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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. [ABSTRACT FROM AUTHOR]

Introduction. The outbreak of COVID-19 has led to various challenges for healthcare workers, including nurses. Nurses play a critical role in the fight against this disease, and their communication of self-efficacy and job satisfaction has garnered significant attention. This study aimed to investigate the relationship between communication self-efficacy and job satisfaction of Iranian nurses during the COVID-19 pandemic. Methods. This study was conducted using a cross-sectional design. A total of 500 nurses working in hospitals in Iran were selected using a convenience sampling method. The communication self-efficacy scale and the job satisfaction scale were used to collect data. Results. The study found that nurses with higher communication self-efficacy exhibited better performance and job satisfaction in various work challenges (r = 0.56, p < 0.001). However, nurses holding a master's degree or higher reported the lowest average communication self-efficacy and job satisfaction scores during the COVID-19 epidemic. The study also explored the impact of shift work on job satisfaction among nurses and found that nurses working exclusively on the morning shift reported the highest average job satisfaction score. Conclusion. The findings of this study suggest that communication self-efficacy is an important factor in predicting job satisfaction among Iranian nurses during the COVID-19 pandemic. Therefore, it is recommended that healthcare organizations provide effective communication training sessions and mental health interventions to enhance nurses' communication self-efficacy and job satisfaction. This can ultimately lead to improved performance and better patient outcomes. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. There were statistically significant correlations between all constructs of the EPPM model except knowledge, with adherence to Covid-19 preventive behaviors. Self-efficacy and response efficacy were the strongest predictors of Covid-19 prevention behaviors Perceived susceptibility and severity were the other significant predictors of Covid-19 preventive behaviors. Knowledge indirectly through the mediating role of response efficiency and self-efficacy effected on preventive behaviors [ABSTRACT FROM AUTHOR]

Simple Summary: We studied real-world patients with locally advanced rectal cancer receiving preoperative radiotherapy with or without chemotherapy. The aim was to find factors associated with complete response to therapy, i.e., no remaining tumour, that could be used to identify patients who would not need surgery in the future. Tumour stage and length, intensity of preoperative treatment, and laboratory factors, such as carcinoembryonic antigen (CEA), leucocyte counts, and platelets, were all associated with complete response. Treatment intensity mattered and when radiotherapy was combined with chemotherapy, 21% had a complete response compared to 8% with radiotherapy alone. A model for identifying patients with a better chance of achieving a complete response was developed using tumour stage and length, CEA, and leukocyte levels as factors predicting complete response. 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effect of Health Belief Model-based education on determinants of intention to perform influenza prevention behaviors among the older adults. In this experimental controlled randomized study conducted on 100 rural older adults (50 in each group), four education sessions were conducted for the experiment group. Data were collected by a researcher who made the questionnaire, before and 2 months after intervention. The data were analyzed in SPSS 21. The level of significance was set at 0. 05. Two months after the intervention, the mean scores of perceived susceptibility, perceived severity, perceived barriers, and perceived benefits in the intervention group significantly changed (P <.001) but mean scores of cues to action perceived self-efficacy, and intention to perform influenza preventive measures did not change significantly. Only the intention to receive the vaccine and using a mask in the experimental group after intervention showed significant differences (p <.001). The finding suggests that the Health Belief Model can be a proper model to promote influenza prevention behaviors, especially vaccination and using masks. [ABSTRACT FROM AUTHOR]