Factors predicting self-care behavior of cardiovascular patients during the COVID-19 epidemic.

BACKGROUND: The COVID-19 virus has had wide-ranging effects on all healthcare systems and a direct impact on all areas of human life in all countries around the world. Therefore, it is necessary to take preventive actions to reduce the prevalence and severity of the complications associated with this disease. The purpose of this study was to explain the dimensions of adopting general self-care behaviors (mask-wearing, social distancing, hand hygiene, and home quarantine) for preventing COVID-19 based on the theory of planned behavior (TPB) in cardiovascular patients. METHODS: This was a descriptive-analytical study conducted with the participation of 420 patients referring to health and treatment centers of Ahvaz, southwest of Iran, in 2022. Sampling was done using a non-random (convenience) method. The data collection tool was a questionnaire containing items addressing demographic characteristics, questions related to the TPB, and questions dealing with the adoption of everyday self-care behaviors against contracting COVID-19. Data were analyzed using descriptive and inferential statistical methods (prevalence, mean, standard deviation, Pearson's correlation coefficient, and linear regression) in SPSS version 25. RESULTS: The results of this study showed that the rate of adoption of self-care behaviors against COVID-19 among cardiovascular patients was moderate. The results also showed that among the constructs of the TPB, Perceived behavioral control, Subjective norms, and Perceived behavioral intention were the most important predictors of adopting self-care behaviors among cardiovascular patients with a change variance of 46%. CONCLUSIONS: The results of the present study have implications for health and treatment policy makers as well as planners of educational and behavioral interventions aimed at promoting the adoption of self-care behaviors against COVID-19. In this respect, managing and institutionalizing desirable behaviors among cardiovascular patients could be beneficial from economic, social, and health-related aspects.

A self-stiffening compliant intracortical microprobe.

Utilising a flexible intracortical microprobe to record/stimulate neurons minimises the incompatibility between the implanted microprobe and the brain, reducing tissue damage due to the brain micromotion. Applying bio-dissolvable coating materials temporarily makes a flexible microprobe stiff to tolerate the penetration force during insertion. However, the inability to adjust the dissolving time after the microprobe contact with the cerebrospinal fluid may lead to inaccuracy in the microprobe positioning. Furthermore, since the dissolving process is irreversible, any subsequent positioning error cannot be corrected by re-stiffening the microprobe. The purpose of this study is to propose an intracortical microprobe that incorporates two compressible structures to make the microprobe both adaptive to the brain during operation and stiff during insertion. Applying a compressive force by an inserter compresses the two compressible structures completely, resulting in increasing the equivalent elastic modulus. Thus, instant switching between stiff and soft modes can be accomplished as many times as necessary to ensure high-accuracy positioning while causing minimal tissue damage. The equivalent elastic modulus of the microprobe during operation is ≈ 23 kPa, which is ≈ 42% less than the existing counterpart, resulting in ≈ 46% less maximum strain generated on the surrounding tissue under brain longitudinal motion. The self-stiffening microprobe and surrounding neural tissue are simulated during insertion and operation to confirm the efficiency of the design. Two-photon polymerisation technology is utilised to 3D print the proposed microprobe, which is experimentally validated and inserted into a lamb's brain without buckling.

A SWOT analysis of the development of health technology assessment in Iran.

BACKGROUND: Health systems need to prioritize their services, ensuring efficiency and equitable health provision allocation and access. Alongside, health technology assessment (HTA) seeks to systematically evaluate various aspects of health technologies to be used by policy- and decision-makers. In the present study, we aim to identify strengths, weaknesses, opportunities, and threats in developing an HTA in Iran. METHOD: This qualitative study was conducted using 45 semi-structured interviews from September 2020 to March 2021. Participants were selected from key individuals involved in health and other health-related sectors. Based on the objectives of the study, we used purposive sampling (snowball sampling) to select individuals. The range of length of the interviews was between 45 to 75 minutes. Four authors of the present study carefully reviewed the transcripts of interviews. Meanwhile, the data were coded on the four domains of strengths, weaknesses, opportunities, and threats (SWOT). Transcribed interviews were then entered into the software and analyzed. Data management was performed using MAXQDA software, and also analyzed using directed content analysis. RESULTS: Participants identified eleven strengths for HTA in Iran, namely the establishment of an administrative unit for HTA within the Ministry of Health and Medical Education (MOHME); university-level courses and degrees for HTA; adapted approach of HTA models to the Iranian context; HTA is mentioned as a priority on the agenda in upstream documents and government strategic plans. On the other hand, sixteen weaknesses in developing HTA in Iran were identified: unavailability of a well-defined organizational position for using HTA graduates; HTA advantages and its basic concept are unfamiliar to many managers and decision-makers; weak inter-sectoral collaboration in HTA-related research and key stakeholders; and, failure to use HTA in primary health care. Also, participants identified opportunities for HTA development in Iran: support from the political side for reducing national health expenditures; commitment and planning to achieve universal health coverage (on behalf of the government and parliament); improved communication among all stakeholders engaged in the health system; decentralization and regionalization of decisions; and capacity building to use HTA in organizations outside the MOHME. High inflation and bad economic situation; poor transparency in decisions; lack of support from insurance companies; lack of sufficient data to conduct HTA research; rapid change of managers in the health system; and economic sanctions against Iran are threats to the developmental path of HTA in Iran. CONCLUSION: HTA can be properly developed in Iran if we use its strengths and opportunities, and address its weaknesses and threats.

Predictors of Smoking Preventive Behavior Based on Empowerment Components among Male Students of High Schools: A Cross-Sectional Study in Iran.

Background: Smoking among adolescents and young adults is believed to be one of the most important preventable health problems. The etiology of smoking is one of the most pivotal activities in designing prevention programs. The aim of this study was to determine the correlates between components of empowerment in the context of smoking prevention in adolescents. Methods: This cross-sectional descriptive study was carried out on 422 high school male students in spring 2020. The data collection tool of this study was a valid and reliable researcher-made questionnaire containing demographic characteristics, items related to various components of empowerment, and items related to the smoking preventive behavior (SPB). A linear regression model was used, where the "SPB" outcome variable assumed three possible values: sensation seeking, problem-solving skills, self-efficacy, self-esteem, dependence on group, and attitude towards smoking reported in the previous literature were taken as independent variables, and smoking preventive behavior was considered as a dependent variable. Results: The results revealed that 10.42% of the students were active smokers and 40.75% of them had the experience of smoking. The results also showed a positive and significant relationship between problem-solving skills (r = 0.394, P < 0.001), self-efficacy (r = 0.340, P < 0.001), self-esteem (r = 0.310, P < 0.001), and attitude (r = 0.333, P < 0.001) with the SPB. In addition, a negative and significant correlation was observed between group dependence (r = -0.313, P < 0.001) and the SPB. Overall, the components of empowerment were able to explain 26.5% of the variance in the SPB. Among the components, problem-solving skills solely explained 15.5% of variance of the SPB. Conclusion: According to the results of this study, it can be said that most adolescents are at risk of smoking. Explanatory factors for adopting the SPB include improving problem-solving skills, creating a negative attitude towards smoking, increasing self-efficacy to prevent smoking, reducing group dependence, and increasing self-esteem in adolescents. Multilevel interventions and actions by policymakers, educators, and related organizations to prevent adolescent smoking and educate them about adolescent empowerment skills to prevent smoking should be considered.

Neural tissue-microelectrode interaction: Brain micromotion, electrical impedance, and flexible microelectrode insertion.

Insertion of a microelectrode into the brain to record/stimulate neurons damages neural tissue and blood vessels and initiates the brain's wound healing response. Due to the large difference between the stiffness of neural tissue and microelectrode, brain micromotion also leads to neural tissue damage and associated local immune response. Over time, following implantation, the brain's response to the tissue damage can result in microelectrode failure. Reducing the microelectrode's cross-sectional dimensions to single-digit microns or using soft materials with elastic modulus close to that of the neural tissue are effective methods to alleviate the neural tissue damage and enhance microelectrode longevity. However, the increase in electrical impedance of the microelectrode caused by reducing the microelectrode contact site's dimensions can decrease the signal-to-noise ratio. Most importantly, the reduced dimensions also lead to a reduction in the critical buckling force, which increases the microelectrode's propensity to buckling during insertion. After discussing brain micromotion, the main source of neural tissue damage, surface modification of the microelectrode contact site is reviewed as a key method for addressing the increase in electrical impedance issue. The review then focuses on recent approaches to aiding insertion of flexible microelectrodes into the brain, including bending stiffness modification, effective length reduction, and application of a magnetic field to pull the electrode. An understanding of the advantages and drawbacks of the developed strategies offers a guide for dealing with the buckling phenomenon during implantation.

The Effect of an Educational Intervention Program on the Adoption of Low Back Pain Preventive Behaviors in Nurses: An Application of the Health Belief Model.

Study Design Randomized controlled trial. Objective The purpose of this study was to identify the effect of a theory-based educational intervention program on the level of knowledge and Health Belief Model (HBM) constructs among nurses in terms of the adoption of preventive behaviors. Methods This pretest/posttest quasi-experimental study was conducted on 100 nurses who were recruited through the multistage sampling method. The nurses were randomly assigned to intervention and control groups. The participants were evaluated before and 3 months after the educational intervention. A multidimensional questionnaire was prepared based on the theoretical structures of the HBM to collect the data. Data analysis was performed using descriptive and inferential statistics. Results There was no significant difference in the mean values of HBM constructs prior to the intervention between the intervention and control groups. However, after the administration of the educational program, the mean scores of knowledge and HBM constructs significantly increased in the intervention group when compared with the control group (p < 0.0001). Conclusion The results of the current study revealed that the educational intervention based on the HBM was effective in improving the nurses' scores of knowledge and HBM constructs; therefore, theory-based health educational strategies are suggested as an effective alternative to traditional educational interventions.

Prevalence of preterm labor in Iran: A systematic review and meta-analysis.

BACKGROUND: Preterm labor, which defines as live-birth delivery before 37 weeks of gestation is a main determinant of neonatal morbidity and mortality around the world. OBJECTIVE: The aim of this study was to determine the prevalence of preterm labor in Iran by a meta-analysis study, to be as a final measure for policy makers in this field. MATERIALS AND METHODS: In this meta-analysis, the databases of Thomson database (Web of Knowledge), PubMed/Medline, Science Direct, Scopus, Google Scholar, Iranmedex, Scientific Information Database (SID), Magiran, and Medlib were searched for articles in English and Persian language published between 1995 and 2014. Among the studies with regard to the inclusion and exclusion criteria, 14 studies (out of 1370 publications) were selected. Data were analyzed by using Stata software version 11. The heterogeneity of reported prevalence among studies was evaluated by the Chi-square based Q test and I2 statistics. RESULTS: The results of Chi-square based on Q test and I2 statistics revealed severe heterogeneity (Q=2505.12, p-value < 0.001 and I2= 99.5%) and consequently, the random effect model was used for the meta-analysis. Based on the random effect model, the overall estimated prevalence of preterm in Iran was 9.2% (95% CI: 7.6 - 10.7). CONCLUSION: Present study summarized the results of previous studies and provided a comprehensive view about the preterm delivery in Iran. In order to achieve a more desirable level and its reduction in the coming years, identifying affecting factor and interventional and preventive actions seem necessary.