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This study was conducted to determine the psychometric properties of the Persian version of an AADL scale in Iranian older adults. A total of 237 males and females aged over 60 years old were recruited. Personal information questionnaires, the CASP-19 Quality of Life, and AADL questionnaires were used for data collection. SPSS 24 and IBM AMOS 24 were used for data processing and analysis. Three factors that had eigenvalues higher than one were extracted, which explained 51.2 % of the total variances. The Cronbach α of the total score was 0.76, and it was >0.64 for each extracted factor. The goodness of fit indices indicated an acceptable fit to the data in confirmatory factor analysis. The culturally modified Persian version of the AADL scale has acceptable psychometric properties and is proper for evaluating the advanced activities of daily living in the Iranian population., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests, (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Diabetes self-management education is necessary to improve patient outcomes and reduce diabetes-related complications. According to the theory of behavioral reasoning, the likelihood of performing a behavior is predicted by the link between beliefs, motivation, intention, and behavior. This study aimed to investigate the effect of an educational intervention based on the Behavioral Reasoning Theory (BRT) on self-management behaviors in patients with Type 2 Diabetes., Methods: A randomized controlled trial based on BRT was conducted on 113 patients with type 2 diabetes, with a control group and an intervention group followed for 3and 6 months. Data were collected using a researcher-made demographic questionnaire based on the constructs of BRT and behaviors related to self-management in patients with type 2 diabetes. In the intervention group were provided, 8 sessions of diabetes self-management education based on BRT. The control group only received the usual training of the center. Data was analyzed using SPSS26 software., Results: After the educational interventions in the intervention group, there were statistically significant changes observed in the mean scores of all constructs, fasting blood sugar, and glycosylated hemoglobin. On the other hand, no statistically significant change was observed in the mean grades of the control group. All the observed changes were significant at the 0.05 level., Conclusions: The results of this study were in favor of the effectiveness of an educational intervention that promotes diabetes self-management behaviors, using the principles of the behavioral reasoning theory. Which can be used in the design of health promotion programs for patients with diabetes., Trial Registration: Iranian Registry of Clinical Trials (IRCT), IRCT20131014015015N21., (© 2024. The Author(s).)

Nutritional education is pivotal in the medical nutritional therapy of type 2 diabetes mellitus (T2DM). The extended parallel process model (EPPM) is a health education method for inducing desirable health behaviours. The present study aimed to investigate the effect of nutritional education based on the EPPM in T2DM patients on knowledge, attitude, practice, anthropometric indices, glycaemic factors, lipid profile and adherence to the diabetic diet. A randomised, double-blind, controlled, factorial field trial was designed for T2DM patients aged 30-59 years ( n 88). Participants were randomly allocated into four groups to receive EPPM-based nutritional education through gain framed message (GFM), loss framed message (LFM), their combination (G\LFM) or usual diabetic education in the control group (CG). Participants were assessed before and after the study duration. After 3 months of intervention, eighty participants finished the study. The EPPM-based intervention increased participants' knowledge, behavioural intention, perceived sensitivity, severity, self-efficacy ( P < 0·001 for all) and response efficacy ( P = 0·029) in comparison with CG. GFM ( P = 0·004) and G\FLM ( P = 0·034) reduced carbohydrate intake and LFM ( P = 0·034) and G\LFM ( P = 0·047) decreased fat intake. Between-group analysis indicated interventions reduced weight ( P = 0·046), BMI ( P = 0·038), fasting blood sugar ( P = 0·030), 2-hour postprandial blood glucose ( P = 0·027) and TAG ( P = 0·002) in comparison with the CG. Results were NS for protein intake, waist and hip circumference, waist:hip ratio, HbA1c, total cholesterol, LDL and HDL. Nutritional education based on EPPM could increase the knowledge and awareness of T2DM patients. Also, it could be beneficial for blood glucose amendment. Further investigations are recommended.

Background: Needle stick injuries (NSI) can lead to dangerous infectious diseases for health care workers. This study aimed to determine the predictors of observance of safe injection guidelines in hospital nursing staff, based on protection motivation theory., Methods: This cross-sectional study was conducted on the nursing staff of five randomly selected teaching and general hospitals of Shiraz University of Medical Sciences, Fars province, Iran, in 2021. Data were collected using a researcher-made questionnaire which was developed based on protection motivation theory. Data were processed and analyzed using SPSS 22 and Amos 24 at a significance level of  < 0.05. Pearson's correlation coefficient, Multiple linear regression, and Structural Equation Modeling were used., Results: The mean age of the participants (No = 280) was 32.5 ± 8.09 years. Most of the participants [80%] had encountered NSI, patients' blood, or body fluids at least once. Protection motivation was the only predictor of protective behaviors (β = 0.573), while perceived efficacy (β = 0.142) and perceived rewards (β = -0.229) were the strongest predictors of motivation. The structural equation modeling analysis showed that standardized total effects of protection motivation, perceived response costs, rewards, and efficacy on the protective behaviors were 0.573, -0.159, -.104, and 0.81, respectively. While standardized total effects of perceived rewards, efficacy, and response cost on protection motivation were -0.229, 0.142, and -0.033, respectively. The model fit indices indicated the acceptable final model fit., Conclusion: The results suggest that perceived efficacy, perceived effectiveness, and perceived rewards were the most important predictors of adherence to Safe Injection Guidelines in nursing staff., (© 2024. The Author(s).)

Introduction: Breast cancer disease is known as the most common cancer among women. Lack of knowledge and awareness is a leading cause of breast cancer, and since nearly all women are increasingly susceptible to this disease, training screening behaviors for early detection is proven essential in order to reduce breast cancer mortality. Therefore, the present study was designed to determine the effect of educational intervention based on the Health Action Model in improving breast cancer screening behaviors in women aged 30 to 69 in Kashan, Iran., Methods: This quasi-experimental study was conducted on 162 women aged 30-69 years old among the clients of Comprehensive health service centers in Kashan, Iran and they were assigned to intervention and control groups. The research instrument included a questionnaire assessed within three phases: baseline, 3-months, and 6-months, containing Health Action Model (HAM) structures and also three screening behaviors. The intervention consisted of a model-based education package and was carried out over 2 months. To evaluate the effect of the intervention, the mean of model structures and proportion screening behaviors in the third and sixth months were compared with the baseline phase. All analyses were carried out using SPSS, version 22., Results: The intervention and control groups were homogeneous regarding the structures of the HAM and the proportion of screening behaviors in the baseline phase (p > 0.05). In the 3-month (p < 0.05) and 6-month (p < 0.05) phases, the mean scores of the HAM constructs in the intervention group were found higher compared with the control group. Moreover, the proportion of clinical breast examinations in the intervention group was statistically higher than in the control group in the 3-month (p < 0.001) and 6-month (p < 0.001) phases. In addition, the proportion of mammography performed in the 3-month (p = 0.002) and 6-month (p < 0.001) phases were reported to be higher in the intervention group compared with the control group., Conclusion: Overall, these results provide important insight into the effectiveness of the interventions based on the Health Action Model in promoting breast cancer screening behaviors and the determinants of such behaviors., (© 2023. The Author(s).)

Background: The skill of communicating with the patient is one of the basic clinical skills and part of the necessary competencies for medical doctors. The present study aimed to evaluate the knowledge, attitude, and performance (KAP) of medical students, assistants, and professors of Shahrekord University of Medical Sciences regarding clinical communication skills with patients., Method: This cross-sectional study was conducted at the hospitals of Shahrekord University of Medical Sciences in Iran. The study included a total of 289 participants, consisting of 51 professors, 72 assistants, 90 external staff, and 76 interns who work at these hospitals. The participants were selected through a convenience sampling method. The data-gathering tools used included a questionnaire to collect demographic characteristics, a researcher-made questionnaire to assess knowledge, a communication skills attitude questionnaire, and a communication skills survey questionnaire. The data were analyzed using descriptive statistics such as mean, standard deviation, and frequency, as well as statistical tests that included one-way ANOVA and Pearson's correlation test. The significance level for the study was considered to be 0.05., Results: The mean scores of knowledge of professors were higher compared to other groups (P = 0.002). All participating groups had a positive attitude toward learning communication skills. There were statistically significant differences between the mean scores of the communication performance of the study groups (P < 0.001). There was a positive relationship between positive attitude and communication performance, and a significant negative relationship was observed between negative attitude and communication performance., Conclusion: The results indicate the relatively favorable attitude and performance of the groups and their low knowledge. It is suggested that the doctor-patient communication skills courses be included as one of the necessary courses in the medical education curriculum., (© 2024. The Author(s).)

Polycystic ovary syndrome is the most common cause of oligo-ovulation and anovulation among women of reproductive age, contributing to infertility. This study aimed to compare the effects of green tea tablets and metformin on ovulation, menstrual cycle regularity, and antioxidant biomarkers in women with polycystic ovary syndrome (PCOS). In this clinical trial study, 94 women with PCOS were randomly assigned to three groups: green tea ( n = 33), metformin ( n = 29), and control ( n = 32). Menstrual status and oxidative stress parameters, including total antioxidant capacity, thiol, and lipid peroxidation, were compared before and 3 months after the intervention among all three groups. Data analysis was conducted using SPSS software version 22 and employing the analysis of variance and paired t-tests. Following the intervention, the mean menstrual cycle duration in the green tea, metformin, and control groups was 32.22 ± 12.78, 48.72 ± 37.06, and 48.53 ± 31.04 days, respectively ( P = 0.040). There was no statistically significant difference between the three groups in terms of biochemical, hormonal, and antioxidant indices before and after the intervention ( P > 0.05). The intake of green tea tablets was associated with better outcomes in regulating the menstrual cycle in women with PCOS., Competing Interests: The authors declare no conflict of interest., (© 2024 by the authors.)

Introduction: The changes that retirees experience during their retirement years will challenge their ability to cope, potentially endangering their health and quality of life. This study aims to design and evaluate a theory-based health promotion programme to improve retirees' psychological well-being and quality of life., Methods and Analysis: This mixed-method, non-blinded study uses an embedded design. The purposive sampling method will be employed for the qualitative aspect of the study. Qualitative data will be collected at baseline, focusing on retirement adjustment, through semistructured, in-depth individual interviews and focus group discussions. The data will be analysed using Graneheim and Lundman's qualitative content analysis method. A pre-post test controlled group design will be conducted for the quantitative part of the study. A sample size of 80 is estimated for both the intervention and control groups. Systematic sampling and the block randomisation method will be employed for sampling. The training programme in the intervention group will consist of eight 60 min sessions and environmental support, implemented after assessing the research environment and obtaining approval from the relevant officials. A brief training programme unrelated to the intervention group's focus (home safety) will be implemented for the control group. Quantitative measures will be collected in both groups at baseline, 3 months and 6 months after the intervention. These measures will include self-administered questionnaires covering demographic variables, retirement adjustment, retirement resources, quality of life, coping methods, spiritual well-being and psychological well-being. Analytical statistics will be performed using the generalised linear model, with p values≤0.05 considered significant., Ethics and Dissemination: This protocol has received approval from the ethics committee of Shiraz University of Medical Sciences. The research findings will be disseminated through peer-reviewed manuscripts, presentation in abstracts at National and International Scientific Conferences, and data sharing among researchers., Trial Registration Number: IRCT20180516039690N2., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

In the present study, a copper(ii) complex containing a pyridine-2-carbaldehyde ligand and its direct binding onto ethylenediamine functionalized with Fe 3 O 4 @SiO 2 nanoparticles [Cu(ii)-Schiff base-(CH 2 ) 3 -SiO 2 @Fe 3 O 4 ] as a heterogeneous magnetic nanocatalyst can be easily prepared using a multi-step method. Next, the structural and magnetic properties of the synthesized nanoparticles were identified using Fourier-transform infrared spectroscopy (FT-IR), inductively coupled plasma (ICP), vibrating-sample magnetometry (VSM), transmission electron microscopy (TEM), field-emission scanning electron microscopy (FE-SEM), thermogravimetric analysis (TGA), PXRD (Powder X-ray diffraction), Brunauer-Emmett-Teller (BET), and energy-dispersive X-ray spectrometry (EDX) techniques. TEM images reveal that the average particle size distribution was found to be in the range of 45-55 nm with spherical shape. The PXRD analysis indicated that the crystallite size was found to be 35.2 nm. The synthesized nanocatalyst exhibited a very good catalytic ability in the synthesis reaction of pyran derivatives and 2-benzylidenemalononitrile derivatives. Product 2-amino-7,7-dimethyl-4-(4-nitrophenyl)-5-oxo-5,6,7,8-tetrahydrobenzo[ b ]pyran 4e was achieved in 97% yield with a TON of 129.3 and a TOF of 646.6 h -1 and product 2-(4-cyanobenzylidene)malononitrile 3j was achieved in 96% yield with a TON of 128 and a TOF of 984.6 h -1 . In addition, the synthesized nanocatalyst was easily separated from the reaction mixture by a magnet and used 7 consecutive times without significant loss of catalytic activity. Also, leaching of copper metal from the synthesized nanocatalyst was very insignificant for this reaction., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Gastric Cancer (GC) is one of the most dangerous malignancies in the world. This study aims to evaluate the relationship between miR-146a and miR-155 in patients with H. pylori infections with GC compared to H. pylori -infected patients and healthy subjects. Forty patients with H. pylori and GC positive diagnoses and 40 patients with H. pylori positive and GC negative diagnoses, and 40 healthy persons were selected. The expression of miR-146a and miR-155 genes in the whole blood was examined using qRT-PCR. Moreover, ROC curves were drawn to represent the sensitivity and specificity of miR-146a and miR-155 expression as biomarkers. The results showed the expression of miR-146a and miR-155 in the whole blood of patients with H. pylori and GC positive diagnoses are significantly higher than in healthy individuals and are non-significantly enhanced compared to H. pylori positive and GC negative. Also, the results stated miR-146a and miR-155 expression in the whole blood of patients who are H. pylori positive and GC negative are significantly increased compared to healthy individuals. Furthermore, the ROC curve analysis of miR-146a and miR-155 RNA level demonstrated the two miRNAs have an appropriate sensitivity and specificity for diagnostic goals. In conclusion, H. pylori infection may increase the expression of miR-146a and miR-155 in patients with H. pylori and GC positive diagnoses, which can be effective in the curbing the progression of GC. For this reason, up-regulation of miR-146a and miR-155 along with H. pylori infection might contribute to the pathogenesis of GC, and also can be suggested as biomarkers for GC diagnosis and treatment., Competing Interests: CONFLICT OF INTEREST STATEMENT: None declared., (© Chonnam Medical Journal, 2023.)

Background: The white cane is globally an important tool in orientation and mobility for blind and visually impaired people, but it is not often used. The goal of this study was to develop and validate the white cane use perceived advantages and disadvantages (WCPAD) questionnaire for detecting effective factors in the use or non-use of canes., Method: The initial questionnaire items were extracted through semi-structured interviews with 21 blind or severely impaired vision individuals under two main themes, the perceived advantages, and disadvantages of using a white cane. Linguistic validity and writing evaluation with seven experts, face validity with 23 blind persons, content validity ratio (CVR), and content validity index (CVI) were used for assessment of validity. Internal and external reliability assessment was done using Cronbach's alpha and intra-class correlation coefficient (ICC). Explanatory factor analysis was conducted to identify the factors of the questionnaire; then, corrected item-total correlations, convergent and discriminant validity, and Confirmatory Factor Analyses (CFA) were done, and model fit indices were reported. A total of 320 blind and severe visual impaired individuals (138 males and 182 females) participated in the study. The final questionnaire contained 12 questions in perceived advantages and 21 in perceived disadvantages., Results: Three factors (social participation, mobility, and culture) extracted for perceived advantages which explained 67.95% of the total variance, Cronbach-α for the three extracted factors was between 0.75 and 0.91. Four factors (social, safety, ergonomics, and family) for perceived disadvantages were extracted which explained 50.98% of the total variance. Cronbach-α for the four extracted factors was from 0.75 to 0.88. CFA confirmed the final models for perceived advantages and disadvantages., Conclusion: WCPAD questionnaire has good reliability and validity, and the factors obtained from factor analysis can measure the reasons for using or otherwise of white canes., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Health professionals assume the quality of life (QOL) as a main outcome of health care activities, especially in the elderly. Thus, they need valid tools for evaluating the effectiveness of their interventions. This study aimed to investigate the psychometric properties of the Persian version of the World Health Organization quality of life-old questionnaire (WHOQOL-OLD). The questionnaire was translated into Persian by standard translate/back-translate procedure. The Cronbach's alpha and intra-class correlation (ICC) coefficients were estimated to assess the internal validity and reliability. Confirmatory factor analyses (CFA) in a sample of 300 Persian-speaking elderly in Shiraz, Iran, were used for construct validity assessment. ROC curve analysis was used to determine the cutoff point for poor or good QOL. All the analyses were conducted using SPSS 24 and IBM AMOS 24. The internal consistency and reliability indices of the Persian version of WHOQOL-OLD were acceptable (Cronbach's alpha: 0.66-0.95; ICC: 0.71-0.91). CFA confirmed the WHOQOL-OLD six-domain structure (CMIN/ df  = 3.12, p  < .001; CFI = 0.93; NFI = 0.89; RMSEA = 0.08). The ROC curve indicated 71.5 as the best cutoff point, with a sensitivity of 82.3% and specificity of 61.8%. The Persian version of the WHOQOL-OLD is valid and can be used for investigating the QOL in Persian-speaking elderly., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Introduction: Nonsuicidal self-injury (NSSI) in adolescents is a growing public health concern, demanding preventive measures, particularly among high school students. Based on social cognitive theory (SCT), self-efficacy coupled with outcome expectations, social support, self-regulation, and behavioral intention, determine the likelihood of engaging in such a behavior. Thus, the present study was to investigate the effect of a SCT-based educational intervention on NSSI prevention in female high school students., Methods: This randomized educational intervention trial was conducted on 191 female high school students, aged 15-17 years (15.95 ± 0.59) (viz. 99 individuals in intervention group and 92 controls). Intervention group attended five SCT-based educational intervention sessions concerning NSSI prevention. Data were then collected by three self-administered questionnaires. The first questionnaire was to measure demographic variables and the second one, intermediate outcome measure, was implemented to evaluate SCT constructs. The third questionnaire also measured NSSI (final outcome measure). Data were analyzed using SPSS software v.24., Results: After controlling the pretest scores, the repeated-measure multivariate analysis of covariance revealed a significant time and group interaction in multivariate (F = 154.8, p < .001) and univariate analysis, which is in favor of the effectiveness of educational intervention on changing the mean scores of NSSI and all SCT constructs. SCT constructs explained 41% of the variance in conforming intention for NSSI prevention (p < .001)., Conclusion: The study findings were in favor of effectiveness of an SCT-based educational intervention in intention of preventing NSSI., (© 2023 The Foundation for Professionals in Services for Adolescents.)

Pregnant women are at higher risk of getting severe Covid-19 disease and consequences on the health status of them and their fetuses. Despite vaccination, all preventive behaviors are emphasized. This study aimed to identify the determinants of Covid-19 preventive health behaviors in pregnant women using Extended Parallel Process Model. This cross-sectional study, was conducted on 175pregnant women. The model fit indices were acceptable. Knowledge had indirect effect on adherence to Covid-19 preventive behaviors trough mediating role of self-efficacy and response efficacy. So, it is suggested that, educational interventions should focus on increasing knowledge.

Background: Osteoporosis, as the most common metabolic disease and the leading cause of death among older people, affects more than 200 million women throughout the world. This study aimed to evaluate the effect of a health communication campaign on knowledge, attitude, and practice of older women towards prevention and control of osteoporosis., Methods: In this multi-stage mixed methods study, 30 days' health communication campaign for prevention of osteoporosis was conducted on 60- 75-year-old women, in rural areas of Fasa, Iran. Subjects were divided into two groups, control (n = 103) and intervention (n = 98). Data were collected using a researcher-made questionnaire and analyzed by SPSS 25.0. The significance level was set at < 0.05., Results: Inter-group group analysis revealed that the mean scores of knowledge, attitude, and practice were not significantly different between the two groups before the intervention, but after the intervention, unlike the behavior (P = 0.569), mean scores of knowledge (p < 0.001) and attitude (p < 0.001) of the intervention group were significantly more than the control group. Intra-group comparisons showed that, unlike the control group, the mean scores of knowledge (p < 0.001), attitudes (p < 0.001), and behavior (P < 0.001) increased significantly in the intervention group., Conclusions: Health communication campaign is an effective way to change the knowledge and attitude and to a lesser extent the practice of the eldery toward prevention and control of osteoporosis., (© 2023. The Author(s).)

Introduction: Girls can use their mother's emotional, informational and behavioral support to perform healthy behaviors due to their constant access to their mothers. This study aimed to evaluate the effect of role modeling and maternal support in the family to improve healthy behaviors and perceived Family Health Climate (FHC) in female students., Methods: In this educational quasi-experimental study, 261 female students (133 in the intervention group and 128 in the control group) and 223 mothers (109 intervention and 114 control) were selected using the cluster multi-stages sampling method and entered the study. Participants (intervention and control groups) completed the FHC scale at three stages (before intervention, immediately after the intervention, and 2 months after intervention). A training program that comprised 12 sessions for students and six sessions for their mothers using collaborative learning techniques and printed materials was conducted with the experimental group. Also after completing the questionnaire in the follow-up phase, pamphlets and educational videos were given to the control group. Data were analyzed using SPSS20 via a chi-square test, independent t-test, and Repeated Measures ANOVA at a significance level of 0.05., Results: Before the intervention, there was no significant difference between demographic variables and the score of the FHC scale in both groups (p < 0.05). Immediately and 2 months after the intervention, the experimental group (female students and their mothers) showed a significant increase in dimensions of FHC, including FHC-NU (Family Health Climate-Nutrition) and FHC-PA (Family Health Climate-Physical Activity), compared to the control group (p < 0.05)., Conclusions: Educating and informing mothers about the impact of their role modeling on their children, especially girls, can make them more aware of health-oriented behaviors towards their children. Such findings reinforced the importance of focusing on actions to encourage a healthy lifestyle (healthy diet and physical activity) in students with a focus on role modeling and parental support, especially mothers., (© 2023. The Author(s).)

Objective: To assess the impact of family social support (FSS) on postpartum quality of life (PQOL)., Methods: This analytical cross-sectional study enrolled postpartum women and asked them to complete the PQOL and FSS questionnaire (FSSQ) between October 2021 and February 2022 in three urban health centres in Shiraz, Iran. Pearson correlation coefficient analysis and multiple regression were used to determine the relationship between the FSS and PQOL variables. Structural equation modelling was used to determine the relationship pathways of the impact of FSS on PQOL., Results: A total of 240 women were enrolled in the study. The mean ± SD scores of PQOL and FSSQ were 61.63 ± 9.59 and 69.80 ± 11.19, respectively. Family support seeking (7.95) and emotional support seeking (-6.80) were two factors affecting PQOL., Conclusion: Women should be empowered to seek support through education and actions from health workers, especially nurses and midwives, during routine regular prenatal care.

Complete pathological response (pCR) is achieved in 10−20% of rectal cancers when treated with short-course radiotherapy (scRT) or long-course chemoradiotherapy (CRT) and in 28% with total neoadjuvant therapy (scRT/CRT + CTX). pCR is associated with better outcomes and a “watch-and-wait” strategy (W&W). The aim of this study was to identify baseline clinical or imaging factors predicting pCR. All patients with preoperative treatment and delays to surgery in Uppsala-Dalarna (n = 359) and Stockholm (n = 635) were included. Comparison of pCR versus non-pCR was performed with binary logistic regression models. Receiver operating characteristics (ROC) models for predicting pCR were built using factors with p < 0.10 in multivariate analyses. A pCR was achieved in 12% of the 994 patients (scRT 8% [33/435], CRT 13% [48/358], scRT/CRT + CTX 21% [43/201]). In univariate and multivariate analyses, choice of CRT (OR 2.62; 95%CI 1.34−5.14, scRT reference) or scRT/CRT + CTX (4.70; 2.23−9.93), cT1−2 (3.37; 1.30−8.78; cT4 reference), tumour length ≤ 3.5 cm (2.27; 1.24−4.18), and CEA ≤ 5 µg/L (1.73; 1.04−2.90) demonstrated significant associations with achievement of pCR. Age < 70 years, time from radiotherapy to surgery > 11 weeks, leucocytes ≤ 109/L, and thrombocytes ≤ 4009/L were significant only in univariate analyses. The associations were not fundamentally different between treatments. A model including T-stage, tumour length, CEA, and leucocytes (with scores of 0, 0.5, or 1 for each factor, maximum 4 points) showed an area under the curve (AUC) of 0.66 (95%CI 0.60−0.71) for all patients, and 0.65−0.73 for the three treatments separately. The choice of neoadjuvant treatment in combination with low CEA, short tumour length, low cT-stage, and normal leucocytes provide support in predicting pCR and, thus, could offer guidance for selecting patients for organ preservation.

Introduction: Menopause is an inevitable part of women's lives. Physical activity as nonhormonal therapy can decrease the symptoms of menopause. This study is aimed at investigating the effect of educational intervention based on the transtheoretical model (TTM) on physical activity and menopausal symptoms of female clients of the health center in Pasargad City, Iran., Methods: This quasi-experimental study was performed on 140 females admitted to health center of Pasargad City, Fars Province, Iran (intervention = 70 and control = 70). The data collection tool consisted of demographic data, menopause rating scale, international physical activities questionnaire, and TTM questionnaire (stages of change, processes of change, decision-making balance, and self-efficacy) that were completed before and two months after intervention. For intervention group, the educational program was implemented during 5 sessions of 50-55 min. Data were analyzed by SPSS 25 and by using Chi-square test, independent t -test, and paired t -test., Results: After intervention, the mean scores of physical symptoms are sleep problems, muscle problems and discomfort, psychological symptoms, depression, irritability, and anxiety of intervention group decreased significantly post intervention ( p < 0.001). Analysis showed that psychological symptoms, mental fatigue, somatic, and urogenital symptoms, and vaginal dryness increased 2 months after the intervention. Also, the mean score of cons, pros, decision balance, self-efficacy, consciousness raising, dramatic relief, environmental reevaluation, and self-reevaluation have significant changed in intervention group ( p < 0.05). In addition, the top percent of progress can be seen in contemplation (31. 5%)., Conclusion: This study showed the effectiveness of educational intervention based on TTM to reduce menopausal symptoms and promote physical activity in postmenopausal women., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2022 Leila Fallahipour et al.)

Background: Breast cancer is known as the most common cancer and the first-rank malignancy among women. Screening plays a crucial role in early diagnosis and timely treatment. This paper presents the results of design, evaluation and analysis of a questionnaire based on the health action model to investigate breast cancer screening behaviors and their relevant factors., Methods: The study is based on using a combination of quantitative and qualitative approaches for optimal design and development of research tools. In order to design the structure of the health action model and screening behaviors related factors, both qualitative methods such as semi-structured interviews and quantitative approaches studied. Psychometric properties of the research tool were investigated through literature review. The research population consisted of 210 30-69 years old females based in Kashan who were selected through simple random sampling. The relative and content validity indexes were calculated to judge the content of the tool. Also, the confirmatory factor analysis was used to evaluate the construct validity. Additionally, intra-class correlation coefficient and Cornbrash's alpha coefficient were calculated to evaluate the reliability of the instrument. The data were analyzed using the SPSS 22 and AMOS 22 software packages., Results: The mean age of the participants was 43 ± 9.82 Years old. The final version of the questionnaire was prepared in four sections, namely demographic factors (15 items), knowledge (12 items), constructs of the health action model or the factors related to breast cancer screening behaviors (67 items), and behavior (6 items). Factor analysis confirmed that the health action model fits in measuring breast cancer screening behaviors., Conclusion: The tool designed for measuring breast cancer screening behaviors showed acceptable psychometric properties amongst females and can be used as a valid tool in conducting research in health studies., (© 2022. The Author(s).)

Background: Oral diseases are considered an important health challenge around the world, especially among children. This study aimed to compare the effects of mothers and students' education on female students' oral health behaviours., Methods: This three-arm randomized controlled educational trial was conducted on 261 fifth- and sixth-grade female students. The participants were selected and divided into two intervention groups (students' mothers and students) and a control group through simple random sampling. The intervention included four 60-min and two 90-min education sessions for the students and their mothers, respectively. The data were analysed using the SPSS 22 software., Results: The results revealed a significant increase in the mean scores of knowledge (p < 0.001), self-efficacy (p = 0.038), and cues to action (p < 0.001) in the students' intervention group. However, in the students-mothers' group the mean score of knowledge significantly increased (p < 0.001), and perceived barriers significantly decreased (p = 0.001). After the intervention, a significant difference was observed among the three study groups regarding the mean scores of knowledge (p < 0.001), perceived susceptibility (p = 0.005), perceived severity (p = 0.005), perceived benefits (p = 0.011), cues to action (p < 0.001) and brushing and flossing behaviours (p < 0.001)., Conclusion: In this study, the mothers' education did not have any additional effects on the students' education. It seems that, in underprivileged communities where mothers had a low level of education, it might be better for oral health education to focus more on the students., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Infertility is one of the disorders that worries many couples around the world, although novel and molecular methods can be used to cure this disease in different stages. One of the factors that causes infertility in men and women is the increased oxidative stress within the cells, which can lead to damage in zygote formation. ROMO1 is one of the most important proteins in the production of reactive oxygen species. This protein can enhance oxidative stress in the cells and body through cellular pathways, such as TNF-α and NF-κB routes, which will eventually lead to many diseases, especially infertility. We engage several international databases by using keywords; ROMO1, Infertility, and Reactive Oxygen Species, and gained a great quantity of information about ROMO1, Infertility, and Oxidative Stress. Although not proven, it is hypothesized that ROMO1 might elevate oxidative stress by activating NF-κB pathway in the cells, furthermore, TNF-α can arouse ROMO1 that can end up with apoptosis and cell death, which consequently can have a lot of disturbing effects on the body, especially the reproductive system. To sum up, revealing the exact cellular and molecular mechanisms of ROMO1-dependent TNF-α and NF-κB pathways in the pathogenesis of infertility might find interesting therapeutic and management strategies for this disorder., Competing Interests: CONFLICT OF INTEREST STATEMENT: None declared., (© Chonnam Medical Journal, 2022.)

Background: Uncontrolled diabetes is an important public health problem that endangers the quality of life of patients. Promoting self-management through well-planned training is an essential strategy to control diabetes effectively. This study aimed to examine the effects of a training program based on social cognitive theory (SCT) on self-management behavior, glycemic index, and quality of life among patients with type 2 diabetes mellitus., Methods: This is a quasi-experimental study with a pretest-posttest design. The statistical population included 106 adults with type 2 diabetes mellitus assigned to the intervention and control groups [n 1  = n 2  = 53], who received services from two urban health centers. A multi-method, SCT-based training program consisting of six 60-80-min sessions was run, followed by 2-3 follow-up home visits [once a month for each participant] for the intervention group. The data were collected before and three months after the intervention and were analyzed in SPSS 19., Results: Before the intervention, there was no significant difference between the two groups regarding the main variables. After the intervention, there was a significant increase in the intervention group's mean scores of knowledge, self-efficacy, social support, outcome expectations, self-regulation, self-management behavior, glycemic index, and quality of life. There were no significant changes in these constructs in the control group after the intervention. The regression analysis results indicated that social cognitive theory and self-management could explain the variance in quality of life [adjusted R-squared = 0.476]., Conclusions: The findings support the effectiveness of the multi-method, SCT-based educational intervention in improving self-management behaviors, glycemic index, and quality of life among patients with type 2 diabetes mellitus. It is suggested that the quality of type 2 diabetes care programs should be promoted. However, further research is needed to evaluate the long-term outcomes., (© 2022. The Author(s).)

Background: COVID-19 is a social health problem. Several risk factors threaten students, and schools can provide a suitable environment for managing and performing health promotion programs. Given the extensive spread of the disease and the existence of multilevel components affecting the adoption of preventive behaviors, understanding the views and opinions of the audience about the barriers and facilitators affecting the behavior using qualitative studies can be one of the ways to have a successful intervention., Materials and Methods: This was a qualitative study performed by a directed content analysis method while using the PRECEDE model (predisposing, reinforcing, enabling constructs in educational diagnosis and evaluation). In total, 38 individuals (teachers, parents, and students) were entered into the study using the purposive sampling method. Data were collected by semistructured interviews, and the implemented data were systematically classified into five stages (condensed meaning units, code, subcategory, category, and theme) and were arranged and analyzed., Results: The findings are classified into three themes of predisposing, enabling, and reinforcing factors. In addition, perceived sensitivity, perceived intensity, mental beliefs, behavior outcome evaluation, and perceived power were considered as subcategories of predisposing factors, whereas normative beliefs and motivation for adherence to protocols were subcategories of reinforcing factors, and control beliefs were subcategories of enabling factors., Conclusion: Our findings could be used as a guide to design educational interventions aiming at promoting COVID-19 prevention behaviors in schools., Competing Interests: We have no conflict of interest., (Copyright © 2022 Mehdi Layeghiasl et al.)

Background: Unhealthy diet including consumption of high amounts of sugar-sweetened beverages is a key modifiable risk factor for obesity and NCDs which begin in childhood and adolescence. The study aimed to compare the effect of gain frame vs. loss frame messages on SSBs consumption intention and behavior of high school boy students., Methods: In this quasi-experimental study, 270 students from three boy's high schools were selected through a multistage random sampling. Data collection was done through a 15 items self-reported questionnaire before and two months after the intervention. Each of the two intervention groups received one of the two types of gain frame or loss frame designed pamphlets inspired with extended parallel process model. The control group received no pamphlet., Results: In control, GFM and LFM groups 91, 86 and 89 students participated in the study, respectively. After the intervention, significant differences were observed in perceived efficacy and threat of the GFM group and perceived efficacy, threat and intention in the LFM group compared with before the intervention. The GFM group had higher perceived self-efficacy than the control group and lower perceived severity than the LFM group. Intention to consume SSBs reduced significantly in LFM group, compared with the control group., Conclusions: A combination of LFM and GFM messages could more effectively lead to nutritional behavior change regarding the consumption of SSBs. Results help to design messages for educational programs and nutritional campaigns., (© 2022. The Author(s).)

Background: Breast cancer is one of the most common health problems worldwide. The mortality rate of this disease is due to the lack of knowledge about screening methods and late diagnosis of cancer., Objective: The purpose of this study is to determine the predictors of breast cancer screening behaviors using protection motivation theory., Methods and Materials: The conduction of study was cross-sectional and on 400 women aged 30-59 in Kashan. The data collection instrument was a researcher-made questionnaire based on protection motivation theory. Sampling was performed from all community health service centers in Kashan and the proportional to size sampling method was used as available sampling. The statistical tests were Pearson correlation and linear regression. The software used was version 22 SPSS and the significance level was 0.05., Results: The results showed that the average age of women was 39.7 ± 7.9 years. There is a direct and statistically significant relationship between perceived breast cancer screening behaviors and perceived self-efficacy (P < 0.05) and there is an inverse statistically significant relationship between breast cancer screening behaviors and perceived cost (P < 0.05). There is also a direct and significant statistical relationship between motivation of protection and perceived sensitivity, intensity, self-efficacy, cost, and perceived response efficiency (P < 0.05). Perceived self-efficacy, cost, and response efficiency are the predictors of breast cancer screening behaviors. The perceived cost is the negative predictor., Conclusion: Overall, health care providers can view PMT as a framework for developing educational interventions aimed at improving behaviors related to breast cancer screening of women., Competing Interests: Conflict of interest statement The authors declare no conflict of interest., (©2021 Pacini Editore SRL, Pisa, Italy.)

The aim of this study was to investigate the level of readiness of Eghlid city community for adolescents' substance abuse prevention programs, and to develop strategies to improve community readiness levels based on the community readiness model (CRM). In this two-stage qualitative study, a 36-item semi-structured CRM questionnaire, was used to interview 11 key informants in Eghlid city, Iran, 2019. The interviews were analyzed and scored by two independent researchers. Strategies for increasing the level of readiness were developed and prioritized by participants using the nominal group method. The readiness levels to prevent substance abuse in community efforts and leadership dimensions were at stabilization and preparation stage. In terms of community awareness of efforts, community space, and public awareness of the issue, the readiness level was at the pre-planning stage, and in the resources for prevention efforts dimension, it was at the vague awareness level. In the strategy development section, the key participants focused on using traditional methods such as holding face-to-face training programs and festivals, using IRIB platform, local media, and lectures. The general level of readiness is at a moderate level. It seems necessary to focus on resources and areas related to public information., (© 2021 Wiley Periodicals LLC.)

Lack of menopausal knowledge damages the quality of life (QoL) and couples' relationships. A new approach to prevent marital distress based upon stress and coping has introduced Couples Coping Enhancement Training (CCET). The present study assessed the effect of menopause care training using CCET approach on QoL and coping in menopausal women. This educational interventional study was conducted in 2019 on 80 postmenopausal women and their spouses. The couples were randomly selected from health care centers using the cluster random sampling method and were divided into control and intervention groups. Four training sessions were held for the intervention group. Data were collected using The Menopause-Specific Quality of Life (MENQOL) questionnaire, menopausal knowledge questionnaire, and Dyadic Coping Inventory (DCI) and were analyzed using independent Sample t-test, Paired Sample T-Test, and Structural Equation Modeling (SEM) in SPSS version 25 and Amos version 21 software. At the beginning of the study, there was no significant difference in menopausal knowledge, QoL, and dyadic coping between the two groups. However, the CCET approach significantly increased menopausal knowledge, coping in couples and women's QoL in the intervention group compared to the control group. CCET can help couples to cope with menopausal symptoms more efficiently.

Objectives: This study examined the validity and reliability of the Family Health Climate Scale (FHC-Scale) among Iranian families. Second, can it be attributed to other family members by measuring the health climate in one person?, Method: In total, 261 female students and 196 mothers completed the FHC-Scale. The study instrument was a Persian version of the FHC-Scale prepared through a translation and back-translation process., Results: The results showed that the Persian version of the FHC-Scale is acceptable. Cronbach's alpha coefficient for FHC-PA in female students and their mothers, respectively, was 0.88 and 0.86 for the whole scale. Cronbach's alpha coefficient for FHC-NU in female students and their mothers, respectively, was 0.83 and 0.92 for the whole scale. The CVI values for all the items were equal to or above 0.8, and the CVR value for the total scale was 0.90., Conclusion: The Persian version of the FHC-Scale is therefore an effective tool for evaluating the different dimensions of family health climate in the Iranian population., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Jeyran Ostovarfar et al.)

Background and objective: Physical activity is an important behavior to reduce the risk of non-communicable diseases. Providing the context for physical activity in the workplace in addition to promoting the employees' physical and mental health has significant economic benefits for organizations. We conducted the present study using a social marketing model to explain the determinants of a Workplace Health Promotion in promoting physical activity among employees of government organizations in Yasuj, Iran. Materials and methods: The present study was qualitative research with directed content analysis based on the social marketing model. Thirty-three employees of government organizations in Yasuj were included in the study using the purposive sampling method. The data collection method included semi-structured interviews and observation. Data analysis was performed manually and by the qualitative content analysis method. The implementation data were systematically sorted and analyzed and classified into five steps. Results: Organizational structure, organizational policies, and a supportive interpersonal climate were extracted and categorized as characteristics of workplace health promotion programs from participant interviews. In addition to participants' emphasis on receiving information from reputable sources, virtual communication networks such as WhatsApp and real communication networks such as physicians and specialists were their preferred media for education and information. Conclusion: Due to the complexity of workplace, diversity, and multiplicity of factors and determinants of physical activity, the findings of the present study will be a basis for designing an appropriate and effective intervention and organizational changes to promote physical activities among employees in the future., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Kaveh, Layeghiasl, Nazari, Ghahremani and Karimi.)

Background: The methylene tetrahydrofolate reductase (MTHFR) is a folate-dependent enzyme which catalyzes the conversion of homocysteine to methionine. Two single nucleotide polymorphisms (SNPs) within this gene namely rs1801133 (C677T) and rs1801131 (A1298C) have been associated with elevated risk of ischemic stroke and total serum homocysteine in some populations. Aim: To assess associations between MTHFR SNPs and risk of ischemic stroke in Iranian population. Methods: In the current case-control study, we genotyped rs1801133 and rs1801131 SNPs in 318 Iranian patients with history of ischemic stroke and 400 age- and sex-matched controls using tetra-primer amplification refractory mutation system-polymerase chain reaction method. Results: The rs1801133 was significantly associated with risk of stroke in recessive model (OR (95% CI) = 1.89 (1.12-3.20), p  = 0.03). The CT haplotype (rs1801131 and rs1801133, respectively) was significantly over-represented in patients compared with controls (OR (95% CI) = 1.71 (0.25-2.32), p  = 0.002). Conclusion: Consequently, our data demonstrate contribution of MTHFR variants in risk of ischemic stroke in Iranian population.

Background: Lynch Syndrome is an autosomal dominant cancer syndrome caused by pathogenic germ-line variants in one of the DNA-mismatch-repair (MMR) genes MLH1, MSH2, MSH6 or PMS2 . Carriers are predisposed to colorectal and endometrial cancer, but also other cancer types. The purpose of this retrospective study was to characterize the tumour spectrum of the Swedish Lynch syndrome families., Methods: Data were obtained from genetically verified 235 Lynch families from five of the six health care regions in Sweden. The material was stratified for gender, primary cancer, age and mutated gene and the relative proportions of specific cancer types were compared to those in the general population., Results: A total of 1053 family members had 1493 cancer diagnoses of which 1011 were colorectal or endometrial cancer. Individuals with pathogenic variants in MLH1 and MSH2 comprised 78% of the cohort. Among the 482 non-colorectal/non-endometrial cancer diagnoses, MSH2 carriers demonstrated a significantly increased proportion of urinary tract, gastric, small bowel, ovarian and non-melanoma skin cancer compared to the normal population. MLH1 carriers had an elevated proportion of gastrointestinal cancers (gastric, small bowel, pancreas), while MSH6 carriers had more ovarian cancer than expected. Gastric cancer was predominantly noted in older generations., Conclusion: Lynch syndrome confers an increased risk for multiple cancers other than colorectal and endometrial cancer. The proportions of other cancers vary between different MMR genes, with highest frequency in MSH2 -carriers. Gender and age also affect the tumour spectrum, demonstrating the importance of additional environmental and constitutional parameters in determining the predisposition for different cancer types., Competing Interests: None.The study was approved by the Regional Ethical Review Board in Stockholm, Sweden. Diary number 2002–241 and Diary number 2014–1320-31.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Among hereditary colorectal cancer predisposing syndromes, Lynch syndrome (LS) caused by mutations in DNA mismatch repair genes MLH1, MSH2, MSH6 or PMS2 is the most common. Patients with LS have an increased risk of early onset colon and endometrial cancer, but also other tumors that generally have an earlier onset compared to the general population. However, age at first primary cancer varies within families and genetic anticipation, i.e. decreasing age at onset in successive generations, has been suggested in LS. Anticipation is a well-known phenomenon in e.g neurodegenerative diseases and several reports have studied anticipation in heritable cancer. The purpose of this study is to determine whether anticipation can be shown in a nationwide cohort of Swedish LS families referred to the regional departments of clinical genetics in Lund, Stockholm, Linköping, Uppsala and Umeå between the years 1990-2013. We analyzed a homogenous group of mutation carriers, utilizing information from both affected and non-affected family members. In total, 239 families with a mismatch repair gene mutation (96 MLH1 families, 90 MSH2 families including one family with an EPCAM-MSH2 deletion, 39 MSH6 families, 12 PMS2 families, and 2 MLH1+PMS2 families) comprising 1028 at-risk carriers were identified among the Swedish LS families, of which 1003 mutation carriers had available follow-up information and could be included in the study. Using a normal random effects model (NREM) we estimate a 2.1 year decrease in age of diagnosis per generation. An alternative analysis using a mixed-effects Cox proportional hazards model (COX-R) estimates a hazard ratio of exp(0.171), or about 1.19, for age of diagnosis between consecutive generations. LS-associated gene-specific anticipation effects are evident for MSH2 (2.6 years/generation for NREM and hazard ratio of 1.33 for COX-R) and PMS2 (7.3 years/generation and hazard ratio of 1.86). The estimated anticipation effects for MLH1 and MSH6 are smaller.

Pancreatic ductal adenocarcinoma (PDAC) is a tumor with an extremely poor prognosis, predominantly as a result of chemotherapy resistance and numerous somatic mutations. Consequently, PDAC is a prime candidate for the use of sequencing to identify causative mutations, facilitating subsequent administration of targeted therapy. In a feasibility study, we retrospectively assessed the therapeutic recommendations of a novel, evidence-based software that analyzes next-generation sequencing (NGS) data using a large panel of pharmacogenomic biomarkers for efficacy and toxicity. Tissue from 14 patients with PDAC was sequenced using NGS with a 620 gene panel. FASTQ files were fed into treatmentmap. The results were compared with chemotherapy in the patients, including all side effects. No changes in therapy were made. Known driver mutations for PDAC were confirmed (e.g. KRAS, TP53). Software analysis revealed positive biomarkers for predicted effective and ineffective treatments in all patients. At least one biomarker associated with increased toxicity could be detected in all patients. Patients had been receiving one of the currently approved chemotherapy agents. In two patients, toxicity could have been correctly predicted by the software analysis. The results suggest that NGS, in combination with an evidence-based software, could be conducted within a 2-week period, thus being feasible for clinical routine. Therapy recommendations were principally off-label use. Based on the predominant KRAS mutations, other drugs were predicted to be ineffective. The pharmacogenomic biomarkers indicative of increased toxicity could be retrospectively linked to reported negative side effects in the respective patients. Finally, the occurrence of somatic and germline mutations in cancer syndrome-associated genes is noteworthy, despite a high frequency of these particular variants in the background population. These results suggest software-analysis of NGS data provides evidence-based information on effective, ineffective and toxic drugs, potentially forming the basis for precision cancer medicine in PDAC., (© 2017 The Authors. Published by FEBS Press and John Wiley & Sons Ltd.)

Background: AXP107-11 is a novel, multi-component crystalline form of the naturally occurring compound genistein. AXP107-11 has improved physiochemical properties and oral bioavailability compared to the natural form of genistein, and it is possible that combining AXP107-11 with chemotherapy may increase the effect and reduce chemoresistance. The purpose of this dose escalation phase Ib study was to assess the safety, maximum tolerated dose (MTD) and pharmacokinetics (PK) of AXP107-11 in combination with gemcitabine in treatment-naïve patients with inoperable pancreatic carcinoma., Patients and Methods: AXP107-11 was given orally in escalating doses (400 mg-1600 mg daily) in combination with standard gemcitabine treatment (1000 mg/m(2)/week) for the first seven of eight weeks and thereafter for a maximum of four × four-week treatment cycles. PK, safety, MTD and efficacy of AXP107-11 in combination with gemcitabine were evaluated., Results: Sixteen patients were enrolled and received AXP107-11. The maximum concentration in serum of unconjugated (free) genistein was 1 μM. Neither dose-limiting toxicities (DLTs) nor signs of hematological or non-hematological toxicities related to AXP107-11 were observed over a period ranging from 0.7 to 13.2 months. The median overall survival time was 4.9 months (range 1.5-19.5 months). Seven patients (44%) survived longer than six months and 19% were alive at the one-year follow-up., Conclusion: Treatment of pancreatic cancer patients with AXP107-11 in combination with gemcitabine resulted in a favorable PK-profile with high serum levels without signs of either hematological or non-hematological toxicity. Accordingly, we suggest further studies with AXP107-11 in pancreatic cancer patients., (Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.)

Introduction: Television (TV) viewing by children may be linked to a range of adverse health and behavioral outcomes. This study was aimed at examining the relationship between socioeconomic factors of families and TV watching behavior among 3-5 years old children in Ardakan, Yazd, Iran., Materials and Methods: In the cross-sectional study, mothers of 188 children (93 boys and 95 girls) between 3 and 5 years old completed a researcher-designed questionnaire. Data were analyzed by using SPSS, using bivariate correlations and t-test for independent samples., Results: The mean of TV viewing was 2.68 ± 1.6 h daily, ranging from 0 to 9 h. There were no statistically significant gender differences on the basis of daily TV watching. There were positive associations between the children's daily TV watching and age as well aschildren's daily TV watching and their mothers' time spent on watching TV. Children who lived in houses with the yard and could use it as a playground watched less TV than did the children who lived in houses without the yard., Conclusion: The results suggest that health care professionals should be aware of the association between different socioeconomic status aspects of families, such as the children's and mothers' time spent on watching TV and having a yard in the house in an attempt to develop effective strategies and interventions to prevent excess TV watching.

Background: Emotional conditions governing the family and patients' perceived social support play important roles in the treatment or relapse process of the chronic disease., Objectives: The current study aimed to investigate the role of family expressed emotion and perceived social support in prediction of addiction relapse., Patients and Methods: The descriptive-correlation method was used in the current study. The study population consisted of the individuals referred to the addiction treatment centers in Ardabil from October 2013 to January 2014. The subjects (n = 80) were randomly selected using cluster sampling method. To collect data, expressed emotion test by Cole and Kazaryan, and Multidimensional Scale of Perceived Social Support (MSPSS) were used, and the obtained data was analyzed using the Pearson's correlation coefficient and multiple regression analyses., Results: Results showed a positive relationship between family expressed emotions and the frequency of relapse (r = 0.26, P = 0.011) and a significant negative relationship between perceived social support and the frequency of relapse (r = -0.34, P = 0.001). Multiple regression analysis also showed that perceived social support from family and the family expressed emotions significantly explained 12% of the total variance of relapse frequency., Conclusions: These results have implications for addicted people, their families and professionals working in addiction centers to use the emotional potential of families especially their expressed emotions and the perceived social support of addicts to increase the success rate of addiction treatment.

Introduction: Rabies is a fatal zoonotic viral disease that is spread to people through animal bites. Around 35,000-50,000 individuals worldwide die of rabies each year, of which more than 99% of deaths occur in the developing countries. Since legislative actions does not appear to have been effective in reducing the incidence and severity of the bites in some developed countries, it seems public education is key to reducing animal bites. For effective education, understanding factors affecting the preventive and protective behaviors based on appropriate health behavior change models is important. So, the study tried to examine the relationship between Health Belief Model (HBM) constructs and rabies preventive measures., Materials and Methods: In the cross-sectional study, a HBM-based researcher-designed questionnaire was completed by 204 participants who were selected via cluster sampling design from urban families of the Abadeh, Iran. The psychometric properties of the questionnaire were established. Descriptive statistics, independent sample t-test, bivariate correlations, and stepwise multiple regression analysis were applied to analyze data using SPSS 19. The level of significance was set a priori at 0.05., Results: The scale mean for the total knowledge of the participants about rabies was 14.12 ± 6.04 out of 29. Participants' preventive behaviors were significantly correlated with their total knowledge, perceived susceptibility, perceived severity, perceived benefits and cues to action, which 19% of the variation in these behaviors were explained by perceived benefits and cues to action. Protective activities of participants who kept animals in their house had statistically significant correlation with their total knowledge score and cues to action. 32.1% of the variation in these activities was explained by cues to action., Discussion: Findings indicate that participants had not enough knowledge about routes of infecting by rabies and how to prevent it. The most powerful predictors for preventive behaviors and protective activities were perceived benefits and cues to action, respectively, which indicate the importance of the availability of accurate information about efficacy of these behaviors, from sources that are easily accessible, such as healthcare providers and veterinary professionals., Conclusion: Educational programs are needed for increasing public knowledge in this area. And more studies should be done to determine predictive factors of rabies preventive measures based on other health behavior change models.

Background: Since the mental health of marginal settlers (non-native population) may affect other citizens' health, the present study attempts to investigate the mental health status of marginal settlers of Yazd., Materials & Methods: this study was a descriptive, cross-sectional research, in which 400 of non-native and native population have participated. To study mental health status of people, a questionnaire was used. The first section of this questionnaire was the 28-item questionnaire of GHQ and the second section dealt with demographic characteristics such as age, sex, employment status, household income, and educational level of the father of the family. The collected data was analyzed using statistical operations of Pearson correlation coefficient, T Student, univariate Anova, and non-parametric Chi Square., Results: The results revealed that the average scores of general health were 20.09±9.84 and 17.04±9.54 for native and non-native population, respectively. Among subscales of general health, the highest and lowest average scores belonged to social dysfunctions, which showed a dangerous mental health status, and depression, respectively. There was significant difference between average score of general health and educational level of the father of the family (p<.001). The temporary employment and leased household differs significantly from the average score of general health among native population. It was indicated that sex was one of the most powerful predictors of mental health and people had more mental health when they grew older. Anxiety was the strongest predictor of general health for both groups., Conclusion: It seems that background factors such as educational level and employment status effect general health of people more than living in marginal settlement.

The p53 tumor suppressor gene is inactivated by point mutation in a large fraction of human tumors, allowing evasion of apoptosis and tumor progression. p53 mutation is often associated with increased resistance to therapy. Pharmacological reactivation of mutant p53 is an attractive therapeutic strategy. We previously identified p53 reactivation and induction of massive apoptosis, a low-molecular weight compound that suppresses the growth of cancer cells in a mutant p53-dependent manner. Here, we report the identification and characterization of an extract from the terrestrial plant Brachylaena ramiflora (Asteraceae) that preferentially induces apoptosis in human tumor cells expressing mutant p53. Further analysis of this extract and identification of active compounds may provide novel structural scaffolds for the development of mutant p53-targeting anticancer drugs.