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An ecologic study was conducted on 177 countries which the information of tobacco tax and price and also Human Development Index (HDI) was available in 2014. In this study, the relationship between HDI and four reported indexes by World Health Organization (WHO) was studied. These four indexes included: Tobacco affordability, Taxes as a percent of price of the most sold brand (total tax), Price of a 20 cigarette pack of the most sold brand international dollars at purchasing power parity (Price_ppp) and Price of a 20 cigarette pack of the most sold brand in US$ at official exchange rates (Price_US$). The data of HDI and tobacco were mined from WHO and United Nations Development Programme sites respectively. To study the correlation between HDI and the variables of this study, Pearson correlation coefficient was used and also Linear Regression Analysis was used to study the relationship between HDI and the variables of the study. According to the findings of the linear regression analysis, there was a significant relationship between HDI and total tax (B = 0.81, CI 95%: 0.63-0.99) and tobacco affordability (B = --0.35, CI 95%: --0.42 _ --0.28). There was also a significant relationship between HDI whit price-ppp (B = 9.44, CI 95%: 7.13-11.75) and price-US$ ;(B = 11.97, CI 95%: 9.71-14.23). According to the findings of this study, less developed countries devote less tax on tobacco. Due to the rising trend of the prevalence and also development of non-communicable diseases such as lung cancer in developing countries, policy makers of these countries are required to design stricter policies toward tobacco production and supply as well.
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This study was conducted to investigate the effect of human development index (HDI) on tobacco smoking prevalence in men and women of countries which their data about tobacco smoking were available for 2015. Pearson's correlation coefficient and linear regression were used to investigate the association between HDI and all types of smoking, particularly cigarette. Daily smoking and current smoking were used as tobacco smoking indices. The information about prevalence of tobacco smoking and HDI was obtained from the World Health Organization (WHO) website and United Nations Development Programme (UNDP), respectively. The results showed that there is no statistically significant relationship between HDI and current tobacco smoking in men (B = -0.45_CI 95%: -29.97, 29.06). However, the same association was significant for women (B = 43.87, CI 95%: 24.97-62.78). The results indicated that women in developed countries are more at risk of health effects attributed to tobacco smoking. Countries should focus on socioeconomic factors to prevent the spread of risk factors for non-communicable diseases.
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BACKGROUND: The prevalence of Type 2 diabetes mellitus (T2DM) has been increasing globally in the recent decades. Physical activity (PA) helps preventing diabetes complications by keeping the blood sugar of T2DM patients within the normal range. The objective of this study was to explore underlying beliefs corresponding to PA in T2DM patients using health action process approach (HAPA). METHODS: This cross-sectional study was conducted in Isfahan, 2015. A convenience sample of 203 participants with T2DM was collected. Participants completed HAPA inventory containing the following constructs: Risk perception, outcome expectation, task self-efficacy, intention, action and coping planning, coping self-efficacy, recovery self-efficacy, and PA questionnaire. Structural equation modeling was used for statistical analysis. RESULTS: The common fit indices revealed that the HAPA had an acceptable fit to the observations (CMIN/df = 2.36 [P < 0.001], root mean square error of approximation = 0.089, comparative fit index = 0.891, normal fit index = 0.902). Intention was associated with task self-efficacy (ß = 0.92, P < 0.001), whereas risk perception (ß = 0.16, P = 0.073) and outcome expectation (ß = 0.32, P < 0.081) did not predict intention to participate in PA behavior. PA was well predicted by planning (ß =0.84, P < 0.01) while it was not significantly associated to coping self-efficacy (ß = 0.66, P = 0.73) and recovery self-efficacy (ß = 0.6, P = 0.69). CONCLUSIONS: HAPA could be used as a proper framework to identify the beliefs of the patients with T2DM and guide for effective theory-based interventions regarding PA.
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BACKGROUND AND AIM: Worldwide, type 2 diabetes mellitus (T2DM) prevalence has increased. Non-healthful diet is one of the main reasons to T2DM growth. This study aims to determine the efficacy of the health action process approach (HAPA) in explaining healthful diet (HD) in T2DM patients. METHODS: This cross-sectional study was conducted based on HAPA in Isfahan, Iran between July and December 2015. Participants were recruited by convenience sampling method. HAPA inventory was administered to 203 Isfahan diabetics. Intentions, outcome expectancies, risk perception, action self-efficacy, action and coping planning, maintenance and recovery self-efficacy, and dietary style were the constructs measured. Structural equation modeling (SEM) in AMOS 21 was used to test the hypothesis. RESULTS: The results based on the common fit indices revealed that the HAPA fitted the data acceptably well among the T2DM patients and within dietary behavior (p<0.001), RMSEA=0.082, CFI=0.903, NFI=0.899). Action self-efficacy was the best predictor of intention (ß=2.49, p<0.001). Result revealed action and coping planning (ß=5.36, p=0.027) and recovery self-efficacy (ß=5.67, p=0.021) significantly predicted behavior. CONCLUSIONS: Our findings provide preliminary support for the practical usage of the HAPA model for predicting HD intention and behavior among T2DM patients. Randomized controlled trials should be performed in the future in order to involve causality.
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BACKGROUND: Long-term effects of diabetes could be prevented or delayed by adopting a proper diet. The aim of this study was to adapt and provide a pilot test using health action process approach (HAPA)-based inventory to capable of capturing significant determinants of healthful diet for diabetics. METHODS: The inventory was reviewed by eight diabetes patients and verbal feedbacks with regard the comprehension, item relevance, and potential new content were obtained. Then, the inventory items were evaluated by an expert panel. Next exploratory factor analysis (EFA) was conducted to assess the scale constructs. Criterion validity was measured by Pearson correlation. Finally, reliability measures of internal consistency and test-retest analysis were determined. RESULTS: A total of 121 diabetic patients participated in this study. EFA extracted seven factors (risk-perception, action self-efficacy, outcome expectancies, maintenance self-efficacy, action and coping planning, behavioral intention, and recovery self-efficacy) explaining 81.14% of the total variance. There were significant correlations between behavioral intentions and both outcome expectancies (r = 0.55, P < 0.05) and action self-efficacy (r = 0.31, P < 0.004) and small to moderate correlations (rs = 23-40) between behavior and the volitional constructs of the HAPA model. Cronbach's alpha ranging from 0.65 to 0.95 and intraclass correlation coefficients ranging from 0.71 to 0.92 indicated an acceptable internal consistency. CONCLUSIONS: Developed scales were valid and reliable for measuring HAPA variables to be used with type 2 diabetes mellitus patients. Further examination with minority persons is warranted.
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BACKGROUND: Moderate increase in physical activity (PA) may be helpful in preventing or postponing the complications of type 2 diabetes mellitus (T2DM). The aim of this study was to assess the psychometric properties of a health action process approach (HAPA)-based PA inventory among T2DM patients. METHODS: In 2015, this cross-sectional study was carried out on 203 participants recruited by convenience sampling in Isfahan, Iran. Content and face validity was confirmed by a panel of experts. The comments noted by 9 outpatients on the inventory were also investigated. Then,the items were administered to 203 T2DM patients. Construct validity was conducted using exploratory and structural equation modeling confirmatory factor analyses. Reliability was also assessed with Cronbach alpha and interclass correlation coefficient (ICC). RESULTS: Content validity was acceptable (CVR = 0.62, CVI = 0.89). Exploratory factor analysis extracted seven factors (risk- perception, action self-efficacy, outcome expectancies, maintenance self-efficacy, action and coping planning, behavioral intention, and recovery self-efficacy) explaining 82.23% of the variation. The HAPA had an acceptable fit to the observations (χ2 = 3.21, df = 3, P = 0.38; RMSEA = 0.06; AGFI = 0.90; PGFI = 0.12). The range of Cronbach alpha and ICC for the scales was about 0.63 to 0.97 and 0.862 to 0.988, respectively. CONCLUSION: The findings of the present study provided an initial support for the reliability and validity of the HAPA-based PA inventory among patients with T2DM.
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BACKGROUND: Postoperative nausea and vomiting is one of the most common side effects associated with surgical procedures. OBJECTIVES: The aim of this study was to determine the effect of ginger on intensity of nausea and vomiting after surgical procedures. PATIENTS AND METHODS: This study was a randomized, double blinded, clinical trial. 160 eligible patients were randomly assigned into experimental or placebo groups. The experimental group received 4 capsules containing 250 mg ginger and placebo group received 4 placebo capsules 1 hour before surgery. The severity of nausea and vomiting was measured at 2, 4, 6 hours post operation using visual analogue scale and a structured questionnaire. The data were analyzed by independent t - test, Mann-Whitney U test, chi -square and GEE using SPSS 16 and STATA version 11. RESULTS: Mean nausea score at 2 hours post operation was significantly lower in the experimental group (P= 0.04). Mean nausea score at 4 and 6 hours post operation was lower in the experimental group; however, there was no significant difference between the groups at any time post operation. The frequencies of nausea in the experimental group at 2 and 6 hours post operation were lower than that in the placebo group, however, at 2 hours post operation, it was borderline significant (P = 0.05) There was no significant differences between two group in the intensity of vomiting at any time. CONCLUSIONS: Use of ginger was effective at decreasing postoperative nausea. Ginger could be used as a safe antiemetic drug at post operation.