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Introduction: Mothers of preterm infants need support to deal with the issues caused by the early birth of their infants. Objective: The authors examined the impact of a multifaceted supportive approach on the mothers' perceived support levels. Methods: The present quasi-experimental study was performed on 143 mother–preterm infant pairs, in two neonatal intensive care units (NICUs) of referral and educational hospitals in Tehran, Iran. The base of developed interventions was known to support system patterns of mothers with preterm infants. Different supportive interventions (appraisal, instrumental, emotional, and informational) of mothers were implemented during three months. The Nurse Parent Support Tool was applied for assessing perceptions of perceived support by mothers. Routine care was provided for the control group. The results were analyzed by STATA software 13. Categorical variables were analyzed by chi-square test, t -test, and inverse probability treatment weights. Results: Following adjustments of mean differences of outcomes between study groups (95% confidence interval), all support scores, such as instrumental support, −1.23 (95% CI −1.04 to −1.43), total support, −1.83 (95% CI −1.6 to −2.06), appraisal support, −2.01 (95% CI −1.73 to −2.29), emotional support, −1.87 (95% CI −2.15 to 1.6), and informational support, −2.12 (95% CI −1.82 to −2.43), were significantly higher in the interventional group than in the control group (p <.001). Conclusions: Support received by mothers of preterm infants determines maternal/neonatal health. Information sharing and effective ways to support are essential elements in the mother's ability to deal with the new, stressful situation. This multifaceted supportive approach considerably improved mothers' perceived support. [ABSTRACT FROM AUTHOR]

Background: Endotracheal intubation and mechanical ventilation are prevalent interventions in the operating room and intensive care unit. Recently, the complications of endotracheal tube cuff pressure have been a topic of interest. Therefore, this study compared the effect of pressure control and volume control ventilation modes on the endotracheal cuff pressure rate in patients undergoing general anesthesia and mechanical ventilation. Methods: In this triple-blinded randomized clinical trial, 50 patients undergoing open limb surgery and inguinal hernia were allocated to two groups of 25 based on inclusion criteria. After intubation, one group underwent ventilation on the pressure control ventilation mode, and the other underwent ventilation on the volume control ventilation mode. In both groups, using a manometer, the cuff's pressure was first adjusted in the range of 25–30 cm of water. Then, the cuff pressure was measured at 10, 20, and 30 min intervals. The data were statistically analyzed using independent t-test, and two-way repeated measures ANOVA. Results: The present study's findings showed that cuff pressure has significantly decreased over time in both study groups (F = 117.7, P < 0.001). However, a repeated measures ANOVA with a Greenhouse-Geisser correction showed no interaction between time and groups (F = 0.019, P = 0.98). The two groups had no significant difference in cuff pressure (F = 0.56, P = 0.458). Conclusion: Since the cuff pressure has been significantly reduced in both groups over time, continuous monitoring of endotracheal tube cuff pressure in patients undergoing mechanical ventilation is essential. Therefore, it is suggested to keep the cuff pressure within the recommended range to prevent complications resulting from cuff pressure reduction, such as aspiration and ventilation decrease. Trial registration: The study was registered in the Iranian Registry of Clinical Trial on 23/02/2019 (trial registration number: IRCT20181018041376N1). [ABSTRACT FROM AUTHOR]

Background. Social isolation is a common and serious health issue in the older community-dwelling adults that leads to negative consequences such as suicidal thoughts, psychological distress, as well as a decline in welfare, health and quality of life. Objectives. This study aimed to determined the prevalence of social isolation and related factors in older Iranian adults. Material and methods. This cross-sectional study was performed on 290 older community-dwelling Iranian adults using a multistage sampling method in Shahroud, Iran. Social isolation was measured using the Lubben Social Network Scale-18 (LSNS-18) with a score higher than 36. Data was analysed using descriptive and inferential statistics (multivariate logistic regression). The significance level was set at 0.05. Results. The prevalence of social isolation was 57.9%. Marriage history (married or deceased spouse – divorced), higher education and living arrangements (living with a spouse or with a spouse and children) were factors associated with lower social isolation; however, social isolation was higher in older adults with two or more children (p = 0.03). Conclusions. A high percentage of older Iranian adults suffer from social isolation. It is suggested that older adults not live alone, get married and have academic education as much as possible, and it is necessary to take extensive measures to reduce this social issue. [ABSTRACT FROM AUTHOR]

Due to the association between substance use abstinence with some psychological syndromes, the use of herbal medicines such as Crocus sativus L. have been considered as a proper approach to controlling withdrawal syndrome. The present study aimed to identify the effect of Krocina™ in reducing withdrawal symptoms, craving, depression, stress, anxiety and durability of treatment in the detoxification period and abstinence phase. In a double-blind randomized parallel clinical trial, 72 opioid users passing the detoxification period who were referred to the Soroush Center during 2020, randomly categorized into the two groups. Motivational interviewing sessions and 15 mg of Krocina™ twice a day were provided for six weeks for the cases. The placebo group received pills with the same coating and motivational interviewing. Withdrawal symptoms, craving, depression, stress and anxiety were assessed at the start of the study and then weekly using the Clinical Opiate Withdrawal Scale, Obsessive-Compulsive Drug Use Scale, and the Depression Anxiety Stress Scales-21, respectively. SPSS-v16 was used for statistical analyses. Drug withdrawal symptoms and craving did not indicate a significant difference by Krocina™ intervention during the time (p > 0.05). Furthermore, depression, stress and anxiety were statistically similar between Krocina™ and placebo groups (p > 0.05). Moreover, we found similar findings between the two groups when analyzing only patients with negative urinary test (F = 0.03;p = 0.86). Our finding rejected the effectiveness of 30 mg/day of Krocina™ for six weeks as an effective substance for decreasing withdrawal symptoms, craving, depression, anxiety and stress at the detoxification period and abstinence phase. [ABSTRACT FROM AUTHOR]

Background. Elderly abuse is a major problem in developing countries and causes complications such as reduced quality of life, increased incidence of mental diseases and even death. Objectives. To evaluate the validity of a Persian version of the Vulnerability Abuse Screening Scale (VASS) in the elderly. Material and methods. This methodological study was performed on 200 older adults (aged ≥ 60) in Iran. Measurements included the Elderly Vulnerability to Abuse Screening Scale (VASS), Mini-Mental State Examination (MMSE) and Abbreviated Mental Test Score (AMTS). Results. The mean and standard deviation of the studied population was 68 ± 5.8 years. After applying the necessary changes in the items at the face and content validity stage, the initial reliability was confirmed in a sample of 50 elderly with a Cronbach’s alpha coefficient of 0.74. The initial tool model (12-question version) was not validated in the factor analysis process, so the second tool model (9-question version) was prepared and found to have construct validity. Cronbach’s alpha coefficient in the 9-question version was 0.70, and the intra-class correlation coefficient was 0.99. Conclusions. According to the study results, it seems that the Persian 9-question version can be used as a valid and reliable tool in the study and assessment of vulnerability to abuse in the Iranian elderly population. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the relationship between assertion and aggression with addiction potential among students in Shahroud University of Medical Sciences. Methods: In this cross-sectional study conducted in 2019, 500 students of Shahroud University of Medical Sciences, were selected by multistage random sampling, for a study using the Addiction Potential Scale, and Assertion and Aggression Questionnaires. Data were analyzed using ANOVA, Chisquare, t test, Pearson's correlation coefficient, and the linear regression model. Results: The mean scores of addiction potential, aggression, and assertion were 32.7 ± 17.2, 41.5 ± 12.9 and 139.4 ± 22.3, respectively. In this study, 38.8% (N = 194) of students had high aggression and 76.8% (N = 384) had high assertion. In the regression model, aggression, history of drug and addictive substances abuse, history of tobacco use, and history of alcohol abuse were significantly related to addiction potential (p ≤ 0.05). There was a negative relationship between assertion and addiction potential so that with oneunit increase in the assertion score, the addiction potential score decreased by -0.11. Conclusion: Given the direct relationship between aggression and addiction potential, and since more than three-quarters of the students had moderate to high aggression, it is necessary to pay more attention to this issue. Interventions may play an important role in improving the current situation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Metabolic syndrome (MetS) is a group of risk factors that are associated with increased risk for atherosclerotic cardiovascular disease. OBJECTIVE: The objective of this study was to determine the prevalence of metabolic syndrome and its individual components among Iranian bakery workers. METHODS: A cross-sectional study enrolling 163 randomly selected bakery workers from Semnan province (Northeast Iran), was conducted in 2017. A standard questionnaire was used for data collection. Analyses were performed using t-test, one-way ANOVA and Latent Class Analysis (LCA) in R software. RESULTS: The prevalence of MetS was 19.8% among bakery workers. More bakery workers with MetS had no regular exercise (p = 0.001) and worked more than eight hours a day (p = 0.001). In this study, the International Diabetes Federation (IDF) diagnostic criteria had more agreement with the American Heart Association (AHA) (49.1%) than the World Health Organization (WHO) and Adult Treatment Panel (ATP) criteria. Also, the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) had the highest sensitivity for diagnosing MetS. The sensitivity of the four diagnostic methods, WHO, IDF, ATP and AHA, were 45.2%, 61.7%, 67.9% and 64.8%; and their specificity were 98.2%, 100%, 100% and 100%, respectively. CONCLUSION: The prevalence of MetS is high among bakery workers in Iran. Increased physical activity and intake of fruit and vegetables are recommended for the prevention of MetS. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the relationship between self-efficacy, general health and burnout of the staff at Shahroud University of Medical Sciences. Methods: In 2015, 249 staff at Shahroud University of Medical Sciences (from a total reference population of 520 staff members) were selected through stratified random sampling. To collect the data, Sherer self-efficacy Scale, General Health Questionnaire and Maslach Burnout Inventory were used. The collected data were analyzed through ANOVA, Pearson correlation and Chi-square tests using SPSS 16. The relationship between self-efficacy, general health and burnout (latent factors) were studied using structural equation modeling with Stata 14. Results: The mean age of participants was 36.97 ± 7.60 years, and the mean number of years work experience was 12.29 ± 7.57. The mean scores of general health, self-efficacy and burnout were 28.24 ± 11.14, 62.30 ± 9.21 and 81.67 ± 22.18, respectively. The results of the study showed a statistically significant relationship between self-efficacy and general health which equals −0.32. A statistically significant relationship also existed between burnout scores and general health scores (beta = 0.78). Conclusion: The results showed that high self-efficacy improves the general health of employees at the Shahroud University of Medical Sciences and reduces burnout. Special attention should be paid to self-efficacy in the prevention of burnout. [ABSTRACT FROM AUTHOR]

Objectives: Unhealthy lifestyles among young people are seriously related to incapacity and health problems in adulthood. The aim of this study was to determine the importance of a health-promoting lifestyle and its association with self-efficacy and well-being. Methods: In this cross-sectional study, a sample of 500 students from Shahroud University of Medical Sciences (Shahroud, Iran) were randomly selected in 2017. The Persian versions of Health-Promoting Lifestyle Profile, Self-Efficacy Scale, and WHO-5 Well-Being Index were used. Results: Among the participants, 34% of students had an abnormal imaginable well-being, and 68% of students had high self-efficacy. The mean score of a health-promoting lifestyle was 127.47 ± 19.78, which is interpreted as moderate, and the mean score of physical activity was 14.10 ± 4.95, which is poor. There was a significant relationship between well-being, and self-efficacy with health-promoting lifestyle. Age, gender, educational level, place of residence, student employment, self-efficacy, and wellbeing were associated with students' lifestyles. Conclusion: A health-promoting lifestyle of students in this study was moderate and they did not have an acceptable level of physical activity. The direct effect of well-being, and self-efficacy on lifestyle, revising students' curriculums to improve their health behaviors, and general health indicators, can all lead to the enhancement of health-promoting lifestyles. [ABSTRACT FROM AUTHOR]

Aim: Traumatic childbirth is among the important factors that make childbirth an unpleasant experience and has psychological negative effects on women. This study aimed to determine the prevalence and risk factors associated with traumatic childbirth. Subject and methods: In this cross-sectional study, 400 women were interviewed in the first 48 h after childbirth in Torbate-heydariyeh (eastern Iran) in 2015. Traumatic childbirth was determined based on DSM-V-A criteria. Statistical analysis of the data was done through chi-square and logistic regression. Results: The prevalence of traumatic childbirth was 48.3% ( N = 193). Logistic regression showed variables such as place of residence, type of delivery, pregnancy complications, bleeding during pregnancy, rupture of grade 3 or 4 during delivery, and emergency cesarean section were significantly correlated with traumatic childbirth ( p <0.001). Conclusion: Considering the high prevalence of traumatic childbirth, it is recommended that its associated risk factors be identified so that negative psychological consequences for the mother can be prevented. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of hypertension and pre-hypertension and its determinants in the 40-64 year old population of Shahroud in the north of Iran. Methods: The blood pressure of 5,190 of the 40-64 year old people participating in the first phase of Shahroud Eye Cohort Study was measured using the standard method. Sampling was done in 2009 using a random cluster approach. The prevalence of hypertension and pre-hypertension was determined by age and sex, and we used a multi-nominal logistic regression model to calculate the odds ratio (OR). Results: The prevalence of pre-hypertension was 37.2 % in men and 30.9 % in women, and the prevalence of hypertension was respectively 37.1 % and 39.0 %. In both sexes, there was an increase in the prevalence of hypertension and a decrease in the prevalence of pre-hypertension with age. Older age, male sex, higher body mass index, blood glucose higher than 140 mg/dl were found associated with hypertension and pre-hypertension. Also, diabetes increases the odds of hypertension (OR = 1.4) and a history of smoking was correlated with a decreased odds of having hypertension and pre-hypertension. Conclusion: According to the criteria of Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, the prevalence of hypertension and pre-hypertension was high in the studied population, and considering the epidemiologic transition of diseases in Iran, it can be concluded that a high percentage of the population are at risk of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: From ancient time human beings have used different plants, animals and minerals to prevent and treat various diseases. In this respect, plants have been of particular importance. Ethnobotany is the science of reviewing how indigenous people and local tribes have used their regional plants for particular purposes such as treating diseases in the past. The information gathered from such studies can help to improve national health systems and even lead to the discovery of new medicines. Keeping this in mind, in this study a survey of Sirjan area ethnobotany was conducted during 2011–2012. Materials and methods: At the beginning, thirteen local people were interviewed about their region?s medicinal plants and their consumptions. These plants were collected and identified using identification keys. The data collected was analyzed using quantitative value indices F IC, RFC and CI. Result: Many plants collected have medicinal properties and have been used by local people to treat various ailments. Of these plants, nineteen families, 37 genera and 43 species belonged to medicinal plants. Among them, Lamiaceae with 8 species and Malva L. with 3 species were the largest medicinal plant families and genera, respectively. These plants are often used as decoction (28%) and as powder (21%). Also, the fruit of these plants are used most often. Besides being used as medicinal plants, they have other uses such as food, fuel, etc. Malva sylvestris has the largest value of relative frequency of citation and cultural importance indices. The most ailment categories have the highest level of informant agreement (mean F IC=0.92). Conclusion: Despite the semi-desert climate and lack of rich vegetation, many medicinal and economic plants are found in Sirjan region. Uncontrolled harvesting of the medicinal plants such as Bunium persicum, Cuminum cyminum, Zataria multiflora and Satureja bachtiarica in this region by local people has increased the risk of their extinction and calls for a restrict control over their protection by the authorities. [Copyright &y& Elsevier]

High concentrations of fluoride (F) in powdered milk (formula milk) can have adverse health effects on the body. The F concentration in powdered milk was analysed in Iran in 2010. A total of twelve commercial brands of highly consumed powdered milk were selected to analyse the F content through the standard F ion-selective electrode method. From each brand, three samples with different production dates were selected. The means and standard deviation for F concentration in all the samples was 1·73 (sd 0·3) μg F/g. The minimum and maximum F content in powdered milk brands Humana2 and Humana3 was 1·32 (sd 0·1) and 2·36 (sd 0·3) μg F/g, respectively. The study revealed that there was no significant difference in F concentration in the samples that belonged to various dates. Humana3 had a high F concentration (with an average of 2·36 (sd 0·3) μg F/g), which can be a risk factor for increased dental fluorosis, especially when being prepared using water with a high content of F. [ABSTRACT FROM PUBLISHER]

Background: Metabolic syndrome (MetS) is a growing public health problem with a worldwide distribution, and its prevalence is rapidly increasing worldwide. Hence, this study aimed to compare the prevalence of MetS based on the International Diabetes Federation (IDF), the National Cholesterol Education Program Expert Panel Adult Treatment Panel III (NCEP ATP III), and the American Association of Clinical Endocrinologists (AACE) diagnostic criteria. Materials and Methods: In this cross-sectional study, a total of 4737 people aged 45–69 years were enrolled in the 2nd phase of Shahroud Eye Cohort Study. We evaluated the prevalence of MetS with 95% confidence intervals by age and sex groups and according to MetS components. The accuracy (sensitivity and specificity) of these three methods was compared using latent class analysis. Finally, kappa statistic was used to determine the agreement between the diagnostic methods. Results: The prevalence of MetS varied from a minimum of 47.2% (as defined by the AACE) to a maximum of 60.0% (as defined by the IDF). The sensitivity of the three diagnostic methods of IDF, NCEP ATP III, and AACE was 98.9%, 94.4%, and 91.1%, respectively, and the specificity of these three methods was 94.6%, 97.0%, and 98.4%, respectively. Moreover, the highest agreement was found between the definition of the IDF and the NCEP ATP III. Conclusion: The IDF diagnostic method has a higher sensitivity for the diagnosis of MetS in Iranian middle-aged people. It is recommended to use this method for identifying more people at risk of MetS. [ABSTRACT FROM AUTHOR]

Background: With the growing rate of cesarean sections, rising morbidity and mortality thereafter is an important health issue. Predictive models can identify individuals with a higher probability of cesarean section, and help them make better decisions. This study aimed to investigate the biopsychosocial factors associated with the method of childbirth and designed a predictive model using the decision tree C4.5 algorithm. Methods: In this cohort study, the sample included 170 pregnant women in the third trimester of pregnancy referring to Shahroud Health Care Centers (Semnan, Iran), from 2018 to 2019. Blood samples were taken from mothers to measure the estrogen hormone at baseline. Birth information was recorded at the follow-up time per 30-42 days postpartum. Chi square, independent samples t test, and Mann-Whitney were used for comparisons between the two groups. Modeling was performed with the help of MATLAB software and C4.5 decision tree algorithm using input variables and target variable (childbirth method). The data were divided into training and testing datasets using the 70-30% method. In both stages, sensitivity, specificity, and accuracy were evaluated by the decision tree algorithm. Results: Previous method of childbirth, maternal body mass index at childbirth, maternal age, and estrogen were the most significant factors predicting the childbirth method. The decision tree model's sensitivity, specificity, and accuracy were 85.48%, 94.34%, and 89.57% in the training stage, and 82.35%, 83.87%, and 83.33% in the testing stage, respectively. Conclusion: The decision tree model was designed with high accuracy successfully predicted the method of childbirth. By recognizing the contributing factors, policymakers can take preventive action. It should be noted that this article was published in preprint form on the website of research square (https://www.researchsquare. com/article/rs-34770/v1). [ABSTRACT FROM AUTHOR]

Objective: Cesarean rates in recent decades have been increasing and a number of studies have shown that cesarean increases maternal morbidities. The aim of this study is to compare the quality of life after cesarean and vaginal delivery. Methods: This prospective study was carried out on 356 pregnant women visiting urban health centers in Shahroud City, Northeast Iran, in 2011. The subjects completed the quality of life questionnaire in the third trimester of pregnancy and at 8 weeks postpartum. Results: In primiparas, the mean global QOL scores for the cesarean and vaginal delivery groups were 67.65±12.7 and 72.12±11.8, respectively. Also, the scores for the physical, psychological and social domains of QOL as well as the global score of QOL were higher in the vaginal delivery group than the cesarean group (p<0.05). In the case of primiparas, multiple regression analysis revealed that after adjusting for education, desirability of pregnancy and the General Health Questionnaire score, the delivery type remained as a predictor of the scores for the physical (R2=1.7%; B=-3.826; p=0.031; CI [-7.301, -.350]) and social (R2=2.5%; B=-5.708; p=0.017; CI [-10.392, -1.023]) domains of QOL and the global QOL score (R2=2.6%; B=-4.065; p=0.006; CI [-6.964, -1.164]). While multiparas, there was no relationship between QOL and type of delivery. Conclusion: In this sample of low-risk women, cesarean negatively affected the QOL of primiparas. More studies with larger sample sizes should be conducted to examine the effects of cesarean on QOL in both primiparas and multiparas within a shorter period after delivery. [ABSTRACT FROM AUTHOR]