The effectiveness of educational program based on health belief model on promotion of puberty health concepts among teen girls: a cross-sectional study in north of Iran.

BACKGROUND: Puberty is a sensitive critical stage of human life. As numerous healthy habits and behaviors are created during adolescence, correct health education during puberty is essential to maintain and improve an individual's physical, emotional, and mental health. The present study aimed to determine the impact of educational intervention based on the predictors of the Health Belief Model (HBM) on female nine-grade students' health behaviors in Rasht, Iran. METHODS: The present randomized controlled trial study examined 110 female nine-grade students. Multi-stage sampling was performed, and the students were randomly divided into two groups of 55 as intervention and control. The data collection tool included a valid and reliable questionnaire with four sections, namely demographic variables, knowledge, HBM constructs, and health behaviors during puberty. The educational program comprised four 45-60-min sessions per group (4 groups of 13) based on HBM. The data were collected two times, before and 1 month after the educational intervention, and were analyzed using the independent t-test, paired t-test, chi-square test, and SPSS 23. RESULTS: The mean age of menarche was 12.26 ± 1.133 in the intervention group and 12.12 ± 1.263 in the control group. The family was a source of information for students and the main cue to action before the intervention. Before the educational intervention, there was no significant difference between the experimental and control groups in terms of knowledge, HBM constructs, and puberty health behaviors; however, the variables increased significantly in the intervention group after educational intervention (P<0.001). CONCLUSIONS: Given the effectiveness of the HBM in improving the health behavior of adolescent girls, it is recommended that health policymakers should plan and implement educational interventions in this field.

Stages of dairy product consumption among Iranian female high school students based on transtheoretical model: The case of osteoporosis prevention.

Background: As nutritional needs increase in adolescence, dairy consumption can play a key role in health and disease prevention; however, unfortunately, inadequate consumption of milk and dairy products has often been reported in adolescents. Aim: The purpose of this study was to investigate the relation between decisional balance, self-efficacy, and the processes of change with the stages of change for dairy consumption in female high school students in Shaft county located in the west of Gilan Province, Iran. Methods: A total of 385 female high school students in Shaft County were studied through the census method in 2019. The data collection instrument was a valid and reliable questionnaire consisting of demographic information, stages of change and items of transtheoretical model constructs including the processes of change (cognitive process: consciousness-raising, dramatic relief, self-reevaluation, environmental reevaluation, and social liberation; behavioral process: self-liberation, counter conditioning, reinforcement management, stimulus control and helping relationships), decisional balance and self-efficacy. Data were analyzed using SPSS 21 software. Results: A total of 208 (54%), 53 (13.8%), 56 (14.5%), 32 (8.3%) and 36 (9.4%) students were in the pre-contemplate, contemplation, preparation, action and maintenance stages, respectively. As the subjects progressed through the stage of change for dairy consumption, an increase in the mean score of self-efficacy, decisional balance, and processes of change was observed (P < 0.01). Conclusion: The constructs of the transtheoretical model should be considered in designing educational interventions to promote dairy consumption with regard to the stage of change for dairy consumption in the subjects.

Evaluating the effectiveness of combined radiotherapy and hyperthermia for the treatment response of patients with painful bony metastases: A phase 2 clinical trial.

INTRODUCTION: Since the survival time of patients with bony metastases has noticeably improved in recent years, these patients are at high risk of complications associated with this metastasis. Hence, the appropriate choice of treatment modality or combination of therapeutic approaches can lead to increasing bone pain relief, improving quality of life, etc. This study is aimed to evaluate the effectiveness of combined radiotherapy and hyperthermia for the treatment response of patients with painful bony metastases. PATIENTS AND METHODS: In a single-arm clinical trial, 23 eligible patients (14 female and 9 male) with the mean age of 67 years old and suffering from bony metastases were enrolled in the study. Two hours after radiotherapy, the patients underwent hyperthermia for 1 h in the supine position. All the patients completed the brief pain inventory (BPI) assessment tool and quality of life questionnaire (QLQ-C30) from the European Organization for Research and Treatment of Cancer (EORTC) at the baseline, end of the treatment and 1, 2 and 3 months thereafter. The response to the treatment was assessed as the zero score (complete response) or two or more than two-point drop of the worst pain within the preceding 24 h (partial response) during the 3-month posttreatment. RESULTS: All the pain intensity and interference scores, except the pain interference with the enjoyment of life score, significantly decreased. A total of 18 out of 23 patients (78%) achieved complete or partial response. The number of patients using pain relief medications decreased from 74% (n=17) at the baseline to 48% (n=11) 3 months later. Moreover, except for nausea and vomiting, appetite loss, diarrhea and financial impact problems, the patients' quality of life improved significantly in all the functional scales and symptoms within 3 months. CONCLUSION: This study showed that using hyperthermia in combination with radiotherapy significantly ameliorated bone pain among the patients suffering from cancer with painful bony metastases.

Effect of multimorbidity on quality of life in adult with cardiovascular disease: a cross-sectional study.

BACKGROUND: The aim of present study was to describe the effect of multimorbidity on Health-Related Quality of Life (HRQoL) in patients with coronary artery disease (CAD). METHODS: A cross-sectional study with a simple sampling method of 296 patients undergoing coronary artery bypass surgery in a referral hospital of the northern part of Iran was conducted between April, 2015 and September, 2016. Multimorbidity was defined as the presence of at least two chronic diseases based on self-reporting and medical records. HRQoL was measured using the 36-item short form (SF-36) health status survey. We used analysis of variance (ANOVA) to assess the effect of multimorbidity on mental and physical component of HRQoL. RESULTS: Approximately, 69% of CAD patients had at least one other disease like diabetes or hypertension. Patients without multimorbidity compared with patients with multimorbidity were significantly older (p = 0.012) and more educated (p = 0.002). Both physical and mental component score of HRQoL was better in patients without any morbidity (48.82 vs. 43.93 with 95%CI of mean difference: 3.37-6.42 and 54.85 vs. 50.44 with 95% CI of mean difference: 1.68-7.15, respectively). Both physical and mental component score was significantly lower in female and lower educated patients (physical mean score 43.07 vs. 46.54 with P = .001 and 42.53 vs. 46.82 with P < .001 and mental mean score 49.98 vs. 52.65 with P = .055 and 49.80 vs. 52.75 with P = .022 for sex and education, respectively). Also, two-way ANOVA showed that regards to morbidity, physical component score was grater in patients with lower education level than higher education level (P < .001). CONCLUSION: The findings of this study suggest that women, lower education level and overweight reported lower quality of life. HRQoL is affected by multimorbidity among CAD patients specially in less educated.

Effect of exercise therapy on quality of life of patients with multiple sclerosis in Iran: a systematic review and meta-analysis.

Multiple sclerosis (MS) is a chronic and progressive disease charachterized by disabilities which adversely affect individuals' quality of life (QOL). In the present study, the effect size of exercise therapy on patients' QOL in both physical and mental dimensions were investigated and the moderator effect of a number of selected theoretical and significant practical variables were assessed. Relevant studies, published before July 2015, were identified by searching PubMed, Scopus, Google scholar, and Persian medical databases including IranMedex, Irandoc, Magiran, Scientific Information Database (SID), and Medlib. Supplementary searches were also performed manually by reviewing the reference lists of the relevant articles. Next, using a randomized controlled trial (RCT) design, English and/or Persian-language articles conducted in Iran and evaluating the effect of exercise therapy on physical and/or mental aspects of QOL of MS patients were pooled. Afterwards, two competent reviewers in the field extracted the required data and rated the quality of the studies. Twenty-one journal articles were identified and reviewed, but only 13 of them contained the as much data as required to serve the purpose of the study. The mean effect size of exercise therapy on mental, physical, and overall QOL of the patients were 1.021 (95%CI 0.712-1.331, P < .001), 1.040 (95%CI 0.730-1.349, P < .001), and 0.846 (95%CI 0.508-1.184, P < .001), respectively. Based on the investigated Iranian studies, there is strong evidence confirming the effect of exercise therapy on QOL of patients with MS; there, however, exists a need for more studies to identify and establish effective exercise programs due to the heterogeneity of the studies conducted in this area.

Validity and Reliability Assessment of the Persian Version of Therapy-Related Symptom Checklist.

Therapy-related symptom checklist for children (TRSC-C) was developed as a symptom assessment tool in children receiving chemotherapy. The objective of the present study was to evaluate the validity and reliability of the Persian version of TRSC-C. This cross-sectional study was conducted in 2013-2014 in Tehran, Iran. TRSC-C was translated using backward-forward approach. The content validity, face validity, and comprehensiveness were investigated based on the opinion of experts. The item content validity index (I-CVI) and scale content validity index (S-CVI) were calculated by the mean approach and inter-rater agreement. The scale was revised based on the comments from a team of five experts, after which it was evaluated by an additional group of four experts. To assess the inter-rater reliability, two raters filled the scale with 29 and 30 patients in the outpatient clinic of Hazrat-e Ali Asghar Hospital. The Cronbach's alpha was calculated and factor analysis was performed. The scores of content validity were analyzed in Excel. Other statistical analyses were performed using the SPSS software version 20.0. Based on the initial assessment, the S-CVI with less conservative approach was 60% for clarity, 33% for relevancy, and 60% for simplicity. After revising the scale, the S-CVI reached 100%. The comprehensiveness and face validity of the scale were appropriate. The scale was inter-rater reliable and the Cronbach's alpha was 0.803. Eleven subscales were found in the TRSC-C. It is concluded that the Persian TRSC-C is a valid and reliable tool for measuring children symptoms. Availability of a valid and reliable checklist is a fundamental step in monitoring the symptoms of patients while receiving chemotherapy.

Calcitriol for Oral Mucositis Prevention in Patients With Fanconi Anemia Undergoing Hematopoietic SCT: A Double-Blind, Randomized, Placebo-Controlled Trial.

Fanconi anemia is a rare inherited aplastic anemia, which is cured only by hematopoietic stem-cell transplantation (HSCT). One of the most debilitating complications of high-dose chemotherapy regimen before HSCT is oral mucositis (OM), which occurs frequently in this population. Vitamin D has identified immunoregulatory, anti-inflammatory, and antioxidant role. This study was designed to examine the efficacy of vitamin D in the prevention of OM in patients with Fanconi anemia undergoing allogenic HSCT. Twenty-eight patients were enrolled in the study. They received either calcitriol (0.025 µg) or placebo capsule once daily, from the first day of chemotherapy schedule for 14 consecutive days. Incidence of OM was assessed as the primary outcome. Moreover, the association of baseline vitamin D level with OM was evaluated. In this study, calcitriol did not change OM incidence (P = 1) and severity (P = 0.54) significantly; however, a significant association of baseline vitamin D level with OM complete resolution was found (P = 0.03; hazard ratio, 1.01; 95% confidence interval, 1.00-1.01). In conclusion, we did not find considerable benefits of calcitriol in the prevention of OM. However, further studies with bigger sample size and different calcitriol supplementation schedules are needed to confirm these findings.

A double-blind, randomized, controlled trial on N-acetylcysteine for the prevention of acute kidney injury in patients undergoing allogeneic hematopoietic stem cell transplantation.

Acute kidney injury (AKI) is one of the complications of hematopoietic stem cell transplantation and is associated with increased mortality. N-acetylcysteine (NAC) is a thiol compound with antioxidant and vasodilatory properties that has been investigated for the prevention of AKI in several clinical settings. In the present study, we evaluated the effects of intravenous NAC on the prevention of AKI in allogeneic hematopoietic stem cell transplantation patients. A double-blind randomized placebo-controlled trial was conducted, and 80 patients were recruited to receive 100 mg/kg/day NAC or placebo as intermittent intravenous infusion from day -6 to day +15. AKI was determined on the basis of the Risk-Injury-Failure-Loss-End-stage renal disease and AKI Network criteria as the primary outcome. We assessed urine neutrophil gelatinase-associated lipocalin (uNGAL) on days -6, -3, +3, +9 and +15 as the secondary outcome. Moreover, transplant-related outcomes and NAC adverse reactions were evaluated during the study period. Statistical analysis was performed using appropriate parametric and non-parametric methods including Kaplan-Meier for AKI and generalized estimating equation for uNGAL. At the end of the trial, data from 72 patients were analysed (NAC: 33 patients and placebo: 39 patients). Participants of each group were not different considering baseline characteristics. AKI was observed in 18% of NAC recipients and 15% of placebo group patients, and the occurrence pattern was not significantly different (p = 0.73). Moreover, no significant difference was observed between groups for uNGAL measures (p = 0.10). Transplant-related outcomes were similar for both groups, and all patients had successful engraftment. Three patients did not tolerate NAC because of abdominal pain, shortness of breath and rash with pruritus and were dropped from the intervention group before transplantation. However, the frequency of adverse reactions was not significantly different between groups. In conclusion, our findings could not show any clinical benefits from high-dose NAC particularly for AKI prevention in allogeneic hematopoietic stem cell transplantation patients.

Effect of magnesium on functional outcome and paraclinical parameters of patients undergoing supratentorial craniotomy for brain tumors: a randomized controlled trial.

BACKGROUND: Several studies have demonstrated that magnesium (Mg) plays an important role in the prevention and treatment of central nervous system (CNS) insults. In this study, we tested the effect of intravenous magnesium sulfate (MgSO4) on the outcome of patients with brain tumors who underwent craniotomy. The outcome was defined clinically as the Barthel index score and paraclinically as blood levels of NSE (neuron-specific enloase) and S100Β protein. METHODS: Sixty patients were randomly divided into two groups of 30 patients: the treatment and control groups. In the treatment group, 5 g of MgSO4 in normal saline was infused in 6 h 2 days before surgery, and the same dosage was repeated the day before and during surgery. The control group received placebo. Serum S100Β and NSE concentrations were measured at baseline before administration of magnesium, before surgery, and on the 2nd postoperative day. The Barthel index score was evaluated and registered before surgery, 3, and 6 months after the operation. RESULTS: The study results showed a significant change in S100Β protein levels before and after surgery (p < 0.05), but we could not find similar results for NSE protein and the Barthel index score. There was a correlation between NSE protein and the Barthel index. CONCLUSIONS: The results of this study revealed that administration of intravenous MgSO4 before and during surgery is safe and effective in reducing S100B protein levels in patients undergoing supratentorial craniotomy for brain tumors. Further studies to elucidate the pathophysiology of brain injuries and role of magnesium are warranted.

Urine neutrophil gelatinase associated lipocalin as an early marker of acute kidney injury in hematopoietic stem cell transplantation patients.

Acute kidney injury (AKI) is common in hematopoietic stem cell transplantation (HSCT) patients with an incidence of 21-73%. Prevention and early diagnosis reduces the frequency and severity of this complication. Predictive biomarkers are of major importance to timely diagnosis. Neutrophil gelatinase associated lipocalin (NGAL) is a widely investigated novel biomarker for early diagnosis of AKI. However, no study assessed NGAL for AKI diagnosis in HSCT patients. We performed further analyses on gathered data from our recent trial to evaluate the performance of urine NGAL (uNGAL) as an indicator of AKI in 72 allogeneic HSCT patients. AKI diagnosis and severity were assessed using Risk-Injury-Failure-Loss-End-stage renal disease and AKI Network criteria. We assessed uNGAL on days -6, -3, +3, +9 and +15. Time-dependent Cox regression analysis revealed a statistically significant relationship between uNGAL and AKI occurrence. (HR = 1.04 (1.008-1.07), p = 0.01). There was a relation between uNGAL day + 9 to baseline ratio and incidence of AKI (unadjusted HR = 1.047 (1.012-1.083), p < 0.01). The area under the receiver-operating characteristic curve for day + 9 to baseline ratio was 0.86 (0.74-0.99, p < 0.01) and a cut-off value of 2.62 was 85% sensitive and 83% specific in predicting AKI. Our results indicated that increase in uNGAL augmented the risk of AKI and the changes of day +9 uNGAL concentrations from baseline could be of value for predicting AKI in HSCT patients. Additionally uNGAL changes preceded serum Cr raises by nearly 2 days.

A comparative study of the effectiveness of self-management and group management on the amount of weight loss of nurses under low-calorie diet treatment: A simultaneous mixed-methods study.

BACKGROUND: Nursing is a profession that is associated with a lot of stress and a risk of being overweight or obese. The purpose of this research was to determine the comparative effectiveness of self-management (self-M) and group management (group-M) on nurses who were following a diet with the aim of proposing a proper planning and a healthy lifestyle for them. MATERIALS AND METHODS: This study was a simultaneous mixed-methods design (interventional and qualitative). The participants were all overweight or obese nurses working in teaching hospitals at Guilan University of Medical Sciences in 2019 (n = 96). In the qualitative part, data were extracted from semi-structured interviews. For quantitative data analysis, relevant statistical methods such as Kolmogorov-Smirnov test, analysis of variance (ANOVA), and analysis of covariance (ANCOVA) were used. For qualitative data analysis, the conventional content analysis approach was used and Lincoln and Guba's criteria were applied to ensure the accuracy of the data. RESULTS: In both quantitative and qualitative sections, the results showed that following a diet treatment with group-M is more effective than self-M. CONCLUSION: The results showed that a healthy lifestyle can be achieved for nurses if they participate in training classes and group programs, which are proven to be effective based on this article and some other studies. Also, since weight gain and obesity, as one of the most important problems of health systems, continue to increase and can impose a heavy economic and social burden on human societies, various general policies should be used and these solutions can range from home to society to prevent and control them.

Effectiveness of Gamification in Enhancing Learning and Attitudes: A Study of Statistics Education for Health School Students.

Introduction: Gamification is the use of game design elements in non-game contexts. It is considered a student-centered instructional design to motivate student learning and academic behavior. In this study, the effects of gamification on learning statistics (hypothesis testing issue) and attitude toward statistics in comparison with the common e-learning approach were investigated. The students' experience and critical elements of gamification on learning statistics were assessed, too. Methods: In a before and after trial, in a census manner, 64 health faculty students of Guilan University of Medical Sciences, Rasht, Iran, non-randomly were assigned to the intervention (n=42) and control (n=22) groups. Learning activities were gamified in the intervention group, while the control group received traditional problem-solving in the learning management system. Narrative, avatar, level, point, progress bar, scoreboard, challenge and feedback elements were used in the game experience. The implementation of gamification was applied based on Landers' theory of gamified content. Valid and reliable Persian version of the Survey Attitude toward Statistics questionnaire measured the students' attitude before and after the intervention. The EGameFlow questionnaire and a valid and reliable researcher-made exam measured the users' experience of gamified content and learning hypothesis testing after the intervention. The independent samples T-test, analysis of covariance and the partial eta-squared effect size were calculated by SPSS software, version 26. Results: Compared to the control group, the intervention group had a more positive attitude toward learning difficulty (moderate partial eta-squared 0.099), value and cognitive competency (weak partial eta-squared=0.01 and 0.05). Learning between the two groups was not different (P=0.522). There was a significant correlation between learning and the students' perceived experience with feedback (r=0.583, P<0.001), concentration (r=0.509, P=0.005), and challenge (r=0.421, P=0.023) of the gamified content. Conclusion: It suggests using gamification on learning statistics while optimizing the design with more focus on the feedback, challenge and concentration elements.

Promoting dairy consumption behavior in the school setting: an experiment based on the transtheoretical model.

BACKGROUND: Nutrition education is a key component of health promotion programs which leads to the improvement of students' nutritional behaviors. The transtheoretical model (TTM) is one of the models extensively used in changing people's behaviors. This study aimed to change the dairy consumption behavior based on the TTM in female students. METHODS: A controlled trial was conducted with 159 female students (intervention group: 56; control group: 103) in the 10-11th grades from two public schools in Soumesara city located in the west of Gilan Province, Iran. Demographic characteristics, knowledge, TTM constructs and stage of change of dairy consumption were collected using a valid and reliable researcher-made questionnaire. Data were gathered before and one month after the educational intervention. Chi-square test, t-test and ANCOVA were used to analyze the data and a p-value < 0.05 was considered statistically significant. RESULTS: Fifty-two students from the intervention and 93 from the control group completed the study. Only 15% of the students were in the action or maintenance stages of dairy consumption. After the intervention, mean scores of behavioral processes of change, cognitive processes of change, decisional balance, and self-efficacy improved in the intervention group (P < 0.05 for all). Also, 37% and 16% of the participants in the intervention and control groups, respectively, were in the action or maintenance phase (P < 0.001). CONCLUSIONS: This study showed that implementing an intervention based on the TTM would positively affect students' dairy consumption behaviors. Also, it is suggested that the TTM be assessed in terms of other daily nutritional needs in students to promote their nutritional behaviors. TRIAL REGISTRATION: The study was registered in the Iranian Registry of Clinical Trials (IRCT) (available online at https://en.irct.ir/trial/50003 ) on April 11, 2020 with the number IRCT20200718048132N1 and was approved by research ethics committee of Guilan University of Medical Sciences, Iran.

Hospitals' Food Services Quality and Factors Associated with Patients' Satisfaction in University Hospitals in the North of Iran.

This cross-sectional study evaluated patients' satisfaction with hospital meals in seven urban public hospitals using a validated questionnaire. The quality of food services based on the hospital standards was assessed using a checklist prepared by Iran's ministry of health. Of 800 subjects, the quality and quantity aspects of hospital meals, in general, were nearly satisfactory to the patients (mean score: 2.13, range: 1-3, SD: 0.39, 40% good and 36% moderate). The mean score of hospitals' food service quality based on hospital standards was 2.17 (range: 0-4, SD: 0.59). Females, younger patients and those with higher education level reported to be less pleased with hospital meal services. No relationship between patients' satisfaction and hospital food quality assessment based on hospital standards was found.

The relationship between body mass index and outcomes in leukemic patients undergoing allogeneic hematopoietic stem cell transplantation.

Hematopoietic stem cell transplantation (HSCT) is being used increasingly in an attempt to cure many hematological disorders. Obesity has become a world wide phenomenon and is a known risk factor for numerous medical conditions, but its role in transplant outcomes remained controversial. Total of 192 patients with acute leukemia who underwent sibling HLA matched HSCT were analyzed to find the effect of pre-transplant body mass index (BMI) on transplant outcomes such as time to engraftment, infections, graft vs. host disease (GvHD), and overall survival (OS) for the period of three yr (April 2006-March 2009). There was a significant correlation between higher pre-transplant BMI and shorter engraftment time (p = 0.010); but no relation between BMI and GvHD, infection, and OS was found. The results of this study showed that patients with higher BMI may have a shorter engraftment time; but lower, although not significant, survival rate compared to non-obese patients.

An In vitro Study on the Protective Effect of Melatonin on Human Sperm Parameters Treated by Cadmium.

Background: Male infertility account for nearly 50% of infertility cases. Cadmium is regarded as a well-known toxic metal for industrial applications; high amounts of cadmium in the human body can result in chronic toxicity. Melatonin as a free radical scavenger has anti-inflammatory, and even anti-cancer and antiapoptotic functions. Aim: In this work, we evaluated the protective effect of melatonin on human sperm parameters treated by cadmium. Study Setting and Design: This was an experimental study carried out from May to December 2019. Materials and Methods: A total of 41 fresh semen samples were collected from fertile men and were divided into 4 groups: (1) control, (2) sperm +25 Nm cd, (3) sperm +25 nM cd +0.1 mM melatonin,(4) sperm +0.1 mM melatonin treated for 60 min. In all groups, semen analysis was performed for motility, viability and DNA fragmentation index (DFI). Statistical Analysis: The groups were compared using the ANOVA test. Results: The group treated with cadmium showed a significant decrease in rapid and slow motility, and survival rate compared with the control group (P < 0.05). However, the degree of DFI and sperm with non-progressive motility in the group treated with cadmium had a significant increase compared to the control (P < 0.05). The use of melatonin significantly improved sperm parameters such as motility, survival rate and decreased sperm DFI with non-progressive motility. Conclusions: The use of melatonin reduces the amount of cadmium damage in human sperm in vitro.

Dietary diversity and food security status among heart failure patients in the north of Iran.

BACKGROUND: Dietary diversity score (DDS) is an indicator for assessing nutritional adequacy. Food security is another important measure in nutrition field which can be associated with several cardiovascular risk factors. Considering the importance of nutrition in heart failure (HF) patients, this study was designed to evaluate the DDS and food security of patients with HF. METHODS: A total of 200 HF patients were enrolled. DDS was evaluated using valid and reliable food frequency questionnaire and was calculated by scoring food intakes as 5 main groups. Household food insecurity access scale was applied to assess food security status. Data were analyzed using descriptive statistics, Chi-square and Kruskal-Wallis tests and multiple logistic regression models. RESULTS: The mean age of patients was 65 (standard deviation: 12) years and 59% of patients were male. Median of DDS was 1.96 (range: 0.29 to 6.12). Adjusted odds of greater DDS (> = median of 2) was 2.58 times higher for patients without hypertension than for patients with hypertension (95%CI: 1.31-5.08, P = 0.006). Also, odds of greater DDS were more in ex-smokers' patients when compared to non-smokers (adjusted odds ratio (AOR): 2.70, 95%CI: 1.27-5.75, P = 0.010), patients with supplement use (AOR: 2.42, 95%CI: 1.16-5.05, P = 0.019), patients with lower total cholesterol level (AOR: 1.01, 95%CI: 1.00-1.02, P = 0.051), and patients with higher ejection fraction (AOR: 1.03, 95%CI: 1.00-1.05, with borderline. P = 0.073). About 57% of patients had experienced degrees of food insecurity as mild (26%), moderate (16%) and severe (15%). On the other hand, women (AOR: 1.90, 95%CI: 0.90-3.71, with borderline P = 0.061) and patients with middle (AOR: 3.48, 95%CI: 1.79-6.76, P < 0.001) or high (AOR: 20.32, 95%CI: 2.56-161.19, P = 0.004) socio-economic status were more likely to be food secure or mild insecure. Also, no relation between DDS and food security was found (r = - 0.08, P = 0.262). CONCLUSION: This study found that HF patients had a low DDS and more than half of the patients were food insecure to some extents.

The role of correlated factors based on Pender health promotion model in brushing behavior in the 13-16 years old students of Guilan, Iran.

BACKGROUND: Tooth decay is one of the diseases that is closely related to people's behaviors and it can have adverse effects on their performance and their success in the future. Brushing twice a day is the simplest and most effective way to reduce tooth decay. The study aim was to determining the roles of correlational factors based on the Pender's health promotion model in brushing behavior of ninth grade students at urban public schools of Guilan province during the academic year 2019. METHODS: The present study was cross-sectional and had a descriptive-analytical type. We performed the multi-stage random sampling on 761 ninth-grade students (374 girls and 387 boys) at urban public schools of six counties (ten cities) of Guilan province in 2019. The primary tool was a questionnaire on oral health behaviors focusing on brushing behavior. In the present study, which was conducted only on brushing behavior, we revised and changed the initial questionnaire during the sessions of the research team, and then confirmed its validity and reliability. The questionnaire consisted of three parts, demographic characteristics, constructs of health promotion model, and brushing behavior. We analyzed data in SPSS 21 using regression models. RESULTS: 20.1% of students brushed their teeth at least twice a day. Optimal behavior had a statistically significant relationship with parents' education level, and gender. Based on the regression model, the health promotion model constructs described 58% of the variance of the commitment to plan of action. Perceived self-efficacy, situational influences, and perceived barriers of action had significantly stronger relationships with commitment to plan of action respectively. Multiple logistic regression analysis indicated that one-unit increase in scores of commitment to plan of action and self-efficacy increased the chance of desired behavior by 12 and 14% respectively. CONCLUSION: Due to the low rate of brushing behavior in the students and the predictive power of the health promotion model in brushing behavior, we suggest planning and implementation of educational interventions for this group with an emphasis on influencing the commitment to plan of action, self-efficacy, and also the level of knowledge.

Comparison between the effect of aromatherapy with lavender and damask rose on sleep quality in patients undergoing coronary artery bypass graft surgery: A randomized clinical trial.

BACKGROUND: Numerous studies have investigated the effect of lavender and damask rose aromatherapy on sleep quality. There is, however, little research to compare the impact of them over each other. The aim of current study was to compare the effect of aromatherapy with lavender and damask rose on sleep quality in patients after coronary artery bypass graft (CABG) surgery in Guilan Province, Iran, in 2017-2018. METHODS: In this randomized clinical trial (RCT) study, 97 patients undergoing CABG were randomly assigned to intervention or control groups. In the intervention groups, the patients were asked by the researcher to inhale the lavender or damask rose randomly every night for 5 consecutive nights at 22:00. The control group received routine nursing care in compliance with the hospital procedure. Data were obtained by demographic-clinical and Beck Depression Inventory (BDI) questionnaires. To analyze the data, chi-square test, t-test, Kruskal-Wallis test, and Wilcoxon test were used. RESULTS: During the 5-night intervention period, despite a relative improvement of sleep quality in intervention groups compared to the control group, none of the two aromatherapies had a statistically significant effect on any of delayed sleep (P = 0.514), sleep duration (P = 0.839), sleep efficiency (P = 0.067), sleep disturbances (P = 0.061), and daily functional disorders (P = 0.114) except for subjective sleep quality (P = 0.016) and use of sleep medications (P = 0.031). CONCLUSION: Using both aromatherapies with lavender and damask rose indicated positive effects on sleep quality of the CABG patients, but we could not find a superiority over each other.

The effects of regular consumption of green or black tea beverage on blood pressure in those with elevated blood pressure or hypertension: A systematic review and meta-analysis.

OBJECTIVE: As a popular beverage, there has been much interest in studying the effects of tea intake on hypertension (HTN), a particular risk factor for cardiovascular disorders (CVDs). We have thus aimed to isolate the randomized controlled trials investigating the efficacy of black or green tea as a beverage in subjects with elevated blood pressure (BP), or HTN. METHODS: PubMed, Scopus, Web of Science, and ProQuest dissertations and theses databases were searched from February 1, 1995, up to July 20, 2019, to identify relevant studies. RESULTS: The search strategy generated 1119 trials, of which finally five trials fulfilled the criteria for being included in the current study. Three out of 5 articles showed a low risk of bias. According to nine measurements derived from 5 trials on 408 individuals, it was found that regular tea intake resulted in the reduction in SBP (weighted mean difference (WMD): -4.81 mmHg, 95 %CI: -8.40 to -1.58, P = .004) and DBP (WMD:-1.98 mmHg, 95 %CI: -3.77 to -0.20, P = .029); however, excluding the most heterogeneous trials showed that regular tea intake might reduce SBP and DBP by about -3.53 and -0.99 mmHg, respectively. Based on meta-regression findings, we found the longer the duration of tea intake (≥3months), the higher the decrease in both SBP and DBP. Categorized studies, according to the tea type, revealed that the hypotensive effects of green tea were more pronounced compared to black tea. None of the studies reported any side effects. CONCLUSION: These results suggest the positive effects of regular tea intake on BP in subjects with elevated BP or HTN. Hence, it may be applicable to physicians, health care providers, and particularly HTN patients.