Background End-Stage Renal Disease (ESRD) is the final and permanent stage of Chronic Kidney Disease (CKD). Hemodialysis (HD) is the most common treatment for CKD. To have desirable therapeutic outcomes, patients have to adhere to a specific therapeutic regimen that reduces the hospitalization rate and side-effects of HD. The present study aimed to determine the effects of the patient education program and nurse-led telephone follow-up on adherence to the treatment in hemodialysis patients. Methods This is a randomized controlled trial in which a total of 66 patients were recruited using convenience sampling and then randomly assigned to two groups of control (n = 33) and intervention (n = 33). Data were collected using a demographic questionnaire, the laboratory results record sheet, and the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), which included four dimensions of HD attendance, medication use, fluid restrictions, and diet recommendations. The intervention group received a patient education program and nurse-led follow-up services through telephone communication and the Short Message Service (SMS) for 3 months. All participants filled in the questionnaire before and after the intervention. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). Results The results showed a significant difference in the mean scores of HD attendance, medication use, fluid restrictions, and diet recommendations between the two groups immediately, 1 month, and 3 months after the intervention (p < .001). The results also indicated a significant difference in the mean scores of four dimensions during the four-time points of measurement in the intervention group (P < 0.0005). Therefore, the level of treatment adherence in the intervention group was higher than in the control group. Moreover, there was a significant difference in the mean score of laboratory values between the two groups after the intervention, except for the level of serum sodium (P = 0.130). Conclusion Implementation of the patient education program and nurse-led follow-up can lead to better adherence to hemodialysis in four dimensions of HD attendance, medication use, fluid restrictions, and dietary recommendations in HD patients. Trial registration IRCT registration number: IRCT20190127042512N1; Registration date: 2020-09-12; Registration timing: retrospectively registered: Last update: 2020-09-12.

Background: Overweight and obesity are major health concerns worldwide, with adverse health consequences during the life span. This study measured socioeconomic inequality in overweight and obesity among Iranian adults. Methods: Data were extracted from 129,257 Iranian adults (aged 35 years and older) participated in the Prospective Epidemiologic Research Studies in IrAN (PERSIAN) in 14 provinces of Iran in 2014. Socioeconomic-related inequality in overweight and obesity was estimated using the Concentration Index (C n ). The C n further decomposed to find factors explaining the variability within the Socioeconomic related inequality in overweight and obesity. Results: Of the total number of participants, 1.98, 26.82, 40.76 and 30.43% had underweight, normal weight, overweight and obesity respectively. The age-and sex standardized prevalence of obesity was higher in females than males (39.85% vs 18.79%). People with high socioeconomic status (SES) had a 39 and 15% higher chance of being overweight and obese than low SES people, respectively. The positive value of C n suggested a higher concentration of overweight (0.081, 95% confidence interval [CI]; 0.074-0.087) and obesity (0.027, 95% CI; 0.021-0.034) among groups with high SES. There was a wide variation in socioeconomic-related inequality in overweight and obesity rate across 14 provinces. The decomposition results suggested that SES factor itself explained 66.77 and 89.07% of the observed socioeconomic inequalities in overweight and obesity among Iranian adults respectively. Following SES, province of residence, physical activity, using hookah and smoking were the major contributors to the concentration of overweight and obesity among the rich. Conclusions: Overall, we found that overweight and obesity is concentrated among high SES people in the study population. . Accordingly, it seems that intersectional actions should be taken to control and prevent overweight and obesity among higher socioeconomic groups.

BackgroundVitamin D has a multitude of functional properties and acts like a hormone in the body. Its effect on the lipid profile is one of the proposed mechanisms for its relationship with many disorders during its deficiency. But, this relationship is still conflicting and debatable, so this study was conducted to determine the association between serum level of vitamin D and lipid profiles, including serum concentrations of cholesterol, triglyceride (TG), HDL, and LDL in healthy subjects.MethodsIn this cross-sectional study, 541 volunteers with age of 5–60 years from normal and healthy subjects were selected via random sampling. Demographics and history of daily or weekly sunlight exposures were recorded. Measuring vitamin D was done in two consecutive seasons: winter and summer. Ten milliliters of peripheral venous blood sample was withdrawn after an overnight fasting. Serum levels of 25(OH) D (25, hydroxy vitamin D3) were measured using the enzyme-linked immunosorbent assay (ELISA), and the Confirmatory test was done by high-performance liquid chromatography (HPLC).ResultsMean age in the total mixed population was 30.83 ± 14.02 years. Subjects were 50.5% male and 49.5% female. Mean 25(OH) D in the total population for winter and summer were 45.8 ± 24.26 ng/ml and 55.24 ± 37.47 ng/ml respectively. In the total population, 38.08% were vitamin D deficient. Comparing serum lipid levels in the summer and winter showed a significant difference for cholesterol, LDL, and HDL, but no significant effect was found for TG. Analysis for the comparison of lipid profiles between the two genders in winter showed that there were significant differences in all lipid profiles except for LDL, while such analysis for summer revealed significant difference just for TG. In multivariate analysis, there was a significant mean difference only for LDL in subgroups with vitamin D insufficiency and deficiency. There was no correlation between Vitamin D and lipid profiles.ConclusionsVitamin D is different between the two seasons regardless of gender variations. Its status showed some significant relationship with some lipid profiles (cholesterol, LDL, and HDL) during the two seasons. There were different results among winter and summer based on the gender.

Key words:Food intake. Plate waste. Hospitalized patients. Iran. Palabras clave:Ingesta. Desperdicio. Hospitalización. Irán. ResumenIntroducción: la desnutrición hospitalaria constituye a la vez un problema y un reto. Una cantidad grande de desperdicio en el menú hospitalario se correlaciona con mayor incidencia de complicaciones asociadas a la desnutrición. Se evalúa en este trabajo la asociación entre la cantidad de comida desechada, el consumo real y la satisfacción de los pacientes con la prevalencia de desnutrición y de riesgo nutricional en tres hospitales iraníes. Métodos: se evaluó una muestra de 120 pacientes, de 18 a 65 años, ingresados a lo largo de 12 meses en tres hospitales universitarios de distinto nivel. Se recogieron datos de la historia dietética, las medidas antropométricas, el índice de masa corporal y el grado de satisfacción de los pacientes con el menú servido. Se pesó el desperdicio de las bandejas de alimentación y la ingesta diaria de cada paciente. El riesgo nutricional se evaluó mediante la herramienta NRS-2000, estimando el riesgo cuando la puntuación era ≥ 3. Resultados: se incluyeron 120 pacientes no críticos, con una duración media de hospitalización de 8,9 ± 3,5 días. El 40,8% (49) eran varones. Los requerimientos energéticos medios eran 2.030,3 ± 409,03 kcal/día y los proteicos de 76,13 ± 15,33 g/día. La ingesta media fue de 1.326 ± 681,44 kcal/día y la proteica de 66,81 ± 31,66 g/día. Se desperdició en la comida y en la cena una media del 37,7 ± 29,88 y 30,4 ± 23,61 respectivamente. Solo un 25% de los pacientes estaban satisfechos con la dieta. Un 12,5% de los pacientes tenían un IMC < 20 y un 14,2% una pérdida no intencionada de peso > 10%. La prevalencia de riesgo nutricional era del 30% al ingreso y del 33,3% al alta. Conclusión: el desperdicio de la comida en el hospital y la desnutrición hospitalaria tienen una alta prevalencia en la muestra estudiada, que se acompañaban de un mayor riesgo nutricional. Las administraciones públicas deberían abordar este problema y desarrollar estrategias de prevención adecuadas. AbstractBackground: Hospital malnutrition is a worldwide dilemma and challenge. High levels of plate waste contribute to malnutrition-related complications in hospital. We investigated the association between the levels of plate waste, food intake and patient satisfaction with nutritional risk and malnutrition prevalence in three hospital settings. Methods: The sample population of 120 patients, aged 18-65 year, admitted consecutively over a 12 month period to 3 different educational university hospitals was included. For all the patients, diet history, anthropometric measurements, body mass index and patient satisfaction with the hospital food service was evaluated. Weight plate waste for all daily meals was done and actual intakes computed individually for each day. Nutrition risk screening (NRS)-2002 (≥ 3) tool was used for estimating the nutritionally at-risk population. Results: From one hundred twenty non-critically ill patients with a mean 8.9 ± 3.5 day len...

Background The level of socioeconomic-related inequality in physical activity in Iran is largely unknown. This study investigates socioeconomic-related inequality in poor-physical activity (PPA) among Iranian adults. Methods A total of 129,257 adult participants enrolled in the PERSIAN (Prospective Epidemiological Research Studies in IrAN) Cohort were included in this study. Physical activity of adults was measured using metabolic equivalent rates (METs). Physical activity less than 41 METs/hour/day was considered PPA. The Concentration index (C) was used to quantify socioeconomic-related inequality in PPA. Moreover, the C was decomposed to identify the relative contribution of explanatory variables to inequality in PPA. Results There were significant regional variations in physical activity level among Iranian adults (29.8–76.5%). The positive value of C (0.098, 95% CI = 0.092 to 0.104) suggested that the higher concentration of PPA among higher socioeconomic status (SES) adults in Iran which was consistently observed in all cohort sites. Conclusions The higher prevalence of PPA among Iranian adults, especially, women and older adults, warrant further public health attention. Since PPA is concentrated more among the high-SES population in Iran, strategies for the promotion of physical activity should focus more on economically well-off population.

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Introducción: la nutrición parenteral (NP) en la infancia es un tratamiento cuyas características son muy variables en función de la edad y la patología que presente el paciente.

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