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Background: Given the extensive impact of road traffic accidents (RTAs) consequences and their potential ramifications on the health of both current and future generations, this study examines the social and demographic factors that influence RTA‐related mortality among women of reproductive age. Methods: The study population consisted of cases retrieved from the database of the Legal Medicine Organization, encompassing all women aged 15–49 who succumbed to road accidents between 2011 and 2021. Results: The mean age of women in the reproductive age group from East Azerbaijan province between 2011 and 2021 was 33.67 years, with a standard deviation of 9.18. RTAs on main roads accounted for the majority of incidents (395 cases, 50.8%), with 93.7% (728 cases) attributed to road traffic. In 54.4% of these cases, the affected organ was the head and neck, and the primary cause of death in 52.1% was head trauma. Across all age groups, injuries to the neck and head were the most common, followed by injuries to the abdomen, chest, back, and sternum. Conclusion: The higher incidence of road accidents in the 25–29 age group highlights the need for targeted interventions to address risky behaviors, inexperience, and peer influences in this demographic. Our observation of passengers experiencing the highest mortality rate emphasizes the vulnerability of road users, particularly pedestrians, in traffic accidents. Pedestrian violations in the 17–30 age group further emphasize the importance of education and awareness campaigns aimed at reducing risky behavior. [ABSTRACT FROM AUTHOR]

Introduction: Acknowledging the considerable influence of undernutrition on health outcomes and HRQOL, this study sought to appraise the nutritional risk status of elderly patients with cardiovascular diseases (CVD) through the utilization of the Nutritional Risk Screening (NRS). Additionally, the investigation aimed to evaluate the correlation between NRS status and HRQOL within the context of patients referred to a cardiac hospital in Tabriz, Iran. Methods: This cross-sectional study was conducted in Tabriz, Iran. The participants were selected randomly from patients referring to Shahid Madani Heart Hospital, a comprehensive university hospital during July to December 2018. A linear regression was used for control of confounding variables (age, gender, education level, marital status, and income levels) and predict the relationship between nutrition risk status and HQRL. Results: Of the 200 patients with CVD participated in this study, 68 (34%) of participants had normal nutrition status, 108 (54%) were at risk for undernutrition, and 24 (12%) had undernutrition. A total of 24 aging patients with undernutrition, 13 (54%) were divorced or widowed. 86% of patients with diabetes were at risk for undernutrition and 13.9% had undernutrition. There were statistically significant relationship between undernutrition and HRQOL dimensions, age, gender, and marital status. Conclusion: The study revealed a correlation between elevated undernutrition scores in patients and factors such as older age, female gender, and marital status of being divorced or widowed. Furthermore, the results imply that a notable elevation in the risk score for undernutrition in patients is significantly linked to impaired HRQOL among elderly individuals with CVD. [ABSTRACT FROM AUTHOR]

Background and Aims: Brucellosis is one of the zoonotic diseases that endanger the health of the population, particularly in developing countries. This study aimed to assess risk perception and behaviors of livestock farmers on brucellosis based on PRECEDE model in a rural area in the northwest of Iran. Methods: This was a cross‐sectional study conducted with 365 livestock farmers in rural areas of Germi, Iran. Participants were selected random sampling method. Data were gathered using a PRECEDE model based questionnaire consisted of five sections including demographic characteristics, predisposing factors (knowledge and attitudes), reinforcing factors, enabling factors, and brucellosis preventive behaviors. Results: The mean ± SD of age of participants was 47.1 ± 14.7 years. The state of knowledge about preventive behaviors and ways of disease transmission was evaluated as appropriate (with 87% and 81% of the maximum score, respectively). Three aspects of attitude in participants were desirable. Predisposing factors including knowledge of prevention ways, knowledge of transmission ways, and attitudes toward prevention, reinforcing factors, as well as education were significant predictors of brucellosis preventive behaviors. R2 and adjusted R2 were 0.312 and 0.310, respectively, according to which, about 31% of the changes in the brucellosis preventive behaviors explained by significant dependent variables. Conclusions: Given that farmers are at particular high risk of exposing brucellosis, improving their knowledge and desirable attitudes of brucellosis is crucial to increasing control the disease. [ABSTRACT FROM AUTHOR]

Cyclic mastalgia is one of the most prevalent problems in women of reproductive age and sometimes it is so severe that it influences their activities and requires treatment. The available drug treatments for mastalgia are not satisfactory and most patients have inclined towards complementary and alternative medicine including herbal medicines. Therefore, in order to evaluate the effectiveness and side effects of herbal medicines conducting systematic review studies and meta-analysis seems essential, thus this systematic review was conducted with the aim of determining the effect of herbal medicines on cyclic mastalgia and its probable side effects. The databases of Pubmed, Medline, Embase, ProQuest, Scopus, Web of science, Complementary Medicine Database, SID (Scientific information database), Magiran and Iranmedex were searched from 1997 to 2020 and limited only for English and Persian languages. The studies were appraised according to the Cochrane Collaboration's tool. Meta-analysis was conducted using RevMan software. Standardized mean difference (SMD) was calculated to assess an overall estimate of effectiveness for the continuous data. Odds ratio (OR) was calculated for dichotomous data. Thirty papers were included in the study. Meta-analysis of data demonstrated that herbal medicine was an effective method in reducing the severity of mastalgia compared to the placebo (SMD: −3.26, 95% CI: −5.05 to −1.46, p=0.00004). Subanalysis of data showed no difference between the effectiveness of herbal medicine on the severity of mastalgia compared to the pharmacologic treatment. This research demonstrated efficacy of herbal medicines in alleviating cyclic mastalgia. Therefore, these herbal medicines can be regarded as an alternative treatment for women suffering from cyclic mastalgia. However, due to the limited number of studies in relation to each specific herbal treatment, conducting further studies in this area is recommended. [ABSTRACT FROM AUTHOR]

Endometriosis is one of the leading gynecological disorders in reproductive ages. About two-thirds of women with endometriosis experience chronic pelvic pain. There are different methods for the assessment of pain in endometriosis. One of these questionnaires is endometriosis painful symptoms-4 dimensions (ENDOPAIN-4D) questionnaire, which has not been validated in Iran. Therefore, we decided to conduct a study to determine the psychometric properties of this questionnaire. In this study, we randomly selected 169 women with endometriosis from two educational-medical centres of Al-Zahra and Taleghani in Tabriz, Iran, in 2020. We evaluated the validity of ENDOPAIN-4D in terms of face, content, and structure (through exploratory and confirmatory factor analyses). We used internal consistency assessment and test-retest reliability to determine the questionnaire reliability. In this study, the CVI and CVR for the ENDOPAIN-4D instrument were obtained as 0.99 and 0.98, respectively. In the exploratory factor analysis, we extracted a four-factor structure, and the confirmatory factor analysis gave a good fit for the extracted model. We obtained Cronbach's alpha coefficient as 0.96 and the intra-class correlation coefficient (ICC) (at 95% confidence interval) as 0.94 (0.85 to 0.98). The Persian version of ENDOPAIN-4D has acceptable content validity, construct validity and reliability for the evaluation of pelvic pain and gynaecology in Iranian women with endometriosis. What is already known on this subject? There are different methods for the assessment of pain in endometriosis. But there is no specific psychometric instrument to determine the painful symptoms of endometriosis in Iran so far. What do the results of this study add? The Persian version of ENDOPAIN-4D is a valid and reliable instrument for the evaluation of pelvic pain and gynaecology in Iranian women with endometriosis. What are the implications of these findings for clinical practice and/or future research? The validation of the Persian version of the ENDOPAIN-4D questionnaire leads to correct assessment of painful symptoms in Iranian women with endometriosis and will be useful in evaluating the patients' pain intensity and the response to treatment in practice. [ABSTRACT FROM AUTHOR]

Background Road traffic crashes (RTCs) and its associated injuries are one of the most important public health problems in the world. In Iran, RTCs rank second in terms of mortality. To address this issue, there is a need for research-based interventions. Prioritizing researches using a variety of approaches and frameworks to determine the most effective interventions is a key nodal point in the RTCs' research policy planning cycle. Thus, this study aims to generate and prioritize research questions in the field of RTCs in Iran. Methods By adapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 25 prominent Iranian academic leaders having role in setting Iran's long-term road safety goals, a group of research funders, and policymakers. The experts' proposed research questions were independently scored on a set of criteria: feasibility, impact on health, impact on the economy, capacity building, and equity. Following the prioritization of Research Questions (RQs), they were all classified using the 5 Pillar frameworks. Results In total, 145 Research Questions were systematically scored by experts against five criteria. Iran's top 20 road traffic safety priorities were established. The RQs related to "road safety management" and "road and infrastructure" achieved a high frequency. Conclusions The top 20 research questions in the area of RTCs in Iran were determined by experts. The majority of these RQs were related to "road safety management". The results of this study may contribute to the optimal use of resources in achieving long-term goals in the prevention and control of road traffic crashes and its related injuries. Considering these RQs as research investment options will improve the current status of Road Traffic Injuries (RTIs) at a national level and further advance toward compliance with international goals. If these research priorities are addressed, and their findings are implemented, we can anticipate a significant reduction in the number of crashes, injuries, and deaths. [ABSTRACT FROM AUTHOR]

Backgrounds: Web-based therapeutic approaches are new and attractive tools for primary health care systems due to their time and cost-saving nature and their accessibility for different populations. The aim of the current systematic review and meta-analysis is to summarize the results of studies evaluating the effect of web-based interventional programs on weight loss among overweight and obese individuals.Methods: A literature review from 2000 to 2016 was conducted. Studies were included in the study if they had adult participants with body mass index (BMI) ≥ 25 kg/m2, a web-user intervention arm, and a non-web user control arm, with the primary aim of weight loss. Weight change in the interventional group versus control group was pooled with the random-effect model. Data were extracted on sample characteristics, drop-outs, weight loss, intervention duration, and the amount of weight loss. The mean weighted difference and 95% confidence intervals (CI) were calculated.Results: Eight studies met the inclusion criteria and included in the final model. Overall, using the web-based interventions had a weak non-significant effect on weight loss in overweight and obese individuals (WMD 0.56 kg, CI - 3.474, 4.592; P = 0.786). The most important reason was the unadjusted baseline weight of experimental and control groups in included studies, although the stratified analysis showed that, low study quality score and not using feedback and goal-setting in the study were the main factors diminishing the effectiveness of web-based intervention treatment group.Conclusion: The results of the current meta-analysis indicated no effectiveness of web-based interventional programs in the weight loss of overweight and obese individuals. Although the great between-study heterogeneity and a small number of included studies further highlight the need for additional researches in this field. [ABSTRACT FROM AUTHOR]

Aims: To identify the association between mental health problems, eating behavior patterns, nutrient intakes and health related quality of life (HRQoL) among Iranian female adolescents. Materials and methods: The current cross-sectional study conducted among three high-schools randomly selected from 10-day-public high schools in the selected sub-county from Tabriz city-Iran between December 2015 through March 2016. Participants were a sample of 107 adolescent girls aged 15–17 years old. Anthropometric parameters were measured and assessments of HRQoL, mental health problems and eating behavioral patterns were performed by Short Form 36 (SF-36), Strengths and Difficulties Questionnaires (SDQ) and Eating Behavioral Pattern Questionnaire (EBPQ) respectively. Dietary intake was assessed using a semi-quantitative Food-Frequency Questionnaire (FFQ) adapted for the Iranian society. Quality of life was measured with HRQoL questionnaire. Quantitative analysis using independent sample t test was performed for comparison of continuous variables between two subgroups (unlikely, possible/probable) of each category of mental health problem. Multiple logistic regression was used to measure the potential predictors (e.g. eating patterns and HRQoL) of mental health problems in two models of crude and adjusted for age and body mass index (BMI). P values less than 0.05 were considered as statistically significant. Results: Indicators of conduct problems and hyperactivity disorders were the most prevalent mental health problems among female adolescents (25.2% and 18.6% respectively). The prevalence of hyperactivity disorders among female adolescents was 35.5%. Female adolescents in high scores of ‘snacking and convenience’, ‘planning ahead’ and ‘meal skipping’ eating patterns were more likely to have indicators of emotional disorders (P < 0.05). Also, being in the high tertile of ‘low fat eating’ pattern made adolescents less likely to have hyperactivity disorders (P < 0.05). Moreover, according to our finding, high scores of vitality and mental health components of HRQoL were associated with reduced likelihood of emotional disorders, conduct disorders and hyperactivity disorders. No significant difference in terms of BMI and nutrient intakes in different categories of mental health problems according to SDQ scoring was identified. Conclusions: In the current study unhealthy eating patterns including ‘snacking and convenience’, ‘planning ahead’ and ‘meal skipping’ eating patterns were positive predictors of “emotional disorders” while “low fat” eating pattern was negative predictor of hyperactivity disorders. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to investigate factors associated with poor blood pressure (BP) control in older hypertensive patients living in Iran. Poorly controlled hypertension was defined as blood pressure greater than or equal to 140/90 mmHg. Multiple logistic regressions were performed to identify factors associated with poor BP control. Results: More than half of the patients (55.1%) had poor control of hypertension. Multivariate logistic regression analysis showed that being over 60 years of age (OR 1.67; 95% CI 1.18-2.37; p = .003), being widowed or divorced (OR 1.56; 95% CI 1.03-2.35; p = .035], smoking (OR 1.78; 95% CI 1.07-2.65; p = .01], BMI > 25 kg/m2 (OR 1.51 95% CI 1.05-2.78), having a waist circumference = 90 cm (OR 1.7; 95% CI 1.2-2.42; p = .003], the use of calcium channel blockers (OR 2.69; 95% CI 1.26-5.72; p = .01], and the use of angiotensin converting enzyme inhibitors (OR 1.66; 95% CI 1.01-2.72; p = .044] contributed significantly to poor control of hypertension. Making a key BP control screening target (such as age over 60 and waist circumference of 90 cm or more) for cardiovascular specialists and other health care practitioners is needed for elderly patients at risk for poor BP control. [ABSTRACT FROM AUTHOR]

Background: There are a few studies evaluating the predictive value of Framingham risk score (FRS) for cardiovascular disease (CVD) risk assessment in patients with metabolic syndrome in Iran. Because of the emerging high prevalence of CVD among Iranian population, it is important to predict its risk among populations with potential predictive tools. Therefore, the aim of the current study is to evaluate the FRS and its determinants in patients with metabolic syndrome.Methods: In the current cross-sectional study, 160 patients with metabolic syndrome diagnosed according to the National Cholesterol Education Adult Treatment Panel (ATP) III criteria were enrolled. The FRS was calculated using a computer program by a previously suggested algorithm.Results: Totally, 77.5, 16.3, and 6.3% of patients with metabolic syndrome were at low, intermediate, and high risk of CVD according to FRS categorization. The highest prevalence of all of metabolic syndrome components were in low CVD risk according to the FRS grouping (P < 0.05), while the lowest prevalence of these components was in high CVD risk group (P < 0.05). According to multiple logistic regression analysis, high systolic blood pressure (SBP) and fasting serum glucose (FSG) were potent determinants of intermediate and high risk CVD risk of FRS scoring compared with low risk group (P < 0.05).Conclusion: In the current study, significant associations between components of metabolic syndrome and different FRS categorization among patients with metabolic syndrome were identified. High SBP and FSG were associated with meaningfully increased risk of CVD compared with other parameters.Trial Registrations: The study is not a trial; the registration number is not applicable. [ABSTRACT FROM AUTHOR]

Background: It is widely accepted that a healthy lifestyle may decrease the probability of developing cancer. This study aimed to describe a study protocol that makes it possible to explore preventive health lifestyles of Iranian women and their received social support for the purpose of developing cultural strategies to increase breast cancer prevention. Methods: A mixed-methods study will be accomplished in two sequential parts. First, a cross-sectional study will be conducted in which 2,250 Iranian women are recruited by using a random multistage cluster sampling of 20 health care centers. Structured face-to-face interviews will be conducted to obtain information on the participants' health lifestyle and perceived social support. Data will be analyzed using both multivariate regression and structural equation modeling techniques. Then, a qualitative study will be conducted among employed women using a purposive sampling design. Data will be collected by means of focus groups and semi-structured interviews and will be analyzed using a conventional content analysis approach. The results of the quantitative and qualitative study will be used to develop breast cancer preventive strategies. Discussion: Researchers need to acquire knowledge regarding the lifestyle and perceived social support of Iranian women that will foster culturally competent approaches to promote healthy lifestyles to develop breast cancer preventive strategies. Examining breast cancer preventive lifestyles provides valuable information for designing applicable intervention programs for improving women's health. [ABSTRACT FROM AUTHOR]

Background: The aim of the present research was to evaluate the relationship between Mediterranean dietary quality index (Med-DQI) and dietary phytochemical index (DPI) with metabolic risk factors of cardiovascular disease in candidates for coronary artery bypass graft (CABG) surgery.Methods: This was a cross-sectional study on 454 patients aged 35-80 years as candidates of CABG and hospitalized in Tehran Heart Center. Anthropometric and demographic characteristics were obtained from all participants and a 138-item semi-quantitative food frequency questionnaire (FFQ) was used to evaluate Med-DQI and DPI. Biochemical parameters including HbA1C, serum lipids, albumin, creatinine and C-reactive protein (CRP) were assessed by commercial laboratory methods.Results: Patients with higher scores of "saturated fatty acids" had lower serum albumin concentrations (P < 0.05). High scores of "cholesterol" subgroup was also accompanied with higher serum Hb A1C percent (P = 0.04). Significantly higher concentrations of serum creatinine were also observed in categorizes with lower "fish" scores. Patients with lower phytochemical intakes had significantly higher Med-DQI scores.Conclusion: According to our findings, high dietary intakes of saturated fatty acids and cholesterol were associated with low serum albumin and Hb A1C concentration. Further studies are needed to better clarify these associations and possible underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease (CAD) is the leading causes of mortality and morbidity in worldwide. This nested case–control study investigated the predictors of death in long-term follow-up after coronary artery bypass graft surgery (CABG). Methods: Cases were defined as CABG patients who died in the period of May 2006–March 2013. Controls were CABG patients who were alive in the same period. Cases and controls were derived from an existing cohort, Tehran Heart Center-Coronary Outcome Measurement. One hundred and fifty-nine patients in control group were randomly selected from 566 available patients in follow-up database. A series of simple and multiple logistic regressions was performed in the context of univariate and multivariate analyses, respectively, for computing unadjusted and adjusted odds ratios and their confidence intervals (CI). In the univariate analyses, demographic or cardiometabolic factors were entered separately, and for multivariate analysis, we got both significant risk factors from univariate analysis and the major risk factors. Results: The results of multivariate analyses showed that for age, the likelihood of mortality increases in CABG patients (95%CI: 1.1; 1.03–1.2;P< 0.005). Other significant independent risk factors were peripheral vascular disease (PVD) (95%CI: 2.7; 1.06–6.8;P= 0.036), diabetics (95%CI: 2.49; 0.9–6.3;P= 0.039), smoking (95%CI: 4.38; 1.45–13.7;P= 0.011), length of stay in hospital after CABG surgery (95%CI: 1.14; 1.0–1.24;P= 0.001), total cholesterol (95%CI: 1.12; 1–1.2;P= 0.001), and C-reactive protein (CRP) (95%CI: 1.12; 0.99–1.27;P= 0.049) (allP< 0.05). Conclusions: The study results indicated that age, diabetes, cigarette smoking, PVD, long length of stay in hospital, elevated triglycerides, total cholesterol, CRP, and high-density lipoprotein cholesterol were significant contributing to increased mortality after CABG. It seems that vulnerable older patients continue to be at high risk with poor outcomes. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the relationship between Mediterranean dietary pattern, anthropometric and metabolic biomarkers and vascular endothelial growth factor (VEGF) +405 G/C gene polymorphism in patient with metabolic syndrome (Mets). Materials and methods: In this study 150 patients with Mets and 50 healthy subjects were enrolled. Dietary intakes were evaluated with a semi-quantitative food-frequency questionnaire (FFQ) and Mediterranean dietary quality index (Med-DQI) was assessed. Anthropometric assessments and blood pressure measurement were performed. Biochemical assays including fasting serum glucose (FSG), matrix metalloproteinase-3 (MMP-3), liver enzymes and lipid profiles were also assessed. Polymorphism of +405 G/C VEGF gene was determined utilizing polymerase chain reaction-restriction fragments length polymorphism (PCR-RFLP) method. Results: Serum high density lipoprotein-cholesterol (HDL-C) was significantly lower and low density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC) concentrations and FSG were significantly higher in metabolic syndrome patients compared with control group (P < 0.05). Metabolic syndrome group with high consumption of “cholesterol” had significantly upper serum TG; also high consumption of “fish” and “vegetables-fruits” was associated with a significantly lower serum LDL concentrations. In metabolic syndrome patients with CC genotype, mean score of “saturated fatty acid” subgroup was significantly higher compared with other genotypes; whereas, in healthy individuals, mean score of “fruit-vegetable” subgroup in individuals of CC and GG genotype was significantly higher (P<0.05). Conclusion: Our findings indicated a significant relationship between Mediterranean dietary quality index and both anthropometric and metabolic risk factors. We also indicated a higher “saturated fatty acid” intake in CC genotype among metabolic syndrome patients. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome is a growing public health problem worldwide. Several interventions have been proposed to specifically target the problem. This study evaluated the effectiveness of an interactive web-based lifestyle for management of metabolic syndrome.Methods: This randomized controlled trial was conducted from June through August 2012 in Tehran, Iran. Participants were individuals with metabolic syndrome who had registered on the study website. Interested eligible participants were invited for a free clinic visit and clinical assessment. They were randomly assigned to the intervention (n =80) or control (n = 80) group. The intervention group received an interactive web-based program called the Healthy Heart Profile and were followed for 6 months. The control group received general information on metabolic syndrome. Anthropometric measures, glycemic status, and lipid profile were evaluated at baseline, and at 3- and 6-month follow-up assessments. Metabolic syndrome was defined according to The National Cholesterol Education Program Adult Treatment Panel (ATP) III report except for waist circumference, which was modified to ≥90 cm for both genders for the Iranian population.Results: In total, 1,437 individuals registered on the study website. The mean age of participants was 44.2 years (SD  = 10.0). There were no significant differences between the intervention and control groups on any baseline variable except that participants in the intervention group recorded higher levels of LDL. The results showed a decrease in metabolic syndrome in both groups. These reductions were significantly greater in the intervention group at the 3- and 6-month follow-ups. The intervention group showed significantly greater decreases (P < 0.05) over the control group for, respectively, systolic blood pressure (3-month: -10 versus -6 mmHg; 6-month: -11 versus -8 mmHg), diastolic blood pressure (3-month: -10 versus -4 mmHg; 6-month: -11 versus -6 mmHg), weight (3-month: -2 versus -1 kg; 6-month: -4 versus -1 kg), body mass index (3-month: -0.5 versus -0.2 kg/m(2); 6-month: -1.1 versus -0.4 kg/m(2)) and improvement in HDL (3-month: 2 versus 0.64 mg/dl; 6-month: 6 versus 4 mg/dl).Conclusion: The findings suggest that the web-based interactive program was beneficial for individuals with metabolic syndrome. Comprehensive interactive web-based prevention programs are promising to help involve patients in improving management of metabolic syndrome and adopting a healthy lifestyle.Trial Registration: IRCT201111198132N1 . Registered 27 May 2013. [ABSTRACT FROM AUTHOR]

BACKGROUND: Lifestyle is recognized as a key factor as the cause and management of the metabolic syndrome. The aim of this study was to identify individuals at increased cardiovascular diseases risk and determine main features of lifestyle of participants with metabolic syndrome via internet. METHODS: The study was conducted from Jun 22 to August 22, 2012 in Tehran, Iran. Recruitment was carried out through the study website. Participants with metabolic syndrome who were interested and met the study criteria were invited for free clinic visits and clinical assessments. Baseline measurements were metabolic syndrome risk factors. Physical activity and dietary intake were measured by international physical activity questionnaire (IPAQ- short form) and the frequency food questionnaire (FFQ) respectively. Metabolic syndrome was defined according to Adult Treatment Panel III diagnostic criteria. RESULTS: Mean (SD) age for men and women were 41.9 (10.4) and 48.1 (7.8) yr respectively. Men were well educated and more likely to participate in the study than women. Men with metabolic syndrome had larger waist circumference (105.5) and lower BMI (29.1) than women with metabolic syndrome (P<0.001). Approximately 73% of the sample was inactive and 3% of participants had health enhancing physical activity. There were significant differences in the intakes of total fat and cholesterol between men and women (P<0.001). CONCLUSIONS: Because of the high prevalence of metabolic syndrome, national lifestyle modification policies must be developed for population. Web-based healthy lifestyle programs may contribute to the reduction of the metabolic syndrome components. [ABSTRACT FROM AUTHOR]

Background: Although effectiveness of web-based interventions on lifestyle changes are recognized, the potential of such programs on metabolic syndrome has not been explored. We describe the protocol of a randomized controlled trial that aims to determine the feasibility, acceptability, usability, and effectiveness of interactive technology on lifestyle intervention in a population with metabolic syndrome. Methods/design: This is a two-arm randomized controlled trial. The study includes 160 participants (n = 80 per arm) who will be recruited via online registration on the study website. The inclusion criteria are that they should have metabolic syndrome and have access to the Internet. All participants will receive information on dietary intake and physical activity through the study website. The intervention group will receive additional resources via the study website including interactive Healthy Heart Profile and calorie restricted diet tailored to the participants. The primary outcomes are feasibility, acceptability, usability, and the change in metabolic syndrome components. The secondary outcomes are comparing quality of life, physical activity and food intake among the study arms. The participants will be followed up to 6 months with data collection scheduled at baseline, 3 and 6 months. Discussion: There is a need for developing and evaluating web-based interventions that target people with high risk for cardiovascular diseases. This study will therefore make an important contribution to this novel field of research and practice. [ABSTRACT FROM AUTHOR]

Background: Understanding the attitudes toward FGM/C held by people who have been involved in this practice can lead to more active interventions to prevent this harmful practice. In order to achieve this, a systematic review was performed on scientific articles. Methods: Electronic databases (PubMed, Scopus, and Science Direct) were examined to identify articles. Results: Our initial search resulted in 3013 articles, of which 40 articles with estimations of attitudes toward FGM/C were reviewed. The results indicate that the random-effects pooled estimation of negative attitudes toward FGM/C practice was 53% (95% CI 47–59; p < 0.001). Furthermore, the pooled estimation of attitudes toward the decision not to circumcise young daughters was 63% (95% CI 46–80; p < 0.001). Conclusion: Despite the increased awareness and efforts to ban FGM/C in many countries around the world, our review demonstrates that positive attitudes toward FGM/C are still far from being eradicated and have hardly changed in the past years. This issue reflects deeply rooted cultural and social concerns of health care professionals with regard to continuing the practice. The authors believe that circumcised women can play a key role in encouraging the abandonment of FGM/C through educational and cultural campaigns. [ABSTRACT FROM AUTHOR]

Acquired immunodeficiency syndrome (AIDS) is one of the main obstacles to communities' development. The disease mostly involves active and productive population groups. This study aimed to determine the knowledge, attitudes, and behaviors of pregnant women regarding HIV prevention and rapid HIV tests. Pregnant women who were referred to the local health centers and who were willing to participate in the study were interviewed. To collect data, a standard questionnaire was used among 200 pregnant women in eight local health centers of Kermanshah, Iran. The survey contained 50 questions on demographic characteristics and the knowledge, attitudes, and behaviors regarding HIV/AIDS prevention and rapid tests for pregnant women. Although the majority (82.5%) of the pregnant women knew that mother-to-child HIV transmission during pregnancy was possible, fewer than half (48.2%) of them knew that HIV can be transmitted from mother to child through breastfeeding. Only 22.5% of pregnant women knew that a Cesarean section for HIV-positive mothers is recommended. The mean attitudes of pregnant women toward HIV prevention and HIV rapid testing were 4.5 (SD = 0.4) and 4 (SD = 0.3), respectively. Of the women, 11.5% had participated in an HIV rapid test counseling class, and 25.5% had participated in HIV education and counseling classes. The low knowledge of mothers regarding HIV transmission highlights the need for education and counseling classes and campaigns to improve knowledge and behaviors related to HIV prevention, especially during pregnancy for women in marginal regions. [ABSTRACT FROM AUTHOR]

Aim: The birth plans were developed as an approach for pregnant women to present their expectations for labour and childbirth. The aim of this study was to assess whether birth plans (a written document in which pregnant women describe preferences about their care during labour and childbearing) compared with standard or routine approach (supine position, continuous fetal monitoring, enema, episiotomy) affect the birth experience (woman's perception of labour and childbirth as positive or negative experience) or satisfaction with birth. Methods: This systematic review was performed by searching several databases, including Cochrane Library, Web of Science, MEDLINE, Embase, CINAHL, Scopus, PsycINFO, ACP Journal Club, Google Scholar, and Persian databases (SID, Magiran, and Barakat) up to February 10, 2018. Results: By searching the databases, 1006 published articles were found, of which 480 and 114 articles were excluded by review of the titles and the abstracts, respectively. Finally, we included three clinical trials (1132 women) in the review. The results of two study showed that the mean score of birth experience in the birth plan group was significantly higher than the control group (P ≤ 0.01). However, the results of a study showed that there were no statistically significant differences between birth plan and control groups (P > 0.05). Quality of included studies was very low. Conclusions: There is not enough evidence to support or refute that birth plan can improve the birth experience or satisfaction with birth. SUMMARY STATEMENT: What is already known about this topic? Birth plans may affect the childbirth experience or satisfaction with labour.What this paper adds? There is not enough evidence to support or refute that implementation of birth plans can improve women's satisfaction with birth.The implications of this paper: Improving women's childbirth experience or satisfaction are important as quality markers of childbirth care.Further randomized controlled trials are needed to study the effect of birth plans on women's childbirth experience or satisfaction. [ABSTRACT FROM AUTHOR]

Background and aims: Metabolic syndrome is a major public health problem in worldwide and Iran. It is argued that metabolic syndrome is the most responsible risk factor for developing the disease People with metabolic syndrome has 1.5- to 3-fold increase in the risk of coronary heart disease and stroke. The prevalence of metabolic syndrome in Iran is very high. Consistent with the Adult Treatment Panel III (ATP III), diagnostic criteria for metabolic syndrome include: Abdominal obesity determined by increased waist circumference, raised triglycerides, reduced HDL, elevated blood pressure, and raised plasma glucose. When 3 of 5 of the characteristics are present, a diagnosis of metabolic syndrome can be made. The internet is a relatively new and effective method of delivering strategies to detecting high risk people with metabolic syndrome and helps them adopt healthy behavior. The aim of study is delivering an online interactive method for metabolic syndrome detection among general population in Tehran. Methods: The study web page (http://www.Heartresearch.ir) is designed in order to increase awareness of visitors about prevention of cardiovascular diseases and metabolic syndrome risk factors. Metabolic syndrome components are designed and implement on the study Homepage as interactive calculator tool. Users could use the calculator tool then receive their own risk signs and feedback about each risk factor for metabolic syndrome that they have. Participants were invited for clinical assessments of metabolic syndrome in Tehran Heart Center. Results: In total, 1,437 individuals registered on the study website. Of these, 815 records were excluded because registrants were living outside Tehran (n=356), had a waist circumference <90 cm (n=392), or had incomplete information (no telephone number; n= 67). In total, 317 individuals were invited to clinical assessments. Of these, 229 were able to attend clinical assessments and were scheduled for a baseline visit, finally 171 had metabolic syndrome. Conclusion: Effective and affordable strategies to control the syndrome could benefit the at risk population. The integration of interactive e-health programs to primary health care practices such as prevention of cardiovascular risk factors offers possibilities for on-time interaction with the target group. The use of web-based approaches is a great interest in the management of patients at high cardiovascular risk, especially in a scenario where the prevalence of obesity, metabolic syndrome and diabetes is increasing. [ABSTRACT FROM AUTHOR]

Background: Previous studies reported the association between dietary patterns and prevalence of diabetes, cardiovascular disease and other chronic disease. However, there are no studies reporting major dietary patterns in patients awaiting coronary artery bypass graft surgery (CABG). The aim of this study was to obtain the major dietary patterns and their association with demographic, dietary factors and biochemical parameters in these patients. Methods and materials: This was a cross-sectional study on 454 patients aged 35 - 80 years as candidates of CABG and hospitalized in the Tehran Heart Center. Anthropometric and demographic characteristics were obtained from all participants and a 138-item semi-quantitative food frequency questionnaire (FFQ) was used to evaluate dietary patterns by factor analysis. Biochemical parameters including HbA,c, serum lipids, hematocrit (HCT), albumin, creatinine and CRP were assessed by commercial laboratory methods. Results: Five major dietary patterns, including: healthy, intermediate, neo-traditional, western and semi-Mediterranean patterns were extracted. Top quartile of healthy pattern was associated with higher educational attainment and lower serum low-density lipoprotein cholesterol (LDL), and total cholesterol (TC) in men, as well as higher high-density lipoprotein cholesterol (HDL) concentrations in women (P < 0.001). Individuals in top quartiles of intermediate and neo-traditional pattern were more likely to be male, had higher smoking and drinking habits, as well as the lower prevalence of diabetes, hyperlipidemia and hypertension (P < 0.05). They also had higher serum triglyceride(TG) concentrations. Patients in the western pattern also had a higher prevalence of a family history of cardiovascular disease and higher serum TG concentrations. Top quartiles of semi-Mediterranean pattern were associated with lower C-reactive protein (CRP) concentrations in women. Conclusions: There were five major dietary patterns using FFQ among patients awaiting CABG surgery. Significant associations were observed between major dietary patterns and risk of diabetes and hypertension. Top quartiles of healthy eating patterns were associated with lower cardio-metabolic risk factors. [ABSTRACT FROM AUTHOR]