Journal of School of Public Health and

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The goal of this study is to evaluate women&aposs behaviors while their family planning programs fail or facing unwanted pregnancy. This is a cross-sectional study. The population is all 15-49 years pregnant women (788 people) in the villages (62 villages) of Najaf Abad City having active health center. Data were gathered through interview and their profiles. They were recorded in questionnaires.T test and X2 were used to analyze data.
The results showed that high-risk behaviors happen %44/3 more when family planning program fails. 105 (%31/72) of women having unwanted pregnancy did unsuccessful activities in order to end their pregnancy. The activities are different. %35 was physical such as: hitting, lifting heavy objects or using unhealthy vulva objects, %28/6 used injection, %9/5 eat chemical and plant medicine. And the other used two or three ones together. Women showed good behaviors in %91 of wanted pregnancy and %45 of unwanted pregnancy. There is significant relationship (p=0/001) between dealing with pregnancy and it&aposs being wanted and unwanted. There is also significant relationship (p=0/Q01) between women&aposs education and their behaviors toward pregnancy. According to the research findings more than one third of women did high-risk activities when a family planning program fails or facing unwanted pregnancy. These certainly influence their own and their family mental and physical health. So role of the prevention, counseling techniques and women&aposs support must be considered more than before. Society should be become aware of the unwanted pregnancy symptoms.

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The purpose of this study was to determine toxoplasmosis seropositivity rates and to record ascending serologic titers in high-school girls. We also searched for possible risk factors. This descriptive-analytic study used 414 serum specimens collected from high school girls in six different regions of Esfahan city through cluster random sampling. The sera were taken from the tip of the finger by hematocrite microtubes. Samples were studied by the Indirect Immunofluorescent Assay Test(IFAT) for estimation of serum titers. Data were analyzed using chi-square (X²) and t tests. The overall seropositivity rate was 18.4% in 14-19 year-old girls and this rate increased with age. IFAT titers in 98% of the positive samples were at 1:100 the remaining 2% showed values above this threshold. For the latter group, we performed another titration test to determine exact titers .The supposed risk factors were age, place of residence, education level (parents and student), consumption of undercooked meat and raw liver, occupation and parent income, and exposure to contaminated material from cats and fowls. The highest positivity rates (27.5%) were recorded in District 1, while the lowest rates (14.5%) were seen in District 5. Significant relationships were found between seropositivity and exposure to cats and fowls.(P>0/05). No significant relationship was observed with the other factors. There was a low level of knowledge about toxoplasmosis and the relevant risk factors: only 2.4% of the subjects were relatively well-informed on this subject. There were not any acute cases. Toxoplasma infection is very important because of its socioeconomic implications, so control measures seem crucial. All seronegative women should be know about this infection and its transmission routes. Education is the most important element in prevention and must be promoted via the mass media, other education systems and the health managers. The studied group in this survey were girls at the usual age of marriage or younger, and it is recommended that health system managers continue to offer education on practices that help prevent infectious diseases in general and toxoplasmosis in particular.

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Background and Aim: Tuberculosis (TB) remains a major public-health problem in Iran, despite employing the DOTS (directly observed treatment short course) strategy in the National Tuberculosis Program (NTP). The aim of this study was to determine the role of teaching hospitals in improving NTP indices.

Materials and Methods: In a retrospective cross-sectional study, the medical files of treated TB patients in Tehran Razi Teaching Hospital and the Khuzestan Provincial Health Center were reviewed. Diagnosis, treatment and follow-up were based on the NTP procedures. The patients hospitalized for at least the first 2 weeks of treatment were placed in the hospitalized TB (HTB) group and the outpatients in the outpatient TB (OTB) group. The NTP indices (the sputum smear positive, fully cured, treatment failure, defaulted, and death rates) and pre-treatment counseling were compared between the 2 groups. Data related to demographic characteristics, risk factors, and the treatment outcome were compared by SPSS 11.5 using the chi square and fisher's tests

Results: A total of 235 patients (mean age 38 years), 67 of whom were hospitalized TB patients, were studied. 122 men (51.9 %) and 42 women (17.9%) had a history of imprisonment, among whom 20 (47.6%) were positive for human immunodeficiency virus (HIV), 53 (22.5%) injection drug users, and 120 (51.1%) smear-positive for pulmonary TB. The rates of cured cases, treatment failures, defaulted and death were, respectively, 80.6%, 8.9%, 4.5%, and 5.9%, in the HTB group, and 66.6%, 17.3%, 10.1%, and 5.9% in the OTB group. Pre-treatment counseling had been done in 75% of the HTB and 52% of the OTB cases.

Conclusion: Teaching hospitals can have an important role in improving pre-treatment counseling and NTP indices, such as increased sputum positivity, cured rate, and, probably, decreased treatment failure and defaulted rate.

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Background and Aim: Considering the social and cultural characteristics of Iranian adolescents, none of the quantitative instruments designed so far to assess their health needs is quite appropriate. The purpose of this study was to design a valid and reliable questionnaire to assess the health needs of Iranian adolescent females.

Materials and Methods: Both qualitative and quantitative approaches to instrument development were adopted in this study conducted in the District of Sari in the north of Iran. Sampling was objective-based, with an attempt to have female adolescent sample as varied as possible. In the qualitative phase, a content analysis approach was used to explore the concept of health needs as seen by female adolescents. Data were collected using 8 focus group discussions (FGDs) with the presence 6-10 adolescents 12-18 years old in each FGD, as well as 11 semi-structured interviews, each one involving 11 well-informed individuals. In the quantitative phase, the psychometric properties, including content validity, face validity, construct validity, concurrent validity, internal consistency, and test-retest reliability, were determined.

Results: Five themes were identified in the qualitative phase of study, including psycho-emotional health, social health, physical health, and educational needs, as well as spiritual beliefs. The mean scale-level content validity index (S-CVI) was found to be 0.92. The factor structure of the instrument was identified by doing a Principal Component Analysis. Five factors were extracted with a total variance account of 45.37%. The reliability and consistency of the instrument were established with the Cronbach's alpha coefficient (0.90) for the entire scale and test-retest reliability with a 2 week-interval Intraclass Correlation Coefficient (ICC=0.984, p<0.001).There was a concurrent correlation between the instrument and Pediatric Quality of Life Inventory (PedsQL TM 4.0) (r=0.66, p<0.001).

Conclusion: The instrument developed in this study is a valid, reliable and culturally appropriate instrument for assessment of health needs of Iranian adolescent females. 

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Background and Aim: Breast and cervical cancer screening is considered a health promotion behavior, influenced by complex factors. The theory of planned behavior provides a useful framework for predicting and understanding the health behavior and designing appropriate educational interventions. Integrating this theory with self-efficacy will increase its predictive value. The objective of this qualitative research project was to understand the factors influencing the behavior of breast and cervical cancer screening of female-workers as a base for future educational planning.

Materials and Methods: This was a qualitative approach research based on the Integrated Model of Planned Behavior and Self-Efficacy. Seventy 20-45 year-old women working in industrial plants in Abbasabad, Pakdasht, selected by purposeful sampling with maximum diversity participated, in 10 groups of 7 each, in focus-group discussions, in which they discussed their experience regarding factors influencing the behavior of breast and cervical cancer screening. Data were collected and their validity, conformability, transferability and dependability confirmed. For data analysis the conventional method of content analysis was used.

Results: The female workers had a low knowledge and attitude concerning the behavior of breast and cervical cancer screening. Attaching importance to comments given by the family members, especially the husband, and preference of treatment to prevention of disease in the society at large were the subjective norms of the female workers. The most important barriers to participating in screening programs were lack of knowledge, depression, fatigue, embarrassment and fear of examinations, fear of being sick, poor quality of services and lack of attention to privacy in health centers, limited access to health centers, and costs of tests. The female workers had a low self-efficacy for planning and overcoming barriers. Most of them had not had screening tests and had no intention of doing their screening tests in the following three month.

Conclusion: The following measures are recommended: designing and implementing specific educational programs in workplaces for female-workers aiming at increasing their awareness and positive attitudes towards breast and cervical cancer screening designing and implementing educational/training programs for families, employers and planners to increase their knowledge and attitude and facilitating women's access to health centers in industrial estates.

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  Background an d Aim : Several factors can affect the sexual function of women. The aim of this study was to determine the correlation between exercise and sexual function in post-menopausal women.

  Materials and Methods : This was a community-based, descriptive-analytical study including 405 post-menopausal women 40-65 years old selected by multi-stage stratified random sampling . The data were obtained through interviews using the Female Sexual Function Index (FSFI) and a researcher-made questionnaire. The data were analyzed using descriptive and analytical tests such as multiple linear regression and logistic regression models .

  Results : On the whole, 61% of the subjects had sexual dysfunction. The most common type of exercise was “walking” (79.8%). For the women who exercised, the mean score in the domain of pain was significantly lower (worse) (p=0.013). The total FSFI, lubrication and pain domains scores were significantly lower in the women who did exercises other than walking as compared to those who did not exercise or practiced only walking. The weekly exercise frequency had positive correlations with lubrication (r=0.18, p=0.014) and orgasm (r=0.146, p=0.045) domain scores. However, multiple regression analysis to determine predictors of total score of FSFI and the domains scores did not give any statistically significant results. Finally, the logistic regression test showed that one additional exercise session per week would result in reduction of chances of sexual dysfunction by 80.2%.

  Conclusion : Based on the findings, it may be concluded that exercise can be a w ay to compensate for sexual problems and dissatisfactions caused by reduced sex and sexuality in post-menopausal women. Exercising more frequently during the week could have positive effects on the sexual function of post-menopausal women.

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Background and Aim: Diabetes mellitus is one of the most common medical problems in pregnant women. Nutrition plays an important role in the prevention and control of this disease. Some studies have found a relationship between gestational diabetes mellitus (GDM) and food insecurity. The objective of this study was to investigate the association between food insecurity and GDM.

Material and Methods: : This case-control study included 274 pregnant women (137 GDM cases and 137 healthy controls) selected by convenience sampling. Data on the subjects’ food insecurity, demographic features and physical activity (MET) were collected by interviewing and their heights and weights measured. For the analysis of the data, the Chi-square test, independent sample t-test and multivariate and univariate logistic regression tests were used, the statistical software being SPSS 16.0.

Results: On the whole, 18.2% and 21.9% of the women in the case and control groups suffered from food insecurity, respectively. There were statistically significant differences between the case and control groups with regard to a previous history of pregnancy, a family history of diabetes in the first and second degree relatives, and a history of giving birth to a baby weighing over 4 kgs.

Further analysis of the data showed a family history of diabetes mellitus and a low socio-economic status to be independent risk factors for GDB.

Conclusion: No statistically significant difference was observed between food insecurity of the women and gestational diabetes mellitus in this study. Despite this finding, considering that there are associations between food insecurity and other types of diabetes mellitus, we recommend further studies on this subject to be able to either accept or reject the hypothesis on the association between food insecurity and gestational diabetes mellitus.

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Background and Aim: The present study aimed to determine the stages of changes and cognitive and behavioral processes (Transtheorical model) in the use of nutrients in overweight middle-aged women.
Materials and Methods: The present study was a descriptive-analytic. The research sample consisted of 281 middle-aged women with overweight referring to comprehensive health centers in Isfahan. Personal characteristics, stage of change and behavior and cognitive behavioral processes, and FFQ questionnaire (168-item) were completed by Questioning, and then the information entered the N4 and SPSS 18 software, and information was analyzed using descriptive and analytical tests.
Results: 57.7% of the people were inactive (pre-thinking, thinking, preparation) and 42.3% of them were in active phase. There was a significant difference between the different stages of change and the use of behavior change processes (p=0.001) And Benfrown's test shows the increasing use of cognitive and behavioral processes during the stage of change in use of nutrients (p<0.001).
Conclusion: The difference in the mean of changes processes during the stage of change show the impact of these processes on the nutritional individual's behavior, which is recommended to use stage of change and behavioral change processes for education nutrition behavioral.

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Background and Aim: This study aimed to improve the symptoms of children with obsessive-compulsive disorder (OCD), relationships between parents and children, and marital satisfaction using the family-based cognitive-behavioral therapy (CBT).
 Materials and Methods: This was a quasi-experimental pretest-posttest research. The statistical population was all of the 9- to 12-year-old school students suffering from OCD who had consulted the Psychological and Consultation Services Center during academic year 2015-2016 in the city of Tehran. A sample of 28 students selected randomly were assigned to an experimental and a control group. The following questionnaires were completed initially (pre-test) and finally (post-test): 1. Questionnaires completed by the mothers of the children: the Spence Anxiety Scale-Parent Form, the Parent-Child Relationship Questionnaire and the Afrooz Marital Satisfaction Questionnaire (short form); 2. The questionnaires completed by the children: the Spence Children's Anxiety Scale. The intervention program was designed based on CBT and included 22 sessions, eight group sessions for mothers, eight individual play therapy sessions for children, and two specific sessions for each family.

Results: Data analysis using multivariate analysis of covariance showed that family-based cognitive-behavioral therapy was effective in improving marital satisfaction and parent-child interaction as well as reducing child anxiety (p <0.01).

Conclusion: Based on the findings, it can be concluded that family-based cognitive-behavioral therapy intervention may lead to improved relationship between parents and children with obsessive-compulsive disorder and marital satisfaction, as well as reduced anxiety of these children and their parents.