Background: The novel coronavirus disease 2019 (COVID-19) has emerged as a major global public health challenge. This study aimed to investigate on how people perceive the COVID-19 outbreak using the components of the Extended Parallel Process Model (EPPM) and to find out how this might contribute to possible behavioral responses to the prevention and control of the disease. Methods: This cross-sectional study was conducted in Iran during March and April 2020. Participants were recruited via online applications using a number of platforms such as Telegram, WhatsApp, and Instagram asking people to take part in the study. To collect data an electronic self-designed questionnaire based on the EPPM was used in order to measure the risk perception (efficacy, defensive responses, perceived threat) related to the COVID-19. Descriptive statistics, chi-square, t-test and analysis of variance (ANOVA), were used to explore the data. Results: A total of 3727 individuals with a mean age (SD) of 37.0 (11.1) years participated in the study. The results revealed significant differences in efficacy, defensive responses and perceived threat among different population groups particularly among those aged 60 and over. Women had significantly higher scores than men on some aspects such as self-efficacy, reactance, and avoidance but men had higher perceived susceptibility scores compared to women. Overall 56.4% of participants were engaged in danger control (preventive behavior) while the remaining 43.6% were engaged in fear control (non-preventive behavior) process. Conclusion: More than half of all participants motivated by danger control. This indicated that more than half of participants had high perceived efficacy (i.e., self-efficacy and response efficacy). Self-efficacy scores were significantly higher among participants who were older, female, single, lived in rural areas, and had good economic status. The results suggest that socioeconomic and demographic factors are the main determinants of the COVID-19 risk perception. Indeed, targeted interventions are essential for controlling the pandemic.

Metabolic syndrome is associated with cardio-metabolic risk factors and lipid abnormalities. Previous studies evaluated the dietary habits and nutrient intakes among patients with metabolic syndrome; however the association between metabolic risk factors and adiponectin with dietary diversity score (DDS) in patients with metabolic syndrome has not been evaluated yet. Therefore the aim of the current study was to evaluate these relationships among patients with metabolic syndrome. One hundred sixty patients with metabolic syndrome were recruited in the study. The anthropometric parameters including weight, height, waist circumference and hip circumference were measured. Serum adiponectin concentration was measured by enzyme- linked immunosorbent assay method (ELISA). Lipid profile and fasting serum glucose concentrations (FSG) were also measured with enzymatic colorimetric methods. Blood pressure was also measured and DDS was calculated using the data obtained from food frequency questionnaire (FFQ). Subjects in lower DDS categorizes had significantly lower energy and fiber intake; whereas mean protein intake of subjects in the highest quartile was significantly higher than second quartile. Higher prevalence of obesity was also observed in the top quartiles (P < 0.001). Subjects in the lower quartiles had higher serum triglyceride concentrations and systolic blood pressure (SBP) values and lower serum adiponectin concentrations compared with subjects in higher DDS categorizes (P < 0.05). The prevalence of metabolic syndrome components among patients in lower DDS quartiles was significantly higher (P < 0.05). Our study found a lower serum triglyceride and SBP and higher serum adiponectin concentrations in top quartiles of DDS. The findings clarify the possible preventive role of higher dietary diversity score against metabolic syndrome. However, for further confirming the findings, more studies are warranted.

Background: Cognitive disorders and dementia have an important effect on individual independence and orientation. According to the Alzheimer's Disease International (ADI) 75% of people with dementia are not diagnosed; this may be as high as 90% in some low- and middle-income countries. This systematic review and meta-analysis aimed to identify the test performance of screening tools and compare them pairwise. The findings of our study can support countries in planning to establish and care for mild cognitive impairment in primary health centers. Methods: Medline (PubMed), Scopus, Cochrane, Dare, All EBM Reviews, CRD (OVID), and Proquest were searched from 2012 to November 2021. The risk of bias was assessed through the QUADAS-2 instrument. Given the high heterogeneity between studies, a random-effects model was used to calculate the pooled effect sizes for diagnostic accuracy measures (sensitivity, specificity, and area under curve indices). I² test was used for assessing heterogeneity and predefined subgroup analyses were performed using participants’ age, country’s income, and sample size of studies. Results: A systematic search identified 18,132 records, of which, 20 studies were included in the quality assessment, and six were included in quantitative analysis. None of the studies had examined the feasibility or efficiency of mass screening. According to a pairwise comparison, IQCODE, AD8 and GPCOG showed equal or better diagnostic performance relative to the MMSE in terms of sensitivity and specificity. The random-effect model for the MMSE showed the pooled sensitivity equal to 0.73 (95% CI 0.57–0.90), the pooled specificity equal to 0.83 (95% CI 0.75—0.90), and the pooled AUC equal to 0.88 (95% CI 0.83–0.93). Conclusion: Several benefits have been attached to short tests making them a suitable choice for use in primary healthcare settings. Considering factors such as accuracy, time of application, ease of scoring, and utilization charges, tests such as IQCODE, AD8, and GPCOG or appropriate combination with counterpart tools seem to be good alternatives to the use of the MMSE in primary care.

Opioid use is a severe problem in Iran. Despite methadone maintenance treatment (MMT) programs being one of the most important treatment strategies for reducing individual and public harms associated with opioid use, a large proportion of Iranian patients refuse to participate in such treatment programs. The present study aims to explore the beliefs and attitudes toward MMT programs of opioid-dependent patients who were participating or had participated in methadone therapy. In-depth interviews were conducted with 23 opioid users between 27 and 58 years of age from Kurdistan provinces. Overall, six themes were discovered to be key barriers relating to methadone treatment, including financial barriers related to methadone treatment, lack of awareness about methadone treatment, negative attitudes regarding using methadone, worries about methadone’s side effects, social stigma ascribed to methadone therapy, and systemic barriers to methadone treatment. Our study revealed that the cost of treatment is a major obstacle to attending and continuing at MMT programs and that addicts and their families are not always accurately informed about the duration of MMT programs and the side effects of methadone treatment.

The present randomized controlled trial (RCT) evaluated the effectiveness of a theory-based physical activity (PA) intervention for rural patients with prediabetes. It was hypothesized that a PA intervention program based on the social cognitive theory (SCT) will modify fasting blood sugar (FBS) among rural people with prediabetes, which in turn will result in a decrease in diabetes incidence in the rural area. A cluster RCT on prediabetic people was conducted in Ahar, East Azerbaijan Province, Iran. A PA intervention in prediabetes was performed over 16 weeks of follow-ups in 12 villages (six per arm). Residents (n = 272; n = 136 per arm) were invited to participate in the study through rural health care centers during screening for eligibility. Participants in the intervention and control groups were informed of their prediabetic conditions and encouraged to make appropriate changes to their lifestyles to modify their prediabetes. The intervention was an educational program delivered over 16 weeks and involved behavioral change techniques. Through the education program, the intervention group received one session per week lasting about 90 min (a total of 16 sessions). The importance of risk control with PA, the duration of hill climbing, as well as exercise and safety tips were explained in a brochure that was given to the participants. Anthropometric measures, glycemic status, and PA were evaluated at the beginning of the program and after 16 weeks of follow-up. The PA program showed a reduction in FBS mg/dl at 16 weeks (large-effect-size Cohen’s d = −0.63, p = 0.001) compared to the control condition. PA intervention led to a large effect size on diastolic blood pressure (BP, − 1.01) and a medium effect size for systolic BP (− 0.57), body mass index (BMI, − 0.33), and weight (− 0.35). Based on generalized linear mixed model analysis, significant reductions in FBS (mg/dl), BMI, weight, and diastolic BP were found in the intervention group compared to the control group. Our results support the effectiveness of an SCT-based PA intervention to reduce the risk of prediabetes developing into diabetes among rural patients with prediabetes. Findings suggest that implementation of SCT-based PA intervention for a rural population at risk of diabetes has potential benefits. Iranian Registry of Clinical Trials, IRCT201607198132N4 . Registered on 1 September 2017. Prospectively registered.