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Background: Diabetes as the most common diseases caused by metabolic disorders is an important global challenge. This is a disease that requires lifelong self-care because self-care and improved quality of life is cost effective. This study is aimed to determine the impact of self-care education program on reducing HbA1c, type 2 diabetic patients and was conducted in Zahedan., Materials and Methods: This is an experimental study done on 138 diabetic female patients in Zahedan city, in 2011 (1390). This sampling method of patients was based on inclusion and exclusion criteria of the Diabetes Center, at Hazrat Ali Asghar Hospital (AS) in Zahedan. Samples were divided randomly in to two groups: 69 cases and 69 controls. Data collected included validity and reliability confirmed questionnaire. Checklist was based on patients 'performance of reporting and (HbA1c) testing. Before the educational intervention, the checklist of questions for recording the (HbA1c) test for both the groups were completed, and study samples received 5 sessions of education (with the group discussion and film show) for a month. However, the control group received only routine training. Three months after the educational intervention, both groups completed the questionnaire and the check list and data using SPSS software and the appropriate tests were analyzed., Results: Findings showed that the mean domain scores of area of knowledge, attitude and practice educational groups, were recorded as (46.6 ± 8.57, 46.5 ± 0.86 and 29.06 ± 10.02), respectively. And after education scores of knowledge, attitude and practice were recorded as (52.80 ± 2.20, 12.98 ± 1.02 and 39.69 ± 4.74), respectively, and in study group significant difference (P < 0/001) was seen., Conclusion: Self-care training in striation leads to improve knowledge, attitude and self-care performance of the study samples and also improves the average (HbA1c). Because it seems to increase the active participation of learners in their care that they have experienced with this training method and their motivation enhanced them to learn better self-care. So this type of care education should be given to the attention of nurses and healthcare's staff.

Background: As individuals live a longer life, health-promoting lifestyle (HPL) becomes even more essential, particularly with regard to maintaining functional independence and improving quality of life (QoL)., Objectives: This study aimed to determine the association between QoL and HPL in the Iranian elderly living in Shiraz., Materials and Methods: This analytical cross-sectional study was conducted in 2013 at retirement centers of Shiraz City, Iran. The sample included 500 elderly who aged > 60 years. Proportional stratified random sampling was used to select the elderly from retirement centers. QoL was assessed by the Farsi version of Short Form Health Survey questionnaire (SF-36) and HPL was measured by health-promoting lifestyle profile (HPLP II). Data were analyzed using independent-samples t test, one-way ANOVA, Pearson's correlation, and stepwise multiple regression using SPSS 21., Results: There were significant differences in QoL in terms of sex, age, education, and marital status. There were significant differences in HPL in terms of gender, age and education (P < 0.05) There was a statistically significant association between QoL and HPL in the elderly (r = 0.42, P < 0.05). Based on HPLP II constructs, the significant predicting factors of QoL in the elderly consisted of spiritual growth, stress management, and physical activity (P < 0.05)., Conclusions: Health providers should improve the QoL in the elderly by facilitating HPL through health-promoting interventions, which will maintain and increase physical activity, stress management, and spiritual growth.

Objective: Evaluating the relation between Iranian drivers' knowledge, attitude, and practice (KAP) regarding traffic regulations, and their deterministic effect on road traffic crashes (RTCs)., Setting: Two cities of Tehran and Zahedan, Iran., Methods: A cross-sectional study was designed. Using a simplified cluster sampling design, 2200 motor vehicle drivers including 1200 in Tehran and 1000 in Zahedan were selected. Sixty locations in Tehran and 50 in Zahedan were chosen. In each pre-identified location, 20 adult drivers were approached consecutively. A questionnaire developed by researchers was filled by each participant. The questionnaire had four sections including items assessing the demographics, knowledge, attitude and practice of drivers toward traffic regulations. Logistic regression analysis was used to evaluate the relationship between the RTCs and KAP variables., Results: The study sample consisted of 619 (28.1%) occupational and 1580 (71.8%) private drivers. Among them, 86.4% were male. The median age was 33.6 ± 10.83. Drivers in Tehran and Zahedan had no significant differences between their mean scores of KAP items of the questionnaire. Higher knowledge, safer attitude, and safer practice were associated with a decreased number of RTC. After adjusting for possible confounders, increase of one standard deviation in attitude and practice scores (but not knowledge) resulted in 26.4% and 18.5% decrease in RTC, respectively. Finally, considering knowledge, attitude and practice of drivers in one model to assess their mutual effect, it was shown that only attitude is significantly associated with a decrease of RTC (OR=0.76, P=0.007)., Conclusion: Increase in attitude and practice accompanied with decreased number of RTCs in Iranian drivers. Specifically, drivers' attitude had the crucial effect. It is not knowledge and standard traffic education; rather it is how such education is registered as an attitude that translates what is being learned into actions. Without safer attitude, even safer self-reported practice will not result in lower RTCs., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: To examine the effect of education on deciding about natural delivery in women opting for elective caesarean section., Methods: The quasi-experimental study was carried out between January and March 2012 and comprised a sample of 200 women in their third trimester of pregnancy attending women's clinics of Imam Ali Hospital, Zahedan, Iran, with the intention of having elective caesarean section. The subjects were voluntarily classified into three groups: one group received an educational package; the other had educational package along with group discussion, and the last one without any intervention was considered the control group. Post-test was conducted a month after intervention. Data were analysed using Kruskal Wallis, and logistic regression tests., Results: Group A represented the controls and had 100 (50%) women; Group B with the educational package had 40 (20%), while there were 60 (30%) women in Group C who had exposure to the educational package as well as group discussion.There were significant changes in behaviour in Group B and C (p < 0.01) but no change among the controls in Group A. In Group C, 25 (42%) women decided to go for natural delivery, while 1 (2.5%) woman had a change of opinion in Group B. Four (4%) women in the control Group A had ultimately natural delivery, but they were all emergency cases., Conclusion: The two educational methods increased model construct scores, including awareness, attitude, perceived behaviour control, subjective norms and behavioural intention. Nevertheless, educational package in conjunction with group discussion was more effective in influencing the choice towards natural delivery.

Background: General knowledge of at risk people regarding malaria is key element to facilitate appropriate treatment and prevention behaviours. The aim of this study was to assess the family heads' understanding of malaria transmission, signs and symptoms, and preventive measures in malaria-affected districts of Iran., Method: In 2009 in a cluster randomized cross-sectional survey data were collected from the heads of 5,466 randomly selected households by trained interviewers and a validated questionnaire. Only one adult person was interviewed per household Once all the information collected and entered to the SPSS Ver. 18 analysis was done and descriptive statistics were used to summarize results. Point estimates and 95% confidence intervals were also estimated for indicators., Results: 63.8% [95% CI: 62.2 - 65.4] of the participants recognized fever as a sign of malaria, 56.4% [95% CI: 54.6 - 58.2] reported that mosquito bites cause malaria and about 35% [95% CI: 32.7 - 37.1] of participants mentioned that the use of mosquito nets could prevent malaria. Furthermore, about one-third of selected samples in target districts did not know symptoms, transmission route and appropriate prevention method of malaria. Data also suggests a slight variation by residency, but substantial discrepancy according to the region., Conclusions: General knowledge of respondents concerning malaria is too far from the levels required to be constructive for malaria elimination. Therefore, the survey suggests developing, and implementing effective health promotion policies to increase the awareness of households about the symptoms, transmission route and control measures of malaria.

Purpose: To assess the association between oral and general hygiene behaviours in 12-year-old Iranians and the impact of sociodemographic and educational factors on the association., Materials and Methods: A representative random sample of 550 12-year-old Iranian adolescents from two deprived tribes answered a 41-item questionnaire on sociodemographic background, education and oral and general hygiene behaviours. The association between tooth cleaning frequency and other study outcome variables were tested using binary logistic regression. The sex differences in the study outcome variables were investigated using chi-square and Mann-Whitney tests., Results: The frequency of tooth cleaning was significantly associated with a general hygiene behaviour: frequency of taking a bath (OR 0.5; 95% CI: 0.3, 0.7). This association remained significant when sociodemographic factors and educational factors were added to the model both separately (P < 0.001) and together (P < 0.001). Girls were significantly more likely than boys to clean their teeth once or more times a day (OR 2.4; 95% CI: 1.7, 3.4)., Conclusion: Oral and a general hygiene behaviour were strongly associated. Oral, general and environmental hygiene programmes should use integrated approaches.

Background: Cardiovascular diseases (CVDs) constitute 53% of deaths above the age of 30; 54% of these deaths are attributed to high blood pressure. Coronary artery disease (CAD) is the main cause of mortality in the world. Hypertension accounts for 13% of mortalities and 6% of morbidities and is one of the main risk factors that cause loss of healthy life years. Blood pressure is not optimally controlled even among those who are aware of their disease. Previous studies showed that apart from pharmacological treatment, lifestyle improvement can also play a significant role in the prevention of high blood pressure CVDs. Self-care among them has been addressed in several previous studies. There are few self-care programs in Iran, but no study has been conducted on blood pressure., Methods: In this study the primary model is designed and then revised, and in the pilot study the feasibility of the project was approved and the final model presented., Results: The current project proposes a model for self-care of hypertensive patients and their families, and is based on education of health care providers and patients in such a way that patients can control their illness., Conclusion: The model can be implemented at a national scale.

Background: A qualitative study was carried out on 200 pregnant women attending obstetric offices and Imam Ali Women's Clinic in Zahedan, Iran during January 2010 to August 2011. Twenty-nine focus group discussions (FGDs) with 5-8 participants in each group were formed. The study included women in the third trimester of pregnancy with the intention or decision to undergo elective cesarean section. The women's views were explored and analyzed in group sessions. Subsequently, the responses were divided into four major categories. The majority (50%) of the opinions expressed were psychological in origin, or stemmed from low perceived behavioral control, improper subjective norms, or wrong attitudes about vaginal delivery., Methods: Twenty-nine focus group discussions (FGDs) with 5-8 participants in each group were formed. The study included women in the third trimester of pregnancy with the intention or decision to undergo elective cesarean section. The women's views were explored and analyzed in group sessions., Results: The responses were divided into four major categories. The majority (50%) of the opinions expressed were psychological in origin, or stemmed from low perceived behavioral control, improper subjective norms, or wrong attitudes about vaginal delivery., Conclusion: It is necessary to hold psychological skills training classes for pregnant women and their husbands to persuade them attend group discussion sessions to increase their control on perceived behavior, highlight their positive attitudes and direct them toward natural vaginal delivery.

Objective: To enhance knowledge and behaviour of Community Health Workers (CHWs) regarding adequate educational content of malaria., Methods: A quasi-experimental study was undertaken in 2003 in Sistan va Baluchestan province, Islamic Republic of Iran. Sixty-four CHWs were selected in both intervention and control groups. A questionnaire consisting of 17 open-ended questions was developed to assess CHWs' knowledge and behaviour about adequate content needed to be taught to the community. A multipurpose programme was held for the intervention group. Two follow-ups were carried out after three and six months. The data were analyzed using t-test, paired t-test, and ANOVA for repeated measurement., Results: The knowledge and behaviour about proper content increased considerably after three months in both the groups. The knowledge increased in the intervention group significantly as compared to control group., Conclusion: The results showed these simple and inexpensive interventions effect to improve proper content in malaria education. The findings highlight the importance of considering the proper content in malaria education when planning CHWs education programmes.

Objective: To determine knowledge, attitude, and behaviour of mothers about neonatal jaundice., Methods: In this cross-sectional study, 400 cases who delivered at Ali-Ebne Abitaleb Hospital in Zahedan-Iran during April and May 2006 were interviewed to complete 21-point questionnaires. The first data was analyzed descriptively then analytically by chi2, Pearson correlation, and independent t-test using SPSS 11 software., Results: The mean age of mothers was 26.8+/-6.5 years. The mean of knowledge score was 7.25+/-2.1 out of 13.5. Although knowledge of mothers about diagnostic methods was acceptable, it was not sufficient about causes, complications, harmful symptoms and prevention of the disease. The mean of attitude score was 18.5+/-3.7 out of 25. The mean of behaviour score was 6.8+/-2.3 out of 10.5. Knowledge had a significant association with history of neonatal jaundice (P=0.033), mother's age (P<0.001), and child's birth rank (P=0.001). There was also a significant association between mother's attitude and their educational level (P<0.001). Results showed a direct correlation between knowledge, attitude and behaviour (P<0.001)., Conclusion: Increasing mothers' knowledge about jaundice of neonates can be the first step to enhance healthy behaviours; through education programmes during pregnancy.

During the years 2000 to 2004, of 248 serologically confirmed cases of Crimean-Congo hemorrhagic fever (CCHF) that occurred in several parts of Iran, 169 were reported from Sistan-va-Baluchestan province. To assess the seroprevalence of CCHF virus infection within the Zahedan and Zabol districts of the Sistan-va-Baluchestan province in Iran, 300 subjects were sampled from the general population. In addition to blood sampling, a questionnaire was completed for every subject. All but just 3 of our 300 sampled subjects participated in blood sampling, and just 7 out of the 297 serum samples were found to be IgG ELISA positive. The point estimate of the seroprevalence was 0.024 (95% confidence interval: 0.003-0.044). A history of keeping livestock in houses (even for short periods) showed an association with seropositivity (P = 0.018). It seems that even occasional contact with livestock could be effective in transmission of the virus.

Objective: To determine the pattern of opportunistic infections (OIs) and non-infectious opportunistic diseases in hospitalized HIV-infected patients in Zahedan, southeast of Iran., Methods: We retrospectively reviewed the records of 52 HIV-infected patients (47 male, 5 female; age range, 21-54 years) who were admitted to Boo-Ali Hospital, Zahedan, Iran for evaluation and management of an HIV-related disorders from April 2000 to December 2005., Results: Tuberculosis (TB) was the most common opportunistic infections (53.8%) followed by hepatitis C (11.5%), typhoid (9.6%), amebiasis (9.6%), candidal esophagitis (5.7%), acute bacterial pneumonia (3.8%), and cerebral toxoplasmosis (1.9 %). Most of the cases of TB were pulmonary (36.5%). Apart from other well-recognized OIs, 2 cases of HIV-associated lymphoma were encountered. Only 12 patients (23.07%) received antiretroviral therapy. Five patients (9.6%) died during hospital stay due to tuberculosis (4 cases) and typhoid (1 case)., Conclusion: The findings show that opportunistic infections are common in HIV-infected patients in Zahedan, southeast of Iran. Tuberculosis remains the most common OIs and is the most common cause of death in these patients.

A qualitative study in Zahedan, Islamic Republic of Iran, used focus group discussions with 120 people in 8 main groups to understand more about couple's decision-making and the role of men in family planning. The study included men and women from Sunni and Shia sects as well as theologians from both sects. Shiites, lay people and theologians, believed that both husband and wife play a major role in decision-making about family planning, while Sunnis believed that men are the main decision-makers. All participants believed that men have an important role in family planning, but also that men do not like attending family planning clinics. Religious tenets were important in couple's decision-making about using contraceptives but there were confusions over different teachings.

To study the prevalence and factors associated with opioid use in pain, 480 consecutive patients with a chief complaint of pain were interviewed at 10 clinics in Zahedan. The data were analysed in relation to 18 possible associated factors. The prevalence of opioid use was 28.5% in patients presenting with pain. There was no significant relation between opioid use and chronic pain (> or = 6 months), but there was a relationship with the following 5 factors: previous opioid use by friends (72.9% versus 20.4% without friends using), occupation (58.5% private sector employees/self-employed versus 17.4% housewives), cigarette smoking (60.8% versus 21.8% not smoking), consultation for a psychological problem (38.3% versus 23.3% without), and death of a spouse (60.0% versus 26.1% without).

A questionnaire about malaria knowledge, beliefs and practices was given to a random sample of 2168 married women from rural and urban areas of Sistan va Baluchestan, Islamic Republic of Iran. The mean knowledge score of subjects was low at 5.5 (maximum 15.0). Few respondents (37.6%) knew that malaria was an important disease in the area and only 58.4% knew that malaria was transmitted by mosquitoes. Most subjects (69.4%) never used a mosquito net. Only 49.9% of rural and 73.8% of urban residents would seek care for fever and chills from the local health centre. Community health workers (behvarz) were the main source of information (29.5%) for rural women; the role of physicians in education was minimal. Subsequent health education must be tailored to the educational needs of the target population in this area.