Lesson learned from assessing teachers' and students' perspectives regarding the quality of e-learning in medical education during the pandemic: a mixed-methods study.

BACKGROUND: The evaluation of e-learning systems ensures the provision of quality training. The goal was to identify the perspectives of teachers and students on e-learning in medical education during the COVID-19 pandemic at Shiraz University of Medical Sciences (SUMS), Iran. METHODS: This study utilized a convergent mixed methods research design with a two-phase approach to collect and analyze data between June and August 2022. In the first stage, a cross-sectional descriptive study was conducted to evaluate the quality of e-learning systems from the perspective of 400 students. In the second stage, semi-structured interviews were conducted with 10 virtual education professors and 10 student representatives to identify the strengths, weaknesses, opportunities, and threats of virtual education. A validated questionnaire was administered to assess the quality of the e-learning system, and data were analyzed using SPSS-21. Qualitative data were subjected to content analysis. RESULTS: Our findings revealed that the student support system, the course structure, and the infrastructure and technology subscales' mean scores were significantly higher than the average level (P < 0.001). However, the professors' methods of teaching and learning strategies were unsatisfactory. The results of the present study showed that the evaluation mean score was significantly higher among, younger, female, and undergraduate students. Virtual education has strengths and weaknesses, and innovative approaches are needed to enhance student engagement. The lack of appropriate infrastructure and virtual teaching tools for teachers and students is a significant challenge that needs to be addressed. Blended learning is effective in medical education, and the shift from teacher-centered to learner-centered teaching approaches is an opportunity to explore innovative teaching approaches. CONCLUSION: From the perspective of students, the quality of eLearning systems at the universities was moderate. Virtual education offers both benefits and drawbacks, and there is a requirement for innovative solutions to enhance student engagement and lessen boredom.

Dietary intake of micronutrients are predictor of premenstrual syndrome, a machine learning method.

BACKGROUND & AIMS: Premenstrual syndrome (PMS) is a common disorder affecting 30-40% of women of reproductive age. Many modifiable risk factors associated with PMS involve nutrition and poor eating habits. This study aims to explore the correlation between micronutrients and PMS in a group of Iranian women and to build a predictor model showing the PMS using nutritional and anthropometric variables. METHODS: This is a cross-sectional study which was conducted on 223 females in Iran. Anthropometric indices were measured, including Body Mass Index (BMI) and skinfold thickness. Machine learning methods were used to assess participants' dietary intakes, Food Frequency Questionnaire (FFQ) and analyze the data. RESULTS: After applying different variable selection techniques, we have created machine learning models such as KNN. KNN achieved 80.3% accuracy rate and 76.3% F1 score indicating that our model is a curate and valid proof to show a strong relationship between input variables (sodium intake, Skin fold thickness of suprailiac, irregular menstruation, total calorie intake, total fiber intake, trans fatty acids, painful menstruation (dysmenorrhea), total sugar intake, total fat intake, and biotin) and the output variable (PMS). We sorted these effective variables based on their 'Shapley values' and figured out that Na intake, suprailiac skinfold thickness, biotin intake, total fat intake and total sugar intake have a major impact on having PMS. CONCLUSIONS: Dietary intake and anthropometric measurements are highly associated with the occurrence of PMS, and in our model, these variables can predict PMS in women with a high accuracy rate.

Intimate partner violence during pregnancy in COVID-19 pandemic: a cross-sectional study from South-west of Iran.

BACKGROUND: Intimate partner violence (IPV) against pregnant women can cause several complications for the mother and her baby, which are life-threatening. Thus, we aimed to find the prevalence of IPV and its associated factors in pregnant women in Shiraz, Iran. METHODS: This cross-sectional study was conducted among pregnant mothers in Shiraz between July 2020 and January 2021. The questionnaire consisted of four parts: demographic data, socio-economic status (SES), obstetric and medical history, and questions about IPV. Univariate analysis was performed using Chi-square, McNemar, or Fisher's exact test, and variables with p-value < 0.20 were included in Logistic regression. The odds ratio and CI 95% for variables with p-value < 0.05 were considered statistically significant. RESULTS: The overall prevalence of IPV was 93.1% among 830 pregnant women in Shiraz. Psychological violence was the most prevalent type (92.9%), followed by sexual (11%) and physical (7.7%) violence. High SES (OR = 3.21, (CI:1.61-6.41)) was the only risk factor for overall violence, and the age group, 30-34, was a risk factor for physical violence. Mother-desired pregnancy (OR = 26 (Cl:0.09-0.79)) and father-desired pregnancy (OR = 0.91, (CI:0.22-3.80)) were protective factors against physical and sexual violence, respectively. Furthermore, Psychological violence and sexual violence increased during COVID-19 Pandemic (P.value < 0.05). CONCLUSION: According to the obtained results, the prevalence of IPV during pregnancy in Shiraz was very concerning, especially psychological violence. Improving conflict-solving skills among family members and addressing economic problems could be considered by health policymakers when designing interventional programs and policies to reduce IPV during pregnancy.

Investigating the effectiveness of Case-Based Technology-Enhanced workshops (e-Flipped vs. Online) among health worker nurses during the COVID-19 pandemic.

AIM: This study aimed to compare the efficacy of e-flipped and online case-based workshops on the nurses' knowledge, attitude and behaviour regarding thalassemia during the COVID-19 pandemic. DESIGN: A pre-test-posttest interventional study was conducted with two intervention groups and a control group. METHODS: One hundred and fifty nurses were recruited from comprehensive urban health centres in June-December 2020. The nurses were randomly allocated to one of the three groups: case-based e-flipped workshop (n = 50), case-based online workshop (n = 50) and control (n = 50). A researcher-made questionnaire was completed by eligible subjects at baseline, after the end of the training sessions and 4 weeks after interventions to assess their knowledge, attitude and behaviour. Data were analysed in IBM SPSS v16.0. ANOVA and Tukey's post hoc tests were used to compare the three groups. RESULTS: The mean knowledge, attitude and behaviour scores in the intervention groups increased significantly more than that in the control group (p < .001). One week and 4 weeks following the intervention, the mean score of knowledge, attitude and behaviour in the e-flipped group was greater than that in the online group (p < .001). According to the results, e-flipped and online case-based workshops can improve nurses' knowledge, attitude and behaviour regarding thalassemia.

Modeling the Trend Changes of Liver Cancer Mortality in the 6 WHO Regions.

BACKGROUND: There is little information about comparison of the mortality patterns in different regions. The current study aimed to assess the trend changes of liver cancer mortality in 6 WHO regions. METHODS: The mortality rates of liver cancer in the 6 WHO regions during 1990 to 2017 were extracted from the Global Burden of Disease database. Growth mixture model was used to identify the latent patterns using a set of tools to handle both the within and between trajectory variations. All the modeling procedures were implemented in Mplus 7.4 software. RESULTS: The mortality rate in Africa showed a slow decreasing trend throughout the observation period, but a slow increase was observed in the Eastern Mediterranean region, European region, region of the Americas, and South-East Asia region. The slope of the rise in liver cancer mortality rate for Western Pacific region was 3-4 times higher than the other regions. 2-pattern growth mixture model was estimated as the best model. The Western Pacific region with annual increase of 0.20 in the liver cancer mortality rate was in the first pattern and the other 5 regions including Africa region, Eastern Mediterranean region, European region, region of the Americas, and South-East Asia region with annual increase of 0.05 in liver cancer mortality rate belonged to the second pattern. CONCLUSION: Observed pattern in the Western Pacific region is not favorable. Taking into account a set of urgent prevention actions to control mortality rate of liver cancer in this region seems necessary.

Comparison of the effect of intravenous dexamethasone and methylprednisolone on the treatment of hospitalized patients with COVID-19: a randomized clinical trial.

OBJECTIVE: In this study, we aimed to compare the effects of intravenous dexamethasone and methylprednisolone on the treatment of inpatients with COVID-19. METHODS: In this randomized clinical trial, 143 patients under 80 years of age with moderate to severe COVID-19 were enrolled and randomly assigned to two groups: dexamethasone (8 mg/day) and methylprednisolone (60 mg/day in two divided doses). The primary outcome was the length of hospital stay. The secondary outcomes included: duration of oxygen therapy, absolute leukocyte and lymphocyte count, hypokalemia, hyperglycemia, intensive care unit admission, and mortality in the two groups for 28 days. Data were analyzed by SPSS version 26 using t-test, chi-square, and analysis of variance. RESULTS: The duration of hospitalization was significantly (P <0.001) shorter in the dexamethasone group than in the methylprednisolone group (8 [95% confidence interval [CI]:6-10] and 11 [95% CI: 7-14], respectively). In addition, the duration of oxygen therapy in the dexamethasone group (7 [95% CI: 5-9]) was significantly (P <0.001) shorter than in the methylprednisolone group (10 [95% CI: 5.5-14]). The mortality rate was 17.1% (95% CI: 8.1-26.1) in the dexamethasone group and 12.3% (95% CI: 4.6-20.0) in the methylprednisolone group, which was not statistically significant (P = 0.46). CONCLUSION: Results showed better effectiveness of 8 mg/day dexamethasone compared with 60 mg/day methylprednisolone based on the shorter hospital stay, which can be considered in the therapeutic protocol of COVID-19. TRIAL REGISTRATION: IRCT20210223050466N1.

Tissue presentation of human pegivirus infection in liver transplanted recipients.

Human pegivirus-1 (HPgV-1) is known for its protective role in HIV co-infected individuals. This immunomodulatory effect raised questions concerning the possible role of HPgV-1 infection and the risk of rejection in liver transplanted patients. We aimed to evaluate the possible protective effect of HPgV-1 on graft outcome of liver transplanted patients. A total of 283 patients were recruited. Formalin-fixed paraffin-embedded tissue samples were collected from the explanted liver. HBV-DNA, HCV-RNA, and HPgV-1-RNA were determined using PCR and multiplex RT-PCR assays. The clinical course of patients including the occurrence of acute cellular rejection was compared between HPgV-1-infected vs. uninfected patients. HBV-DNA, HCV-RNA and HPgV-1-RNA were detected in 42.6%, 4.9%, and 7.8% of samples, respectively. None of the HPgV-1-infected patients experienced graft rejection. Group LASSO logistic regression revealed that HPgV-1 infection was the only factor which significantly reduced the odds of graft rejection (OR = 0.5, 95% CI = 0.29-0.89). No significant association was found between the presence of HPgV-1 with HBV and HCV infections. The lack of graft rejection in HPgV-1-infected liver transplanted patients might indicate a possible role of this virus for graft surveillance. Since these are still preliminary findings, prospective studies should further elucidate the role of HPgV-1 in liver transplantation outcomes.

Modeling trend changes in percent of under five-year-old children with malnutrition amongst 39 Asian countries from 1987 to 2016 via growth mixture model.

PURPOSE: Malnutrition is an important public health issue and the main cause of child morbidity and mortality, especially in developing countries. The present study aimed to model trend changes in percentage of the malnourished children under 5 among 39 Asian countries during 1987 to 2016. METHODS: Information about percentage of the malnourished under 5 years children based on under-weight (weight for age) malnutrition for 39 Asian countries were extracted from Gapminder web site during 1987 to 2016. To cluster Asian countries based on trend changes, Growth Mixture Model (GMM) was implemented. All the statistical analyses were performed in Mplus 7.4 software and P < 0.10 in likelihood ratio test (LRT) was considered as statistically significant. RESULTS: Based on P-value of LRT, the model with 3 clusters was selected. Although, cluster 3 with 9 countries had higher intercept in 1987 and the worst situation in malnutrition, they gained a sharp decrease (- 0.93) in percentage of malnourished children under five annually. The slope of - 0.64 for cluster 1 countries indicate a moderate decrease annually in percent of children with malnutrition. The other 20 countries with slope of - 0.29 in their linear trend belonged to cluster 2 which shows slow decrease in the percentage of children with malnutrition. CONCLUSION: The investments in public health and education programs, as well as political commitment and government proper response in line with needs and demands are crucial to promote food security, nourishing diets and improving child nutrition. Certainly, most of them are still a long way from eradicating malnutrition.

Investigation of academic motivation in medical students and its association with clinical education quality, academic achievement, and academic burnout.

BACKGROUND: Improving the quality of clinical education requires continuous review of the current situation, identifying strengths, and correcting weaknesses. This study aimed to investigate the association between academic motivation with quality of clinical education, academic achievement, and burnout. MATERIALS AND METHODS: This cross-sectional study was done in 2020 on all of the 140 internship students of Shahrekord University of Medical Sciences, using the consensus method. The data collection tools included standard questionnaires such as Herman's Academic Motivation, Clinical Education Quality, Maslach Modified Academic Burnout, Pham and Taylor Academic Achievement, Satisfaction of Educational Welfare Facilities. Data were analyzed using SPSS (ver. 22) software and descriptive statistics (mean, standard deviation, frequency and percentage of frequency), Spearman rank, correlation coefficient and Mann-Whitney and Kruskal-Wallis statistical tests. P < 0.05 is considered statistically significant. FINDINGS: The mean ± SD of age was 25.68±2.03. 86 (61.4%) of the internship were female and 87 (62.1%) were single. Mean± SD of academic motivation and quality of clinical education were 81.51± 8.73 and 28/99± 11/52 respectively. Also, the Mean± SD of academic achievement and academic burnouts were 147/61± 14/94 and 42/37± 10/42 respectively. RESULTS: Academic motivation had a meaningful and positive relationship with academic achievement and satisfaction of welfare facilities but a negative correlation with academic burnout. Also, academic achievement and academic burnout had a negative correlation but a positive correlation was seen between the quality of clinical education and satisfaction of welfare facilities. CONCLUSION: Considered the results, recommended improving welfare education facilities by using up-to-date training aids, upgrading educational infrastructure, and employ young staff in the education office. For improving the quality of clinical education, appropriate educational methods, conducting developmental assessments continuously, using simulated environments, and improving students' motivation.

Non-communicable diseases in the southwest of Iran: profile and baseline data from the Shahrekord PERSIAN Cohort Study.

BACKGROUND: Critical inter-provincial differences within Iran in the pattern of non-communicable diseases (NCDs) and difficulties inherent to identifying prevention methods to reduce mortality from NCDs have challenged the implementation of the provincial health system plan. The Shahrekord Cohort Study (SCS) was designed to address these gaps in Chaharmahal and Bakhtiari, a province of high altitude in the southwest of Iran, characterized by its large Bakhtiari population, along with Fars and Turk ethnicity groups. METHODS: This ongoing cohort, a prospective, large-scale longitudinal study, includes a unique, rich biobank and was conducted for the first time in Chaharmahal and Bakhtiari Province in Iran. SCS is a part of the PERSIAN (Prospective Epidemiological Research Studies in IrAN) cohort. The study began in 2015, recruited 10075 participants (52.8% female, 47.2% male) from both urban (n=7034) and rural (n=3041) areas, and participants will be annually followed up for at least 15 years. A cross-sectional analysis was conducted using baseline data from the SCS, using descriptive statistics and logistic regression. Data analysis was performed using Stata software. RESULTS: The prevalence of NCDs was 9.8% for type 2 diabetes, 17.1% for hypertension, 11.6% for thyroid disease, 0.2% for multiple sclerosis and 5.7, 0.9 and 1.3% for ischemic heart disease, stroke and myocardial infarction, respectively. The prevalence of multimorbidity (≥2 NCDs) was higher in women (39.1%) than men (24.9%). The means (standard deviations) of age, BMI, systolic blood pressure and fasting blood glucose were 49.5 (9) years, 27.6 (4.6) kg/m2, 115.4 (17.3) mmHg and 96.7 (27.3) mg/dL, respectively. Logistic regression models showed that older age, female gender, living in an urban area, non-native ethnicity, high wealth index, unemployment, obesity, low physical activity, hypertriglyceridemia, high fasting blood sugar, alkaline urine pH and high systolic and diastolic blood pressure were associated with increased prevalence of NCDs. CONCLUSIONS: The SCS provides a platform for epidemiological studies that will be useful to better control NCDs in the southwest of Iran and to foster research collaboration. The SCS will be an essential resource for identifying NCD risk factors in this region and designing relevant public health interventions.

The effect of multi-stage mobile training based on Gagne instructional design on learning, retention, and satisfaction of health volunteers.

BACKGROUND: One of the most important ways to acquire knowledge in the present age is education based on new technologies, including mobile learning. The purpose of this study was to investigate the effect of a multi-stage mobile training based on Gagne instructional design on learning, retention, and satisfaction of health volunteers. MATERIALS AND METHODS: In this interventional study, 112 health volunteers a Health Centre in Mashhad during 2019-2020 were enrolled. The participants were randomly divided into two groups: mobile education based on Gagne model (n = 56) and conventional lecture (n = 56). A researcher-made questionnaire was completed by the eligible subjects before, after, and 2 months after the intervention to assess their learning, retention and satisfaction in educational methods. Face validity, content validity, and reliability of the data collection tool and model fitness indices were confirmed. Content validity of data collection tools verified by experts and its reliability was calculated to be 0.78. The collected data were analyzed in SPSS-25, using descriptive (mean and standard deviation [SD]) and analytical statistical tests (independent t-test). RESULTS: The results showed that 2 days and 2 months after the intervention, learning, and retention rate was significantly higher in the mobile learning based on Gagne model group in comparison to conventional lecture group (P < 0.001). Furthermore, the intervention group was generally satisfied with the mobile training method. CONCLUSION: Mobile learning based on Gagne model is recommended for improving learning, retention among health-care workers.

Clustering time trends of breast cancer incidence in Africa: a 27-year longitudinal study in 53 countries.

BACKGROUND: Breast cancer is the most common, frequently diagnosed cancer with the highest incidence among female worldwide. Although the incidence is decreasing in developed countries, it is on increase in most of the African countries. OBJECTIVE: This study aimed to identify different time trends of breast cancer incidence among African countries using latent mixture approach. METHODS: The information includes newly diagnosed breast cancer patients per 100,000 women for 53 African countries in a period of 1990-2016. Latent mixture modeling was performed in Mplus 7.4 software. RESULTS: The overall trend of breast cancer in Africa was increasing. Latent mixture model with 5 clusters was estimated as the best using fit indices and linear growth trajectories were specified for each cluster. Nigeria was the only country which belongs to a cluster with negative slope indicating a slow decrease in the breast cancer incidence; also, Seychelles was the only country that showed a sharp increase over time. 31 countries belonged to a cluster with a slope of 0.08, indicating that the incidence of breast cancer is almost constant over time. Cluster 3 including Algeria, Angola, Botswana, Central African Republic, Cote d'lvoire, Equatorial Guinea, Lesotho, Libya, Namibia, Somalia, Sudan, Swaziland, Uganda and Zimbabwe and cluster 2 including Gabon, Mauritius, Morocco, South Africa, Tunisia and Congo showed a slow and moderate increase in the incidence of breast cancer, respectively. CONCLUSION: Providing health education programs is essential in African countries with rising trend of breast cancer during the last decades.

A Detailed Study in Adenomyosis and Endometriosis: Evaluation of the Rate of Coexistence Between Uterine Adenomyosis and DIE According to Imaging and Histopathology Findings.

The current study was designed to evaluate the relationship between adenomyosis and its subtypes with endometriotic lesions (ovarian endometrioma (OMAs) and posterior deep infiltrative endometriosis (DIE)), to examine the probability of existence of a common cause of these mysterious diseases, and to evaluate the accuracy, sensitivity, and specificity of both transvaginal ultrasonography (TVS) and MRI in diagnosis of adenomyotic uterus. In this retrospective cross-sectional study, we selected 154 women with coexistence of endometriosis and adenomyosis according to their imaging, intraoperative, or pathological findings who were nominated for laparoscopic surgery. Eighty-six patients with just DIE resection without LH (laparoscopic hysterectomy) (group 1), and 68 patients with LH + DIE resection (group 2). The accuracy, sensitivity, and specificity of ultrasonographic and MRI findings for diagnosing adenomyosis were 72.1%, 77.6%, 40.0% and 49.2%, 41.5%, 90.0% respectively. So, TVS is a more sensitive diagnostic tool for diagnosing adenomyosis. However, MRI was more specific than TVS in the diagnosis of diffuse adenomyosis especially with simultaneous presence of uterine leiomyoma. Regarding the association of different types of adenomyosis (focal and diffuse) with different endometriosis lesions (OMA and posterior compartment DIE), we just found diffuse type of adenomyosis more frequent in the absence of rectal and rectovaginal septum (RVS) DIE (p ≤ 0.05). In addition to the questionable different nature of rectal and RVS DIE lesion, there is no relationship between adenomyosis subtypes and endometriotic lesions.

Chamomile Extract versus Clotrimazole Vaginal Cream in Treatment of Vulvovaginal Candidiasis: A Randomized Double-Blind Control Trial.

OBJECTIVES: Vulvovaginal candidiasis (VVC) treatment is advised for all women due to its symptoms and complications. In this study, the standard treatment, clotrimazole, was compared with chamomile extract cream in outpatient clinics. METHODS: We recruited 73 women with VVC, who were randomly allocated into two groups, clotrimazole versus chamomile extract cream. After two weeks of treatment with the same criteria, cheese-like vaginal discharge, itching and burning sensations, strawberry cervix, and recovery percentage was evaluated. RESULTS: Thirty patients in each group were analyzed. There was no significant difference in age and number of pregnancies between groups (p = 0.85 and 0.09, respectively). Comparing before and after treatment, cheese like discharge (p < 0.001), itching (p < 0.001), burning (p < 0.001) had significantly improved in both groups. Further, the recovery percentage was not significantly different between groups (88.9% vs 75% in the chamomile vs clotrimazole groups, respectively). CONCLUSION: Chamomile is as effective as clotrimazole in VVC treatment; a higher percentage of women who used this medication recovered, although this did not reach significance. In addition, no complications were reported in either group.

Identifying genotype profile of chronic hepatitis C infection in Southwest Iran.

BACKGROUND: Hepatitis C virus (HCV) infection is one of the most important risk factors for liver failure which can lead to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Approximately 170-200 million (almost 3% of the world's population) people have been reported to have HCV infection worldwide. HCV has six genotypes and multiple subtypes. HCV genotyping and identification of subtypes are critical steps for HCV vaccine development. MATERIALS AND METHODS: In this community-based study, we aimed to investigate the HCV genotypes in infected patients referring to the laboratory of Hajar Hospital of Shahrekord city (the capital of Chaharmahal and Bakhtiari Province) in Iran from November 21, 2016, to October 21, 2017. During 2016-2017, the sera were obtained from 2377 individuals referring to the laboratory of Hajar Hospital of Shahrekord, Iran. The anti-HCV antibody was tested for all sera by enzyme-linked immunosorbent assay test. Following HCV RNA isolation and cDNA synthesis, HCV genotype detection was performed by quantitative reverse transcription-polymerase chain reaction. RESULTS: Genotypes 3, 1a, and 1b were found in 28.6% (95% confidence interval [CI]: 17.0%-40.0%), 9.5% (95% CI: 2.1%-17.0%), and 3.2% (95% CI: 0.0%-7.6%) of the patients, respectively. In 5 patients (7.9%, 95% CI: 1.1%-14.8%), however, we did not observe any genotypes. We could not find any significant difference between the plasma viral load of infected patients and different genotypes. There was no significant difference either between age groups and genotypes (P > 0.05). CONCLUSION: The findings of the present study determined that HCV genotype 3 was the predominant genotype followed by the genotypes 1a and 1b in Chaharmahal and Bakhtiari Province.

Dietary inflammatory index and metabolic syndrome in Iranian population (Fasa Persian Cohort Study).

Metabolic syndrome (MetS) is one of the risk factors for all causes of mortality. Inflammation is an important risk factor for MetS. The present cross-sectional study aimed to investigate the relationship between MetS and pro-inflammatory diet by using the food inflammation index (DII). This study consists of 10,017 participants with an age range of 35 to 70 years. The Fasa Cohort Study (FACS) population (Fars Province, Iran) was used to collect data. The DII was estimated according to Shivappa et al. method using a validated 125-item FFQ. To determine the association between MetS components and DII Logistic regression was used (P > 0.05). The overall mean of DII was - 0.89 ± 1.74. However, adjusted multinomial logistic regression indicates each unit increase in waist circumference (WC) (OR 0.98, 95% CI 0.96-0.99) and HDL-C (OR 0.99, 95% CI 0.98-0.99) was associated with significantly decreased odds of being in the 4th DII quartile in men and all participations respectively, there is no statistically significant relationship between MetS and DII. Overall, although people in the highest quartile of inflammatory food consumption had more likely to develop MetS, this relationship was not statistically significant among males and females.

Measurement Invariance and Psychometric Analysis of Oxford Happiness Inventory Scale across Gender and Marital Status.

BACKGROUND: The Oxford Happiness Inventory (OHI) is a self-report tool to measure happiness. A brief review of previous studies on OHI showed the lack of evaluation of OHI fairness/equivalence in measuring happiness among identified groups. METHODS: To examine the psychometric properties and measurement invariance of the OHI, responses of 500 university students were analyzed using item response theory and ordinal logistic regression (OLR). Relevant measures of effect size were utilized to interpret the results. Differential test functioning was also evaluated to determine whether there is an overall bias at the test level. RESULTS: OLR analysis detected four items across gender and two items across marital status to function differentially. An assessment of effect sizes implied negligible differences for practical considerations. CONCLUSIONS: This study was a significant step towards providing theoretical and practical information regarding the assessment of happiness by presenting adequate evidence regarding the psychometric properties of OHI.

Correlation of resting heart rate with anthropometric factors and serum biomarkers in a population-based study: Fasa PERSIAN cohort study.

BACKGROUND: There is a positive association between raised resting heart rate (RHR), and all causes of mortality and shorter life expectancy. Several serum biomarkers and some anthropometric factors can affect the resting heart rate. This study aimed to investigate the determinants of resting heart rate in a large random sample of the Iranian population. MATERIAL AND METHODS: It is a standardized, retrospective study and the subjects were chosen from the baseline survey of the Prospective Epidemiological Research Study in IrAN (PERSIAN) Fasa non-communicable disease cohort study. It was conducted from winter 2014 to summer 2019 and after obtaining informed consent from a random sample, all the eligible subjects were enrolled. All anthropometric factors and biologic laboratory factors were collected and analyzed by implement smoothly clipped absolute deviation (SCAD) linear regression and SCAD quantile regression. The comparisons between males and females were done via independent T-test. RESULTS & CONCLUSION: A total number of 9975 persons from 35 to 90 years old were included. The overall median resting heart rate was 74 (interquartile range:66-80). Mean age has no important difference between males and females (P = 0.79) but, resting heart rate was significantly higher in females (76.6 versus 71.4, P < 0.001). All anthropometric factors except wrist circumference were higher in females (P < 0.05). Age has an adverse effect on resting heart rate and also, there was a direct association between resting heart rate and systolic blood pressure and blood glucose. Alpha-blockers (coefficient = 5.2) and Beta1-blockers (coefficient = - 2.2) were the most effective drugs with positive and negative effects on resting heart rate respectively. Lower hemoglobin, obesity, and more body mass index, and more low-density lipoprotein were associated with more resting heart rate. Continuing the monitoring of this sample via our cohort study and put to action multinational prospective researches with large sample sizes and long follow-ups can lead to more precise results and better scientific judgments.

The effects of mindfulness training on the level of happiness and blood sugar in diabetes patients.

PURPOSE: The present study aimed at investigating the effect of mindfulness training on the level of happiness and blood glucose in diabetic patients in Zarghan city, Iran. METHODS: This quasi-experimental study was conducted in 2018 in Fars province, Iran. 136 diabetic patients who were eligible (had diabetes for more than one year, older than 18 years, willingness to participate in the research, and reside in Zarqan city) were selected based on convenience sampling method. Next the participants were randomly divided into two groups, each comprising 68 individuals. Both of the study samples and statistical analyser were blinded to intervention group (mindfulness training) and control group (without intervention). Before and three month after the intervention the patients' levels of happiness (based on Oxford Happiness Questionnaire), fasting blood sugar (FBS) and Glycated Hemoglobin test (HbA1c) were measured. RESULTS: The results indicated that after the sessions, the level of happiness in the Intervention group was significantly higher than the control group (p value <0.001). Also, the level of blood glucose and HbA1c after the sessions was significantly lower in the Intervention group compared to the control group (p value<0.001, p value = 0.004). After the intervention, there was a significant correlation between mean blood glucose levels and mean HbA1c levels in the Intervention group and their level of happiness (p value<0.01 and p value<0.001). CONCLUSION: The findings revealed that the mindfulness-based educational intervention can increase happiness in people with diabetes and regulate their blood glucose.