Effect of Lifestyle Promotion in the PRECEDE-PROCEED model among pre-diabetic adults based on PERSIAN cohort study: a randomized controlled trial study.

Background: Diabetes is a chronic disease caused by impaired glucose metabolism. This study aimed to design and evaluate the effect of a lifestyle promotion program based on the PRECEDE-PROCEED model among pre-diabetic individuals. Methods: This randomized controlled trial evaluated the effect of a lifestyle promotion program using the PRECEDE-PROCEED model among pre-diabetic individuals in Hoveizeh city in 2019. The study collected information on the disease status and risk factors associated with non-communicable conditions from the website of Hoveizeh Cohort Study Center. The primary outcome of the study was the percentage of glycated hemoglobin (HbA1c) with a three-month follow-up. Results: A total of 240 individuals participated in the study. There was no significant difference in anthropometric characteristics between the intervention and control groups (P < 0.05). Initially, there was no significant difference in the mean HbA1c between the intervention and control groups (P = 0.97). However, after three months of intervention, a statistically significant difference was observed (P > 0.001). The results indicated an increase in the mean quality of life in the intervention group, but no significant difference was found between the two groups or before and after the intervention within each group (P < 0.05). Conclusion: The findings suggest that the PRECEDE-PROCEED model provides a suitable framework for training pre-diabetic individuals and patients with type 2 diabetes mellitus (T2DM) to promote self-care behaviors. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01273-7.

Non-Adherence to Preventive Behaviors and the Risk of COVID-19: A Comparative Study.

Background: Transmission routes of COVID-19 have been well identified and documented. Considering the high prevalence of the Covid-19 and its impacts on the population, this study aimed to assess the status of preventive behaviors against coronavirus infection and estimate the odds of its transmission routes among people. Methods: A comparative study was conducted from March to April 2021. A total of 1256 participants were randomly selected, including 262 COVID-19 patients and 994 healthy people from 10 counties in Khuzestan, southwest Iran. A two-part questionnaire was used for data collection that included items on demographic and adherence to preventive behaviors. Statistical analysis was performed using the statistical software SPSS 18.0.0 applying logistic regression. Results: The mean age of participants was 37.60±11.48 years (female: 36.49±11.15 years; male: 38.86±11.74 years). The results showed that having contact with infected patient at home (OR = 4.90, 95%CI = 3.32-7.25), going to the hospital for not-necessary medical reasons (OR = 4.47, 95%CI = 3.05-6.55), leaving home for essential daily services (OR = 2.49, 95% CI = 1.63-3.81), and going to doctors' office (OR = 1.78, 95% CI = 1.20-2.63) could increase the odds of infection. Conclusion: The findings suggest that different factors are responsible for the increased spread of the Covid-19. Indeed, since the intervention for every single factor will have a small contribution to reducing the prevalence of the disease, it seems essential to design comprehensive interventions while emphasizing isolation and contacts tracing. The study provides evidence for multi-level and multi-faceted policy and interventions for promoting adherence to COVID-19 preventive behaviors.

The association between various indicators of hospital capacity, age category, and the number of screening tests performed with case fatality rate and recovery rate during the COVID-19 disease pandemic.

BACKGROUND: The COVID-19-related deaths are growing rapidly around the world, especially in Europe and the United States. PURPOSE: In this study we attempt to measure the association of these variables with case fatality rate (CFR) and recovery rate (RR) using up-to-date data from around the world. METHODS: Data were collected from eight global databases. According to the raw data of countries, the CFR and RR and their relationship with different predictors was compared for countries with 1,000 or more cases of COVID-19 confirmed cases. RESULTS: There were no significant correlation between the CFR and number of hospital beds per 1,000 people, proportion of population aged 65 and older ages, and the number of computed tomography per one million inhabitants. Furthermore, based on the continents-based subgroup univariate regression analysis, the population (R2 = 0.37, P = 0.047), GPD (R2 = 0.80, P < 0.001), number of ICU Beds per 100,000 people (R2 = 0.93, P = 0.04), and number of CT per one million inhabitants (R2 = 0.78, P = 0.04) were significantly correlated with CFR in America. Moreover, the income-based subgroups analysis showed that the gross domestic product (R2 = 0.30, P = 0.001), number of ICU Beds per 100,000 people (R2 = 0.23, P = 0.008), and the number of ventilator (R2 = 0.46, P = 0.01) had significant correlation with CFR in high-income countries. CONCLUSIONS: The level of country's preparedness, testing capacity, and health care system capacities also are among the important predictors of both COVID-19 associated mortality and recovery. Thus, providing up-to-date information on the main predictors of COVID-19 associated mortality and recovery will hopefully improve various countries hospital resource allocation, testing capacities, and level of preparedness.

Socialization During the COVID-19 Pandemic: The Role of Social and Scientific Networks During Social Distancing.

In the COVID-19 era, while we are encouraged to be physically far away from each other, social and scientific networking is needed more than ever. The dire consequences of social distancing can be diminished by social networking. Social media, a quintessential component of social networking, facilitates the dissemination of reliable information and fighting against misinformation by health authorities. Distance learning, telemedicine, and telehealth are among the most prominent applications of networking during this pandemic. Additionally, the COVID-19 pandemic highlights the importance of collaborative scientific efforts. In this chapter, we summarize the advantages of harnessing both social and scientific networking in minimizing the harms of this pandemic. We also discuss the extra collaborative measures we can take in our fight against COVID-19, particularly in the scientific field.

Estimating Case Fatality and Case Recovery Rates of COVID-19: is this the right thing to do?

Introduction: Case fatality rates (CFRs) and case recovery rates (CRRs) are frequently used to define health consequences related to specific disease epidemics, including the COVID-19 pandemic. This study aimed to compare various methods and models for calculating CFR and CRR related to COVID-19 based on the global and national data available as of April 2020. Methods: This analytical epidemiologic study was conducted based on detailed data from 210 countries and territories worldwide in April 2020. We used three different formulas to measure CFR and CRR, considering all possible scenarios. Results: We included information for 72 countries with more than 1,000 cases of COVID-19. Overall, using first, second, and third estimation models, the CFR were 6.22%, 21.20%, and 8.67%, respectively; similarly, the CRR was estimated as 23.21%, 78.86%, 32.23%, respectively. We have shown that CFRs vary so much spatially and depend on the estimation method and timing of case reports, likely resulting in overestimation. Conclusions: Even with the more precise method of CFRs estimation, the value is overestimated. Case fatality and recovery rates should not be the only measures used to evaluate disease severity, and the better assessment measures need to be developed as indicators of countries' performance during COVID-19 pandemic.

Cross-Country Comparison of Case Fatality Rates of COVID-19/SARS-COV-2.

OBJECTIVES: Case fatality rates (CFR) and recovery rates are important readouts during epidemics and pandemics. In this article, an international analysis was performed on the ongoing coronavirus disease 2019 (COVID-19) pandemic. METHODS: Data were retrieved from accurate databases according to the user's guide of data sources for patient registries, CFR and recovery rates were calculated for each country. A comparison of CFR between countries with total cases ≥ 1,000 was observed for 12th and 23rd March. RESULTS: Italy's CFR was the highest of all countries studied for both time points (12th March, 6.22% versus 23rd March, 9.26%). The data showed that even though Italy was the only European country reported on 12rd March, Spain and France had the highest CFR of 6.16 and 4.21%, respectively, on 23rd March, which was strikingly higher than the overall CFR of 3.61%. CONCLUSION: Obtaining detailed and accurate medical history from COVID-19 patients, and analyzing CFR alongside the recovery rate, may enable the identification of the highest risk areas so that efficient medical care may be provided. This may lead to the development of point-of-care tools to help clinicians in stratifying patients based on possible requirements in the level of care, to increase the probabilities of survival from COVID-19 disease.

Correction to: Evaluation of serum 25-Hydroxy vitamin D levels in children with autism Spectrum disorder.

The original article [1] contained an error in author Mohammad Taghi Mansouri's name.

Evaluation of serum 25-Hydroxy vitamin D levels in children with autism Spectrum disorder.

BACKGROUND: Vitamin D plays an important role in etiology of Autism Spectrum Disorders (ASDs). We aimed to evaluate the serum 25 - hydroxyl vitamin D level among children with ASDs in Ahvaz city, Iran. METHODS: It was a cross-sectional study which had conducted on 62 subjects in two groups: a case group (n = 31) consisted of ASD children who study in especial schools; and a control group (n = 31) of healthy children who were selected by simple random sampling from regular schools in Ahvaz city, Iran during 2016. Maching between two groups has done regarding Socioeconomic status, type and amount of food intake, place of living and age. The levels of serum 25 - hydroxyl vitamin D were assessed in early morning means fasted state and also measured using ELISA method. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. The significant level was considered < 0.05. RESULTS: In ASD children, the average serum 25-hydroxyvitamine D level was 9.03 ± 4.14 ng/mg. In ASD group, 96.8% (30 subjects) had vitamin D deficiency. In healthy children group, average serum 25-hydroxyvitamine D level was 15.25 ± 7.89 ng/mg. Average serum 25-hydroxyvitamine D level in intervention group was significantly lower than the control group (P > 0.001). Although the parents of patients in control group reported longer exposure to sun (27.42 m per day against 33.06 m per day), no significant difference was observed between these groups in terms of exposure to sun (P < 0.05). CONCLUSIONS: A significant difference was observed between serum 25-hydroxyvitamine D levels between the healthy and ASD children. It is recommended to use vitamin D supplement in children with ASDs under medical care.

Temporal and spatial distribution of under-five mortality and factors associated with multiple cases of under-five deaths within a family in the rural area of Khuzestan, Southern Iran.

Under-five mortality (U5M) is an important indicator of the overall health and development of society. There is a wide gap in U5M among different countries and also within the countries. This study was carried out to assess the prevalence, as well as the socio-demographic, and health-related causes of U5M in the region of study. A cross-sectional study was conducted among all registered cases of U5M in rural areas of Khuzestan province, Iran, during the years 2011 to 2015. To assess the socio-demographic determinants of U5M, the sample surveyed consists of 320 families with at least one under-five death using a multistage random sampling method. Also, this study evaluated the number of variables, which may increase the chance of families to have more than one U5M. U5M was 26 per 1000 live births in 2011, but decreased to 22 per 1000 live births in 2015. With the highest cumulative incidence of 43 in Masjed Soleyman and the lowest of 15 in Dehdez, infant mortality constitutes 76% of all U5M. Prematurity and congenital anomalies were responsible for 46% of all causes of mortality (that is, U5). Maternal age at delivery <18 years or >35 years (OR = 3.5; 95% CI, 1.29-6.22), marriage duration >9 years (1.85, 1.06-3.21), spouse age gap >5 years (2.32, 1.20-4.50), cesarean section (3.85, 1.19-5.74), delivery interval <3 years (2.83, 1.22-5.58), non-Arab ethnicity (2.58, 1.50-4.44), and mother working in agriculture or animal husbandry (3.93, 1.41-6.94) were the most important determinants associated with more than one child death per family. Spatially, there was a great disparity in U5M with different reduction rate during the 5 years of the study. Marriage age, cesarean delivery, delivery interval, and mother field activity were associated with U5M. This may have implications for the preventive health program.

Thunderstorm asthma outbreak, a rare phenomenon in southwest Iran: patients' perspectives.

Previous studies that described thunderstorm asthma, which is a rare event, are not being well explained. This study was conducted, to describe the patient perspective on their asthma attack experience during Ahvaz post-rain phenomenon. We have interviewed patients present in the Naft clinic of Ahvaz, during 28th October and the first week of November 2015. Recruitment was continued as saturation ensued by 33 participants. An inductive content analysis was used to evaluate the interviews. The key finding indicated a climatic condition, direct or indirect contact with rain, history of allergy, and physical conditions are the main categories. The patient emphasized the importance of dust, humidity, first autumn rainfall, and environmental air pollution in occurrences of the event. When exposed to further rains (third rainfall onward), they were less likely to experience dyspnea or shortness of breath. However, being indoor or out at the time of rainfall reported not to be related to the onset of asthma exacerbation. This study yielded that patients' asthma outbreak is a climate-related health impact and many individual factors triggering this issue. Patients concerns need future investigation and public health emergency planning and response arrangements.

Khuzestan dust phenomenon: a content analysis of most widely circulated newspapers.

Dust is an atmospheric phenomenon that causes adverse environmental effects. It is deemed to have harmful effects on health, economics, and climate. This study aimed to analyze the content published on the phenomenon of dust in the widely circulated newspapers in Iran. We investigated the content of all national and provincial newspapers that were published between July and August 2014. Data on the materials related to the dust phenomenon in the newspapers were categorized and coded. From a total of 510 newspaper issues, 143 articles were devoted to the dust phenomenon which 74.1% of them were published in provincial newspapers. Among the national newspapers, Hamshahri newspaper with 16 headlines and from the provincial newspapers; Karoon with 23 headlines published the highest number of articles on dust phenomenon. 45.5% of content on dust were printed on the first page of the newspapers. The most common approach to the type of content published in these newspapers was an interview. Moreover, we noticed that 28.7% of the content published in the newspapers was related to the health issue. The media plays an important role in the transmission of health information. Weaknesses in addressing the causes of dust occurrence and also in providing solutions for the dust control and prevention were noticeable in the content published in the newspaper. It seems necessary to take practical measures to disseminate relevant information to dust and also address the needs of the target audience community influenced by the dust phenomenon properly.

Effectiveness of a theory-based mobile phone text message intervention for improving protective behaviors of pregnant women against air pollution: a randomized controlled trial.

Health impact of exposure to air pollution is a public health concern. The aim of this study was to investigate an extended parallel process model (EPPM)-based mobile phone text message intervention for improving protective behaviors against air pollution among pregnant women. In this randomized controlled trial (IRCT2016102810804N8), 130 pregnant women were randomly assigned into either experimental or control groups. A valid and reliable questionnaire was used to collect data. Experimental group received mobile phone intervention on a daily basis for 2 months. Control group received usual care, only. Data were analyzed using SPSS 15 applying t test, chi-square, and Wilcoxon and Mann-Whitney U test. Although before intervention, there were no significant differences between different structures of EPPM (P > 0.05), after intervention, there were statistically significant differences between perceived severity, response efficacy, self-efficacy, and protective behaviors between two groups (P < 0.05). Implementing EPPM based-mobile phone intervention could promote protective behaviors against air pollution among pregnant women. The present study might be used as a framework for evidence-based health promotion regarding air pollution risk communication and self-care behaviors. TRIAL REGISTRATION: IRCT2016102810804N8.

Particulate matter and markers of glycemic control and insulin resistance in type 2 diabetic patients: result from Wellcome Trust Genetic study.

There is growing evidence that air pollution is associated with increased risk of type 2 diabetes (T2DM). However, information related to whether particulate matter (PM) contributing to worsened metabolic control in T2DM patients is inconsistent. We examined the association of PM10 exposure with glucose-function parameters in young-onset T2DM patients. We investigated the association between a year ambient concentration of PM10 at residential places, using AERMOD dispersion model, with fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), 2 h post meal plasma glucose (2hPG), homeostasis model assessment of insulin resistance (HOMA-IR), ß-cell function (HOMA-ß) and disposition index (DI) in 1213 diabetic patients from the Wellcome Trust Genetic study at the Diabetes Unit, KEM Hospital Research Center, Pune, India. We used linear regression models and adjusted for a variety of individual and environmental confounding variables. Possible effect modification by age, gender, waist-to-hip ratio (WHR) and smoking status were investigated. Sensitivity analysis assessed the impact of relative humidity (RH) and temperature a day before examination and anti-diabetic and HHR medication (Hydralazine, Hydrochlorothiazide and Reserpine). We found that 1 SD increment in background concentration of PM10 at residential places (43.83 µg/m3) was significantly associated with 2.25 mmol/mol and 0.38 mmol/l increase in arithmetic means of HbA1c and 2hPG, respectively. A similar increase in PM10 was also associated with 4.89% increase in geometric mean of HOMA-IR. The associations remained significant after adjustment to RH and temperature, and WHR and smoking enhanced the size of the effect. Our study suggests that long-term exposure to PM10 is associated with higher glycaemia and insulin resistance. In context of our previous demonstration of association of SO2 and NO x and plasma C-reactive protein, we suggest that air pollution could influence progression of diabetes complications. Prospective studies and interventions are required to define mechanism and confirm causality.

Air pollution and respiratory health among diabetic and non-diabetic subjects in Pune, India-results from the Wellcome Trust Genetic Study.

Diabetics may be more vulnerable to the harmful effects of ambient air pollutants than healthy individuals. But, the risk factors that lead to susceptibility to air pollution in diabetics have not yet been identified. We examined the effect of exposure to ambient PM10 on chronic symptoms and the pulmonary function tests (PFT) in diabetic and non-diabetic subjects. Also, to investigate possible determinants of susceptibility, we recruited 400 type 2 diabetic and 465 healthy subjects who were investigated for chronic respiratory symptoms (CRSs) and then underwent measurement of forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) according to standard protocol. Percent predicted FEV1 and FVC (FEV1% and FVC%, respectively) for each subject were calculated. Particulate matter (PM10) concentrations at residence place of subjects were estimated using AERMOD dispersion model. The association between PM10 and CRSs was explored using logistic regression. We also used linear regression models controlling for potential confounders to study the association between chronic exposure to PM10 and FEV1% and FVC%. Prevalence of current wheezing, allergy symptom, chest tightness, FEV1/FVC <70%, and physician-diagnosed asthma and COPD was significantly higher among diabetic subjects than non-diabetics. There was no significant difference between percent predicted value of PFT among diabetic and non-diabetic subjects (P < 0.05). We estimated that 1 SD increase in PM10 concentration was associated with a greater risk of having dyspnea by 1.50-fold (95% CI, 1.12-2.01). Higher exposure to PM10 concentration was also significantly associated with lower FVC%. The size of effect for 1 SD µg/m3 (=98.38) increase in PM10 concentration was 3.71% (95% CI, 0.48-4.99) decrease in FVC%. In addition, we indicated that strength of these associations was higher in overweight, smoker, and aged persons. We demonstrated a possible contribution of air pollution to reduced lung function independent of diabetes status. This study suggests that decline in exposure may significantly reduce disease manifestation as dyspnea and impaired lung function. We conduct that higher BMI, smoking, and older age were associated with higher levels of air pollution effects.

Predicator of Pregnant Women's Self-care Behavior against Air Pollution: An explanation based on the Extended Parallel Process Model (EPPM).

INTRODUCTION: Air pollution is one of the most important problems of metropolitan cities. The level of air pollution in the city of Ahvaz is so much higher than the standard level, that it can create risks, particularly for pregnant women in the area. The aim of the study was to examine the predictors of self-care behavior of pregnant women against air pollution according to Extended Parallel Process Model (EPPM) in Ahvaz. METHODS: In this cross-sectional study, 330 pregnant women who were referred to health care centers in western Ahvaz in 2015 were examined. The data collection tool was a reliable and valid researcher-made questionnaire consisting of three parts: The first part was demographic information, the second part according to the extended parallel process model, included perceived susceptibility, perceived severity, response efficacy, and self-efficacy. The third part examined self-care behavior. Then, the collected data was analyzed by using the software SPSS 16. Data analysis was done by using Spearman's correlation coefficient and linear regression. RESULTS: The average age of study subjects was 26.07 ± 2.3 years, and most (45.5%) were in the second trimester of pregnancy. These findings showed that self-efficacy constructs (ß = 0.41) and response efficacy (ß= 0.15) have predictive power of self-care behavior (p < 0.05). CONCLUSION: The findings showed that self-efficacy and response efficacy, are important factors to predict air pollution self-care behavior. Therefore, to develop a theory-based behavioral modification program for pregnant women, more emphasis on these constructs is recommended.