Iranian Journal of Epidemiology

The Association between the Consumption of Dairy Products and the Risk of Cardiovascular Disease: Tehran Lipid and Glucose Study

Parvin Mirmiran

Background and Objectives: The association between the consumption of dairy products and the risk of cardiovascular disease (CVD) is not well-known yet. Here, we aimed to determine the potential effects of total intake and subtypes of dairy products on the development of CVD in an Iranian adult population.
Methods: Among adult participants of the third phase of the Tehran Lipid and Glucose Study (TLGS), after excluding those with incomplete dietary, biochemical and anthropometric data, and those who had CVD events at baseline, 2635 adults were selected and followed up till the sixth phase of the TLGS. Baseline dietary intakes were evaluated using a validated food frequency questionnaire with 168 items. There was no significant difference between the baseline characteristics of participants who did not complete the FFQ and those of the total population in the third phase of the TLGS. Finally, the risk of CVD events after adjusting for potential confounding variables was evaluated across the tertile categories of dairy products using the Cox proportional hazard regression models.
Results: During a 10.6-year follow-up, the incidence rate of CVD was 6.5%. After adjusting for confounding factors, there was no significant association between CVD risk and total dairy, low-fat and high-fat dairy, fermented and non-fermented dairy products, high- and low-fat milk, high- and low-fat yogurt, cheese, and cream cheese, as well as ice cream.
Conclusion: According to numerous evidence in previous studies that revealed there is no association between the consumption of dairy products, and CVD risk, independent of high-fat or low-fat dairy products. Hence, it is vital to reconsider dietary recommendations on lowering the intake of high-fat dairy products for the prevention of CVD.

Effect of Stress Management Training Based on Multimedia Software on the Stress Response of Nurses in Children's Wards of Iran University of Medical Sciences

Raheleh Mohammadi

Background and Objectives: The use of modern and technology-based educational methods can play a significant role in enhancing nurses' capabilities in stress management and improving their responses to stressful situations. Therefore, this study aims to determine the impact of stress management on the stress responses of nurses working in pediatric departments of educational hospitals affiliated Iran University of Medical Sciences through a multimedia software intervention.
Methods: In this quasi-experimental study, a random sampling method was employed to select 102 nurses (51 individuals in the intervention group and 51 in the control group) working in general hospital departments. The inclusion criteria for evaluating the effectiveness of stress management training on the stress responses of nurses included having at least a bachelor’s degree, a minimum of 6 months of work experience in pediatric wards, no reported psychological disorders, and no use of psychiatric medications based on self-reports. Additionally, participants were required to have access to a computer capable of running DVDs and familiarity with its operation, with no prior experience or readiness to participate in a stress management workshop within the last 6 months. Conversely, the exclusion criteria were participant dissatisfaction, change of department, and hospital relocation. This assessment is shared in improving the skills and response to the stress of nurses in pediatric department of medical centers. To measure the stress responses, the Inventory Response Stress questionnaire was utilized, which was completed by both groups prior to the intervention. Subsequently, the educational content regarding stress management was provided to the intervention group for duration of 8 weeks. At the end of the eighth week, both groups completed the stress response questionnaire again. Data analysis was performed using SPSS version 22 software, with statistical tests including Fisher's exact test, Mann-Whitney U test, Kruskal-Wallis H test, and Analysis of Variance (ANOVA).
Results: No significant difference was observed in the mean of stress response in the intervention (29.69 ± 23.66) and control (33.20 ± 27.95) groups before the intervention (p = 0.661). The average stress response score in the intervention group (19.65 ± 16.74) was significantly lower than the control group (32.67 ± 28.17) after the intervention (p < 0.001).
Conclusion: These data demonstrated the positive effect of the stress management program on nurses' stress response who participated in this study.

Factors Affecting the Severity of Domestic Violence against Pregnant Women: A Cross-Sectional Study in Northeastern Iran

Ashraf Saber

Background and Objectives: Violence against pregnant women is a clear violation of women's rights associated with many consequences and complications both for the mother and fetus. In this study, we aimed to determine factors affecting the severity of domestic violence against pregnant women.
Methods: This cross-sectional descriptive-analytical study was carried out between July 2020 and September 2021. The participants were 234 women with low-risk pregnancies (28-40 weeks) who were transferred to the maternity ward of Bentolhoda Hospital in Bojnurd City. Mothers were selected by the convenience sampling method. A two-part questionnaire was used in this study, which included demographic and midwifery information questionnaires and a domestic violence questionnaire created by Tabrizi in 2013. Subsequently, the data were analyzed using logistic regression.
Results: The prevalence rate of violence against pregnant women (experiencing at least one type of domestic violence from the husband) was 64.6%. Among those who had experienced violence, 36.1% of the participants experienced low to very mild violence during pregnancy and 63.9% experienced moderate violence. However, severe violence was not experienced by any of the research units. Also, there was a significant relationship between babies' gender and the severity of violence (P=0.03). Pregnant women with male fetus (OR = 3.14, CI95%:1.093–9.069) were 3.14 times more exposed to violence with moderate severity.
Conclusion: In this study, most women suffered domestic violence with moderate severity. Among pregnant women with male fetuses, the severity of violence was even higher. Thus, it is necessary to pay a proper attention to the design and implementation of educational and support programs for these women to prevent domestic violence and reduce its adverse impacts.

Investigating the Status of Non-Communicable Diseases and Dietary Patterns of Patients with Lipid Disorders in Alvand City

Sareh Shakerian

Background and Objectives: Evidence shows that blood lipid disorders in people are influenced by their unhealthy diet. This study was conducted with the aim of investigating the dietary pattern of people with lipid disorders and the status of non-communicable diseases in the studied population.
Methods: A cross-sectional study was conducted on 300 patients with lipid disorders. The participants were selected among people with lipids who referred to comprehensive health service centers in Alvand city by multistage sampling method. The data were collected using a semi-quantitative food frequency questionnaire (FFQ). The findings were analyzed by SPSS software.
Results: Three dietary patterns including healthy, unhealthy and average were identified in the research participants. Most people (66.3%) followed a moderate dietary pattern. Also, 85% of people were overweight or obese. The results of the logistic regression analysis showed that an unhealthy eating pattern increases the likelihood of developing diseases by 2.267 times compared to a healthy eating pattern. It also showed that with increasing age, the probability of contracting the disease increases by 1.093. Also, there was a significant relationship between food pattern and education level (P<0.05). In this study, there was no significant relationship between age, marital status of people and their food pattern (P>0.05).
Conclusion: The results showed that people who follow an unhealthy food pattern have more non-communicable diseases. Therefore, it seems that modifying the food pattern through nutrition education is appropriate and can be effective in preventing other non-communicable diseases in the future.

Familial Aggregation of Alcohol Consumption and Associated Factors in East Azerbaijan Province: A Cross-Sectional Study

Saeed Dastgiri

Background and Objectives: The present study aimed to assess the prevalence and familial aggregation pattern of alcohol consumption among father-offspring, mother-offspring, siblings, and spouses in Tabriz city, and to investigate the associated risk factors.
Methods: This cross-sectional study was conducted in 2023 on 860 individuals in Tabriz city. The heads of households were selected as proband individuals. Conveniently, probands were recruited from daily visitors, and upon agreeing to participate, their first-degree relatives (spouse and children) were also invited to join in. Data were collected using standard self-reported questionnaires. Generalized Estimating Equations (GEE) were employed to assess family aggregation among father- offspring, mother-offspring, and siblings.
Results: No significant of familial aggregation alcohol consumption was observed between spouses (OR=0.54 (0.16-1.8)). Although familial aggregation was observed between mothers and children, this was not statistically significant (OR=1.54 (0.8-2.94)). There was a significant familial aggregation of alcohol consumption between fathers and children (OR=1.98 (1.08-2.5)). Among siblings, familial aggregation was not statistically significant (OR=1.38 (0.41-4.63)).
Conclusion: Based on the findings of this study, family members play an important role in influencing the alcohol consumption behaviors of other family members. Additionally, individuals with lower socioeconomic status, those who are divorced, and singles may be more appropriate targets for alcohol consumption screening programs.

The Prevalence of Depression Among Students with Nursing Major in Iran Using the Beck Questionnaire: A Systematic Review and Meta-Analysis

Seyedeh Mahboobeh Hosseini Zare

Background and Objectives: Depression is one of the most prevalent mental disorders among students associated with a major decline in academic and social performance. This study was carried out to determine the prevalence of depression in Iran's nursing students.
Methods: the research was conducted as a systematic review and meta analysis, all published scientific articles related to the prevalence of depression in nursing students were searched in 5 databases (Web of Science, Scopus, PubMed, SID, Magiran) and Google Scholar search engine and then their quality was evaluated. The heterogeneity of the studies was investigated using the I² index and meta-regression model to evaluate heterogeneity-prone variables at a significance level of 0.05. Ultimately, 9 articles met the criteria for inclusion in this study and were analyzed using Comprehensive Meta-Analysis (CMA) software.
Results: Based on the random model, the prevalence of depression in Iranian nursing students was equal to 3.2% (2.1 – 4.5; 95% confidence level). Results showed that the highest prevalence of depression in nursing students was 6.2% (5.3-7.1; 95% confidence limit) in Sistan and Balochestan province in 2004, while the lowest prevalence was 0.8% (0.5-1.2; confidence limit 95%) in Esfahan and Qom provinces in 2016. Also, there was a significant relationship between the calendar year, sample size, average age, and prevalence of depression in Iranian nursing students (P<0.05).
Conclusion: The results showed that the prevalence of depression in nursing students was 3.2%, which decreased with the increase of the calendar year and average age. Nevertheless, policymakers and managers must take measures to reduce depression.

Different Types of Migration among Skilled Medical Professionals

Azam Bazrafshan

The migration of elites has become a major challenge worldwide. In Iran, in recent years, there has been a remarkable increase in the number of immigrants. Migration often occurs in different ways including educational migration within geographical borders, field migration, experts avoiding professional activities, and forced or semi-forced migration. Due to the fact that each form of migration can lead to diverse problems, it is imperative to pay attention to the nature and complications of each type of migration in the discussion of human resources management.