Journal of School of Public Health and

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Background and Aim: Breast cancer is the leading cause of cancer death among women, both in Iran and worldwide. The wide variation in breast cancer incidence in different geographical areas calls for studies to clarify the role of potential risk factors. In this study we looked at some factors that could be involved in the pathogenesis of breast cancer.
Material and Methods: This matched case-control study was carried out in the summer of 2004, and it drew on data recorded in Babol (Caspian) Cancer Registry. We investigated 250 biopsy-proven cases of breast cancer, together with 500 controls chosen from the neighbors of cases. We matched the subjects with regard to age (with 3 years intervals). Crude and adjusted odds ratios and relevant 95% confidence intervals were calculated through conditional logistic regression, using STATA 8.0.
Results: This study involved 250 incident cases of breast cancer and 500 age-matched controls. The mean age of the cases was 48.7 (±11.37) years with 48, 22 and 80 years as median, min. and max. values, respectively. Mean age in the controls was 48.0 (±11.46) years with 47.5, 19 and 77 years as median, min. and max. values, respectively. In the multivariate analysis, the following variables were found to be risk factors: university education (OR=5.89, 95%CI: 1.73-20.09), menopause (OR=3.98, 95%CI: 2.29-6.91), induced abortion (OR=1.56, 95%CI: 1.02-2.22), BMI (OR=1.02, 95%CI: 1.01-1.03) and longer duration of breast feeding was determined as protective factor against breast cancer (OR=0.995, 95%CI: 0.990-0.999).
Conclusion: Modifiable risk factors should be considered in the community-based preventive interventions. The following areas could serve as topics for community education in Mazandaran: the role of high BMI and induced abortion in increasing the chance of breast cancer and also the protective role of breast feeding on this issue.

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Background and Aim: Community involvement is the most important strategy in development. In health program planning, community assessment is a process in which society members get a thorough understanding of all matters, problems, resources, weaknesses, strengths, needs, and surveillance related to health by collecting, analyzing, and publishing relevant data and information. This study was conducted to identify and prioritize problems of the Chahestani region, a poor region in Bandar-Abbas city, Iran, with active participation of the people.

Materials and Methods: The study was based on a model designed in North Carolina, US.  In this model, the assessment process is performed in eight steps.  In the first seven steps problems are identified and prioritized, and in step 8 a plan of action is developed to deal with the problem selected.

Results: A total of 60 problems were identified, of which the following were considered to be top priorities: lack of responsibility of the authorities, insecurity, unemployment, poverty, sewerage disposal, insufficient water, insufficient electricity,  unpaved roads, lack of green space, and dirty streets and passages.  

Conclusion: Most of the problems identified were non-health problems, including social, cultural, and economic issues.

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Background and Aim:  Community assessment is a process by which a clear picture of the community assets, strengths, resources, and needs is obtained with active participation of the community itself, followed by prioritization of the community needs and formulating strategies and programs to solve the problems. This study was conducted to identify and prioritize problems and needs of the Azerbaijan Borough in Tehran city, Iran, with active participation of the people.

Materials and Methods: This study was conducted to determine the attitudes and beliefs of the community members about their community needs and problems. The study was based on a model designed in North Carolina, US. In this model, the assessment process is performed in eight steps.  In the first seven steps problems are identified and prioritized, and in step 8 a plan of action is developed to deal with the problem selected.

Results: A total of 40 problems were identified and divided into several groups. The most important problems were as follows: social problems environmental health problems educational and cultural problems, civil rights and urban services distribution and use of drugs lack of family counseling centers shortage of parks and playgrounds for neighborhood children lack of supervision by municipal contractors on urban cleaning and lack of mental health services specially for the elderly.

Conclusion: Several types of problems, including health, as well as non-health - social, cultural and economic - problems were identified. Community assessment provides an appropriate opportunity for active participation of community members and makes available sufficient information for sound decision-making. Thus, community assessment can be regarded as a suitable technique for identifying and prioritizing community needs.

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Background and Aim: Despite all the current diabetes prevention programs, only a limited number of patients are identified and receive care.
Materials and Methods: This was a cross-sectional descriptive-analytical study including individuals over 30 years old in Buin Zahra city, Iran selected using the multi-stage sampling method (sample size = 1154). Data were collected using a questionnaire for the general public and the health team, the validity and reliability of which had been determined based on the CVR and CVI indexes and the correlation coefficient, respectively.
Results: The average age of the sample and the prevalence of diabetes were 48.42 ± 14.45 years and 9.9%, respectively. Further analysis of the data showed the following:
1. the prevalence of diabetes in at-risk people: women with a history of abortion and large children, 12.8% and 31.7%, respectively; gestational diabetes 36.5%;
2. obesity during pregnancy: 19.7%; a family history of diabetes: 22.4%;
3. waist circumference>90 cm: 14.08%, BMI>25: 13.95%; and
4. triglyceride<200: 22%, hypertension: 32.97%.
Further analysis of the data showed statistically significant associations between diabetes and blood sugar level above 100 mg/dl (OR = 2.73), waist circumference >90 cm (OR = 3.02) and gestational diabetes (OR =12.22); no other significant associations were found.
Only 55% of the health team personnel had received diabetes prevention training.
Conclusion: It can be concluded that patient care and education are not of a proper quality. The considerable prevalence of diabetes among people at risk shows that more follow-up and care are needed for them. The training of health team personnel should be very efficient and the number of trainings related to the diabetes program should increase.