An Intervention Program Using the Health Belief Model to Modify Lifestyle in Coronary Heart Disease: Randomized Controlled Trial.

BACKGROUND: Most effective interventions to control coronary heart disease (CHD) and prevent negative outcomes involve behavioral modification. This study examined how such modification based on the Health Belief Model (HBM) might improve lifestyle and clinical outcomes. METHODS: A total of 120 people with CHD seeking help at a general hospital in Iran were randomly assigned to either the intervention or control group. Information was collected using an HBM-specific questionnaire and the Health Promoting Lifestyle II (HPLP-II) scale. Clinical outcomes (blood pressure, body mass index, and fasting blood sugar) were also measured. The intervention group received a tailored education based on HBM principles plus routine care, while those in the control group received only routine care. Three months after the intervention, both groups were reassessed using Student's t test and analysis of covariance. RESULTS: All HBM subscale scores indicated significant improvements in the intervention group, in contrast to the control group, where scores worsened or stayed the same. Perceived severity and susceptibility were the dimensions that changed most. Total score on the HPLP-II improved significantly in the intervention group (p < 0.001, F = 747.5); however, subscale scores on spiritual growth and interpersonal relationships did not demonstrate significant between-group differences at follow-up. After adjustment for baseline scores, significant improvements in lifestyle subscales were also accompanied by significant improvements in clinical measures. CONCLUSIONS: This HBM-based behavior modification program improved both lifestyle and clinical measures in patients with CHD. Utilizing this program in patients with other cardiovascular diseases may in the future demonstrate similar results.

An educational intervention using the health belief model for improvement of oral health behavior in grade-schoolers: a randomized controlled trial.

BACKGROUND: Oral health problems especially dental caries are common in school children, and education programs may help to prevent these conditions. The aim of current study was to examine the effects of an educational program based on a Health Belief Model (HBM) to improve oral health behaviors of elementary school children. METHODS: A total of 112 children ages 6-12 years old accompanied by one of their parents were randomly assigned to intervention/test and control groups. In the intervention group, five consecutive weekly educational sessions based on the HBM were provided, while the control group received only routine education delivered by the dental clinic. The Decayed, Missing, and Filled Teeth (DMFT) score, papillary bleeding index, and responses to the HBM questionnaire were assessed in the intervention and control groups at baseline and three-month follow-up after the intervention was completed. Within-group and between-group differences were examined using the Student's t-test and analysis of covariance. RESULTS: All HBM domains were improved at follow-up in the intervention group compared to the control group (p < 0.001). The largest change was in perceived susceptibility, whereas the smallest changes were in perceived severity and perceived benefits. The papillary bleeding index demonstrated a significant change from baseline to follow-up in the intervention group (reduction of 0.7, 95% CI = - 0.9 to - 0.5). All components of the DMFT score except missing teeth also improved in the intervention group compared to controls. However, no significant difference was found in total DMFT score between intervention and control groups. CONCLUSION: An education program based on HBM may be more effective than current methods used to educate children and their parents on optimal oral health behaviors. Administration of interventions of this type along with other school-based programs to prevent dental caries may be helpful in grade-school children.

Investigation of rheological, physicochemical, and sensorial properties of traditional low-fat Doogh formulated.

Doogh is a fermented beverage made from yoghurt with water and salt. Similarly, drinks based on yoghurt are available in different countries with varying degrees of dilution, fat content, rheological properties, and taste. In this project, the use of mathematical calculations in describing rheological parameters from traditional low-fat Doogh enriched with Caspian Sea (Huso huso) gelatin (0.4 w/v %), xanthan hydrocolloids (0.4 w/v %), and their mixture at a ratio of 0.2:0.2 w/v % studied. Also, serum isolation, pH, and sensory evaluation of samples were investigated. Also, the relationship between apparent viscosity and temperature of Doogh samples using the Arrhenius equation was studied. The sensory evaluation revealed that the overall acceptance scores of the samples containing gelatin, xanthan, mix, and control were 4.31, 4.33, 4.58, and 4.12, respectively. The study on serum separation value showed control sample (45.07) and mix sample (0.84) at the end of 30 days. On the first day, the pH of the Doogh samples decreased with the addition of hydrocolloids, and this trend was time dependent. pH reduction was higher in Doogh with gelatin than in other samples. Mathematical calculations showed that the low-fat Doogh is a non-Newtonian type and shear-thinning (Pseudoplastic) fluid. The activation energy was calculated between 11.65 and 19.15 kJ/mol. According to the obtained results, it concluded that the use of two hydrocolloid compounds improved the physicochemical and sensory characteristics of the low-fat Doogh samples. Also, the Ostwald-de Waele mathematical model had a high correlation with the rheological behavior of the samples.

Management of urolithiasis in pregnancy: A systematic review and meta-analysis.

PURPOSE: Management of nephrolithiasis is unique in pregnancy and requires multidisciplinary care. To identify the effectiveness or safety of temporary drainage or definitive treatment methods to manage urolithiasis in pregnancy. METHODS: The search strategy aimed to find both published and unpublished studies was conducted in August 2021. Studies published in any language on any date were considered for inclusion. RESULTS: Of a total of 3349 publications, 36 studies were included in our qualitative evaluation and 32 studies in the quantitative synthesis. The commonly reported method was stent insertion (n = 29 studies), pneumatic (n = 12), laser (n = 9) lithotripsy, and stone removal using any devices (basket, grasper, or forceps) (n = 11). In seven studies, the authors reported the outcomes of conservative management, and the results showed that the stone-free rate is 54%, and symptom relief occurred in 62% of women. Seven eligible studies reported that 79.9% of urolithiasis were expulsed through stent insertion, while this rate was 94.6% among percutaneous nephrostomy use in two included studies, 88.5% for pneumatic lithotripsy (n = 7 studies), and 76.4% for laser lithotripsy (n = 4 studies), or 95.4% for stone removal method. In addition, adverse events were reported in less than 10% of pregnant women. CONCLUSIONS: The results showed that stent, pneumatic or laser lithotripsy, and ureteroscopic stone removal were the commonest used methods in the included studies. They can be effective and safe treatment approaches without major maternal or neonatal complications, and could be introduced as an effective and safe therapeutic method for urolithiasis during pregnancy. However, most of the included studies had moderate quality according to critical appraisal checklists. Further prospective studies are needed to reach a conclusion.

Investigating the effectiveness of psychological interventions in response to stress, anxiety, and depression in coronavirus disease 2019 patients: A systematic review.

Coronavirus disease 2019 (COVID-19) has caused different kinds of psychological consequences. Identifying and providing psychological plans and protocols can be effective in promoting patients' mental health. The study was conducted to investigate the effect of psychological interventions in response to stress, anxiety, and depression in COVID-19 patients. The present study was performed based on a systematic review. The studies were done by using different combinations of keywords in databases such as Science Direct, ProQuest, PubMed, and Google scholar search engines and in Persian databases such as Magiran, SID, Iranmedex from July 25 to September 7, 2020. Out of 4533 articles that were found after extensive search, 9 articles were evaluated and qualitatively analyzed for data extraction with the 2010 consort checklist. The final articles were from different countries of China, the USA, France, Italy, and Iran and were about COVID-19 patients and their health-care providers. Interventions ranged from relaxation, music therapy to mental health and extensive psychological skills including adaptation methods, mindfulness and self-care, and crisis management. Anxiety was the highest and then stress and depression were the next indicators. The results showed a positive effect of these interventions on stress, anxiety, depression, and even the quality of life, sleep and family and child function. The number of studies in this field is increasing. We see a variety of psychological and educational interventions every day. It is hoped that by designing standard protocols for psychological intervention, effective steps can be taken to improve the mental health of patients and health-care providers.

Development and Psychometric Properties of the Mental Health Literacy Questionnaire (MHLQ) Among Young Iranian Soldiers.

Background: Prevention of the incidences of mental disorders, psychological problems, or their rapid diagnosis is an important issue that has led to the creation of a mental health literacy concept and the development of standard tools for evaluating them. This study is the first step in the designing and psychometrics of the Mental Health Literacy Questionnaire (MHLQ) in Iran. The purpose of this study was to design the psychometric properties of the MHLQ in soldiers. Methods: This study is a methodological study that was designed in three phases: 1) Designing the instrument, 2) Assessing the items, and 3) Psychometric assessment. This study was conducted during 2017-2018, and the soldiers were selected by using a convenience sampling method from different garrisons of Tehran, Iran. To evaluate the content validity of the questionnaire 10 experts, to evaluate the face validity 9 soldiers, and for the pilot study 103 soldiers formed the sample size. Finally, construct validity was assessed among 251 soldiers. Results: In the first phase, 78 items were collected and designed. Then, based on the experts' opinions and preliminary studies, the items were reduced to 52 in the "Assessing the items phase" and then to 42 items in the psychometric phase. In the third phase, 31 items remained in the final version. The CVR and CVI scores of the 52 items were 0.91 and 0.94, respectively. Exploratory factor analysis revealed a 4-factor structure with 31 items of special value that were higher than five that accounted for 55.04 of the total scale variance. The fit indices values indicated that the model is fit for the data. In the total scale, the test-retest reliability and Cronbach's alpha were 0.81 and 0.76, respectively. Conclusion: The MHLQ of soldiers has appropriate psychometric properties and can be considered as a suitable tool for evaluation and screening as well as a basis for educational and research interventions.

Comparing the effectiveness of motivational interviewing and self-development education on type II diabetes mellitus patients' lifestyle.

BACKGROUND: Lifestyle can play an important role in controlling type II diabetes (T2D), and a high-risk lifestyle can exacerbate its effects. The aim of this study was to compare the effectiveness of motivational interviewing with self-development education on T2D patients' lifestyle. MATERIALS AND METHODS: This was a quasi-experimental study in 2017-2018. The design was pretest-posttest with an active comparison group. The population of this study was T2D patients of Firouzgar and Imam Reza Hospitals in Tehran. Using targeted sampling, 80 patients were selected and randomly assigned into experimental and comparison groups. The instrument was a tool for assessing lifestyle determinants in T2D patients (determinants of lifestyle behavior questionnaire) based on the theory of planned behavior. Intervention program was initially performed, and motivational interviewing was conducted on Firouzgar Hospital's patients for 10 sessions while self-development education was conducted on Imam Reza Hospital's patients for 10 sessions (active comparison group). To analyze the data, independent t-test and Chi-square test were used. RESULTS: The results showed that the patients who received motivational interviewing had significant improvement in their lifestyles with a 95% confidence level at P = 0.042, compared to the patients who had been trained with self-development education. CONCLUSION: Motivational interviewing improves the lifestyle of T2D patients compared to self-development education. It is recommended that motivational interviewing be used to help the rehabilitation of these patients. This method helps patients control their blood sugar while improving their lifestyle.

Evaluation of psychometric properties of the maastricht upper extremity questionnaire (MUEQ) in iranian computer users.

BACKGROUND: Measurement of the essential risk factors for work-related musculoskeletal disorders is a fundamental step in predicting the problem and identifying high-risk individuals. In this regard, Maastricht upper extremity questionnaire (MUEQ) has not been validated in Iran. This study aimed to develop a valid and reliable Persian version of MUEQ. MATERIALS AND METHODS: In this descriptive study, the computer users employed in a governmental informatics administration in Tehran, Iran, were included during the end of 2018 and early 2019. Face and content validity of the MUEQ was conducted, and a six-part questionnaire was provided. The reliability of the questionnaire was obtained using Cronbach's α and test-retest. Concurrent validity was assessed with Nordic Musculoskeletal Questionnaire (NMQ). Exploratory and confirmatory factor analysis, comparison test of independent mean, internal consistency coefficient, test-retest, and Pearson correlation were carried out using the AMOS and SPSS 22 software. RESULTS: Participants consisted of 282 computer users (110 males) with a mean age of 35.17 ± 7.65 years. The mean duration of computer use in a working day was 6.68 ± 2.10 h with a range of 1-12 h. The most prevalent symptoms were existed in the neck (39.1%), back (31.0%), and lower back (30.3%) areas. KMO test and Bartlett's test of sphericity showed that a significant correlation existed among questions. Cronbach's alpha coefficient of the questionnaire varied from 0.61 to 0.83 and test-retest coefficient was higher than 0.7. Correlation coefficient was between NMQ and body posture (r = 0.23, P = 0.004) and between NMQ and work environment (r = 0.28, P = 0.000). Evaluations related to the construct validity and concurrent validity demonstrated that the questionnaire has acceptable construct validity. Six factors of the MUEQ in Root Mean Squared Error Approximation (RMSEA) index (0.062) were acceptable and satisfactory in Parsimony Comparative Fit Index (PCFI), Comparative Fit Index (CFI), Normed Fit Index (NFI), and Parsimony Goodness of Fit Index (PGFI) (0.732, 0.8000, 0.680, and 0.680, respectively). CONCLUSIONS: The Persian version of the MUEQ represented a satisfactory validity and reliability and was suitable for computer users in the assessment of their risk factors of musculoskeletal complaints.

Designing a model for patient relationship management in the general hospitals using the combination of analytic hierarchy process and interpretive structural modeling.

BACKGROUND: Patient relationship management (PRM), in addition to saving costs, increases patient loyalty and creates a satisfactory environment for the patient and the service provider. This study aimed to design a model of PRM in general hospitals using the combination of the analytic hierarchy process and interpretive structural modeling (ISM). METHODS: This was an applied and cross-sectional study conducted in 2020 at three stages. At the first stage, using a systematic review, factors affecting PRM were identified. In the second stage, these factors were prioritized based on the pair-wise comparisons. In the third stage, the interaction levels of the factors were modeled for the general hospitals using ISM through the use of the MICMAC technique and Excel 2007 software. RESULTS: The results showed that "integrated information system," "registration of the patient's essential information," and "right data at the correct time" were the first to third priority in implementing PRM in the general hospitals. In the final model of ISM, three levels of effective factors were extracted, and 10, 4, and 6 factors were identified in the first, second, and third levels, respectively. CONCLUSION: Establishing the PRM strategy in the hospital, in addition to executive and managerial requirements, depends on the existence of an electronic customer relationship management system, and the choice of new technology, as well as the integration of information systems and technology culture, should be given special attention by managers.

Preparation and physicochemical characterization of camptothecin conjugated poly amino ester-methyl ether poly ethylene glycol copolymer.

In the present study, camptothecin grafted poly amino ester-methyl ether polyethylene glycol (CPT-PEA-MPEG) as a novel copolymer was synthesized by Michael reaction at different ratios of MPEG and CPT (60 : 40 and 80 : 20). The microemulsion was used to prepare nanomicelles, and in vitro cytotoxicity was performed on the HT29 cell line, and cell survival was measured by MTT assay. The syntheses were confirmed by 1H NMR and FT-IR. Several characterization methods including CMC, particle size, size distribution, and transmission electron microscopy were performed to evaluate features of prepared nanomicelles. Low critical micelle concentration, small particle size and IC50 of 0.1 mg ml-1 at MPEG to CPT ratio of 60 : 40 make this micelle a promising drug delivery carrier. CPT-PAE-MPEG nanomicelles at a MPEG : CPT ratio of 60 : 40 can be a suitable choice to improve the physiochemical properties of CPT and its therapeutic effect, while it can be potentially used as a nano-carrier for other anticancer drugs to purpose a dual drug delivery.

Modeling of drying kiwi slices and its sensory evaluation.

In this study, monolayer drying of kiwi slices was simulated by a laboratory-scale hot-air dryer. The drying process was carried out at three different temperatures of 50, 60, and 70°C. After the end of drying process, initially, the experimental drying data were fitted to the 11 well-known drying models. The results indicated that Two-term model gave better performance compared with other models to monitor the moisture ratio (with average R2 value equal .998). Also, this study used artificial neural network (ANN) in order to feasibly predict dried kiwi slices moisture ratio (y), based on the time and temperature drying inputs (x1, x2). In order to do this research, two main activation functions called logsig and tanh, widely used in engineering calculations, were applied. The results revealed that, logsig activation function base on 13 neurons in first and second hidden layers were selected as the best configuration to predict the moisture ratio. This network was able to predict moisture ratio with R2 value .997. Furthermore, kiwi slice favorite is evaluated by sensory evaluation. In this test, sense qualities as color, aroma, flavor, appearance, and chew ability (tissue brittleness) are considered.