Latent Class Analysis of knowledge, Attitude, and Practice of a Population-Based Sample of Iranian Pregnant Women toward COVID-19.

Background: The aim of the study is to identify latent class (LC)-derived patterns of women's knowledge, attitude, and practice (KAP) toward coronavirus disease 2019 (COVID-19) in Iran. Materials and Methods: This cross-sectional survey of 2029 women, who participated in the PERSIAN Birth Cohort, was conducted in Isfahan, Iran. KAP was assessed by shortened and validated form of a recently used questionnaire in Iran. LC analysis was used to discover underlying response patterns of KAP toward COVID-19 using Mplus 8.0 software. Results: Three classes were identified: Class 1 (n = 514, 25.33%) "Low knowledge and poor practice, Class 2 (n = 423, 22.08%) "Moderate knowledge and proper practice," and Class 3 (n = 1092, 53.82%) "Low knowledge and proper practice." The lowest rate of positive attitude was seen in Class 3. Women living in rural areas, as well as those with lower education, were more likely to member classes with improper practice. Conclusion: The findings suggest that the LCA approach can provide important information reflecting different levels of adoption of protection toward COVID-19 infection. The results may be useful to conducting health-care programs during the outbreaks.

Effects of DNA methylation on cardiometabolic risk factors: a systematic review and meta-analysis.

BACKGROUND: Epigenetic changes, especially DNA methylation have a main role in regulating cardiometabolic disorders and their risk factors. This study provides a review of the current evidence on the association between methylation of some genes (LINE1, ABCG1, SREBF1, PHOSPHO1, ADRB3, and LEP) and cardiometabolic risk factors. METHODS: A systematic literature search was conducted in electronic databases including Web of Science, PubMed, EMBASE, Google Scholar and Scopus up to end of 2020. All observational human studies (cross-sectional, case-control, and cohort) were included. Studies that assessed the effect of DNA methylation on cardiometabolic risk factors were selected. RESULTS: Among 1398 articles, eight studies and twenty-one studies were included in the meta-analysis and the systematic review, respectively. Our study showed ABCG1 and LINE1 methylation were positively associated with blood pressure (Fisher's zr = 0.07 (0.06, 0.09), 95% CI: 0.05 to 0.08). Methylation in LINE1, ABCG1, SREBF1, PHOSPHO1 and ADRB3 had no significant association with HDL levels (Fisher's zr = - 0.05 (- 0.13, 0.03), 95% CI:-0.12 to 0.02). Positive association was existed between LINE1, ABCG1 and LEP methylation and LDL levels (Fisher's zr = 0.13 (0.04, 0.23), 95% CI: 0.03 to 0.23). Moreover, positive association was found between HbA1C and ABCG1 methylation (Fisher's zr = 0.11 (0.09, 0.13), 95% CI: 0.09 to 0.12). DNA methylation of LINE1, ABCG1 and SREBF1 genes had no significant association with glucose levels (Fisher's zr = 0.01 (- 0.12, 0.14), 95% CI:-0.12 to 0.14). CONCLUSION: This meta-analysis showed that DNA methylation was associated with some cardiometabolic risk factors including LDL-C, HbA1C, and blood pressure. REGISTRATION: Registration ID of the protocol on PROSPERO is CRD42020207677 .

Knowledge, Attitudes, and Practices toward COVID-19 among Persian Birth Cohort Participants.

BACKGROUND: Knowledge, attitudes, and practices (KAP) toward COVID-19 play an important role in controlling the outbreak. The present study aimed to investigate the KAP of a group of women toward COVID-19 during the second wave of the outbreak in Iran. METHOD AND MATERIAL: A cross-sectional survey of 2862 women was conducted in May and June 2020 in two centers of Persian birth cohort. The survey instrument was a self-reported questionnaire Multivariable linear regression analysis to identify factors associated with knowledge and practice. toward COVID-19 and multinomial logistic regression analyses to identify factors associated with attitudes. Unstandardized regression coefficients (ß) and odds ratios and their 95% confidence intervals were used to quantify the associations between variables and KAP. RESULT: Good knowledge and optimistic attitudes toward the successful control of COVID-19 was seen among participants. Overall, about 57.3% (1640), 41.1% (1176), and 1.6% (46) of respondents were categorized as low (score <50%), moderate (score: 50%-80%), and high (score > 80%) proper practice, respectively. Eighty-five individuals with COVID-19 experience (3.0%) had lower knowledge score (79.91 ± 17.93 vs. 83.81 ± 13.88, P < 0.001) and lower proper practice score (40.22 ± 16.57 vs. 47.96 ± 16.15, respectively, P < 0.001) compared to those who were not infected. A higher level of knowledge was associated with appropriate practice in both groups of positive attitudes (χ2 = 32.23, P < 0.001) and negative attitudes (χ2 = 31.49, P < 0.001). CONCLUSION: This survey recorded good knowledge and relatively good attitudes among women. Special health policies plan should be taken for target populations among women during the COVID-19 pandemic.

Evaluating Community-Based Programs in Promoting Traffic Behaviors and Safe Road Crossing Behaviors in Youth: An Application on Theory of Planned Behavior.

BACKGROUND: Today, one of the most serious causes of mortality and disability among youth is the traffic accidents. Regarding its importance, this paper aimed to investigate the community-based program to promote the safe traffic behaviors among youth. METHODS: This was a quasi-experimental conducted on 5000 youth in five Iranian cities named Lanjan, Gomishan, Fasa, Tehran, and Zahedan in 2015-2016. The questionnaire was based on the constructs of the theory of planned behavior as well as a questionnaire of pedestrian behavior and driving behavior, which was completed before and after the intervention. The educational intervention was carried out based on the theory of planned behavior. Finally, the obtained data were analyzed using STATA software. RESULTS: Six months after the intervention, the mean score of the theory of planned behavior and safe driving behavior in different cities was significantly increased. Here, regarding the safe crossing of the street, the most behavioral changes were observed in Gomishan (P = 0.000), Fasa (P = 0.001), and Tehran (P < 0.0001). The mean score of driving behaviors in Gomishan (P < 0.000), Fasa (P = 0.016), Lanjan (P = 0.047), and Tehran (P < 0.0001) scores was significantly higher. CONCLUSIONS: In most of the studied cities, it can be concluded that education based on the theory of planned behavior can improve the safe driving behaviors among youth. Therefore, it is recommended to be implemented this program in other cities using the theory of planned behavior.

Factors Associated with Screen Time in Iranian Children and Adolescents: The CASPIAN-IV Study.

BACKGROUND: Prolonged screen time is frequent in children and adolescents. Implementing interventions to reduce physical inactivity needs to assess related determinants. This study aims to assess factors associated with screen time in a national sample of children and adolescents. METHODS: This nationwide study was conducted among 14,880 students aged 6-18 years. Data collection was performed using questionnaires and physical examination. The World Health Organization-Global School Health Survey questionnaire was used. Logistic regression analysis was used to examine the relationship between demographic variables, socioeconomic status (SES), family structure, physical activity, unhealthy eating habits, body mass index, and mental distress with screen time. RESULTS: The participation rate was 90.6% (n = 13,486), 50.8% were male, and 75.6% lived in urban areas. Mean (standard deviation) age of participants was 12.47 (3.36) years. The SES, eating junk foods, urban residence, and age had significant association with screen time, watching television (TV), and computer use (P < 0.05). With increasing number of children, the odds ratio of watching TV reduced (P < 0.001). Statistically, significant association existed between obesity and increased time spent watching TV (P < 0.001). Girls spent less likely to use computer and to have prolonged screen time (P < 0.001). Participants in the sense of worthlessness were less likely to watch TV (P = 0.005). Screen time, watching TV, and using computer were higher in students with aggressive behaviors (P < 0.001); screen time was higher in those with insomnia. CONCLUSIONS: In this study, higher SES, unhealthy food habits, and living in urban areas, as well as aggressive behaviors and insomnia increased the risk of physical inactivity.

Assessment of Mental Health among Iranian Medical Students: A Cross-Sectional Study.

OBJECTIVES: More mental morbidities were reported in medical students than their nonmedical peers, which may negatively influence their lives and future career. The aim of this study was to assess the mental health status among medical students of Shiraz University of Medical Sciences. METHOD: Two hundred and eight 1(st) to 4(th) year Medical students took part in this cross-sectional study. General Health Questionnaire with 28 items (GHQ-28) was used for data collection. We performed descriptive statistics, Mann Whitney U test, one way ANOVA and Tukey's post hoc and Kruskal Wallis H and Chi square test for statistical analysis. RESULTS: The mean age of participants was 20.70 ± 1.14 (mean ± SD) years. More than half of them (54.4%) had total GHQ score above the cut-off point considered as probably abnormal mental health status. Years of education, positive family history and low satisfaction of the medicine discipline affected their mental health. Third and fourth year students had significantly higher mean scores of total GHQ (p-value = 0.009) and anxiety, somatic and social subscales (p-value = 0.001, 0.004 and 0.026). Students with positive family history of mental illness and low satisfaction of field of the study significantly had higher GHQ scores (p-value = 0.012 and < 0.001 respectively). CONCLUSION: Poor mental health prevalence is high among medical students in Shiraz. Proper changes in educational programs and other effective interventions to raise the students' satisfaction may reduce the effect of other stress reasons and improve their mental health status.

Factor structure of the General Health Questionnaire-28 (GHQ-28) from infertile women attending the Yazd Research and Clinical Center for Infertility.

BACKGROUND: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group. OBJECTIVE: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women. MATERIALS AND METHODS: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. RESULTS: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90. CONCLUSION: Analysis of the factor structure and reliability of General Health Questionnaire-28 showed that it is suitable as a screening instrument for assessing general health of infertile women.

Development of a Questionnaire to Assess Drug Abuse among High School Students of Isfahan Province, Iran: An Action Research.

BACKGROUND: Considering the problem of drug abuse in Iran especially in adolescents and the youth, recent alterations in drug abuse rate and its trend, the necessity to have local information about this problem, applied research has a determining role in management of this problem and making proper decisions. Therefore, the current study was conducted to develop a questionnaire to assess the status of drug abuse among high school students of Isfahan Province, Iran. METHODS: This cross-sectional study was conducted out in 2009 in 20 cities of Isfahan Province. A researcher-made questionnaire was developed to determine knowledge, attitude, and practice of high school students regarding addictive drugs and their associated causes. This was accomplished by recruiting 7137 students who were selected by multistage random cluster sampling. RESULTS: The designed questionnaire identified the status quo of drug abuse according to age, gender, and different cities of Isfahan Province. We also accessed information about the type of abused drug, the most common causes of drug abuse for the first time, the most important causes of drug abuse, mean age of abusers and mean age at the first abuse, common time and locations of drug abuse, and the most common routes of drug abuse according to gender as well as urban and rural areas of Isfahan Province. Reliability of the questionnaire, based on the calculated Cronbach's alpha coefficient, was 77% considering a cut-off point of 0.07. CONCLUSIONS: According to the obtained results, the designed questionnaire is capable to assess the drug abuse status among high school students of Isfahan Province. Regarding the importance of teenage years in forming the future behaviors of adolescents and the opportunities provided at schools, it is prudent to pay more attention to interventions in this age group in order to increase their knowledge and correct their attitude toward illegal drugs and strengthening their confidence in this regard. These interventions can have an important role in decreasing the rate of drug abuse in this age group and consequently in the whole community.