Background: Today, one of the most serious causes of mortality and disability among youth is the traffic accidents. Regarding its importance, this paper aimed to investigate the community-based program to promote the safe traffic behaviors among youth. Methods: This was a quasi-experimental conducted on 5000 youth in five Iranian cities named Lanjan, Gomishan, Fasa, Tehran, and Zahedan in 2015–2016. The questionnaire was based on the constructs of the theory of planned behavior as well as a questionnaire of pedestrian behavior and driving behavior, which was completed before and after the intervention. The educational intervention was carried out based on the theory of planned behavior. Finally, the obtained data were analyzed using STATA software. Results: Six months after the intervention, the mean score of the theory of planned behavior and safe driving behavior in different cities was significantly increased. Here, regarding the safe crossing of the street, the most behavioral changes were observed in Gomishan (P = 0.000), Fasa (P = 0.001), and Tehran (P < 0.0001). The mean score of driving behaviors in Gomishan (P < 0.000), Fasa (P = 0.016), Lanjan (P = 0.047), and Tehran (P < 0.0001) scores was significantly higher. conclusions: In most of the studied cities, it can be concluded that education based on the theory of planned behavior can improve the safe driving behaviors among youth. Therefore, it is recommended to be implemented this program in other cities using the theory of planned behavior.

Background: Women tend to outlive men and are at higher risks of functional disability compared to men. Specifically, women are more likely to develop conditions like osteoporosis and stress urinary incontinence which can further increase the risk of functional disability. Regular physical activity and/or exercise programs can minimize the physiological decline that occurs during aging and can improve overall physical fitness, bone health, and pelvic floor muscle function; however, exercise programs tend to focus on only one parameter. Mini-trampoline jumping is a highly beneficial low-impact aerobic exercise capable of improving aerobic fitness, balance, muscle strength, and potentially bone health as well as pelvic floor muscle functioning. The aim of the proposed research project is to examine the benefits of a 3-month mini-trampoline exercise intervention on physical fitness, bone health, and pelvic floor muscle functioning in postmenopausal women. Methods: Fifty postmenopausal healthy women aged 50–69 years will be recruited. Assessments on physical fitness (aerobic fitness, walking speed, balance, lower extremity strength, flexibility), bone health, and pelvic floor muscle functioning will occur within 1 week before and after the exercise intervention, including a 3-month follow-up assessment. The exercise intervention will last 12 weeks, with three sessions of 40 min each per week. Conclusions: The proposed research has the potential to improve functional ability and women-specific risk factors in older women with an innovative and fun exercise program.

Background: Recurrent event data arise frequently in longitudinal medical studies. In many situations, there are a large portion of patients without any recurrences, manifesting the “zero-inflated” nature of the data. Moreover, there often exists a terminal event which may be correlated with the recurrent events. The goal of this study is to extend the application of joint frailty model to identify the prognostic factors associated with curing in patients with breast cancer. Methods: As a prospective study, medical records of women who had been attended to Cancer Research Center, Shahid Beheshti University of Medical Sciences from January 1998 to February 2016 were reviewed. Finally, after an initial review of medical records, 711 patients were included in the study and analyzed. A checklist that included items drawn from the demographic background of patients was provided in the study. Two joint frailty models for zero-inflated recurrent events, combining a logistic model for “structural zero” status (Yes/No) and a joint frailty proportional hazards model for recurrent and terminal event times were performed to identify factors associated with BCS. Results: The mean age of patients was 38.2 years. The numbers of subjects with 1, 2, 3, and 4 recurrent events were 392, 207, 97, and 15, respectively. The median follow-up time was 6.87 years. There were 137 (19.2%) deaths from cancer during the follow-up. Among the 574 patients who were censored, 418 had no tumor recurrence. Thus, there may exist a large portion of “cured” subjects. We can see that the radiation (OR = 6.02, CI = (3.87, 8.61)) and tumor size interaction with radiation (OR = 1.065, CI = (1.002–1.26)) were significant in the cure model (P < 0.05) which means that patients with smaller tumor sizes were more likely to be cured by radiation therapy. Conclusions: Our proposed models can help investigators to evaluate which treatment will result in a higher fraction of cured subjects. This is usually an important research question in biomedical studies.

Background: This review seeks to determine the relationship between food insecurity among elderly people over the past decades and nutrient deficiency, which is rather unclear. We aim to systematically review the relationship between food insecurity and dietary intake among elderly population. Methods: In this systematic review, we systematically searched the international databases including PubMed, Web of Sciences, and Scopus for scientifically related papers which have been published up until January 2018. For a more refined search, we used the Medical Subject Headings (MeSH) terms and Emtree. In terms of search protocol, no restrictions were placed on time and language. Two independent reviewers conducted the data refining processes. Validated form (PRISMA) was used to conduct quality assessment and data extraction. Results: Eight cross sectional studies have been included in this review. Two of the studies were conducted in Asia and the remaining six studies were largely based in the United States and Canada. Food insecurity was associated with low levels of vitamin and mineral intakes such as vitamins E, A, B, and D and also zinc, calcium, magnesium, and iron. Most studies also reported insufficient energy, and micro and macronutrients intake among elderly people. Conclusions: The findings of this review evidence a considerable amount of food insecurity and nutrient deficiency, including vitamins E, C, D, B 2, and B 12 and zinc, phosphorus, and calcium among elderly population. These findings could be used as reliable evidence by policy makers and future complementary analyses.

Background: The association between dietary patterns and cardiovascular disease (CVD) risk factors has been investigated in very limited studies in patients with type 1 diabetes mellitus (T1DM). The aim of this study was to determine the relationship between the major dietary patterns and CVD risk factors in these patients. Methods: A cross-sectional study was performed on 169 females of 18--35 years who were diagnosed with T1DM attending Iranian Diabetes Association in Tehran. Anthropometric measures, blood glucose, and lipid levels of all participants were measured. Dietary data was collected using a food frequency questionnaire. Dietary patterns were determined by factor analysis. Using the analysis of covariance (ANCOVA), mean value of the biochemical factors across the tertiles of dietary patterns was compared. Results: Three major dietary patterns were identified: the grain, legume and nut (GLN), the fruits and vegetables (FV), and the high calorie foods, salty snacks, sweet and dessert (HSD). After adjustment for age, body mass index and energy intake, subjects who were in the highest tertile of FV pattern had significantly lower levels of LDL-c (P = 0.01), triglyceride (TG) (P = 0.02), and total cholesterol (P = 0.01). GLN and HSD patterns had no significant relationship with blood glucose and lipids. Conclusions: This study demonstrates that a dietary pattern rich in vegetables and fruits may be inversely associated with dyslipidemia in patients with T1DM. The results can be used for developing interventions that aim to promote healthy eating for the prevention of CVD in these patients.

Background: Logotherapy encourages the individual to find meaning in life, which is recognized as the driving force of every individual in their lifetime. Diabetes, caused by the impairment in metabolism of glucose, fat, and protein, is associated with lack of secretion or dysfunction of insulin. This study aims to investigate the effectiveness of logotherapy on death anxiety, hope, depression, and proper use of glucose control medication in diabetic patients with depression. Methods: The population in the present quasiexperimental pretest–posttest study with control group is comprised of diabetic patients with depression attending Baghban Endocrine Clinic in Sari. A sample of 40 diabetic patients (20 in the trial and 20 in the control group) entered the study. Data were collected using Templer Death Anxiety Scale, Miller Hope Scale, Beck's Depression Inventory, and Medication Adherence Scale. Covariance analysis was used to evaluate the effectiveness of logotherapy on death anxiety, hope, depression, and proper use of glucose control medication, where P value lower than 0.05 is considered significant. Results: Death anxiety and depression of diabetic patients with depression were reduced by following logotherapy training, and their hope was increased. The results confirmed the effectiveness of logotherapy training on death anxiety, hope, and depression in diabetic patients with depression (P < 0.05). Logotherapy was effective on proper use of blood- glucose drugs in depressed diabetic patients and 19% of changes in scores of proper use of medication were caused by the effectiveness of logotherapy (P < 0.05). Conclusions: Logotherapy appears to be a suitable psychological treatment for diabetic patients with depression.

Background: Multiple sclerosis (MS) is the third most common cause of adult neurologic disabilities. The aim of this study was to determine the effect of 8 weeks of neuromuscular exercises on strength, proprioceptive receptors, and balance of women with MS. Methods: In this randomized controlled trial study, 20 female volunteers with relapsing-remitting MS were randomly assigned into the experimental group (n = 10) and control group (n = 10). Maximum muscular strength of knee extensor and flexor muscles, knee joint proprioceptive error (Biodex), and balance (Berg Balance Scale) was measured at baseline and after 8 weeks of neuromuscular exercise. The data were analyzed using paired t-test and independent t-test. Results: The results showed a significant improvement (P < 0.05) in the quadriceps strength, hamstring strength, proprioceptive receptor error, and the balance in the experimental group, but not in the control group. A significant difference was evident between the experimental and control groups in terms of strength, balance, and proprioceptive receptor error (P < 0.05). Conclusions: Neuromuscular exercise training is effective in improving balance, strength, and reducing the proprioceptive error in people with MS, and it could be recommended as modalities for these patients.

Backgrounds: Acute respiratory distress syndrome (ARDS) causes high mortality rate in clinic, and the pathogenesis of this syndrome may interact with renin angiotensin system (RAS) components. The main objective of this study was to determine the protective role of AT1R antagonist (losartan) on oleic acid (OA) induced ARDS and kidney injury. Methods: The animal model of ARDS was performed by intravenous administration of 250 μl/kg oleic acid (OA). Male and female rats were subjected to received intravenously vehicle (saline, groups 1 and 4), OA (groups 2 and 5), or losartan (10 mg/kg) plus OA (groups 3 and 6), and six hour later, the measurements were performed. Results: Co-treatment of OA and losartan increased the serum levels of blood urea nitrogen significantly (P < 0.05) and creatinine insignificantly in both gender. However, the OA induced kidney damage was decreased by losartan significantly in male (P < 0.05) and insignificantly in female rats. In addition, co-treatment of OA and losartan decreased lung water content significantly in male rats (P < 0.05). Based on tissue staining, no significant difference in lung tissue damages were observed between the groups, however some exudate were observed in lung male rats treated with OA alone which were abolished by losartan. Conclusions: Losartan may protect the kidney and lung against OA induced tissue injury in male rats. This protective action is not certain in female rats.

Background: Opium addiction, as a major health problem, has been reported in Middle East countries. Recently, contaminated opium has been reported as a probable source of lead poisoning. Thus, the aim of this study is to evaluate blood lead levels (BLL), liver enzymes, and hemoglobin (Hb) concentrations in opium-dependent addicts with healthy controls. Methods: In a cross-sectional study, 75 opium-addicted men (case group) referred to Zahedan Baharan Hospital were evaluated. A group of 75 nonaddicted men were selected as a control group. BLL, Hb, and liver enzymes levels were measured. Body mass index (BMI) was also calculated. Results: The case group had elevated BLL compared to the controls (19.1 ± 1.6 vs. 9.1 ± 0.4; P < 0.0001). Hb concentrations were significantly lower in the patients compared to the controls (13.3 ± 1.6 vs. 15.1 ± 1.3; P < 0.0001). A positive correlation was found between BLL and opium addict duration in the case group (r = 0.52, P < 0.0001). Conclusions: Due to the contamination of opium to lead, it seems that opiate addicts are at risk of lead poisoning. Thus, it is recommended that the blood lead level is frequently monitored to control the adverse effects of poisoning and prevent lead accumulation.

Background: Pyelonephritis is the most common bacterial infection in children that can cause renal failure if not diagnosed or treated early. We used serum biomarker interleukins (IL-6 and IL-8) and then confirmed the results by the findings dimercaptosuccinic acid (DMSA) scan to distinguish upper-tract infection from lower-tract infection. Methods: Serum IL-6 and IL-8 were measured in 57 children with newly diagnosed untreated urinary tract infection (UTI) documented by a positive urine culture. All children had a DMSA to determine whether serum IL6, IL-8 can be used as a marker to predict upper-tract from lower-tract infection. IL-6 and IL8 were determined by the enzyme link immunosorbent assay (ELISA) technique. Results: Of the 57 patients, 24 (42%) had renal parenchymal lesions on the DMSA scan. Patients with abnormal DMSA had significantly higher serum IL-6 and IL-8 compared with those with normal DMSA scan (187.1 ± 113.1 ng/mL vs. 396.1 ± 246.0 ng/mL, P = 0.005; and 165 ± 76.1 ng/mLvs. 190.8 ± 60.8 ng/mL, P = 0.026, respectively). Pyelonephritis was more frequent in children younger than 20 months old (n = 36, 63%, P < 0.005) and more prevalent in girls (n = 36, 63%, P = 0.005). Serum IL-6 had a sensitivity of 67.3% and a specificity of 63.0% and serum IL8 had a sensitivity of 80.1% and a specificity of 73.5% in the differential diagnosis of pyelonephritis and cystitis (P = 0.03). Conclusions: Serum levels of IL-6 and IL-8 are both sensitive biomarkers of UTI and can discriminate the upper from lower tract urinary infections. Determination of these biomarkers may help to identify patients with acute pyelonephritis and need for DMSA study.

Background: There is an increase in the prevalence of head lice among urban communities with high density in recent years. This study was aimed to determine the efficacy of 1% permethrin shampoo and some traditional physical treatment for head lice infestation in Qom Province, central Iran. Methods: This analytical cross-sectional study was carried out on all 11,223 cases in six categories that were referred to Qom health care system from 2016 to March of 2017. The infested people were treated with 1% permethrin shampoo, twice at a 1-week interval and other recommended therapeutic categories, such as the use of physical treatments such as wooden fine-toothed combs impregnated with a mixture of water and white vinegar on infested hair for 30 min and secondly, carrier oils such as olive oil, bitter almond on infested hair over a therapeutic period. After completing the course of treatment, treatment success was checked by questionnaires. Results: A total of 11,223 cases with head lice infestation were confirmed and were enrolled for study. Out of six categories, three therapeutic categories were utilized as follows: (a) 1% permethrin shampoo and the use of physical treatments; (b) 1% permethrin shampoo and the use of carrier oils; (c) the above-mentioned therapeutic categories combined had high treatment success. It was estimated to be 82.00%, 87.31%, and 94.33%, respectively. Conclusions: According to the findings, in addition to the application of 1% permethrin shampoo, the use of physical treatments and carrier oils such as olive oil, bitter almond can increase the treatment success of head lice infestation.