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  1. Fulltext YouTube Video Comments on Healthy Eating: Descriptive and Predictive Analysis
    Teng S, Khong KW, Pahlevan Sharif S, Ahmed A
    JMIR Public Health Surveill, 2020 10 01;6(4):e19618.
    PMID: 33001036 DOI: 10.2196/19618
    BACKGROUND: Poor nutrition and food selection lead to health issues such as obesity, cardiovascular disease, diabetes, and cancer. This study of YouTube comments aims to uncover patterns of food choices and the factors driving them, in addition to exploring the sentiments of healthy eating in networked communities.

    OBJECTIVE: The objectives of the study are to explore the determinants, motives, and barriers to healthy eating behaviors in online communities and provide insight into YouTube video commenters' perceptions and sentiments of healthy eating through text mining techniques.

    METHODS: This paper applied text mining techniques to identify and categorize meaningful healthy eating determinants. These determinants were then incorporated into hypothetically defined constructs that reflect their thematic and sentimental nature in order to test our proposed model using a variance-based structural equation modeling procedure.

    RESULTS: With a dataset of 4654 comments extracted from YouTube videos in the context of Malaysia, we apply a text mining method to analyze the perceptions and behavior of healthy eating. There were 10 clusters identified with regard to food ingredients, food price, food choice, food portion, well-being, cooking, and culture in the concept of healthy eating. The structural equation modeling results show that clusters are positively associated with healthy eating with all P values less than .001, indicating a statistical significance of the study results. People hold complex and multifaceted beliefs about healthy eating in the context of YouTube videos. Fruits and vegetables are the epitome of healthy foods. Despite having a favorable perception of healthy eating, people may not purchase commonly recognized healthy food if it has a premium price. People associate healthy eating with weight concerns. Food taste, variety, and availability are identified as reasons why Malaysians cannot act on eating healthily.

    CONCLUSIONS: This study offers significant value to the existing literature of health-related studies by investigating the rich and diverse social media data gleaned from YouTube. This research integrated text mining analytics with predictive modeling techniques to identify thematic constructs and analyze the sentiments of healthy eating.

  2. Role of Sex, Socioeconomic Status, and Emotional Support in Predicting Aging Perception Among Older Adults
    Yaghoobzadeh A, Sharif Nia H, Pahlevan Sharif S, Hosseinigolafshani SZ, Mohammadi F, Oveisi S, et al.
    Int J Aging Hum Dev, 2018 Jul;87(1):77-89.
    PMID: 28859489 DOI: 10.1177/0091415017727211
    Self-perception is found to be a central predictive factor in experiencing successful aging. The aim of this study was to explore the role of sex, socioeconomic status, and emotional support in elders' aging perception. A cross-sectional design was used with 300 older aged participants recruited from 23 clinics and health centers in Qazvin, Iran. Data were collected included questions to elicit demographic information and Barker's aging perception questionnaire. Exploratory multiple linear regression showed that the level of emotional support (β: -12.10; 95% CI: [-20.72, -3.48]), socioeconomic status (β: 2.84; 95% CI: [0.25, 5.43]), and women (β: -4.34; 95% CI: [-6.91, -1.77]) were associated with aging perception among elders. Educational level and marital status did not significantly contribute to the variance of AP. Findings revealed that aging perception was related to individual differences as well as social and emotional factors. Researchers, health-care professionals, and elders may benefit from thinking about old age as an inevitable life stage.
  3. A Model of Aging Perception in Iranian Elders With Effects of Hope, Life Satisfaction, and Socioeconomic Status: A Path Analysis
    Yaghoobzadeh A, Gorgulu O, Yee BL, Wibisono AH, Pahlevan Sharif S, Sharif Nia H, et al.
    J Am Psychiatr Nurses Assoc, 2018 01 22;24(6):522-530.
    PMID: 29357723 DOI: 10.1177/1078390317753676
    BACKGROUND: Aging perception plays a central role in the experience of healthy aging by older people. Research identified that factors such as hope, life satisfaction, and socioeconomic status influence the perception of aging in older populations.

    OBJECTIVE: This study sought to test a hypothetical model to quantitatively evaluate the relationship between hope, life satisfaction, and socioeconomic status with aging perception.

    DESIGN: A cross-sectional design was used with 504 older aged participants who live in Qazvin, Iran. Data were collected using the Barker's Aging Perception Questionnaire, Life Satisfaction Index-Z, and Herth Hope Index.

    RESULTS: The results of path analysis showed that hope was the most important factor affecting aging perception. Results drawn from correlation analysis indicated that there was a positive significant correlation ( r = .383, p < .001) between hope and aging perception. Further analysis found that hope had the strongest impact on aging perception compared with the other variables analyzed (e.g., life satisfaction and socioeconomic status).

    CONCLUSIONS: A model of aging perception in Iranian elders is presented. The findings suggested that hope had a significant and positive impact on aging perception. Implications for clinical practice and research are discussed.

  4. Prevalence of Acute Myocardial Infarction and Changing Meteorological Conditions in Iran: Fuzzy Clustering Approach
    Sharif Nia H, Gorgulu O, Pahlevan Sharif S, Froelicher ES, Haghdoost AA, Golshani S, et al.
    Iran J Public Health, 2020 May;49(5):923-930.
    PMID: 32953680
    Background: The prevalence of Acute Myocardial Infarction (AMI) varies from region to region caused by seasonal climate changes and temperature variation. This study aimed to assess the relationship between changing meteorological conditions and incidence of AMI in Iran.

    Methods: This retrospective prevalence study was based on medical records of the heart center of Mazandaran Province on all patients diagnosed with AMI in Mazandaran, northern Iran between 2013 and 2015. Patients' sex and the day, month, year and time of hospital admission were extracted from patients' records. Moreover, the meteorological reports were gathered.

    Results: A statistically significant difference was found between the distributions of AMI cases across 12 months of the year (P < 0.01). Fuzzy clustering analysis using 16 different climatic variables showed that March, April, and May were in the same cluster together. The other 9 months were in different clusters.

    Conclusion: Significant increase in AMI was seen in March, April and May (cold to hot weather).

  5. Fulltext Retaining nurses via organizational support and pay during COVID-19 pandemic: The moderating effect between intrinsic and extrinsic incentives
    Pahlevan Sharif S, She L, Liu L, Naghavi N, Lola GK, Sharif Nia H, et al.
    Nurs Open, 2023 Jan;10(1):123-134.
    PMID: 35906871 DOI: 10.1002/nop2.1286
    AIM: There has been growing concern about the nurses' turnover intention as well as life satisfaction during COVID-19 pandemic in Iran. The past research has provided evidence on the effect of organizational support on nurses' job satisfaction and turnover intention. However, little is known about the underlying mechanism behind these associations.

    DESIGN: A cross-sectional survey was undertaken.

    METHODS: An online survey was conducted in Iran from May to June 2020 through Google Docs Forms. In total, 305 nurses were participated and completed the online survey. Data were analysed using structural equation modelling through (AMOS). This study was checked with the STROBE checklist.

    RESULT: The results showed that nurses' perception of organizational support was positively related to their job satisfaction which in turn decreases the turnover intention. Likewise, the job satisfaction partially mediated the relationship between organizational support and nurses' life satisfaction.

  6. Fulltext Psychometric Properties of the Persian Version of Spiritual Well-Being Scale in Patients with Acute Myocardial Infarction
    Soleimani MA, Pahlevan Sharif S, Allen KA, Yaghoobzadeh A, Sharif Nia H, Gorgulu O
    J Relig Health, 2017 Dec;56(6):1981-1997.
    PMID: 27629419 DOI: 10.1007/s10943-016-0305-9
    The purpose of this study was to assess the psychometric properties of the Persian version of Spiritual Well-Being Scale (SWBS) in patients with acute myocardial infarction. A multisite, cross-sectional survey was employed to determine the instrument's reliability (Cronbach's α and construct reliability) and validity (face, content, and construct). Using systematic sampling of adult outpatients at primary care clinic sites in the Qazvin City, Iran (N = 300), it was found that the Cronbach's alpha and construct reliability of both factors associated with the SWBS were above 0.7. The construct validity of the scale was determined using exploratory factor analysis. The findings supported two factors: relation with God and relation with life. Further investigation through confirmatory factor analysis (eigenvalues of greater than one) confirmed a third factor construct associated with the SWBS. A total of 50.65 % of the variance were explained by these three factors. The overall findings of the study demonstrated that the SWBS is a valid and reliable instrument that has potential utility in future research and clinical practice settings.
  7. Fulltext The Psychometric Properties of the Center for Epidemiological Studies Depression Scale (CES-D) for Iranian Cancer Patients
    Sharif Nia H, Rezapour M, Allen KA, Pahlevan Sharif S, Jafari A, Torkmandi H, et al.
    Asian Pac J Cancer Prev, 2019 09 01;20(9):2803-2809.
    PMID: 31554380 DOI: 10.31557/APJCP.2019.20.9.2803
    Objectives: The Center for Epidemiologic Studies Depression Scale (CES-D) was specifically created to assess
    depression in cancer patients. However, to date, the CES-D has not been validated in Farsi. Therefore, this study aimed to
    assess the psychometric properties of the CES-D in Iranian cancer patients. Methods: During a three-month period
    (October to December, 2015), a total of 380 cancer patients completed a Farsi version of the CES-D. The construct
    validity of the scale was evaluated by exploratory factor analysis. Reliability was assessed using Cronbach’s alpha
    and McDonald Omega. All of the statistical procedure were run by SPSS 22 (SPSS Inc., Chicago, IL, USA). Results:
    The construct validity of the CES-D determined three factors (somatic affect, negative affect, and positive affect),
    which explained 65.60% of the total variance. The internal consistency was greater than 0.70. Conclusion: Findings
    revealed that the Farsi version of the CES-D has acceptable validity and reliability, which can be used to measure
    depression in Iranian cancer patients.
  8. Development and psychometric evaluation of a Persian version of the Death Depression Scale-Revised: a cross-cultural adaptation for patients with advanced cancer
    Sharif Nia H, Pahlevan Sharif S, Lehto RH, Boyle C, Yaghoobzadeh A, Kaveh O, et al.
    Jpn J Clin Oncol, 2017 Aug 01;47(8):713-719.
    PMID: 28505271 DOI: 10.1093/jjco/hyx065
    Objective: The surfacing of thoughts and depressive affect associated with the prospect of death are prevalent among patients with advanced cancer. Because death cognitions and associated negative affect occur along an adaptive-less adaptive continuum, it is essential that valid and reliable instruments are available to measure death depression. The present study aimed to determine the psychometric properties of the Death Depression Scale among Iranian patients with advanced cancer.

    Methods: About 497 cancer patients completed a Persian version of the 21-item Death Depression Scale-Revised. The face, content and construct validity of the scale were ascertained. Reliability was also assessed using internal consistency, construct reliability and intra-class correlation coefficient (ICC).

    Results: Construct validity determined one factor with an eigenvalue greater than 1. The model had a good fit (χ2 (179, N = 248) = 520.345, P < 0.001; χ2/df = 2.907, CFI = 0.916, TLI = 0.902, IFI = 0.917, SRMR = 0.049 and RMSEA = 0.088 (90% confidence interval = 0.079-0.097)) with all factors loadings greater than 0.5 and statistically significant. The internal consistency, construct reliability and ICC were greater than 0.70. Convergent validity of the scale was demonstrated.

    Conclusions: Findings revealed that the Persian version of the Death Depression Scale-Revised is valid and reliable, and may be used to assess and evaluate death depression in Iranian patients with advanced cancer.

  9. Spirituality and quality of life in women with breast cancer: The role of hope and educational attainment
    Pahlevan Sharif S, Lehto RH, Amiri M, Ahadzadeh AS, Sharif Nia H, Haghdoost AA, et al.
    Palliat Support Care, 2021 02;19(1):55-61.
    PMID: 32580795 DOI: 10.1017/S1478951520000383
    OBJECTIVE: This study investigated relationships among spirituality, hope, and overall quality of life in Muslim women with breast cancer in Malaysia.

    METHOD: A cross-sectional descriptive design with a convenience sample of 145 Malay patients was used. The mediating role of hope in the relationship between spirituality and quality of life as well as the moderating effect of education level on the spirituality hope link were examined.

    RESULTS: Participants with higher self-reported spirituality reported more hope (b = 6.345, p < 0.001) and higher levels of quality of life (b = 1.065, p < 0.001). Higher educational attainment weakened relationships between spirituality and hope (b = -1.460, p < 0.001).

    SIGNIFICANCE OF RESULTS: The role of advanced education in contributing to lessened hope in relation to spirituality emphasizes the importance of skilled and personalized spiritual counseling in the respective socio-cultural religious context.

  10. The Relationship between Religious Coping and Self-Care Behaviors in Iranian Medical Students
    Sharif Nia H, Pahlevan Sharif S, Goudarzian AH, Allen KA, Jamali S, Heydari Gorji MA
    J Relig Health, 2017 Dec;56(6):2109-2117.
    PMID: 28229351 DOI: 10.1007/s10943-017-0376-2
    In recent years, researchers have identified that coping strategies are an important contributor to an individual's life satisfaction and ability to manage stress. The positive relationship between religious copings, specifically, with physical and mental health has also been identified in some studies. Spirituality and religion have been discussed rigorously in research, but very few studies exist on religious coping. The aim of this study was to determine the relationship between religious coping methods (i.e., positive and negative religious coping) and self-care behaviors in Iranian medical students. This study used a cross-sectional design of 335 randomly selected students from Mazandaran University of Medical Sciences, Iran. A data collection tool comprised of the standard questionnaire of religious coping methods and questionnaire of self-care behaviors assessment was utilized. Data were analyzed using a two-sample t test assuming equal variances. Adjusted linear regression was used to evaluate the independent association of religious copings with self-care. Adjusted linear regression model indicated an independent significant association between positive (b = 4.616, 95% CI 4.234-4.999) and negative (b = -3.726, 95% CI -4.311 to -3.141) religious coping with self-care behaviors. Findings showed a linear relationship between religious coping and self-care behaviors. Further research with larger sample sizes in diverse populations is recommended.
  11. Fulltext Psychometric Properties of the Impact of Events Scale-Revised (IES-R) Among General Iranian Population During the COVID-19 Pandemic
    Sharif Nia H, Kaur H, Fomani FK, Rahmatpour P, Kaveh O, Pahlevan Sharif S, et al.
    Front Psychiatry, 2021;12:692498.
    PMID: 34408679 DOI: 10.3389/fpsyt.2021.692498
    Objective: The aim of this study was to translate and evaluate the validity and reliability of the Impact of Events Scale-Revised (IES-R) among the Iranian general population during the coronavirus disease 2019 (COVID-19) pandemic. Method: This study was methodological cross-sectional. It was conducted on an Iranian public population from April to July 2020 which was during the COVID-19 pandemic. Construct validity was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with a total of 500 adults recruited via online data gathering. Reliability was checked through the average inter-item correlation (AIC), Cronbach's alpha, and McDonald's omega. Convergent and divergent validity was determined using Fornell and Larcker's approach. Results: The results showed that the Persian version of IES-R had three factors, including intrusion (six items), avoidance (seven items), and hyperarousal (five items), that explained 59.22% of the total variance of the IES-R. The CFA findings indicated that all goodness-of-fit indices confirmed the model fit. The Cronbach's alpha, McDonald's omega, composite reliability (CR), and maximal reliability were excellent, and the three factors have good convergent validity. Conclusion: The findings of this study indicated that the Persian version of the IES-R scale is efficient and useful to assess post-traumatic stress disorder among Iran general population in the COVID-19 outbreak.
  12. Fulltext Psychometrics of Persian Version of the Ageism Survey Among an Iranian Older Adult Population During COVID-19 Pandemic
    Sharif Nia H, She L, Rasiah R, Khoshnavay Fomani F, Kaveh O, Pahlevan Sharif S, et al.
    Front Public Health, 2021;9:683291.
    PMID: 34869136 DOI: 10.3389/fpubh.2021.683291
    Background: Studies have revealed an increase in discrimination, neglect, and abuse among the older adult population during this period. This study assessed the validity and reliability of the Persian version of the ageism survey instrument tested on a sample of the Iranian older adult population during coronavirus disease (COVID-19) pandemic. An important move in counteracting ageism is to classify the ageism scale comprehensively by employing adequate psychometrics. Methods: The Persian version of the ageism scale was developed using a two-step procedure. The first step involved translating and revising the original scale to develop a Persian version of the ageism scale. The second step involved assessing the psychometric features of the newly adapted scale using construct validity through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) and thereafter assessing the reliability through the average inter-item correlation (AIC), Cronbach's alpha. The sample consisted of 400 older adults (age 65 and older), who were recruited through online data collection, with samples for EFA and CFA randomly selected from the total samples. Results: The Persian version of the ageism survey has three factors: age-related deprivation with five items, dignity with three items, and employment with three items; all of which explained 57.02% of the total variance. The outcome of the EFA was verified by the CFA, with internal consistency reliability being excellent (Cronbach's alpha was 0.725, 0.698, and 0.708 for the three factors). Conclusion: This study specifically offers a restructured three factors Persian version of the ageism survey for Iranian older adults with acceptable construct validity and reliability.
  13. Effect of acupressure on pain in Iranian leukemia patients: A randomized controlled trial study
    Sharif Nia H, Pahlevan Sharif S, Yaghoobzadeh A, Yeoh KK, Goudarzian AH, Soleimani MA, et al.
    Int J Nurs Pract, 2017 Apr;23(2).
    PMID: 28058748 DOI: 10.1111/ijn.12513
    Nonpharmacological methods of pain relief such as acupressure are becoming increasingly popular worldwide. Practitioners often claim that such methods are highly effective and less invasive than analgesic drugs, but available empirical evidence is largely inconclusive. This study aimed to test the hypothesis that, postacupressure intervention, the amount of pain experienced by sampled leukemia patients, who received acupressure in addition to standard care, will reduce substantially compared to patients who received only routine treatment. This controlled trial was undertaken with hospitalized leukemia patients between February and June 2015. Our primary sample consisted of 100 participants who were randomly allocated to 2 groups. One (intervention) group underwent 12 acupressure sessions in addition to standard treatment while the control group received no intervention apart from being given the standard treatment for leukemia. The visual analogue scale was used to measure the levels of pain experienced. No significant differences were found between the 2 groups across 12 interventions. However, each group reported significantly different pain level changes before and after each intervention, suggested that the acupressure method was effective in reducing pain in the short term. Nurses are able to apply this complementary therapy alongside other procedures to manage these patients' pain. It is recommended that further studies be conducted to better understand the specific conditions under which acupressure can provide effective pain relief.
  14. Fulltext Psychometric evaluation of Persian version of the balanced measure of psychological needs scale among university students
    Sharif Nia H, Rahmatpour P, Khoshnavay Fomani F, Arslan G, Kaveh O, Pahlevan Sharif S, et al.
    Nurs Open, 2021 09;8(5):2784-2793.
    PMID: 33797864 DOI: 10.1002/nop2.854
    AIM: The purpose of the present study was to evaluate the reliability, validity and factor structure of the Persian version of the BMPN in Iranian university students.

    DESIGN: Cross-sectional.

    METHODS: Study was conducted among Iranian medical sciences students from April to May 2020. A total of 660 students participated in the online self-administrated questionnaire. Construct validity, convergent and divergent validity, and reliability of P-BMPN were evaluated.

    RESULTS: The Exploratory factor analysis showed that the Persian version of the BMPN has 17 items with four factors: dissatisfaction, autonomy Satisfaction, relatedness satisfaction and competence satisfaction that explained 40.17% of the total variance. Based on confirmatory factor analysis, all goodness-of-fit indices confirmed the model fit.

    CONCLUSION: These results suggest that the Persian version of the BMPN is a reliable and valid measure to assess satisfaction and dissatisfaction of the psychological needs in Iranian university students.

  15. Attitudes toward mammography: questionnaire psychometric properties
    Pahlevan Sharif S, Abaeian V, Khanekharab J
    Int J Health Care Qual Assur, 2018 Jun 11;31(5):391-399.
    PMID: 29865960 DOI: 10.1108/IJHCQA-02-2017-0026
    Purpose The purpose of this paper is to evaluate the Persian version of the Attitude toward Breast Cancer Screening Procedures Scale (ABCSPS) among Iranian women. Design/methodology/approach In this methodological study, 1,000 Iranian women completed a demographic questionnaire and the 14-item Persian ABCSPS. The scale's construct validity was evaluated using exploratory and confirmatory factor analysis. Internal consistency and reliability were assessed using Cronbach's α and McDonald's coefficient ω. Findings The exploratory factor analysis revealed a two-factor solution accounting for 55.1 percent of the variance. The two-factor measurement model had a good fit with all factor loadings greater than 0.5, which were statistically significant. The results showed good reliability and internally consistency ( α=0.767 and 0.872; ω =0.979 and 0.997). Moreover, model structure was invariant across different income groups. Originality/value The Persian ABCSPS translation demonstrated good validity and reliability among Iranian women. The results also showed that the scale had a multidimensional structure. Regarding proper psychometric properties, the validated scale can be used in future studies as a reliable and relevant breast cancer screening attitude measure.
  16. Fulltext Integrating health belief model and technology acceptance model: an investigation of health-related internet use
    Ahadzadeh AS, Pahlevan Sharif S, Ong FS, Khong KW
    J Med Internet Res, 2015;17(2):e45.
    PMID: 25700481 DOI: 10.2196/jmir.3564
    Today, people use the Internet to satisfy health-related information and communication needs. In Malaysia, Internet use for health management has become increasingly significant due to the increase in the incidence of chronic diseases, in particular among urban women and their desire to stay healthy. Past studies adopted the Technology Acceptance Model (TAM) and Health Belief Model (HBM) independently to explain Internet use for health-related purposes. Although both the TAM and HBM have their own merits, independently they lack the ability to explain the cognition and the related mechanism in which individuals use the Internet for health purposes.
  17. Cross-Cultural Adaptation and Psychometric Evaluation of the Herth Hope Index Within a Sample of Iranian Older Peoples
    Yaghoobzadeh A, Pahlevan Sharif S, Ong FS, Soundy A, Sharif Nia H, Moradi Bagloee M, et al.
    Int J Aging Hum Dev, 2019 12;89(4):356-371.
    PMID: 30569732 DOI: 10.1177/0091415018815239
  18. Fear of negative appearance evaluation and attitude towards mammography: Moderating role of internal health locus of control,cancer worry and age
    Pahlevan Sharif S, Ahadzadeh AS, Ong FS, Naghavi N
    Health Promot Perspect, 2020;10(3):220-229.
    PMID: 32802758 DOI: 10.34172/hpp.2020.35
    Background: Mammography screening tends to reduce mortality rate through early detection. One of the barriers to mammography screening is fear of negative appearance evaluation(FNAE). This study investigated the impact of internal health locus of control, breast cancer worries and age on the relationship between FNAE and attitude towards mammography. Methods: A cross-sectional, questionnaire-based survey design was used. Samples were Iranian women, living in Iran, aged at least 30 years old, without any history of cancer, and had not performed mammography previously based on self-report. In total, 823 samples were collected through conducting an online survey from April to June 2016. The questionnaire consisted of several instruments including attitude toward breast cancer screening procedures scale, FNAEscale, the internal dimension of the multidimensional health locus of control, and two items to measure breast cancer worry. Using covariance-based structural equation modeling the model was tested. Results: The interaction of FNAE with internal health locus of control (β = -0.128, P<0.05,CI: -0.200, -0.056), breast cancer worry (β = 0.090, P<0.05, CI: -0.162, -0.017), and age (β =-0.095, P<0.05, CI = -0.163, -0.026) was significant. The three tested moderators dampened the positive relationship between FNAE and negative attitude towards mammography. Conclusion: More information about the screening procedure should be given to women to overcome their fear. The findings indicate the need for interventions seeking to shift women's health locus of control from external to internal. Women with low level of cancer worry need more attention.
  19. The Relationship Between Spirituality Dimensions and Death Anxiety among Iranian Veterans: Partial Least Squares Structural Equation Modeling Approach
    Pahlevan Sharif S, Sharif Nia H, Lehto RH, Moradbeigi M, Naghavi N, Goudarzian AH, et al.
    J Relig Health, 2021 Apr;60(2):999-1014.
    PMID: 31646425 DOI: 10.1007/s10943-019-00931-6
    The purpose of the present study was to examine the relationship among spiritual intelligence, spiritual well-being and death anxiety among Iranian veterans. In this predictive correlational study, 211 veterans completed King and DeCicco's Spiritual Intelligence Scale, Paloutzian and Ellison's Spiritual Well-being Scale and Templer's Death Anxiety Scale-Extended. After confirming the reliability of the constructs using intra-class correlation coefficient, partial least squares structural equation modeling method was utilized to assess the impact of spiritual well-being and spiritual intelligence on death anxiety. This study found a significant positive relationship between spiritual intelligence and death anxiety after controlling for the effects of age, education level and disability. However, there was a significant negative relationship between spiritual well-being and death anxiety among Iranian veterans. Negative relationships were found between spiritual well-being and death anxiety among Iranian veterans. However, spiritual intelligence had a positive impact on death anxiety.
  20. Fulltext Weather fluctuations: predictive factors in the prevalence of acute coronary syndrome
    Sharif Nia H, Chan YH, Froelicher ES, Pahlevan Sharif S, Yaghoobzadeh A, Jafari A, et al.
    Health Promot Perspect, 2019;9(2):123-130.
    PMID: 31249799 DOI: 10.15171/hpp.2019.17
    Background: Meteorological parameters and seasonal changes can play an important role in the occurrence of acute coronary syndrome (ACS). However, there is almost no evidence on a national level to suggest the associations between these variables and ACS in Iran. We aim to identify the meteorological parameters and seasonal changes in relationship to ACS. Methods: This retrospective cross-sectional study was conducted between 03/19/2015 to 03/18/2016 and used documents and records of patients with ACS in Mazandaran ProvinceHeart Center, Iran. The following definitive diagnostic criteria for ACS were used: (1) existence of cardiac enzymes (CK or CK-MB) above the normal range; (2) Greater than 1 mm ST-segment elevation or depression; (3) abnormal Q waves; and (4) manifestation of troponin enzyme in the blood. Data were collected daily, such as temperature (Celsius) changes, wind speed and its direction, rainfall, daily evaporation rate; number of sunny days, and relative humidity were provided by the Meteorological Organization of Iran. Results: A sample of 2,054 patients with ACS were recruited. The results indicated the highest ACS events from March to May. Generally, wind speed (18 PM) [IRR = 1.051 (95% CI: 1.019 to1.083), P=0.001], daily evaporation [IRR = 1.039 (95% CI: 1.003 to 1.077), P=0.032], daily maximum (P<0.001) and minimum (P=0.003) relative humidity was positively correlated withACS events. Also, negatively correlated variables were daily relative humidity (18 PM) [IRR =0.985 (95% CI: 0.978 to 0.992), P<0.001], and daily minimum temperature [IRR = 0.942 (95%CI: 0.927 to 0.958), P<0.001]. Conclusion: Climate changes were found to be significantly associated with ACS; especially from cold weather to hot weather in March, April and May. Further research is needed to fully understand the specific conditions and cold exposures.
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