Lipid variability and risk of microvascular complications in patients with diabetes: a systematic review and meta-analysis.

BACKGROUND AND AIMS: The current systematic review aimed to elucidate the effects of lipid variability on microvascular complication risk in diabetic patients. The lipid components studied were as follows: High-density lipoprotein (HDL), High-density lipoprotein (LDL), Triglyceride (TG), Total Cholesterol (TC), and Remnant Cholesterol (RC). METHOD: We carried out a systematic search in multiple databases, including PubMed, Web of Science, and SCOPUS, up to October 2nd, 2023. After omitting the duplicates, we screened the title and abstract of the studies. Next, we retrieved and reviewed the full text of the remaining articles and included the ones that met our inclusion criteria in the study. RESULT: In this research, we examined seven studies, comprising six cohort studies and one cross-sectional study. This research was conducted in Hong Kong, China, Japan, Taiwan, Finland, and Italy. The publication years of these articles ranged from 2012 to 2022, and the duration of each study ranged from 5 to 14.3 years. The study group consisted of patients with type 2 diabetes aged between 45 and 84 years, with a diabetes history of 7 to 12 years. These studies have demonstrated that higher levels of LDL, HDL, and TG variability can have adverse effects on microvascular complications, especially nephropathy and neuropathic complications. TG and LDL variability were associated with the development of albuminuria and GFR decline. Additionally, reducing HDL levels showed a protective effect against microalbuminuria. However, other studies did not reveal an apparent relationship between lipid variations and microvascular complications, such as retinopathy. Current research lacks geographic and demographic diversity. Increased HDL, TG, and RC variability have been associated with several microvascular difficulties. Still, the pathogenic mechanism is not entirely known, and understanding how lipid variability affects microvascular disorders may lead to novel treatments. Furthermore, the current body of this research is restricted in its coverage. This field's lack of thorough investigations required a more extensive study and comprehensive effort. CONCLUSION: The relationship between lipid variation (LDL, HDL, and TG) (adverse effects) on microvascular complications, especially nephropathy and neuropathic (and maybe not retinopathy), is proven. Physicians and health policymakers should be highly vigilant to lipid variation in a general population.

Cardiovascular anomalies in patients with Tessier syndrome: a systematic review.

Tessier clefts are skeletal and soft tissue abnormalities of a neonate's facial structures. They could be classified as syndromic and non-syndromic clefts, which can be attributed to disruptions in fetal development and genetic mutations, respectively. Reported cases of these clefts typically document the presence of additional abnormalities associated with these clefts. In this systematic review, we analyzed reports of Tessier clefts accompanied by cardiovascular anomalies, as one of the commonly encountered anomalies. We systematically searched PubMed (MEDLINE), Scopus, Web of Science, Science Direct, and Google Scholar. We selected and included case reports, case series, and case reviews on patients with Tessier cleft and cardiovascular anomalies. The critical appraisal of the included studies was performed by two independent investigators using the Consensus-based Clinical Case Reporting Guideline Development (CARE) checklist. Overall, 20 reports (18 case reports and 2 case series) were eligible for inclusion in this review. Tessier clefts 3 and 30 were the most commonly observed. In addition, the most prevalent cardiovascular anomalies consisted of the ventricular septal defect (VSD), double-outlet right ventricle, and atrial septal defect (ASD). Most of the patients received cosmetic and cardiovascular surgeries. However, some were not proper candidates for cardiovascular surgery because of their unstable condition and therefore did not survive.   Conclusion: Regardless of the focus placed on the cleft and subsequent plastic surgery procedures in these cases, it is important to prioritize other abnormalities that may be associated with mortality. A complete cardiovascular system and associated disorders assessment should be performed before facial cosmetic surgeries. What is Known: • Tessier clefts are congenital defects in the soft tissues and bones of the face and like many other congenital defects, they are accompanied by defects in other parts of the body. • In the current literature, the emphasis is on clefts and the cosmetic issues rather than the coinciding defects, particularly cardiovascular anomalies. What is New: • Review the cardiovascular anomalies that are commonly encountered in patients with Tessier clefts.

Immunologic aspects of migraine: A review of literature.

Migraine headaches are highly prevalent, affecting 15% of the population. However, despite many studies to determine this disease's mechanism and efficient management, its pathophysiology has not been fully elucidated. There are suggested hypotheses about the possible mediating role of mast cells, immunoglobulin E, histamine, and cytokines in this disease. A higher incidence of this disease in allergic and asthma patients, reported by several studies, indicates the possible role of brain mast cells located around the brain vessels in this disease. The mast cells are more specifically within the dura and can affect the trigeminal nerve and cervical or sphenopalatine ganglion, triggering the secretion of substances that cause migraine. Neuropeptides such as calcitonin gene-related peptide (CGRP), neurokinin-A, neurotensin (NT), pituitary adenylate-cyclase-activating peptide (PACAP), and substance P (SP) trigger mast cells, and in response, they secrete pro-inflammatory and vasodilatory molecules such as interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) as a selective result of corticotropin-releasing hormone (CRH) secretion. This stress hormone contributes to migraine or intensifies it. Blocking these pathways using immunologic agents such as CGRP antibody, anti-CGRP receptor antibody, and interleukin-1 beta (IL-1ß)/interleukin 1 receptor type 1 (IL-1R1) axis-related agents may be promising as potential prophylactic migraine treatments. This review is going to summarize the immunological aspects of migraine.

Facilitators and barriers of herbal medicine use in diabetic patients: A qualitative study.

BACKGROUND: In several countries such as Iran, the use of complementary and alternative medical products like herbal medicine is growing. There is, however, a lack of research on the prospects of herbal medicine patrons regarding facilitators and herbal medicine use barriers. The aim of this study was to explain the facilitators and the barriers of herbal medicine use in type 2 diabetes mellitus (T2DM) patients. MATERIALS AND METHODS: Qualitative one-to-one in-depth interviews were conducted with patients with T2DM from the Yazd Diabetes Research Center, using a semi-structured guide. For the recruitment of T2DM participants who used herbal medicine beside conventional medicine, purposeful sampling was used. Analysis of the data was carried out using the steps proposed by Graneheim and Landman strategies. RESULTS: Sixteen patients were interviewed. There were 2 subjects (facilitators and barriers herbal medicine use), 8 categories, and 89 initial codes. The facilitators included individual preferences, preparation skills, and family support and the factors obstructing the use of herbal medicine included insufficient skills about preparing, lack of easy access to consumption, insufficient of efficacy of herbal medicine, and negative properties of herbal medicine and taking time in preparing herbal medicine. CONCLUSION: Although some people use herbal medicine, the interest in use of herbal medicine is limited because of inadequate awareness of the impact and usage them. Therefore, the use of effective strategy in the integration of herbal remedies with conventional medicine can promote well-being of patients.

Incentives to Reduce Salt Intake Resulting From Women's Experiences: A Qualitative Study.

INTRODUCTION: Over consumption of salt adversely affects health and is associated with some diseases. Salt over consumption has been reported to be higher in Asian countries including Iran. This research aimed to identify the facilitative factors of reduced salt consumption among 20-65 year-old women to develop effective educational interventions. Methods: This research used qualitative content analysis. We included 42 (31 women aged 20-65 years residing in Hamidia, Yazd and 11 healthcare providers) using Purposeful sampling method. Data were collected through focal group discussions (three groups of 6) and in-depth semi-structured individual interviews with 24 Participants. Data analysis was done using Graneheim and Lundman's approach. Results: Motivators and facilitators were extracted. The former consisted of sub-categories: physical fitness and healthcare, obtaining others' approval, family cooperation and support, internal motivators, contextual motivators and healthcare staff support. Sub-categories of the latter were gaining more information from different instructions, willingness to acquire self-protection skills and nutritional advice. These factors affected to reduce the salt intake among women. Conclusion: In the light of the qualitative results of motivating and facilitating factors, it is essential to enhance internal motivators and increase access to information via different communicative channels in community including schools, medical care providers and public associations. It is also necessary to pave the way for more family and medical staff support, provide appropriate educational and advertising programs, raise women's awareness and change their attitude and behavior with this concern.

Determining Skin Cancer Protective Behaviors in the Light of the Protection Motivation Theory among Sailors in Bandar-Bushehr in the South of Iran.

BACKGROUND: Skin cancer is among the most prevalent cancers in Iran and worldwide. Due to the nature of work, sailors are constantly exposed to the ultraviolet rays of the sun, which in the long run damages their skin and raises the chances of skin cancer. Thus, the present research aimed to predict the skin cancer protective behaviors among sailors in the south of Iran in the light of the protection motivation theory. MATERIALS AND METHODS: The present analytical, cross-sectional research was conducted on 360 sailors in Bandar-Bushehr selected randomly from 4 border healthcare centers. To collect the required data, a reliable and valid questionnaire based on the protection motivation theory was used. The data were analyzed in SPSS21 using descriptive and inferential statistics including Pearson correlation coefficient and linear regression analysis. RESULTS: Pearson correlation coefficient showed a statistically significant positive correlation between protection motivation, perceived severity, fear, reward on the one hand and a statistically significant negative correlation between protection motivation and rewards and response costs. All constructs of protection motivation explained 43% of the variance of skin cancer protective behaviors. Among the influential predictors, perceived self-efficacy showed to be the strongest (ß=0.328). CONCLUSION: Considering the effectiveness of the protection motivation theory in determining skin cancer preventive behaviors among sailors, it can be concluded that this theory can be used as a framework in planning health education and promotion programs to motivate sailors to adopt more skin cancer protective behaviors.

A survey on the enablers and nurturers of physical activity in women with prediabetes.

BACKGROUND AND OBJECTIVE: Metabolic syndrome, especially prediabetes, is one of the most common health problems due to incomplete glucose metabolism that has a direct relationship with lifestyle. This study was conducted to determine the factors that enable and nurture physical activity in women with prediabetes based on the PEN-3 model. MATERIAL AND METHOD: This descriptive-analytical study was conducted on 41 prediabetic women aged 30-65 years and 9 service providers in health centers. Data were collected from a semi-structured individual interview based on the PEN-3 model. The Graneheim and Lundman method was used to analyze the data. RESULTS: During data analysis, two main themes that include enabling factors and nurturing factors in the domain of physical activity and 6 classes including enablers (positive, negative, and existential) and nurturers (positive, negative, and existential) were extracted from the data content. CONCLUSION: By determining enablers and nurturers, the providers of services can facilitate the participation of prediabetic women in physical activity by applying positive social and structural effects and also to eliminate negative environmental conditions.

Comparison of spectral and spatial-based approaches for mapping the local variation of soil moisture in a semi-arid mountainous area.

Accurate information on soil moisture (SM) is critical in various applications including agriculture, climate, hydrology, soil and drought. In this paper, various predictive relationships including regression (Multiple Linear Regression, MLR), machine learning (Random Forest, RF; Triangular regression, Tr) and spatial modeling (Inverse Distance Weighing, IDW and Ordinary kriging, OK) approaches were compared to estimate SM in a semi-arid mountainous watershed. In developing predictive relationship, Remote Sensing datasets including Landsat 8 satellite imagery derived surface biophysical characteristic, ASTER digital elevation model (DEM) derived surface topographical characteristic, climatic data recorded at the synoptic station and in situ SM data measured at Landsat 8 overpass time were utilized, while in spatial modeling, point-based SM measurements were interpolated. While 70%(calibration set) of the measured SM data were used for modeling, 30%(validation set) were used to evaluate modeling accuracy. Finally, the SM uncertainty maps were created for different models based on a bootstrapping approach. Among the environmental parameter sets, land surface temperature (LST) showed the highest impact on the spatial distribution of SM in the region at all dates. Mean R2(RMSE) between measured and modeled SM on three dates obtained from the MLR, RF, IDW, OK, and Tr models were 0.70(1.97%), 0.72(1.92%), 0.59(2.38%), 0.59(2.27%) and 0.71(1.99%), respectively. The results showed that RF and IDW produced the highest and lowest performance in SM modeling, respectively. Generally, the performance of RS-based models was higher than interpolation models for estimating SM due to the influence from combination of topographic parameters and surface biophysical characteristics. Modeled SM uncertainty with different models varies in the study area. The highest uncertainty in SM modeling was observed at the north part of the study area where the surface heterogeneity is high. Using RS data increased the accuracy of SM modeling because they can capture the surface biophysical characteristics and topographical properties heterogeneity.

Improved digital soil mapping with multitemporal remotely sensed satellite data fusion: A case study in Iran.

Modeling and mapping of soil properties are critical in many environmental, climatic, ecological and hydrological applications. Digital soil mapping (DSM) techniques are now commonly applied to predict soil properties with limited data by developing predictive relationships with environmental covariates. Most studies derive covariates from a digital elevation model (named static covariates). Many works also include single-day remotely sensed satellite imagery. However, multitemporal satellite images can capture information about soil properties over time and bring additional information in predicting soil properties in DSM. We refer to covariates derived from multitemporal satellite images as dynamic covariates. The objective of this study was to assess the performance of DSM when using terrain derivatives (static covariates), single-date remotely sensed satellite indices (limited dynamic covariates), multitemporal satellite indices (dynamic covariates), and combinations of terrain derivatives and satellite indices (covariate fusion) as covariates in predicting soil properties and estimating uncertainty. Three soil properties are considered in this study: organic carbon (OC), sand content, and calcium carbonate equivalent (CCE). Inclusion of single and/or multitemporal remotely sensed satellite indices improved the prediction of soil properties over traditionally used terrain indices. Significant improvements were observed in the prediction of soil properties using two models, Cubist and random forest (RF). The increase in the R2 values for Cubist and RF were 126% and 78% for OC, 110% and 54% for sand, and 87% and 32% for CCE. The RMSE decreased by 34% and 27% for OC, 25% and 12% for sand, and 39% and 19% for CCE, when compared to the terrain indices only model. This also reduced the uncertainty of estimation and mapping. These clearly showed the advantage of using multitemporal satellite data fusion rather than simply using static terrain indices for DSM of soil properties to deliver a great potential in improving soil modeling and mapping for many applications.

Determiners of fast-food consumption in Iranian university students: Application of prototype/willingness model.

BACKGROUND: Today, marked by advanced scientific approach, urbanism, and changing life style, there is an ever-growing rate of fast-food consumption, which has significantly affected public health. Hence, the present research aimed to predict factors involved in fast-food consumption in light of the prototype/willingness model among the students of Rafsanjan University of Medical Sciences. MATERIALS AND METHODS: In the present descriptive/analytical research conducted in 2018-2019, 350 students in Rafsanjan University of Medical Sciences were selected through proportionate stratified random sampling. The required data were collected using a self-administrated questionnaire in light of the constructs within the prototype/willingness model and fast-food consumption behavior. The data were analyzed in SPSS version 16.0 using descriptive and inferential statistics including mean scores, standard deviation, correlation coefficient, and linear regression. RESULTS: Behavioral intention of fast-food consumption showed to be positively correlated with positive willingness, positive prototype, positive subjective norms, and positive attitude toward fast-food consumption. Furthermore, the correlation between positive behavioral intention of consuming fast food and positive subjective norms and positive attitude toward fast-food consumption was statistically significant (P < 0.05). The underlying constructs of prototype/willingness model altogether managed to explain 13% of the total variance of fast-food consumption behavior. Behavioral intention showed to be the strongest predictor of the behavior (ß = 1.613). CONCLUSION: It is suggested that the preventive measures aimed to reduce fast-food consumption among the youth focus more on strengthening negative attitudes and subjective norms concerning fast-food consumption.

Predictors of mammography based on Health Belief Model in Khorramabad women.

BACKGROUND: Health beliefs play an important role in people's willingness to participate in health-promoting behaviors. Given the role of beliefs in women's function and the importance of the benefits of mammogram, and because the predictors of a behavior are a major prerequisite to codification of an effective prevention program, the present study was conducted with the aim of predicting mammography based on Health Belief Model (HBM) in women in Khorramabad. MATERIALS AND METHODS: In this cross-sectional study, 262 women referring to health centers in Khorramabad, Lorestan province, in 2018, were selected by randomly sampling. The data collection tool was a four-part questionnaire including demographic information, knowledge on breast cancer and mammography, Champion's Health Belief Model, and Champion's Self-Efficacy Questionnaire for Mammography. Validity and reliability of the tool were investigated and confirmed. Data were analyzed by version 16 of SPSS software using descriptive statistics, Chi-squared test, and multiple logistic regression. RESULTS: The mean (standard deviation) age of the participants was 49.26 (±7.79) years. Seventy-nine (30.85%) of the 262 participants reported mammography. Constructs' sensitivity, benefits, barriers, and perceived self-efficacy were significantly different in terms of performing mammography (P < 0.05). Participants with a history of breast cancer (odds ratio [OR] = 11.18, 95% confidence interval [CI] = [3.73-33.46]) had lower perceived barriers (OR = 3.54, 95% CI= [1.77-7.09]), were more likely to undergo mammography than women with no family history of breast cancer, and had moderate-to-high perceived barriers (P < 0.001). CONCLUSION: The results of this study indicate that health managers are required to pay more attention to training and promoting screening methods. Understanding the barriers to mammography in women by managers can help design and implement effective programs that enhance mammography in women.

Evaluation of Educational intervention on Standard Precautions among Healthcare Provider Based on Health Belief Model

Background and objective: Occupational exposure makes healthcare provider at risk of a variety of infections such as AIDS, Hepatitis B, and Hepatitis C. This study investigated the effect of educational intervention on standardized precautionary behaviors in healthcare provider based on health belief model, in Jam city, Iran during 2016. Methods: This experimental study was carried out on Tohid hospital staff and health care provider of Jam`s health center. Random stratified sampling based on different occupation designated into two groups, intervention (n=50) and control (n=50). After confirming the validity and reliability of the data collection tool, the educational intervention was examined before and after the intervention. Data were analyzed using descriptive statistical methods, independent t-test and one-way ANOVA (SPSS 20). Results: The results revealed that the healthcare provider did not have any previous educational background on standardized precautionary (34.3%). Furthermore, the history of needle stick injuries (42.5%) and contact with patients' body fluids (17.5%) were reported. Educational intervention regarding to standardized precautions in the intervention group was significantly increased the mean score of knowledge constructs, perceived sensitivity, perceived severity, perceived benefits, perceived barriers and behaviors. However, no significant changes were observed in increasing the self-efficacy the score. Conclusion: The results indicate the effectiveness of educational intervention on standard precautionsamong healthcare provider based on health belief model. Educational program based on promotion behavioral pattern in relation to standard precautionsis recommended to the healthcare provider

Evaluating perceived threat of skin cancer and preventive measures in South Iranian sailors: A qualitative study.

BACKGROUND: Sailors are exposed to sunlight as their job requires and are, in the long run, more prone to different types of skin cancer. This study aimed to explore sailors' experience of perceived threat and to show protective behaviors against sunlight in the south of Iran. MATERIALS AND METHODS: The present follows a qualitative approach and directed content analysis in 2018-2019 among sailors who were selected purposively through an interview procedure. Finally, 22 sailors and 3 patients with skin cancer with an experience of sailing were interviewed until data satiation occurred. The data were collected through a semi-structured interview based on two constructs, perceived susceptibility and perceived severity of protection motivation theory, and were instantly transcribed and read more than once by the present researcher. Simultaneously, the data were entered into MAXQDA 10 for the primary categorization. RESULTS: Data analysis results were classified into 5 categories and 12 subcategories: protective attempts (change of work time and use of protectives), passivity in self-protection (not showing protective behaviors and not examining skin), inadequate perception of affliction risk (beliefs hindering preventive behaviors and low sensitivity), perceived threat to personal and familial conditions (loss of peace and loss of occupational-familial positions), and threat to health (incurable disease and perceived skin disease). CONCLUSIONS: Awareness of these factors helps planners to choose the best preventive strategies with a focus on correcting beliefs and promoting protective behaviors as well as examining and screening sailors regularly to diagnose skin cancer. Moreover, to develop practical measures of protective strategies against sunlight among sailors, the required steps should be taken. This can help to reduce the rate of work-related risks while exposed to sunlight in this population.

Evaluating Reliability of Theory of Planned Behaviour Questionnaire for Withdrawal of Divorce Petition.

BACKGROUND: Given the increased rate of divorce, it is important to analyse the characteristics of divorce applicants. The theory of planned behaviour (TPB) can provide a suitable framework to predict, explain, and/or change the behaviours. In Iran, no instrument can be found, based on health education models, to investigate divorce petition filing as a behaviour. AIM: This study was conducted to design a questionnaire on withdrawal of divorce petition based on the TPB and estimate its validity and reliability. MATERIAL AND METHODS: A qualitative study was conducted in 27 participants involved in the divorce process using directed content analysis. The face and content validity of 58 items, drawn from the qualitative study, were evaluated by 10 experts. The reliability was estimated using Cronbach's alpha coefficient. The SPSS version 16 was used to analyse data. RESULTS: Estimates of the face and content validity (quantitative and qualitative), revealed that of the 58 items, 48 were valid based on four of the constructs of the TPB. Cronbach's alpha coefficient was also derived greater than 0.6. CONCLUSION: The designed questionnaire, whose validity and reliability was confirmed in this study, can be used in similar studies. However, the social and cultural differences and their related effects should be considered.

Deficiency of Self-Efficacy in Problem-Solving as a Contributory Factor in Family Instability: A Qualitative Study.

Objective: Problem-solving ability is one of the most important means of family stability that enables the families to understand their roles, functions, and performances. Self-efficacy deficiency in problem-solving runs through many families. This qualitative study was conducted to investigate and describe how couples solve problems in their families. Method: This study was conducted to detect couples' self-efficacy deficiency in problem-solving using purposive sampling method. Several deep semi-structured interviews based on McMaster model and observations were conducted by nine family therapists and psychiatrists on four couples (eight persons) living in Yazd (Iran).The interviews were performed, audio-recorded, and transcribed verbatim. The analysis was interpreted through directed content analysis methods. Results: Families in Yazd (Iran) made some attempts to solve their problems, but their efforts were not enough, and thus they suffered from self-efficacy deficiency, which included 8 categories. The main theme distilled from the data of 17 participants was self-efficacy deficiency, which included the following categories: avoidance, insolvency, interference from others, ineffective self-treatment, behavioral problems, stubbornness, superficiality, and denial. Conclusion: It is of paramount importance to identify self-efficacy deficiency in families and promote problem- solving programs to increase family stability. In the present study, the main deficiencies in problem-solving were detected.

The Concept of Withdrawal of Divorce Petition Based on the Theory of Planned Behavior: A Qualitative Study.

AIM: The present study sought to explore the experiences of participants in divorce process according to the theory of planned behaviour. MATERIAL AND METHODS: This qualitative study was conducted using content analysis method. In this research, 27 participants involved in the divorce process were selected. The data were coded, and the qualitative content analysis was performed. RESULTS: Based on four constructs of the theory of planned behaviour, the subcategories of instrumental attitude were "Divorce as the last solution" and "Divorce as damage for individuals and society". From the perceived behavioural control theme, two subcategories of behavioural control and self-efficacy were drawn; the first subtheme included "Others' meddling in the married life", "Social problems reducing behavioural control power" and "Personality characteristics affecting the behavioural control power"; and the second one included: "Education as a means for developing self-efficacy" and "barriers to self-efficacy". The injunctive norms theme included three subcategories of "Others help to reconcile", "Others meddling and lack of reconciliation", and "Families support to reconcile". The descriptive norms theme was "High divorce rate and misuse of satellite channels and social networks as factors making reconciliation difficult". CONCLUSION: It seems that education and counselling, within a predefined framework, such as applied theories, can be useful.

Exploring the adaptive experiences of children with parents of myocardial infarction: A Qualitative Study.

BACKGROUND: Cardiovascular diseases are the world's leading cause of mortality. These diseases are rooted in an unhealthy lifestyle. In order to confront this subject, it is essential to identify several risk factors that contribute to heart disease (HD) in people with different attitudes, values, beliefs, expectations and motivations. This study was therefore an attempt to explain the adaptive experiences of children whose parents were involved in myocardial infarction since they were more likely subjected to get the so-called disease. OBJECTIVE: To identify the risk factors and to clear ambiguity using a qualitative research method from the experiences of people at risk of the above mentioned disease. METHODS: This qualitative study was a directed content analysis. Eighteen children (above 18 years old) of parents with a history of myocardial infarction participated, and were chosen with purposive sampling and the highest diversity. Data were collected through deep and semi structure interviews based on Protection Motivation Theory (PMT) from March to November 2015, and were analyzed along with their data collection and with usage of Lundman and Graneheim method. Interviews were conducted in non-stressful conditions with a place and time agreement. RESULTS: During content analysis process, 220 codes were extracted. After reviewing several times and summarizing, the codes were categorized based on similarity and proportion, and finally 12 subcategories and three categories were elicited including efforts to perform self-care in order to prevent HD, poor life style as a factor not to do preventive HD and health continuation with positive changes in life style. CONCLUSIONS: Most participants, despite intending to do self-care behaviors to prevent HD, due to factors such as time constraint, high costs, laziness, impatience and prioritizing other life affairs, did not pay attention to their health. Therefore, providing the training programs with an emphasis on life skills can play an important role in reducing perceived response cost and promoting health.

Contribution of raindrop impact to the change of soil physical properties and water erosion under semi-arid rainfalls.

Soil erosion by water is a three-phase process that consists of detachment of soil particles from the soil mass, transportation of detached particles either by raindrop impact or surface water flow, and sedimentation. Detachment by raindrops is a key component of the soil erosion process. However, little information is available on the role of raindrop impact on soil losses in the semi-arid regions where vegetation cover is often poor and does not protect the soil from rainfall. The objective of this study is to determine the contribution of raindrop impact to changes in soil physical properties and soil losses in a semiarid weakly-aggregated agricultural soil. Soil losses were measured under simulated rainfalls of 10, 20, 30, 40, 50, 60 and 70mmh-1, and under two conditions: i) with raindrop impact; and, ii) without raindrop impact. Three replications at each rainfall intensity and condition resulted in a total of 42 microplots of 1m×1.4m installed on a 10% slope according to a randomized complete block design. The contribution of raindrop impact to soil loss was computed using the difference between soil loss with raindrop impact and without raindrop impact at each rainfall intensity. Soil physical properties (aggregate size, bulk density and infiltration rate) were strongly damaged by raindrop impact as rainfall intensity increased. Soil loss was significantly affected by rainfall intensity under both soil surface conditions. The contribution of raindrop impact to soil loss decreased steadily with increasing rainfall intensity. At the lower rainfall intensities (20-30mmh-1), raindrop impact was the dominant factor controlling soil loss from the plots (68%) while at the higher rainfall intensities (40-70mmh-1) soil loss was mostly affected by increasing runoff discharge. At higher rainfall intensities the sheet flow protected the soil from raindrop impact.