---

Introduction: Oral health is an important public health issue that influences general health and quality of life. Mothers are key persons in families paying attention to whom not only guarantees their oral health, but also the oral health of the family members. Therefore, this study aimed to determine the dental service demand status and its related factors among mothers in Yazd city. Materials & Methods: In this cross-sectional survey, total numbers of 300 mothers in urban areas of Yazd city were selected by cluster random sampling. Data was collected by a researcher designed questionnaire which validity was approved by a panel of experts and were completed by mother’s private interview. Results: Twenty seven percent reported that they use dental services less than 1 time per year, 28% reported 1 time per year and 45% reported more than one time per year. Only 30.7% had a regular check up program every six months. Annual dental services utilization rate was in relationship to educational level, receiving dental treatment source, the rate of a parent's attention to oral health, receiving oral health information source, socioeconomic status and deprivation from dental treatment because of financial problems. Having a dental check-up plan also was in relation to the above variables and income level. Conclusion: Demand for dental care among women is sophisticated and is in related to a variety of factors such as education level, financial issues, cultural issues, availability and accessibility of oral health services and cues to action. Addressing the above factors in intervention programs aimed to increase dental care utilization among women is recommended

---

Introduction: Malignant melanoma is a fatal cutaneous neoplasm and one of the fastest growing cancers worldwide. The objective of this study is to evaluate the prevalence of melanoma in different cultural settings and the probable role of clothing for prevention.Materials and Methods: In this cross-sectional study, data about diagnosed melanoma patients in Kerman Province, Iran including age, pathology, sex, location, and site of skin involvement, were obtained from the Kerman and Rafsanjan Cancer Registries from 2005 to 2009. Similar data related to melanoma incidence in Victoria, Australia were obtained from the Victorian Cancer Council, Melbourne. Incidence by age, sex and site of skin was calculated in both Kerman Province and Victoria State. Then the incidence differences for exposed and unexposed limbs were calculated and compared. Results: Melanoma incidence in Kerman was 5.7 in million annually. Incidence in men was higher than women. The highest incidence was seen in 70-79 years of age. Most cases of melanoma (30%) were localized in the face. Incidence in Victoria State was 431.9 in million annually. The incidence in men was more than women. The highest incidence was seen above 80 years of age. Most of the cases (30.1%) of melanoma were seen in the trunk and then arm with 22.1%. The incidence difference between the two nations was significant except for the hands and male’s feet. Conclusion:The present study suggests that clothing is possibly preventing about 25.7, 37.4 and 72.6 cases of melanoma respectively in the trunk, arm and leg in 1,000,000 people annually in Iran.

---

Introduction: Attention to food safety and health at all stages from production to consumption is inevitable. Inappropriate sanitary status of the food production, distribution and supply centers caused food-borne diseases. The aim of this study was to evaluate the environmental health indicators of halva and tahini production centers in the city of Ardakan in 2013. Materials & Methods: This is a descriptive, cross- sectional study. For data collection, the checklist were prepared consisting 5 part raw materials store, production processing halls, packaging halls, product store and bathrooms according to regulations form of article 13, law of edible, drinking, cosmetics materials of the department health, treatment and medical education with questions in different fields such as health card status, observance personal hygiene, status production centers structural, observance the criteria about the number of bathrooms, showers and toilets, wastewater disposal method and observance health principles in the halva and tahini production centers that during a inspection from 16 production centers were completed in the winter. Final, obtained data analyzed by SPSS, version 18 and χ2 test. Results: Generally, 75% production centers had favorable hygienic status and 25% had slightly favorable hygienic status. According to obtained results, hygienic status of production centers had relatively favorable and favorable conditions and only in January and February in 31.3% and 18.8% processing hall and 12.5% product store was in a very favorable hygienic status. The results showed that in terms of environmental health status, 62.5% production centers in raw materials store part, 66.66% in production processing hall, 20.83% in packaging hall, 60.41% in product store and 37.5% in bathrooms had favorable status. Based on the results, hygienic status of bathrooms and processing hall achieved lowest and highest score, respectively. Statistical analysis showed that between hygienic status and production rate (p=0.411) there is no significant relationship. Conclusion: The results of this study indicate that the halva and tahini production centers of Ardakan city in terms of environmental health indicators had slightly favorable status to favorable and none of the production centers had not very favorable conditions. The results of this study can be used to improve health status of halva and tahini production centers.

---

Introduction- Satisfaction as a key indicator of health care quality is important for development, recognition and treatment of people in need. The aim of this study was to determine the rate of satisfaction of referral people to health center of Yazd city. Materials and methods: This was a descriptive analytic (cross- sectional) study. The participants were 360 clients referred to 13 health centers of Yazd city whom were selected by simple sampling methods. The data was collected by a standard questionnaire. After collection, the data were analyzed by SPSS 18 and descriptive tables and ANOVA and T-test. Results: The mean age of participants was 32.81±9.96 of which 135(37.6%) were male and 224(62.2%) were female .About 303(62.2%) were married. 187(51.9%) were university educated and 15(4.2%) were illiterate. Results showed that more than 94% satisfaction of participants from the time was moderate. The satisfaction of 49.4% of participants by the behavior of employees was good . Conclusion: Results of the present study showed that the most discontent was of equipment, which should be considered in Planning by authorities.

---

Introduction: Malignant melanoma is a fatal cutaneous neoplasm and one of the fastest growing cancers worldwide. The objective of this study is to evaluate the prevalence of melanoma in different cultural settings and the probable role of clothing for prevention. Materials and Methods: In this cross-sectional study, data about diagnosed melanoma patients in Kerman Province, Iran including age, pathology, sex, location, and site of skin involvement, were obtained from the Kerman and Rafsanjan Cancer Registries from 2005 to 2009. Similar data related to melanoma incidence in Victoria, Australia were obtained from the Victorian Cancer Council, Melbourne. Incidence by age, sex and site of skin was calculated in both Kerman Province and Victoria State. Then the incidence differences for exposed and unexposed limbs were calculated and compared. Results: Melanoma incidence in Kerman was 5.7 in million annually. Incidence in men was higher than women. The highest incidence was seen in 70-79 years of age. Most cases of melanoma (30%) were localized in the face. Incidence in Victoria State was 431.9 in million annually. The incidence in men was more than women. The highest incidence was seen above 80 years of age. Most of the cases (30.1%) of melanoma were seen in the trunk and then arm with 22.1%. The incidence difference between the two nations was significant except for the hands and male’s feet. Conclusion: The present study suggests that clothing is possibly preventing about 25.7, 37.4 and 72.6 cases of melanoma respectively in the trunk, arm and leg in 1,000,000 people annually in Iran.

---

Introduction: Heavy metals widely used in the industrial and refining activities are frequently detected in sediments. The main objectives of this research were focused on determining the concentration of Cd and Pb in the sediments of Asaluyeh and compare with the standard. Methods: The concentration of Pb and Cd in the sediments of Nayband Bay area (contaminated area) and Lavar-e Saheli (control area) were measured. In the summer of 2013, the samples of sediment were collected from 40 stations. The samples were digested using the method Yap 2002 and analyzed by atomic absorption spectrophotometer. Results: The median concentration of Pb and Cd in the sediments collected from Nayband ranged from 3.56 to 5.25 μg/gdw and 1.16 to 1.44 μg/gdw, respectively. The concentrations of Pb and Cd in most of the sediment samples in the study area were higher than the Persian Gulf standards. Conclusion: Therefore, it is essential to use abatement efforts to clean-up the polluted areas in the coastal area of the Asaluyeh Bay and prevent the discharging of the untreated or partially treated wastewater to the Persian Gulf as well.

---

Introduction: Humic acid (HA) is one the original disinfection byproducts processors in water treatment. So, removing it is necessary before water chlorination. In the present study, photodegredation of humic acid in water using Ag/ZnO nano particle under UVc irradiation in batch system was investigated. Material and Methods: Photocatalytic study was carried out to evaluate the effect of UVc (15w), irradiation time of (10 - 40min), pH (5 - 9), initial humic acid concentration of (10-50 mg/L) and Ag/ZnO dosage of (0.2 – 0.8 g/L) on humic acid removal. HA concentration was monitored spectrophotometrically by measuring the HA absorbance at 254 nm. Results: HA removal efficiency was obtained 88% at pH 7, Ag/ZnO dosage 0.6 g/L, initial humic acid concentration 25 mg/L and irradiation time 40 min. The removal of HA from aqueous solution increased by increasing irradiation time and decreasing initial HA concentration. Also, the kinetic study was consistent with pseudo-first order reaction. Conclusion: The results showed that photocatalytic degredation process using Ag/ZnO nanoparticles can be used efficiently for HA removal from aqueous solutions.

---

Introduction: Nickel is found in varies industrial processes such as electroplating, leather tanning, cement preservations, paints and pigments, textile, steel fabrication and canning industries. It is proved that Ni(II) has several health hazards such as carcinogenic. The aim of this study was the evaluation of Ni(II)adsorption on Apple peel granola from aqueous solution.
 Material and Methods: This study was done in laboratory scale and batch condition. In this study, the effects adsorbent dose, contact time and pH were investigated on the removal of nickel by batch process. The Apple peels granola prepared in lab conditions, and sieved by standard sieves of 60-100 mesh. The nickel concentration in standard and unknown samples was measured by AA spectrophotometer. For understanding of the adsorption process, the experimental data were analyzed with some isotherm and kinetic models.
 Results: The maximum removal at was found in pH= 7. The nickel removal efficiency decreased from 50.1 to 25% by increasing adsorbent dosage. By increasing of pH from 3 to 7, the removal efficiency increased from 19.8% to 35.0% at 30 min contact time. The adsorption isotherm and Kinetic analysis of our results showed that the results well fitted by the Frundlich isotherm model (R2= 0.909) and pseudo-first-order kinetic model (R2= 0.926).
 Conclusion: the results showed that Apple peel granola is able to absorb the nickel from aqueous solutions and removal efficiency was more in pH=7. Preparing of Apple peel granola adsorbent is simple, cheap and its application is in priority because of its porous structure in comparison with other natural adsorbents.

---

Abstract

Introduction: Death is defined as the permanent loss of all signs of life at any time after birth (Irrevocable disappearance of all vital signs after birth). Unnatural deaths seem to be either suspicious or  unexpected. Deaths that occur suddenly and their causes need to be investigated, are termed unnatural deaths. According to the death certificate contents of Ministry of Health and Forensics, if the cause of death is unnatural, the corpse will be submitted to the forensic medicine departments in 19 cases in order to determine the death cause and to issue the burial permit.  

Material & Methods: In this descriptive study, the data were extracted from unnatural death cases in the province of Yazd during 2003 to 2013 recorded by Yazd Forensic Medicine. 

Results: During 2003 -2013, 5552 cases of unnatural deaths were recorded by the Forensic Medicine of Yazd, out of which 4373 cases of unnatural deaths were caused by road traffic accidents (outside and inside the city), 89 deaths from electrocution, 439 deaths from poisoning, 72 deaths from drowning, 129 deaths from asphyxia (by carbon monoxide), 56 deaths from work incidents, and 394 deaths from burns. The group of males aged 20-29 years allocated the highest number of unnatural deaths to themselves.

Conclusion: Road traffic accidents are the second leading cause of unnatural deaths in Iran. The number of unnatural death incidents in men is more than women indicating that men are more exposed to risk factors than women, though regarding the deaths due to the burns, women are exposed to the high risk factors. 

---

Introduction: Nowadays, use of virtual socail networks is increasing . However, few studies have been conducted  about  factors influencing the use of social networks by using theories of health education  among students.  The present study was to determine predictive factors of virtual social networks among students of Yazd university of medical sciences based on the constructs of the Theory of Planned Behavior.

Methods: This cross-sectional study was conducted on 300 Students in 2016, who were selected by stratified random sampling method. The  study data was collected from a questionnaire based on the constructs of the Theory of Planned Behavior including attitudes, subjective norms, perceived behavioral control, and behavioral intentions and behaviors. The data collected were then analyzed via the SPSS Software using descriptive statistics, Pearson product-moment correlation test, one-way analysis of variance, and regression.

Results: The mean age of university students was 22.28±3.69 years. The results also suggested that 98.3% of these university students were using virtual social networks. Moreover, the findings of the regression analysis indicated that attitudes, subjective norms, and perceived behavioral control were predictors of intention to use social networks and attitudes had the highest predictive power for the intention to use social networks (β=0.38). Furthermore, the results of the regression analysis demonstrated that behavioral intention, attitudes, and subjective norms among the constructs of the Theory of Planned Behavior could predict the behavior to use virtual space.

Conclusion: Given the high level of social networking utilization, the necessity of planinig and doing of interventions should be noted to manage it. It is also required to induce and educate the correct attitude about the use of network and how to take advantage of  it 

---

---

Introduction: It is generally accepted that cutaneous leishmaniasis is an important health problem in the world which is caused by leishmaniasis protozoan. This disease is also considered as a health problem in some regions of Iran including Bushehr province. The present study investigated the geographical dispersion and epidemiological characteristics of subjects with the cutaneous leishmaniasis in this province during 2011-2015.

Methods: In this cross-sectional and analytical study, the epidemiologic data including the age, gender, residential area, and counties with this disease was analyzed and collected from 663 patients who were followed up and treated during 2011 to 2015.

Results: 422 (63.7%) of studied people were residents of urban areas and 241 (36.3%) lived in rural areas. 59.4% (394 people) were male and 40.6% (269) were female. The mean age of subjects was 21.91± 17.01 (ranging from 1 to 80 years). Kangan County with an average 5-year incidence of 17.72 per a hundred thousand people had the highest incidence, but Tangestan County with the incidence of 8.47 per a hundred thousand people had the lowest average incidence. Based on GIS results, Jam County, which was not recognized as the focus of this disease in the past, has been considered as a new focus of disease in recent years.

Conclusion: The geographic information system (GIS) is an effective tool for the organization of diseases and health data. The crisis can be identified and controlled by taking proper measures with the discovery of spatial accumulation of diseases.

---

Dear Editor,
According to the International Agency for Research on Cancer (IARC), Asia has the highest death rates and incidence of breast cancer; 27% of all cancers that occur among women in Iran are attributed to breast cancer. The role of obesity in breast cancer development has been known for decades. S strong evidence exists on the idea that obesity and weight gain during adulthood are associated with increased risk of postmenopausal breast cancer. Furthermore, growing evidence is available on the association of obesity with breast cancer and overall mortality rate in women’s premenopausal and postmenopausal periods (1).
Evaluation of the breast cancer risk helps identification of the women with the high risk of developing breast cancer in the future. Some strategies to reduce this risk involve adopting a healthier lifestyle as well as involving diet and exercise in everyday life (2).
Obesity and overweight are defined by Body Mass Index (BMI). The effect of high BMI on breast cancer was assessed in selected studies using the odds ratio (OR). The results of the data analysis using the random effects method showed that the risk of breast cancer was higher among the people with obesity (BMI ≥ 30): Pooled OR = 1.81, 95% CI = 1.24 - 2.64 and for overweight (30 > BMI ≥ 25): Pooled OR = 1.46, 95% CI = 1.13 - 1.89(3).
According to the care plan for risk factors in non-communicable diseases (Steps 2016), the prevalence rates of obesity and overweight were 29.77% and 34.96% among Iranian women, respectively. Furthermore, population-attributable fractions of these diseases were 13.32% and 11.01%, respectively, which indicates that by eliminating obesity and overweight factors, we can expect 24.33% reduction in the population’s breast cancer.
For instance, a well-designed randomized controlled trial in children with a particular disease found that 20% of the control group developed
bad outcomes compared with only 12% of the individuals who received treatment. Absolute risk reduction (ARR) – also called risk difference
(RD) – is the most useful way of presenting research results to help your decision-making. In this example, the ARR is 8% (20% - 12% = 8%), which means that, if 100 children were treated, 8 would be prevented from developing bad outcomes. Another way of expressing this is the number needed to treat (NNT); that is the number of people who must be treated to benefit one person. It is the inverse of absolute risk reduction. If 8 children out of 100 benefit from a treatment, the NNT for one child to benefit is about 13 (100 ÷ 8 = 12.5)(4).
A randomized, controlled, primary prevention trial was conducted in 40 US clinical centers from 1993 to 2005. In this study, a total of 48,835 postmenopausal women, aged 50 to 79 years, without prior breast cancer were enrolled. Women were randomly assigned into the dietary modification intervention group (40% [n = 19,541]) and the control group (60% [n = 29,294]) (5). The baseline characteristics of BMI and breast cancer incidence indicated that overweight ARR rate equals 0.0025 that is 0.25% (NNT: 400), obesity ARR equals 0.0012 i.e., 0.12% (NNT: 833.33) and obesity grade 2 and more equals 0.0033 that is 0.33% (NNT: 303.03). In other words, by treating 400 patients suffering from overweight and 833.33 patients suffering from obesity, we can prevent one case of breast cancer.
Overweight, obesity, and abdominal fat are associated with the risk of developing breast cancer in women during the premenopausal and postmenopausal periods. Therefore, in order to prevent breast cancer and its complications, an intervention program should be implemented to control obesity and a breast cancer screening program should be conducted among the obese and overweight women (6).
Governments are responsible for maintaining, restoring, and promoting health in the community. In order to make the right decisions and direct resources of the health sector, the most common cancer in women should be investigated as a priority for the health system. Therefore, a special study of breast cancer is necessary considering the mortality rate and disability. In this regard, we decided to investigate the most relevant risk
factor and evaluate the risk associated with breast cancer by reviewing articles related to breast cancer. Later, we examined the most effective interventional strategies in this area. Consequently, given high prevalence of the overweight and obesity, intervention plans should be implemented to reduce the risk factors of the breast cancer.

---

 
Introduction: Social and organizational supports are effective factors closely related to job burnout and Due to the limited studies in this area on Iranian workers, this study aims to determine the predictability of social support and organizational support in  job burnout for workers in Yazd.
Methods: This cross-sectional study was carried out among 200 textile workers in Yazd through stratified random sampling. The data were collected by the tools including demographic characteristics, questionnaires of social support, organizational support, and Maslach's job burnout. The data were analyzed by SPSS using the Pearson correlation coefficient and the multiple linear regressions. The Significance level of tests was considered as p <0.05. 
Results: There was a significant strong positive relationship between job burnout and emotional exhaustion (r= 0.88) (p <0.001 (. There was found a significant negative correlation between job burnout and social support (r =- 0.390), friend support (r= -0.401), family supoert (r= -0.218), important others support (r= - 0.283) (p <0.001 (. Multiple linear regression analysis showed that 17.8% of the changes in job burnout were explained by friends, family, and important others support (R²=0.178, p<0.001) whereas support from friends was the strongest predictor of job burnout (β= - 0.338, p <0.001). Social and organizational support explained 35.9% of the changes in job burnout (R²= 0.359, p<0.001) with organizational support being the strongest predictor of  job burnout (β= - 0.472, p<0.001).

Conclusion: Given that organizational support was the most significant predictor of job burnout in workers, developing organizational interventions to increase support in workplace can be regarded as effective strategy to reduce or slow down job burnout among workers.

---

Abstract
Introduction: The World Health Organization on March 11, 2020 declared the outbreak of severe acute respiratory syndrome Corona virus 2 disease (COVID-19) a pandemic situation. The main aim of this study was investigating mortality of COVID 19 by considering chronic diseases.
Materials and methods: this study was conducted as a cross-sectional in which all confirmed cases were examined. The variables considered in this study were age, sex, diabetes mellitus, cancers, hypertension, heart diseases, kidney diseases, and liver diseases. Independent sample t test, Chi-square and binary logistic regression were used to data analysis. All statistical analysis was done in SPSS 16 and significant level was set at 0.05.
Results: Out of 22849 PCR and CT scan tests, 16061 ones were positive. According to the confirmed cases, prevalence of COVID-19 was calculated about 0.019. Also hospital case fatality rate and mortality rate were calculated 156 and about 8.2 per 100000 respectively.
 Hypertension, and age had significant relationship with morbidity of COVID-19, in other hand, age (OR: 4.51, p<0.001), kidney diseases (OR: 1.84, p<0.001), diabetes mellitus (OR: 1.31, p<0.001), cancer (OR: 2.73, p<0.001), liver diseases (OR: 2.27, p<0.001) had impact on mortality of covid-19. Population Attributable Fraction (PAF) showed that diabetes mellitus, cancers, kidney diseases, and liver diseases had 4.2, 2.4, 1.3, and 0.2 percent, respectively.
Conclusion: age and some underlying diseases increase odds of death due to COVID-19. It seems that preventing high-risk people from being infected is an effective solution to reduce COVID-19 death rate. To do this, health protocols need to be implemented more seriously for these sensitive groups.

 

---

Background: Finding meaning in life reduces stress and increases life expectancy in human beings. The purpose of this study was to examine the lived experiences of women recovered from breast cancer and the meaning of their lives.

Methods: This qualitative study was performed on cured women with breast cancer, who referred to Yazd cancer medical centers in January and February, 2021. Eleven women with breast cancer who have been healthy for at least 5 years were interviewed based on theoretical saturation, and purposeful, in-depth and semi-structured talks. Due to COVID-19 condition, all interviews were done by telephone the interviews were analyzed using the Colaizzi's method of data analysis.

Results: Data analysis led to the emergence of a main theme called individual and social development and four sub-themes including spiritual perfection, oneness, individual well-being and social growth. The patients saw cancer as an opportunity to reflect their own values and goals and to correct them in order to draw themselves closer to spirituality and to love other beings.
Conclusion: Achieving perfection, personal growth, striving for well-being and social interest play a significant role in life experiences of women recovered from cancer. Findings of this study can be used as a conceptual basis for designing meaningful teaching intervention models for patients who have recently been diagnosed with cancer.

---

Background: Internet addiction can affect students' general health. Regarding to the importance of healthy eating and the impact on health and academic achievement of students. This research was conducted to aim the assessment of relationship between internet addiction and dietary behavior among students.
Methods: In this an analytical cross-sectional study, 373 nursing and midwifery students of Tehran University of Medical Sciences participated in 2020. Data were collected by Young's Internet Addiction Scale, demographic data and Dietary Behavior questionnaire. Data analyzed by SPSS V.21 and descriptive indicators including frequency, percentage, and inferential tests including chi-square test. A significance level of less than 0.05 was considered.
Results: The majority of the student population had no internet addiction by 91.4%. Also, 8.3% and 0.3% from student population were potential risk and high risk respectively. There was a statistical significant correlation between levels of internet addiction and dietary behavior in high-fat diets (r = 0.483, P = 0.004), snacking (r = 0.455, P > 0.001), emotional eating behavior (r = 0.543, P > 0.001) and poor dietary pattern (r = 0.632; P < 0.001).
Conclusions: It is suggested to improve students' beneficial use of the internet with training and improve their dietary behavior.

---

Background: The present study was conducted to develop and validate the Persian version of the Volition in Exercise Questionnaire (VEQ).

Methods: The statistical population of the analytical cross-sectional    research was the students of Kashan University of Medical Sciences in 2022, selected using two-stage cluster random sampling.  Confirmatory factor analysis was used to fit the measurement model and factors obtained from exploratory factor analysis.The reliability of the questionnaire was assessed using Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) and its validity was evaluated using face validity, content validity, and construct validity.The SPSS software version 24 and AMOS software version 24 were used for data analysis.

Results: Descriptive findings showed that 310 questionnaires were completed (mean age: 21.94 ± 3.03 years).CVR, CVI, and impact score were calculated for each question. After calculating the CVR coefficients, all questions had a CVR above 0.99. All questions had a CVI above 0.79. In quantitative face validity, all questions had an impact score of ≥ 1.5 and therefore remained in the questionnaire. Exploratory and confirmatory factor analysis led to the extraction of five factors and the model had a good fit and the values and parameters of the model were statistically significant (χ2/df: 2.15, CFI: 0.915, TLI: 0.884 RMSEA: 0.07). The results showed that the overall Cronbach's alpha coefficient calculated for the tool and its factors were acceptable (0.894). Also, the stability of the questionnaire with a 2-week interval showed satisfactory results (overall ICC: 0.576

Conclusion:   The results confirmed the measurement model and showed that the obtained factors had a favorable fit as the original version.