mitra moodi

The purpose of this study was to investigate the knowledge, attitude, and practice of households living in Darmian city, South Khorasan, Iran, with regard to municipal solid waste (MSW) management.

The quota sampling method was used based on Darmian city zoning. The questionnaire was included questions about knowledge, attitude, and practice in the MSW management domain. Data were analyzed by SPSS version 18 (SPSS Inc, Chicago) using descriptive statistics and appropriate nonparametric statistical tests.

The findings showed that the mean score of knowledge was 8.53 ± 2.46, of attitude was 16.60 ± 2.70, and of practice was 3.02 ± 1.10. It was found that the implementation of management plans could improve health and environmental aspects.

According to the findings, the scores of knowledge and practice were higher among urban residents than rural ones. Therefore, proper planning for improving the cultural level of rural residents in this regard should be considered. To increase participation in waste separation and recycling practices, educational campaigns and mass media can be the used as one of the effective educational strategies

Deep fat frying is one of the oldest processes used to dry, cook, and formulate food products. The success of this process is due to its adaptability and flexibility in domestic and industrial scale. Fried foods are very popular owing to their good mouthfeel, high pleasantness, good taste, and texture. Foods absorb a significant amount of oil during frying, which increases the risk of such diseases as increased cholesterol levels, blood pressure, cardiovascular diseases, and cancer. The shift in consumer attitude and preference towards healthier options with lower fat content has markedly affected the fried food industry. Numerous attempts have been made globally to create low-fat products due to the excessive oil content in fried foods. There are novel methods to reduce the amount of oil in fried products. This review aimed to assess the effect of new technologies of blanching, microwave, and ultrasound on physicochemical properties, especially the reduction of oil absorption in fried products.

This study aims to investigate cognitive determinants of functional foods (FF) consumption which contain fiber among Iranian students based on the theory of planned behavior (TPB).

A cross-sectional study was carried out between March and May 2018 on the students of Birjand University of Medical Sciences (BUMS). A structured questionnaire was used which was validated with Cronbach’s alpha of 0.78.

515 questionnaires were completed, and the majority of the respondents were females. 20% of the participants were the primary household food purchasers, and familiarity with functional foods was the only effective factor regarding consumption. Subjective norms could predict the students’ consumption of the macaroni which contained fiber. In addition, monthly income of the family had a major effect on having the macaroni containing fiber. The parents’ education also impacted the consumption of these foods.

Attitudes and perceived control had a poorer effect on choosing the food containing fiber rather than subjective norms.

 The global population is undergoing rapid aging, highlighting the importance of assessing the hope levels of the elderly to develop educational and welfare programs aimed at enhancing their quality of life. This study aimed to assess the state of hope and its associated factors among elderly individuals in Birjand city.

 This descriptive-correlational study included 441 elderly aged 60 and above from Birjand City, selected using a systematic stratified sampling method in 2018. Data were collected through interviews conducted by trained interviewers using the standard questionnaire “Schneider's Hope of the Elderly (SHS)." Data were analyzed using SPSS 19 software, and statistical tests, including independent T-Test, ANOVA, and Tukey's post hoc test, were applied at a significance level of α = 0.05.

 The average age of the participants was 70.1 ± 7.3 years. The mean scores for hope, agentive thinking, and strategic thinking were 27 ± 3.3, 12.9 ± 2.1, and 14.1 ± 2.1, respectively. Men had significantly higher scores in agentive thinking (P < 0.001) and the overall hope score (P < 0.003) compared to women. Illiterate individuals had lower agentive thinking scores than other groups (P < 0.001). Additionally, married individuals had significantly higher scores in agentive thinking, strategic thinking, and overall hope scores compared to other elderly individuals. Conversely, elderly individuals without children had lower scores in these areas compared to other groups (P < 0.05).

 Based on the study's findings, it is essential to develop and implement educational and welfare interventions aimed at increasing hope among the elderly, particularly targeting women, single individuals, those who are lonely, and those with lower levels of education.

The importance of Early Clinical Experience (ECE) in education is increasing. This study aimed to investigate the viewpoints of medical students about ECE in teaching  endocrine and gastrointestinal physiology lessons.

This study was conducted on 96 second-year medical students in endocrinology and gastrointestinal physiology classes including 15 sessions in the first and second academic semesters of 2022-2023. The first 45 minutes of the class was taught via the lecture method, after the 5 minutes break, the second 45 minutes of the class started by lecture method and a question based case-senario related to the teaching subject of the same session was asked from standard questions of United States Medical Licensing Exam (USMLE). A researcher-made questionnaire was used at the end of sessions to assess the students' viewpoints. The questionnaire included 12 questions about ECE teaching method, quality of learning, content quality, and student motivation. They were rated by a 5 point Likert scale from completely disagree to completely agree.

The mean age of students was 20.82±1.37 years and 51 (53.1%) of them were male. The mean score of overall students’ motivation, quality of teaching and learning quality was 6.85 ± 1.97,  7.16±2.46, and 14.47±3.8 respectively.

This study suggested the early clinical exposure in teaching endocrine and gastrointestinal physiology. This educational method can be used to solve problems such as students' understanding of the lack of connection between basic and clinical sciences to increase their motivation for learning.

 In recent decades, spiritual well-being has gained fundamental importance in many healthcare environments. Spiritual well-being is important information about healthcare needs, allowing people to deal with mental stress.

 The present study aimed to determine the spiritual well-being of nurses working in Birjand University of Medical Sciences hospitals in 2022.

 In this cross-sectional study, 354 nurses working in the hospitals of the University of Medical Sciences in Birjand City in 2022 were selected by proportional stratified random sampling, and they completed the questionnaire related to demographic information and the standard questionnaire of spiritual well-being. Data were analyzed by SPSS v26 software and ANOVA with Tukey's post hoc test, Pearson correlation, and chi-square at 0.05 significant level.

 The mean age of the nurses participating was 35.76 ± 7.29 years, and the mean total score of nurses' spiritual well-being was 180.55 ± 16.95. Most of the people in the field of communication with God (78.5%), self (58.8%), others (75.1%), and nature (78.5%), and the total score (52%) were in the medium level of spiritual well-being. There was a significant direct correlation between all dimensions of spiritual well-being (P < 0.001). Also, there was a statistically significant relationship between the mean score of spiritual well-being and age, employment status, and workplace hospital (zage = 7.76; z employment = 18.95; z workplace = 18.62; P < 0.05).

 Considering that the nurses were medium in terms of spirituality and spiritual well-being, it is suggested to hold educational workshops to improve the level of spiritual well-being of nurses.

Accurate and timely diagnosis of mild cognitive disorders is essential to prevent their progression to dementia. This study aimed to determine the relationship among the serum levels of lipid markers of cognitive disorders in older adults in Birjand.

The community-based cohort study was performed on 1400 older adults population (60 years and older) living in urban and rural areas of Birjand, among whom 242 older adults were selected by multi-stage random sampling; the Mini-Mental State Examination Cognitive Disorders Questionnaire was completed, and five cc of blood samples were taken to assess Triglyceride, Cholesterol, Low density lipoprotein, High-density lipoprotein, lipoprotein a, Apo lipoprotein A, and Apo lipoprotein B.

The mean age of participants was 70.6± 6.96 years. 55.4% were women. The level of MMSE was significantly different based on the demographic information. Mean serum levels of Lipid profile, Apo B/ Apo A Ratio, and LP a, were not significantly different from MMSE.

The study showed a significant relationship between demographic information and MMSE level, so it can be used to improve the cognitive level of older adults by changing their life situation, marital status, and education. However, the parameters of Lipid profile, Apo B/ Apo A Ratio, and LP a are not used to diagnose cognitive disorders in older adults.

This study sought to identify the factors that influence online health-related behaviors among Iranian healthcare workers during the COVID-19 outbreak. The study utilized the Uses & Gratification and Self-Determination theories to explain the factors associated with workers' behaviors and their use of social media to share information about the pandemic. A decision tree technique known as the Chi-Square Automatic Interaction Detector (CHAID) was used to analyze the responses of 406 participants. The results revealed that healthcare workers' engagement in online health-related behaviors was primarily influenced by their attitude and motivation to use social media during the epidemic. Attitude was identified as the most important and first factor, while motivation was the second factor. The usefulness of information and interactions in the face of a health crisis can be linked to the development of self-efficacy and the promotion of social capital, as well as satisfaction with media. In conclusion, this study highlights the importance of understanding the factors that drive healthcare workers' engagement in online health-related behaviors during a pandemic. The findings can be used to develop strategies to promote the use of social media for health-related purposes and improve healthcare workers' response to future pandemics.

Dyslipidemia is one of the most common modifiable risk factors for cardiovascular diseases. One of the most important strategies for controlling dyslipidemia is improving lifestyle. This study was conducted with the aim of determining the effect of educational intervention on beliefs related to the prevention of dyslipidemia in women.

The current study is a semi-experimental type that was conducted on 80 women who referred to comprehensive health service centers in Tabas city. Sampling was done in several stages. The data collection tool was a researcher-made questionnaire that was completed before and one month after the intervention. The educational intervention based on the health belief model included two group training sessions and presentation of an educational booklet. Data was collected based on SPSS software version 21 and analyzed using descriptive and analytical statistical tests. The significance level of the tests was considered less than 0. 05.

The average score of perceived intensity in the test group after the intervention has increased significantly compared to the control group and the average score has increased from 12.45 to 13.13(p=0.003). The average score of perceived barriers in the test group has also decreased from 29.62 to 27.44(p=0/011). The average perceived self-efficacy score in the test group increased from 30.18 to 32.16, which was a significant increase compared to the control group(p=0/019).

Considering the effect of the intervention on improving some constructs such as perceived severity, perceived barriers, self-efficacy, it can be concluded that the educational intervention based on the health belief model can be effective in promoting beliefs related to preventive behaviors of dyslipidemia.

Aging is identified as a risk factor for vitamin D deficiency (VDD) therefore this investigation was designed to determine the prevalence of VDD and its determinants in a sample of older adults.

The data of this study were obtained from the baseline wave of the Longitudinal Aging Study (LAS). Demographic, past medical history, medication history, and smoking behavior were collected using an interview approach. The physical activity and nutritional status of the participants were assessed using a standard questionnaire. Anthropometric indices were measured according to a standard protocol then body mass index (BMI) was calculated. Serum vitamin D and calcium levels were measured by autoanalyzers. Univariate and multiple logistic regression models were applied to detect the associated factors with VDD.

Mean age of the participants was 71.82 (SD = 7.63) years. A total of 1319 people participated in our study, and 51.16% (n = 688) were female. A total of 8.42% (n = 111) of the participants had VDD and 17.06% of them (n = 225) had insufficient vitamin D levels. In the multivariable logistic regression model, the age group of 70–79 years in comparison with the age group of 60–69 years had a 43% less chance of VDD. Furthermore, being overweight (OR = 0.36, P = 0.01) and obese (OR = 0.35, P = 0.02), and taking vitamin D supplements (OR = 0.31, P = 0.04) were significantly associated with VDD.

Our results showed that 25% of older adults had vitamin D deficiency or insufficiency. In addition, some modifiable lifestyle factors were associated with VDD. Given that, old age is considered a risk factor for VDD. Therefore, detection and improvement of VDD may be a preventive measure in at‑risk subjects.

Age-related aspects of addiction are one of the most important public health challenges in the world and also in Iran. Therefore, the present study aimed to compare the level of common cardiac factors in addicted and non-addicted older adults.

This case-control study was conducted on 230 older adults over 60 years in Birjnd, the capital of South Khorasan, Iran. A total of 115 older adults with at least one year of drug use history and 115 older adults without a history of addiction were included in the study. A questionnaire containing demographic and addiction information was completed for each subject. Body mass index (BMI), as well as systolic and diastolic blood pressure, was determined. Blood samples were taken from each individual after 12 hours of fasting to measure fasting blood sugar (FBS), and lipid profile (HDL, LDL, total cholesterol, and triglyceride).

There was no significant difference in FBS between addicted and non-addicted older adults (P> 0.05). In the lipid profile, there was only a significant decrease in triglyceride levels in the addicted group compared to their non-addicted counterparts (P=0.02). Mean blood pressure in the addicted group was significantly lower than that in the non-addicted group (P=0.01).

As evidenced by the results of this study, opium dependence does not seem to have a protective effect on blood sugar and lipid profiles. Therefore, education and promotion of community health literacy, especially among older adults, are necessary to improve traditional beliefs about opium use.

Chronic diseases affect daily life activities. Naturally, as people age, their activity level drops, increasing the risk of diseases. Therefore, physical activity and aging are in a vicious cycle. The present study aimed to investigate the relationship between chronic diseases and physical activity in the elderly in Birjand, Iran.

This cross-sectional study was part of a cohort study entitled "Comprehensive Plan for the Elderly in Birjand" conducted on 1,418 participants aged 60 years and older in 2018. Before data collection, informed consent was obtained, and physical activity was measured using LASA Questionnaire. The standard medical history questionnaire assessed the participant's chronic disease history.

Out of 1,418 elderly participants, 683 (48.1%) were male, and 735 (51.8%) were female, 1,063 (74.9%) were in the age range of 60-74. Around 351 (24.8%) of the participants had diabetes, 606 (42.7%) had high blood pressure, 457 (32.2%) suffered from dyslipidemia, and 79 (5.6%) had experienced a heart attack. The results showed that 50% of the geriatrics in the current study had moderate physical activity (more than 600 minutes per week), 37% had no physical activity (less than 300 minutes per week), and 13% had little physical activity (between 300 and 600 minutes per week). Diseases such as arthritis (P=0.03), cancer (P=0.02), hypertension (P=0.001), stroke (P=0.001), myocardial infarction (P=0.04), and heart failure (P=0.03) had a significant relationship with physical activity.

As there was a relationship between chronic diseases and physical activity, the results of this study help policymakers in the field of geriatrics' health and proper planning for health and treatment services.

Colorectal cancer is the most common cancer of the gastrointestinal tract. Health beliefs play an important role in the development of health behaviors. In this study, the effect of educational intervention based on Health Belief Model on colorectal cancer screening behavior was investigated.

This study was performed as a randomized controlled intervention. The study population was 50–70‑years old in Khosf city. Initially, 120 eligible populations were randomly divided into intervention and control groups (60 people in each group). The data collection tool was a standard colorectal cancer screening questionnaire that was completed before, immediately, and 3 months after the intervention. The intervention consisted of eight 60‑min training sessions. The collected data were analyzed using SPSS19 software and statistical tests.

The mean age of the intervention and control groups was 63.53 ± 5.67 and 57.73 ± 5.77 years. In terms of mean scores of knowledge, perceived susceptibility, perceived severity, and perceived barriers were homogeneous before intervention. After the intervention, the mean score of the model constructs showed significant changes, which was statistically significant (P < 0.05). The rate of occult blood test in stool 3 months after training reached 90% in the intervention group and 15% in the control group.

The results of this study showed that by taking measures to reduce perceived barriers as well as increase knowledge, perceived susceptibility, severity, benefits and self-efficacy, the rate of participation in occult blood testing in feces can be significantly increased.

Tetanus is a neurological disease associated with increased muscle contraction and spasm in patients. The risk and progression of the disease are higher in elderly patients. Numerous elderly people in our country, especially in rural areas, lack tetanus vaccination in childhood. Due to the weakness of the immune system in the elderly, this study aimed to assess the tetanus immunity in the elderly over 60 years old in Birjand, Iran, 2018-2019. In this cross-sectional descriptive study, the level of tetanus antibody was measured in serum samples of 186 individuals from the elderly population of Birjand in 2018-2019. The mean level of tetanus antibody was estimated at 0.355±0.63 IU/ml, showing that 132 (71%) cases lacked immunity against tetanus (95% CI: 0.23-0.36). In the present study, the level of tetanus antibody decreased significantly with aging (P=0.002), and a significant difference was observed between the job and the level of tetanus antibody (P=0.003). The mean level of tetanus antibody increased significantly in individuals with an increase in education level (P=0.018). However, the mean level of tetanus antibody showed no significant difference with the living place (P=0.232) and gender (P=0.872). In this study, more than 70% of the elderly lacked immunity against tetanus, indicating the need for more attention in providing more health services to the elderly.

Quarantine, an unpleasant experience, was implemented in many countries to limit the spread of Coronavirus disease 2019 (COVID-19), which it could associated whit lifestyle changes. The present study aimed to determine the changes in Iranian’s lifestyle during COVID-19 pandemic.

In the present cross-sectional study, 2710 Iranian people completed an online researcher-made questionnaire asking lifestyle regarding COVID-19, which includes five sections about physical activity, stress and anxiety, nutrition habit, sleep disorders, and interpersonal relationship in addition to demographic data from January to February 2021, using the multistage cluster sampling method.

The participants’ mean age was 33.78 ± 11.50 years and 68.3% of them were female. Traveling, sightseeing, and family visits have been eliminated from 91%, 83.5%, and 77.5% of participants’ lives, respectively. There were increase in stress level (P < 0.001), weight of the participants (P < 0.001), sleep problems (P < 0.001), and healthier foods (P < 0.001) but decrease in interpersonal communication(P<0.001) and the amount of physical activity( P < 0.001).

In summary, this study indicates some changes in lifestyle of Iranian people, including changes in some eating practices, physical activity, social communication, and sleeping habits during the pandemic. However, as the COVID-19 pandemic is ongoing, a comprehensive understanding of these behaviors and habits can help develop interventions to mitigate the negative lifestyle behaviors during COVID-19 pandemic.

Coronavirus disease 2019 (COVID-19) is a viral infectious disease and a pandemic since late 2019. One of the factors affecting the quality of life (QoL) and longevity of patients is social support. Social support reduces the effects of stress and calls for effective coping responses in the face of illness. Patients behave better if they have social support.

The aim of this study was to evaluate the QoL and perceived social support in patients with improved COVID-19 in Birjand, Iran, in 2020.

Using the available samplingmethod, the participants of this descriptive-analytical study were selected from the list of patients in the health center. A total of 100 patients with improved COVID-19 were included. Data were collected using the demographic information, the Perceived Social Support (PSS) Questionnaire (Kanti-Michel and Zimmet 2000), and WHOQOL-BREF Questionnaire. Data were analyzed by descriptive and analytical tests (one-way analysis of variance and correlation test) using SPSS version 22 at a significance level of P < 0.05.

The mean age of participants was 50.08±9.63 years and 44% of the samples were male. The mean score of perceived social support was 52.15±7.62 (out of 60), and the mean QoL score was 86.63±16.72 (out of 100). Also, there was a significant relationship between perceived social support and QoL (P = 0.03, r = 0.21).

Our findings showed a significant relationship between perceived social support and QoL. Thus, implementation of interventions to promote perceived social support and QoL by the governments, health care workers, family, and friends is essential

 Diabetes is one of the most common chronic and non-communicable metabolic diseases and one of the major public health problems. Lifestyle and diet are remarkable factors in controlling diabetes.

 This study aimed to determine the level of knowledge and stages of nutritional behavior change in diabetic patients.

 In this descriptive-analytical study, a simple random sampling method was used to select 330 diabetic patients covered by comprehensive health service centers in Ghayenat city, South Khorasan Province, Iran. The research instrument addressed the participants’ demographic information, knowledge, and stages of nutritional behavior change in diabetic patients. The ordinal logistic regression was used to examine factors affecting behavior change. In this regard, the significance level was set to be P < 0.05.

 The participants’ mean age was 57.86 ± 11.72 years, and 63.7% of the patients were female. The mean score of knowledge was 15.73 ± 2.61, and 52.8, 16.9, 8.9, 11.3, and 10.1 percent of the participants were in the maintenance, action, preparation, contemplation, and pre-contemplation stages. The ordinal Logistic regression model revealed that the main factors affecting behavior change were knowledge, level of income, and a family member with diabetes (P < 0.05).

 Given that about two-thirds of diabetic patients take no training course on diabetes, that above forty percent of these individuals have no proper knowledge about the disease, and that half of the patients are in the pre-maintenance stages of behavior change, holding a training course is of paramount importance for patients.

The COVID-19 epidemic is a newly emerging infectious disease. This study was conducted to design an appropriate psychometric questionnaire of cultural and social characteristics to evaluate beliefs and preventive behaviors toward COVID-19 among the Iranianchr('39')s population according to change behavior theory as   health belief model (HBM). 

The study population included all those who had access to social networks and answered the questionnaire voluntarily. The sample size in this study was 350 people. In this cross-sectional study, a questionnaire was designed using scientific sources and based on the health belief model, and its face and content validity was determined by Content Validity Ratio (CVR), and reliability was determined by the internal consistency; Test-retest was applied to examine the internal consistency of the questionnaire. Data were analyzed using SPSS software version 19. Cronbach’s alpha and Intra-class Correlation Coefficient (ICC) were used for the assessment of the reliability of data.

Initially, the questionnaire was designed based on the literature reviews and expert’s opinion in the field of health education with 79 items. After that, 2 of them were deleted and corrected qualitatively by performing the face and content validity of some items. Therefore, finally, a questionnaire with 77 questions was approved. Based on the constructs of the health belief model, the domains of the questionnaire included perceived sensitivity , severity , benefits barrier , self-efficacy, knowledge and behavior .The content validity of the questionnaire was confirmed. The Cronbach’s alpha and ICC for each domain were greater than 0.7.

The Questionnaire of beliefs and preventive behaviors toward COVID-19 based on HBM is a valid and reliable instrument in the Iranian population that could be used in related research.

Anemia is a multifactorial and common public health problem in geriatric age groups, especially in developing countries. Therefore, this study was designed to study the prevalence of anemia and associated factors among the elderly population in Birjand, Iran, in 2019.

This was a cross-sectional approach to the baseline data of the Birjand longitudinal aging study (BLAS) in which 1396 people aged ≥ 60 years were screened for the presence of anemia based on the World Health Organization (WHO) criteria. For each participant, a standard questionnaire was administered. Furthermore, the height, weight, and body mass index (BMI) were calculated. Blood samples were obtained from each participant for hematological examination. Hemoglobin, hematocrit, and other indices of cell blood count were measured using an automatic cell counter. The prevalence rates were estimated using survey analysis with the weight of Birjand county older population. Univariate and multivariable logistic regression analyses were applied to detect the associated factor with anemia.

The mean age of the participants was 69.73±7.66 years. The crude prevalence of anemia was 11.10%, and the age-standardized prevalence based on the standard WHO population 2000-2025 was equal to 16.78% (12.81%–21.66%) (15.95% [10.41%–23.69%] in women and 17.32% (12.65%–23.25%) in men. Mild and normocytic anemia were the predominant types. The mean hemoglobin, hematocrit, mean cell volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were lower in women than in men and the mean platelet count in women was higher (p<0.001). In the final multivariate logistic regression model, only age groups, BMI, fish consumption, and chronic kidney disease (CKD) were related to anemia.

In conclusion, our findings showed the association of anemia with some risk factors and diseases. Anemia in geriatric age groups is often underdiagnosed; hence, identification of subgroups at risk for anemia and its associated risk factors in geriatric groups has a paramount importance in preventing adverse outcomes.

Breast cancer is a preventable disease, using three secondary preventive methods of mammography, clinical breast examination (CBE), and breast self‑examination (BSE) that can lead to early detection of breast cancer. This study was designed to assess breast cancer screening behavior and its associated factors in females employed in South Khorasan.

In this analytic‑descriptive study, 2256 female personnel of governmental organizations were investigated in Birjand city in 2016–2017. The data collection tool was a three‑part questionnaire: sociodemographic characteristics, knowledge about breast cancer screening methods plus women’s performance, and stage of change regarding screening behaviors of mammography, CBE, and BSE. The data were analyzed by SPSS 16 and one‑way analysis variance, Tukey’s post hoc, and multiple logistic regression model statistical tests.

The mean ± standard deviation score of knowledge of the women was 3.45 ± 1.5. There was a significant difference of the mean score of knowledge between the single and married (P = 0.03) and age group (P = 0.04). The stage action of mammography, CBE, and BSE was 6.8%, 12.3%, and 16.8%, respectively. Logistic regression model showed that variables such as age and family history of breast cancer were highly significant related to mammography and also CBE. Knowledge was also highly significant in mammography, CBE, and BSE. Education level in CBE, marital status in BSE and mammography, and job in BSE were also significant (P < 0.001).

This study reveals insufficient knowledge of female workers about breast cancer and the negative influence of low knowledge on the practice of breast cancer screening behavior. Therefore, the establishment and maintenance of regular educational courses for female employees is essential.

The burden of gastrointestinal (GI) cancer is increasing worldwide, and in the past decade, cancer had entered the list of chronic debilitating diseases whose risk is substantially increased by hypernutrition. Obesity may increase the risk of cancer by the imbalance of various mechanisms including insulin and insulin‑like growth factor1 (IGF‑I) signaling, systemic inflammation, immune dysregulation, tumor angiogenesis, adipokines secretion, and intestinal microbiota that usually act interdependently. An increased understanding of the mechanisms underlying obesity‑GI cancer link can provide multiple opportunities for cancer prevention. This review discusses various mechanisms involved molecular mechanisms linking obesity with GI cancers including esophagus, stomach, colorectal and hepatocellular. Furthermore, an optional intervention such as diet restriction and exercise is described, which may be preventive or therapeutic in GI cancer.

Arthritis is the most common type of arthritis in people over 40 years. This study aimed to determine the effect of an educational intervention on the prevention of arthritis among middle-aged women using the health belief model.

This was a randomized controlled field trial. The study population was women aged 29–59 years who referred to health centers in Birjand. Seventy-three women were selected by a systematic random sampling method and were randomly divided into intervention (n = 36) and control (n = 37) groups. The data collection tool was a researcher-made questionnaire. Data were analyzed using the Chi-square test, Fisher's exact test, t-test, repeated-measures ANOVA, and Bonferroni post hoc test. As for the cases where the data were not normally distributed, the Friedman nonparametric test, Mann–Whitney U-test, and Wilcoxon post hoc tests were used.

In the intervention group, the mean score of knowledge, perceived susceptibility, severity, benefits, self–efficacy, and behavior significantly increased, and the mean score of perceived barriers significantly decreased after the intervention (≤0.001). In the control group, there were significant differences in the mean scores of perceived susceptibility, perceived severity, perceived self-efficacy, and performance after an intervention (P ≤ 0.001). However, this increase was significantly higher in the intervention group than in the control group.

Based on the present study and according to the positive impact of the educational intervention based on the health belief model on the prevention of arthritis, it is recommended to use this theory in educational programs to prevent arthritis.

Teenagers are increasingly interested in computer games, and the adverse effects of these games are dependent on the execution of these games. The theory of planned behavior (TPB) is one of the most important theories in behavior change. This study aimed to determine the effect of educational planning based on TPB on the level of dependence on computer games in high school male students in Gonabad, Iran.

This was a randomized controlled trial. The study population was students of computer games in Gonabad. Sixty-four students were selected by a multistage random sampling method and were randomly divided into intervention (n = 32) and control (n = 32) groups. Data-gathering tool was the standard questionnaire of computer game dependency and researcher- made questionnaire according to TPB constructs that were completed before, immediately, and 3 months after the intervention. The intervention consisted of eight 90-min training sessions. Data were analyzed using the Chi-square test, Fisher’s, t-test, repeated measures ANOVA, and Bonferroni post hoc test.

Before the intervention, the intervention and control groups were matched for the mean score of model constructs. However, after the intervention, the mean score of computer game addiction significantly decreased (≤0.001). However, the mean score of knowledge, attitude, perceived behavioral control, and behavioral intention increased, which was statistically significant. Furthermore, the mean changes of model structures were statistically significant (P < 0.05).

The findings revealed that TPB can be used as a good theoretical framework for designing and implementing educational programs to reduce the dependency of computer games on students.

The aim of present study was to determine the effect of using the experimental model of induction of structural-functional disorder in the practical training of gastrointestinal (GI) physiology on the level of knowledge and attitude of medical students.

The present study was a descriptive studyconducted on medical students for three consecutive semesters. Initially, students were divided into groups of 15 people and the experimental models of stress and peptic ulcer induction were explained theoretically using PowerPoint software. Then, for each group of students a rat, which was prepared on the same day as the stress ulcer model, was described after induction of anesthesia. At the end, students were asked to complete a researcher-made questionnaire consisting of 7 questions in a 5-point Likert scale.

The participants were 187 medical students with mean age of 20.28 ± 1.82 years. Students agreed “high” and “very high” with holding the laboratory for raising knowledge (90.4%), changing their attitude towards GI physiology (68.5%), enhancing their skills (54.5%), being interesting and innovative (89.9%), increasing their interest in learning the topics of GI physiological theory (75.7%), identifying "stress ulcer and peptic ulcer" (79.2%), as well as holding the sessions of the laboratory for the future courses (84.5%).

Findings indicated that experimental work on live animals greatly enhanced students’ knowledge and learning. It seems that using animals should not be replaced entirely by virtual experiments; however, the combination of several teaching methods such as blended laboratories is recommended for some concepts and physiological processes including in GI physiology.

 Pregnant women are at increased risk of HIV acquisition, whose rapid diagnosis not only saves the lives of the mother and fetus and prevents the infection of the husband, but also prevents the transmission of the virus to other people in the community.

 In this line, this study aimed to assess pregnant women’s knowledge and beliefs in Birjand about voluntary HIV counseling and testing based on health belief model constructs.

 In this descriptive-analytical study, 238 pregnant women referring to Birjand comprehensive health centers (CHC) in 2018 are studied. Participants were selected using multi-stage random sampling. First, Birjand was divided into four districts as north, south, east, and west. Then, one health center and one CHC were selected from each district. Data were collected using a researcher-made questionnaire consisting of demographic information, knowledge, model constructs, and behavior, whose validity and reliability were determined. Data were analyzed using SPSS19 and independent t-test and one-way ANOVA.

 The mean age of participants was 28.3 + 5.1 years. Mean score of knowledge, susceptibility, severity, benefits, barriers and perceived self-efficacy were 5.9 + 3.6, 8.9 + 2.21, 23.7 + 4.7, 34.7 + 4.2, 28.2 + 5.9, and 24.5 + 7.3 respectively and behavior was determined to be 5%. Knowledge was evaluated to be poor in 1.7%, moderate in 51.7%, and good in 46.6%. There was a significant negative relationship between barriers and all model constructs (P < 0.05) and a significant positive relationship between knowledge with perceived susceptibility (r = 0.15) and guidance for action (r = 0.2), susceptibility with perceived severity (r = 0.23).

 This study showed the insufficiency of pregnant women’s knowledge about the importance of HIV screening. Therefore, it is recommended to use the Health Belief model in CHC to improve the knowledge, attitude, and practice of this target group.