1.The Associations between Bone Mineral Density and Oxidative Stress Biomarkers in Postmenopausal Women
Sanaz MALEKIAN ; Mojgan MIRGHAFOURVAND ; Farzad NAJAFIPOUR ; Alireza OSTADRAHIMI ; Nafiseh GHASSAB-ABDOLLAHI ; Azizeh FARSHBAF-KHALILI
Korean Journal of Family Medicine 2023;44(2):95-101
Background:
Oxidative stress plays an essential role in bone health among postmenopausal women. This study aimed to compare the oxidative stress biomarkers among postmenopausal women aged 50–65 years with normal bone mineral density, osteopenia, and osteoporosis.
Methods:
In this observational study, 120 women with normal bone mineral density, 82 with osteopenia, and 86 with osteoporosis were selected based on the densitometry data obtained from the dual-energy X-ray absorptiometry method. The serum total antioxidant capacity (TAC), superoxide dismutase (SOD) activity, and malondialdehyde (MDA) levels were measured using biochemical methods. A binary logistic regression model adjusted for confounders was used to estimate the risk of osteopenia and osteoporosis. The P-value of <0.05 was considered statistically significant.
Results:
There were significant differences between the three groups in age, menopausal age, body mass index, and education (P<0.05). According to the binary logistic regression model, higher SOD activity and serum TAC levels were associated with a lower risk of osteoporosis (adjusted odds ratio [aOR], 0.991; 95% confidence intervals [CI], 0.986 to 0.996; and aOR, 0.373; 95% CI, 0.141 to 0.986, respectively). MDA was a significant risk factor for osteopenia in postmenopausal women (aOR, 1.702; 95% CI, 1.125 to 2.576).
Conclusion
Higher SOD activity and serum TAC levels in the studied postmenopausal women were associated with a significantly lower risk of osteoporosis. Moreover, the risk of osteopenia increased significantly with higher serum MDA levels.
2.Global Mapping of Potentially Inappropriate Prescribing for Older Adults in Community Settings: An Umbrella Review
Nafiseh GHASSAB-ABDOLLAHI ; Haidar NADRIAN ; Fatemeh SAADATI ; Fariba ASHAZADEH ; Elnaz SHASEB ; Mina HASHEMIPARAST ; Hamid ALLAHVERDIPOUR
Korean Journal of Family Medicine 2023;44(4):189-204
Potentially inappropriate prescribing (PIP) is a major public health concern with several undesirable health consequences for older adults. In this overview, we aimed to map and gather information from existing literature to provide a better insight into the prevalence of PIP among community dwellers. Electronic databases were searched from their inception to April 2022. The quality of the included systematic reviews (SRs) was assessed using the assessment of multiple systematic reviews checklist. The degree of overlap within the SRs was also evaluated (2% overlap). All SRs on the prevalence of PIP in older individuals in community settings were included, and a narrative approach was used to synthesize data. Nineteen SRs comprising 548 primary studies met the inclusion criteria, and the average quality of the included SRs was moderate. More than half (50.5%) of the primary studies were conducted in Europe, followed by the United States (22.8%), and Asia (18.9%). Thirty different criteria were used in the primary studies to estimate the prevalence of PIP. The most widely used criteria were those presented in Beers (41.8%) and STOPP (Screening Tool of Older Persons’ Prescriptions)/START (Screening Tool to Alert to Right Treatment) (21.8%) criteria. Benzodiazepines, nonsteroidal anti-inflammatory drugs, and antidepressants were the most frequently reported PIPs. A considerable variation in the prevalence of PIP ranging from 0% to 98% was reported by SRs. However, there is a high degree of uncertainty regarding the extent of PIP in community settings. To identify knowledge-to-action gaps, SR authors should consider the differences in prevalence of PIP according to settings, applied tools, data sources, geographical areas, and specific pathologies. There is also a need for primary and SR studies from low- and middle-income countries regarding the prevalence of PIP.
3.Indices/Indicators Developed to Evaluate the “Creating Supportive Environments” Mechanism of the Ottawa Charter for Health Promotion: A Setting-Based Review on Healthy Environment Indices/ Indicators
Fatemeh SAADATI ; Haidar NADRIAN ; Nafiseh GHASSAB-ABDOLLAHI ; Fariba PASHAZADEH ; Neda GILANI ; Mohammad-Hossein TAGHDISI
Korean Journal of Family Medicine 2023;44(5):261-267
This study aimed to identify the indices/indicators used for evaluating the “creating supportive environments” mechanism of the Ottawa Charter for Health Promotion, with a focus on built environments, in different settings. A search for literature with no time limit constraint was performed across Medline (via PubMed), Scopus, and Embase databases. Search terms included “Ottawa Charter,” “health promotion,” “supportive environments,” “built environments,” “index,” and “indicator.” we included the studies conducted on developing, identifying, and/or measuring health promotion indices/indicators associated with “built environments” in different settings. The review articles were excluded. Extracted data included the type of instrument used for measuring the index/indicator, the number of items, participants, settings, the purpose of indices/indicators, and a minimum of two associated examples of the indices domains/indicators. The key definitions and summarized information from studies are presented in tables. In total, 281 studies were included in the review, within which 36 indices/indicators associated with “built environment” were identified. The majority of the studies (77%) were performed in developed countries. Based on their application in different settings, the indices/indicators were categorized into seven groups: (1) Healthy Cities (n=5), (2) Healthy Municipalities and Communities (n=18), (3) Healthy Markets (n=3), (4) Healthy Villages (n=1), (5) Healthy Workplaces (n=4), (6) Health-Promoting Schools (n=3), and (7) Healthy Hospitals (n=3). Health promotion specialists, health policymakers, and social health researchers can use this collection of indices/indicators while designing/evaluating interventions to create supportive environments for health in various settings.