Effects of anti-Inflammatory-antioxidant-rich diet and co-supplemented synbiotics intervention in patients with progressive forms of multiple sclerosis: a single-center, single-blind randomized clinical trial.

BACKGROUND: Current evidence has demonstrated that patients with Multiple Sclerosis (MS) have dysbiotic gut microbiomes, and anti-inflammatory nutritional interventions can normalize this status. Therefore, we aimed to investigate the effects of dietary intervention in patients with progressive forms of MS. METHODS: Seventy patients with three forms of progressive MS (primary-progressive, secondary-progressive, and progressive-relapsing) were randomly assigned into intervention (daily synbiotics capsule plus anti-inflammatory-antioxidant rich diet) or control (placebo capsule plus dietary recommendations) groups for four months. Faecal calprotectin level, Impact of Vision Impairment (IVI), Gastrointestinal Symptom Rating Scale (GSRS), and anthropometric measurements were evaluated at baseline and trial cessation. Analysis of covariance was conducted and adjusted for age, gender, education level, family history & duration of MS, type of progressive MS, type of main drug, and physical activity. RESULTS: Sixty-nine participants were included in the final analysis (n of intervention = 34; n of control = 35). Synbiotics and dietary intervention significantly reduced Faecal calprotectin level after six months (110.5 ± 75.9-44.7 ± 49.3 É¥g/g, P < 0.001), and mean changes were statistically significant in comparison with control group. However, intervention did not elicit any change in the anthropometric measurements. CONCLUSION: Synbiotics supplementation and adherence to an anti-inflammatory-antioxidant-rich diet reduced intestinal inflammation and improved clinical manifestations in progressive forms of MS.Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20141108019853N7..

Application of the Protection Motivation Theory (PMT) in Teaching Skin Cancer Prevention Behaviors in Male Students.

Adolescents are at high risk of skin cancer. Since protecting the skin from the sun's ultraviolet rays is an important way to prevent this disease, the present study aimed to evaluate the effectiveness of teaching skin cancer prevention behaviors using the Protection Motivation Theory (PMT) in male students in Isfahan. An intervention study examined change in attitudes and behaviors among 104, 13-year-old male students from two schools in Isfahan, Iran. The schools were randomized to either receive or not receive a 5-session skin cancer prevention curriculum based in PMT theory. Data were collected using a validated questionnaire that included demographic, PMT, and behavior construct variables. Questionnaires were completed by both groups before and 2 months after the intervention. Data were analyzed using SPSS 20, chi-square test, Mann-Whitney test, paired t-test, and McNemar's test. The results indicated that the mean scores of all constructs of PMT increased in the intervention group compared to the baseline assessment, except for the response cost (P < 0.001). The mean score of students' skin cancer preventive behaviors was 39.6 (21.4) in the intervention group, and it increased to 74.7 (23.5) after educational intervention, while the control group did not exhibit any significant behavior change. The intervention certainly shows the potential for being effective over the short-term. Therefore, it is recommended that PMT-based educational interventions be designed to teach and promote social health, particularly at an early age.

The effect of educational intervention based on the Progressively Lowered Stress Threshold extended model on the process of caregiving for people with dementia.

BACKGROUND: This study examined the impacts of an educational intervention based on the Progressively Lowered Stress Threshold (PLST) extended model on caregiving for people with dementia (PWD). METHOD: This study was conducted in Isfahan, Iran, from May 2016 to June 2018, with 38 caregivers of PWD as participants assigned to an intervention group. Data were collected using a multi-sectional, researcher-developed questionnaire that recorded the demographic characteristics, and measured the dementia-related knowledge and caregiving practices of the participants. The questionnaire and an educational program were designed in three parts according to the educational needs of caregivers to enhance their practice, skills, and ability to handle challenging behaviours in PWD. The questionnaire's face validity was confirmed by expert review, and its reliability was assessed with Cronbach's alpha coefficient (knowledge section, 0.838; practice section, 0.802). The sampling method used was convenience sampling, and none of the caregivers refused to receive the educational content. Therefore, the evaluation of the program lacks a randomized controlled group. To tailor the intervention program to the participants' needs, the educational content was based on the PLST extended model. RESULTS: The mean scores for knowledge and practice increased following the intervention (P < 0.05). An educational intervention, using the PLST extended care model, thus produced positive impacts in improving the knowledge and practice of caregivers of PWD. CONCLUSION: Educating caregivers with the PLST extended model, with a specific focus on the cultural and religious backgrounds of societies, is recommended.

The effects of Mediterranean diet on severity of disease and serum Total Antioxidant Capacity (TAC) in patients with Parkinson's disease: a single center, randomized controlled trial.

Background: Parkinson's disease (PD) as one of the most common neurodegenerative disorders may be affected by healthy dietary pattern. The aim of this study was to investigate the effects of the Mediterranean Diet (MeD) on serum Total Antioxidant Capacity (TAC) and disease severity in PD patients.Materials & Methods: In this single-center randomized clinical trial, patients with idiopathic PD (n = 80) were selected randomly allocated to either MeD or control group (Iranian traditional diet); an individualized dietary plan based on the MeD was designed. Serum TAC and the motor & non-motor disease aspects using the Unified Parkinson's Disease Rating Scale (UPDRS) were evaluated in two groups. Statistical Analysis of data was performed using SPSS 24.Results: 70 PD patients with a mean age of 58.96 ± 8.7 and UDPRS of 41.66 ± 20.19 were analyzed in this study. MeD significantly increased serum TAC (P < 0.001). UPDRS score was also lowered in MeD group (P < 0.05).Conclusions: Mediterranean diet seems to have some benefits in PD. as well, TAC levels can also be affected by MeD. Anyway, further studies are needed to confirm the mentioned outcomes.Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20141108019853N4.

Sesame Oil Ameliorates Alanine Aminotransferase, Aspartate Aminotransferase, and Fatty Liver Grade in Women with Nonalcoholic Fatty Liver Disease Undergoing Low-Calorie Diet: A Randomized Double-Blind Controlled Trial.

Background: The type and amount of dietary fats play an important role in fat accumulation in the liver. Sesame oil (SO) is a good source of monounsaturated acids (MUFAs) and polyunsaturated fatty acids (PUFAs). Objective: This trial aimed at examining the effect of SO consumption on the levels of liver enzymes and the severity of fatty liver in women with nonalcoholic fatty liver disease (NAFLD) undergoing a weight loss diet. Methods: This randomized, double-blind, controlled trial was carried out on 60 women with NAFLD. Subjects were randomly assigned to the SO group (n = 30) and sunflower oil (SFO) group (n = 30), each person consuming 30 grams of oil per day for 12 weeks. All the participants received a hypocaloric diet (-500 kcal/day) during the study. Fatty liver grade and liver enzymes were assessed at pre- and postintervention phases. Results: 53 patients completed the study. Significant reductions in body weight, body mass index (BMI), waist circumference (WC), and fatty liver grade were observed in both groups (P < 0.05). Following SO, significant decreases in serum aspartate and alanine aminotransferases (AST and ALT) were observed. After adjusting for confounders, ALT, AST, and fatty liver grade of the SO group were significantly reduced compared to the SFO group (P < 0.05). However, the changes in serum alkaline phosphatase (ALP) were not significant (P > 0.05). Conclusions: The desired effects of weight loss were reinforced by the consumption of SO through improving fatty liver severity and serum ALT and AST levels in NAFLD patients. Moreover, low-calorie diets may lead to favorable outcomes for NAFLD patients through mitigation of obesity and fatty liver grade.

Application of BASNEF model in students training regarding cutaneous leishmaniasis prevention behaviors: a school-based quasi experimental study.

BACKGROUND: Cutaneous leishmaniasis (CL) is endemic in 98 countries, and 350 million people are at risk of the disease worldwide. In endemic areas, conducting educational interventions is necessary to change preventive behaviors of CL. This study aimed to investigate the effect of an educational intervention based on the BASNEF model on CL preventive behavior in students. METHODS: The present quasi-experimental study examined 80 students living in endemic areas of leishmaniasis in Isfahan province, Iran based on the BASNEF model. The required data were collected twice before and two months after the educational intervention based on a questionnaire whose validity and reliability had been already proven in other studies. The intervention was performed in three educational sessions for the students in the intervention group and 1 educational session for teachers and parents. Data were analyzed by SPSS (VER26) using the chi-square test, independent t-test, analysis of covariance (ANCOVA), and Paired t-test. RESULTS: After intervention, the mean scores of Knowledge (P < 0.001), attitude (P = 0.02), subjective norms (P = 0.04), behavioral intention (P < 0.001), and behavior (P = 0.02) indicated significant differences between the intervention and control groups, but an increase in mean scores of enabling factors was not significant (P = 0. 93). CONCLUSIONS: Providing students with the educational intervention based on the BASNEF model improve their ability to the extent that they transmit these educations to their family members, which would be effective in preventing and controlling CL in leishmaniasis-prone areas. TRIAL REGISTRATION: Name: Iranian Registry of Clinical Trials. Registration number: IRCT20201024049131N1. Registration date: 2020-11-20. Registration timing: prospective.

The alternate-day fasting diet is a more effective approach than a calorie restriction diet on weight loss and hs-CRP levels.

Background and Objective: The aim of present study was to compare, and determine, the effects of a modified alternate-day fasting diet vs. calorie restriction on inflammatory indices and coagulation factors. Methods: This was a randomized clinical trial consisting of 80 metabolic syndrome patients, who were enrolled and randomly dichotomized into a modified alternate-day fasting diet or calorie restriction group for 4 months. We measured weight, body mass index (BMI), waist circumstance (WC), waist-hip-ratio (WHR) and fat mass as primary outcomes and assessed high sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α) and coagulation factors levels as secondary outcomes before and after intervention. Results: Compared to the calorie restriction diet, following a modified alternate-day fasting diet led to a greater reduction in body weight (kg) (-6.43 ± 4.34 vs -4.11 ± 4.27; P = 0.02), BMI (kg/m2) (-3.19 ± 2.90 vs -1.43 ± 2.72; P = 0.01), fat mass (kg) (-4.88 ± 2.09 vs -3.72 ± 2.43; P = 0.03), WC (cm) (-5.57 ± 5.64 vs -2.32 ± 5.95; P = 0.01) and WHR (-0.05 ± 0.06 vs -0.02 ± 0.07; P = 0.04). Furthermore, a greater change was found in hs-CRP levels (mg/L) (-2.06 ± 1.18 vs -0.97 ± 0.82; P = 0.03), prothrombin time (s) (1.41 ± 2.34 vs -0.41 ± 2.17; P < 0.001), activated partial thromboplastin time (s) (0.26 ± 3.70 vs -1.78 ± 3.56; P = 0.04) in modified alternate-day fasting diet when compared to calorie restriction diet. However, there was no difference in TNF-α or IL-6 and fibrinogen between groups (P > 0.05). Conclusions: These findings suggest that a modified alternate-day fasting diet can be a beneficial alternative for the management of body weight, fat mass and WC as well as hs-CRP and coagulation factors levels among metabolic syndrome patients.

The efficacy of the prenatal administration of Lactobacillus reuteri LR92 DSM 26866 on the prevention of infantile colic: a randomized control trial.

Infantile colic is a functional gastrointestinal disease of the infancy that its cause has not yet been properly identified. It leads to severe discomfort in the infants and anxiety in their mothers. Probiotics have recently been recommended as an effective treatment for the improvement of infantile colic. The objective of this study is to determine the role of prenatal administration of Lactobacillus reuteri (L. reuteri) LR92 DSM 26866 on the occurrence of infantile colic. This double-blinded, placebo-controlled, randomized trial was conducted with healthy pregnant women from December 2017 to December 2018 in Isfahan, Iran. A total of 145 patients was included in this study. The case group consisted of 87 pregnant women, who received daily doses of 1 × 108 colony-forming units of live L. reuteri LR92 DSM 26866, and the control group with 88 pregnant women received the placebo (containing 9% glucose solutions) for the last 4 weeks of pregnancy. Mothers and their infants in both groups did not have significant differences in anthropometric indices, and the infants' feeding pattern. Infants born to both groups of mothers followed for 5 months on signs and symptoms of colic with the repetitive examination by a blinded pediatrics assistant to record the occurrence of colic and its grading. Mothers who received placebo were 2.36 times more likely to have infants exhibiting infantile colic than mothers in the L. reuteri LR92 DSM 26866 group (CI 95%, 1.18-4.73). Using Mann-Whitney U test, the Mean (SD) of colic severity was significantly lower in the intervention group (p = 0.01). The frequency of colic and its higher grades were significantly lower in the intervention group (p = 0.03 for the presence of colic and p = 0.01 for high grades of colic). The frequency of colic presence and its different grades according to mothers' delivery mode and infant feeding patterns were not different between the two groups (p > 0.05).Conclusion: Maternal prenatal supplementation with probiotic L. reuteri LR92 DSM 26866 during the last 4 weeks of pregnancy can prevent the occurrence and reduce the severity of infantile colic. What is Known • Lactobacillus reuteri LR92 DSM 26866 is effective in improving the symptoms of infantile colic. What is New • Prenatal administration of Lactobacillus Reuteri LR92 DSM 26866 can prevent the occurrence of infantile colic or reduce its severity.

Designing an educational intervention to prevent excessive gestational weight gain: a protocol for a randomized controlled trial.

BACKGROUND: Pregnancy as one of the critical stages of life carries a high risk to the health of pregnant women. The amount of weight gained during pregnancy can affect the woman and her infant health immediately or in the future. The present study is conducted to design and explore the effectiveness of an educational intervention based on health belief model (HBM) to preventing excessive gestational weight gain (GWG). METHODS: This research-based planning is designed in three phases and will be conducted on pregnant women in first trimester. In the first phase of this randomized controlled trial study, body mass index (BMI), the level of knowledge and the level of the HBM constructs will be measured using a questionnaire. The HBM questionnaire is designed based on a literature review and experts opinions. In the next phase the educational program content will be designed based on the results of the first phase of the study on the level of women's knowledge, and HBM constructs as well as a literature review and experts opinions. The intervention will be designed in four training sessions about the importance of behaviors, especially physical activity and nutrition, in the prevention of excessive weight gain during pregnancy. The tired phase includes the implementation of educational intervention with two intervention and control groups. The efficacy of the program will be evaluated by measuring the level of the knowledge, HBM constructs and women's weight gain during pregnancy in the second and third trimesters. Appreciate weight gain will be considered according to the BMI in first trimester. DISCUSSION: The present study will provide strong information regarding the effetiness of the HBM and appropriate framework to develop educational interventions together with enhancing pregnant women's knowledge and belief toward weight management behaviors. TRIAL REGISTRATION: Registration of this randomized control trial has been completed with the Iranian Registry of Clinical Trials, IRCT20180703040325N1 . Date of registration: 2018-08-20.

Effectiveness of continuous-care model on self-care in patients with heart failure: application of line follow-up.

BACKGROUND: Self-care behaviours are one of the most important determinant factors in the prognosis of heart failure, which can improve the symptoms of the disease, the performance and the reduction of mortality in these patients. OBJECTIVE: The aim of this study was to determine the effectiveness of continuous-care pattern on self-care in heart failure patients admitted to Shahid Chamran Hospital in Isfahan. METHODS: This quasi-experimental study is implemented on 72 patients with heart failure who are admitted to Shahid Chamran Hospital in Isfahan. The patients are randomly assigned to the experimental and control groups (36 patients in each group). For a period of three months, a continuous-care model is performed, and then, the self-care score of patients with heart failure is compared in both groups at baseline and follow-up assessment. The required data were gathered using a demographic questionnaire and a European Heart Failure Self-Care Behavior (EHFSCB). RESULTS: Regarding the implementation of the continuous-care model, the results showed that the mean self-care score before the implementation of the continuous-care model was 28.2 ± 5.02 in the experimental group and 29.5 ± 3.7 in the control group, which was not statistically significant (p = 0.22). However, after implementing continuous-care model, the mean self-care score of the experimental group was 51.4.4 ± 2.8 as compared to the control group (30.8 ± 3.2) (p < 0.001). CONCLUSION: Based on the findings of this study, it can be concluded that the implementation of this care model can lead to an increase in self-care score in patients with chronic heart failure.

Detection of antibiotic resistant Acinetobacter baumannii in various hospital environments: potential sources for transmission of Acinetobacter infections.

BACKGROUND: Antibiotic resistant Acinetobacter baumannii has emerged as one of the most problematic hospital acquired pathogens around the world. This study was designed to investigate the presence of antibiotic resistant A. baumannii in various hospital environments. METHODS: Air, water and inanimate surface samples were taken in different wards of four hospitals and analyzed for the presence of A. baumannii. Confirmed A. baumannii isolates were analyzed for antimicrobial susceptibility and also screened for the presence of three most common OXA- type carbapenemase-encoding genes. RESULTS: A. baumannii was detected in 11% (7/64) of air samples with the highest recovery in intensive care units (ICUs). A. baumannii was also detected in 17% (7/42) and 2% (1/42) of surface and water samples, respectively. A total of 40 A. baumannii isolates were recovered and analysis of antimicrobial susceptibility showed the highest resistance towards ceftazidime (92.5%, 37/40). 85% (34/40) and 80% (32/40) of the isolates were also resistant to imipenem and gentamicin, respectively. Resistance genes analysis showed that 77.5% (31/40) strains contained OXA-23 and 5% (2/40) strains contained OXA-24, but OXA-58 was not detected in any of the strains. CONCLUSION: Detection of antibiotic resistant A. baumannii in various samples revealed that hospital environments could act as a potential source for transmission of A. baumannii infections especially in ICUs. These results emphasize the importance of early detection and implementation of control measures to prevent the spread of A. baumannii in hospital environments.

Assessment of the Physicochemical Quality of Drinking Water Resources in the Central Part of Iran.

The aim of the study described in this article was to assess the physicochemical quality of water resources in Isfahan province, located in the central part of Iran, from June to November 2012. Comparison of the results with the acceptable limits recommended by the World Health Organization (WHO) for drinking water showed that nitrate, chloride, iron, and fluoride concentrations exceeded the maximum acceptable level in 12.3%, 9.2%, 6.8%, and 1.5% of samples, respectively. Total dissolved solids (TDS) and turbidity values also exceeded the maximum acceptable level in 9.2% and 3.1% of samples, respectively. In general, the quality of drinking water resources in the central part of Iran at present is mostly acceptable and satisfactory. It may be deteriorated in the future, however, because water quantity and quality in arid and semiarid areas are highly variable over time. Therefore, continued monitoring of the water resources quality is extremely important to environmental safety.

The impact of self-efficacy education on self-care behaviours of low salt and weight setting diets in hypertensive women covered by health-care centers of Dehaghan in 2013.

OBJECTIVE: To examine the impact of self-efficacy-based education on promoting self-care behaviour in low-salt and weight-setting diets for hypertensive women. METHODS: The quasi-experimental study was conducted in 2013 and comprised hypertensive women registered with healthcare centres in Dehaghan, Iran. The subjects were divided into two equal groups; intervention group and comparison group. For the intervention group, four educative sessions were conducted based on self-efficacy leading to self-care behaviours, while the comparison group did not receive any education. Self-efficacy and self-care questionnaires data (obtained before intervention, immediately after intervention and 3 months after intervention) was analysed using SPSS 20. RESULTS: There were 64 subjects divided into two groups of 32(50%) each. The mean age in the intervention group was 51.2±6.86years and 49.1±7.99years in the comparison group. Self-care behaviours of low salt diet (p=0.002) and weight-setting diet (p=0.004) were more significantly seen in the intervention group. The means of systolic blood pressure (p=0.004) and diastolic blood pressure (p< 0.001) were significantly reduced in the intervention group. The mean value for body mass index was not the same in the intervention group (p< 0.001). CONCLUSIONS: Self-efficacy-based education had an impact on self-care behaviours in hypertensive patients.

Pulmonary function tests in ulcerative colitis.

BACKGROUND: Pulmonary impairment in patients suffering ulcerative colitis (UC) has been suggested by several investigators using standard pulmonary function tests (PFTs). This changes in pulmonary function associated with minimal respiratory symptoms have been documented, especially in patients with active disease. The aim of this prospective study was to determine airway resistance and lung volumes in patients with UC who have no respiratory symptoms in comparisons to a healthy control group. MATERIALS AND METHODS: We evaluated a total of 30 patients with UC by means of spirometry, body plethysmography, and impulse oscillometry. The patients were not complaining of any pulmonary symptoms and did not present any history of previous respiratory diseases. As controls we examined 30 healthy subjects matched for gender, age, and smoking status. The relationship between PFT, lung volume, and airway resistance; and the activity, localization, and duration of the UC disease were analyzed. RESULTS: There was a significant difference between airway resistances (kPa/L/s) measured by body plethysmography in patients with UC and those of the controls (R5hz; 0.60 ± 0.44 vs. 0.39 ± 0.13; P < 0.001) and R20hz (0.37 ± 0.19 vs. 0.29 ± 0.1, P = 0.02). There were no correlation between PFT, airway resistance and site and scoring activity (P > 0.05). CONCLUSION: Despite the lack of pulmonary symptoms, increased airway resistance was found in UC patients. We also have not found correlation between PFT, lung volume and airway resistance values and scoring of UC activity.

A survey on functional constipation and its risk factors in older people in Shahreza, Iran.

BACKGROUND: Functional constipation is prevalent among older people. It has major effects on the quality of life of them, as well as the high costs of treatment. This study investigated functional constipation and risk factors affecting older people living in Shahreza, Iran. MATERIALS AND METHODS: This cross-sectional study was performed on 200 older people in Shahreza. They were selected by simple random sampling. We used the Rome III Criteria, the Elderly Physical Activity Questionnaire (PASE), and related questions from the SIB system (integrated health system). After completing the questionnaires, the data were analyzed using the mean and standard deviation, Chi-square test, independent-samples t-test, Fisher's exact test, and Mann-Whitney test. RESULTS: The prevalence of functional constipation was 45%. There are significant relationships between functional constipation with dental problems (P = 0.02), intake of fluid (P = 0.001), fruits (P = 0.001), and vegetables (P < 0.001), polypharmacy (P = 0.003), and antidepressants (P = 0.008), history of colon (P = 0.003) and anal (P = 0.001) diseases, stroke or mobility disabilities (P = 0.002), the level of physical activity (P = 0.002), and gender (P = 0.04) in older people living in Shahreza. CONCLUSIONS: According to the high prevalence of functional constipation in the studied older people, it is necessary to focus on controlling risk factors and planning to prevent the destructive effects of social restrictions on older people during the coronavirus disease 2019 (COVID-19) pandemic.

The effect of a health belief model-based education on nutritional behavior and biochemical factors of patients with myocardial infarction: A line follow-up experimental study.

Background and Aim: Myocardial infarction is a common cause of hospitalization, and nutritional behaviors are risk factors in such patients. The present study aimed to determine the effect of education based on the health belief model on nutritional behavior and indices in patients with myocardial infarction. Methods: The present experimental study examined patients with myocardial infarction in 2021. Seventy-two patients with myocardial infarction were randomly divided into intervention and control groups. The intervention group received educational interventions based on the health belief model in four 60-min sessions for 3 months. The constructs of the health belief model, nutritional behavior, and indices were measured using a valid questionnaire before, 1, and 3 months after the intervention. At the end, the study data was analyzed using SPSS version 22 software. Results: There was a significant difference between the two groups in the mean scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, self-efficacy, nutritional behaviors, and body mass index after the intervention (p < 0.05); however, no significant difference was found in the field of perceived barriers (p > 0.05). Biochemical factors also had a significant difference after the intervention (p < 0.05). Conclusion: Educational intervention based on the health belief model is effective for myocardial infarction patients and has a significant impact on the constructs of perceived sensitivity, perceived intensity, perceived benefits, and self-efficacy as well as biochemical factors, so it can be used to improve the nutritional status of patients suffered from a myocardial infarction.

Surveillance of Legionella species in hospital water systems: the significance of detection method for environmental surveillance data.

Monitoring of hospital water systems to prevent and control nosocomial legionellosis is important from a public health perspective. This study was conducted to survey the prevalence of Legionella contamination of hospital waters. A total of 44 water samples from the hot-water system of 11 hospitals were tested for Legionella by a culture method and a nested polymerase chain reaction (PCR) assay with Legionella-specific primers to identify the more sensitive method. Some physicochemical parameters and heterotrophic plate counts of water samples for possible association with Legionella contamination were also determined. The contamination rate of hospitals in our study varied between 64% (eight of 11)-100% based on culture method and nested PCR, respectively. Of the 44 water samples examined, 23% were positive for Legionella spp. by the culture method, while the nested PCR assay using the primers LEG448-JRP revealed 66% of the water samples being positive. Given the importance of monitoring hospital water systems for the presence of Legionella spp., the present PCR assay proved highly applicable for practical and sensitive surveillance of Legionella in such water systems. In addition, rapid monitoring of Legionella contamination could eliminate the potential exposure of high-risk patients through effective control measures.

Application of Theory of Planned Behavior in Pregnant Women Training Regarding Urinary Tract Infection Prevention Behaviors: A Randomized Controlled Trial.

OBJECTIVE: This study aimed to determine the effect of the theory of planned behavior-based education program on promoting the urinary tract infection prevention behaviors in pregnant women. METHODS: The present study was a randomized controlled trial in which 100 pregnant women, who visited the healthcare centers of Zarinshahr City, were randomly divided into two groups, intervention and control. Five education sessions based on the theory of planned behavior were held for the intervention group. RESULTS: After implementing the educational intervention, the mean scores of knowledge and constructs of the theory of planned behavior significantly increased in the intervention group over time (P < 0.001). After the educational intervention, the incidence of urinary tract infections (UTI) was 4.3% in the intervention group and 21.3% in the control group. CONCLUSION: In this study, the use of methods such as group discussion and role playing promoted attitudes, perceived behavioral control and subjective norms of pregnant women, and as a result, UTI in women in the intervention group was reduced.

The effect of educational intervention based on the PEN-3 model on breast cancer screening behaviors.

Background: Breast cancer is the most important malignancy and the main cause of cancer deaths among women worldwide. Breast cancer screening is an effective way to reduce breast cancer deaths. Objectives: The present study aimed to provide breast cancer screening behavior training for female teachers in Isfahan, Iran. Materials and methods: This randomized controlled trial included 120 teachers who have randomly divided into two groups (60 in the control group and 60 in the intervention group). The data collection tool was a PEN-3 model-based questionnaire. Four 90 min training sessions were held for the intervention group to modify perception and enablers. Breast self-examination (BSE), Clinical breast exam (CBE), and mammography (MMG) were investigated in both groups before and after 6 months after the last training using SPSS20 and appropriate statistical tests. Results: The frequency of BSE (p = 0.02), CBE (p = 0.04), and MMG (p = 0.01) in the intervention group was significantly higher than in the control group 6 months after training. The mean scores of perception and enablers were significantly higher in the intervention group than in the control group 3 and 6 months after training (p < 0.001). The logistic regression analysis indicated that perception factors were the strongest predictors of breast cancer screening behavior in teachers. Conclusion: Results of the present study indicated that using the PEN-3 model in the educational intervention was effective in improving breast cancer screening behavior.

Anti-inflammatory-antioxidant modifications and synbiotics improved health-related conditions in patients with progressive forms of multiple sclerosis: A single-center, randomized clinical trial.

BACKGROUND AND PURPOSE: There is growing evidence that dietary modification can improve clinical manifestations in multiple sclerosis (MS) patients. This study aimed to assess the impact of synbiotics and anti-inflammatory-antioxidant-rich diet on fatigue, pain, gut and bladder status, and sexual function in patients with progressive forms of MS. MATERIALS AND METHODS: In this single-center, single-blind, randomized, controlled clinical trial, seventy participants with three forms of progressive MS (primary-progressive, secondary-progressive, and progressive-relapsing) were randomly assigned to receive either synbiotics supplement and anti-inflammatory-antioxidant-rich diet or a placebo along with their usual diet for a duration of four months. Modified fatigue impact scale (MFIS), global pain scale (GPS), bladder control scale (BLCS), bowel control scale (BWCS), and sexual satisfaction scale (SSS) were assessed at baseline and at the end of the trial. RESULTS: Sixty-nine participants successfully completed the trial, resulting in a 98% adherence rate to the diet, and no reports of serious side effects. Significant mean changes were observed in fatigue (Δ for experimental group = -10.5 ± 10.8 vs. Δ for control group = -0.08 ± 4.1; P < 0.001), pain (-14.1 ± 19.0 vs. 0.9 ± 10.3; P < 0.001), bladder (-0.76 ± 2.1 vs. 0.3 ± 1.1; P = 0.013) and bowel (-6.6 ± 3.2 vs. -0.05 ± 2.3; P < 0.001) control, as well as sexual function (-1.0 ± 2.3 vs. 0.51 ± 0.21; P < 0.001). CONCLUSION: The anti-inflammatory-antioxidant-rich diet and synbiotics co-supplementation demonstrated improvements in fatigue, pain, sexual function, and bowel/bladder status among patients with progressive MS.