Effect of educational intervention on safe traffic behaviors of high school male students in Iran, using the theory of planned behavior: a quasi-experimental study.

BACKGROUND: Behavior change interventions in tackling road traffic injuries are a public health concern. Thus, this interventional research was to survey the effect of safe traffic behaviors among male students in Hamadan, Iran, utilizing theory of planned behavior. METHODS: In this quasi-experimental study, 204 students were randomly selected through multistage sampling from male high school students of Hamadan city, west-central of Iran, and non-randomly allocated to control and intervention groups (102 students in every group). The self-administrate questionnaire was used for data collection in this research. Frequency (percentage) and mean (SD) were used for description. Cronbach alpha coefficient, content validity ratio (CVR) and content validity index (CVI) were used for psychometric evaluation of questionnaire and paired/independent sample t-test was used for data analysis. All statistical analyses were done in SPSS 19 and significant level was considered 0.05. RESULTS: In both groups, more than 50 % of students walked to school. The two study groups were homogeneous in terms of confounding variables (p >  0.05). The validity of the questionnaire was confirmed and the total Cronbach's alpha value was equal to 0.97. There was no significant difference in the score of safe traffic behaviors between the two groups before the intervention (p >  0.05). But after the intervention, the score in the intervention group was significantly increased (p < 0.05). Intragroup comparison also showed that only in the intervention group the score was significantly changed (p < 0.05). CONCLUSION: Theory of planned behavior is a suitable conceptual framework for planning the interventions to increase safe traffic behaviors in students.

Effects of orange juice intake on cardiovascular risk factors: A systematic review and meta-analysis of randomized controlled clinical trials.

Previous investigations exploring the effects of orange juice (OJ) as a nutrient-dense beverage on cardiovascular risk factors were inconsistent. We aimed to conduct a systematic review and meta-analysis of randomized controlled clinical trials to determine the effectiveness of OJ intake on major cardiometabolic markers including anthropometric indices, blood pressure, lipid profile, inflammation, and glycemic control markers. PubMed, Scopus, and ISI Web of Science were searched from inception until January 2021. Fifteen eligible trials with 639 participants were included in the present study. The meta-analysis showed that OJ intake significantly reduces circulating total cholesterol levels (10 trials; weighted mean difference [WMD] = -6.84 mg/dl; 95% CI: -12.38 to -1.29; p = .01) and homeostatic model assessment for insulin resistance (four trials; WMD = -0.39, 95% CI: -0.77 to -0.006; p = .04) compared to control group. The analyses failed to reveal a significant effect of OJ intake on other cardiometabolic risk factors (p > .05). This review suggests that the intake of OJ might be associated with improved serum total cholesterol and insulin sensitivity. Due to low-to-moderate quality of meta-evidence, our results must be interpreted with caution and more well-designed studies are still needed to confirm the current findings.

The interaction effect of body mass index and age on fat-free mass, waist-to-hip ratio, and soft lean mass.

BACKGROUND: Research has shown that body mass index (BMI) does not take into consideration the gender and ethnicity. The primary purpose of this study was to examine the interaction effect of the BMI and age on fat-free mass (FFM), waist-to-hip ratio (WHR), and soft lean mass (SLM). The secondary purpose was to evaluate the practical significance of the findings by examining effect sizes. MATERIALS AND METHODS: The study was comparative in nature and employed a factorial design. Due to nonexperimental nature of the investigation, no causal inferences were drawn. The nonprobability sample consisted of 19,356 adults. Analysis of the data included factorial analysis of variance, analysis of simple effects, calculation of mean difference effect sizes, and data transformation. The Statistical Package for the Social Sciences version 22 was employed for the purpose of data manipulation and analysis. RESULTS: The BMI by age interaction effects on FFM, F (10, 19,338) = 28.26, P < 0.01, on WHR, F (10, 19,338) = 18.46, P < 0.01, and on SLM, F (10, 19,338) = 14.65, P < 0.01, was statistically significant and ordinal in nature. Analysis of the effect sizes, ranging from 0.30 to 1.20, showed that the BMI and age influenced the WHR but their interaction effects on FFM and SLM, ranging from 0.04 to 0.36 and 0.03 to 0.33, respectively, were mainly negligible. CONCLUSION: Based on the examination of the statistical and practical significance of the results, it is concluded that the BMI and age together can influence the WHR but their interaction effect on the FFM and SLM is questionable.

The Accuracy of Body Mass Index and Gallagher's Classification in Detecting Obesity among Iranians.

BACKGROUND: The study was conducted to examine the comparability of the BMI and Gallagher's classification in diagnosing obesity based on the cutoff points of the gold standards and to estimate suitable cutoff points for detecting obesity among Iranians. METHODS: The cross-sectional study was comparative in nature. The sample consisted of 20,163 adults. The bioelectrical impedance analysis (BIA) was used to measure the variables of interest. Sensitivity, specificity, positive predictive power (PPV), and negative predictive power (NPV) were used to evaluate the comparability of the two classification methods in detecting obesity. RESULTS: The BMI wrongly classified 29% of the obese persons as overweight. In both classifications, as age increased, the accuracy of detecting obesity decreased. The Gallagher's classification is better than MBI in detecting obesity in men with the exception of those older than 59 years. In females, the BMI was better in determining sensitivity. In both classifications, either female or male, an increase in age was associated with a decrease in sensitivity and NPV with the exception of the BMI for the 18 year olds. Gallagher can correctly classify males and females who are less than 40 and 19 years old, respectively. CONCLUSION: Gallagher's classification is recommended for non-obese in both sexes and in obese males younger than 40 years old. The BMI is recommended for obese females. The suitable cutoff points for the BMI to detect obesity are 27.70 kg/m(2) for females and males, 27.70 kg/m(2) for females, and 27.30 kg/m(2) for males.

Thyroid dysfunction and autoantibodies association with hypertensive disorders during pregnancy.

BACKGROUND: Thyroid dysfunction and autoimmunity are relatively common in reproductive age and have been associated with adverse health outcomes for both mother and child, including hypertensive disorders during pregnancy. Objective. To survey the relation between thyroid dysfunction and autoimmunity and incidence and severity of pregnancy-induced hypertensive disorders. METHOD: In this case control study 48 hypertensive patients in 4 subgroups (gestational hypertension, mild preeclampsia, severe preeclampsia, eclampsia) and 50 normotensive ones were studied. The samples were nulliparous and matched based on age and gestational age and none of them had previous history of hypertensive or thyroid disorders and other underlying systemic diseases or took medication that might affect thyroid function. Their venous blood samples were collected using electrochemiluminescence and ELISA method and thyroid hormones and TSH and autoantibodies were measured. RESULTS: Hypertensive patients had significant lower T3 concentration compared with normotensive ones with mean T3 values 152.5 ± 48.93 ng/dL, 175.36 ± 58.07 ng/dL respectively. Anti-TPO concentration is higher in control group 6.07 ± 9.02 IU/mL compared with 2.27 ± 2.94 IU/mL in cases. CONCLUSION: The severity of preeclampsia and eclampsia was not associated with thyroid function tests. The only significant value was low T3 level among pregnancy, induced hypertensive patients.

WHO quality of life-BREF 26 questionnaire: reliability and validity of the Persian version and compare it with Iranian diabetics quality of life questionnaire in diabetic patients.

There are several tools for the assessment of quality of life (QOL) in diabetes mellitus. In the current research, two standard questionnaires for evaluating of QOL were selected. First one was a questionnaire from the World Health Organization quality of life (WHOQOL-BREF 26) and the second one, The Iranian diabetics quality of life (IRDQOL). The first aim of this study was to reliability and validity of the Persian Version of WHOQOL-BREF 26. The second aims compare it with IRDQOL questionnaire in diabetic patients. A random sample of Iranian adult outpatient diabetics (n=387) was selected and they completed the WHOQOL and IRDQOL assessment instruments. In addition HbA1c was measured in these patients by calorimetric method. Data analysis was carried out by the use of T-test, Spearman correlation coefficient, Pearson's correlation coefficient. Data analysis based on Pearson correlations in the two questionnaires showed all subscales and total QOL have highly acceptable test-retest reliability. Comparison of total QOL and similar domains in the two questionnaires showed physical domain score in IRDQOL was lower than in WHOQOL and it was significant (P<.0001). Total QOL is more highly correlated with social domain and environmental domain in IRDQOL and WHOQOL, respectively. In IRDQOL, spiritual domain is not correlated with physical domain. Calculated parameters of reliability in the questionnaires indicated that stability present promising results in total QOL. In this study, WHOQOL domains have a logical relationship between glycemic control and QOL, but this logical relationship cannot be found in IRDQOL questionnaire. In IRDQOL spiritual domain is a very unreliable domain. We recommend more questions to be added spiritual domain in IRDQOL questionnaire and also distribution of items to be some how equal in four domains. By these, it may help to find some rational relations between afore-mentioned domains and glycemic control.

The effect of literacy level on health related-quality of life, self-efficacy and self-management behaviors in diabetic patients.

Illiteracy in studies on quality of life (QOL) and self-efficacy (SE) of diabetic patients has been ignored. Illiteracy and diabetes have high rates in developing countries. The aim of this study was to identify the effect of literacy level on health outcomes. To achieve this, we studied health outcomes such as SE, self-management behaviors and Health-Related Quality of Life (HRQOL) in diabetic patients. A cross-sectional study was carried out in an Iranian urban federally-funded diabetes clinic (with 1400 diabetes patients) in Bandar Abbas, a city located in south of Iran. 256 Non Insulin Dependent Diabetic Mellitus patients were chosen during June, July and August 2007. Patients were grouped as illiterates, low-literates and literates. SE and QOL were measured by standard questionnaires. HbA1C was measured by calorimetric method. Data was collected with interview. Data analysis was carried out with one way ANOVA Post Hoc, and bivariate analysis method. Literacy level among the three groups from the view points of age, physical domain, psychological domain, environmental domain and SE were significant. There was no significant difference for the level of HbA1C among three groups. Literacy level does not have any effects on glycemic control. There is a strong relationship between self-efficacy and QOL domains.

Can quality of life questionnaires be used in diabetics to assess the relation between HbA1c and patients' domain aspects?

Over the past few decades, quality of life (QOL) has become an important concept in medical researches and treatments. Different meaningful reasons are given for this development. In the current research two standard questionnaires for evaluating of QOL were selected. First one, was a questionnaire from The World Health Organization (WHOQOL-BREF 26) and the second one, The Iranian Diabetics' Quality of Life (IRDQOL). The goal of this study is to assess the relation between different domains of these questionnaires and HbA1c in diabetics. A random sample of Iranian adult outpatient diabetics (n=76) was selected and they completed the WHOQOL and IRDQOL assessment instruments. In addition HbA1c was measured in these patients by calorimetric method. Comparisons were made between scores of "questionnaires' domains" and "HbA1c". Data analysis was carried out by the use of T-test, Spearman correlation coefficient, Pearson's correlation coefficient, and non-parametric statistical methods including Spearman correlation coefficient. Data analysis shows Psychological domain score in IRDQOL is lower than in WHOQOL and it is significant (P<0.0001). Physical domain score in IRDQOL is lower than WHOQOL and it is significant (P<0.0001). In WHOQOL questionnaire, analysis data showed when the patient's age increased, physical and psychological domain's score decreased. There is probably no relation between questionnaire domains and HbA1c in diabetics. Based on the findings in this research, there was obviously almost no difference between the two questionnaires for checking the QOL, but in IRDQOL spiritual domain is a very unreliable domain.

Stopping insulin and achieving a good metabolic control in a heavy drinker five months after stopping alcohol.

In this case study, we describe a 25 year-old male who showed the symptoms of diabetes after a period of heavy drinking. (HbA1c=13%). Treatment was started with 120 units of insulin. After stopping alcohol consumption and taking an appropriate diet, insulin was tapered down. Five months after the start of treatment, insulin was stopped (HbA1c=5%). The results showed that he was in a good metabolic control after 18 months (HbA1c=5.9%).