Socioeconomic inequality in self-rated health and its determinants: an Oaxaca blinder decomposition in Ilam, West of Iran during 2023.

AIM: To determine inequality and decompose it's in Self-Rated Health (SRH). METHOD: This population-based cross-sectional study was undertaken on the entire population of the city of Ilam, Iran, in 2023. Multi-stage stratified cluster random sampling with proportion-to-size approach was used to select the participants. Oaxaca-Blinder decomposition technique was used to show the amount of inequity in SRH and to decompose of the gap of SRH between the poor and the rich group of participants. RESULTS: 1370 persons participated in the study. The 59.38% of participants stated good SRH status and just 8.86% of participants had poor SRH status. The results of the Oaxaca-Blinder decomposition revealed a considerable gap (15.87%) in the poor status of SRH between the rich and the poor. A large proportion (89.66%) of this difference was described by explained portion of the model. The results of decomposition showed that economic status was directly responsible for explaining 27.98% of overall inequality gap between rich and poor people. Moreover, hopelessness to future (32.64%), having an underlying disease (18.34%) and difference in the education level (10.71%) were associated with an increase in inequality disfavoring the poor. CONCLUSION: For people suffering from underlying disease, it is suggested to devise policies to improve access to/and remove healthcare utilization barriers. To address hopelessness to future, it is recommended to carry out further studies to reveal factors which affect it in more details. This can help policy makers to formulate more realistic and evidence-informed policies on order to lessen the current socioeconomic inequity in SRH.

Circulating FABP-4 Levels in Patients with Atherosclerosis or Coronary Artery Disease: A Comprehensive Systematic Review and Meta-Analysis.

Background: Cardiovascular diseases (CDs), notably coronary artery disease (CAD) due to atherosclerosis, impose substantial global health and economic burdens. Fatty acid-binding proteins (FABPs), including FABP-4, have been recently linked to CDs. This study conducted a systematic review and meta-analysis to examine FABP-4 levels in CAD and atherosclerosis patients, exploring their potential links to these conditions. Methods: A systematic review and meta-analysis were done based on the PRISMA guideline. The international databases including Medline, Embase, Cochrane Library, Scopus, Web of Science, and UpToDate were searched to find all related studies on the effect of FABP-4 on patients with CAD or atherosclerosis which were published till June 2022 without language restriction. The Cochran's Q-test and I2 statistic were applied to assess heterogeneity, a random effect model was used to estimate the pooled standardized mean difference (SMD), a metaregression method was utilized to investigate the factors affecting heterogeneity between studies, and Egger's test was used to assess the publication bias. Results: Of 1051 studies, 9 studies with a sample size of 2327 were included in the systematic review and meta-analysis. The level of circulating FABP-4 in the patient groups was significantly higher than in the control groups (SMD = 0.60 (95% CI: 0.30 to 0.91, I2: 91.47%)). The SMD in female and male patients were 0.26 (95% CI: 0.01 to 0.52, I2: 0%) and 0.22 (95% CI: 0.08 to 0.35, I2: 44.7%), respectively. There was considerable heterogeneity between the studies. The countries had a positive relationship with heterogeneity (coefficient = 0.29, p < 0.001); but BMI, lipid indices, gender, study design, and type of kit had no effect on the heterogeneity. No publication bias was observed (p: 0.137). Conclusion: In summary, this meta-analysis revealed elevated circulating FABP-4 levels in CDs, suggesting its potential as a biomarker for these conditions. Further research is warranted to explore its clinical relevance.

Effectiveness of a school-based health education program to improve the symptoms of premenstrual syndrome in high school girls in Ilam.

BACKGROUND: The premenstrual syndrome happens periodically and affects both the individual and family. The aim of this study was to determine the effect of the health education program on reducing premenstrual syndrome in high school girls in Ilam. MATERIALS AND METHODS: This experimental study was conducted in girls' high schools in Ilam, in 2017-2018. In total, 120 students were enrolled in the study (intervention group = 61 and control group = 59) and selected through convenience sampling. In this study, a standard Premenstrual Symptoms Screening Tool (PSST) was used to diagnose students with premenstrual syndrome or Premenstrual Dysphoric Disorder (PMDD). The educational program for the intervention group was held in four sessions of 30 min for 4 consecutive weeks. The obtained data were analyzed by the SPSS statistical software at a significance level of less than 0.05. RESULTS: The results showed a significant difference in the proportion of cases with moderate and severe PMS and PMDD between intervention and control groups in follow-up (P < 0.001). However, these proportions were not significantly different between the two groups in the baseline. CONCLUSIONS: According to the results, the educational program can be recommended as an effective intervention for girls with moderate-to-severe premenstrual symptoms and premenstrual dysphoric disorder.

The Effect of Cerebellar tDCS on Static and Dynamic Balance of Inactive Elderly Men.

The aim of this study was investigating the effect of cerebellar transcranial direct current stimulation (tDCS) on static and dynamic balance of inactive older adults. Twenty-four older adults participated in this study. All participants underwent static and dynamic balance tests. In the Experimental group, anode electrode was positioned at the O point in the cerebellum and cathode electrode was positioned on the left eye socket (FP1). In the control group, the anode and cathode electrodes were positioned at O and FP1 points, respectively, but the current stimulation was stopped after 30 s. Then, the posttest was performed. Data analysis was done using MANCOVA. There was a significant difference between the Experimental and control groups in static balance (p = .12) and dynamic balance (p = .18) and the performance was better in the experimental group. It can be concluded that tDCS can improve static and dynamic balance in inactive older adults.

Investigation of health-promoting behaviors of employees of medical university: A perspective from West of Iran.

BACKGROUND: Employees spend most of their time at work, and hence, it is important to pay attention to health-promoting behaviors. The purpose of the present study was to investigate the status of health-promoting behaviors of employees in the Medical University of Ilam-Iran. MATERIALS AND METHODS: This cross-sectional, descriptive study has been conducted by the participation of 208 employees, whom selected through the simple random sampling method. In the present study, participants completed Walker's Health Promoting Life Style Profile II in the self-report form. The gathered data were analyzed using software at the significant level of 0.05. Data were analyzed by the independent samples t-test, one-way analysis of variance, and Pearson correlation coefficients. RESULTS: The highest correlation of health-promoting behaviors was related to spiritual growth (r = 0.785), stress management (r = 0.777), interpersonal relationships (r = 0.767), health responsibility (r = 0.730), nutrition behaviors (r = 0.641), and physical activity (r = 0.611) were in the next places (P < 0.001), respectively. Among sub-scales, the highest correlation was observed between spiritual growth and stress management (r = 0.676, P < 0.001) and the lowest correlation between physical activity and interpersonal relationships (r = 0.253, P < 0.001). CONCLUSIONS: The score of physical activity was lower compared to other dimensions of health promoting behaviors. Therefore, it is necessary to make more effective interventional measures for improving physical activity status.

Lifestyle intervention for gestational diabetes prevention in rural woman of Shoush city.

BACKGROUND: Physical activity and nutrition interventions are the most important ways to prevent gestational diabetes. The purpose of the study was to determine the effect of healthy lifestyle intervention to promote preventive behaviors of gestational diabetes in the rural woman of Shoush city. MATERIALS AND METHODS: In an experimental study, 60 pregnant women were selected using simple random sampling and allocate into intervention group (n = 30) and nutrition program. The study was conducted from September to June 2018. The data were collected in baseline and 1 month and 3 months of follow-up phase and were analyzed using Chi-square test, repeated-measure test, and generalized linear model (GLM). The α = 0.05 was considered as significance. RESULTS: The mean age in the intervention and control group was 25.9 ± 5.6 and 27.2 ± 5.9, respectively. The GLM test showed a significant increase in the physical activity level and the mean of nutrition behaviors within the intervention group over time (P = 0.013). Further, based on the results of repeated-measure test, the mean of weekly MET-minute was increased in the intervention group in comparison to the control group at 1 month and 3 months of follow-up (P < 0.001). DISCUSSION AND CONCLUSION: The lifestyle interventions are appropriate programs to the reduction of the risk of development of gestational diabetes in pregnant women.

Application of health belief model to predict COVID-19-preventive behaviors among a sample of Iranian adult population.

BACKGROUND: The novel coronavirus (COVID-19) has infected nearly 9.5 million people in 216 countries, areas, or territories in the world. The fight against the COVID-19 has become a very serious international challenge. The aim of this study was to determine the predictors of COVID-19-preventive behaviors using the health belief model (HBM). MATERIALS AND METHODS: This cross-sectional study was conducted with the participation of 558 samples from the adult population of Iran. The online convenience sampling was conducted in this research. The online 68-item questionnaire link was published all over Iran through social networks including Telegram and WhatsApp, which are common in Iran. The data were analyzed using SPSS software version 19. Descriptive statistics, bivariate Pearson's correlation test, and multiple linear regression were used to analyze the data. RESULTS: The mean age of the subjects was 33.3 ± 10.01 years. The participants were often female (61.3%), married (57.9%), and resident of the city (81.0%) with university educational level (78.8%). The results showed that the HBM structures predicted 29.3% of the preventive behaviors of COVID-19 in the subjects. The perceived benefits, perceived barriers, and self-efficacy significantly predicted the preventive behaviors, but the perceived susceptibility and perceived severity were not significant in the regression model. The internet and virtual social networks (49.8%), broadcast (33.5%), and healthcare providers (15.8%) were the most important sources of information related with COVID-19. In response to COVID-19-related internal cues to action, 36.6% did not pay attention and 34.7% tried to self-medicate. Only 28.5% of the subjects referred to the hospital, healthcare center, or physician. CONCLUSION: Self-efficacy, perceived barriers, and perceived benefits were the key determinants of COVID-19-preventive behaviors in the subjects. It can be concluded that the HBM is a good tool to predict COVID-19-preventive behaviors in Iranian population.

The Effect of Stress Management Program on Perceived Stress in Patients with Type 2 Diabetes: A Randomized Controlled Trial.

INTRODUCTION: Stress management plays an important role in improving metabolic control in type 2 diabetes patients. The aim of this study was to find the effect of educational intervention on improving stress management in type 2 diabetic patients in Dezful, Iran. METHODS: In an experimental study, 92 patients with type 2 diabetes who were referred to the Diabetes Clinic of Ganjavian Hospital of Dezful were selected by available sampling method. Then, they were randomly divided into two groups: 46 as intervention and 46 as control. For the intervention group, a stress management training program was designed for one month (8 sessions), while there was no training for the control group. All participants filled the Cohen Perceived Stress Questionnaire (PSQ) in baseline and follow up (3 months) phases. All the data were analyzed using SPSS software by conducting an independent t- test, and paired sample t- test, and Chi-square test at a significant level of 0.05. RESULTS: The mean age of participants was 52.70 ± 10.91 years. Pre-test data revealed that there was no significant difference between the stresses of the two groups (P> 0.05); however, the results of the independent t-test, 3 months after the educational intervention, demonstrated a significant decrease in stress level in the intervention group compared to the control group (P <0.05). CONCLUSION: Based on the findings of this study, it is concluded that the design and implementation of health education interventions can be useful to improve stress management in people with type 2 diabetes.

Developing and Testing an Instrument to Measure the Factors Affecting the Salt Restriction Behaviors among Women.

BACKGROUND: High salt intake is considered as one of the most important causes of hypertension and cardiovascular diseases. Measuring and identifying factors contributing to people's salt intake behaviors is important to evaluate effectiveness of interventions focusing on salt reduction behaviors. The purpose of this study was to develop and test a new theory of planned behavior (TPB)- based instrument to measure factors influencing three different salt intake behaviors (adding salt during cooking, at the table, purchasing salty food) among women. STUDY DESIGN: A mixed-method study. METHODS: After the face and content validity of developed instrument were established, a representative sample of women (N= 300, age (SD):42.82(12.10)) were recruited to assess the construct validity using Partial Least Square confirmatory factor analysis. Coefficient alpha and composite reliability (CR) were used to establish reliability of instrument. The content validity index (CVI) and content validity ratio (CVR) were used to assess the content validity. RESULTS: Assessing validity and reliability of instrument led to 56-item questionnaire. CVI was more than 0.70 and CVR more than 0.56. Internal consistency as assessed by Cronbach's alpha was acceptable. Convergent and discriminant validity were established. The GOF index for behavior one was 0.250, for behavior two was 0.414 and behavior three was 0.374. The results of confirmatory factor analysis indicate that TPB model has an acceptable fit with data. CONCLUSION: Our instrument provides a validated and reliable tool for assessing different aspects of salt intake behaviors in women to evaluate effectiveness of interventions focusing on salt reduction behaviors.

Physical Activity Stage of Change and Its Related Factors in Secondary School Students of Sarableh City: A Perspective from Iran.

BACKGROUND: Physical activity is highly beneficial to health. These benefits are so important and indispensable for adolescents. AIM: The aim of this study was to investigate the Physical activity stage of change and its related factors in the male secondary School students of Sarableh city. MATERIAL AND METHODS: In a cross-sectional study, 261 male secondary School students possessing the eligibility criteria were selected using the simple random sampling technique. After giving their informed consent, the students filled the stage of change questionnaire and the structures of the transtheoretical model in a self-reporting manner. Using SPSS.21, the data were analysed through One-way ANOVA and Pearson correlation test with a 0.05 level of significance. RESULTS: The mean age of the students was 16.16±0.89 years. According to the stage of change, 26.8 per cent (n = 70) were in preaction stages (precontemplation, contemplation, and preparation) and 73.2 per cent (n = 191) were in action and maintenance stages. The one-way ANOVA revealed that awareness is raising, self-reevaluation, counter conditioning and reinforcing management differed significantly across stages (P < 0.05). However, this difference is not significant for other cognitive and behavioural processes (P > 0.05). According to the findings, increase in the self-efficacy, pros and decrease in cons was found by students' progress in the Physical activity stage of change (P < 0.05). CONCLUSION: Self-efficacy and processes of change are warranted when designing Physical activity stage interventions in the adolescents.

Food Safety Knowledge and Practices of Male Adolescents in West of Iran.

BACKGROUND: Every year many people around the world become infected with food-borne infections. Insufficient knowledge and skills related to food safety and hygiene are among the factors affecting the incidence of food-borne diseases, especially in adolescents. AIM: The purpose of this study was to determine the knowledge and practices associated with food safety and hygiene in Ilam city male adolescents. MATERIAL AND METHODS: Three hundred and eighty of male adolescents aged 13 to 19 were selected randomly and entered the cross-sectional study. Data were collected using a researcher-made questionnaire From December 2016 to February 2017. Descriptive statistics, Pearson correlation, independent t-test and one-way ANOVA were used to analyse the data in SPSS software (version 19.0). RESULTS: The findings of the study showed a positive and significant relationship between knowledge and practices related to food safety and hygiene (r = 0.122; p = 0.018). Also, the findings showed that food safety knowledge and practice of adolescents were significantly affected by the level of their education, parental education level, parental employment status and household economic conditions, (p < 0.005). Also, the results showed that the participants generally obtained 57.74% of the knowledge score and 57.63% of practices score. The subjects had the most knowledge about food supply and storage (60%), and the highest practice was related to personal and environmental hygiene, (61.73%). CONCLUSION: The inadequacy of knowledge and performance of adolescents about food safety and hygiene shows the need for implementation of health education interventions in this area.

An application of a theory of planned behaviour to determine the association between behavioural intentions and safe road-crossing in college students: perspective from Isfahan, Iran.

OBJECTIVE: To identify the determinants of behavioural intention towards safe road-crossing among college students. METHODS: The cross-sectional study was conducted in 2013-14 and comprised students of Isfahan University of Medical Sciences, Isfahan, Iran. A self-administrated questionnaire was distributed among the subjects related to road-crossing based on the theory of planned behaviour. Data was analysed using SPSS 21. RESULTS: Of the 300 questionnaires distributed, 278(92.66%) were returned completed. The mean age of the subjects was 23.16±3.66 years. There were 149(53.6%) females and 129(46.4%) males, with females crossing the street more safely than the males. There was a significant difference between the genders for subjective norms (p=0.001), perceived behavioural control (p=0.002) and behavioural intention (p=0.001), but no differences were traced with respect to attitude towards safe crossing (p=0.597). Results showed a direct and positive correlation between attitude towards safe crossing (r=0.276; p=0.001), subjective norms (r=0.368; p=0.001) and perceived behavioural control (r=0.419; p=0.000) with behavioural intention to safe crossing. CONCLUSIONS: The attitude towards safe crossing and perceived behavioural control had significant effect on behavioural intention among college students.

Physical activity stage-matched intervention: Promoting metabolic control in type 2 diabetes.

BACKGROUND: Regular physical activity has an important role in reducing cardiovascular risk factors and improving metabolic control in patients with type 2 diabetes. This study aims to investigate the effect of physical activity stage-matched intervention on metabolic control in type 2 diabetes patients. MATERIALS AND METHODS: An 8-week physical activity program conducted with 50 type 2 diabetes females who were physically inactive and in precontemplation, contemplation, and preparation stages of change. Participants were divided into intervention and control groups (each group, n = 25). Data were collected by physical activity stage of change questionnaire and metabolic factors were measured by laboratory tests before initiation program. Subsequently, stage-matched physical activity program was conducted for the interventional group. Control group received routine education from the diabetes center. After 8 weeks, physical activity questionnaire filled out by participants and metabolic factors were evaluated by a laboratory test. RESULTS: Findings showed patients in the intervention group and compared with control group significantly moved through stages of change after physical activity program (P-value < 0.05). Evaluation of physical activity after educational program demonstrated that the intervention group adopted regular physical activity more than the control group and also the difference between groups was significant (P-value < 0.05). Our findings indicate a significant relationship between physical activity level and moving in stages of change in the intervention group (P-value < 0.05). Comparison of metabolism factors after physical activity program showed significant decrease in glycosilated hemoglobin in the intervention group than the control group (P-value < 0.05). However, significant differences between groups were not observed in other metabolism factors. CONCLUSION: Designing and implementing physical activity stage-matched intervention can improve metabolic control and management of type 2 diabetes.

Prevalence and related factors for choosing self-medication among pharmacies visitors based on health belief model in Hamadan Province, west of Iran.

BACKGROUND: Self-medication has increased in the last decade in Iran; can be followed several complications. The aim of this study was to determine the prevalence and factors influencing self-medication based on health belief model. METHODS: A cross-sectional study was conducted among 1400 Hamadan Province pharmacies visitors, during spring and summer 2012 which was randomly selected with the proportional to size among different pharmacy at Hamadan for participation in this study. A structured questionnaire was applied for collecting data, which were analyzed by SPSS version 16 using bivariate correlations and logistic regression statistical tests. RESULTS: 35.4% of the participants had self-medication. Pain medication (10.6%), antibiotics (7.3%) and anti-cough and cold medications (4.5%) had the largest consumption. The main reasons of self-medication among participants were previous use of medication, symptoms improve and similar prescribed. The best predictor for self-medication was perceived severity with odds ratio estimate of 0.790 [95% CI: 0.694, 0.900]. CONCLUSION: It seems that designing and implementation of educational programs to increase seriousness about side effect of self-medication may be usefulness of the results in order to prevent of self-medication.