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Background and aim It seems that acceptance of COVID-19 vaccination is the most effective way to tackle the COVID-19 pandemic now. Health care workers (HCWs) are one of the most important groups who are at risk for COVID-19 infection. This study aimed to assess the COVID‐19 vaccine acceptance among HCWs in Iran and its determinants. Methods A cross‐sectional survey was carried out among 3600 HCWs in Iran. Data were collected through a self-administered questionnaire by a trained team from February to March 2021. Multi-stage cluster sampling method was used for selecting respondents of the study. Multivariate logistic regression analysis was used to determine the key factors of COVID-19 vaccine acceptance among participants. P-value Results Out of the 3536 respondents, 2191 (62.1%) intended to uptake the COVID-19 vaccine. Only about 10 percent of respondents said they did not trust any vaccine (domestic or foreign). Willing to accept a COVID-19 vaccine was relatively high among males, doctors, and those who had a history of hospitalization due to COVID-19 infection. The multivariate regression analysis showed respondents who were 40–50 years (aOR: 1.56; 95% CI: 1.47–1.66), had a history of COVID-19 infection (aOR: 0.85; 95% CI: 0.83–0.88), and hospitalized due to COVID-19 infection (aOR: 2.18; 95% CI: 1.97–2.39), were significantly associated with vaccine acceptance (p Conclusion Our study showed moderate acceptance of COVID-19 vaccination in the HCWs in the Islamic Republic of Iran. The most important factor in the acceptance of the COVID-19 vaccine by the health staff is having a history of hospitalization. Further training and justification of health personnel is needed to increase the acceptance of COVID 19 vaccine.

Background The Cancer Attitude inventory (CAI) was developed to measure attitudes toward cancer. The aim of the present study was to describe the development of the Persian version of the CAI and to evaluate its psychometric properties in an Iranian sample. Methods The forward–backward method was used to translate the CAI scale from English into Persian. After linguistic validation and a pilot check, a cross-sectional study was performed and psychometric properties of the Iranian version of the questionnaire were assessed. The scale validation was conducted with a convenience sample of 820 laypeople. Construct validity was assessed through both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency was assessed through Cronbach’s alpha analysis and test-retest analysis. Results Five factors were identified in CAI: isolation, helplessness, fear of consequence, belief of control and independence, and fear of death. The results achieved from the CFA displayed that the data fit the model: the relative chi-square (× 2/df) = 2.98 (p Conclusions The results indicate that the Persian version of the CAI is practical, reliable and valid. Consequently, the instrument could be used in plans to create positive attitudes about cancer control and treatment among Persian people.

Background and Objectives: This research aimed to determine the relationship between awareness of Islamic citizenship rights and organizational similar-to-me of education managers of Zanjan University of Medical Sciences, Zanjan, Iran. Materials and Methods: This descriptive and correlational research was performed on all education department managers and faculty members with a history of education department management. Convenience sampling was applied to select 117 subjects who had passed online courses on citizenship rights. Moreover, data were collected using a researcher-made questionnaire in the form of a five-point Likert scale. In addition, data analysis was performed applying Lisrel 8.5. Results: In this study, the results demonstrated that in the direct path, the principle of dignity (path coefficient=-0.20) had the most effect on the dependent variable. However, in the indirect path, the variables of freedom of expression (-0.17), social-political right (-0.15), and freedom of thought (-0.04) had the most impact on the dependent variable of the research (organizational similar-to-me of education department managers) due to the mediating variable of the right to security. Conclusion: According to the results of the study, all variables exerted impacts on the indirect path through the mediating role of the right to security. In order to better realize Islamic citizenship rights, it is recommended that the right to security (occupational-psychological) be provided so that a decrease could occur in the organizational similar-to-me effect in education department managers.

Background At the end of December 2019, a novel coronavirus tentatively named SARS‐CoV‐2 in Wuhan, a central city in China, was announced by the World Health Organization. SARS‐CoV‐2 is an RNA virus that has become a major public health concern after the outbreak of the Middle East Respiratory Syndrome‐CoV (MERS‐CoV) and Severe Acute Respiratory Syndrome‐CoV (SARS‐CoV) in 2002 and 2012, respectively. As of 29 October 2020, the total number of COVID‐19 cases had reached over 44 million worldwide, with more than 1.17 million confirmed deaths. Discussion SARS‐CoV‐2 infected patients usually present with severe viral pneumonia. Similar to SARS‐CoV, the virus enters respiratory tract cells via the angiotensin‐converting enzyme receptor 2. The structural proteins play an essential role in budding the virus particles released from different host cells. To date, an approved vaccine or treatment option of a preventive character to avoid severe courses of COVID‐19 is still not available. Conclusions In the present study, we provide a brief review of the general biological features of CoVs and explain the pathogenesis, clinical symptoms and diagnostic approaches regarding monitoring future infectivity and prevent emerging COVID‐19 infections., The essential structural proteins play an important role in budding the virus particles released from different host cells. Notably, reported cases confirm human‐to‐human transmission, along with numerous cases of exported virus infections all over the world. However, to date, an approved vaccine or treatment option of preventive character to avoid severe courses of COVID‐19 is still not available. In the present study, we provide a brief review of the general biological features of CoVs and explain the pathogenesis, clinical symptoms and diagnostic approaches with regard to monitoring future infectivity and preventing emerging COVID‐19 infections.

Introduction: This study was carried out to determine the extent of prostitution and its causes among Iranian children at risk of social harm. Material and Methods: The authoritative websites on the topic of childhood prostitution performed in Iran during the period 1985 to 2019 were searched in WHO, UNFPA, UNDP, ISI, ProQuest, Medline, Scopus, CINAHL, and Google Scholar databases for reviewing studies conducted in Iran. Articles from internal dissertations and Google's databases, SID, Magiran, Google Scholar, Iran Medex and Iran Doc search engines. Upon leaving unrelated and unqualified articles, finally, seven studies were selected. Information by 2blind researchers in the form of the article title, the first author, year of research, sample size, age was included in the Excel program. Results: The search yielded a total of 1256 records. After removing duplicates, 45 documents were retained for further examination. After screening the titles and abstracts, seven papers were retained for full-text review. Based on pre-defined inclusion criteria, seven records were included in the systemic review. Many reasons for prostitution were: running away from home, sexual harassment, forced sex, presence of a child among prostitutes including family members or friends, and other reasons including the history of addiction of parents, the history of detention and imprisonment before prostitution and the responsibility of supplying them (sponsorship) gifts and prices, membership in sex offending gangs, sex trade, and sex sales. Conclusion: Violence, sexual abuse, and sexually transmitted infections, pregnancy, mental illness, involvement in child trafficking networks and substance abuse are the consequence of the experiences of these children in prostitution, therefore, it is very important that specialists and authorities should first consider heavy penalties for adults seeking sexual contact with children and key measures should be taken for the use of these children by social services.

Background & Objective:Social support helps patients cope with the outcomes of diseases and therapy side effects. However, there is little information about the social support status among Iranian cancer patients. This study assessed the amount of perceived social support status (SSQN) and satisfaction (SSQS) in gastrointestinal (GI) cancer patients based on socio-economic factors. Methods & Materials:This study was carried out in 2018 on all GI cancer patients referred to health centers in the province of Zanjan (i.e., Vali-e Asr teaching hospital and Mehraneh charity clinic for cancer therapy). The Persian version of Sarason’s social support questionnaire was applied. Results:The questionnaire was completed by 284 patients. The average amount of SSQN was 3.56±1.25. The average score of SSQS was 4.87±0.57. Network dimension and satisfaction status were significantly correlated (PP Conclusion:Cancer patients reported high levels of social support in terms of network (SSQN), but were not highly pleased with the support received (SSQS). More secure employment, higher income, a higher level of education, and being an urban resident are predictors of high levels of satisfaction of perceived social support.

Background: Child growth is an important health indicator in human’s lifespan. Evaluating growth variations in infants and children is highly important. This study was conducted to evaluate the risk factors of child growth retardation and determine childhood growth velocity in Zanjan province, Iran. Methods: This longitudinal study was conducted on 7892 children aged 0 to 2 years in Zanjan province in 2013. The sampling method was multi-stage cluster sampling. To determine the growth velocity, 2- pointed model was used. We applied the marginal models of generalized equation estimators (GEE). The related curves were obtained using LOWESS method, and data were analyzed using R Version 2.14.1. Results: In this study, 3879 (49%) of the participants were female, and the mean age of mothers was 27.1±5.4 years. Growth velocity had a significant association with gender, mother’s residency, multiple pregnancies, gestational age, and exclusive breastfeeding (p

Objective Foreign-origin street children are vulnerable to HIV/AIDS mainly due to poverty, violence, early sexual activity and poor access to health care services. This study aimed to highlight the effectiveness of peer education intervention to reduce HIV-risky behavior among street children with Afghan nationality. Methods Sixty-one street children were stratified by sex and then randomly allocated to either an intervention or control group by assigning each participant computerized random numbers. The intervention provided peer education services, focused on mode of disease transmission, prevention approaches and awareness of HIV/AIDS services by peers. Results At least 80% of participants in the intervention and control groups completed the study period, respectively. At the end of the study, statistically significant increase of knowledge and attitude improvement as well as a decreased tendency to do risky sexual intercourse among the intervention subjects was shown. Moreover, there was a time intervention interaction for knowledge and attitude improvements followed by intervention (interaction p value=0.001), while it was not significant for risky sexual behavior (interaction p value=0.44). Conclusion Peer education was an effective and easy-to-apply educational method that increased knowledge and improved attitudes about HIV/AIDS among foreign-origin street children, while it was less efficient with regard to long-term reduction in risky sexual behavior.

Background and Objective: Health literacy refers to a collection of skills, which enable the individuals to read, hear, analyze, and decide on the health-related issues. The possession of these skills by women have a significant effect on the improvement of health and happiness in their family and community. Regarding this, the aim of the present study was to determine health literacy level among the women referring to healthcare centers in Zanjan, Iran. Materials and Methods: This cross-sectional study was conducted on 323 women referring to the urban healthcare centers of Zanjan in 2016. The study population was selected using stratified random sampling technique. Data collection tools included a demographic questionnaire and Short Test of Functional Health Literacy in Adults. The data were analyzed in SPSS (version 21) using Pearson correlation test, t-test, and one-way ANOVA. Results: The mean health literacy among the participants was obtained as 71.56±17.8. According to the results, 22.6%, 22.3%, and 50.1% of the subjects had inadequate, borderline, and adequate health literacy, respectively. Furthermore, health literacy showed a significant relationship with education level (P

Background and Objective: Assessment and evaluation of quality of education and performance of academic departments at universities are highly important. A common model to evaluate performance of an organization and its branches is Balanced Score Card. This study aimed to develop a model based on Balanced Score Card and Analytic Hierarchical Process in order to assess the performance of academic departments of Zanjan School of Pharmacy. Materials and Methods: In this descriptive study, 24 academic members of six departments of Zanjan Pharmacy School and 100 pharmacy students were surveyed. Data was gathered through questionnaires and semi-structured interviews. Collected data was organized by Excel and then weighted and analyzed using Expert Choice software version11 and SPSS 16. Results: According to results, in the learning environment, growth and development dimension with weighted score of 0.377, customer (0.345), process (0.158) and financial perspective (0.121) were ranked respectively. Pharmaceutics and food and drug control departments achieved highest performance respectively. Conclusion: Findings of this research could be used to provide and develop an appropriate combination of BSC and AHP techniques to give an image of four perspectives application of BSC in educational environment and in addition it can be used in planning and promoting the performance of similar educational systems by improving the quality of performance assessment and ranking.

AIDS, including emerging disease that has no cure has been discovered for it and primary prevention is the only way to avoid it, Barbers are those who use sharp tools as a means for work and contamination of these devices is effective at infecting others. This study aimed to determine the knowledge, attitude and practice of the male and female barber carried about AIDS prevention in Zavjan. Methods: In this cross - sectional study involving questionnaires to examine the knowledge and attitude about AIDS among male and female barbers in Zanjan city who were selected randomly distributed the necessary information. Statistical analysis was then extracted information and considered. In this study we evaluated information of 375 questionnaires, of which among them 4.42 percent were male and 6.57 percent were female barbers. The average age of men is 34.85 ± 47 years, the average age of women is 34.25± 9.36 years and the mean age of the patients studied 36.9 ± 25.34 years.4.26 of low level of knowledge, 3.28% of moderate of knowledge and 4.45 percent had good knowledge. In attitude part 1.26 percent positive attitude and 1.62 percent acceptable attitude, and 7.11 percent had moderate attitude, knowledge and attitudes have positive relationship between gender, level of education and years of education. The results of this study showed that knowledge of the subjects is at relatively low levels, and among people with low literacy and the education and men and those with a history of less do not have AIDS majority of people in an appropriate level of awareness the propose future studies will also be considered in addition to the knowledge and attitude of the people.

Background: The demanding nature of nursing work environments signals longstanding and growing concerns about nurses' health and job satisfaction and the provision of quality care. Specifically in health care settings, nurse leaders play an essential role in creating supportive work environments to avert these negative trends and increase nurse job satisfaction. Objective: The purpose of this study was to examine the relationship between structural empowerment and organizational commitment of nurses. Methods: 491 nurses working in Zanjan hospitals participated in this descriptive-correlational study in 2010. Tools for data collection were Meyer and Allen’s organizational commitment questionnaire and “Conditions for Work Effectiveness Questionnaire-II” (CWEQ-II). Data was analyzed by SPSS16. The statistical tests such as variance analysis, t-test, pearson correlation coefficient and linear regression were used for data analysis. Results: According to the findings, the perception of nurses working in hospitals on "Structural Empowerment" was moderate (15.98±3.29). Nurses believed "opportunity" as the most important element in structural empowerment with the score of 3.18 ±0.79. Nurses working in non-academic hospitals and in non-teaching hospitals had higher organizational commitment than others. There was a significant relationship between structural empowerment and organizational commitment. Conclusion: Generally, structural empowerment (relatively strong) correlates with nurses’ organizational commitment. We concluded that a high structural empowerment increases the organizational commitment of nurses. Keywords: Structural empowerment, organizational commitment, nurses, Zanjan

Background: The association between Metabolic syndrome (MetS), its components and mortality has not been clearly established. The aim of this study was to determine the effects of Mets and its components on all cause and cause-specific mortality and to examine whether MetS or its components were better predictors of mortality. Methods: In this retrospective cohort study, we used data from the Zanjan Healthy Heart Study performed in 2003 on 4000 persons. Based on the definitions provided by the NCEP- ATPIII, 1051 participants with MetS and 1219 with none or one of its components at study entry were enrolled. Information regarding the mortality and morbidity of 502 participants with MetS and 523 controls was collected in 2013 by telephone. Cause of death was defined as Cardio-Vascular Disease (CVD) or non-CVD. Data were analyzed using the Cox Proportional Hazards model to estimate the hazard ratios predicted by MetS and its individual components. Results: The median duration of follow-up was 104±10.7 months. Thirty-five deaths occurred, including 18 cardiovascular deaths. The proportion of those with CVD, hypertension, diabetes or hospital stay was statistically higher in MetS patients than controls (p

Background Malaria re-introduction is a challenge in elimination settings. To prevent re-introduction, receptivity, vulnerability, and health system capacity of foci should be monitored using appropriate tools. This study aimed to design an applicable model to monitor predicting factors of re-introduction of malaria in highly prone areas. Methods This exploratory, descriptive study was conducted in a pre-elimination setting with a high-risk of malaria transmission re-introduction. By using nominal group technique and literature review, a list of predicting indicators for malaria re-introduction and outbreak was defined. Accordingly, a checklist was developed and completed in the field for foci affected by re-introduction and for cleared-up foci as a control group, for a period of 12 weeks before re-introduction and for the same period in the previous year. Using field data and analytic hierarchical process (AHP), each variable and its sub-categories were weighted, and by calculating geometric means for each sub-category, score of corresponding cells of interaction matrices, lower and upper threshold of different risks strata, including low and mild risk of re-introduction and moderate and high risk of malaria outbreaks, were determined. The developed predictive model was calibrated through resampling with different sets of explanatory variables using R software. Sensitivity and specificity of the model were calculated based on new samples. Results Twenty explanatory predictive variables of malaria re-introduction were identified and a predictive model was developed. Unpermitted immigrants from endemic neighbouring countries were determined as a pivotal factor (AHP score: 0.181). Moreover, quality of population movement (0.114), following malaria transmission season (0.088), average daily minimum temperature in the previous 8 weeks (0.062), an outdoor resting shelter for vectors (0.045), and rainfall (0.042) were determined. Positive and negative predictive values of the model were 81.8 and 100 %, respectively. Conclusions This study introduced a new, simple, yet reliable model to forecast malaria re-introduction and outbreaks eight weeks in advance in pre-elimination and elimination settings. The model incorporates comprehensive deterministic factors that can easily be measured in the field, thereby facilitating preventive measures. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1192-y) contains supplementary material, which is available to authorized users.

The existence of street and working children in Iran is undeniable. The precarious conditions of these children (including disrupted family, poverty, high prevalence of crime among relatives, family members and peers) cause social harm and high-risk behaviours, including drug addiction, selling sex or having sex with adolescents or peers. Here we explore the HIV, hepatitis B and hepatitis C status of street and working children in Tehran.One thousand street and labour children, aged 10-18 years, were recruited by using the time-location sampling method, and semistructured questionnaires were used to find demographic information and information on HIV/AIDS-related high-risk sexual behaviours. Blood samples were collected from children, with use of the dried blood sampling method.4.5% of children were HIV infected, 1.7% were infected with hepatitis B virus and 2.6% were infected with hepatitis C virus (HCV). Having parents who used drug, infected with HCV and having experience in trading sex significantly increased the likelihood of getting HIV among the street children of Tehran.HIV prevalence among street children is much higher than general population (0.1%), and in fact ,the rate of positivity comes close to that among female sex workers in Iran. These findings must be an alarm for HIV policymakers to consider immediate and special interventions for this at-risk group.

Additional file 1. An overview of the questioner for gathering information in foci affected by reintroduction of malaria transmission/outbreak.

CONTEXT The crucial role of academic leadership in the success of higher education institutions is well documented. Medical education in Iran has been integrated into the health care system through a complex organisational change. This has called into question the current academic leadership, making Iranian medical universities and schools a good case for exploring the challenges of academic leadership. OBJECTIVES This study explores the leadership challenges perceived by academic managers in medical schools and universities in Iran. METHODS A qualitative study using 18 face-to-face, in-depth interviews with academic managers in medical universities and at the Ministry of Health and Medical Education in Iran was performed. All interviews were recorded digitally, transcribed verbatim and analysed by qualitative content analysis. RESULTS The main challenges to academic leadership could be categorised under three themes, each of which included three sub-themes: organisational issues (inefficacy of academic governance; an overly extensive set of missions and responsibilities; concerns about the selection of managers); managerial issues (management styles; mismatch between authority and responsibilities; leadership capabilities), and organisational culture (tendency towards governmental management; a boss-centred culture; low motivation). CONCLUSIONS This study emphasises the need for academic leadership development in Iranian medical schools and universities. The ability of Iranian universities to grow and thrive will depend ultimately upon the application of leadership skills. Thus, it is necessary to better designate authorities, roles of academic staff and leaders at governance.

In Iran, restructuring of medical education and the health care delivery system in 1985 resulted in a rapid shift from elite to mass education, ultimately leading to an increase in the number of medical schools, faculties, and programs and as well as some complications. This study aimed to investigate views on academic culture, values, and routines held by faculty members. A nation-wide survey conducted in six public medical schools in Iran. The research findings show weak organizational culture and values, together with routine behaviors sensed as a negative and low satisfaction with academic leadership. The research evidence suggests bureaucracy, politicization, conservativeness, and centralization as common features of medical schools in Iran and also suggests suitable supervisory skills to tackle the tension between governmental management and academic leadership with cultural changes, the creation of new values, and adoption more efficient routines.

To explore the preferences of women; once at the time of delivery and then three months later, in using contraceptive methods during post partum period.A sample of 575 women who gave birth during July 2007 and February 2008 in Vali-Asre teaching hospital of Zanjan, were recruited and interviewed once after delivery and then three month later. The interview questions included demographic characteristic and questions assessing the tendency of mothers to use the contraceptives they preferred at time of delivery and three months later.According to 537 (93.4%) of interviewed mothers, they intended using at least one contraceptive after getting discharged from the hospital. This figure dropped to 438 (76.1%) three months after delivery. Women who expressed the desire to use minipill after delivery were 169 (29.3%). However this value rose to 187 (32.2%) three months later. The difference was not statistically significant. There was significant relationship between type of contraceptives used and women's age, number of children, place of residence and level of education three months following delivery.Results suggest that health care must focus extensively on giving necessary information and consultation to pregnant women also their partners to help to improve selection of most favourite and safe method of contraception.

Background During the last two decades, medical education in Iran has shifted from elite to mass education, with a considerable increase in number of schools, faculties, and programs. Because of this transformation, it is a good case now to explore academic leadership in a non-western country. The objective of this study was to explore the views on effective academic leadership requirements held by key informants in Iran's medical education system. Methods A nominal group study was conducted by strategic sampling in which participants were requested to discuss and report on requirements for academic leadership, suggestions and barriers. Written notes from the discussions were transcribed and subjected to content analysis. Results Six themes of effective academic leadership emerged: 1)shared vision, goal, and strategy, 2) teaching and research leadership, 3) fair and efficient management, 4) mutual trust and respect, 5) development and recognition, and 6) transformational leadership. Current Iranian academic leadership suffers from lack of meritocracy, conservative leaders, politicization, bureaucracy, and belief in misconceptions. Conclusion The structure of the Iranian medical university system is not supportive of effective academic leadership. However, participants' views on effective academic leadership are in line with what is also found in the western literature, that is, if the managers could create the premises for a supportive and transformational leadership, they could generate mutual trust and respect in academia and increase scientific production.

INTRODUCTION: Birthweight is one of the most important predicting indicators of the health status in adulthood. Having a balanced birthweight is one of the priorities of the health system in most of the industrial and developed countries. This indicator is used to assess the growth and health status of the infants. The aim of this study was to assess the birthweight of the neonates by using quantile regression in Zanjan province. METHODS: This analytical descriptive study was carried out using pre-registered (March 2010 - March 2012) data of neonates in urban/rural health centers of Zanjan province using multiple-stage cluster sampling. Data were analyzed using multiple linear regressions andquantile regression method and SAS 9.2 statistical software. RESULTS: From 8456 newborn baby, 4146 (49%) were female. The mean age of the mothers was 27.1±5.4 years. The mean birthweight of the neonates was 3104 ± 431 grams. Five hundred and seventy-three patients (6.8%) of the neonates were less than 2500 grams. In all quantiles, gestational age of neonates (p0.05).CONCLUSION: This study revealed the results of multiple linear regression and quantile regression were not identical. We strictly recommend the use of quantile regression when an asymmetric response variable or data with outliers is available.

This retrospective study aimed to address whether or to what extent spatial and non-spatial factors with a focus on a healthcare delivery system would influence successful tuberculosis (TB) treatment outcomes in Urmia, Iran. In this cross-sectional study, data of 452 new TB cases were extracted from Urmia TB Management Center during a 5-year period. Using the Geographical Information System (GIS), health centers and study subjects’ locations were geocoded on digital maps. To identify the statistically significant geographical clusters, Average Nearest Neighbor (ANN) index was used. Logistic regression analysis was employed to determine the association of spatial and non-spatial variables on the occurrence of adverse treatment outcomes. The spatial clusters of TB cases were concentrated in older, impoverished and outskirts areas. Although there was a tendency toward higher odds of adverse treatment outcomes among urban TB cases, this finding after adjusting for distance from a given TB healthcare center did not reach statistically significant. This article highlights effects of spatial and non-spatial determinants on the TB adverse treatment outcomes, particularly in what way the policies of healthcare services are made. Accordingly, non-spatial determinants in terms of low socio-economic factors need more attention by public health policy makers, and then more focus should be placed on the health delivery system, in particular men’s health.