A New Behavioral Model (Health Belief Model Combined with Two Fear Models): Design, Evaluation and Path Analysis of the Role of Variables in Maintaining Behavior

With the increased pace of industrialization and higher life expectancy in the present century, lifestyles across the world have changed significantly. Some of these changes include changes in the pattern of diseases and prevalence of chronic diseases, such as diabetes (Narayan et al., 2000). Diabetes is one of the most prevalent noninfectious diseases in the world that affects approximately 6% of the world population (Task Force on Community Preventive, 2002). The prevalence of this condition is at the epidemic level in ..

Determining the Accuracy of Body Mass Index: Body Composition Using Bioelectrical Impedance Analysis (BIA)

Abstract Background: Body Mass Index (BMI) is commonly used to determine overweightness and obesity in epidemiological studies regardless of the sex and age of the subjects. Golden Standards were presented by the World Health Organization to estimate obesity by measuring body fat percentiles. The primary purpose of this study was to estimate the accuracy of the BMI by Cut-points of gold standard. Materials and Methods: This is a cross-sectional and descriptive study. Measuring body composition was done by Bioelectrical Impedance Analysis (BIA) method. Accuracy of the BIA method is documented in comparison with more complicated methods Diagnosis performance to estimate the accuracy of Body Mass Index was based on measuring specificity, sensitivity, percentile of the power of positive anticipation, and percentile of the power of negative anticipation to diagnose obesity, with due attention to the cut-points of world health organization gold standards and according to sex and age ranking. Data analysis was performed by T-test, Chi-Square and Roc curve. Two Roc curves were compared by Honely formule and regression analysis. Results: According to the cut-point of gold standard, statistical findings showed that the amounts of sensitivity and specifity were 66% and 90.5% for all persons, respectively. With due attention to data analysis, the level of sensitivity was 50.2% to 73.3% in males and 28.9% to 69.7% in females. Also, with respect to age ranking, percentile of the power of negatire anticipation was reported between 26.7% to 63.6% in males and between 28.9% to 69.7% in females. Conclusion: Body Mass Index could not accurately classify people in obesity and overweightness groups. The power of BMI for classifying obese and overweight people decreases with increasing age. Overall, comparing BMI and the cut-points of gold standard showed the medium effect of this index in classifying obese and overweight persons. The appropriate cut-point to diagnose obesity was 27.8

The interaction effect of body mass index and age on fat-free mass, waist-to-hip ratio, and soft lean mass

Background: Research has shown that body mass index (BMI) does not take into consideration the gender and ethnicity. The primary purpose of this study was to examine the interaction effect of the BMI and age on fat-free mass (FFM), waist-to-hip ratio (WHR), and soft lean mass (SLM). The secondary purpose was to evaluate the practical significance of the findings by examining effect sizes. Materials and Methods: The study was comparative in nature and employed a factorial design. Due to nonexperimental nature of the investigation, no causal inferences were drawn. The nonprobability sample consisted of 19,356 adults. Analysis of the data included factorial analysis of variance, analysis of simple effects, calculation of mean difference effect sizes, and data transformation. The Statistical Package for the Social Sciences version 22 was employed for the purpose of data manipulation and analysis. Results: The BMI by age interaction effects on FFM, F (10, 19,338) = 28.26, P < 0.01, on WHR, F (10, 19,338) = 18.46, P < 0.01, and on SLM, F (10, 19,338) = 14.65, P < 0.01, was statistically significant and ordinal in nature. Analysis of the effect sizes, ranging from 0.30 to 1.20, showed that the BMI and age influenced the WHR but their interaction effects on FFM and SLM, ranging from 0.04 to 0.36 and 0.03 to 0.33, respectively, were mainly negligible. Conclusion: Based on the examination of the statistical and practical significance of the results, it is concluded that the BMI and age together can influence the WHR but their interaction effect on the FFM and SLM is questionable

The Accuracy of Body Mass Index and Gallagher’s Classification in Detecting Obesity among Iranians

Background: The study was conducted to examine the comparability of the BMI and Gallagher’s classification in diagnosing obesity based on the cutoff points of the gold standards and to estimate suitable cutoff points for detecting obesity among Iranians. Methods: The cross-sectional study was comparative in nature. The sample consisted of 20,163 adults. The bioelectrical impedance analysis (BIA) was used to measure the variables of interest. Sensitivity, specificity, positive predictive power (PPV), and negative predictive power (NPV) were used to evaluate the comparability of the two classification methods in detecting obesity. Results: The BMI wrongly classified 29% of the obese persons as overweight. In both classifications, as age increased, the accuracy of detecting obesity decreased. The Gallagher’s classification is better than MBI in detecting obesity in men with the exception of those older than 59 years. In females, the BMI was better in determining sensitivity. In both classifications, either female or male, an increase in age was associated with a decrease in sensitivity and NPV with the exception of the BMI for the 18 year olds. Gallagher can correctly classify males and females who are less than 40 and 19 years old, respectively. Conclusion: Gallagher’s classification is recommended for non-obese in both sexes and in obese males younger than 40 years old. The BMI is recommended for obese females. The suitable cutoff points for the BMI to detect obesity are 27.70 kg/m2 for females and males, 27.70 kg/m2 for females, and 27.30 kg/m2 for males

The Effect of Literacy Level on Health Related-Quality of Life, Self-Efficacy and Self-Management Behaviors in Diabetic Patients

Illiteracy in studies on quality of life (QOL) and self-efficacy (SE) of diabetic patients has been ignored. Illiteracy and diabetes have high rates in developing countries. The aim of this study was to identify the effect of literacy level on health outcomes. To achieve this, we studied health outcomes such as SE, self-management behaviors and Health-Related Quality of Life (HRQOL) in diabetic patients. A cross-sectional study was carried out in an Iranian urban federally-funded diabetes clinic (with 1400 diabetes patients) in Bandar Abbas, a city located in south of Iran. 256 Non Insulin Dependent Diabetic Mellitus patients were chosen during June, July and August 2007. Patients were grouped as illiterates, low-literates and literates. SE and QOL were measured by standard questionnaires. HbA1C was measured by calorimetric method. Data was collected with interview. Data analysis was carried out with one way ANOVA Post Hoc, and bivariate analysis method. Literacy level among the three groups from the view points of age, physical domain, psychological domain, environmental domain and SE were significant. There was no significant difference for the level of HbA1C among three groups. Literacy level does not have any effects on glycemic control. There is a strong relationship between self-efficacy and QOL domains

Can Quality of Life Questionnaires be Used in Diabetics to Assess the Relation Between HbA1c and Patients' Domain Aspects?

Over the past few decades, quality of life (QOL) has become an important concept in medical researches and treatments. Different meaningful reasons are given for this development. In the current research two standard questionnaires for evaluating of QOL were selected. First one, was a questionnaire from The World Health Organization (WHOQOL-BREF 26) and the second one, The Iranian Diabetics' Quality of Life (IRDQOL). The goal of this study is to assess the relation between different domains of these questionnaires and HbA1c in diabetics. A random sample of Iranian adult outpatient diabetics (n=76) was selected and they completed the WHOQOL and IRDQOL assessment instruments. In addition HbA1c was measured in these patients by calorimetric method. Comparisons were made between scores of "questionnaires' domains" and "HbA1c". Data analysis was carried out by the use of T-test, Spearman correlation coefficient, Pearson's correlation coefficient, and non-parametric statistical methods including Spearman correlation coefficient. Data analysis shows Psychological domain score in IRDQOL is lower than in WHOQOL and it is significant (P<0.0001). Physical domain score in IRDQOL is lower than WHOQOL and it is significant (P<0.0001). In WHOQOL questionnaire, analysis data showed when the patient's age increased, physical and psychological domain's score decreased. There is probably no relation between questionnaire domains and HbA1c in diabetics. Based on the findings in this research, there was obviously almost no difference between the two questionnaires for checking the QOL, but in IRDQOL spiritual domain is a very unreliable domain

Thyroid Dysfunction and Autoantibodies Association with Hypertensive Disorders during Pregnancy

Background. Thyroid dysfunction and autoimmunity are relatively common in reproductive age and have been associated with adverse health outcomes for both mother and child, including hypertensive disorders during pregnancy. Objective. To survey the relation between thyroid dysfunction and autoimmunity and incidence and severity of pregnancy-induced hypertensive disorders. Method. In this case control study 48 hypertensive patients in 4 subgroups (gestational hypertension, mild preeclampsia, severe preeclampsia, eclampsia) and 50 normotensive ones were studied. The samples were nulliparous and matched based on age and gestational age and none of them had previous history of hypertensive or thyroid disorders and other underlying systemic diseases or took medication that might affect thyroid function. Their venous blood samples were collected using electrochemiluminescence and ELISA method and thyroid hormones and TSH and autoantibodies were measured. Results. Hypertensive patients had significant lower T3 concentration compared with normotensive ones with mean T3 values 152.5±48.93 ng/dL, 175.36±58.07 ng/dL respectively. Anti-TPO concentration is higher in control group 6.07±9.02 IU/mL compared with 2.27±2.94 IU/mL in cases. Conclusion. The severity of preeclampsia and eclampsia was not associated with thyroid function tests. The only significant value was low T3 level among pregnancy, induced hypertensive patients

Safe Traffic Behaviors in Adolescents : A Cross-sectional Study Based on the Theory of Planned Behavior

Adolescents do not have adequate safe traffic behaviors. This cross-sectional study investigated safe traffic behaviors of 414 male high school students of Hamadan, Iran, randomly selected using the multistage sampling method in 2020. This study used a researchermade questionnaire based on the theory of planned behavior about safe traffic behaviors with Cronbach’s alpha coefficient of 0.95, content validity ratio of 0.70, and content validity index of 0.85. There was a strong positive correlation between safe traffic behaviors with perceived behavioral control and intention. Adolescents can be influenced to internalize behavioral safety precursors that can lead to a sustained increase in safe traffic behaviors and the prevention of road traffic injuries