Abstract Background Academic stress can cause mental and physical problems and affect adolescents’ healthy development. This study aimed to estimate academic stress and explore its sources at the individual- and school levels among school-going adolescents in the city of Qazvin, Iran. Results This cross-sectional study used a stratified cluster sampling to recruit 1724 students aged 12–19 years from 53 schools in Qazvin City. Data were collected using a validated self-administered questionnaire. The mean academic stress score was 45.7 (95% CI 45.2, 46.3). The stress level was statistically higher among older 47.5 (95% CI 46.7, 48.3) than younger 44.1 (95% CI 43.4, 44.9) adolescents. The main academic stressors included: future uncertainty 69.7 (95% CI 68.8, 70.7), academic competition 58.5 (95% CI 57.3, 59.6), and interaction with teachers 56.1 (95% CI 55.3, 56.9). Gender, educational period, school type, family socioeconomic status, and father’s education were associated with academic stress. Conclusions We conducted a multilevel study using a random sample of male and female students in the city of Qazvin, Iran. Results indicated moderate levels of stress among Iranian adolescents. The academic stress was associated with several individual and school-level variables. Students and their families and teachers need education on stress prevention methods and coping mechanisms. Future research should focus on developing and testing multilevel policies and interventions to improve students’ mental health and academic performance.
Abstract Introduction One major barrier to develop health systems is the limited capacity for conducting research and implementation of research findings. We assessed the views of researchers, decision makers and research policy makers on how the development and usage of evidence from systematic reviews can be promoted in a country with limited resources. Methods We surveyed 131 participants in six systematic review workshops for their views on important items influencing the production and usage of systematic reviews in a developing country. They were also asked to propose interventions to deal with potential barriers. We analysed the quantitative data using multidimensional scaling methods, and the qualitative data using content analysis approach. Results We identified seven clusters of items that contribute to the promotion of conducting and using systematic reviews. For each cluster a set of interventions are proposed that health care decision makers and research policy makers may use for promoting conduct and use of systematic reviews. The clusters are ‘importance for policy makers’, ‘access to international research’, ‘priority and support for systematic reviews’, ‘competency and willingness of researchers to conduct reviews’, ‘importance for end‐users’, ‘quality of local primary research’ and ‘visibility and access to local research’. Discussion The proposed interventions focus on national level initiatives for making the systematic reviews ‘wanted’ and improving the capacity to conduct research. Our findings emphasize the essential role of policy makers for promoting systematic reviews. They demonstrate that many barriers stem from the lower quality of and lack of access to primary research originating from developing countries.
The celebrated generalized estimating equations (GEE) approach is often used in longitudinal data analysis While this method behaves robustly against misspecification of the working correlation structure, it has some limitations on efficacy of estimators, goodness-of-fit tests and model selection criteria The quadratic inference functions (QIF) is a new statistical methodology that overcomes these limitations.We administered the use of QIF and GEE in comparing the superior and inferior Ahmed glaucoma valve (AGV) implantation, while our focus was on the efficiency of estimation and using model selection criteria, we compared the effect of implant location on intraocular pressure (IOP) in refractory glaucoma patients We modeled the relationship between IOP and implant location, patient's sex and age, best corrected visual acuity, history of cataract surgery, preoperative IOP and months after surgery with assuming unstructured working correlation.63 eyes of 63 patients were included in this study, 28 eyes in inferior group and 35 eyes in superior group The GEE analysis revealed that preoperative IOP has a significant effect on IOP (p = 0 011) However, QIF showed that preoperative IOP, months after surgery and squared months are significantly associated with IOP after surgery (p < 0 05) Overall, estimates from QIF are more efficient than GEE (RE = 1 272).In the case of unstructured working correlation, the QIF is more efficient than GEE There were no considerable difference between these locations, our results confirmed previously published works which mentioned it is better that glaucoma patients undergo superior AGV implantation.
BACKGROUND: Health promotion of adolescents requires appropriate evidences of its determinants. The aim of this study was to investigate predictors of self-rated health (SRH) among adolescents in Qazvin, Iran.MATERIALS AND METHODS: In this descriptive cross-sectional study, with a multistage sampling method, we recruited 1740 adolescents aged 12–19 years from 53 schools in Qazvin, Iran (2018). We used the Strengths and Difficulties Questionnaire and Adolescents' Academic Stress Questionnaire for data collection. The analysis was conducted using a multilevel logistic regression model. Gender, educational period, and socioeconomic status were considered as confounders.RESULTS: Almost 21% of the adolescents reported their SRH suboptimal. Suboptimal SRH was higher in girls and older adolescents. Mental health disorders and academic stress had a positive association with SRH. However, this association was negative for academic achievement and physical activity. The interaction between mental health disorders and academic stress with SRH had a significant association in a crud regression model.CONCLUSION: Mental health, academic stress, academic achievement, and physical activity were important predictors for SRH. Interventions that focus on promoting mental health, academic stress, academic achievement, and physical activity such as physical activity for 1 h and each day for 3 days per week can improve SRH in adolescents. Hence, policymakers should pay more attention to this issue in health promotion programs of adolescents.
People are increasingly interested in health news. As a mass media, the 'Islamic Republic of Iran Broadcasting' (IRIB) has the highest number of target audiences. In Iran, some people follow health news via health programs on satellites and other means of communication. However, all of these programs do not live up to the standards of scientific evidence. In this study, we examined Tehran people's trust in health news disseminated by the IRIB and other mass media outlets.A cross-sectional study was conducted in Tehran. Through multistage sampling, 510 households proportional to size were randomly selected from five regions of Tehran including northern, eastern, western, southern and central regions. One person from each household completed the questionnaire through interviews. The questionnaire included questions on people's level of trust in health news delivered by the IRIB, satellite programs, the internet and magazines. It also included demographic questions. The validity and reliability of the questionnaire was evaluated.Among the interviewees, 50.6% was female. The highest level of trust by the participants was observed in the IRIB (65.2%), and the lowest trust was observed in satellite news (43.4%); p< 0.001. The interviewees believed that the IRIB news broadcasters had more mastery over the subject than the ones in satellite channels (p< 0.001). The IRIB's coverage of important and relevant health topics was also significantly perceived to be better than that of satellite news (p< 0.001). According to 83.5% of interviewees, the quality of health news had improved in the past 10 years. Fifty nine point eight percent of participants believed the quality and accuracy of the IRIB health news was monitored.People's higher level of trust in domestic news as compared to foreign sources and the better status of domestic sources in other areas such as precision in reporting, coverage of more important news, its delivery in lay language, the news broadcasters' proficiency, and other cases - from the participants' point of view - can highlight the significance of designing interventions for changing health behavior among domestic health news producers. Therefore, the results of this study can prove useful to health news policy makers in the IRIB.
The aim of the authors in this randomized controlled study was to assess the effect of exercise and nutrition education on quality of life and early menopausal symptoms. This trial was conducted in east Azerbaijan Province, Iran, during the period from 2013 to 2014 with 108 women allocated into one of four groups (n = 27 in each group) by block randomization. The interventions received by the three intervention groups were: nutrition education, aerobic exercise, or exercise plus nutrition education. The control group did not receive any intervention. The Greene and MENQOL menopause symptom scales were completed before and at 8 and 12 weeks after the intervention. The mean Greene score was significantly lower than the control group in the exercise (adjusted mean difference: −5.1) and exercise plus nutrition groups (−8.0) at the end of week 8 and in the nutrition (−4.8), exercise (−8.7), and exercise plus nutrition (−13.2) groups at the end of week 12. Also, the mean MENQOL score was significantly lower than the control group in the exercise (−8.3) and exercise plus nutrition groups (−13.8) at the end of week 8 and in the nutrition (−6.6), exercise (−13.5), and exercise plus nutrition (−22.1) groups at the end of week 12. Nutrition education with aerobic exercise can improve quality of life.
Introduction: According to the health-promoting approach, people should be empowered such that they take responsibility for their health and follow a healthy lifestyle.Empowerment is a process in which people confront problems and tasks in their lives in order to better control them.This study was conducted to specify the relationship between individual empowerment and health-promoting lifestyle among women NGOs of northern Iran.Methods: In this cross-sectional study, 290 women NGOs of Guilan Province were selected randomly using multistage cluster sampling, and were examined using the questionnaire of health-promoting lifestyle profile II and individual empowerment inventory scale.Data were analyzed using STATA 11 software via one-way ANOVA, Pearson correlation coefficient and multivariate linear regression.Results: Both variables of individual empowerment and health-promoting lifestyle were of favorable status among the population under study.The highest score in individual empowerment belonged to the domain of social support and the highest score in lifestyle belonged to spiritual growth.A significant relationship was found between individual empowerment and health-promoting lifestyle (p<0.001).The highest correlation between individual empowerment and dimensions of health-promoting lifestyle was related to interpersonal relationships.In addition, it was specified that 21% of lifestyle variance could be explained by individual empowerment. Conclusion:There is a relation between individual empowerment and health-promoting lifestyle.Individual empowerment is a predictive variable to have a health-promoting lifestyle.Therefore, by increasing individuals' empowerment, their healthy lifestyle can be promoted.
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