Psychometric properties of the COVID-19 Yorkshire Rehabilitation Scale: Post-Covid-19 syndrome in Iranian elderly population.

BACKGROUND: This study aimed to assess the construct validity and reliability of the Iranian version of the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) among the elderly population. METHOD: A cohort of 230 elderly individuals who tested positive for Covid-19 via PCR were administered a health and demographic information questionnaire along with the C19-YRS. Both exploratory and confirmatory factor analyses were conducted, and Cronbach's alpha was calculated. RESULTS: Findings from the exploratory and confirmatory factor analyses of the C19-YRS revealed alterations compared to the original version, resulting in an adapted version with three factors achieved by redistributing the questions. These factors accounted for 57.46% of the total variance. Despite a relatively lower factor loading in the 6th question, it was retained due to its significance among the elderly. The Cronbach's alpha for the C19-YRS subscales ranged from 0.730 to 0.890, indicating acceptable reliability. CONCLUSION: The validation results indicated a well-adjusted factor structure and internal consistency, affirming the utility of this tool among the elderly population. Consequently, the C19-YRS in Iran can serve as a valuable resource in healthcare settings, aiding in the assessment of chronic complications arising from Covid-19 in the elderly. It can be utilized as an initial screening or triage test and to evaluate the effectiveness of interventions.

Depression, anxiety, stress, and PTSD symptoms during the first and second COVID-19 waves: a comparison of elderly, middle-aged, and young people in Iran.

BACKGROUND: A widespread outbreak of epidemics like Covid-19 is a lethal threat to physical and mental health. Recent studies reported a higher prevalence of mental problems in younger individuals, contrary to the general assumption expected in older people. Therefore, it is necessary to compare anxiety, stress, depression and PTSD (post-traumatic stress disorder) symptoms in different age groups during the Covid-19 crisis. METHODS: A cross-sectional online survey was performed (from Dec. 2020 to Feb. 2021) on three age groups of elderly, middle-aged and young people. Data were collected by DASS-21 (Depression, Anxiety and Stress Scale) and IES-R (Impact of Event Revised Scale) and analyzed using ANOVA, χ2 test and logistic regression analysis. RESULTS: Overall, 601 participants completed the questionnaires, including 23.3% of the elderly (≥ 60 years), 29.5% of the young (18-29 years) and 47.3% of the middle-aged (30-59 years) with 71.4% of women. The logistic regression analysis revealed that the risk of PTSD in young people was higher than in the elderly (ß = 2.242, CI: 1.03-4.87, P = 0.041), while the risk of depression, anxiety and stress did not differ significantly among the three age groups. Female gender, occupation, lower economic status, solitary life, and chronic disease were risk factors for psychological symptoms during the Covid-19 pandemic. CONCLUSION: Findings on the higher odds ratio of PTSD symptoms in younger individuals have interestingly potential implications to meet the needs of mental health services during Covid-19.

Factors affecting students' attitudes towards reproductive health in the north of Iran: Designing an educational program.

BACKGROUND: It is essential to empower young people to promote reproductive health (RH) and develop effective educational programs to prevent risky behaviors. This study aimed to investigate the factors affecting students' attitudes towards RH based on the ecological model and then design an educational program. METHODS: This cross-sectional study was conducted on 461 female students aged 18-29 in the north of Iran. This study was done in two stages. In the first stage, factors affecting the attitude towards RH including demographic questionnaire, interpersonal communication skills, family communication pattern, depression, stress and anxiety, body self-image, and self-confidence were determined. In the second stage, an educational program was designed based on the most effective factors. Independent t-test, ANOVA, and multiple linear regression were employed using SPSS version 20 software. Also, STATA version 15 software was utilized for statistical modeling to predict the best predictive model of attitude towards RH. RESULTS: 47.7% of students had a good attitude toward RH. The majority of students had problems with interpersonal communication skills (60.7%). Also, 28.5% experienced depression, 35.8% anxiety, and 12.8% stress at different levels. More than a quarter of the students (26.5%) had poor body self-image and 18.7% had Undesirable self-esteem. Interpersonal skills (P = 0.002), family communication pattern (P = 0.004), stress (p = 0.019), anxiety (P = 0.001), and body self-image (P = 0.034) have a significant relationship with the attitude towards RH. The multiple regression showed that the most important effective factor on RH is the dialogue orientation of family communication pattern (P = 0.041), stress (P = 0.002), and anxiety (P = 0.001). CONCLUSION: Stress and anxiety management training and the use of dialogue orientation in the family communication pattern for young female students are recommended based on the scientific model.

Subjective well-being predicts Covid-19 risk in the elderly: a case-control study.

BACKGROUND: Covid-19 is a serious public health concern. Previous studies have shown that although there are concerns about the subjective well-being (SWB) of older people in the Covid period, the link between SWB and the risk of Covid-19 is still unclear. This study aimed to investigate the predictive effect of SWB on the Covid-19 risk in the elderly as well as the determinants of SWB. METHODS: This case-control study was performed in the elderly over 60 years of age. The case group consisted of all hospitalized patients with COVID-19 and the control group from the same population with no history of COVID-19 matched by age, sex, and place of residence. Data collection tools included a demographic questionnaire and SWB scale of Keyes and Magyarmo to measure emotional, psychological and social well-being. All data were analyzed via SPSS and STATA software. Multiple binary logistic regression was run to predict the probability of Covid-19 risk on the values of total SWB and its three subscales and multiple linear regression to identify SWB determinants. RESULTS: The results showed that increasing one unit in total SWB reduces the risk of Covid-19 by 4% (OR = 0.969, CI = 0.947-0.991, p = 0.006). Emotional well-being with 0.823 had the highest odds ratio for predicting Covid-19 risk, followed by social well-being with an odds ratio of 0.981. Increasing age and education, better economic status, marriage against celibacy, lack of comorbidity, and a better understanding of own health were associated with greater SWB. DISCUSSION: This study provides evidence for the protective effect of SWB on Covid-19 risk. To promote SWB, we need to focus on the elderly with higher financial worries and comorbidities, as well as those with less education, health perception and SWB. Therefore, it will be important for the elderly to determine strategies to improve SWB during the epidemic.

Comparison of competitive cognitive models in explanation of women breast cancer screening behaviours using structural equation modelling: Health belief model and theory of reasoned action.

INTRODUCTION: The efficacy of the theory of reasoned action (TRA), compared with the health belief model (HBM), has not been fully elucidated in screening practices. METHODS: This population-based cross-sectional study was conducted with samples of 500 women aged 35-85 years, in the north of Iran. The data of demographic characteristics, awareness, health belief, subjective norms and screening behaviours were collected using standard instruments. Structural equation modelling (SEM) was applied to estimate the pathways of regression coefficients. RESULTS: The model that incorporated the health belief and the standardised coefficient of the knowledge scores influenced significantly on the health belief perception (beta = 0.375), and consequently, the health belief directly affected screening behaviours (beta = 0.73). In contrast, In TRA model, while the direct effect of knowledge on intention was negligible it has a greater indirect effect by mediating health belief and subjective norms (indirect beta = 0.35) on behaviour intention. A high coefficient of intention was observed by subjective norms (beta = 0.626), and the intention has a great positive effect on screening behaviour (beta = 0.601). All fitting indexes were quietly improved in the TRA model as compared with HBM. CONCLUSION: Thus, the unifying structure of knowledge, health belief, subjective norms and intention improves the predictor power in breast cancer screening behaviours.

Student Attitudes About Reproductive Health in Public Universities: A Cross-Sectional Study.

BACKGROUND: Determine attitude of young people to reproductive health issues can somewhat predict their behavior in this area. This helps us in planning future on reproductive health. The aim of this study was to determine the attitude of reproductive health and related factors among Iranian students in public universities in Iran. METHOD: A cross-sectional study was carried out. The tool was developed based on a literature review to find out about reproductive health attitudes and sociodemographic factors associated. The face and content validity of the questionnaire was performed using expert judgment. Cronbach's coefficient and test-retest were used to determine the reliability. Data were analyzed using the Statistical Package for Social Sciences software by independent t test, ANOVA, and multiple linear regression. RESULTS: Out of 461 respondents, the majority of students were nonmedical sciences (81.1%). The main sources of information for reproductive health awareness were the media (40%); 54.9% disagreed with having premarital sex in both sexes, while only 36% agreed to postpone sexual activity until marriage in order to prevent sexually transmitted diseases. Moreover, 64% believed that contraception would cause infertility in the future. The majority found the need for reproductive health services and education essential for single youth. Multiple regression showed a poor reproductive health attitude in nonmedical students, families who did not talk about boy-girl relationships, as well as in satellite users and hookah consumers. CONCLUSION: The students' level of attitude on reproductive health was not satisfactory. Intervention programs related to reproductive health taking into account the cultural aspects of Iranian society can protect young people from risky behaviors and unwanted pregnancies by creating a positive attitude.

Nutrition assessment and geriatric associated conditions among community dwelling Iranian elderly people.

BACKGROUND: Although malnutrition risk is well documented in elderly care institutions, few studies have been conducted to address concerns regarding community-dwelling elderly people. This study has been aimed to describe the nutritional status and its related socioeconomic and geriatric factors in community-dwelling elders with malnutrition. METHOD: For this study, a randomized sampling among people aged 60 has been done (n = 326). Information on nutrition status (full MNA) and health information, like cognitive status (MMSE), daily functional status (ADL and IADL scales) and frailty was obtained. Multiple logistic regression analyses have been carried out, in order to identify the association of demographical and clinical factors with malnutrition. RESULTS: 28.1% of the participants suffered from poor nutrition. In the binary analysis, low MNA scores were associated with increasing age, female gender, lower education level, financial dependence, solitary life, poor self-rated health, multiple physical disabilities and chronic disease, polypharmacy, smoking, functional and cognitive decrease and frailty. In the final model of the multivariate analysis, living alone (OR:1.249,CI:1.105-2.620), multiple physical disabilities (OR:2.183,CI:1.246 ± 3..250) and chronic disease (OR: 2.148,CI:1.167-2.879) were independently associated with malnutrition. Also financial independency (OR:0.625,CI:0.233-0.938), functional ability on ADL (OR:0.536,CI:0.327-0.976) and IADL (OR:0.319,CI:0.194-0.856), normal cognitive (OR:0.456,CI:0.293-0.934) and no frailty (OR:0.253,CI:0.117-0.729) independently were inversely associated with malnutrition. The model was adjusted for all socio- demographic and health variables that were significantly related in the previous models. CONCLUSIONS: Our results indicated a strong correlation between malnutrition and health status. Identifying predictive factors can potentially improve prevention and management strategies used for malnutrition in elderly.

Does Religion Predict Health-Promoting Behaviors in Community-Dwelling Elderly People?

As the aging phenomenon gains importance in many societies, regular health-promoting activities by the elderlies become more crucial for disability reduction and their health promotion. Religious viewpoints and perspectives can have an influence on the individuals' assessment of life events. Recent studies show a correlation between religiosity and mental health. However, there is limited number of studies on the relationship between religiosity and health behaviors, especially in elderly. The purpose of this research is to evaluate religion's predictive power in health-improving behaviors of the elderly. This cross-sectional study was conducted on 316 community-dwelling elderly with the mean age of 67.9 ± 6.6 years, who were functionally independent without cognitive or mental impairments. Health-promoting lifestyle profile 2 assessment (HPLP2) and Alport questionnaires were used to assess health behaviors and religious orientation, respectively. Data analysis was performed by independent T test and multiple linear regression models with SPSS version 23. An internal religious orientation was found in 71 elderly; this accounts for 22.5% of the study population. Based on the health behavior scoring 154 individuals, 48.8% of the study population obtained a score of higher or equal to 139. These individuals were placed on third quartile and higher. Among the health behavior components, "the health responsibility" was the only component related to religious orientation [internal 25.1 ± 6.6 (P < 0.001, r = 0.78) vs. external 22.6 ± 6.5 (P > 0.05, r = 0.22)]. Based on the multiple linear regression models, no significant relationship was found between total health behavior score and religious orientation. However, a significant relationship existed between the participants' health behaviors and some of their profile. The results indicate that despite good health behaviors in nearly half of the elderlies, no significant relationship was found between health behavior and religious orientation. The results suggest possible impact of other religion-related concepts including private religious behaviors, devotion, spiritual transcendence, religious adaptation, and religious traditions and experiences on the health behaviors. These concepts require further study for better understanding of their impact.

Health Promotion Behaviors and Its Predictors Among the College Students in Iran.

The health-promoting behaviors form typically during adolescence and youth. This study was conducted to determine the status of the health-promoting behaviors in the students of Babol University of Medical Sciences and its predictors. This cross-sectional study was done on 350 students from April 2016 to July 2016. The applied questionnaires were health-promoting lifestyle profile II, general self-efficacy scale, and sociodemographic variables. Data were analyzed using the SPSS software by descriptive tests, one-way analysis of variance, and multivariable linear regression. The mean total health-promoting lifestyle profile II score was 126.79 ± 19.28. In the subscales, the participants scored the highest in interpersonal relations (24.62 ± 4.59) and the lowest in physical activity (16.53 ± 4.17). Analyses of the data showed that there was a significant association among some subscales of health-promoting behaviors and gender, family size, living in dormitory and also showed that self-efficacy remained as significant factor in relation to all subscales of health-promoting behaviors.

Health-Promoting Behaviors and Their Predictors in Iranian Women of Reproductive Age: A Cross-Sectional Study.

Health-promoting behaviors are one of the main determinative components of health in the prevention of many diseases. This cross-sectional study aimed to determine health-promoting behaviors and their relationship to sociodemographic variables on 330 women of reproductive age admitted to the selected primary health-care centers in Qom city (one of the biggest cities in Iran) from March 2016 to July 2016. Data were collected using the health-promoting lifestyle profile II (HPLP-II) questionnaire and the sociodemographic characteristics and also were analyzed by one-way analysis of variance, with post hoc (if necessary), and multivariable linear regression. The total HPLP-II mean score of women was 136.64 ± 22.37. The highest score in the HPLP-II subscales of women was found for interpersonal relations subscale (26.43 ± 4.21) and the lowest score for physical activity subscale (14.66 ± 4.62). The educational level and income had significant association with some subscales ( p < .05).

Preventive behaviors of COVID-19 in the Iranian adult population during the pandemic: Integrated effect of the health belief model and the planned behavior intention using causal path analysis.

Background: This study aimed to investigate the integration of the health belief model (HBM) and the theory of intention to plan preventive behavior for COVID-19 during the pandemic. Methods: In a cross-sectional study, a sample of 480 adult participants from different outpatient clinics were recruited in the study. The participant responded by self-report; the health belief model (HBM) scale, preventive behavior scale, subjective norms scale, the intention of planned behavior scale, and perceived control behavior scale were measured. The hypothesized causal path models were examined using SEM analysis. Results: The HBM had significant effects on perceived behavior control (ß=0.60, P=0.001), the intended preventive behavior (ß=0.32, P=0.001), and subjective norm (ß=0.53, P=0.001). Subsequently, the intention of preventive behavior (ß==0.39, P=0.001) and subjective norms (ß=0.27, P=0.001) significantly affected the performance of preventive behaviors. The estimated fitting criteria showed that the hypothesized model fits relatively well. Conclusion: The health belief model with the integration of subjective norms, perceived control behavior and mediation by the intention of planned behavior in a pathway relationship explains well the preventive behavior of COVID-19. The findings present a deeper understanding of how integrating HBM and intended planned behavior enhances people's preventive behavior against COVID-19.

Role of family communication patterns as predictors of behavioral health among students of public universities in north of Iran.

BACKGROUND: Communication is one of the oldest and greatest human achievements and the basis of social life. The aim of this study was to evaluate the role of family communication patterns as predictors of behavioral health among students of public universities in the north of Iran. MATERIALS AND METHODS: In this cross-sectional study, a total of 461 students from all the public universities of Babol, Iran, were selected in 2019. A stratified sampling random method was used to select the samples. The demographic characteristics, Depression Anxiety Stress Scale, Acceptance and Action Questionnaire, Rosenberg self-esteem questionnaire, and Communication Skills Interpersonal Test were used to collect data. Simple and multi-variate linear regressions as well as Pearson's correlation coefficient were utilized for data analysis. RESULTS: The mean and standard deviation scores of conversation orientation and conformity orientation were 35.61 ± 0.55 and 19.31 ± 0.41, respectively. Family conversation orientation was a significant predictor of behavioral health scales of students (except for acceptance and action), predicting negatively and significantly depression, anxiety, stress, and positively self-esteem and inter-personal communication skills of students. Family conformity orientation was also a significant predictor of behavioral health scales (except for inter-personal communication skills) of students, which predicted positively and significantly depression, anxiety, stress, and negatively acceptance, action, and students' self-esteem. CONCLUSION: To prevent behavioral health problems, it is necessary to observe conformity orientation and rely on conversation orientation.

Effectiveness of Group Psychosexual Training for Marital Adjustment and Sexual Self-Efficacy of Infertile Women: A Randomized Controlled Trial.

Objective: Infertility can be associated with unfavorable psychological consequences such as a sense of marital incompatibility and sexual inadequacy. To address these issues, this study aimed to assess the effectiveness of group psycho-sexual training in improving marital adjustment and sexual self-efficacy of infertile women. Method : A randomized controlled clinical trial (RCT) study was conducted in Babol, Iran, with 72 infertile women, randomly assigned to either the intervention group (n = 36) or the control group (n = 36). The intervention group underwent psychosexual training, while the control group received routine care. The Dyadic Adjustment Scale (DAS) and Sexual Self-Efficacy Scale (SSES) were used to assess their marital adjustment and sexual self-efficacy. Data analysis was performed using various tests, including the independent t-test, Chi-squared test, paired t-test, ANCOVA, and MANCOVA. Results: Most infertile women had moderate sexual self-efficacy (80%). The intervention group had a significantly better response to group psycho-sexual training compared to the control group. This intervention improved sexual self-efficacy and marital adjustment and its subscales including marital consensus, satisfaction, cohesion (P < 0.0001), and affectional expression (P < 0.001). The mean pre-to-post treatment scores of sexual self- efficacy, marital adjustment, and its subscales increased significantly in the intervention group, while no significant difference was observed in the control group (P < 0.0001). Conclusion: Based on the findings, it is recommended to provide educational services alongside the infertility treatment process for enhancing the quality of marital adjustment and promoting sexual self-efficacy.

The Effectiveness of Information-Motivation-Behavioral Skills Model on Self-Care Practices in Early Pregnancy to Prevent Gestational Diabetes Mellitus in Iranian Overweight and Obese Women: A Randomized Controlled Trial.

BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common metabolic dysfunction in pregnancy and as overweight and obesity are of the major risk factors. The aim of this study was to determine the effect of Information-Motivation and Behavioral skills (IMB) model-based counseling on preventing GDM in overweight and obese pregnant women. METHODS: This randomized controlled trial study was conducted on 137 pregnant women in two groups; education and counseling IMB model-based for four sessions (n = 70), and antenatal usual care (AUC) (n = 67). This study was conducted on overweight and obese pregnant women, at the 12 to 16 weeks' gestation and recruited from the Prenatal Clinic of Rohani Hospital in north of Iran. Blood glucose was measured before and 8 weeks after the intervention. Descriptive and inferential statistics including mean, frequency, t-test, chi-square and ANCOVA were used. RESULTS: The prevalence of GDM was lower in the intervention group than the control group (10% and 29.9%, respectively, RR = 0.33, CI 95% (0.15- 0.74) p = .004) as well as mean fasting blood glucose (Cohen's d = 0.28, p = .07), and glucose tolerance test at the first and second hour (d = 0.41 and Cohen's d = 0.73, respectively, p < .01). CONCLUSIONS: A lifestyle intervention in early pregnancy by IMB counseling in overweight and obese pregnant women can be effective in decrease GDM.

Structural model of the relationship between physical activity and students' quality of life: Mediating role of body mass index and moderating role of gender.

BACKGROUND: As a country's future leaders and pioneers, University students must live with healthy habits. In order to achieve a healthy lifestyle, Physical activity and Quality of Life can serve as suitable indices to study. The purpose of the study was to clarify how physical activity (PA), Body mass index (BMI) and gender relate to the quality of life (QOL) of students of Medical Sciences University by using a structural equation model. METHODS: The research was a cross-sectional study. The number of participants was 225 students of the University. The participants answered three questionnaires, including Demographic, International Physical Activity Questionnaire (IPAQ short form), and Quality of Life Questionnaire (SF-12), BMI was calculated by anthropometric measures, as well. The Structural equation model (SEM) method was employed. The Fitness of the proposed pattern was measured using the following indexes: chi-square/degree of freedom ratio (CMIN/DF), Normed Fit Index (NFI), comparative fit index (CFI), the goodness of fit index (GFI), and standardized root mean squared residual (SRMR). In the analysis the significant level was considered as P < 0.05. RESULTS: PA (r = -0.726, P<0.001) and QOL (r = -0.405, P<0.001) have significantly inverse relationship with BMI, whereas the QOL and PA were proven to be positively related (r = 0.357, P<0.001). Moreover, the results signify gender as a moderator in the relationship between PA and QOL (Δχ2 (10) = 19.903, P = 0.030) and also the mediatory role of BMI among students. BMI affects the QOL in men (P < 0.001, ß = -0.307) more in compare to women women (P = 0.324, ß = -0.158). CONCLUSION: Study findings supported the research hypothesis. Gender exhibited moderating role in the relationship between PA and QOL, considering the mediating role of BMI.

Effectiveness of distance education program on mothers' empowerment in exclusive breastfeeding: A randomized clinical trial.

BACKGROUND: Mothers need the necessary skills to be empowered in successful breastfeeding. This study aimed to investigate effectiveness of the distance education program on the mothers' empowerment in exclusive breastfeeding. MATERIALS AND METHODS: A randomized clinical trial study was done on 72 nulliparous pregnant women 28-32 weeks with normal pregnancy. The qualified women were randomly assigned to the intervention and control groups based on the random-number table. The breastfeeding training packages were sent to women in the intervention group via Telegram every week from 32 until 37 weeks of gestation. The mothers' empowerment in breastfeeding (primary outcome) and the exclusive breastfeeding rate (secondary outcome) were assessed by questionnaires. RESULTS: Based on the repeated measured tests, although scores for all domains and also the total score of the mothers' empowerment in breastfeeding between two groups had increased during the study period, there was a significant difference between the increasing trends of the maternal empowerment domains in two groups (interaction P value <0.001). Also, the prevalence of exclusive breastfeeding (secondary outcome) at 6 months was significantly higher in the intervention group (81.8% and 57.1% in the intervention and control groups, respectively) (P = 0.028). CONCLUSION: Distance education could increase all domains of the mothers' empowerment in breastfeeding after delivery. Also, exclusive breastfeeding at 6 months after delivery was significantly higher in mothers who were receiving the distance education packages.

Risk Factors for Gestational Diabetes Mellitus: A Case-Control Study.

Background: The underlying causes of gestational diabetes mellitus (GDM) are important because they are effective for the diagnosis and prevention of this condition. The aim of this study was to identify the risk factors for GDM and the possible etiological agents. Materials and Methods: This case-control study was conducted with 100 women with GDM and 100 healthy pregnant women at a tertiary care hospital, affiliated to Babol University. GDM was identified by impaired oral glucose tolerance test based on the Carpenter and Coustan criteria. Healthy women were randomly selected from the prenatal health care clinic of the same center and were matched to gestational age of 24 to 28 weeks. Descriptive and inferential statistics were used for data analysis via the SPSS software. Results: After adjusting variables, multivariate analysis identified 4 significant risk factors of GDM, including prepregnancy low physical activity (odds ratio [OR] = 2.85, 95% confidence interval [CI]= 0.97-8.34), advanced maternal age (OR = 1.24, 95% CI = 1.13-1.35), body mass index ⩾ 30 kg/m2 (OR = 1.10, 95% CI = 1.02-1.20), and family history of diabetes mellitus (OR = 5.62, 95% CI = 2.26-13.96). Conclusion: We observed significant associations between low prepregnancy physical activity and obesity with GDM risk. Thus the finding of this study can help devise strategies for the prevention of GDM.

Triglyceride to high-density lipoprotein cholesterol and low-density lipoprotein cholestrol to high-density lipoprotein cholesterol ratios are predictors of cardiovascular risk in Iranian adults: Evidence from a population-based cross-sectional study.

BACKGROUND: The superiority of TG/HDL-C and LDL-C/HDL-C ratios in predicting CVD risk is a matter of debates. Thus, the objective of this study was to compare TG/HDL-C and LDL-C to HDL-C ratios in predicting the risk of CVD events. METHODS: In a population-based cross-sectional study, 567 representative participants aged 40 years or older were entered in the study in Babol, North of Iran. The demographic data, anthropometric measures, and the cardio metabolic risk factors were measured. The individual risk of CVD events was assessed by ACC/AHA risk model. ROC analysis was applied to estimate the diagnostic accuracy and the optimal cut-off points of TG/HDL-C and LDL-C/HDL-C ratios. RESULTS: The AUC of TG/HDL-C and LDL-C/HDL-C ratios were rather similar and both parameters significantly predicted CVD risk in men comparably, and TG/HDL-C at optimal cutoff point of 3.6 produced 75% sensitivity and 39% specificity. However,in women TG/HDL-C with AUC of 0.65( p=0.091) at optimal cutoff value of 3.4 produced a sensitivity of 82% and specificity of 51%. The LDL-C/HDL-C ratio had no discriminative ability in predicting CVD risk in women. The adjusted OR of TG/HDL-C at 2nd quartile was significant (OR=3.22, 95% CI:1.25-8.29) and a greater association was found with 3rd and 4rth quartiles. CONCLUSION: Both TG/HDL-C and LDL-C/HDL-C ratios comparably predict CVD risk in men, whereas in women only TG/ HDL-C is a significant predictor but not LDL-C/HDL-C.

Risk Assessment for Breast Cancer Development and Its Clinical Impact on Screening Performance in Iranian Women.

INTRODUCTION: The aim of this study is to estimate the objective and subjective risk and to examine their associations with three forms of breast cancer screening. METHODS: This cross-sectional study was conducted with a sample of 800 women aged 35-85 years from the community setting and outpatient clinic in Babol, the north of Iran. The demographic, socio-economic characteristics and the risk factor profiles were collected through in-person interview. The health belief model (HBM) and visual analog scales were used to assess the women's perceived risk of breast cancer. The practice of women regarding breast self-examination (BSE), breast clinical examination (BCE), and mammography were measured. We used the Gail model in estimating 5-year and lifetime risk. The logistic regression model was applied to determine the relationship of calculated and perceived risk on screening behaviors. RESULTS: The mean of estimated 5-year and lifetime risk were 0.89 ±0.89 and 8.87 ±3.84 percent respectively while the perceived personal risk on visual scale perception was much greater than the calculated risk. The high 5-year calculated risk was a predictor of mammography practice but not BSE and BCE; however, after adjusting the subscales of HBM and socio-demographic characteristics, its effect remained significant (adjusted OR=1.97(95% CI: 1.02-3.08)). The perceived risk from HBM in particular self-efficacy (p=0.001) remained positively significant on all forms of screening practice. CONCLUSION: While the perceived risk from HBM scale was meaningful in screening performance, the calculated risk from the Gail model had a clinical impact on mammography behaviors independent of HBM scales.

Clinical and metabolic response to soy administration in older women with metabolic syndrome: a randomized controlled trial.

BACKGROUND: There are many studies on the health effects of soy, only a few describe the effects of the simultaneous use of two types of soy on multiple components of metabolic syndrome (MetS). The present study was designed to determine the effects of roasted soy-nut and textured soy protein (TSP) intake on clinical and metabolic status of older women with MetS borderline parameters. METHOD: This randomized, single-blind, controlled clinical trial included 75 women ≥ 60 years old with a diagnosis of MetS based on ATP III criteria. The participants were randomly allocated into three groups of 25 people; soy-nut, TSP and control groups for 12 week. Fasting blood samples were taken at the beginning and end of the trial to compare the metabolic responses. All participants provided three dietary records and physical activity records during the intervention. We used the Kolmogorov-Smirnov, ANOVA, ANCOVA, paired-t test, and the Generalized Linear Model (GLM) repeated measures analysis. RESULTS: Dietary intake and physical activity of the participants in two groups were not significantly different. After 12 weeks of intervention the participants who received soy-nut had a significant decrease in total cholesterol (TC) (p < 0.001), low density lipoprotein, very low density lipoprotein, apolipoprotein B100, fasting blood glucose, insulin (p < 0.05), HOMA-IR, malondialdehyde (MDA) (p < 0.01) level. Morever, a significant increase in total antioxidant capacity (TAC) (p < 0.01) level compared with the control group. At the same time, the TSP brought significant decrease only in TC, insulin, MDA (p < 0.05) level and a significant increase in total TAC (p < 0.05) level. We did not find any significant effect in intervention groups, on apolipoprotein AI, triglyceride (TG), high density lipoprotein (HDL-C), TG/HDL, C-reactive protein and fibrinogen levels after intervention. CONCLUSION: Short-term intakes of roasted soy-nut and TSP have shown to improve the lipid profiles, markers of glucose intolerance and oxidative stress; although the roasted soy-nut was more effective than TSP. Therefore, a moderate daily intake of roasted soy-nut as snacks or TSP as a meal complement by individuals with borderline parameters of MetS can be a safe and a practical modality to avoid the progression of the disease as well as to limit the side effects of drug intake.Trial registration MUBABOL.REC.1388.1.