Assessment of the psychometric properties of the Persian version of the diabetes self-management questionnaire (DSMQ) in patients with type 2 diabetes.

Background: Performing self-care behaviors by diabetic patients is essential to achieve optimal glycemic control, reduction of complications, and improvement in the quality of life. The Diabetes Self-care Questionnaire (DSMQ) is designed to assess self-care behaviors that can predict glycemic control. The present study aimed to evaluate the psychometric properties of the Persian version of the DSMQ in patients with type 2 diabetes. Methods: The present methodological cross-sectional study investigated 460 patients with T2DM referred to the Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran through the convenience sampling procedure. The translation process of the DSMQ was carried out based on the guidelines suggested by Beaton et al. We assessed the reliability (internal consistency), content validity, convergent validity and construct validity. Construct validity was evaluated using exploratory factor analysis (calibration sample = 230) and confirmatory factor analysis (validation sample = 230). Furthermore, a linear regression analysis was used to determine the prediction power of self-care behaviors in explaining the variance of the HbA1c level. Results: In the EFA with Varimax rotation, we extracted four factors that could explain 67.46% of the total variance of the DSMQ scale. The CFA exhibited a satisfactory fit level for the four-factor structure extracted from EFA with the following measures. CFI: 0.980, IFI: 0.980, NFI: 0.956, TLI: 0.974, RMSEA: 0.042). Internal consistency was good (Cronbach's alpha coefficient for the whole scale: 0.84; the subscales: 0.75-0.91). The convergent validity showed significant negative correlations (GM: -0.53; DC: -0.22; PA: -0.16; HU: -0.17; SS: -0.45; p < 0.01) between DSMQ subscales and HbA1c. However, only two factors of glucose management and diet control in the statistical model obtained from regression analysis (stepwise) were able to explain 30% of the HbA1c level (P < 0.001). Conclusion: The Persian version of the DSMQ is a valid and reliable instrument to assess self-care behaviors associated with glycemic control in Iranian patients with T2DM. Therefore, this instrument can be used in both future research and clinical practices.

The Effect of Bronchial Asthma on Interatrial Electromechanical Delay Coupling Obtained Using Tissue Doppler Imaging.

BACKGROUND: Asthma is a predisposing factor for the development of atrial fibrillation. Asthma disturbs the electrophysiology in the right and left atrium. The aim of this study was to evaluate atrial electromechanical delay by coupling obtained from tissue Doppler imaging (TDI) in children. METHODS: A cross-sectional study was conducted on 50 patients with Bronchial Asthma, compared with 50 healthy children. The intra-right atrial conduction time (IRCT), intra-left atrial conduction time (ILCT), and interatrial conduction time (IACT) were calculated. The function of systolic and diastolic right ventricular (RV) was assessed by TDI, conventional echocardiography, and pulse Doppler wave. The pulmonary function test was carried out for all the subjects by spirometry. We used an independent Student's t test and Pearson's correlation test for analyzing the data. RESULTS: The findings revealed normal shape in both atrial between the two groups. The diastolic RV function was not significantly different between the subjects as measured by the pulse wave Doppler in the tricuspid flow. Patients in the experimental group had significantly higher intra and interatrial electromechanical delays (P=0.007) than the control group. This difference was statistically significant with regard to IRCT (P=0.0001) and IACT (P=0.005). IRCT/IACT and myocardia performance index (r=0.35, P=0.004; and r=0.52, P=0.008) correlated with isovolumetric relaxation time (r=0.46, P=0.003; and r=0.58, P=0.008). CONCLUSION: We found that IRCT and IACT prolonged in pediatrics with asthma. Also, it was found that there was a correlation between IRCT and IACT, on one hand, and RV myocardial performance index, on the other hand, but they were not related to TDI diastolic parameters.

Evaluation of interleukin 8 +2767 A/T polymorphism in visceral leishmaniasis.

OBJECTIVE: To evaluated the relationship between the genetic variations at IL-8 +2767 position with VL pathogenesis among Iranian patients. METHODS: Three groups including patients with VL clinical presentation and leishmania seropositive (n = 124), patients seropositive but without clinical presentation (n = 82) and healthy controls (n = 63) were selected to conduct this cross-sectional study. Polymorphism at +2767 position of IL-8 was investigated using PCR-RFLP techniques. Anti-leishmania antibody titration was evaluated by the immunoflorescence technique. RESULTS: We observed higher significant frequencies +2767 A/A and A/T genotypes in Group 1 compared to Group 2 and healthy controls (P = 0.001). Also, patients in Group 1 carrying A/A genotype showed higher titer of anti-leishmania antibody than patients with A/T and T/T genotypes (P = 0.05). The validity of the data was analyzed using Hardy-Weinberg equilibrium and one way analysis of variance (ANOVA), as well as χ2 tests. CONCLUSIONS: Our findings indicate that the IL-8 +2767 polymorphism is significantly involved in impaired immune responses against VL and it could be considered as a risk factor for the VL progress.

Development and psychometric properties of a self-regulation scale about leisure time physical activity in Iranian male adolescents.

BACKGROUND: Self-regulation is one of the current psychological concepts that have been known as a determinant of leisure time physical activity. Due to cultural and social diversity in different societies and age groups, application of specific questionnaires is essential to perform investigations about physical activities. The aim of this study is development and evaluation of psychometric properties of a self-regulation questionnaire about leisure time physical activity in Iranian male adolescents. MATERIALS AND METHODS: This cross-sectional study was conducted in 2013, and data of 603 male students from 12 high schools in Isfahan were collected. A comprehensive literature review and similar questionnaire review were conducted and 25 items were selected or developed to measure self-regulation. Comprehensibility of items was evaluated in a pilot study and an expert panel evaluated face and content validity. Exploratory factors analysis (EFA) was used for evaluation of construct validity and extraction of sub-constructs of self-regulation. Leisure time physical activity was assessed using International Physical Activity Questionnaire (IPAQ). RESULTS: The mean age of the participants was 16.3 years (SD =1.0) and the range was 15-19 years. Cronbach's α coefficient of the questionnaire in the pilot and main study was 0.84 and 0.90, respectively. EFA resulted in four sub-constructs including "enlistment of social support", "goal setting", "self-construction", and "self-monitoring", which explained 63.6% of the variance of self-regulation. CONCLUSIONS: Results of this investigation provide some support to the validity and reliability of the 16-item questionnaire of self-regulation abut leisure time physical activity in the target group.

A self-efficacy questionnaire regarding leisure time physical activity: Psychometric properties among Iranian male adolescents.

BACKGROUND: Attention to different aspects of self-efficacy leads to actual evaluation of self-efficacy about physical activity. This study was carried out in order to design and determine psychometric characteristics of a questionnaire for evaluation of self-efficacy about leisure time physical activity (SELPA) among Iranian adolescent boys, with an emphasis on regulatory self-efficacy. MATERIALS AND METHODS: This descriptive-analytic study was conducted in 734 male adolescents aged 15-19 years in Isfahan. After item generation and item selection based on review of literature and other questionnaires, content validity index (CVI) and content validity ratio (CVR) were determined and items were modified employing the opinions of expert panel (N = 10). Comprehensibility of the questionnaire was determined by members of target group (N = 35). Exploratory factors analysis (EFA) was operated on sample 1 (N 1 = 325) and confirmatory factors analysis (CFA) on sample 2 (N 2 = 347). Reliability of SELPA was estimated via internal consistency method. RESULTS: According to EFA, barrier self-efficacy and scheduling self-efficacy are the two main aspects of SELPA with the total variance of 65%. The suggested model was confirmed by CFA and all fitness indices of the corrected model were good. Cronbach's alpha was totally estimated as 0.89 and for barrier and scheduling self-efficacy, it was 0.86 and 0.81, respectively. CONCLUSIONS: The results provide some evidence for acceptable validity and reliability of SELPA in Iranian adolescent boys. However, further investigations, especially for evaluation of predictive power of the questionnaire, are necessary.

Interleukin-4 receptor alpha T1432C and A1652G polymorphisms are associated with risk of visceral leishmaniasis.

BACKGROUND: Immune responses play significant roles in protection against leishmaniasis. Polymorphisms within the interleukin 4 receptor alpha chain (IL-4Rα) gene affect the production of cytokines, which is important for the clearance of many pathogens. The aim of the current study was to identify the relationship between visceral leishmaniasis (VL) infection and polymorphisms at positions T1432C and A1652G of IL-4Rα in an Iranian population. MATERIALS AND METHODS: This cross-sectional study was performed during 2004-2012 and included three groups of participants: VL patients (Group 1, n = 124), seropositive healthy controls (Group 2, n = 101), and seronegative healthy controls (Group 3, n = 55). The IL-4Rα T1432C and A1652G polymorphisms were evaluated using a polymerase chain reaction-restriction fragment length polymorphism technique, and anti-Leishmania antibody titers were determined by using immunofluorescence technique. Alleles and genotypes were compared between groups of the study as well as Groups 1 and 2 based on the titer of antibodies. The validity of the data was analyzed using Hardy-Weinberg equilibrium and one-way analysis of variance, as well as χ (2) tests. RESULTS: The polymorphisms at IL-4Rα positions T1432C and A1652G were significantly associated with active VL infection. These results demonstrated that the IL-4Rα T1432C and A1652G polymorphisms were not associated with anti-Leishmania antibody production. CONCLUSION: Our results indicate that these IL-4Rα polymorphisms may be risk factors for the development of VL.

Introducing an Outcome Expectation Questionnaire and Its Psychometric Properties Regarding Leisure Time Physical Activity for Iranian Male Adolescent.

BACKGROUND: Outcome expectation (OE) is known as a psychosocial determinant of leisure time physical activity (LTPA). Despite importance of this construct evaluation, there is no evidence of special questionnaire for measuring OE in Persian speaking Iranian male adolescents. OBJECTIVES: This article reports development and psychometric evaluation process of a specific questionnaire that evaluates OE about LTPA among Iranian male adolescents. MATERIALS AND METHODS: Literature review and group discussions were used to select 26 items of this questionnaire based on 3 dimensions of OE (self-evaluation, social expectancy, and physical expectancy). All Participants (n = 720) were divided into two groups randomly after evaluating comprehensibility, face and content validity, and items analysis. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were separately operated on one of these groups for evaluation of the construct validity of questionnaire. The reliability of the questionnaire was estimated by the Cronbach α. RESULTS: EFA extracted 3 main factors explained 45.80%, 10.31%, and 7.51% of OE variance, respectively. Almost all fit indexes in CFA were acceptable (CMIN = 107.39, CMIN/DF = 2.619, CFI = 0.938, PCFI = 0.699, RMSEA = 0.067, PCLOSE = 0.034). Finally 11 items remained in the questionnaire, which showed excellent reliability on main study (α = 0.85). CONCLUSIONS: This study provided evidence regarding the reliability and validity of the Iranian male adolescent outcome expectation about leisure time physical activity (IMAO-PAC) and illustrated that this new questionnaire can be used to measure the perceived exercise benefits among target group in observational and interventional studies.

Evaluation of interleukin-8 -251 t/a polymorphisms in visceral leishmaniasis.

BACKGROUND: Interleukin (IL)-8 plays important roles in the recruitment and activation of immune cells during visceral leishmaniasis (VL). Genetic variations in IL-8 modulate the expression of IL-8 protein and may be associated with VL. This study aimed to evaluate polymorphisms at the IL-8 -251 position in VL patients. METHODS: This cross-sectional study was performed on three groups: Leishmania-seropositive patients with clinical symptoms of VL (n = 91), seropositive patients without clinical symptoms (n = 104), and healthy controls (n = 110). Polymorphisms at the IL-8-251 position were analyzed using allele-specific polymerase chain reaction (PCR). Anti-Leishmania antibody titers were assessed by immunofluorescence. RESULTS: IL-8-251 polymorphism was significantly associated with VL (P<0.002). The IL-8-251 T/T genotype was significantly higher in group 1 than in groups 2 and 3 (P<0.002). The validity of the data was analyzed using Hardy-Weinberg equilibrium and one-way analysis of variance (ANOVA), as well as χ2 tests. CONCLUSIONS: IL-8-251 polymorphism was significantly associated with impaired immune responses in VL and might be considered a risk factor for disease development.

The L-selectin Phe206Leu gene polymorphism is not associated with visceral leishmaniasis.

BACKGROUND: Previous studies revealed that selectins play key roles in homing of immune cells to inflamed tissues and lymphatic organs. L-selectins are expressed on immune cells and interact with P and E selectins to homing to the tissues, hence, the polymorphisms within the gene of L-selectins may are associated with alteration in its expression. Thus, the current cross-sectional analytical study has been designed to investigate the polymorphisms within L-selectin gene and their relation with visceral leishmaniasis (VL). METHODS: This study was performed on 194 samples during 2004-2012.The PCR-SSP and immunoflorescence techniques were used to evaluate the L-selectins polymorphism and anti-Leishmania antibody titration, respectively, in 56, 74 and 64 seropositive VL patients (group 1), seropositive healthy controls (group 2) and seronegative healthy controls (group 3). RESULTS: The results showed that the genotypes (P=0.711) and alleles (P=0.679) within L-selectins gene (A/C) was not differ between groups. Our results also demonstrated that the genotypes within L-selectins in group 1 (P=0.807) and 2 (P=0.441) were not associated with the titration of anti-leishmania antibody. CONCLUSIONS: The results identified that the polymorphisms within L-selectins gene were not associated with VL and it may be concluded that these genotypes and alleles are unable to affect immune responses in VL patients.

Evaluation of FcγRIIIB-NA1/NA2 Polymorphism in Visceral Leishmaniasis.

BACKGROUND: Several lines of evidence demonstrating that innate and adaptive immunity play important roles in the defense against visceral leishmaniasis (VL). A polymorphism within the FcγRIIIB gene can lead to the expression of three variants of NA1, NA2, and the combined one (NA1/NA2) which alters affinity of IgG to its receptor. OBJECTIVES: The main aim of this study was to evaluate the FcγRIIIB-NA1/NA2 polymorphism in the FcγRIIIB gene of VL patients in comparison to healthy controls. PATIENTS AND METHODS: In this cross-sectional study, three groups; 54 seropositive patients with clinical presentation of VL (group 1), 104 seropositive patients without clinical presentation (group 2), and 104 healthy controls (group 3) were evaluated with respect to the FcγRIIIB-NA1/NA2 polymorphism using a PCR-SSP method. The titration of anti-leishmania antibodies was analyzed using an immunoflorescence technique. RESULTS: Our results indicated that polymorphisms within the FcγRIIIB gene (that lead to the expression of the NA1/NA2 isoforms) are significantly associated with VL. The results demonstrated that the genotype heterozygotic for FcγRIIIB-NA1/NA2 expression was significantly increased in VL patients, group 1 when compared to groups 2 and 3. Conversely, there is a decrease in homozygous NA1 and NA2 genotypes in VL patients; however, the overall frequency of NA1 and NA2 alleles appear similar across the three cohorts examined. CONCLUSIONS: According to our results, it is likely that the increased frequency of the FcγRIIIB-NA1/NA2 genotype is associated with impaired immune responses against VL and its subsequent clearance from the patient.