Psychometric validation of the nursing care behavior questionnaire during emerging disease epidemics: A theory of planned behavior approach.

Background and objective: The Covid-19 pandemic could compromise the quality of care by impacting nurses' intention to provide care. Hence, investigating nurses' behavioral intentions when caring for patients during epidemics is essential. This research aims to assess the psychometrics of the "Nursing Care Behavior in Epidemics of Emerging Diseases" questionnaire, based on the constructs of the Theory of Planned Behavior. Methods: This cross-sectional study involved 311 nurses working in Covid-19 wards of selected hospitals in Ilam City, all of whom were enrolled through a census in 2021. The questionnaire underwent initial translation from English to Persian, followed by evaluations of its face, content, and construct validities. The nursing caring behavior questionnaire, comprising 46 items, was designed to assess behavioral beliefs, normative beliefs, control beliefs, behavioral attitudes, subjective norms, perceived behavioral control, and nurses' intentions to care for Covid-19 patients. Data were analyzed for face, content, and construct validity using the Theory of Planned Behavior and Pearson correlation. Reliability was determined by calculating the Cronbach's alpha coefficient. Results: The intention to care dimension demonstrated an inverse correlation with the behavioral attitude dimension (p < 0.001). The most robust correlations were observed between the following paired dimensions: behavioral attitude and perceived power (p < 0.001), subjective norms and intention to care (p < 0.001), perceived behavioral control and subjective norms (p < 0.001), care intention and behavioral beliefs (p < 0.001), behavioral beliefs and behavioral outcome evaluation (p < 0.001), and normative beliefs with motivation to comply (p = 0.001). The Cronbach's alpha coefficient of the instrument exceeded 0.75. Conclusion: According to the Theory of Planned Behavior, the nursing care behavior questionnaire proved to be a valid and reliable tool for evaluating nurses' care behaviors amidst emerging disease epidemics.

The role of social media literacy in infodemic management: a systematic review.

Background: The term infodemic refers to the proliferation of both accurate and inaccurate information that creates a challenge in identifying trustworthy and credible sources. Among the strategies employed to mitigate the impact of the infodemic, social media literacy has emerged as a significant and effective approach. This systematic review examines the role of social media literacy in the management of the infodemic. Methods: Six databases, including SID, Magiran, Scopus, PubMed, Google Scholar and Web of Science were systematically searched using relevant keywords. We included the relevant publications between 2012 and 2023 in our analysis. To ensure a qualitative assessment of the studies, we used the STROBE and AMSTAR checklists as evaluation tools. The Preferred Reporting Items for Systematic Reviews (PRISMA) guideline was used for the design of this review study. Finally, we organized the studies into groups based on similarities and retrieved and analyzed evidence pertaining to the challenges and opportunities identified. Results: Eleven papers were included in this study after reviewing the retrieved studies. Five of them examined the effect of social media literacy and health literacy on acceptance of health behaviors. Four studies investigated the role of media literacy in managing misinformation and fake news related to health. Two studies focused on infodemic management and promoting citizen engagement during health crises. Results showed that health-related infodemics are derived from the users' lack of media knowledge, distrust of government service systems, local influencers and peers, rapid circulation of information through mass media messages, weakness of solutions proposed by health care providers, failure to pay attention to the needs of the audience, vertical management, and inconsistency of published messages. Conclusion: The findings of this study highlight the importance of increasing social media literacy among the general public as a recognized strategy for managing the infodemic. Consequently, it is recommended that relevant organizations and institutions, such as the Ministry of Health, develop targeted training programs to effectively address this need.

Assessing and predicting the trend of cardiovascular risk factors in 40-80-year population based on the Ira-PEN program as an integrated service in primary health care.

BACKGROUND: In Iran, half of all mortalities and 79% of those induced by noncommunicable diseases are attributed to cardiovascular diseases. In Iran, due to the high rate of noncommunicable diseases, a modified program (PEN) called Ira-PEN was integrated into the primary care program in health centers. The Ira-PEN program is adapted from the comprehensive WHO-PEN program to estimate the 10-year risk of cardiovascular diseases to control the main risk factors of noncommunicable diseases nationally. This study was conducted to investigate the process of service provision to determine the information needs and the necessary interventions in the comprehensive health service centers of Ardabil Province. MATERIALS AND METHODS: The present descriptive and analytical study was conducted in the Ardabil University of Medical Sciences. It used the data available in the registration system of the Health Network. The research population consisted of all people aged between 40 and 80 who visited the comprehensive health service centers to perform risk assessment of cardiovascular strokes in the province from 2018 to the end of 2021. The collected data were added to Excel. FORCAST function was used to predict the future through a linear regression analysis. To compare the final results, which is actually a reduction in mortality due to cardiovascular diseases, the difference test of two mortality rates due to cardiovascular diseases was used in 2018 and 2021. Test of two death proportions was performed through z test and Minitab21 Software. RESULTS: The prevalence of cardiovascular disease risk factors was as follows: history of heart attack (0.59%), history of stroke (0.51%), history of diabetes (7.9%), history of high blood pressure (15.7%), and history of prediabetics (12.8%). The probability of suffering from lipid disorder was 26.4% and BMI > 30 was 32.4%. The risk factors of hypertension, abdominal obesity, and smoking showed a decrease in the measurement of disease risk factors during 4 years. CONCLUSIONS: Identification of the common risk factors in the region helps to focus interventions on effective prevention and treatment measures and adopt evidence-based policies in order to reduce these risk factors. Since the investigated risk factors are rooted in inappropriate behaviors and lifestyles, by modifying these behaviors and changing lifestyles, their prevalence can be reduced and reducing these risk factors will lead to a reduction in the prevalence of cardiovascular diseases.

Investigating the factors affecting the self-care behaviors of patients with type II diabetes and the role of demographic variables: A case study in Iran.

BACKGROUND: Self-care practices in diabetes patients are crucial to keep the illness under control and prevent complications. Effective management of diabetes will be a difficult task without an adequate understanding of the current level of practice related to diabetes self-care. Therefore, this study aims to assess the factors affecting the self-care behaviors of patients with type II diabetes and the role of demographic variables in Iran. MATERIALS AND METHODS: The present study is a descriptive-analytical study that was designed and conducted in 2022. This study population was type II diabetic patients at the Diabetes Research Center of Ayatollah Taleghani Hospital in Kermanshah who were selected by available sampling method of 280 samples. Data collection tools included demographic characteristics questionnaire and standard self-care questionnaire for the Glasgow and Toobert diabetic patients. Data were analyzed using SPSS-23 software, independent t-tests, one-way analysis of variance, and stepwise regression. RESULTS: The mean of self-care scores was 2.07 ± 2.08 and indicated an unfavorable condition. The highest mean scores of self-care were in the field of regular use of medications, and the lowest scores were in the field of blood-glucose testing. The mean scores of self-care were significantly different based on marital status, occupation status, residence, type of treatment, duration of diabetes, years, smoking status (P < 0.05). Regression results showed that the variables predictors; type of treatment, smoking status, the complication of diabetes, education level status, place of residence explained 515% of the variance of self-care. CONCLUSIONS: The study showed that the extent to which individuals adhere to type II diabetes recommended management is substantially low. Improving awareness of patients and the community at large is imperative, especially on the diet, exercise, blood-glucose testing, foot care, and no smoking.

Role of demographic variables in investigating occupational stress of disaster and emergency medical management center.

BACKGROUND: Emergency medical services face stressful environments such as departments dealing with injuries and sick patients that pose challenging situations for the healthcare staff. This present study investigates the role of demographic variables in investigating occupational stress of disaster and emergency medical management center in 2021. MATERIALS AND METHODS: This present descriptive study selected a sample size of 200 medical personnel associated with disaster and emergency medical management center in Iran, according to the inclusion chosen criteria. The study used a tool consisting of two parts, including demographic information and a job stress Health and Safety Executive (HSE) standard questionnaire. The study selected respondents through Cochran's sample size formula using stratified random sampling with a cross-sectional research design for data collection. This present study has analyzed received data using performed the descriptive and inferential information (t-test and one-way ANOVA) at a significance level P < 0.05. The participants of the survey were males only. RESULTS: The study results specified that the mean age of respondents was 30.14 ± 5.96. The study results exhibited that the mean score of total occupational stress was 3.41 ± 0.26. The results showed the highest (4.34 ± 0.35) and the lowest (2.72 ± 0.86) stress levels were related to role dimensions. CONCLUSIONS: The study findings revealed a significant relationship between stress level and participants' age, marital status, educational level, type of base, workplace, and the number of work hours per month. Emergency medical personnel experience a high level of occupational stress. Senior managers can use similar studies to implement measures to reduce the experience of employees' stress.

Explaining barriers to childbearing using the risk communication and community engagement (RCCE) strategy: Based on action research.

Background and Aims: Reluctance to childbearing and then the reduction of the total fertility rate are common experiences of developed countries and many developing countries, including Iran, therefore, the purpose of this study was explaining barriers to childbearing using the risk communication and community engagement (RCCE) strategy. Methods: The study was conducted by action research and according to RCCE during 9 months in Ardabil city. The statistical population consisted of 41 married women aged 15-54 who were eligible for childbearing, these women were purposefully selected from among the people covered by Ardabil health centers and interviewed. Data were collected using open and in-depth interviews by the researcher and analyzed by content analysis. Results: The results of data analysis led to the extraction of three main categories, personal, familial, and social barriers. The "personal barriers" category was classified into three subcategories, namely mental, belief, and awareness barriers, the "familial barriers" category was classified into two subcategories, namely social and financial barriers, and the "social barriers" category was classified into two subcategories, political and managerial barriers. Conclusions: According to the results, a set of personal, familial, and social factors could affect childbearing among married women. Identification of these factors can play an effective role in designing educational and managerial programs.

Effectiveness of motion graphic-based narrative therapy with a cognitive-behavioral approach in reducing fluoride varnish therapy anxiety for six-year-old children.

BACKGROUND: Fluoride varnish therapy (FVT) is a dental caries preventive service that its effectiveness has been well documented. A lot of children, especially the five-year-old and six-year-old ones, are suffering with anxiety during this service and do not readily allow it. The present study aimed to cast light on the effect of motion graphic-based narrative story with a cognitive-behavioral approach in reducing FVT anxiety among six-year-old children. MATERIALS AND METHODS: This study was an intervention trial type that was conducted in Ardabil city and among school students. Five children suffering from FVT anxiety were randomly selected for the intervention. First, Venham and Gaulin-Kremer's anxiety scale was completed for them. The motion graphic-based narrative therapy was implemented for six weeks. Session 1 was assigned to filling the questionnaire and collecting data. The motion graphic-based narrative therapy started from the second session. The anxiety scale was filled for the children every ten days for a total of four times. The results were analyzed by Blanchard and Schwarz's progress formula and control charts. The intervention sessions included gathering information, watching motion graphics, relaxation skills, watching the process of performing fluoride varnish therapy, teaching the advantages of fluoride varnish therapy, and in the last session performing fluoride varnish therapy with the technique of attention diversion while watching motion graphics. RESULTS: The motion graphic-based narrative therapy by the cognitive-behavioral approach proved effective in reducing anxiety. At the end of the intervention sessions, the level of anxiety decreased from 8 to 2.2 and the statistical control chart of the process shows that the intervention process is stable and the stability in order to reduce anxiety and the results are within the control limits. CONCLUSION: The results show that motion graphic-based narrative therapy can be a psychotherapy method for reducing the symptoms of dental anxiety among children.

Prevalence of Hypertension among Children Based on the New American Academy of Pediatrics Clinical Practice Guidelines.

Background: In 2017, the American Academy of Pediatrics (AAP) updated clinical practice guidelines for the diagnosis and management of hypertension in children. The present study aimed to assess the prevalence of hypertension in Iranian children based on the latest guidelines. Methods: Data on 7301 student participants (3589 boys and 3712 girls) aged between 7-12 yr were assessed. The data were extracted from the fifth Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease (CASPIAN V) school-based study conducted in the 30 provinces of Iran in 2015. Blood pressure (BP) was classified as normal, elevated BP, and stage 1 and 2 hypertension using weighted analysis and the 2017 AAP guidelines. All analyses were performed in STATA 14.0 statistical software, with findings presented in terms of prevalence. Results: The overall prevalence of high BP in Iranian children was 14.7%. In addition, 15.1% of boys had high BP, with 9.4% and 1.7% of them with stage 1 and 2 hypertension, respectively. Moreover, 14.3% of girls had high BP, of which 10% had stage 1 and 1.3% with stage 2 hypertension. For elevated hypertension, it was observed in 4% of boys and 3% of girls. Conclusion: Using the 2017 AAP guidelines demonstrated a higher prevalence of hypertension in children (14.7%) in Iran. The prevalence of hypertension in boys was slightly higher compared to girls.

The feasibility study of Internet-assisted play therapy to resolve psychological disorders in primary healthcare settings: A qualitative study.

BACKGROUND: Play therapy is an intelligent tool in cognitive-behavioral therapies. In today's world, the Internet and technology play a key role in all aspects of people's life including mental health. The present study explores the feasibility of using Internet-assisted play therapy to solve children's psychological issues in primary healthcare systems. MATERIALS AND METHODS: The present qualitative research was conducted by the content analysis approach on 20 experts working in the healthcare centers, who were selected purposefully. The sample was saturated with these 20 participants. Data were collected through semi-structured interviews and were coded manually. Then, they were analyzed in the Atlas.ti software package. RESULTS: The results revealed 15 themes and 10 sub-themes. The themes included (1) safety, (2) efficiency, (3) client-orientedness, (4) organizational growth, (5) time, (6) effectiveness, (7) justice-orientedness, (8) access, (9) feedback, (10) analysis, (11) children's computer game room, (12) reward, (13) group game, and (14) capability to be integrated into other electronic programs. CONCLUSION: It seems that Internet-based play therapy is plausible to be used as a service in primary healthcare to tackle the psychological problems of children in the target population if the challenges related to the exploratory themes are taken care of.

Intervention to Improve Menstrual Health Among Adolescent Girls Based on the Theory of Planned Behavior in Iran: A Cluster-randomized Controlled Trial.

OBJECTIVES: Poor menstrual health may lead to school absenteeism and adverse health outcomes for adolescents. The purpose of this study was to determine the effect of pubertal and menstrual health education on health and preventive behaviors among Iranian secondary school girls. METHODS: A quasi-experimental study was conducted to evaluate the effectiveness of a health intervention program. A total of 578 students (including intervention and control participants) in 12 schools in Tehran Province, Iran were included by multistage random sampling. The program comprised seven 2-hour educational sessions. After confirming the reliability and validity of a researcher-made questionnaire, that questionnaire was used to collect the required data, and the groups were followed up with after 6 months. RESULTS: After the educational intervention, the mean scores of menstrual health-related knowledge and constructs of the theory of planned behavior were significantly higher in the intervention group than in the control group (p<0.001 for all dimensions). CONCLUSIONS: The results of this study emphasize the effectiveness of menstrual health interventions in schools. These findings should also encourage health policy-makers to take committed action to improve performance in schools.

Sexual health concerns in women with intellectual disabilities: a systematic review in qualitative studies.

BACKGROUND: Studies indicate that women with intellectual disabilities (ID) face various personal and socio-environmental barriers in their sexual lives. This study aimed to identify the concerns and sexual health needs experienced by women with ID. METHOD: A systematic review of relevant qualitative articles was conducted in PubMed, Web of Science Scopus and PsycINFO databases from June 2018 to August 2018. We designed our search strategy according to two main foci: (1) sexuality; and (2) women with ID. In the study, searches were limited to articles published from January 2000 to December 2017. In this review, studies on women ages 16 and over were included. RESULTS: Within the four databases, the search found 274 unique articles. After three steps of screening (title, abstract and full text), 22 studies were included in the final review. The articles mentioned difficulties with lack of sexual experience, negative experiences with sexuality, negative attitudes towards sexuality by nondisabled individuals, limited cognitive capacities to understand sexual identity, difficulty with finding the right partner, lack of access to sexual health information, lack of school-based sexuality education, violence and sexual abuse, lack of support from families and caregivers about sexuality, fear of sexual acts and unwanted pregnancy, shyness in expressing sexual desires, and limited knowledge of sexual behaviors. CONCLUSION: Our findings indicate that women with ID need to be provided with school-based sexuality education tailored to the level of understanding needed to attain the requisite knowledge to form relationships, understand sexual and romantic relationships, and practice safe sex when they choose this option. Families along with education and healthcare systems should provide opportunities for women with ID to talk about their sexual needs and make their own choices.

The effect of educational intervention based on theory of planned behavior on the improvement of colorectal cancer screening intention among average-risk individuals referring to Asadabad city clinics.

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in men and the fourth most common cancer in women in Iran. Therefore, the aim of this study was to determine the effect of educational intervention based on the theory of planned behavior (TPB) on the improvement of CRC screening intention among average-risk individuals. MATERIALS AND METHODS: This quasi-experimental study was performed on the 50-69-year-old individuals referred to Asadabad city clinics in 2020. The individuals were randomly assigned to multistage cluster sampling in each intervention and control group. The instrument used in this research was a researcher-made questionnaire based on TPB. Educational intervention was conducted for the intervention group, one of their family members, and staff of clinic under intervention. Finally, the data were entered into SPSS and analyzed utilizing descriptive and analytical statistics. Results were considered significantly <0.05. RESULTS: There were no significant differences between two intervention and control groups in the preintervention phase in terms of the mean scores of attitude (P = 0.58), subjective norms (P = 0.59), and behavioral intention (P = 0.66). However, in the postintervention phase, these differences were significant. Furthermore, regarding the mean score of perceived behavioral control, there was a significant difference between the two groups in the preintervention phase (P < 0.02), while in the postintervention phase, this difference was not significant (P = 0.29). CONCLUSION: Educational intervention based on the TPB has been effective in improving the CRC screening intention among average-risk individuals. Therefore, using the results of this research and developing appropriate educational programs at the community level can be increased the participation of community members in CRC screening programs.

The effect of consuming multivitamin/mineral supplements on elderly quality of life: Based on randomized control trial.

BACKGROUND: Clinical trials concerning the effect of supplements or multivitamin on improving the quality of life have proven different results. The present study was conducted to examine the effect of multivitamin supplement on quality of life of the elderly. MATERIALS AND METHODS: Sixty-four old people over 65 years of age in Kermanshah Elderly Care Center participated in this randomized trial. The samples were first selected using the convenience sampling and then were randomly assigned into intervention and control groups. The intervention group received one multivitamin mineral (MVM) supplement capsule every day for 3 months with no intervention for the control group. Standard quality of life questionnaire was used to collect the data. Data were analyzed using the SPSS software version 22. RESULTS: The mean age of the participants was 70.77 ± 8.29 years. The results of intra-group evaluation of the aspects of quality of life of the elderly show the lack of significant changes in the mean scores of physical health and environmental health of the elderly in the intervention group (P > 0.05) and the significant reduction of these aspects in the control group (P < 0.05) after intervention. The mean score of mental health scores in the intervention group significantly increased (P = 0.01), but there are no significant changes in the control group (P = 0.273). The mean scores of social relationships as well as the overall score of quality of life in the intervention and control groups showed no significant changes (P > 0.05). CONCLUSION: The present study showed that the consumption of MVM supplements can have a positive effect on increasing the quality of life of the elderly, but it is recommended to be done in the long term along diet. Moreover, considering the fact that no change was observed in the other aspects of the quality of life, attentions should be paid to the environmental and social factors such as social supports and empowerment of the old people in the future studies.

The Effect of Theory-Based HIV/AIDS Educational Program on Preventive Behaviors Among Female Adolescents in Tehran: A Randomized Controlled Trial.

BACKGROUND: Adolescents are increasingly at risks of HIV infection through high-risk sexual behaviors. This paper aimed to assess the effectiveness of a HIV/AIDS educational intervention among female adolescents in Tehran. METHODS: A randomized controlled trial was conducted among high school girls aged 12-16 years studying in Tehran in 2016-17. The sample was selected using multistage random cluster sampling. Four schools per district were randomly selected using probability-proportional to size. Adolescents were randomly assigned to the experimental (n=289) and the control (n=289) groups. The theory of planned behavior (TPB) was the basis of both the intervention and the evaluation phase. Both experimental and control groups completed a questionnaire designed for HIV related behaviors for female adolescents (HBQFA) at baseline and after six months follow up. A theory-based educational program was implemented for the experimental group. RESULTS: The mean age of participants was 14.1 years (SD=0.96). In the experimental group, significant improvements were shown in adolescents' HIV knowledge (31.9%, 95% CI: 28.8-35.0), attitudes towards HIV (16.6%, 95% CI=14.4-18.8), subjective norm (16.8%, 95% CI=12.9-20.6) and perceived behavioral control (19.1%, 95% CI=16.2-22.1), perceived parental support (17%, 95% CI=13.8-20.2), behavioral intention to prevent HIV (19%, 95% CI=16.3-21.6), and HIV preventive behavior (17.3%, 95% CI=13.9-20.6) (p<0.001). CONCLUSION: Theory-based educational intervention on HIV/AIDS prevention can significantly protect adolescents from misconceptions, wrong attitudes and risky behaviors and unsupportive social environment that expose them to greater HIV risk. Health policy -makers are advised to consider effective training programs related to HIV/AIDS prevention behaviors in the school system.

Oral health status and associated lifestyle behaviors in a sample of Iranian adults: an exploratory household survey.

BACKGROUND: Poor oral hygiene can lead to serious diseases, such as periodontitis, tooth decay, pain and discomfort in teeth or gums, infections, and loss of teeth. In Iran, adults aged 50 y and older are a high-risk group for oral health problems, and this age group will grow in the coming decades. Despite increasing attention on healthy aging, there is relatively less emphasis on oral hygiene and health-related problems. The present study investigated the oral health status of Iranian adults using the oral health self-assessment questionnaire (OHQ) developed by the World Health Organization (WHO). METHODS: A population-based household survey of a sample of adults aged 18-65 y was conducted. In this study, the participants were recruited between May and October 2016 in Tabriz, Iran, and the study population was sampled using a multi-stage cluster sampling design. The WHO's OHQ for adults was used for measuring oral health status and oral hygiene behavior. RESULTS: In total, 2310 respondents completed the survey. The mean age (SD) of the participants was 41.6(23.4) y. Males accounted for 48.8% of the participants. Of the 2310 respondents,187 (8.1%) individuals were edentulous, 152(20.7%) of whom were aged 51-65 y. Furthermore, 72.3% of those aged 51-65 y were dentate, and 50% of adults aged 51-65 y said they had 20 or more teeth. About one-third of the participants reported that they did not brush their teeth daily (23% of those aged 18-35 y,35.9% of those aged 36-50 y, and 44.6% for those aged 51-65 y). In the sample, 39.4% of individuals aged 18-35 y,34.1% of individuals aged 36-50 y, and 26.6% of individuals aged 51-65 y had visited a dentist less than 6 month ago. One-third of the participants consumed sweets and sugary drinks daily. CONCLUSIONS: Although the majority of Iranian adults considered their oral health status good, only a small percentage of the sample visited their dentist regularly. Furthermore, visits to the dentist declined in accordance with increasing age, a time when the incidence of oral health problems may increase. Poor oral health may increase the risk of adverse health outcomes, particularly among the aging population.

Spatial analysis of driving accidents leading to deaths related to motorcyclists in Tehran.

PURPOSE: Traffic accidents are one of the main causes of death and disability, causing annual deaths of 1.23 million and tens of millions injured people worldwide. Meanwhile, a significant proportion of the deaths and injuries caused by traffic accidents occur among motorcyclists. According to the world health organization's 2015 report, about 25% of deaths from traffic accidents occur in motorists. In Iran, a significant proportion of deaths and injuries result from traffic accidents among motorcyclists, especially in passages within the cities. According to traffic police, about 25% of deaths and 50% of injuries in traffic accidents of Tehran are reported among motorcyclists. Therefore, due to the importance of this issue, the spatial factors influencing the incidence of motorcycle-related accidents in Tehran were investigated using the geographic information system. METHODS: The present work was a cross-sectional and descriptive analysis study. The data necessary for the study were extracted from Tehran traffic police as well as municipality databases. Zoning maps were used to display the distribution of events. In the analytical investigation, Moran index was used to determine the distribution pattern of the events, while Getis-Ord G * statistics were applied to analyze hot spots. To investigate the role of regional and environmental factors in the frequency of traffic accidents related to motorcyclists in geographic units (Tehran 22 districts), Poisson regression and negative binomial models were used. The geographically weighted regression (GWR) model was used to analyze the relationship between environmental factors and the location of these events. Statistical analyses were performed using SPSS, STATA, ARC-GIS and GWR software. RESULTS: The southern and eastern margins of Tehran are the most vulnerable areas in terms of deaths related to traffic accidents of motorcyclists. Highways are considered the location of most traffic accidents which lead to death of motorcyclists. Getis-Ord General G * (p < 0.04) indicates that the distribution of high-risk points is statistically significant. The final model showed that in Tehran, the association of different variables including demographic characteristics, pathways network and type of land use with the number of accidents in geographic units was statistically significant. The spatial distribution of traffic accidents leading to deaths of motorcyclists in the center of Tehran varies considerably with changes in population density, length of highways, volume of traffic, and land use in different parts. CONCLUSION: Most of the traffic accidents leading to deaths of motorcyclists occur in highways. Various environmental variables play a role in determining the distribution pattern of these types of events. Through proper traffic management, controlling environmental risk factors and training people the safety of motorcyclists in Tehran can be improved.

The effectiveness of self-management program for people with type 2 diabetes mellitus based on PRECEDE-PROCEDE model.

AIMS: Diabetes mellitus (DM) is one of the most common chronic diseases worldwide that requires a person with diabetes to make a multitude of daily self-management decisions. This study sought to evaluate the effectiveness of a self-management program based on PRECEDE-PROCEDE model on self-management behaviors in patients with type 2 diabetes. METHODS: This experimental study was conducted on 86 diabetic patients referred to the diabetes clinics in Ardabil, Iran, in 2017. From a total of 326 patients with diabetes medical records in those clinics, 86 (26.3%) patients agreed to participate in this study. They were then randomly divided into two groups; intervention (n = 43) and control (n = 43). The intervention group received eight sessions of PRECEDE model-based self-management education program while the control group did not receive any education program. Both groups were assessed at baseline and six months after the intervention. RESULTS: The mean age of the participants was 55.69 ±â€¯12.04 years (range 32-86 years). 41 patients were men, and 45 were women. The mean time since the first diagnosis of diabetes was 8.6 years (SD = 5.2), and the mean BMI of the patients was 31.63 (SD = 4.20). At baseline, 35.01% of patients had poor self-management behaviors. All PRECEDE variables, including predisposing factors (knowledge, attitude, and self-efficacy), enabling factors, and reinforcing factors, as well as self-management behaviors, were significantly improved in those of intervention group after the education program. CONCLUSION: Self-management education program substantially enhances the self-management behaviors in patients with type two diabetes.

The effectiveness of home-use photobiomodulation toothbrush for treating dentin hypersensitivity: A pilot study.

BACKGROUND AND AIMS: Dentin hypersensitivity is a frequent oral condition among patients suffering from gingival recession. Recent studies have suggested that photobiomodulation has the potential to reduce inflammation and relieve pain. The present study aims to assess the effectiveness of a new design of photobiomodulation toothbrush with specific irradiation parameters as a homecare device in treating dentin hypersensitivity and to compare its therapeutic effect with that of fluoride varnish. MATERIALS AND METHODS: Thirty patients with gingival recession and dentin hypersensitivity were selected and randomly assigned to three groups of equal size: fluoride varnish, photobiomodulation, and the combination. Dentin pain and hypersensitivity were measured using visual analog scale (VAS) by two distinct tests: the contact test with a periodontal probe and the air blast test on the areas of gingival recession and denuded root; once at baseline and again one month after the initial application of treatments. Laser irradiation was carried out at the wavelength of 660 nm in CW with an output power of 40 mW for 30 seconds per spot (1.2 J per spot, 6 J/cm2 energy density, and 200 mW/cm2 power density), perpendicularly to denuded root surfaces in non-contact mode. RESULTS: A significant reduction in dentin pain and hypersensitivity was observed in all three groups. However, the reduction was significantly greater in the combination group. CONCLUSION: At-home treatment of dentin hypersensitivity with photobiomodulation toothbrush is a convenient, safe, and effective method for the management of dentin hypersensitivity.

Developmental and Psychometric Properties of a Belief-based Reproductive Health Behavior Questionnaire for Female Adolescents.

BACKGROUND: The aim of this study was to develop and evaluate the psychometric properties of a questionnaire for the measurement of reproductive health among female adolescents in Iran. METHODS: This cross-sectional study was conducted among 289 female students aged 12-15 yr in Tehran, Iran from 2015-2016. The participants were selected using multi-stage random cluster sampling. In addition, the Belief-Based Reproductive Health Questionnaire (BBRHQ) was designed using the properties of the Theory of Planned Behavior (TPB). RESULTS: Exploratory factor analysis of 104 items identified a six-factor solution. These factors jointly accounted for 67% of the observed variance of outcome variable. The confirmatory factor analysis indicated a good fit to the data. In addition, the Cronbach's alpha coefficient showed an excellent internal consistency (alpha=0.92). CONCLUSION: Belief-Based Reproductive Health Questionnaire (BBRHQ) is a valid and reliable instrument for measurement of reproductive health behaviors of adolescents.