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Background: Awareness, knowledge, and attitude towards waste management, environmental factors of waste disposal sites and citizens’ as well as waste generators’ behaviors should be considered for implementing a waste segregation plan at the source. Methods: The statistical population of this cross-sectional study includes 150 000 households living in Kerman. The sample size is calculated as 444 individuals using a stratified sampling method considering a 15% withdrawal probability. The correlation between Kerman citizens’ demographic data (age, gender, mean income, and household head’s educational level) and behavioral patterns (knowledge and awareness, attitude and behavior) regarding waste management and environmental factors of waste disposal sites was evaluated using SPSS software. Results: Examining the variables indicates that attitude, environmental factors, behavior, awareness, and knowledge have the highest mean and standard deviation, respectively. The highest mean score of awareness and knowledge was observed among individuals who earned 40 million IRR and higher income (2.55 ± 0.24) and those who had a PhD degree (2.63 ± 0.27). The results show that one unit increase in the score of awareness and knowledge, attitude and environmental factors could increase the mean behavior score. Conclusion: Teaching the households waste-related environmental issues and how to properly separate recyclable waste as well as providing correct information regarding the current (COVID-19 period) and future plans and policies of the waste management organization, and developing suitable motivational mechanisms could improve the performance level of a society.

Introduction Substance abuse in women has an increasing trend in all socio-economic classes. In addition to the fetal consequences, this problem has many other economic and social consequences as well.This study aimed to determine the prevalence of substance abuse and its related factors in pregnant women. Materials and MethodsThis descriptive cross-sectional study was performed employing a self-administered valid questionnaire on 587 pregnant women in Kerman, Iran who referred to public health centers and private offices to receive prenatal care. Participants were recruited from January to February 2020 using a multistage sampling method.ResultsThe most prevalent substances used during pregnancy (current use) were waterpipe (8.5%), opium (2.6%), and alcohol (1.7%).Substance abuse in first-degree relatives was a very strong correlate of substance abuse in pregnant women (OR = 7.26). The low level of education of pregnant women's husbands was also a strong predictor of substance abuse in pregnant women. (OR = 3.15).ConclusionSince substance abuse by family members was the strongest correlate of drug abuse during pregnancy, family-based interventions should be tailored to address early detection of such vulnerable women and necessary counseling services.

IntroductionHIV drug resistance (HIVDR) is an important challenge in the fight against HIV/AIDS and can threaten progress toward achieving the target of HIV elimination by 2030. Genotyping pretreatment HIVDR testing (DRT) has been proposed as a potential solution. However, the cost-effectiveness of this intervention needs to be evaluated to determine its feasibility and potential impact on healthcare systems. This study aimed to assess the cost-effectiveness of DRT among people living with HIV (PLHIV) in Iran.Methods1000 hypothetical PLHIV were simulated in terms of cost and effectiveness based on quality-adjusted life Years (QALY). The Markov Model was developed to calculate incremental cost-effectiveness ratio (ICER) using TreeAge Pro 2020. Deterministic and probabilistic analyses were performed for sensitivity analyses.ResultsResults showed that compared to not performing pretreatment HIVDR testing, this intervention gained 0.035999 QALY with an incremental cost of 1,695.32 USD. The ICER was calculated as 47,093.53 USD, indicating that pretreatment DRT was not cost-effective. The probability of opportunistic infection (OI) in people with viral failure, the effectiveness of Dolutegravir in people without drug resistance, and the quality of life (QoL) of people in the AIDS stage were found to be the most important variables affecting ICER. With an increasing willingness to pay more than 53,000 USD, pretreatment DRT testing will become cost-effective.ConclusionBased on our findings, pretreatment HIVDR testing is not currently cost-effective in Iran as it imposes high costs on healthcare systems with few benefits for People living with HIV (PLHIV). However, if resources are available, drug resistance testing can be a valuable tool in generating HIV molecular data and molecular surveillance of HIV.

Abstract Background Quality of life (QOL) and mental health among marginalized populations, including people experiencing homelessness in Iran, are understudied. We assessed the QOL and mental health status as well as their associated factors among youth experiencing homelessness in Kerman, Iran. Method We recruited 202 participants using a convenience sampling method from 11 locations, including six homeless shelters, three street outreach sites, and two drop-in service centers, from September to December 2017. Data were collected using a standardized questionnaire that included QOL, mental health, demographics, drug use, and sexual behaviors questions. Scores in each domain were indexed with a weight of 0-100. The higher score indicated a higher QOL and mental health status. Bivariable and multivariable linear regression models were performed to examine correlates of QOL and mental health. Result The mean (SD) score of QOL and mental health were 73.1 (25.8) and 65.1 (22.3), respectively. Multivariable analysis showed that youth experiencing homelessness who were aged 25–29 years old (β = -5.4; 95% CI: -10.51; -0.30), and lived on the streets (β = -12.1; 95% CI: -18.19; -6.07) had a lower mental health score. Moreover, those who had higher education (β = 5.4; 95% CI: 0.58; 10.38), had no history of carrying weapons (β = 12.8; 95% CI: 6.86; 18.76), and had a higher QOL score (β = 0.41; 95% CI: 0.31; 0.50) had a higher mental health score. Conclusion This study highlights that QOL and mental health among youth experiencing homelessness in Iran are concerning, particularly among those who were older, were less educated, were living on the street, and had a history of carrying a weapon. Community-based programs, including mental health care and affordable housing are needed to improve QOL and mental health among this population in Iran.

Background: Online education has become more vastly recognized as a powerful educational tool after the Covid-19 pandemic. It provides educational opportunities that were not previously possible because of time or place restrictions.Objectives: This study investigated the factors influencing students' acceptance of online learning systems during the Covid-19 pandemic.Methods: The study sample comprised 435 students from Kerman University of Medical Sciences. We used the external technology acceptance model (TAM) to determine the acceptance of online education systems by undergraduate students during the Covid-19 pandemic. Partial least square structural equation modeling (PLS-SEM) was used to check the model hypotheses. P-values less than 0.05 were considered statistically significant.Results: In this study, 65% of the participants were men. The mean score for the items in the questionnaire was 53.1±19.3. The constructs of perceived ease of use and perceived usefulness had a significant effect on students' attitudes, and students' attitudes and perceived usefulness strongly influenced their behavior in using the online education system.Conclusion: The results of this study show that the perceived ease of use and perceived usefulness of the online education system indirectly affect students' behavior in using online education. Thus, educational policymakers at universities can emphasize the ease of learning and especially the easy use of mobile phones when choosing an online education system. In addition, the creation and expansion of the necessary infrastructure can facilitate student use of online education.

Abstract Background and objectives Drug addiction is a chronic and relapsing brain disease. Practicing self-care is one of the rules offered by therapists to improve the withdrawal process and prevent relapse. Based on the evidence, health beliefs, including Pender’s proposed model, are significantly effective in adopting self-care behaviors in patients. On the other hand, in order to evaluate preventive interventions regarding drug use and relapse of drug use; Having a good and appropriate tool is a special priority. Therefore, the present study aims to design and determine the psychometric characteristics of the questionnaire for measuring health-promoting self-care behaviors in patients recovered from drug addiction has been carried out in the west of Mazandaran province. Methods The current study is a cross-sectional descriptive methodological research. In the first stage, the items and primary classes of the new tool were extracted based on the review of studies consistent with Pender’s self-care promotion and a questionnaire was designed. In the second stage, the psychometric characteristics of the designed questionnaire were examined using face validity, content validity, construct validity and reliability. In the construct validity, the number of participants was 245 for exploratory factor analysis and 203 for confirmatory factor analysis. In the reliability test, 25 people participated to check internal consistency and test-retest. Random sampling was done from 12 drug addiction treatment clinics in two cities of Tonkabon and Ramsar in the west of Mazandaran province during 2021–2022. Data were analyzed using SPSS and AMOS software version 23. Results The exploratory factor analysis revealed 7 factors containing 29 item explained more than 61% of the total observed variance. The results of confirmatory factor analysis showed that the data fit the model. In the reliability test, Cronbach’s alpha coefficient indicated the appropriate internal consistency of the tool and retesting the tool with an interval of 2 weeks showed acceptable stability of the tool. Conclusion The present study showed that the researcher-made questionnaire has good validity and reliability and can be used to measure self-care behaviors of patients who have recovered from addiction in order to provide appropriate solutions to prevent the relapse of drug use.

Background: The group discussion method is one of the student-centered and active teaching methods in which learners actively participate in educational activities using discussion, and they are given the opportunity to share their opinions and experiences with others.Objectives: The present study was conducted to compare the effects of the group discussion method and the lecture method on health workers’ knowledge and attitudes.Methods: In this quasi-experimental study, 70 health workers working in Baft, Kerman province, were selected by census method and divided into two groups of 35 people. Asthma-related educational content was presented for one group as a lecture and the other as a group discussion. Before and after the intervention, health workers’ knowledge and attitudes scores were evaluated and compared using a researcher-made questionnaire.Results: The mean age of participants was 38 ± 2.7 years. After the intervention, the mean score of attitude was 65.86 ± 6 in the lecture group and 68.66 ± 4.7 in the group discussion group, indicating a significant difference (p = 0.04). The mean score of knowledge after the intervention was 11.4 ± 1.66 in the lecture group and 11.28 ± 1.6 in the group discussion group, which was not statistically significant (p = 0.77). In both groups, the mean scores of knowledge and attitude increased significantly after the intervention (p

Background: Inadequate health literacy (HL) in dialysis patients increases the risk of poor self-care and decreases severe self-care and severe negative health outcomes in these patients. This study aimed to investigate HL and its related factors in dialysis patients in Kerman, Iran, in 2021. Methods: This cross-sectional study was performed on 280 dialysis patients who referred to Kerman (Iran) dialysis centres. The participants were selected through multi-stage sampling method. The study was conducted using the Iranian Health Literacy Questionnaire (IHLQ). The higher score shows a better HL. Results: The mean age of the subjects was 57.75 ± 13.87 years. The mean score of HL was 9.12 ± 4.54 out of 20 points. During multivariate regression, there was a significant relationship between HL and age (β = -0.08, P = 0.02) and level of education (elementary/literacy (β = 4.607, P < 0.001), middle school (β = 6.38, P < 0.001), high school (β = 8.573, P < 0.001) and academic education (β = 9.410, P < 0.001), and there was a significant relationship between HL and eye disease (β = -0.903, P = 0.001). Conclusion: Most participants did not have adequate HL, while HL as the most important determinant of self-care can improve patients’ quality of life and reduce their health care costs. Therefore, in order to increase self-care, planning and necessary interventions, the HL of these patients seems to be necessary

BackgroundEarthquakes cause many casualties worldwide. Taking preventive measures and improving community preparedness is critical to reducing earthquake damage. The social cognitive theory explains how individual and environmental factors cause behavior. This review was conducted to identify the social cognitive theory structures, in research on the preparedness of households against earthquakes.Materials and methodsThis systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted from January 1, 2000, to October 30, 2021 in Web of Science, Scopus, PubMed, and Google Scholar. Studies were selected based on inclusion and exclusion criteria. The initial search yielded 9,225 articles, and finally, 18 articles were selected. Articles were assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist.ResultsEighteen articles about disaster preparedness behaviors based on the socio-cognitive constructs were identified and reviewed. The essential constructs used in the reviewed studies included self-efficacy, collective efficacy, knowledge, outcome expectations, social support, and normative beliefs.ConclusionBy identifying the dominant structures that have been used in studies related to the preparedness of households against earthquakes, researchers can implement appropriate and more cost-effective interventions by focusing on improving suitable structures.

Abstract Introduction Homelessness is increasing among young adults in large cities. According to the United Nations, there are more than one billion absolute or relative homeless people in the world. This study was conducted to explain the lived experiences of homeless youth in southeastern Iran. Materials and methods In this qualitative study, we recruited 13 participants in a big city, southeast Iran, in 2020. The participant was young homeless adults aged 18–29 years who were using homeless shelters provided by the municipality, sleeping in parks or on streets. Data were collected through in-depth and semi-structured interviews and three focus group discussions. Data were analyzed by conventional qualitative content analysis. Results The main category of “lonely, annoyed, and abandoned in society” and three subcategories of avoidance of/by society, comprehensive harassment, and lack of comprehensive support were extracted. The experiences of young homeless adults showed that they escaped from the community due to addiction, feeling like a burden to others, and social isolation, and not only have they been left without support in society, but they have also suffered from all kinds of physical and psychological harassments. Conclusion The lived experiences of homeless people show that in addition to appropriate facilities and living conditions, they require respect, reduced social stigma, discrimination, and favorable conditions for a return to life. Therefore, authorities should identify and settle their problems and needs.

IntroductionTeacher violence is defined as the intentional use of power by teachers against students in a variety of ways, including physical, verbal, psychological, and sexual assault. Victims of school violence are more anxious and insecure than other students. An in-depth and comprehensive study on the prevention of violence in schools is urgent and necessary. We conducted this study to determine teacher violence from the perspectives of schoolteachers and students and related factors.MethodsWe conducted this descriptive-analytical study on 313 teachers and 400 students in Ardestan, southern Iran, in 2019. We selected teachers and students using a census method and stratified random sampling, respectively. The research instrument was the school violence questionnaire.ResultsFrom the perspective of teachers, the mean score of teacher violence (5.7) was significantly lower than that of students (18.3). Male, young, single teachers with diploma and less work experience had significantly higher violence scores than other teachers (P < 0.001). We witnessed this trend in public boys’ schools as well (p < 0.001). The total mean score for teacher violence was not significantly different between male and female students. From the perspective of students, the mean score of teacher violence was significantly different (P < 0.001).ConclusionOur results suggest that education authorities and school principals should supervise public school teachers with less education, younger students, and boys’ schools and provide practical training to improve the communication and emotional skills among these teachers.

Introduction Complete cessation of breastfeeding (CCB) at the right time is as important as starting breastfeeding, as well as identifying the factors that affect the duration of breastfeeding, so that breastfeeding promotion programs focus on these causes, to increase mothers’ ability and desire to breastfeed. This study aimed to determine the time of CCB and its related factors. Methods This analytical cross-sectional study was conducted in 2020. This study was performed at all health centers and health homes affiliated to Kerman University of Medical Sciences, in Kerman province, Iran. A total of 802 urban and rural mothers with children aged from 30 to 36 months completed the questionnaire. The validity and reliability of the questionnaire were confirmed by Cronbach’s alpha of 85%. Data were analyzed using SPSS software version 16. Results The mean time of breastfeeding was 19.23 ± 7.09 months and the median was 22-month-year. About 41% of children were breastfed until 24-month. There was a significant relationship between the time of CCB with contraception, number of households, place of residence, and weight at 6-month at the level of 0.05. Conclusion Duration of breastfeeding is influenced by some demographic and cultural factors. The timing of the CCB is near to the suggestions of the World Health Organization (WHO) and religious teachings.

Background: This study aimed to measure internal and external HIV stigma and their associated factors among people living with HIV in the southeast of Iran.Methods: Using convenience sampling and a standard questionnaire, we recruited 104 HIV-positive patients (40% women) in 2018-2019 from two public clinics in Kerman, Iran. The internal stigma scale ranged from 0-22 and the external stigma scale ranged from 0-11 in which a higher score indicates higher stigma.Results: The mean internal stigma score was 10.7 (SD: 5.2), and that of the external stigma score was 3.1 (SD: 2.9). In multivariable regression analysis, women (Adjusted (Adj). ᵦ=-3.3; p=0.08), and married people (Adj. ᵦ=-5.5; p=

Abstract Introduction: Self-care programs can raise health in patients with Multiple Sclerosis (MS). This study aimed to identify the self-care behaviors and determinants in patients with MS according to the Health Belief Model (HBM). Methods: In this cross-sectional study, we included 280 MS patients through convenience sampling method. The collection tool was a self-administered questionnaire based on HBM. The participants were the members of MS society in Kerman, Iran. The data were analyzed using descriptive statistics, path analysis, and multivariable linear regression in SPSS software Version 22. Results: The mean (SD) score for self-care practices was 2.86 (0.64), and medication adherence was the most conducted practice. The perceived benefits and cues to action exerted positive influence on self-care practices. The most frequent symptoms experienced by the participants were fatigue (82.5%), visual impairment (76.4%), headaches (72.1%), and muscle weakness (71.4%). The most important cues to action for self-care behavior were the physician (77%), media (52%), and other MS patients (32%). Conclusion: The quality of life (QOL) of MS patients is heavily influenced by self-care behaviors. In this study, only about half of the patients accomplished self-care behaviors, which seems to be insufficient. Since the perceived benefits and cues to action are the main predictors of self-care practices, intervention based on these two constructs can be utilized to promote self-care programs and QOL in MS patients. Health-care providers should pay more attention to these factors for promoting self-care behaviors.

Background and Objective: Using chewing tobacco is one of the most important health problems in ports of the southern coast of Iran. The prevention of this problem requires identifying the factors affecting this phenomenon. The aim of this study was to determine the prevalence of chewing tobacco and related factors among adolescents in South- East of Iran (2018). Methods: This descriptive-analytical study was conducted on 204 male high school students through multistage sampling in two the ports of Konarak and Chabahar located in south - east of Iran during March to June 2018. The data collection tool was a self-administered standardized questionnaire including items about knowledge, attitude and prevalence of chewing tobacco among participants, intimate friends and family members of the study population. Results: Prevalence of chewing tobacco in life time and current use (pervious 30 days) was 71.8% and 43.1%, respectively. Supari was the main chewing tobacco were used (80.8%) by participants. The negative attitudes about chewing tobacco was a protective factor (OR=0.41) and easy access (OR=6.88), using by family members (OR=2.28), and close friends (OR=3.28) were the most important risk factors. Conclusion: The prevalence of chewing tobacco was alarming in male high school students in south - east of Iran.

Introduction: Medication adherence is regarded as one of the most important factors in caring for hypertension. This study aimed to investigate the effect of intervention based on the theory of planned behavior (TPB) on medication adherence and its influencing factors on the elderly with hypertension in a rural area, Kerman province, Iran. Methods: This quasi-experimental study of the pre and post-control type was conducted on 109 elderly patients with hypertension. Data were collected using a multistage random sampling and a valid questionnaire based on the TPB. The intervention was an educational program based on TPB constructs using educational videos, pamphlets and booklets approved by the Ministry of Health. The collected data were analyzed by the SPSS 22 using parametric tests (Independent t-test, paired t-test, and regression analysis). Results: The average score of the attitudes , perceived behavioral control, as well as medication adherence behavior constructs increased significantly after the intervention in the intervention group compared to the control group (p < 0.001). Multivariate regression analysis in intervention group after intervention showed that 76% of variations in intention were explained by the model. Attitude, subjective norms and perceived behavioral control were independent predictors of intention. The association between subjective norms and intention was of marginal significance (B = 0.89). Conclusion: The results of this research showed that an educational program based on TPB can affect medication adherence on elderly rural patients suffering from hypertension.

Background Stigmatizing attitudes among healthcare providers are an important barrier to accessing services among people living with HIV (PLHIV). This cross-sectional study aimed to assess the status and correlates of HIV-related stigma among healthcare providers in Kerman, Iran. Methods Using a validated and pilot-tested stigma scale questionnaire, we measured HIV-related stigma among 400 healthcare providers recruited from three teaching hospitals (n = 363), private sectors (n = 28), and the only voluntary counseling and testing (VCT) center (n = 9) in Kerman city. Data were gathered using self-administered questionnaires at participants’ workplace during Fall 2016. To examine the correlates of stigmatizing attitudes, we constructed bivariable and multivariable linear regression models. Results The mean ± standard deviation (SD) of stigma score was 25.95 ± 7.20 out of the possible 50, with higher scores reflecting more stigmatizing attitudes. Paramedics, nurses’ aides, and housekeeping staff had the highest, and VCT personnel had the lowest average stigma scores, respectively. Multivariable regression analyses showed that prior experience of working with PLHIV (β = -2.48; P = .03), exposure to HIV-related educational courses (β = -2.03; P = .02), and P < .001) were associated with lower stigma scores. Conclusion Our findings highlight the need for health managers to provide training opportunities for healthcare providers, including programs that focus on improving HIV-related knowledge for healthcare providers. Enforcing policies that aim to reduce HIV-related stigma and discrimination among healthcare providers in Iran are urgently needed.

Background: Alcohol use and drug injection are prevalent among homeless youths. The aim of this study wasto identify the associated factors of alcohol consumption and drug injection among homeless youths aged18-29 years.Methods: Data on 202 homeless youths (111 males and 91 females) were collected using a standardizedquestionnaire and face-to-face interview. Lasso logistic regression was applied to determine the impact ofassociated factors on alcohol consumption and drug injection.Findings: The mean age of the participants was 26.30 ± 3.19 years. Also, the prevalence of alcoholconsumption and drug injection was 33.0% [95% confidence interval (CI): 30-36] and 4.0% (95% CI: 0-8),respectively; 6 people (3.0%) consumed alcohol and injected drugs at the same time. Correlates of alcoholconsumption and drug injection were male sex [odds ratio (OR)Alc = 5.7], age (ORAlc = 0.96 and ORDI = 0.98),bachelor or higher education level (ORAlc = 1.34), non-Iranian nationality (ORAlc = 0.05 and ORDI = 0.18),food score (ORDI = 0.92), smoking (ORAlc = 2.05), substance use (ORAlc = 1.12), opposite sex relationship(ORAlc = 1.6), homosexual relationship (ORAlc = 3.56 and ORDI = 2.69), and mental disorder (ORAlc = 0.99).Conclusion: Based on our findings, it seems that the homeless youth are more desired to use alcohol and druginjection, whereas the prevalence of alcohol consumption and drug injection in homeless youth was higherthan general youth population in Iran. Therefore, some suitable solutions are needed to prevent thehomelessness. Also, the effective variables that were identified in this study for alcohol use and drug injectioncan help design and implement beneficial interventions.

Background: Heavy vehicle drivers spend a great deal of time away from their families. This issue and other difficulties around their job may increase risky behaviors among them. The current study aims to investigate the prevalence of opium drugs, stimulants, cannabis, and alcohol use 12 hours before driving among heavy vehicle drivers. Methods: We selected two sites that were in charge of medical examination of drivers and recruited 363 drivers of heavy vehicles (trucks, trailers, and buses). We asked drivers about total number of drivers they knew and number of drivers who experienced use of different types of drugs. The data were analyzed using Network Scale Up Method (NSUM). Findings: Mean of age and job experience was 43.28 ± 10.04 years and 16.07 ± 9.67 years, respectively. The highest and lowest prevalence of drug use related to opium-based drugs at 12.8% to 14.0% and simulants at 1.97% to 2.84%, respectively. The prevalence of alcohol use 12 hours before driving was 4%. Conclusion: 12-hour before driving prevalence of opium-based drugs among drivers was high. This might put them in higher risk of road accidents. There is a need to design appropriate educational programs for them.

Introduction: Bedbugs (Cimex spp.) are a public health problem and an urban pest that require blood meal from humans, other mammals or birds to survive. Bedbugs constitute an emerging public health problem and infestations have been reported globally. This paper reports three cases of social health problems caused by bedbugs in three residential buildings in Kish Island, Dezful, and Ahvaz in southern Iran. Case presentation: Case 1; A 42-year-old male living in Dezful city had a bedbug infestation in his house (September 2018). He developed a phobia (entomophobia) about bedbugs. Case 2; A 36-year-old man and 33-year-old woman living in Ahvaz city had a bedbug infestation in their house (August 2017). The woman was very concerned about the bedbug infestation in the house and she had entomophobia, stress, anxiety, insomnia and paranoia; this issue caused resentment and hence conflict between the couple. Case 3: A 25-year-old woman and a 28-year-old man living in Kish Island rented a house from a 45-year-old man. The landlord was very concerned about the bedbug infestation in the house (July 2017), and claimed that the tenants were responsible for bedbugs’ presence. This issue caused hostility and conflict between them. Generally, all cases had bedbug infestations in their houses and this issue caused some social health problems such as entomophobia, concern, fear, stress, anxiety, insomnia, paranoia, resentment and conflict. Take-away lesson: Bedbugs are not vectors for infectious disease. But, with regard to our observations in the present study, bedbug infestations can produce some social health problems such as entomophobia, concern, fear, stress, anxiety, insomnia and paranoia, as well as resentment, hostility and conflict between residents in infested houses.

In the early decades of the 20th century, discussions regarding alcohol were dominantly directed toward itstherapeutic uses, but authorities now state that any level of alcohol consumption poses negative effects onhealth. Over recent months, increased attention has been devoted to disease burdens attributable to alcoholuse worldwide. As more and more studies are conducted to illuminate the harmful effects of alcohol ondifferent body systems, the mounting evidence generated requires documentation and publication. Thecurrent review was aimed at providing an overview of the recent literature on the adverse consequences ofalcohol consumption.

Background: Social capital (SC) is one of the most important assets and a vital determinant of sustainabledevelopment of any country. The aim of this study was to determine the prevalence and the relationshipbetween SC and substance use (SU) in Southeast Iranian adolescents.Methods: This cross-sectional study was conducted among high school students in three cities located in southeast of Iran. We recruited 600 adolescents (329 girls and 271 boys) through multistage sampling duringSeptember to November 2018. The data collection instrument was a self-administered standardizedquestionnaire that included basic demographic characteristics, SC constructs items, and questions about SUbehavior in the participants.Findings: The mean SC score among boys and girls studied was 3.46 and 3.33, respectively (from 5 score).Among the SC constructs, respectively, the lowest and highest score belonged to social trust and [2.84 in girlsand 2.98 in boys with 95% confidence interval (CI) of 0.06-0.21, P < 0.001] and bonding to family (3.92 ingirls and 4.25 in boys with 95% CI of 0.22-0.44, P < 0.001). The ever use prevalence of at least one substanceabuse was 55.9% (n = 181) for boys and 36.6% (n = 68) for girls. Hookah (41.8%) and alcohol (16.9%) were themost substances abused by participants. One-point increase in score of the constructs of social participation,social cohesion, bonding with family, and bonding with schools was associated with a reduce of 17%, 22%, 26%,and 46% in the probability of ever SU, respectively.Conclusion: There was a strong relationship between SU and SC. Thus, rising SC as an effective communitybased and indirect approach can help policy makers and professionals in preventing SU in Iran. However, priorto any intervention, identification of more causality may be required

Stigma and discrimination are one of the important challenges in coping with HIV infection. Stigma and discrimination are universal phenomenon for the epidemic of HIV and exposure to people with HIV. The present study aimed to develop and measure psychometrically the HIV/AIDS Stigma and discrimination scale from the general population viewpoint in southeast Iran. Data collection lasted from May to September 2016. The results showed that the “HIV/AIDS Stigma and discrimination scale” had an acceptable internal consistency and stability (Cronbach’s alpha coefficient = 0.69, omega coefficient = 0.7, and r = 0.57, p = 0.001). The scale had acceptable content and face validities. The Principal Axis Factoring (PAF) with varimax rotation analysis shows that the scale has 4 dimensions: “patient social position” (5 items), “social support” (4 items), “social disease perspective” (7 items), and “social harassment” (2 items). In general, the psychometric properties of “HIV/AIDS Stigma and discrimination scale” are acceptable, and this scale can be used in studies.

Background One of the most effective ways to prevent substance abuse is to promote addiction knowledge in influential social groups. Objectives The purpose of this study was to identify the current status of substance abuse education in medical universities of Iran in order to develop a targeted curriculum on drug abuse and include it in the curriculum of medical students. Methods In this descriptive library study, documentary (library) method and checklists were used for data collection. In order to identify the extent to which the existing units and courses deal with substance abuse and with the subject of addiction, the announced titles for active disciplines of the Ministry of Health and Medical Education were reviewed in 2017 - 2018. Results Of the 7685.5 units taught in different faculties of medical sciences universities in all disciplines except clinical residency programs.106.1% (optional or mandatory) are related to substance abuse. Of these, 49.5 units were related to the pathophysiology, treatment and pharmacology of substances, and 57.6 units covered topics related to prevention strategies and pathologies of substance abuse. Conclusions Despite the high importance of substance abuse issues for medical sciences students, a general unit for prevention and familiarity with the physical, psychological and social consequences of substance abuse does not exist in most of these disciplines. Therefore, it is recommended that studies be conducted to provide specific courses related to the substance abuse phenomenon or to consider substance abuse topics in the courses related to this subject.

Background: Adolescence is the age of increased sensation-seeking and risk-taking. To prevent such behaviors, the adolescent tendency to engage in high-risk behaviors must be measureable. This study aimed to develop a questionnaire about risk-taking tendencies among Iranian students.Methods: This study was conducted using cluster sampling of the tenth-grade students in three cities in Kerman province, Iran. The students were assured that the questionnaires would remain anonymous and unlinked. Construct validity was assessed using exploratory factor analysis (EFA) and comparison of known groups. Corrected item-scale correlation and Cronbach's alpha were calculated to evaluate reliability.Findings: A total of 551 high school students participated in this study. Of these, 57 were excluded after checking the “non-existent drug” item (10.3%). Girls accounted for 49.2% of the sample. Of the 33 initial questions, 13 were removed due to factor loading of less than 0.5. Two factors were extracted using the scree plot (“drug abuse tendency" and "other risky behavior tendency"). The tendency toward high-risk behavior was significantly higher in male students than in female ones (P < 0.001). This indicates the known group validity of the questionnaire. The Cronbach's alpha of the above-mentioned factors were 0.93 and 0.83, respectively.Conclusion: The questionnaire measuring the tendency toward high-risk behavior among students showed acceptable validity and reliability.

Background: Prisoner’s addiction is one of the major problems in many countries which imposes very high medical costs and social harm to communities. This study investigated the pattern of substance use and related factors in male prisoners in one of the prisons in southeastern Iran.Methods: This cross-sectional study was carried out in 2016. The study population was inmates of a prison in southeast Iran. Sampling was carried out randomly according to the list of prisoners. Data were collected using a form and were analyzed with statistics software SPSS.Findings: More than four-fifths (75.3%) of the subjects consumed at least one substance (alcohol, tobacco and other drugs), 74.4% were smoking, 73.2% used a narcotic substance, and about one-fifth (19.3%) reported drinking alcohol. With a frequency of 62.0%, opium was the most frequently utilized narcotic substance. Poppy juice (31.6%), cannabis (29.8%), crystal (16.9%) and tramadol (16.9%) were the next frequent substances used. A percentage of 41.5% subjects reported using two or more drugs. A percentage of 80.7% subjects reported substance use among their friends, 39.2% by siblings and 37.2% by father. Regression analysis showed predictor variables of substance use were education, substance use by prisoner before being imprisoned, substance use by father, friends and siblings.Conclusion: This study showed a remarkable prevalence of substance use in prisons, which was more than general population. Therefore, it is necessary to consider alternative penalties of imprisonment due to the factors associated with substance use. Screening of people at high risk for substance use should be considered on admission to prison, and primary prevention measures should be focused on them.

Background and Objectives: Breast cancer is the most common form of malignant diseases in women. Early diagnosis is effective on its successful treatment. The aim of this study was to evaluate breast self-examination and its effective factors based on the theory of planned behavior among women in Kerman, Iran. Materials and Methods: In this descriptive-analytical cross-sectional study, 300 women referred to the health centers in Kerman, Iran, were selected by the cluster and convenience sampling. Data were collected using questionnaires included demographic variables and questions about knowledge and constructs of the theory of planned behavior. Data analysis was done using descriptive statistics and Pearson’s correlation, Spearman, Chi-square, independent t-test, Mann-Whitney and logistic regression with the SPSS 21 software. Results: The mean age of the participants was 30.26 ± 8.18 years. Results showed that 12.7% of the women performed breast self-examination regularly every month. The most common reason for not doing breast self-examination was not knowing how to perform it. Knowledge was the most important predictor in breast self-examination (OR= 0.896, P

Introduction: Cardiovascular diseases are the main causes of mortality and disability in the world. Many risk factors are involved in cardiovascular diseases including hypertension, high cholesterol, overweight and obesity, smoking, diabetes, inadequate physical activity, unhealthy diet. The aim of this study was to evaluate cardiovascular diseases risk factors and the relationship between knowledge level and preventive behaviors for cardiovascular diseases among women in Kerman. Methods: This descriptive-analytical cross-sectional study was performed on 400 women in Kerman. Participants were selected using multistage cluster sampling method. Data were collected using demographic questionnaire and a questionnaire about cardiovascular disease risk factors, knowledge, nutritional behavior, and physical activity. Data were analyzed using Pearson’s correlation, Spearman, one-way ANOVA, Kruskal wallis test and Mann-Whitney U test by SPSS 21. Results: The average age of women was 42.11±1.40 years. Daily stress (71.75%) and inadequate physical activity (62.75%) were the most common risk factors among the participants. There was a significant positive relationship between knowledge and nutritional behavior (P

Introduction:The first step in any educational programs is determining the educational needs of the target group. Providing adequate information to couples helps them to start their marital life based on a correct basis. The aim of this study was to determine the pre-marriage educational needs of couples who are about to get marry. Methods:This descriptive-analytical and cross-sectional study was performed on 250 couples attending in Pre-marriage counseling classes. Available sampling was used in this study. Data were collected by a questionnaire including demographic variables and 47 questions in 7 areas including family planning, congenital diseases, common cancers in men and women, sexual relationships, relationship with spouse and family, and Islamic and legal issues. Data were analyzed using analytical statistics Chi-square, t-test, ANOVA, and correlation coefficientthrough SPSS 21. Results:The results show a significant relationshipbetween the need for training and education in women and men (P

Background: Substance use is a growing public health problem among adolescents. In the lack of a valid and reliable instrument based on social development model (SDM), this study aimed to develop risk and protective factors of substance use scale based on SDM to determine risk and protective factors influencing substance use among adolescents. Methods: A total of 235 male students from 9th and 10th grade (14-18 years old) of public high schools in Kerman, Iran, selected through multistage cluster sampling. Items pool extracted from the literature and focus groups with male adolescents. Face validity of the questionnaire assessed for readability and clarity of items. Then, an expert panel evaluated the items for content validity. Consequently, construct validity of questionnaire confirmed through exploratory factor analysis (EFA). Known group validity is determined by the degree to which the instrument shows different scores between two groups of those who had an experience in drug use and those who did not have such an experience. In addition, reliability assessed via internal consistency and test-retest. Results: About 10 factor solution (containing 38 items) emerged as a result of EFA entitled adolescent’s “beliefs on hookah and alcohol,” “bonding to parents,” “family rules on substance use,” “drug resistance skills,” “adolescent’s beliefs on hard drugs,” “situational perception on hookah and alcohol,” “rules of school,” “situational perception on hard drugs,” “attachment to school,” and “perceived opportunity at school.” The first four emerged factors explained 46% of the total variance observed. Among these factors, adolescent’s beliefs on hookah and alcohol explained a more than 25.3% of the total variance. Results indicated satisfactory internal consistency (Cronbach¢s alpha ranging from 0.71 to 0.85) and intra-class correlation coefficients (ICC) (ranging from 0.48 to 0.81). Conclusion: The risk and protective factors of substance use questionnaire are the first instrument based on the SDM. The findings showed that this questionnaire is a valid and reliable instrument for assessing determinants of substance use which can be used by researchers and policymakers in preventive initiatives.

Objectives Elderly people are at risk of low health literacy outcomes and exposed to many health problems due to lack of personal independence. We aimed to investigate the relationship between health literacy and health status of older adults in Kerman, Iran. Methods & Materials This was a cross-sectional study in which 200 elderly people were questioned in Kerman. Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA) And health status was measured using the Activity Daily Living tool and 10 questions of the short form of SF-36. To analyze the data we used descriptive statistics and to study the relationship among variables, statistical tests such as Chi-square, T, and one-way ANOVA were used. Results Most of the elderly people had inadequate health literacy (52.5%). There was a statistically significant association between health literacy and education (P=0.021) as well as occupation (P=0.041) in the elderly. We also found a statistically significant association between ADL and health literacy (P=0.038), but there was no statistically significant association between age, sex, marital status, economical status, and physical functional with health literacy. Conclusion Enhancing health literacy may be an effective strategy to improve elderly people’s health status. According to the results of this study, education and health-promoting behavior as well as improving health literacy are recommended in planning health promotion programs

Background: The growing supply and prevalence of waterpipe (WP) smoking among Iranian adolescents have become a concern for both families and policymakers. The aim of this study was to determine the factors underlying WP use and also to design an intervention program based on social cognitive theory (SCT) aimed to reduce the demand for WP smoking among male adolescents. Methods: This quasi-experimental study involved 189 high-school students in Kerman, Iran, who were split into two groups, an intervention group and a control group. A validated questionnaire based on SCT constructs was used to collect data. The intervention was performed over four sessions with a focus on preventing WP smoking. Results: Before intervention, the lifetime and current-use prevalence of WP smoking across both groups was 48.5% and 20.2%, respectively. In the intervention group, the most change was related to knowledge score from 10.70 ± 4.38 to 16.52 ± 3.89 (P < 0.0001) and outcome values score from 12.40 ± 3.81 to 13.53 ± 4.23 (P = 0.007); however, in the control group, no significant changes were seen in posttest scores. The scores for self-efficacy (P = 0.21), outcome expectations (P = 0.09), and environment constructs (P = 0.06) did not show any statistically significant changes after the intervention in both groups. Overall, there was no significant difference in the rate of WP smoking after the intervention. Conclusions: Based on the results of this study, although some construct scores showed significant differences after the intervention, there was no significant change in the prevalence of WP smoking. More effective educational interventions based on this theory but with a greater focus on self-efficacy and environmental influences may be warranted.

Introduction: Society needs are constantly changing. As a result, it seems to be necessary to make changes in education as well. The viewpoints of faculty members as the educators and the most authentic group involved in medical education system are of significant influence. This study was conducted to investigate the determinants of effective teaching from non-clinical teachers' viewpoint in Kurdistan University of Medical Sciences in year 2009. Methods: In this descriptive cross-sectional study, the entire 72 non-clinical teachers in academic year 2009 were selected for investigation. Data collection tool was a questionnaire made by researcher which was validated and reliable. Faculties’ viewpoints toward educational status of the university were collected via this questionnaire. After completion of the questionnaire by these non-clinical teachers, data was collected and codified. Then the SPSS software v.11.5 was used to analyze the data using descriptive statistical tests (frequency and percent). Results: Nonclinical teachers believed that: having scientific capability (97.2%), oratory competency (97.2%), having communication skills (95.9%), the capability to develop critical thinking in the students (91.6%), the role of professional degree (88.8%), and the ability to motivate students for problem solving (84.7%) are respectively the most important factors determining effective teaching. Meanwhile, 68.1% of the respondents believed that the teacher’s research activity is considered significant in his educational success. Conclusion: The results of the study revealed that several factors may influence the effective teaching of non-clinical teachers. Considering these factors at the time of developing educational plans and retraining workshops for teachers may help these workshops to be more effective and successful. Our results may also be an emphasis on the necessity of including courses like the basics and teaching methods in the curriculums of master degree and PhD.