and Mazandaran provinces of Iran

@#Background and objective: A successful family physician program needs ongoing and full cooperation between people and the organizations in charge. Ensuring the satisfaction of family physicians through improvement of the underlying factors could motivate them to provide high-quality services. This study aimed to determine the family physicians’ satisfaction level with the factors affecting the dynamism of the urban family physicians program in the Fars and Mazandaran provinces of Iran. Method: This cross-sectional study was carried out in urban areas in the Fars and Mazandaran provinces in 2016. The sample consisted of 143 and 96 family physicians, respectively, in Fars and Mazandaran provinces and was selected using the stratified random sampling method. Data were collected using a questionnaire and included both sociodemographic variables and factors assessing the family physicians’ satisfaction levels. Each factor was scored based on a Likert scale from 0 to 5 points, and any satisfaction level higher than 3 out of 5 was equated with being satisfied. Results: The overall satisfaction levels among family physicians in Fars and Mazandaran provinces were 2.77±0.53 and 3.37±0.56, respectively, revealing a statistically significant difference between provinces (p<0.001). Moreover, the mean satisfaction scores for the performances of healthcare centers, insurance companies, specialists, healthcare workers, and the population covered were 2.78±0.1, 2.54±0.9, 2.52±0.8, 4.24±0.07, and 2.96±0.8, respectively. The family physicians’ levels of satisfaction were significantly correlated with population size (p=0.02, r= -0.106), and willingness to stay in an urban family physician program (p<0.001, r= +0.398). Conclusion: This study revealed that family physicians exhibited a low level of satisfaction with the urban family physician program. Given the direct association between family physicians’ satisfaction levels and retention in the program, it is expected that family physicians will no longer stay in the program, and it is likely to have subsequent executive problems.

Assessment of overweight and obesity in Iranian adolescents: optimal cut-off values of anthropometric indices

Background: Various indices have been used to estimate overweight and obesity; all have limitations and strengths. The prevalence of overweight and obesity may differ by ethnicity.

Aims: This study evaluated waist circumference [WC], waist-to-hip ratio [WHpR], waist-to-height ratio [WHtR] and neck circumference [NC] as reliable alternatives to body mass index for screening for overweight and obesity, and determined their optimum cut-off values in different ethnic groups.

Methods: The study was conducted from November 2015 to February 2016 among adolescents aged 12–14 years from five ethnicities in the Islamic Republic of Iran: Arab, Kurdish, Sistani and Baluchi, Turkish and Turkman. Stratified multistage sampling was used to select 2444 students. Receiver operating characteristic curves were constructed to evaluate WC, WHpR, WHtR and NC as screening indices for overweight and obesity as categorized by body mass index centiles.

Results: The prevalence of overweight and obesity in the total sample were 15.3% and 9.2% respectively, with higher rates in students of Arab, Kurdish and Turkish ethnicity. The areas under curve ranged from 0.8 to 0.9 for WC, WHtR and NC. The mean optimum values with the highest sensitivity and specificity to identify overweight were: 72.3 cm [sensitivity 0.80, specificity 0.75] for WC, 0.46 [0.85, 0.70] for WHtR and 31 cm [0.76, 0.76] for NC. For obesity mean optimum values were: 77 cm [0.84, 0.81] for WC, 0.50 [0.84, 0.84] for WHtR and 31.5 cm [0.88, 0.71] for NC.

Conclusions: WC, WHtR and NC may be useful tools to screen for adiposity using their optimum values for sex and ethnicity

Overweight and obesity among preschool children from Fars province of Iran: prevalence and associated factors

Background: the global prevalence of overweight and obesity had risen in recent decades, and obesity is taken into consideration as a public health concern and a major risk factor of common chronic disease. The objective of the present study was to estimate the prevalence of overweight and obesity and to identify its underlying factors among children 2-6 yr of age in Fars Province, southern Iran

Methods: a total of 8911 children, aged 2-6 yr age, were selected thorough multi-stage sampling in 30 cities of Fars Province in 2012-13. Overweight and obesity status was assessed through comparison by standard BMI for age and for sex percentiles [NCHS/CDC]. In addition, socio-demographic measures obtained from structured questionnaire were compared between normal and overweight plus obese [ow/ob] groups. We used backward stepwise Logistic Regression, Chi-square and Independent sample t-test to relate the underlying factors to the nutritional indices

Results: the prevalence of overweight and obesity was 5.7% [95% CI: 5.2%, 6.1%] and 5.2% [95% CI: 4.7%, 5.6%], respectively. The ow/ob was significantly correlated with male sex, urbanization, type of father's occupation, universal education of mothers, the higher birth weight, low access to household facilities, and not using health-care services [P<0.05]. Besides, the logistic regression analysis showed urbanization [OR=1.46, CI: 1.26, 1.70], second sibling [OR=1.183, CI: 1.00, 1.39], and less access to a variety of food groups [OR=1.32, CI: 1.05, 1.65] as ow/ob risk factors

Conclusions: the rate of overweight and obesity in the study population is at an alarming level. Therefore, a preventive program is needed to control ow/ob since early childhood considering the underlying factors for each region and individual groups

effects of nigella sativa hydro-alcoholic extract on memory and brain tissues oxidative damage after repeated seizures in rats

Regarding the therapeutic properties of Nigella sativa [NS], the effects of the plant hydro–alcoholic extract on learning, memory and brain tissues oxidative damage were investigated in penthylenetetrazole [PTZ]-induced repeated seizures. There were 4 experimental groups including: 1- control group; received saline, 2- PTZ group; received saline and PTZ [50 mg/Kg, i.p], 3- PTZ-NS 200 and 4- PTZ-NS 400 ; received 200 and 400 mg/Kg of NS extract respectively, before PTZ injection in 5 consecutive days. Seizure scores were lower in PTZ–NS 200 and 400, furthermore the seizure onset latencies were higher in these groups than PTZ group [P<0.05 and P<0.01]. In Morris water maze, the time spent in target quadrant by PTZ group was lower than control group [P<0.05]; while, 400 mg/Kg of the extract increased it [P<0.01]. In the passive avoidance test, delay time to enter the dark by PTZ group was lower than control at 1 and 24 hours after training [P<0.01 - P<0.001]; while, 400 mg/Kg of the extract increased it [P<0.05]. The total thiol concentration in hippocampal and cortical tissues of PTZ group was reduced while, MDA concentration was higher than control [p<0.05 - p<0.001]. Administration of the extract increased the total thiol and decreased the MDA concentrations [p<0.01 - p<0.001]. It is concluded that the hydro-alcoholic extract of NS possess beneficial effects on learning and memory impairments in repeated seizures model which is accompanied by antioxidant effects in the brain

Growth faltering of preschool-aged children with poor appetite is associated with snacking behaviors

Background: The association between snacking patterns, sleep hours, and physical activity with growth status and appetite of preschool children was investigated

Methods: Sixty three children aged 3-7 years with low appetite and weight for age ratio below the 25[th] percentile were enrolled from those referring to Nader Kazemi Polyclinic in Shiraz. Information regarding the parents' education, sleep hours, physical activity, appetite, and snacking patterns was obtained by interview. Height and weight were measured and energy intake was estimated by 2-day food recall. Appetite was rated on a 5-point scale based on the maternal report

Results: Mother's education, the number of children in the household, and physical activity were not associated with either growth failure, energy intake, or appetite, but the fathers' education more than Diploma was associated with higher energy intake in children [P=0.015]. Children who slept <11 hours a day had higher energy intake [P=0.026] but worse weight status [P=0.015]. Children who always ate snacks close to the main meals had significantly higher energy intake but more severe growth failure. High consumption of fruit drinks, cakes, and potato chips was associated with exacerbated growth faltering whereas nuts consumption was related to better height status. None of the evaluated parameters was associated with children's appetite

Conclusion: Overall, the results suggest the importance of sufficient sleep, limited consumption of snacks, and the type and time of snack consumption in growth of children with poor appetite. Nutritious snacks such as nuts may be more beneficial than nutrient-poor snacks for growth of children