Social Determinants of Health

Background: The consumption of high energy and low nutritional content foods, which are known as junk foods, is considered as one of the main causes of obesity particularly in adolescents. The aim of this study was to determine the association of junk food consumption with overweight-obesity among preclinical medical students of Shahid Beheshti University of Medical Sciences (SBMU).

  Methods: In this cross-sectional study, preclinical students of SBMU were recruited by simple randomized sampling. Study participants included 18-23 years old male and female. Demographic and socio-economic data were collected by a questionnaire. Information relating to the consumption of junk foods was provided by a 24-items self-administered semi-quantitative food frequency questioner (F.F.Q). The relationship between the consumption of fast food and overweight-obesity (O.O) was analyzed using IBM SPSS Statistics for Windows, Version 21.0. through binary logistic regression method.  

  Results: A total of 186 students participated in this study. Overweight-obese students (BMI 25) accounted for 63 (34%) of the total participants. A total of 58 (31.1%) students consumed fast foods more than 1.52 serving/week. Students who were at the highest tertile of fast food consumption, had a higher chance of O.O (OR=2.42, 95% CI=1.17-4.99, P=0.01) in comparison with those in the lowest tertile (OR=2.21, 95% CI=1.01-4.84, P=0.04). After adjustment for age and socioeconomic factors, this chance was increased (OR=3.824, 95% CI=1.66-8.811, P=0.002); but, after adjusting lifestyle variables (physical activity) this relationship was not significant anymore (OR=2.247, 95% CI=0.998-5.058, P=0.05). 

  Conclusion: The findings of this study represent a positive association between fast-food consumption and O.O in medical students.

  Background: The current medicine teaching curriculum has caused medical students several psychological ailments including depression, and stress. Our study aimed to find a relationship between some socioeconomic characteristics of medical student and their life skills at Mashhad University of Medical Sciences, Iran.

  Methods: 146 Interns of Mashhad University of Medical Sciences were enrolled in our cross-sectional study by census. The framework was obtained from education department of faculty. Students reported a history of psychological disorders, and foreign students were excluded. We evaluated participant's Proficiency in computer, habitat, parent's education, and family income and life skills. Data were analyzed by SPSS Inc. Released 2007. SPSS Inc. Released 2007. SPSS for Windows, Version 16.0.

  Results: Participants aged between 22 to 27 and 98 (66.2%) of them were female. Comparison between four levels of father's education (lower than diploma, diploma, bachelor and higher than bachelor) showed worldview (P=0.014), social behavior (P=0.011) and ability to use new technologies (P=0.018) had a significant difference. Regarding the mother's education, there are no significant differences among 20 life skills. There were significant differences between levels of computer proficiency and communication skills (P=0.042), interpersonal relations (P=0.011), mental health status (P=0.035), problem-solving (P=0.021), creativity (P=0.013), ability of using new technologies (P=0.001), participate in activities that improve benefits (P=0.027), and total score (P=0.043).

  Conclusion: Despite mothers' education, fathers' education has a role in medical students' world view, technology access, and social behavior. However, comparison of means and subgroup analysis didn't show a logical relationship. Computer proficiency besides affecting different aspects of life skills can affect total life skill scores.

  Background: Dairy products are required for bone metabolism; however, the majority of adolescent do not consume the products adequately. This study was performed to assess the prevalence of dairy products consumption, daily calcium, vitamin D intake, and vitamin D deficiency.

  Methods: In this cross-sectional study, 444 females and males’ students in middle and secondary school were recruited by using mixed sampling method. Food Frequency Questionnaire (FFQ) was used to estimate dietary calcium and vitamin D consumption. Serum calcium, and 25 (OH) vitamin D were measured. The data was analyzed by IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp. T-test, Chi² and Spearman correlations tests were used as well.  

  Results: Out of all participants, 214 (48.2%) were females. The average age of the participants was 14.34 years and 206 (46.6%) of the students were in middle and 238 (53.6%) were in high school. 409 (92.1%) of the students consumed at least one glass of milk per week. Calcium intake from milk and yoghurt was more than calcium intake from other dairy products. The amount of calcium lower than 700 mg/day was consumed in 176 (39.6%) of adolescents. There was a significant positive correlation between weekly calcium intake and serum vitamin D level (P=0.001). The prevalence of vitamin D deficiency was higher in females rather than males (151 (71.2%) vs. 40 (17.5 %)). 

  Conclusion: Adolescents in Tehran do not consume dairy products enough. Indeed, encouraging teenagers to consume dairy products and alter in dietary patterns that improve calcium intake, should be taken in to consideration.

Background: Recent studies have shown that sleep difficulties could be related to abnormal eating patterns. Apparently, eating and sleeping behaviors both affect human lives. Dysregulation of these behaviors lead to distress and negative health and psychological outcomes. The present study aimed to investigate the association between disordered eating behaviors and sleep disturbance among medical students.

  Methods: This was a cross-sectional study which was conducted at Shahid Beheshti University of medical sciences. The eating disorder behaviors were assessed based on the Eating Attitudes Test-40 questionnaire and Sleep disturbances were assessed by two items related to difficulties initiating sleep (DIS) and maintaining sleep (DMS). Each individual correlation was used to calculate variable associations. Linear multiple regression analysis was performed to identify variables contributing to an explanation of sleep difficulties.  

  Results: In total, 172 people participated in this study. It was observed that bulimic behaviors (BB) and social pressure to eat (SPE) were the dimensions that significantly explained difficulties maintaining sleep (r=0.207, P<0.001 and r=0.286, P<0.001, respectively) and overall sleep disturbances (r=0.355, P=0.001 and r=0.225, P=0.003, respectively). Negative correlation between body mass index (BMI) and difficulties maintaining sleep (DMS) (r=-0.069, P=0.527) was not remarked which was found in males. 

  Conclusion: It was ultimately attained that age and sex could be accounted as confounder variables in the association between sleep disturbance and eating behaviors. The results indicated that a normal eating behavior has a positive relation with the quality of sleep.

Background: Burnout is one of the most common illnesses due to stress among nurses. Nurses should be able to respond to ethical conflicts by using professional value. This study aimed to determine the relationship between professional value and occupational burnout of nurses working in the emergency department of educational hospitals at Shahid Beheshti University of Medical Sciences in Tehran.

  Methods: This cross-sectional study included 241 nurses from 6 educational hospitals during 2018 by using convenience sampling. The Maslach Burnout questionnaire and a professional nursing questionnaire were used for collecting data. The data were described by mean±SD, frequency (percentage) and analyzed by Pearson correlation coefficient and linear regression using SPSS Inc. Released 2009. PASW Statistics for Windows, Version 18.0.

  Results: Of all participants 132 (54.8%) were female. The mean±SD of occupational burnout score was 70.71±15.25. The mean±SD of score for emotional exhaustion was 27.78±11.57, depersonalization was 13.34±5.37, the personal accomplishments was 29.64±10.63, and the professional value was 88.25±22.0. There was a significant reverse relationship between professional value score and occupational burnout score (r=-0.19, P=0.01, 95% CI=-0.23_-0.03). The demographic data was no associated with the occupational burnout (all P>0.05).

  Conclusion: Overall, occupational burnout in emergency department in nurses was high. According to the attained data, the professional value is one of the factors which has been associated to the occupational stress and burnout.

Background: Death anxiety is among disruptive factors in mental health of a patient with breast cancer. Therefore, the present study was conducted to compare effectiveness of acceptance and commitment therapy and spiritual therapy on death anxiety of women with breast cancer.

  Methods: In this quasi-experimental study, 24 women with breast cancer referred to Haft-e-Tir Hospital, Tehran, Iran were included by available sampling method. The participants were randomly assigned to two groups experimental and one control group. They were asked to fill out the Templer Death Anxiety Questionnaire consisting of 15 questions in a 3-month period in 3 phases of pre-test, post-test, and follow-up. Experimental groups received acceptance and commitment therapy and spirituality therapy in eight, 90-minute sessions, and they were followed up 2 months after the interventions. Data analysis was performed using Repeated-Measures ANOVA by SPSS Ver. 21.0.  

  Results: Results of the study showed that, 16 of the participants (66.7%) were 30-50 years old, and 17 of the participants (70.8%) were married. In addition, 15 of the participants (62.5%) had a degree below high school diploma and 15 (62.5%) of the participants had been diagnosed with Breast Cancer for less than one year. Results of the study showed a significant difference in the effect of spiritual therapy on death anxiety compared to acceptance and commitment therapy (P 0.05, F=4.07). On the other hand, the effect of spiritual therapy on death anxiety (P 0.001, F=10.09) was significant. But, acceptance and commitment therapy did not have a significant effect on death anxiety (P 0/05, F=2.704).

  Conclusion: Since, spiritual involvement and beliefs could account for any of the variation in death anxiety, spiritual therapy was found to improve death anxiety indices in the patients with breast cancer and therefore, the therapists could use this method to improve death anxiety in these patients.

Epidemiologists have recently declared coal workers’ pneumoconiosis, more commonly known as “black lung disease”, an epidemic in the economically underserved areas of eastern Kentucky, southwestern Virginia and southern West Virginia. The epidemic was declared after black lung cases increased significantly after decades of declining estimates. The circumstances associated with verifying the presence of black lung disease and obtaining subsequent compensation benefits have a long-standing and controversial history clouded by allegations of bias and corruption. In the article, I question the accuracy of government reported estimates and discuss why true estimates of black lung disease likely are greatly underestimated due to a combination of poor data collection methodologies and unique social, cultural, economic and political factors surrounding underserved and vulnerable coal miners in Appalachia.