Journal of School of Public Health and

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The educational authorities are concerned with preparation of a suitable snack for the students (6-11 yrs).Considering the potential effects of the snack on cognitive and learning functions, this project was designed for the production and evaluation of a nutritionally suitable cake for students.
The cake&aposs ingredients were egg(87%), skimmed milk powder (26%), sugar (1 12%), oil (26%), baking powder(5.2%),defatted soya(22%) and wheat flour (100%) NaFeEDTA (was added as an iron fortificant). Moisture, ash, protein, Ca and iron contents were determined by AOAC methods.Five panelists were selected and trained as recommended by ISO. They evaluated student cake (x), enriched student cake(Y) and the control (z) for taste,texture (scoring), crumb and crust color (ranking). Eighty-five students evaluated the cakes as target group (hedonic).True protein digestibility (TPD) was determined using three diets (non protein,casein,students&apos cake) and three groups of 21 days rats. The results were analyzed using the SPSS program. A students cake with 11.6% protein, 8.7% fat, 21% moisture and 2,5% ash had an energy content of 300 Kcal plus 10 gr protein while the control preparation had 5,7gr (6.6%) protein, 15.6% fat, 19.1% moisture and 1.8% ash and an energy content of 339 Kcal energy and 5.7 gr per unit weight.The taste and texture of x and y were similar but different from the controls (p

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The traditional methods is used to inspect based on the end-products in manufactures , yet. The Global movement is more commonly reffered to use HACCP system which its main characteristics is preventing contorl of hazards at all stages of food productions. The main goals of implementation of this project was based on three following points: 1-Preparation of a guidelines for application of HACCP system . 2-Familizariation of quality control officers and manufacturers with HACCP concepts,its principle,and establishment of HACCP in different food industries. 3-Establishment of HACCP in a selected Dairy plant as a pilot. To implement of this project, central and administrative groups were formed and 15 workshops were organized for introducing of system during 39 days. Then concerning to prerequistics and G.M.P, HACCP system established in selected plant successfully. This plant has been able to get the HACCP certification from a certification body. The result of this project indicated that establishment of HACCP system is possible in food industries.Preparation and implementation of HACCP has an effective movement in improvement of food safety quality management, food hygien, upgrades of food safety and consumer protection. In addition to above subjects , developing of this system throughout the country, could make a good oppourtunity for ability of competition in export fields and international trade such as join to WTO (World Trade Organization).

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Background and Aim: Public-private partnership is a type of privatization in which the public sector continues to participate in the provision of services. Based on an agreement between the Ministry of Health and the Ministry of Cooperatives, Tabriz University of Medical Sciences started the process of creating health cooperatives in the Eastern Azerbaijan Province. In this study we compare the function of various health service processes between public health centers and health cooperatives.

Material and Methods: This study looks at coverage, quality and continuity of primary health care in 9 health centers handed over to cooperatives as compared to 18 current public health centers. Data were collected over a period of three months and analyzed by the SPSS-10 statistical package. Chi-Square and t tests were used for data analysis.

Results: Family planning coverage rates, infant health care, 1- to 6-year-old health care, prenatal care and the number of households covered by volunteers were all higher in cooperatives compared to public health centers. The mean care delivery volume was smaller in health cooperatives. The mean numbers of screening visits, outpatient visits, control visits, consultations, injections and dressings as well as follow-ups were higher in health cooperatives. Despite the greater numbers of family planning visits, vaccinations, health certificates issued and water chlorimetry tests in the public sector, the differences were not statistically significant. Concordance of data between forms and registers was higher in health cooperatives in the case of child health care, periodic visits and vaccination forms.

Conclusion: Compared to the public sector, health service delivery through cooperatives not only functions well but also yields better indices in many health domains. This is an example that a private institutions functioning under the supervision of the public sector can implement nationwide health care programs better than the public sector itself.

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Background and Aim: The aim of this study was to assess the adherence to anti-retroviral prophylaxis after occupational and non-occupational exposure to human immunodeficiency virus (HIV) in patients consulting the Voluntary Counseling and Testing Center (VCT) of Imam Khomeini Hospital, Tehran during the period 2008 to 2009.

Materials and Methods: In this prospective study, patients were selected, the required information about them was recorded, and adherence to anti-retroviral drugs (including Ziduvudin, Lamivudin and Efavirens) was determined based on self-report by the patients. Eighty-nine exposed patients were followed monthly for 4 months, and in the case of low-adherence (less than 95%) they were asked for the reason(s) for noncompliance.

Results: Of the 89 patients, 55 were men (61.8%) and 34 (38/2%) were women with a mean age of 30.16± 8.39 years 47 participants (52.8%) were single and 42 (47.1%) married 27 subjects (30.3%) were physicians, 35 (39.3%) nurses and 27 (30.3%) had occupations outside the healthcare system. From among the 36 subjects (40.5%) who stopped the treatment, 24 (27.0%) stopped it correctly (that is, when the serological test proved to be negative), while 12 (13.4%) did not stop it on a sound basis. Fifty-three subjects (59.6%) completed the prophylaxis. Adherence was found to be significantly associated with age and marital status (p<0.05).

Conclusion: The main reason for stopping the prophylaxis (a negative serological test result of the resource patient) was more pronounced than previous studies, which indicates the higher availability of the resource patient.

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Background and Aim: Diabetes mellitus is a widespread disease. Diabetes patients should be fully familiar with the different dimensions of this chronic disease and possess the skills required for self-management and self-care. They should realize that each patient is a different case. It is to be noted that promoting self-management behavior is an essential component of case management in type-2 diabetes mellitus. The objective of this study was to assess self-management behavior of type-2 diabetes patients in Isfahan, Iran and determine factors influencing it.  

Materials and Methods: This was a 6-month cross-sectional study conducted in 2011. The study population was type-2 diabetes patients consulting an outpatient diabetes center in Isfahan, Iran. The sample included a group of 350 patients selected by the continuous sampling method. The self-management behavior of the patients was assessed using a diabetes self-management instrument (DSMI), containing questions on 5 domains. The responses were rated on a 5-point Likert scale and SPSS software, version 11.5 was used for analyzing the collected data.

Results: The response rate was 88%. The majority of the patients were 50-60 years (55.52 ± 8.42) old and 54.3% of them demonstrated borderline metabolic control according to the World Health Organization criteria. Mean scores of self-integration, self-regulation, interaction with health professionals and other influential persons, self-monitoring blood glucose, and adherence to recommended regime were 33.67±6.36, 29.09±5.9, 27.08±4.81, 11.71±3.91 and 11.46±2.9, respectively. On the whole, the global diabetes self-management behavior seemed to be not quite desirable (the score was at an intermediate level). Further analysis of the data revealed that self-management behaviors (at 3 levels, namely, desirable, intermediate, and undesirable) had significant associations (p<0.001) with demographic (age, gender, marital status, education level) and health-related (duration of diabetes, diabetes-related diseases, diabetes complications, general health, type of treatment, family income, and serum HbA₁C level) variables. Self-management behavior had no association with disease history 

Conclusion: Empowerment of patients afflicted with diabetes and, more generally, non-communicable diseases, which are quite prevalent and on the increase, in the area of self-management at the individual and community level will be a vital step towards promotion of health of the population.

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  Background and Aim: Candida albicans, the most common human fungal commensal pathogen, is a normal member of the human microbiota which can colonize the oral cavity, vagina and gastrointestinal tract. This opportunistic pathogen can cause diseases ranging from mucosal infections to systemic mycoses, depending on the vulnerability and weakness of the immune system of the host. In addition, it is the most common cause of septicemia with 50-100% mortality. Ultraviolet-B (UV-B) radiation is an electromagnetic radiation with a wavelength of 100-400 nm. It reduces the synthesis of proteins and nucleic acids, retards growth, and causes mutation in eukaryotic and prokaryotic cells. Previous investigators have reported on the different effects of UV irradiation on Candida albicans including cidal effect, inhibitory growth, as well as phenotype switching. In the present study we investigated the effect of UV-B irradiation on C. albicans’s growth in a solid medium, production of chlamydoconidia, carbohydrate assimilation and pathogenesis in mice.

  Material and Methods: C. albicans was grown in a SC medium, followed by incubation at 30° C for 24 hours and irradiating the cells with UV-B for 5,10,15,20 min at 302 nm wavelength by transilluminator. A sample of non-irradiated yeast cells served as control.

  Results: After 24, 48 and 72 hours of irradiation growth rate was reduced, the maximum reduction occurring after 20 minute. There was no difference between irradiated and non-irradiated C. albicans samples as regards sugars assimilation. Irradiation could inhibit production of chlamidoconidia by the fungus, the magnitude of inhibition increasing with increasing length of exposure to irradiation, such that after 20 minutes no chlamidoconidia could be seen in the medium. Further analysis of the data showed that pathogenicities of the fungus in irradiated and control samples were not statistically different. Neither was there any difference between them as regards size or number of bands of DNA molecules on 1% agarose gel.

  Conclusion: The findings throw some light on how UVB irradiation can affect the phenotype of C. albicans isolates. Certainly more studies, e.g., on gene regulation, are required to find the effects of UVB at the molecular level in this fungus.

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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: Overcoming barriers of living with type-2 diabetes mellitus is a challenge in line with empowering patients for a well-managed life. This study was conducted to determine the effect of an educational intervention based on the BASNEF model on the living barriers among type-2 diabetes patients and factors affecting it.

Materials and Methods: This study, conducted in 2014, was a quasi-experimental intervention including a total of  90 type-2 diabetes patients under coverage of South of Tehran Health Centers, randomly divided, after a pre-test, into 2 groups ─ an experimental and a control (comparison) group. Based on the information obtained through the pre-test, a one-month education was imparted at the experimental group in 6 sessions the control group received no education. The educational contents included, based on the BASNEF model constructs, diabetes as a disease and its cardiovascular complications, healthy nutrition, physical activity, methods of self-monitoring blood glucose control, and ways of communication with the health personnel and physicians.

Results: The findings showed significant differences between the mean scores of constructs of the BASNEF model (beliefs, attitudes, subjective norm, enabling factors) and constructs of barriers of living with diabetes (diagnosis, treatment, self-monitoring, communication with health professionals) in both the experimental and control groups before and after the intervention (p<0.0001).

Conclusion: The findings of this study show the necessity of educating type-2 diabetes patients aiming at reducing barriers to living with the disease. The BASNEF model is one of the applicable theories that can be used to this end.

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Background and Aim: Considering the ongoing national malaria elimination program in Iran, establishing a bank of human Plasmodium genes and proteins can be very useful for research purposes. This study was conducted to collect some of the native isolates of human Plasmodia from endemic areas in the country.

Materials and Methods: A 2ml vein-punctured blood sample was prepared from each confirmed malaria case. The samples were dispensed in EDTA pre-dosed tubes and cryopreserved for further tests. Moreover, relevant Geimsa-stained thick and thin blood smears were kept in a safe place. Tests for genetic indicators of MSP-1 was performed for each of the P. vivax samples with the RFLP-PCR techniques. In addition, an in vivo drug sensitivity test was performed for each P. falciparum case. Collecting and cryopreserving samples will continue.

Results: A total of 131 samples, including 109, 19 and 3 P. vivax, P. falciparum and mixed samples, respectively, were preserved with relevant data such as species, parasitaemia and nationality of the donor. MSP-1 gene classification resulted in three different haplotypes including Hap.1, Hap.2 and Hap.3 with frequencies of 20.6%, 41.2% and 38.2%, respectively. The In vivo drug sensitivity tests on P. facilparum isolates showed that all of the isolates were sensitive to the current drug of choice, namely, a combination of artesunate and fansidar.

Conclusion: This study resulted in the preservation of considerable amounts of P. vivax and P. falciparum samples for further relevant studies and research purposes.

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Background and Aim: Considering the protection of, and safeguarding, the health of industrial workforce, this study was conducted to determine the prevalence of overweight and obesity in the personnel of Abadan oil refinery in the south-west of Iran and factors related to it.

Materials and Methods: The study included 721 oil refinery staff members randomly selected based on the yearly occupational health examination records. The information recorded included anthropometric measurements and blood test results; in addition, Breslow lifestyle and Global Physical Activity (GPAQ) questionnaires were completed for each subject.

Results: The mean body mass index (BMI) was 28.2 for men and 27.5 for women. The prevalence of obesity and overweight were 29.8% and 48.7%, respectively. Further analysis of the data showed that the prevalence rates were different between men and women; while 48.6% and 30.24% of the men suffered from overweight and obesity, respectively, the corresponding proportions among women were 50% and 15%. Overweight and obesity were associated with age, fasting blood glucose level, lipid profile and hypertension (in all cases    p < 0.001).

Conclusion: The prevalence of overweight and obesity among Abadan oil refinery staff is higher as compared to the mean values in the general population in Iran or to personnel of other industries globally. Development and implementation of public educational programs with particular emphasis on high-risk individuals, such as middle-aged people and those with a low socioeconomic status, and focusing on healthy lifestyle and rotation shift workers can be effective, resulting in improvements in physical and general health of the personnel.

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Background and Aim: Diabetes mellitus (DM) is one of the most common public health problems worldwide. Diabetic foot as a late complication of DM imposes high physical and emotional costs to the patients. The purpose of this study was to determine the effect of an educational program based on the Health Belief Model (HBM) on diabetic foot care in type-2 DM patients.
Materials and Methods: Ninety seven (female=57, male=40) type-2 diabetes patients, randomly divided into two groups ̶ and intervention (n = 47) and a control group (n = 50) ̶   participated in this study. Using questionnaires data were collected, initially and 3 months after the educational intervention, on demographic characteristics, awareness and the HBM constructs. The intervention group participated in 3 educational sessions during the3-month period. The data were analyzed by SPSS 20, the statistical test being Shapiro-Wilk, Chi-Square, Wilcoxon, McNemar tests and paired T-Test.
Results: There were no statistically significant differences before the intervention between the experimental and control groups with respect to the mean scores of knowledge and HBM’s components (perceived susceptibility, severity, benefits and barriers, as well as self-efficacy and self-care). The intervention improved the scores significantly in the experimental groups (p<0.05), while there were no significant changes in the control group scores (p>0.05). 
Conclusion: This study shows that type-2 diabetic patients need to learn how to take care of their feet and that implementing educational programs based on the Health Belief Model can be effective in this regard.
 

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Background and Aim: Quality of life is considered as an effective indicator for general, as well as mental, health. With increasing longevity of individuals, health-promoting behaviors and rising quality of life will become much more important. This study aimed to determine the quality of life predictors among health volunteers in South Tehran Health Centers.
Materials and Methods: : This cross-sectional study was conducted on 200 health volunteers of South Tehran Health Centers selected by cluster sampling. Data were collected using valid and reliable questionnaires for demographic variables, Health-promoting Behaviors (HPLPII) and Quality of life (SF-36), as well as the BAZNEF model constructs, whose validity and reliability were assessed (α: %88). Data analysis was done using the SPSS24 software, the statistical tests being descriptive statistics and multi-linear regression; a p-value <0.05 was used to show statistical significance.
Results: Regression analysis revealed that the strongest predictors for the quality of life were  age (p=0.003), enabling factors (p=0.02) and general health-promoting behaviors (p<0.001).
Conclusion: The findings of this study confirm the suitability of the BAZNEF model for predicting health-promoting behaviors for the quality of life. Using this model can help in identifying factors influencing the quality of life of health volunteers and designing an appropriate educational program for them.
 

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Background and Aim: In health promotion, empowerment is a process through which people gain greater control over decisions and actions affecting their health. This study aimed to assess the predictive factors of health care empowerment among women in reproductive age in 2016.
Materials and Methods: This cross-sectional study was conducted on 549women in reproductive age referring to health centers in South Tehran. The participants were recruited through cluster and multi-stratified sampling. Data were collected using the Health Care Empowerment Questionnaire (HCEQ), which has three subscales, namely, degree of control, involvement in interactions and involvement in decision-making. The data were analyzed using the descriptive and analytical tests and multi-regression analysis.
Results: Husbands' education level, women's employment, family size, ethnicity, history of chronic diseases and economic status were predictors of degree of control. Husbands' education level (under high school diploma and high school diploma), family size (2-3, 3-4) and moderate economic status (sufficient income) predicted involvement in interactions. In addition, husbands' education (incomplete high school diploma and high school diploma), family size (2-3, 3-4), women's employment and history of chronic diseases predicted involvement in decision-making. 
Conclusion: The findings indicate that various individual, family and socio-economic conditions of reproductive-age women influence their potential empowerment for receiving health care services. A family-based approach to facilitate receiving reproductive health care seems to be essential.

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Background and Aim: Heavy metals in the surface soils of cities from various sources (traffic, industrial emissions, erosion from buildings, etc.) can accumulate through inhalation, ingestion and dermal contact in the human body and imperil health. The purpose of this study was to assess the ecological and human health risks caused by some heavy metals in roadside soil at the intersections of Ahvaz (Modares, Kharchar, Zargan, Behbahani, Golestan, Abadan, Khorramshahr, Susangerd and Andimeshk).
Materials and Methods: In this study, the concentration of heavy metals in roadside surface soils in intersections of Ahvaz in the summer of 2016 was investigated. The sampling at each intersection was carried out at specified intervals of 1, 10 and 30 meters on the sides of the main road (6 samples from each intersection) from the surface soil (depth 0 to 20 cm); the total number of samples was 54. The samples were transferred to the laboratory and dried at 60 ° C in an oven. After digestion of the samples with an acid mixture, concentrations of heavy metals Zn, Pb, Ni, Cu, Cr, Cd and As were measured by inductive coupled plasma-mass spectrometry (ICP-MS). The contamination level was estimated based on potential ecological and human health risks of heavy metals.
Results: The average concentrations of Zn, Pb, Ni, Cu, Cr, Cd and As were 116.61 ± 49.42, 284.02 ± 166.91, 25.53 ± 4.47, 220.63 ± 87.75, 137.21 ± 84.80, 3.44 ± 3.23 and 8.65 ± 3.8 mg/kg, respectively. Isotope ratios indicated that emissions from automobiles/traffic and industrial emissions were the most important sources of lead in the samples studied. The average value of potential ecological risk (RI) in Andimeshk, Golestan and Susangerd intersections was low; that in Modarres, Behbahani and Zergan intersections was medium; and that in Chaharsir, Abadan and Khorramshahr intersections was high. Cr poses the highest risk of cancer in both children and adults, although the risk of carcinogenesis in children is higher than in adults.
Conclusion: The results show that the source of contamination with the metals studied is anthropogenic, including road traffic and industrial activities, in the area investigated.
 

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Background and Aim: Ixodidae (hard ticks) are obligate blood-feeders of vertebrates with majorroles in transmission of pathogenic microorganisms including theileriosis, babesiosis and CCHF virus, as well as relapsing fever, to domestic animals and humans. This study was conducted to determine the distribution of ixodidae species, vectors of Crimean-Congo hemorrhagic fever (CCHF), in the border areas in North West of Iran.

Materials and Methods: This was a descriptive cross-sectional study conducted in Ahar and Kaliybar Counties, East Azarbaijan Province, Iran. Randomized cluster sampling was done in villages in the forest and mountainous regions. Ticks were isolated by forceps from the animals, kept in sampling tubes and transferred to the laboratory. Then the tick samples were identified using taxonomical keys.
Results: A total of 2022 hard ticks were isolated from 1400 head of livestock (1000, 200, 180 and 20 head of sheep, goat, cow and buffalo, respectively).  On the average, the infestation rate was 1.44 per head of cattle ─ 0.11% in goats, 0.32% in sheep, 0.90% in buffaloes, 9.25% cows. Out of the ticks isolated, 498 (24.63%) were male, 741 (36.65%) were female and 782 (38.67%) nymph, plus one larva. The ticks belonged to the lxodidae family, including four genera:  Hyalomma (88.82%, with the following three species: Hyalommaanatolicum (39.22%), Hyalommamarginatum (9.15%) and Hyalommaasiaticum (0.69%)); Rhipicephalus (8.8%); Dermasentor (1.58%); and Haemaphisalis (0.8%). The others identified were Hyalomma nymph (38.67%), Hyalomma sp. (1.04%) and Hyalomma larva (0.05%), Rhipicephalus bursa (5.19%), Rhipicephalussanguineus (3.61%), Dermasentor marinates(1.58%), Haemaphisalissulcata (0.59%), and Haemaphisalispunctata (0.15%), as well as Haemaphisalisconcinae (0.05%).  Hyalommaanatolicum was the dominant species.                                                                                                                                          
  Conclusion: The dominant tick species in the regions studied was Hyalommaanatolicum, a tick having a major role in transmission of many disease vectors including CCHF, ovin babesiosis, theileriosis, anaplasmosis, ehrlichiosis, etc. It is essential that the provincial Contagious Disease Center and Veterinary Department take appropriate action with the collaboration of other relevant departments to combat the tick. 

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Background and Aim: Orexin is a hormone involved inoverweight and obesity and a regulator of glucose metabolism. The purpose of this study was to determine the effects of a high-intensity interval training (HIIT) on plasma levels of orexin-A (OXA) and insulin resistance in overweight women.
Materials and Methods: In a semi-experimental study, 24 overweight women (aged 20-25 years; body mass index (BMI), 25-30 kg/m²) were divided into 2 groups, namely, a control (n=12) and a training (n=12) group. The training group performed selective HIIT including 6 movements for 6 weeks (3 sessions/week). Initial and final blood markers were measured in blood samples collected 24 hours after the test. The data were analyzed using the paired and independent sample t-tests; a p<0.05 was considered to show statistical significance.
Results: There were no statistically significant differences between body weight, BMI, plasma levels of glucose, insulin and insulin resistance before and after the period in either the training or control group (p>0.05). Neither were there any significant differences between the training and control groups after the 6-week period as regards plasma levels of glucose, insulin, OXA or insulin resistance (p>0.05).
Conclusion: The findings of this study show that a 6-week high-intensity interval training has no influence on plasma OXA or insulin resistance in overweight women.

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Background and Aim: Since many of the healthy behaviors are adopted and develop during adolescence, proper choice of such behaviors is very important in this period of life. In addition, paying attention to the health of girls is crucial because they will transfer such behaviors to the next generation. Therefore, this study aimed to identify the role of health literacy and demographic variables in determining health-promoting behaviors among second-grade high school girl students in the City of Tehran, Iran.
Materials and Methods: This descriptive-analytic cross-sectional study was conducted on 370 female students using cluster sampling method in 2018. Data were collected using demographic, Health Literacy Measure for Adolescents (HELMA) and Health-Promoting Lifestyle Profile II (HPLPII) questionnaires and analyzed using SPSS₂₅.
Results: The results of multivariate regression analysis revealed that there were statistically significant direct associations between health-promoting behaviors and the following variables: one’s health literacy (β= 0.39, p<0.001), interest in health topics (β= 1.35, p<0.001), reading of journals and newspapers (β=0.76, p= 0.007), father's education (p= 0.002), body mass index (p= 0.022), field of study (p<0.001), the first source of health information (p<0.001) and place of residence (p = 0.023). Further analysis of the data showed an indirect association between health-promoting behaviors and age (β= -1.69, p<0.001) and health assessment (β=-1.67, p<0.01).
Conclusion: Based on the findings it is concluded that the subjects’ health literacy and health-promoting behavior scores were “not sufficient” and “intermediate”, respectively. It is recommended to design and implement appropriate training/intervention programs aiming at increasing the heath literacy and promoting health behaviors of female students.

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Background and aim: Despite rapid diagnostic and therapeutic advances, patients with chronic coronary artery disease (CCAD) should adopt self-care behaviors. This study aimed to determine predictors of perceived health competence among CCAD patients in Tehran, Iran in 2019-2020.
Materials and Methods: This cross-sectional study was conducted among 700 patients with CCAD referred to Shahid-Rajaie Cardiovascular Center in Tehran selected using the available sampling method. Data were collected using the perceived health competence scale (PHCS), 12-item quality of life scale and Modanloo's adherence to treatment scale questionnaires. The content validity ratio and content validity index were used to determine validity, and the Cronbach's alpha to determine reliability, of the PHCS questionnaire. Data analysis was performed using descriptive statistics, Pearson correlation coefficient, Structural Equation Modeling (SEM), the software being SPSS₂₅.
Results: The multivariate regression analysis showed that perceived health competence had statistically significant direct associations with physical (β = 1.08, p< 0.001) and psychological (β = 0.85, p< 0.001) domains of quality of life, commitment to treatment (β = 0.12, p =0.01), willingness to participate in treatment (β = 0.12, p = 0.05) and uncertainty about implementation (p = 0.1, p‹ 0.001) of adherence to treatment. There was a significant indirect association between age and perceived health competence (β = -0.13, p = 0.03).
Conclusion: Based on the findings, considering a “very good” and a “poor” mean score for adherence and the quality of life among the patients, respectively, adopting strategies for promoting quality of life in both the physical and mental dimensions can lead to improvements in perceived health competence in cardiovascular patients. In addition, it seems that focusing on subscales of “willingness to participate in treatment” might help in improving the patients' perceived health competence.

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Background and Aim: Patient education is an essential component of diabetes control, and increasing the health knowledge of diabetic patients based on suitable educational theories is crucial. This study aimed to determine the effect of educational intervention using the Transtheoretical Model (TTM) on improving the nutritional habits among patients with type-2 diabetes mellitus in Maragheh city, Iran during 2017-2018.
Materials and Methods: This study was a randomized controlled trial conducted on 136 diabetic patients under coverage of Maragheh health centers, Maragheh city, Iran, randomly divided into two groups of intervention and control (68 participants in each group). The data collection tool was a three-part questionnaire with questions/items related to demographic characteristics and nutritional habits, as well as constructs of TTM and HbA1c based on the TTM. The educational program included four weekly sessions of 45-60 minutes each. The data were analyzed using the SPSS₁₆ software, the statistical tests being descriptive and inferential tests such as ANCOVA; the significance level was set as a p-value < 0.05.
Results: Before the intervention, the comparison and control groups did not differ significantly as regards demographic variables, HbA1c, TTM constructs and nutritional habits (p<0.05). After the educational intervention, the mean scores of nutritional habits, constructs of TTM and HbA1c were statistically significant in patients with type 2 diabetes (p <0.01).
Conclusion: The study results reveal that the application of transtheorical model can improve the nutritional habits of diabetic patients.

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Background and Aim: Despite the increasing prevalence of infection with some blood-borne viruses, no standard precautions have been developed so far based on the Health Belief Model (HBM). This study aimed to assess, based on the HBM, the predictors of adherence to standard precautions in preventing needle stick injuries among the Personnel of Sanandaj Teaching Hospitals, Sanandaj City, Iran in 2020.
Materials and Methods: This cross-sectional study included 444 medical and non-medical staff members of the Sanandaj teaching hospitals in Sanandaj City, Iran, using a researcher-developed questionnaire. Descriptive and analytical data analysis was performed using Mann-Whitney U and Kruskal-Wallis tests, Pearson correlation coefficient, one-way analysis of variance, multivariate regression and the chi-square test, the software being SPSS version 22.
Results: The results of multivariate regression analysis showed that from among the HBM constructs, three constructs, namely perceived sensitivity (p=0.033), perceived benefits (p=0.032) and self-efficacy (p=0.001), were the predictors of staff duty performance (implementation of  standard precautions) in preventing needle stick injuries. As regards the implementation of standard precautions, 22%, 75.3% and 2.7% of the staff members had a low, medium and high performance level, respectively.
Conclusion: The constructs of perceived sensitivity, perceived benefits and self-efficacy are the strongest predictors in adherence to standard precautions.