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Background: Breast cancer is a prevalent cancer characterized by its aggressive nature and potential to cause mortality among women. The rising mortality rates and women's inadequate perception of the disease's severity in developing countries highlight the importance of screening using conventional methods and reliable scales. Since the validity and reliability of the breast cancer perception scale (BCPS) have not been established in the Iranian context. Therefore, this study aimed to determine the measurement properties of the BCPS in women residing in Tabriz, Iran. Methods: The present study comprised a cross-sectional design, encompassing a sample of 372 Iranian women. The participants were selected through a multi-stage cluster random sampling technique conducted over a period spanning from November 2022 to February 2023. The measurement properties of the Iranian version of BCPS were assessed following the guidelines outlined in the COSMIN checklist. This involved conducting various steps, including the translation process, reliability testing (internal consistency, test-retest reliability, and measurement error), and methodological tests for validity (content validity, face validity, construct validity, and hypothesis testing). The study also investigated the factors of responsiveness and interpretability. The presence of floor and ceiling effects was assessed. Results: The internal consistency of the scale was assessed using Cronbach's alpha, yielding a satisfactory value of 0.68. Additionally, McDonald's omega (95% CI) was computed, resulting in a value of 0.70 (0.66 to 0.74). Furthermore, the test-retest reliability was evaluated, revealing a high intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94 to 0.99). The CVI, CVR, and impact scores of the BCPS were determined to be 0.98, 0.95, and 3.70, respectively, indicating favorable levels of content and face validity. To assess construct validity, an examination of the Exploratory Factor Analysis (EFA) was conducted on a set of 24 items. This analysis revealed the presence of six distinct factors, which collectively accounted for 52% of the cumulative variance. The fit indices of the validity model (CFI = 0.91, NFI = 0.96, RFI = 0.94, TLI = 0.90, χ2/df = 2.03, RMSEA = 0.055 and SRMR = 0.055) were confirmed during the confirmatory factor analysis (CFA). The overall score of BCPS exhibited a ceiling effect of 0.3%. The floor effect observed in the overall score (BCPS) was found to be 0.5%. Concerning the validation of the hypothesis, Spearman's correlation coefficient of 0.55 was obtained between the BCPS and the QLICP-BR V2.0. This correlation value signifies a statistically significant association. Furthermore, it is worth noting that the minimum important change (MIC) of 3.92 exhibited a higher value compared to the smallest detectable change (SDC) of 3.70, thus suggesting a satisfactory level of response. Conclusions: The obtained findings suggest that the Iranian version of the BCPS demonstrates satisfactory psychometric properties for assessing the perception of breast cancer among Iranian women. Furthermore, it exhibits favorable responsiveness to clinical variations. Consequently, it can serve as a screening instrument for healthcare professionals to comprehend breast cancer and as a reliable tool in research endeavors. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of postpartum anxiety as a common psychological problem affects a large part of women's lives. Despite the existence of tools in this field, but due to the lack of specificity in reflecting postpartum anxiety, it is necessary to have a specific tool to screen it. Since the psychometric evaluation of the Postpartum Specific Anxiety Scale-Research Short-Form (PSAS-RSF) among Iranian women has not been assessed in Iran until now, so we decided to conduct this study with the aim of psychometric evaluation of the PSAS-IR-RSF. Methods: We included 180 women (six weeks to six months postpartum) in the study by random sampling during the period from December 2021 to June 2022. We examined the validity of the PSAS-IR-RSF tool in terms of face, content and construct (through exploratory and confirmatory factor analyses). We used internal consistency and test-retest reliability to determine the reliability of the scale. Results: In the present study, content validity index (CVI) and content validity ratio (CVR) of the PSAS-IR-RSF tool were equal to 0.91 and 0.97, respectively. We extracted a four-factor structure through the process of exploratory factor analysis. The values of fitting indices confirmed the validity of the model. Cronbach's alpha coefficient was equal to 0.72 and intra-class correlation coefficient (with 95% confidence interval) was 0.97 (0.98 to 0.93). Conclusions: The Persian version of the PSAS-IR-RSF is a valid and reliable tool for the specific evaluation of postpartum anxiety among Iranian women. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of postpartum anxiety as a common psychological problem affects a large part of women's lives. Despite the existence of tools in this field, but due to the lack of specificity in reflecting postpartum anxiety, it is necessary to have a specific tool to screen it. Since the psychometric evaluation of the Postpartum Specific Anxiety Scale-Research Short-Form (PSAS-RSF) among Iranian women has not been assessed in Iran until now, so we decided to conduct this study with the aim of psychometric evaluation of the PSAS-IR-RSF. Methods: We included 180 women (six weeks to six months postpartum) in the study by random sampling during the period from December 2021 to June 2022. We examined the validity of the PSAS-IR-RSF tool in terms of face, content and construct (through exploratory and confirmatory factor analyses). We used internal consistency and test-retest reliability to determine the reliability of the scale. Results: In the present study, content validity index (CVI) and content validity ratio (CVR) of the PSAS-IR-RSF tool were equal to 0.91 and 0.97, respectively. We extracted a four-factor structure through the process of exploratory factor analysis. The values of fitting indices confirmed the validity of the model. Cronbach's alpha coefficient was equal to 0.72 and intra-class correlation coefficient (with 95% confidence interval) was 0.97 (0.98 to 0.93). Conclusions: The Persian version of the PSAS-IR-RSF is a valid and reliable tool for the specific evaluation of postpartum anxiety among Iranian women. [ABSTRACT FROM AUTHOR]

Background: Due to its high pervasiveness and adversarial consequences, postpartum anxiety has been one of the most worrying public health concerns in the last decade. According to previous research, the occurrence of mental disorders among women in the postpartum period upsurges significantly in the course of universal disasters. The Postpartum Specific Anxiety Scale – Research Short Form – for use in global Crises [PSAS-IR-RSF-C] has not been used in Iran for postpartum women during a health system shock. Consequently, this study was conducted to determine the validity and reliability of the Persian version (PSAS-IR-RSF-C) during the COVID-19 pandemic. Methods: This cross-sectional study was performed with 180 women who were between six weeks and six months after delivery, by random sampling method from December 2021 to June 2022. The validity of the PSAS-RSF-C in terms of face, content, was analyzed, and the construct validity was assessed using exploratory and confirmatory factor analyses. Internal consistency and test–retest reliability of the questionnaire were measured using (Cronbach's alpha, McDonald's ω) and intraclass correlation coefficient (ICC), respectively. Results: The content validity index and content validity ratio of the Persian version of the PSAS-IR-RSF-C were 0.96 and 0.98, respectively. A three-factor structure was extracted during the exploratory factor analysis process, and model validity was confirmed by the values of fit indices. Cronbach's alpha coefficient, McDonald's ω and intra-cluster correlation coefficient (95% confidence interval) were 0.74, 0.92 (0.78 to 0.93) and 0.97 (0.93 to 0.98), respectively. Conclusions: For the specific assessment of postpartum anxiety among Iranian women during crises, the Persian version of the PSAS-IR-RSF-C is a valid and reliable tool. [ABSTRACT FROM AUTHOR]

Background: The quality of sleep has different physicalandpsychological consequences, andcan affect students' academic achievement. Objectives: This study aimed to explore factors associated with sleep quality in university students using panel regression. Methods: This study was conducted based on the data from a longitudinal study, namely the "Health and Lifestyle of University Students". The Pittsburgh Sleep Quality Index (PSQI), a self-administered questionnaire containing general information about sleep quality, Beck Anxiety Inventory (BAI), a questionnaire consisting of information about anxiety, Healthy Lifestyle Scale for University Students (HLSUS), and a questionnaire including information about lifestyle were completed by students during the first eight weeks of their first semester. The Panel linear regression and frontier model were used to assess the association of sleep quality with sex, unit, residency, marital status, teeth brushing, drug use, alcoholic drinks, age, anxiety, and healthy lifestyle. Results: A total of 706 individuals (46.8%) suffered from poor sleep quality. Between the two models of panel linear regression and frontier, the former (i.e., panel linear regression) was determined to be a more powerful model with the Akaike information criteria = 3790.68 and Bayesian information criteria = 3899.712, suggesting that the dormitory students with a high level of anxiety and low level of healthy lifestyle had significantly poor sleep quality. Conclusions: Residency, drug use, anxiety, and healthy lifestyle scale were found to be closely associated with sleep quality of university students by using panel linear regression model. Our finding may have been of valuable help to policymakers and planners in their effort to improve the sleep quality of university students. [ABSTRACT FROM AUTHOR]

In this prospective cohort study, we aimed to investigate external validity of the Allouche's nomogram to predict preterm birth in symptomatic women in Iran. We employed six variables of cervical length, uterine contractions, rupture of membranes, vaginal bleeding, gestational age, and multiple pregnancy to draw the nomograms. These variables were examined in the first day of women's hospitalization and participants followed up until giving birth. The concordance index of area under the curve (AUC) was used for validation of the nomograms. Of the participants 10% gave birth within 48 hours and 29% before 34 weeks. The nomogram had sufficient accuracy in predicting birth within 48 hours (AUC 0.89 [95% Cl 0.82-0.96]) and birth before 34 weeks (AUC 0.89 [95% Cl 0.84-0.94]). The optimal risk threshold for nomogram predicting birth within 48 hours was 0.16. Use of these two nomograms, can improve the health of women and their neonates. [ABSTRACT FROM AUTHOR]

Background. Parents are especially important for young teens, and they have a considerable impact on adolescents’ development and social adaptation. One of the important factors for understanding parental influence on children’s development is the concept of “parenting style”. Objectives. Due to the lack of standard instruments to measure parenting style, this study was conducted to assess the psychometric properties of the Persian version of the Parenting Style-Four Factor Questionnaire (PS-FFQ). Material and methods. The study included 992 mothers of female students in Tabriz, Iran. Construct validity was assessed by using exploratory factor analyses with varimax rotation and principal component analysis extraction method and by confirmatory factor analysis. In addition, the feasibility of the measure was judged based on ceiling and floor effects. Reliability of the questionnaire was determined using internal consistency. Results. The exploratory and confirmatory factor analysis confirmed four factors, which included 30 of the 32 items and also accounted for 32.91% of the variance. In the Confirmatory Factor Analysis (CFA), the fit indices indicated: Comparative Fit Index (CFI) = 0.92, Tucker-Lewis Index (TLI) = 0.90, Root Mean Square Error of Approximation (RMSEA) = 0.04, providing a strong fit to the data. The internal consistency for the overall scale was acceptable (Cronbach’s alpha = 0.70). Conclusions. The PS-FFQ provides a more comprehensive assessment of parenting styles of adolescents’ parents and may be suitable for wider use. It could also be applicable for psychologists and researchers to examine and identify parenting styles. [ABSTRACT FROM AUTHOR]

Adolescence is a period of transition for developmental and social domains that may also be accompanied by behavioral problems. Aggressive behavior may be a mental health concern for young teens and is defined as a behavioral and emotional trait that may be distressing for others. This study aimed to understand the factors associated with aggressiveness among young teenage girls. A cross-sectional study was conducted among a sample of 707 female middle school-aged students using multistage random sampling in Tabriz, Iran. The variables of interest were aggressiveness, general health status, happiness, social acceptance, and feelings of loneliness. Structural equation modeling was employed to analyze the data. Low parental support, low satisfaction with body image, high sense of loneliness, and lower perceived social acceptance were found to be the factors influencing aggressiveness. The current study found that the school environment, home environment, individual and interpersonal factors all play a part in aggressiveness. As a result, the contributing elements must be considered when creating and executing successful interventions to improve this population's psychological well-being. [ABSTRACT FROM AUTHOR]

Background: Anxiety is one of the most prevalent mental health disorders among mothers during the postpartum period, which can lead to maternal and infant physical and psychological consequences. The Postpartum Specific Anxiety Scale (PSAS) predicts unique variance in postnatal outcomes over and above general anxiety tools. It has never been used in Iran and its validity and reliability have not been assessed either. Therefore, the present study aimed to translate and investigate the psychometric properties of the PSAS-IR.Methods: 510 women, from six weeks to six months postpartum, were selected through random sampling in 2020. After forward and back-translation, the face validity, content validity, and construct validity of PSAS (through confirmatory factor analysis) were examined. The reliability of the scale was assessed using both internal consistency (Cronbach's alpha) and test-retest stability methods.Results: CVI and CVR values of the PSAS tool were 0.89 and 0.88, respectively. The good fit indices confirmed the validity of four-factor structure. Cronbach's alpha coefficient and Intra Correlation Coefficient (ICC) equaled 0.93 and 0.92, respectively.Conclusion: The Persian version of PSAS is a valid and reliable four-factor scale, it will improve the measurement of postpartum anxiety in an Iranian setting. This will improve the measurement of postpartum anxiety in an Iranian setting. [ABSTRACT FROM AUTHOR]

Background: The artificial intelligence field is obtaining ever increasing interests for enhancing the accuracy of diagnosis and the quality of patient care. Deep learning neural network (DLNN) approach was considered in patients with brain stroke (BS) to predict and classify the outcome by the risk factors. Materials and Methods: A total of 332 patients with BS (mean age: 77.4 [standard deviation: 10.4] years, 50.6% -- male) from Imam Khomeini Hospital, Ardabil, Iran, during 2008-2018 participated in this prospective study. Data were gathered from the available documents of the BS registry. Furthermore, the diagnosis of BS was considered based on computerized tomography scans and magnetic resonance imaging. The DLNN strategy was applied to predict the effects of the main risk factors on mortality. The quality of the model was measured by diagnostic indices. Results: The finding of this study for 81 selected models demonstrated that ranges of accuracy, sensitivity, and specificity are 90.5%-99.7%, 83.8%-100%, and 89.8%-99.5%, respectively. Based on the optimal model (tangent hyperbolic activation function with the minimum--maximum hidden units of 10-20, max epochs of 400, momentum of 0.5, and learning rate of 0.1), the most important predictors for BS mortality were time interval after 10 years (accuracy = 92.2%), age category (75.6%), the history of hyperlipoproteinemia (66.9%), and education level (66.9%). The other independent variables are at moderate importance (66.6%) which include sex, employment status, residential place, smoking habits, history of heart disease, cerebrovascular accident type, blood pressure, diabetes, oral contraceptive pill use, and physical activity. Conclusion: The best means for dropping the BS load is effective BS prevention. DLNN strategy showed a surprising presentation in the prediction of BS mortality based on the main risk factors with an excellent diagnostic accuracy. Moreover, the time interval after 10 years, age, the history of hyperlipoproteinemia, and education level are the most important predictors for BS. [ABSTRACT FROM AUTHOR]

aim of the present study was to explore the psychometric properties of a culturally adapted and translated Persian version of the Menopause Rating Scale (MRS). Study Design: The study was conducted on a random sample of 270 middle-aged women (age range 40– 60 yrs) selected from 25 urban health service centers across Tabriz, Iran. Content validity was evaluated by a panel of 11 experts. Construct validity was assessed by exploratory factor analyses with Varimax rotation and principal axis factoring extraction method and by confirmatory factor analyses. Internal consistency and test–retest reliability were assessed with Cronbach's alpha and intra-class correlation coefficient (ICC), respectively. In addition, the feasibility of the measure was judged based on ceiling and floor effects. Results: Content validity of the measure was good with a mean content validity index (CVI) and mean content validity ratio (CVR) of 0.88 and 0.94, respectively. Exploratory factor analyses identified three factors accounting for 47.69% of the variance. Confirmatory factor analyses found the original three-factor model to have the best fit to the data. Cronbach's alpha coefficient (0.85) and the test–retest reliability score (0.91) indicated good internal consistency. Conclusion: The Persian version of the MRS demonstrated excellent reliability and validity. It can therefore be used in both clinical and research settings to assess menopause-related symptoms and associated quality of life. [ABSTRACT FROM AUTHOR]

Background: Fear of progression (FOP) is a common and significant concern among cancer patients, encompassing worries about cancer progression during active treatment. Elevated levels of FOP can be dysfunctional. This study aims to assess the efficacy of an Acceptance and Commitment Therapy (ACT)-based intervention on FOP, anxiety sensitivity (AS), and quality of life (QOL) in breast cancer patients. Methods: A clinical trial was conducted involving 80 stage I-III active-treatment breast cancer patients with a score greater than 34 on the Fear of Progression Questionnaire-Short Form scale. These patients were randomly assigned in a 1:1 ratio to either an intervention group, which received weekly 70-min sessions of 5-ACT-bsed group-therapy, or a control group that received usual treatment. Variables including FOP, AS, QOL, and ACT-related factors were assessed using ASQ, QLQ-C30, Cognitive Fusion Questionnaire, and Acceptance and Action Questionnaire-II at three time points: baseline, post-intervention, and 3-month follow-up. The efficacy of the intervention was evaluated using mixed model analysis across all time-points. Results: The fidelity and acceptability of the ACT-based manual were confirmed using significant methods. A significant reduction in FOP was observed only in the ACT group at post-intervention (P-valueACT < 0.001; Cohen dACT = 1.099). Furthermore, the ACT group demonstrated a more significant reduction in FOP at follow-up. Furthermore, all secondary and ACT-related variables, except for the physical symptoms subscale, showed significant improvement in the ACT group compared to the control group. Conclusions: Our ACT-based manual showed promise for reducing FOP, AS, and improving QOL, and ACT-related variables in breast cancer patients 3 months following the intervention. [ABSTRACT FROM AUTHOR]

Correction: Psychometric evaluation of the postpartum specific anxiety scale - research short-form among Iranian women (PSAS-IR-RSF) B Correction: BMC Pregnancy Childbirth 23, 531 (2023) b B https://doi.org/10.1186/s12884-023-05855-4 b Following publication of the original article [[1]], the authors reported an error in Table 3 in PDF proof. Table 3 in the PDF version contains incomplete details, but HTML version contains complete details. [Extracted from the article]

Background: Childhood overweight/obesity is increasing worldwide. There is evidence on the role of dietary patterns (DPs) and sleep quality on body weight in adults, but studies on the association of major DPs, sleep quality and overweight/obesity among school-age children are scarce, so the present study was done to shade a light on the subject. Methods: This study was a case-control study, conducted on school-age (7-13 years) children. Cases were healthy children who had a body mass index (BMI) percentile of ≥ 85th for age and sex (n = 102). Sex-matched children with a BMI percentile between 5th and 85th were considered as control group (n = 102). Dietary data were collected using a validated 168-item food frequency questionnaire. Sleep quality was assessed by Pittsburgh sleep quality index. Binary logistic regression was used to assess the association between DPs, sleep quality, and overweight/obesity. Results: Three DPs were identified: "Low-energy healthy", "High-energy healthy" and "Unhealthy diet". Adherence to the first and second DPs was associated with 51%-62% lower odds of overweight/obesity (Odds ratio [OR]: 0.49, 95% CI: 0.24-0.97, and 0.38, 95% CI: 0.15-0.94, respectively, P < 0.050). However, we found no significant association for the third DP with overweight/obesity. Furthermore, there was no significant association between sleep quality/duration and overweight/obesity. The interactions of DPs and sleep quality/duration with overweight/obesity were not significant. Conclusion: Eating a diet high in white meats, eggs, vegetables, fruits and juices, nuts, dairy products, whole grains, and low in refined grains and snacks is associated with a lower likelihood of overweight/obesity in children. This inverse association does not depend on sleep quality/duration. [ABSTRACT FROM AUTHOR]

Background: Children's growth is one of the important components of health affected by various environmental factors like delivery type. This study aimed at determining the relationship between delivery mode and children's growth from birth to 6 months.Methods: In this prospective cohort study, the growth indices were studied among 526 children (272 Natural Vaginal Deliveries (NVDs) and 254 Caesarean sections (C/S) who were only breastfed. The primary samples consisted of pregnant women referred to Yasuj and Gachsaran Hospitals and health centers in 2014-2015. Data were collected using questionnaires and health records.Results: The results showed that there was no significant difference (p > .05) between the groups at birth, 2, 4 and 6 months in the mean (SD) of "weight, height and head circumference".Conclusions: Attention to growth trend in NVD group was better, this is better for mothers that were encouraged to choose physiological and vaginal delivery. [ABSTRACT FROM AUTHOR]

Objective: Group discussion can enhance the knowledge and capabilities of the nurses in clinical judgments, however, its impact on the attitude toward respecting the patients' rights by nurses has been less focused. Therefore, this study aimed to investigate the effect of group discussion on nurses' attitude toward respecting the rights of patients in Shahid Madani hospital, Tabriz in 2014. Materials and Methods: This experimental study with a pretest and posttest design and a control group was conducted on nurses. The research sample consisted of 142 working nurses who had a negative attitude score of less than 88 toward patients' rights. They were selected through the random sampling method and were assigned to 2 groups of experimental and control. A 2-partite questionnaire was used to collect data which included demographic data and observance of physical, psychological, and social rights of patients. Data were analyzed using SPSS. Results: According to the results, no significant demographic difference existed between the 2 groups (P > 0.05). However, the analysis of covariance showed a statistically significant difference between the 2 groups in the score which was significantly higher in the intervention group compared to the control group (P < 0.05). Conclusion: The results showed that group discussion can enhance observance of patients' rights by nurses. Therefore, it is recommended to use group discussion as an appropriate method in hospitals in order to change the attitude of nurses and to increase attention to patients' rights [ABSTRACT FROM AUTHOR]

Background: The human factors are of great importance, especially Motorcycle Rider Behavior Questionnaire (MRBQ) and attention deficit hyperactivity disorder (ADHD) in motorbike riders in road traffic injuries. This study aimed to predict MRBQ score by ADHD score and the underlying predictors by the logistic quintile regression (LQR), as a new strategy. Methods: In this cross-sectional study, 311 motorbike riders were randomly sampled by a clustering method in Bukan, northwest of Iran. The data were collected by MRBQ and ADHD standard surveys. To assess the relationship at all levels of MRBQ distribution, LQR in 5th, 25th, 50th, 75th and 95th quantiles of MRBQ score was utilized to assess the predictability of ADHD score and its subscales in addition to the underlying predictors of MRBQ score. To do this, an unadjusted and as well as adjusted 4-step hierarchical modeling was used. Results: Almost in all quantiles of MRBQ scores, direct and significant relationships were observed between MRBQ score and ADHD score and its subscales (coefficients: 0.02 to 0.10, all P < 0.05). Besides, the driving period (coefficients: -0.58 to -0.95, P < 0.05) and hour driving (coefficients: 0.42 to 0.52, P < 0.05) also came to be the significant predictors of MRBQ score. Conclusion: ADHD score and driving parameters can be taken into the consideration when planning actions on the motorcycle rider behaviors at all levels of the MRBQ. [ABSTRACT FROM AUTHOR]

BACKGROUND: Neck pain is an important cause of disability. In spite of its high prevalence rate, treatment of the disorder is a challenging topic. Stabilization exercise has been the topic of many studies. OBJECTIVE: To compare the effects of stabilization and routine exercises on chronic neck pain. METHODS: Forty patients were randomly assigned into either stabilization or routine exercise groups and undertook a 10-week training program. Electromyographic (EMG) activity was recorded from Sternocleidomastoid (SCM), Anterior Scalene (AS) and Splenius Capitis (SC) muscles bilaterally. Endurance time of deep flexor muscles was measured by chronometer. Pain and disability were measured using Visual Analogue Scale (VAS) and neck disability index (NDI) questionnaire, respectively before and after training period. RESULTS: Findings revealed significant decreased pain and disability in both groups after intervention (P < 0/001). Flexor muscles endurance of stabilization group was significantly increased compared with that of routine (P < 0/001). Also EMG activity of SCM, AS and SC muscles were significantly decreased in stabilization group compared with routine (P <0/001). CONCLUSION: Increased deep flexor endurance and decreased EMG activity of SCM, AS and SC muscles suggest an important role for stabilizing exercises on reducing the activity of superficial muscles in chronic neck pain. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a critical stage of growth and development. That is associated with changes in body shape and appearance. Issues such as irregular menstrual periods, amenorrhea, and menstrual cycle are major issues in women's health. The purpose of this study was to examine the determinants of physical puberty health based on the Health Belief Model (HBM) among female adolescents. Methods: This analytical cross sectional study was conducted in welfare boarding centers in Tehran, Iran. Data were collected in 2011 by a structured and valid questionnaire. Total 61 female adolescents (age range: 12-19 yrs) participated in this study from welfare boarding centers in Iran, Tehran, by using convenience sampling method. The questionnaire consisted of demographic characteristics, health belief model constructs and physical puberty health behaviors gathered by using interview. A series of univariate general linear models were used to assess the relationship between puberty health and health belief model constructs. Results: According to the results of this study there were positive significant relationships between perceived susceptibility, perceived benefits, perceived barriers, cues to action and increased puberty health in female adolescents (p<0.05). Perceived benefits, perceived barriers and cues to action were predictors of physical puberty health behaviors. Conclusion: Based on the results of the study to improve the physical Puberty health behaviors of female adolescents should make them aware of the benefits of health behaviors, and remove or reform the perceived barriers of health behaviors. Also, the appropriate information resources should be introduced for obtaining information about puberty health. [ABSTRACT FROM AUTHOR]

BACKGROUND: Discharge against medical advice (DAMA) has been associated with increased morbidity and re-admission of the patients who have been DAMA. The present study aims to evaluate the prevalence of DAMA and to determine the associated factors for DAMA. METHODS: A cross-sectional study was conducted from April 2012 to September 2012 in 17 hospitals in Tabriz, Iran. Data collection was performed using a two-part checklist including demographic factors, information about hospital and DAMA reasons. The profile of all DAMA patients was studied. RESULTS: The overall DAMA rate among hospitals was 5.7%. The highest DAMA rates were from private and educational hospitals, 10.8% and 9.6% respectively. The lowest rates were from social security hospitals with 2.5%. In this study, sex, age, month and health insurance were significant predictors of DAMA. CONCLUSION: In comparison to other studies, relatively higher rates of DAMA in this study show the need for conducting additional studies to define the causes of DAMA and to devise appropriate interventions to decrease DAMA rate. Determining DAMA rate and its determinants can play an important role in early detection of these at-risk patients and in instituting appropriate intervention. [ABSTRACT FROM AUTHOR]

Introduction: Chronic constipation is one of the most common complaints of patients in developed countries, which affects 2 to 28% of the world’s population and alters patients’ quality of life extensively. This study aimed to determine the validity and reliability of the Persian version of the comprehensive constipation questionnaire. Materials and Methods: The comprehensive constipation questionnaire was translated into Persian, and its back-translation was confirmed after evaluating the content validity ratio index (CVR) based on Lawshe table (CVR≥0.62). The content validity of the questionnaire was assessed by the content validity index, followed by examining its reliability by Cronbach alpha and test-re-test reliability using the intra-class correlation coefficient (ICC). A total of 100 patients with chronic constipation completed the questionnaire. Results: Content validity was confirmed in the range of 0.84 to 1.00, and the Cronbach alpha values in the range of 0.90-1.00 were acceptable. In this questionnaire, was ICC in the range of 0.76-0.99 which indicates a level of good to excellent reliability of the questionnaire. Also, the results of the factor analysis were confirmed at a moderate level Kaiser Meyer Olkin test (KMO>0.6) and Bartlett test (P<0.05) by extracting a 1-factor solution. Conclusion: The Persian version of the comprehensive constipation questionnaire had acceptable validity and reliability and seems to be an effective tool to evaluate patients with constipation. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To validate and culturally adapt the Diabetes-specific Quality of Life Brief Clinical Inventory (DQOL-BCI) for the Iranian population. Methods: After translation – back translation, content validity was assessed utilizing a panel of six experts. Based on a sample of 180 diabetic patients referred to two Diabetics Clinic Centers from September to May 2011 in Karaj, Iran, construct validity via detecting the factor structure, and convergent and discriminant validity were evaluated by scale-item correlations and known group analyses. Internal consistency and test–retest reliability were assessed in sample of 30 patients by Cronbach''s and intraclass correlation coefficient (ICC). Results: The IDQOL-BCI showed good content validity (CVI values>0.75 and CVR values>0.99), internal consistency (α =0.75) and test–retest reliability (ICC=0.81). A 3-factor solution was found. In addition, high values of item-scale correlations confirmed the convergence validity, and some subscales and total scores differentiate between groups defined by sex, disease duration, income levels, drug using status and physical activity demonstrated the discriminant validity. Conclusions: Our findings demonstrate the initial feasibility, reliability and validity of the Iranian version of the IDQOL-BCI as a measure of diabetic-specific QOL measure in Iranian patients. [Copyright &y& Elsevier]

Background: Given the importance of the childbirth experience, its effects on women's life and society, and the need for its assessment by accurate instruments, this study aimed to determine the psychometric properties of the Questionnaire for Assessing the Childbirth Experience (QACE) in an Iranian women population.Methods: The validity of the Farsi edition of the questionnaire was assessed using the opinions of eight experts. Its construct validity was assessed by studying 530 mothers, at 1-4-month postpartum, who delivered in health centers of Tabriz, Iran. The exploratory factor analysis (EFA) was performed to identify its factors. Then, the confirmatory factor analysis (CFA) was performed for the structural assessment of the extracted factors. Spearman's correlation coefficient was used to investigate the correlation between factors. Cronbach's alpha and intraclass correlation coefficient (ICC) were used to obtain the internal consistency and test-retest reliability.Results: In total, four factors were extracted from the EFA: "relationship with staff" (4 questions), "first moments with the newborn" (3 questions), "feelings at one-month postpartum" (3 questions), and "emotional status" (3 questions). According to the CFA, the model achieved desired fit level (RMSEA < 0.08, GFI, CFI, IFI > 0.90, and x2/df < 5.0). Cronbach's alpha (0.77-0.82) and intraclass correlation coefficient index (0.83-0.98) were desirable for all factors.Conclusion: The short edition of the QACE, as a standard tool, can be used by future studies to measure the experience of Iranian women. [ABSTRACT FROM AUTHOR]

Background: Insufficient data are available on the effects of long-term whey protein (WP) consumption on patients with type 2 diabetes mellitus (T2DM). So, in this study, we aimed to examine the effects of WP combined with individualized diet on anthropometric parameters, resting energy expenditure (REE), oxidative stress markers, and appetite among overweight/obese women with T2DM. Methods: In this 3-month double-blind placebo-controlled randomized clinical trial, 48 women with T2DM were randomly allocated into either WP group (one bread fortified by 20 g whey protein concentrates (WPC)) or placebo group (one unfortified bread) along with their individualized diets. At both pre- and post-intervention phases, physical activity, anthropometric parameters, REE, appetite, and serum levels of total antioxidant capacity (TAC) and malondialdehyde (MDA) as well as diet were assessed. Results: Thirty-five patients completed the trial. At the endpoint, there were no significant between-group differences for anthropometric parameters (p > 0.05), except for waist circumference (WC), which was lower in the WP group after adjusting for the confounders (p = 0.040). Serum level of MDA was significantly decreased in the WP group (p = 0.022). There were no significant within- or between-group changes for serum levels of TAC, REE, and appetite sensations (p > 0.05), except for the "hunger", which was lower in the WP group after adjusting for the confounders (p = 0.045). Conclusion: Regarding significant reduction in WC, serum levels of MDA, and feeling of hunger, consumption of the WPC fortified bread could be beneficial in women with T2DM. Registration Number: IRCT20110123005670N26; Registration date: 2019/01/07. [ABSTRACT FROM AUTHOR]

Background: There is a lack of scientific literature on the application of fear appeals theories to evaluate lung cancer risk perception among smokers. The aim of the present study is to apply the Extended Parallel Process Model (EPPM) to discover the perception of the smokers about their lifetime risk of developing lung cancer (perceived susceptibility), their perception of lung cancer survival (perceived severity), response efficacy, self-efficacy, and readiness to quit.Methods: In this cross-sectional study, 215 eligible smokers (aged 45 years and over who have smoked at least 1 pack per day in the last 5 years) were recruited. The data collection tool was designed using validate self-report questionnaires and it was contained items on the perceived risk of a smoker contracting lung cancer and perceived lung cancer survival rate. It also had questions to measure the main constructs of the EPPM and Readiness to quit ("Low_Readiness", and "High_Readiness"). To test how the data support conceptual EPPM to data, Generalized Structural Equation Modeling (GSEM) was used.Results: Findings showed a significant relationship between Perceived_Susceptibility and Perceived_Response Efficacy; (B = 1.16, P < 0.001); between Perceived_Susceptibility and Perceived_Self Efficacy, (B = -0.93, P < 0.001), Perceived_Severity, and Perceived_Response Efficacy (B = 1.07, P < 0.001). There was also a significant relationship between Perceived_Threat and Perceived_Response Efficacy; between Perceived_Threat and Perceived_Self Efficacy. The relationship between High_Readiness and Perceived_Self Efficacy, and between High_Readiness and Perceived_Severity also were significant. However, the relationships between High_Readiness and Perceived_Threat were not significant (P > 0.05).Conclusion: Perceived_threat and Perceived_efficacy were important for smokers with low readiness to quit, while Perceived_efficacy was most important for smokers with high readiness to quit. These findings could be used in promoting lung cancer awareness and designing smoking cessation programs based on smokers' stages of change. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. This study was designed to investigate the effects of melatonin and/or magnesium supplementation on metabolic profile and levels of sex hormones in PCOS women. Methods: In an 8-week randomized double-blind placebo-controlled trial, 84 subjects with PCOS aged 18-40 years were randomly assigned based on the random block procedure to take magnesium, melatonin, magnesium plus melatonin, and placebo. Fasting blood samples were obtained at the beginning and end of the study. Results: After intervention, the mean Pittsburg Sleep Quality Index score decreased significantly in both co-supplementation and melatonin groups (P < 0.001). Magnesium supplementation in combination with melatonin resulted in a significant greater decrease in testosterone concentrations compared with the placebo (P < 0.05). Co-supplementation of magnesium-melatonin had significantly reduced serum insulin levels (geometric means difference: -1.11 (mIU/mL) (percent change: -15.99)), homeostasis model of assessment-insulin resistance (HOMA-IR) (-0.28 (-18.66)), serum cholesterol (mean difference: -16.08 (mg/dl) [95% CI -24.24, -7.92]), low-density lipoprotein cholesterol (LDL-C) -18.96 (mg/dl) [-28.73, -9.20]) and testosterone levels (-0.09 (ng/ml) (-25.00)), as compared to the baseline values (P < 0.05). An increase in serum high-density lipoprotein cholesterol (HDL-C) levels was also observed following the administration of the melatonin alone (2.76 (mg/dl) [0.57, 4.95]) or in combination with magnesium (2.19 (mg/dl) [0.61, 3.77]) (P < 0.05). Conclusions: Co-supplementation with magnesium and melatonin had beneficial effects on sleep quality and total testosterone. Additionally, melatonin supplementation alone was found to be associated with a significant reduction in PSQI score. Moreover, combined melatonin and magnesium supplementation was more effective in improving serum levels of cholesterol, LDL-C, HDL-C and insulin, and HOMA-IR. [ABSTRACT FROM AUTHOR]

Introduction: Infant colic, causing excessive crying, poses anxiety for parents and a challenge for pediatricians and nurses. The Infant Colic Scale (ICS) serves to assess the severity and causal factors of colic. Despite its significance, the psychometric properties of ICS have not been evaluated in the Iranian population. This study seeks to address this gap by assessing the psychometric properties of ICS in Iran. Methods: A sample of 220 mothers with 2-16-week-old term infants diagnosed with infantile colic was selected through convenience sampling. Following forward and back-translation, the face validity, content validity, and construct validity of ICS were systematically evaluated. Reliability was examined through both internal consistency (Cronbach's alpha) and test-retest stability methods. Results: Content validity index (CVI) and content validity ratio (CVR) values for ICS were 0.94 and 0.81, respectively. The good fit indices confirmed the validity of the five-factor structure. Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were 0.71 and 0.94, respectively. Conclusion: The Persian version of ICS is a valid and reliable tool, suitable for assessing infantile colic in the Iranian population. Future studies and clinical practice can utilize this tool to identify major causes of this disorder in the Iranian context. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to evaluate the validity of a Persian-language perinatal anxiety screening tool in the Iranian population. Materials and Methods: This cross-sectional study was performed on 300 low-risk women who participated in the perinatal period. Pregnant women aged 18-42 years were randomly selected from comprehensive health centers in Ardabil, Iran and included in the study from 9.10.2017 to 6.3.2018, and finally, followed up as well. Several questionnaires were used in this study, including demographic, perinatal anxiety, perceived stress, and postpartum depression in Edinburgh. The forward-backward method was used to translate the English version of the tool into Persian. Eventually, the content and face validity were assessed and the reliability of the tool was evaluated using the intra-class correlation coefficient (ICC) and Cronbach's alpha coefficient. Results: The validation of the anxiety instrument showed that the content validity ratio (CVR) (0.6-0.1) and content validity index (CVI) (0.8-1.0) were acceptable. Using the exploratory factor analysis (EFA) (χ² = 4.966, df = 465, and P < 0.01), reliability assessment demonstrated that the instrument had four subscales. The mean (standard deviation) of the total score of the instrument in pregnancy and delivery was 36.6 (13.1) and 43.3 (7.7) in the range of 0-93, respectively. Finally, the Cronbach's alpha coefficient (0.84-0.94) and ICC of 0.96 (95% CI: 0.93-0.98) revealed that the instrument has a high ICC and excellent test-retest. Conclusions: In general, the findings of this study support the validity and reliability of the tool thus it can be used in clinical and research cases. [ABSTRACT FROM AUTHOR]

As there is limited and inconsistent evidence in potential role of vitamin D on insulin resistance and matrix metalloproteinases, this study aimed to examine the effect of vitamin D supplementation on glucose homeostasis, insulin resistance, and matrix metalloproteinases in obese subjects with vitamin D deficiency. A total of 44 participants with serum 25-hydroxyvitamin D (25(OH)D) level ≤ 50 nmol/L and body mass index (BMI) 30–40 kg/m2 were randomly allocated into receiving weight reduction diet with either 50 000 IU vitamin D3 pearl (n = 22) or placebo (n = 22) once weekly for 12 weeks. Primary outcomes were changes in fasting serum glucose (FSG), homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and matrix metalloproteinases (MMPs). Secondary outcomes were changes in weight, BMI, 25(OH)D, calcium, phosphorous and parathyroid hormone (PTH). Sun exposure and dietary intakes were also assessed. Serum levels of 25(OH)D3 increased significantly with a simultaneous decrease in serum concentration of PTH in the vitamin D group. Weight, BMI, FSG, and MMP-9 decreased significantly in both groups, and there were significant differences in changes in weight, serum 25(OH)D3, PTH, and MMP-9 levels between the groups. Within- and between-groups analysis revealed no significant differences in serum calcium, phosphorous, serum insulin, HOMA-IR, QUICKI, and MMP-2 after intervention. Our results indicated that improvement in vitamin D status resulted in greater reductions in weight and MMP-9 during weight loss. These preliminary results are sufficient to warrant a bigger study group. [ABSTRACT FROM AUTHOR]

Background: Due to the lack of an instrument to measure mental health literacy among Persian/Farsi speaking people, this study was conducted to examine the psychometric properties of the Persian version of the Mental Health Literacy Scale (P-MHLS). Participants and Methods: The 2019 cross-sectional study with 992 participants was conducted in Tabriz, Iran. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to establish the construct validity of the P-MHLS. The internal consistency/reliability was estimated by computing Cronbach's coefficient alpha. Feasibility of the scale was examined and item response theory (IRT) models were applied to characterize the test items. Results: An exploratory factor analysis of data resulted in five factors, which included 30 of the 35 items and accounted for 42.00% of the variance. The construct validity of the 5-factor model was supported by the results of our confirmatory factor analysis. The factors were the 1) ability to recognize mental disorders, 2) confidentiality of mental health practitioners, 3) skills of mental health information seeking, 4) beliefs about mental illnesses, and 5) attitudes toward patients with mental illness. Conclusion: The study provides initial support for the use of the MHLS among Persian/Farsi speaking adults to assess mental health literacy. [ABSTRACT FROM AUTHOR]

Background and Aim. Breast cancer is the most frequent cancer in women and the second most common cancer across the globe. The aim of this study was to report the survival data and trend analysis of breast cancer between 2007 and 2016 in a northwest region in Iran. Methods. Data were obtained from East Azerbaijan cancer registry database for the 10-year period between 2007 and 2016. Survival analysis was performed to calculate the breast cancer-specific survival proportions and mortality rates. Joinpoint trend analysis was performed to estimate the incidence trend of the cancer. Results. A total number of 4989 patients were recorded with primary diagnosis of breast cancer. Of them, we collected follow-up data for 1335 (1309 female and 26 male). The 10-year crude mortality rate was 3.34 (per 100,000). The one-, two-, three-, five-, and ten-year breast cancer-specific survival proportions were 0.92 (95% CI 0.91-0.93), 0.88 (95% CI 0.86-0.90), 0.84 (95% CI 0.83-0.86), 0.77 (95% CI 0.74-0.80), and 0.65 (95% CI 0.60-0.70), respectively. Over the study period, the age-standardized incidence rates increased from 21.68 to 36.99 (per 100,000) with an annual percentage change of 5.5 percent. Older individuals and males patients had significantly worse survival, and patients with high-grade tumors had significantly higher risk of mortality. Conclusion. A relatively better survival for breast cancer in East Azerbaijan, Iran, was observed compared to the overall breast cancer-specific survival proportions and mortality rates in the country. However, it is still poor compared to the developed countries indicating that inappropriate treatment modalities might have played a role on this. [ABSTRACT FROM AUTHOR]

Introduction: Despite evidence that early diagnosis of Colorectal Cancer (CRC) reduces the associated death burden, screening programs are uncommon even in developed countries. Aim: To develop and validate a simple, practical and efficient tool to improve CRC risk assessment by identifying moderateand high-risk disease. Materials and Methods: The National Comprehensive Cancer Network guideline has been used to develop the CRC risk assessment tool. Content validity was assessed by a panel of 10 experts by generating a Content Validity Index (CVI), which was recorded quantitatively as the proportion of experts who agreed that the item was relevant, before calculating the Content Validity Ratio (CVR) per item. Results: The CVI was in the range 0.7-1 and the acceptable CVR was in the range 0.4-1. The overall mean CVI and CVR values were 0.93 and 0.62, respectively. Changes were made according to the experts' recommendations, and the final online Persian questionnaire was assessed for face validity by 15 individuals (general population voluntarily). Only a few items subsequently needed modification and expansion. Conclusion: The Persian Risk Assessment tool is simple, quick, and easy to apply to different clinical categories and subcategories of CRC and can even be self-administered. This is the first translated tool in Persian version, usable in Iran. [ABSTRACT FROM AUTHOR]

Background: Mothers' capability for childcare and compatibility with the maternal role represent important challenges in postpartum care. Given the significance of evaluating maternal functioning, and the lack of adequate standard instruments in Iran for this purpose, the present study was aimed at translating and conducting a psychometric assessment of the Barkin Index of Maternal Functioning (BIMF) for Iranian women.Methods: The instrument was translated into Persian using the Backward Forward method. The study included 530 women in the postpartum period admitted to healthcare centers in Tabriz, Iran; they were selected through the cluster sampling method. Face, content, and construct (through exploratory and confirmatory analyses) validity were presently examined. Reliability of the questionnaire was determined using the internal consistency and test-retest reliability methods.Results: Two factors (mom's needs and competency), emerged based on exploratory factor analysis. The x2/df ratio was less than 5, and the values of the Root Mean Square Error of Approximation (RMSEA) and the Root Mean Square Residual (RMR) were less than 0.08 and 0.1, respectively, verifying the model validity. Cronbach's alpha coefficient and Intra-class Correlation Coefficient (ICC) were calculated as 0.88 and 0.85, respectively, indicating reliability.Conclusion: The Persian version of the BIMF is a valid and reliable instrument for measuring the postpartum functioning of Iranian mothers. [ABSTRACT FROM AUTHOR]

Objectives: To assess the relationship between serum lipid profile and some cardiovascular risk factors. Methodology: This cross-sectional study consisted of pregnant and nonlactating women aged 30-55 years, selected by convenience sampling method from who referring health center in Tabriz, Iran from April to May 2017. Anthropometric measurements, blood pressure, fasting serum lipid profile, and dietary intakes of participants were evaluated data was analysis STATA of software. P>0.1 was taken as significant. Results: Total of 152 non pregnant women were included. Significant positive relationship were found between serum triglyceride (TG) and weight (B = 2.23 and p = 0.032), and between serum TG and total cholesterol (TC) with systolic blood pressure (B=1.58 and 1.01 with p=0.059 and 0.096, respectively) and diastolic blood pressure (B = 2.43 and 1.56 with p =0.029 and 0.027, respectively) by multiple-adjusted quantile regression analyses. There were significant correlation between serum TC and daily zinc intake (B=7.93 and p= 0.003) and between serum HDL-C with age (B = -0.48 and p = 0.029), waist circumference(B=-0.86 and p=0.025), and waist-hip ratio(B=-72.3 and p= 0.041). No significant relationship were seen between serum lipids and other variables. Conclusions: Serum TG and TC levels were associated with higher blood pressure and HDL-C levels increased with enhancing of central obesity. These findings emphasizes the role of lipid profile as cardiovascular risk factors in women. Effective strategies are necessary for improving dyslipidemia in women. [ABSTRACT FROM AUTHOR]

Background: Urmia Lake of Iran used to be the largest saltwater lake in the world. It has now disastrously shrunk to 10 percent of its previous size. This study aims to investigate the impact of this environmental catastrophe on the occurrence of asthma. Methods: The whole population of ten districts in the area were investigated in this retrospective cohort study: “Exposed group” in the neighbouring areas of the lake, “Not exposed group 1” with medium distance (65 km) from the lake, and “Not exposed group 2” with more than 160 km from the lake. Clinical diagnosis of asthma was performed by the family physicians in the whole population. Results: The occurrence risk of asthma in “Exposed group” was 1.85 times higher (CI95%: 1.1- 3.0) than of “Not exposed group 1”. The risk of disease, similarly, in “Exposed group” was 1.44 times more (CI95%: 0.9-2.3) when compared to “Not exposed group 2”. Conclusion: The country and provincial authorities should consider this hazardous climate change in the region seriously before it becomes a harmful event for millions of people living in the area. [ABSTRACT FROM AUTHOR]

In the oil industry, many flammable products such as liquid hydrocarbons are usually stored in the atmospheric storage tanks. One type of these suitable tanks is the floating roof tanks. Among the floating roof tanks, external floating roof tanks are mainly used to store large quantities of petroleum products such as crude oil or condensate, gasoline, kerosene. The purpose of this study is prioritizing the causes of fire and explosion in the external floating roof tanks. In this study, firstly, the causes of fire and explosion of the external floating roof tanks were identified and then the obtained variables were scored by the process and safety specialists. In the next step, the causes were weighed and prioritized using the analytic network process method and Super Decisions software. The findings of the study identified 11 main criteria and 71 sub-criteria for fire and explosion of external floating roof tanks. Results revealed that several effective risk factors in the fire and explosion are natural disasters, static electricity, operational error, faulty firefighting system, maintenance error, piping rupture/leak, equipment/instrument failure, open flames, tank crack/rupture, runaway reactions, and sabotage, respectively. This study will help experts to identify the effective risk factors in fire and explosion in external floating roof tanks and their importance. Therefore, they can prioritize and implement the control measures to prevent fire and explosion incidents in external floating roof tanks. [ABSTRACT FROM AUTHOR]

Introduction: The transition to motherhood is a major life event that affects all aspects of psychosocial functioning. Aim: The aim of this study was to determine the relationship between physical activity during pregnancy and postpartum functional status. Materials and Methods: This cohort study was carried out on 165 Iranian women 18-35 years old referred to health centers of Tehran from April 2013 to March 2014. Pregnant women were selected by proportional distribution to each center. International Physical Activity Questionnaire (IPAQ) was completed by pregnant women in 28-34 weeks and they were categorized into two groups; low (68 patients), and moderate and high (97 cases) groups, according to the physical activity level. Follow-up in both groups continued until 6 weeks postpartum and Inventory of Functional Status after Childbirth (IFSAC) was completed at the end of six week postpartum period. Independent-t test was used for data analysis. Results: No statistically significant difference was observed between the two groups in terms of sociodemographic characteristics (p>0.05). In the low physical activity group, the mean (standard deviation) of the total score of physical activity was 1680.9 (2204.7), and in the moderate and high group, it was 3182.6 (3946.5). Two groups were not significantly different in terms of the mean score of functional status (p=0.279). Conclusion: The results of the present study showed that physical activity during the third trimester of pregnancy has no significant effects on functional status after childbirth in primiparous women. Appropriate strategies should be adopted to encourage women to participate in physical activities so as to promote maternal and neonatal health during pregnancy and after childbirth. [ABSTRACT FROM AUTHOR]

Background: Health literacy has been considered as a predictor of starting, maintaining, and stop smoking. However, such relations have not been well documented in previous texts. Therefore, the purpose of this study was to investigate the relation between health literacy and changes in the behavior of smoking in Tabriz University of Medical Sciences. Methods: In this correlational descriptive study, a total of 297 employees of Tabriz health centers were examined. To collect data, a demographic-social questionnaire, Iranian Health Literacy Questionnaire, and DiClemente's behavior change questionnaire were used. Besides, SPSS 13 software (significance level = 0.05) was employed to analyze the data. Results: The average health literacy rate of participants was 70, and most respondents had adequate health literacy. Nearly 41.1% were in the precontemplation phase which is one of the stages of behavior change. There was a positive and significant statistical relation between behavior change variable with all health literacy areas (except the scope of understanding) and total health literacy score (P = 0.011 and r = 0.147). The results of ordinal regression analysis demonstrated that there is a significant positive relationship between the score of health literacy and behavioral change (b = 0.019, 95% confidence interval = (0.010-0.029), P < 0.001). Conclusions: Improving the level of health literacy can lead to change people's behavior in relation to tobacco consumption. However, due to the lack of relevant texts, there is a need for further studies in this field. [ABSTRACT FROM AUTHOR]

Objective: This study was designed with the purpose of determining the relationship between social capital and lifestyle and their sub-variables among older adults. Methods: This is a cross-sectional study using interviews that was conducted in 2017. This study was performed with randomly selected older people over 60 years of age in an urban area of Iran. Data were collected using a questionnaire in 3-month duration. The relationship between the study variables (lifestyle and social capital) was assessed through correlation analysis (in the case of non control of the underlying variables) and general linear modeling (in the case of control of the underlying variables). Data were analyzed using SPSS v.24 software at a 0.05 significant level. Results: A total of 512 questionnaires were filed out. According to the Pearson correlation test, all social capital variables were associated with lifestyle components. However, in the general linear model test, feeling of trust and safety (p < 0.001), value of life (p = 0.030), and social participation (p = 0.004) had a significant relationship with the lifestyle. Conclusions: The results indicated that social capital and lifestyle in the older adults were interconnected. Therefore, there is a need to improve social capital factors, especially social participation, feeling of trust and safety, and value of life, which is in-line with the strategies of achieving healthy older population. The results can be used to learn how to increase lifestyle in older adults. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Comparison of fracture resistance in root canals of immature sheep teeth after filling with calcium hydroxide or MTA," that was published in the previous issue.

The online version of the original article can be found at https://doi.org/10.1186/s13098-019-0400-7 Retraction: Khalili I et al. References 1 Khalili L, Alipour B, Jafar-Abadi A, Faraji M, Hassanalilou I, Mesgari Abbasi T, Vaghef-Mehrabany M, Sani A. The Effects of Lactobacillus casei on glycemic response, serum Sirtuin1 and Fetuin-A levels in patients with type 2 diabetes Mellitus: a Randomized Controlled Trial. [Extracted from the article]

Background: To investigate the combinations of Musculoskeletal pain (MSP) (neck, shoulder, upper and low back pain) among a sample of Iranian school children. Methods: The MSP combinations was modeled by latent class analysis (LCA) to find the clusters of high–risk individuals and multigroup LCA taking into account the gender and age (≤ 13 years and ≥ 14 years of age categories). Results: The lowest and highest prevalence of MSP was 14.2% (shoulder pain in boys aged ≥14 years) and 40.4% (low back pain in boys aged ≤13 years), respectively. The likelihood of synchronized neck and low back pain (9.4–17.7%) was highest, while synchronized shoulder and upper back pain (4.5–9.4%) had the lowest probability. The probability of pain at three and four locations was significantly lower in boys aged ≥14 years than in other gender–age categories. The LCA divided the children into minor, moderate, and major pain classes. The likelihood of shoulder and upper back pain in the major pain class was higher in boys than in girls, while the likelihood of neck pain in the moderate pain class and low back pain in the major pain class were higher in children aged ≥14 years than those aged ≤13 years. Gender–age specific clustering indicated a higher likelihood of experiencing major pain in children aged ≤13 years. Conclusions: The findings highlight the importance of gender– and age–specific data for a more detailed understanding of the MSP combinations in children and adolescents, and identifying high-risk clusters in this regard. [ABSTRACT FROM AUTHOR]

Objective: Growth and development of preterm infants may be negatively affected by constant bright light in neonatal intensive care units ( NICUs ). It may also contribute to sleep pattern disorders commonly seen in in this group of infants. Reducing exposure to light by covering the incubators is recommended by guidelines of the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP). Materials and Methods: This randomized clinical trial study was performed on 60 preterm infants with gestational age of 28-32 weeks admitted at NICU of Al-Zahra Teaching Hospital of Tabriz University of Medical Sciences in 2014. Preterm infants were divided randomly in 2 groups: In the first group (intervention), incubators were covered with a thick cover and the face was covered with a cloth (face cover). In the second group (observation), incubators were covered with a thick cover but the face was not covered. We darkened the environment of NICU by closing the curtain and turning off additional florescent lights from 19:30 pm till 7:30 am in both groups, then we compared sleep pattern in 2 groups of infants by using sleep diagram. Results: In the intervention group (face cover), the mean frequency of sleep during the 6 days increased by 2.96 times/ observations and the mean amount of sleep increased by 59 minutes. Conclusion: This study showed that light reduction with incubator covers and eye shield, increases the frequency and sleep duration in premature infants. [ABSTRACT FROM AUTHOR]

Background: Most available data on the prevalence and characteristics of back pain in schoolchildren is related to industrialised and developed countries. The aim of this study was to investigate the prevalence of low back pain (LBP) and potential risk factors among schoolchildren and adolescents in a developing country, Iran. Methods: A cross-sectional study was conducted among 1611 Iranian schoolchildren aged 11-14 years. A self-complete questionnaire was used to assess LBP prevalence, physical leisure activities, school-related and psychosocial factors. Results: The prevalence of LBP was 34.3%. Female gender (odds ratio [OR] = 1.57, 95% CI: 1.28-1.94), family member with back pain (OR = 1.82, 95% CI: 1.40-2.36), difficulty in viewing the (black)board (OR = 1.50, 95% CI: 1.13-1.99), too much homework (OR = 1.47, 95% CI: 1.09-1.99), time spend carrying a schoolbag (min/d) (OR = 1.37, 95% CI: 1.01-1.85), and psychosocial factors (emotional symptoms) (OR = 2.28, 95% CI: 1.54-3.39) were independently associated with LBP. Physical activity, having a job, watching television, using a computer, playing games and schoolbag weight had no effect. Conclusion: It can be concluded that both physical and psychosocial factors influenced the risk for LBP, but emotional symptoms had a stronger association with LBP than physical factors. Knowledge about LBP in school children and adolescents could be important in assessment and treatment of such symptoms in this population. [ABSTRACT FROM AUTHOR]

Objective: Pulmonary thromboembolism (PTE) importance is due to some reasons, first, it is one of the most common cardiovascular diseases, second it has high mortality and morbidity especially in some situations and third, prevention of this event is applicable and effective in most cases. The aim of this study was evaluation of predisposing factors of pulmonary emboli in young patients and defining preventive strategies in this age group. Materials and Methods: In this retrospective study, recorded data including age, sex, presentation month, chief complaint, vital signs at admission, positive findings of physical examination, venous thromboembolism (VTE) risk factors, laboratory and imaging findings of patients with pulmonary embolism diagnosis who had 45 years old or less from March 2008 to March 2014 in Shahid Madani Heart hospital, Tabriz, Iran were evaluated. Statistical analysis was done via SPSS version 21. Results: Eight hundred seventy patients had pulmonary emboli diagnosis during study period, 101 of them were ≤ 45 years old. Fifty-three patients were men and 48 of them were women. Mean age of patients was 33.6 years. Abnormal lower limb was the most frequent positive finding at physical examination. The important risk factor in women was hormonal change due to pregnancy or oral contraceptive pill use which was present in 50% of females. Smoking and immobilization due to surgery or trauma were the most common risk factor in men. Women had higher pulse rate (113.53± 21.84 vs 101.33 ± 20.27, P = 0.005) and lower hemoglobin (11.76 ± 2.00 vs 13.52 ± 2.21, P = 0.000) than men. The overall mortality rate was 10.8%. Conclusion: Although all the risk factors of pulmonary emboli were not evaluated in our patients but the determined ones seem to be modifiable in majority of cases. [ABSTRACT FROM AUTHOR]

Introduction: Investigation of supportive care needs of cancer patients is important to implement any supportive care programs. There is no relevant studies investigated supportive care needs of Iranian cancer patients and factors affecting such needs. So, the aims of present study were to determine the unmet supportive care needs of Iranian cancer patients and its predictive factors. Methods: In this descriptive- correlational study 274 cancer patients in one referral medical center in North West of Iran participated. For data collection, demographic and cancer related information checklist and Supportive Care Needs Survey (SCNS) was used. Logistic regression was used for data analysis of un-adjusted and adjusted Odds Ratios (ORs) for patients needs and analysis of variables of study based on Backward LR procedure SPSS Ver.13. Results: More than fifty percent of participants reported unmet needs in 18 items of SCNS. Most frequent unmet needs were related to health system and information domains and most meet needs were related to sexuality and psychological domains. The result of logistic regression identified predictors of each domain of supportive care needs. The variable such as sex, age and living situation were most important predictors of unmet needs. Conclusion: The results showed that Iranian cancer patients have many supportive care needs in different domains. In general female cancer patients are at risk of more unmet supportive care needs. So, health care professionals should be more sensitive to fulfillment of supportive care needs of female. [ABSTRACT FROM AUTHOR]

Background: The prevalence of cesarean birth in Iran is very high. Having a negative childbirth experience is one of the reasons that primiparous women provide to prefer caesarean birth over a vaginal birth. This study is aimed to understand women's perspective on what determines a positive or negative birth experience for them.Methods: This qualitative study is a part a mixed method study that was conducted among primiparous women with a previous vaginal birth experience. The purpose of the main study was to develop a guideline based on Iranian primiparous women's birth experiences. The quantitative phase of the study was a cross-sectional study where women's childbirth experiences was measured in a survey via the Childbirth Experience Questionnaire-2. In the qualitative part of the study, women were invited for an in-depth interview via a random stratified sampling method based on their childbirth mean score (women with 10% of the upper bound score which indicated a positive birth experience and 10% of the lower bound indicating negative birth experience, n = 17). Conventional content analysis was used for data analysis.Results: We extracted three main themes: (a) "Internal control", (b) "External control", and (c) "Support". Possessing internal control, having a balanced external control to feel cared and feeling supported were the main reasons for women to feel positive about their birth experiences. Whereas, loss of internal control, imbalanced external control and unsupportive environment were related to their negative childbirth experiences.Conclusion: Considering that women's sense of control, the care and support that they receive can influence their childbirth experiences, there is a need for changing maternity policies and practices to highlight the importance of a woman-centred care to create a pleasant, respectful and positive memory for primirparous women who experience normal vaginal births. [ABSTRACT FROM AUTHOR]

This study aimed to develop and validate a labor induction nomogram for nulliparous and multiparous women who were 38 weeks pregnant or more and had their labor induced by an unfavorable cervix. This prospective study was conducted on 300 individuals (200 for nomogram development and 100 for nomogram validation). Height, body mass index at delivery, parity, gestational age, adjusted bishop score, and cesarean section risk assessment were all recorded on a checklist. Participants were followed until they gave birth, and the type of delivery was noted in the checklist. Out of 300 labor inductions, 80 (26.7%) underwent a cesarean section. Cesarean risk estimation was the only predictor of delivery type based on multivariate logistic regression. The AUC (Area Under the Curve) in development group was 0.68 and in validation group was 0.71. The developed nomogram for predicting of cesarean section risk following labor induction has a relatively good predictive value among women. [ABSTRACT FROM AUTHOR]

Objective: Due to insufficient data on the metabolic consequences of long-term whey protein consumption, in this trial, we aimed to examine the effects of whey protein, as fortified bread, on glycemic status, lipid profile, and blood pressure in overweight/obese women with type 2 diabetes mellitus. Methods: In a 12-week double-blind placebo-controlled randomized clinical trial, 48 overweight/obese women with type 2 diabetes mellitus were randomly allocated into either whey protein (bread fortified by 20 g whey protein concentrate) or placebo (unfortified bread) group. At pre- and postintervention phase, physical activity, blood pressure, serum levels of glucose, insulin, glycosylated hemoglobin A1C, lipid profile, and dietary intakes were assessed. The homeostatic model assessment for insulin resistance was used for the estimation of insulin resistance. Results: Totally 35 patients completed the trial. At the endpoint, there were no significant between-group differences for the assessed glycemic parameters (P > .05), except glycosylated hemoglobin A1C, which was higher in the whey protein group after adjusting for the confounders and baseline values (P < .05). Fasting blood glucose was significantly increased in whey protein group (P < .05). There was a significant increase in HOMA-IR and serum level of insulin in both whey protein and placebo groups (P < .05). There were no significant within- or between-group changes in the lipid profile and blood pressure of the patients (P > .05). Conclusion: Three-month consumption of the whey protein concentrate fortified bread has no effects on lipid profile and blood pressure. It may cause some undesirable changes in some glycemic indices among overweight/obese women with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: Unhealthy lifestyle behaviors during young adulthood can have negative impacts on health for the rest of a person’s life. University students are in a transition stage to adulthood and face considerable changes in their life during their time at university. Therefore, the evaluation of their lifestyle and its changes over time using a valid and reliable tool is very important. This study aimed at assessing reliability and validity of the Persian version of the Healthy Lifestyle Scale for University Students (HLSUS). Methods: The HLSUS was developed by Wong et al, based on Pender’s Health Promotion Model, and was translated into Persian using forward/backward translation methods. Content validity of the scale was assessed by a panel of eleven experts. Moreover, Cronbach α coefficient was calculated to examine internal consistency. The construct validity was assessed via detecting the factor structure of measurements on a sample of 400 students from different faculties of Tabriz University of Medical Sciences. Scale-item correlations and known group analyses were used to evaluate. convergent and discriminant validity Results: The HLSUS demonstrated good content validity (content validity index [CVI] values 0.80-1.00 and content validity ratio [CVR] values 0.71-1.00), internal consistency (α = 0.87) and test–retest reliability (intraclass correlation coefficient [ICC] = 0.89). Based on exploratory factor analysis, it was determined that the eight factor solution was optimal for distinguishing the underlying factors. Conclusion: The Persian version of the HLSUS demonstrated initial reliability and validity. [ABSTRACT FROM AUTHOR]