Journal of School of Public Health and

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  Background and Aim: Although self-care is known to affect favorably the control and treatment of osteoporosis, the effective factors from the patients’ viewpoint have not been investigated. The aim of this study was to explore factors affecting self-care from the viewpoint of women suffering from osteoporosis.

  Materials and methods: This was a qualitative study conducted with a content analysis approach in 2014, including 15 women consulting the bone mass densitometry centers in Sanandaj, Iran, selected by purposeful sampling. The inclusion criteria were women aged &ge 50 years suffering from osteoporosis diagnosed definitively at least 6 months before, a T-score index > -2.5 (lower back or hip bone), taking drugs upon a physician^’s advice, ability to speak, and willingness to participate in the study. Data were collected through face-to-face and group semi-structured in-depth interviews and analyzed using the content analysis method. The accuracy and rigor of the data were confirmed based on such criteria as credibility, confirmability and transferability.

  Results: Five main categories were extracted including “ background factors of the disease ”, “hope and weakness in confrontation with the disease”, “role of the physician”, “role of the family”, and “administrative centers and organizations”. Based on further analysis of the data, 11 subcategories were emerged including “cultural issues”, “lack of knowledge”, “non-priority of health”, “weakness and fear”,

  “hope for the future” , “positive role of the physician”, “negative role of the physician”, “ active role of the family”, “ passive role of the family”, “ role of the media”, and “information centers”.

  Conclusion: The finding of the study show that the responsibility of women suffering from osteoporosis towards their health is not a single-factor, but rather a multifactorial, phenomenon. Pre-requisites for empowering women to adopt self-care behaviors include increasing their hope to live longer, physician’s attention to the patient’s needs, increasing health promotion programs in the media, and strengthening role of the family (particularly role of men).

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Background and Aim: Children are one of the most vulnerable groups in the population. Child abuse is a complex phenomenon with multiple causes. The purpose of this study was to do a confirmatory factor analysis of child abuse potential inventory among Ahvazi children in Ahvaz, Iran.

Materials and Methods: This was a descriptive-analytical study, including all Ahvazi primary school pupils aged 8-13 years in the academic year 2015-2016.

The sample size for confirmatory factor analysis was determined based on the number of questions per parameter.The variance was extracted on the basis of mean scores and

composite reliability for structural equation modeling was determined based on the first-order and second-order confirmatory factor analysisusing the LISREL software.

Results: Confirmatory factor analysis revealed a short form of the child abuse's original 3-actor structure, including the psychological, physical and neglect scales. The outcomes indicated that the firstorder model was a better fit for the data than the second.

Conclusion: It can be concluded that the Ahvazi version of the child abuse potential inventory questionnaire is acceptable from a psychometric point of view. We think it is essential to take into consideration the diversity of perspectives between parents and children in future research in this area.

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Background and Aim: The incidence of breast cancer in women is expected to rise sharply over the coming decades in Iran. The aim of this study was to determine risk factors for breast cancer in under-50-year-old women during the period 2013-2015 in Kermanshah, Iran.

Materials and Methods: This case-control study was carried out in Imam Reza Hospital and private clinics of oncologists (three clinics) in Kermanshah, Iran. The participants were 202 patients with breast cancer and 398 without breast cancer. Subjects of the experiment group were selected from among patients in the Departments of Oncology, Radiation Therapy, and Chemotherapy of the hospital, while the control group subjects were selected from among outpatients referred to specialty and subspecialty departments and private clinics of the hospital (outpatient, oncology, gynecology, ophthalmology, sonography, ENT, infertility). The two groups were matched for age. Data were collected by interviewing the subjects, the Gill standard questionnaire and the patients’ files and analyzed using the STATA software (version 12) ─ Odds Ratio (OR), 95% Confidence Interval (CI) and the Conditional logistic regression model.

Result: The following variables were found to be the most important risk factors for breast cancer among under-50-Year-old women: a family history of breast cancer in second degree relatives, an age of 18-35 years at the first childbirth, and a history of a benign breast lump.  

Conclusion: It is recommended to conduct further studies on the subject with due consideration of other risk factors for breast cancer, as well as education of women about breast self-examination  and importance of periodic clinical examinations.

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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: Although staying at home seems to be the best way to reduce the risk of Covid 19 virus and stay safe from it, the home has physical and psychological effects on people, especially vulnerable populations. Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders in women which, in addition to many physical problems, it has many psychological manifestations. Thus, the present research was conducted to determine the effect of home-made aerobic activity on the psychological state of adolescent girls with PCOS in home quarantine conditions.
Materials and Methods: In this 12-week study a sample of 40 adolescent girls with PCOS participated ─ 20 in the intervention, and 20 in the control, group, the intervention group performing home-based aerobic training for the whole period. In both groups anxiety and depression, as well as body image concern were determined at the beginning and at the end of the period, using the Hospital Anxiety and Depression and Littleton Body Image Concern questionnaires, respectively; so was body composition by weight and height. The data were analyzed using the SPSS-22 software, the statistical tests being the Kolmogorov-Smirnov test and Analysis of covariance.
Results: Before the intervention, the experimental and control groups did not differ significantly as regards anxiety, depression, body image concern and body composition (p> 0.05). Further analysis of the data revealed significant differences between the two groups regarding these variables (p = 0.001) at the end of the period.
Conclusion: Supervised aerobic exercise in the home has a favorable effect on the psychological state of adolescent girls with PCOS and can be recommended as a safe therapy for these patients in corona conditions.

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Background and Aim: The Primary Health Care (PHC) system is the most comprehensive, equitable and efficient way to promote people's health and social welfare by providing preventive, curative, rehabilitative and palliatvie services in a place close to where people live and work. Iran's PHC system faces challenges that limit its effectiveness and efficiency. The aim of this study was to identify strategies to strengthen Iran's PHC system.
Materials and Methods: A realistic review method was used in this research. Published articles on strategies to strengthen the PHC system between 1978 and 2019 were searched in eight databases and Google scholar search engine. Finally, 29 articles were found to be eligible for inclusion in this study; framework analysis was done using the MAXQDA-10 software. 
Results: Twenty-nine strategies were identified for strengthening the PHC system. A well designed PHC system is one with the following characteristics: realistic goals and appropriate strategies  equipped with necessary resources, organized in multidisciplinary teams that provide comprehensive and quality health services (intervention program), with strong governance and leadership, financing, work force, equipment and medicines, information systems and robust health services delivery processes and well adpated to the external environment (context). Such a PHC system will increase healthcare providers’ satisfaction and commitment, as well as the  patients’ trust, participation and satisfaction (the mechanism) and, finally, promotes, restores, and maintains the people health (result).
Conclusion: A strong PHC system is a pre-requisite for strengthening a health system. Various strategies such as strengthening management and leadership, improving organizational structure and culture, improving the information system, empowering human resources and increasing population coverage can lead to an improved PHC system. Historical, social, cultural and economic factors affecting the health system should be considered in redesigning and stregtening a PHC system.