Journal of School of Public Health and

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Background and Aim: Looking at population pyramid from the 1996 census and its estimates for the years 2003 and 2004, it is clear that the size of the elderly population will be greater in men than in women. According to Iran’s Ministry of Health, the life expectancy for women is greater than that for men. This article is devoted to the discussion and analysis of this paradox.
Materials and Methods: Analysis of the population sex ratio.
Results: Its trend- based on data generated by censuses from 1956 to 1996- indicate that a large proportion of women did not live beyond the age of 35 women were most likely to die in years 35-45 of their life. It is possible that this age group, which included many women who were still of reproductive age, suffered the effects of war and socioeconomic crises of the 1940's. The trend had improved by the time of the 1376 census and there is no singe of an increase in the sex ratio thereafter. This change is probably due to the improvement in socioeconomic status and the development of an effective health care system.
Conclusion: Since the life expectancy estimates are based on the probability of death and are thus affected by socioeconomic conditions, the apparent incompatibility between the population age pyramid and life expectancy among elderly women and men is due to higher mortality among women of reproductive age before the 1970’s.

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Background and Aim: Domestic violence against women is a major public health problem throughout the world. Feelings of shame, guilt and fear on the part of women, together with an unresponsive health care system continue to silence and isolate women who suffer abuse and negligence- with major effects on their physical and mental health. Mental health consequences include depression, anxiety, stress disorders, and somatization. This study estimates the prevalence of domestic violence and its associated effects on the victims' mental health.
Materials and Methods: This cross-sectional study used data from 1189 married women over the age of 15, selected randomly among the residents of Tehran.
Results: The overall prevalence of domestic violence was 35.7%. Thirty percent of the subjects had experienced physical violence, 29% suffered mental violence and 10% had been victims of sexual violence many of these women had suffered all the three types. The most frequent types of physical violence included beating in the form of kicks, punches, and slaps (91%) common types of mental abuse included humiliation, verbal abuse and insults (93%), and threats of violence (83%). Data on mental health status indicate that overall, as many as 34.1% of women could be suffering from disorders such as depression and anxiety. The risk of psychiatric disease was 3.5 times higher in victims of violence compared to other women (OR = 3.5, CI 95% = 2.72 - 4.58). Major factors contributing to domestic violence were husband addiction, low economic status, and the number of children (P<0.001). These results are consistent with the current literature on domestic violence and illustrate the high prevalence of this phenomenon. Victims are commonly depressed and have a higher rate of anxiety.
Conclusion: Violence is an important indicator of women’s health. Screening programs for domestic violence could be effective, along with community support and referral to health care and legal facilities. It is also crucial to promote knowledge and awareness of violence among health care providers. This study shows that a community-wide effort to establish links between health care settings and community services may be important in addressing the needs of victims.

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Background and Aim: Domestic violence against women is a major health problem, as well as a violation of human rights. It adversely affects the physical, mental, and social well being of women, families and communities. This phenomenon exists in all countries around the world. Although its prevalence, strength, types, effects, and risk factors are different, it is not limited to any geographical zone or distinct social class. This article presents the views of Tehrani couples and experts on underlying factors causing domestic violence against women in Iran and action to be taken for prevention.
Materials and Methods: This qualitative study was carried out through eight FGD meetings, in 2 days, with the participation of 50 couples. The couples were divided into 8 groups based on sex, education, and history of violence. Results of the FDGs were categorized and analyzed. Data were discussed in group meetings of 50 experts in different fields, such as health, medicine, law, education, and Islamic studies, from academic, policy making, governmental executive, and women's affairs organizations, divided into three groups of community general education and information dissemination, health system, and judiciary system. Results were discussed and finalized in a general meeting.
Results: The couples and experts identified underlying factors in 4 categories socio-cultural, economic, legal, and medical. Actions to be taken for prevention and control were believed to be educational, legal, and supporting services.
Conclusion: On the basis of the findings of this study, it was suggested that strategies/actions/services to solve the problem and reduce harm should include providing appropriate information and education for couples and the community emphasizing the health system responsibility empowering physicians and other health personnel to help women who are victims or susceptible to domestic violence legal transparency and reforms meeting legal needs law reinforcement and implementation providing safe shelters for victims and establishment of a national center for research and planning on violence.

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Background and Aim: Presently not sufficient attention is paid to adolescent health promotion in many countries, because of the widespread belief that adolescents are generally healthy. The purpose of this study was to evaluate predictors of adolescent girls' quality of life using path analysis based on Pender's health promotion model.

Materials and Methods: The Pender's health promotion model served as the framework of this cross-sectional study, which included a total of 500 adolescent girls (grades 9-11) selected by stratified random sampling from 20 high schools for girls in 4 districts of Kashan province, Iran. Inclusion criteria were being in grades 9-11 and a written informed consent (from teachers, parents and the girls themselves). Data were collected through interviewing the girls, the interviewers being trained persons, using several standard questionnaires (for perceived self-efficacy, perceived affect, perceived barriers, perceived social support health promoting lifestyle, and health-related quality of life). Data analysis was done using SPSS18 and LISREL 8.8, the statistical test being path analysis.

Results: All constructs of the health promotion model and health promoting lifestyle were significantly related to adolescent girls' quality of life. Perceived self-efficacy (β=0.70, p<0/01) and perceived affect (β=0.21, p<0/01) had the highest correlation with the quality of life. The model and the health-promoting lifestyle as a mediator accounted for 73% and 39% of variance in adolescent girls' quality of life, respectively.

Conclusion: The findings of this study indicate that the health promotion model can be used to explain and predict the quality of life of adolescent girls. Thus, the Pender's health promotion model is recommended to health planners for promoting the quality of life in this population.

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Background and Aim: The prevalence of chronic diseases can be reduced by correcting people's food habits. Therefore, the purpose of this study was to assess the explanatory power of the Expectation-Confirmation Model for the intention to continue fruit and vegetable consumption.
Materials and Methods: This descriptive-analytic study included 332 elderly people with a history of receiving health care services from 8 rural health centers and 40 health houses in Abadan city, Iran in the second half of 2015. Data were analyzed by path analysis and the multicolinearity test using LISREL8.8 and SPSS16 software, respectively.
Results: Less than half (48%) of the subjects consumed 1 to 3 servings of fruit and vegetable daily. The model used could explain 79% of the intention to continue fruit and vegetable consumption. Analysis of the data also showed positive associations between the intention to continue fruit and vegetable consumption and the following variables: self-efficacy (β = 0.09, P <0.01), perceived ease of use (β = 0.15, P <0.01), perceived benefits (β = 0.37, P <0.01), and satisfaction (β = 0.35, P <0.01); however, the perceived barriers had an inverse relationship with that intention (β=-0/2, P <0.01). From among the constructs of the mode, perceived benefits were the most effective factor influencing the intention to continue fruit and vegetable consumption (β=0.85, P <0.01).
Conclusion: The model used in  this study is suitable for explaining the elderly people’s intention to continue fruit and vegetable consumption. It is recommended that policy-makers use appropriate strategies to increase the understanding of the benefits of eating fruits and vegetables by the elderly and, thus, sensitize them to increase their consumption through public campaigns and communication with the relevant organizations, families, etc.
 

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Background and Aim: Diabetes mellitus is one of the most prevalent and important health problems in the world.Considering the high prevalence of metabolic syndrome in diabetic patients and the potential effects of its components on HbA1C in these patients, the present study was conducted to determine the effect of metabolic syndrome components on HbA1C in type-2 diabetic patients.
Materials and Methods: This retrospective cohort study was conducted on 157 diabetic patients regularly referring to the Diabetes Control Center in Qazvin City during 2014, where complete data about theirmetabolic syndrome components, as well as HbA1C levels were available. The data were analyzed using multiple linear regression (α=0.05 for statistical significance).
Results: Based on the regression model, the effects of age, HDL-C and fasting blood glucose on HbA1C were statistically significant; the effects of other variables were nonsignificant. The R²value for the variables entered for prediction of HbA1C was found to be 0.45 (R² = 45%).
Conclusion: Considering the significant relationship between some components of the metabolic syndrome such as HDL-C and fasting blood glucose on HbA1C in diabetic patients, it is essential to design and implement programs to reduce the level of HbA1C in these patients.

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Background and Aim: Delays in childbearing, in addition to creating health risks for the mother and the child, may lead to permanent parental bereavement. The purpose of this study was psychometric assessment of the validity and reliability of the Iranian version of attitude toward reproductive and childbearing inventory (ATRCI) in women without a history of pregnancy.
Materials and Methods: This study was done on 235 women without a history of pregnancy selected by multi-stage sampling in the South of Iran. They completed a fertility and childbearing attitude questionnaire. The validity and reliabilty of the ATRCI were determined using SPSS-16 software, the statitical tests being Cronbach's alpha coefficient and exploratory factor analysis.
Results: The mean age of the women was 24.47 ± 4.1 years, and the Cronbach's alpha total coefficient was 0.888. The KMO and Bartlett's test of sphericity value (0.890) was  significant.
In this study, in addition to the main components of the questionnaire, the childbirth postponement component was also extracted; they explained  63.01% of the total variance related the attitude toward fertility and childbearing. 
Conclusion:  The 4-component Iranian version of the attitude toward fertility and childbearing inventory was found to have acceptable psychometric validity and reliability. It is recommended that in the future studies this inventory be used in intervantional studies and heath and demographic programs for women without a history of pregnancy.

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Background and Aim: Individualism is a mental and behavioral tendency that leads to individual autonomy in such a way that the individual's goals and desires are more important to him than the goals and desires of others; such a person considers himself responsible for his successes and failures. The main purpose of this study was to determine the relationship between lifestyle and individualism in women in Shiraz, Iran.
Materials and Methods: This was a cross-sectional correlational study conducted in Shiraz, Iran 2019 on a sample of 564 single women aged 25 to 49 years selected by a combination of appropriate and purposive stratified sampling methods. The data were collected using the horizontal and vertical individualism questionnaire of Triandis et al. and analyzed using the SPSS software version 25 at both the descriptive and analytical levels, the statistical test being the Pearson correlation coefficient test.
Results: The rate of individualism of the respondents was about 69%. Investigating the dimensions of individualism showed that the respondents' tendency to individualism in the dimension of prioritizing the individual activities of the individuals (78.15%) was higher than those of the other two dimensions. The lifestyle score of the respondents was 63.4%. Based on the Pearson correlation coefficient, there was a significant inverse relationship between the women's lifestyle in Shiraz and their individualism, which means that a better lifestyle can lead to a decrease in the women's individualism.
Conclusion: Based on the findings, there is an inverse relationship between lifestyle and the degree of individualism of women in Shiraz, Iran. Therefore, improving the lifestyle by focusing on the family and paying attention to its supportive dimensions can have a positive effect on reducing the individualism of this group.

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Background and Aim: The objective of this research was to identify the components of electronic foundation data theory teaching and learning in the workplace.
Materials and Methods:  This research was conducted using qualitative content analysis with a conventional content analysis approach. The statistical population was comprised of two groups: 1.Three sources of information (a sample of 26 out of 317 textbooks, scientific articles and theses/dissertations) selected by judgment sampling; 2. Relevant specialists and experts (a sample of 22) selected according to the theoretical saturation technic. The methods and tools used to collect data and information included archival surveys and field studies (interviews and questionnaires).
Results: For the primary coding, 644 categories were identified and converted into 45 secondary categories based on common conceptual aspects, which were finally became nine (9) main themes in the axial coding phase; these themes were used to build the thematic network.
Conclusion: The research model shows that the following nine categories are involved in electronic teaching and learning in the workplace: 1). organization and management; 2). information and contents; 3). interaction and communication; 4). characteristics of the person who teaches; 5). effectiveness; 6). technical quality; 7). learning objectives; 8). learning requirements, and 9). electronic education dimensions.