Journal of School of Public Health and

Background and Aim: Many studies show that the only way to control diabetes and prevent its debilitating complications is continuous self-care. This study aimed to determine factors affecting self-care behavior of diabetic women in Khoy City, Iran based the extended theory of reasoned action (ETRA).

Materials and Methods: A sample of 352 women with type 2 diabetes referring to a Diabetes Clinic in Khoy City in West Azarbaijan Province, Iran participated in the study. Appropriate instruments were designed to measure the relevant variables (diabetes knowledge, personal beliefs, subjective norm, self-efficacy and behavioral intention, and self-care behavior) based on ETRA. Reliability and validity of the instruments were determined prior to the study. Statistical analysis of the data was done using the SPSS-version 16 software.

Results: Based on the data obtained, the proposed model could predict and explain 41% and 26.2% of the variance of behavioral intention and self-care, respectively, in women with type-2 diabetes. The data also indicated that among the constructs of the model perceived self-efficacy was the strongest predictor for intention for self-care behavior. This construct affected both directly and indirectly self-care behavior. The next strongest predictors were attitudes, social pressures, social norms, and intervals between visiting patients by the treating team.

Conclusion: The proposed model can predict self-care behavior very well. Thus, it may form the basis for educational interventions aiming at promoting self-care and, ultimately, controlling diabetes.

Background and Aim: To examine the association of diet and the risk of esophageal squamous cell carcinoma (SCC) in Kurdistan province.

Materials and Methods: This was a case-control study including 47 patients with esophageal SCC and 96 healthy controls. Dietary intake was assessed using a valid semi-quantitative food frequency questionnaire. Logistic regression analysis was run to estimate odds ratios and 95% confidence intervals.

Results: The controls had a significantly higher mean body mass index (25.3 vs. 20.4) and a higher level of education than the case group, while the latter had significantly higher records of tobacco consumption and symptomatic gastresophageal reflux. An independent protective effect was observed for the highest tertile of total fruit consumption (OR: 0.13, CI: 0.04-0.45, p-value=0.001). Within the fruits group, a significant inverse association was observed for bananas, kiwis and oranges (P for trends: 0.03, 0.02 and 0.01, respectively). The effect of total vegetable intake on esophageal SCC was not significant (OR: 0.66, CI: 0.23-1.87), although a reduction in risk was observed in the highest tertile of intake. With regard to other food groups we did not find a statistically significant association.

Conclusion: The results of the present study suggest an inverse association only between fruit consumption and esophageal SCC.

Introduction: Development of effective antiretroviral therapies (ART) has reduced mortality and increased life expectancy among individuals with HIV infection. Antiretroviral therapy regiments have improved symptoms and quality of life among these patients, whose sexual and reproductive needs, have, therefore, increased as well. In 2010, 20.8% of HIV-infected Iranians acquired the disease through sexual relations. The objective of this study was to define high-risk sexual behaviors among individuals infected with HIV referred to the Triangular Clinics of Universities of Medical Sciences in Tehran.

Materials and Methods: This cross-sectional interview-based survey included 400 HIV-positive individuals selected by consequential sampling.

Results: The majority (60%) of the subjects was males, and 44.2% of men and 51.3% of women with HIV were in the age group 34-25 years. On the whole, 15.6% of the women and 49.6% of the men had high-risk sexual behaviors after diagnosis of HIV infection. Further analysis of the data showed that 62.5%  of HIV-positive individuals were not aware of the risks of unsafe sexual relationship (using no condom) for HIV-positive transmission.. Based on the logistic regression module, it was found that factors strongly associated with high-risk sexual behavior were being male, being single, under high school diploma/graduate degree, alcohol intake and use of hormonal and permanent methods of family planning  (p<0.05).

Conclusion: The findings of this study confirm previous reports showing common high-risk sexual behaviour after diagnosis in HIV-positive populations. Providing suitable health services and advice on fertility and sexual health will result in no- or low-risk sexual life for couples.

Background and aim: Oral and dental diseases limit an individual&aposs activities at the school, work place and home, leading to a loss of millions of work and school hours all over the world. The period of adolescence is critical as regards shaping of healthy behaviors related to oral and dental diseases. The purpose of this study was to explore and describe school pupils&apos viewpoints on factors influencing development of dental caries.  

Materials and Methods: A qualitative study with a content analysis approach was conducted to collect the perspectives of 18 Iranian students in 8 guidance schools selected by purposive sampling. Structured and semi-structured interviews were held to collect data. An informed consent was obtained and the interviews were recorded and transcribed. The data was analyzed through an inductive approach of content analysis. In order to support the validity and rigor of the data, different criteria such as acceptability, confirmability and transferability were utilized.

Results: Data analysis could identify four major factors influencing dental caries development: "family interactions in dental health", "role of school in caring for teeth", "role of dentists in caring for teeth" and "effect of education in caring for teeth". The factors influencing caring for teeth and mouth had a greater significance.

Conclusion: The students&apos experiences, as observed in this study, can help in developing mutual trust between students and dentists, delivering better services in schools by relevant organizations, and designing more effective oral health interventions, with due consideration of vital role of the parents.

Background and Aim: Prenatal and neonatal care provides an opportunity for counseling, resulting in reduction of pregnancy-related and neonatal complications. It is expected that such care would result in promoting the health status of these vulnerable groups and improving the relevant indicators.

Materials and Methods: This was a cross-sectional survey including 668 mothers and 2-month-old children. Data were collected using questionnaires and structured interviews.

Results: On the whole, 35.9%, 21.0% and 5.1% of the mothers reported, at least, one pregnancy, one complication, and one neonatal complication, respectively. Results of the logistic regression model showed that the odds ratio of reporting at least one of the pregnancy complications increased by more than double in women who had a medical history or a high-risk pregnancy, increase decreased by 63% in those who had continuous care during pregnancy, decreased by 40% in those who had received thorough prenatal care, and increased by 0.05% for every unit increase in age. The odds ratio of reporting at least one postpartum complication increased by 70% per unit of in the density of health workers. Moreover, the odds ratio of reporting at least one neonatal complication decreased by 48% in women who had received full neonatal care and by 50% per every unit of increase in the density of health workers.

Conclusion: The findings of this study show the important role of behvarzes (community health workers) in detecting postpartum and neonatal complications, as well as the importance of antenatal care and quality of antenatal care as regards detecting at-risk women and neonates and prevention of pregnancy and antenatal complications.