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Awareness of Lassa Fever in a Rural Community in South West Nigeria آگاهی از تب لاسا در جامعه روستایی در جنوب غرب نیجریه 2 2 Background: Lassa fever is an acute, virulent viral haemorrhagic illness with high morbidity and mortality rates. Its awareness remain low in sub urban or rural community. This study was carried out to assess the awareness of Lassa fever of a rural community in the south western part of Nigeria. Methodology: A descriptive cross sectional study of 122 respondents prior to a sensitization seminar on Lassa fever was carried out at Ijebu – Owo, Owo in Ondo State. Interviewer guided questionnaire was used to collect information and analysed with SPSS version 21. Descriptive statistics were done and frequencies and proportions were used to summarize variables of interest. Association between socio-demographic characteristics and awareness were explored using chi square. Level of significance was set at 5%. Results: The mean age of the respondents was 54.5±19.2years. Of the 122 respondents, 50.8% were males, three out of four (73.8%) were married, and 87.7% had secondary education and below. Those who had previously heard about Lassa fever were 17.2%. In all 7(46.7%) who had tertiary education had previously heard about Lassa fever compared to 14(13.1%) respondents who had secondary education and below (p=0.001) Conclusion: The study showed that there was poor awareness of Lassa fever among members of the community. Thus efforts should be made to increase the awareness of the populace through health campaigns, and to reduce the spread of both the vector and the virus. 1 10 2015/02/6 1393/11/17 2015/06/9 1394/3/19 Olayinka Ilesanmi Olayinka Ilesanmi Department of Community Health, Federal Medical Centre, Owo, Ondo State, Nigeria ileolasteve@yahoo.co.uk Bridget Omotoso Bridget Omotoso Department of Community Health, Federal Medical Centre, Owo, Ondo State, Nigeria toshama@yahoo.com Faith Alele Faith Alele Department of Community Health, Federal Medical Centre, Owo, Ondo State, Nigeria blazinggold4real@yahoo.com Peter Adewuyi Peter Adewuyi NIgeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria peter.adewuyi@gmail.com Lassa fever Mortality Environmental hygiene Health campaign Awareness Lassa fever mortality environmental hygiene health campaign awareness 1. Buchmeier MJ, de la Torre JC, Peters CJ. Arenaviridae: The viruses and their replication. Fields Virology, eds Knipe DM, Howley PM (Lippincott Williams & Wilkins, Philadelphia), 5th Ed, 2007:1791-1827.##2. Bowen MD, Rollin PE, Ksiazek TG, et al. Genetic diversity among Lassa virus strains. Journal of Virology. 2000;74:6992–7004.##3. Richmond, JK, Baglole DJ. Lassa fever: epidemiology, clinical features and social consequences. BMJ.2003;327:1271-1275##4. Gunther S, Emmerich P, Laue T, et al. Imported Lassa fever in Germany: molecular characterization of a new Lassa virus strain. Emerging Infectious Disease journal. 2000; 6:466–476.##5. McCormick JB, Webb PA, Krebs JW, et al. A prospective study of the epidemiology and ecology of Lassa fever. The Journal of Infectious Disease. 1987;155(3):437-44.##6. Frame JD, Baldwin JMJ, Gocke DJ, et al. Lassa fever, a new virus disease of man from West Africa. I. Clinical description and pathological findings. The American Journal of Tropical Medicine and Hygiene. 1970;19(4):670-6. ##7. McCormick JB, Webb PA, Krebs JW, et al. A prospective study of the epidemiology and ecology of Lassa fever. The Journal of Infectious Disease.1987;155:437-44.##8. Kelly JD, Barrie MB, Ross RA, et al. Housing equity for health equity: a rights based approach to the control of Lassa fever in post war Sierra Leone. BMC International Health and Human Rights.2003; 13:2 doi:10.1186/1472- 698X-13-2 ##9. Healing T, Gopal R. Report on an assessment visit to Sierra Leone, April 12th-30th 2001. London: Merlin, 2001.##10. Keenlyside RA, McCormick JB, Webb PA, et al. Case-control study of Mastomys natalensis and humans in Lassa virus-infected households in Sierra Leone. The American Journal of Tropical Medicine and Hygiene .1983;32: 829-37##11. Fisher-Hoch SP. Lessons from nosocomial viral hemorrhagic fever outbreaks. British Medical Bulletin. 2005;73-74(1):123-137.##12. Weber DJ, Rutala WA. Risks and prevention of nosocomial transmission of rare zoonotic diseases [review]. Clinical Infectious Disease. 2001; 32:446-56.##13. McCormick JB, King IJ, Webb PA, et al. A case-control study of the clinical diagnosis and course of Lassa fever.The Journal of Infectious Disease. 1987; 155: 445-55.##14. Bausch DG, Demby AH, Coulibaly M, et al. Lassa fever in Guinea: I. Epidemiology of human disease and clinical observations. Vector Borne and Zoonotic Disease. 2001;1(4):269-281.##15. Ibekwe TS, Okokhere PO, Asogun D, et al. Early-onset sensorineural hearing loss in Lassa fever. European Archives of otorhinolaryngology. 2011; 268(2):197-201. ##16. Inegbenebor U, Okosun J, Inegbenebor J. Prevention of Lassa fever in Nigeria. Transaction of Royal Society of Tropical Medicine and Hygiene. 2010;104(1):51-54.##17. Hadi CM, Goba A, Khan SH, et al. Ribavirin for Lassa fever postexposure prophylaxis. Emergency Infectious Disease. 2010;16(12):2009–2010.##18. Nigeria center for disease control, NCDC 2014: Weekly Epidemiology Report, WER-Nigeria, 4th. 2014;4(13).##19. Bonner PC, Schmidt WP, Belmain SR, et al. Poor housing quality increases risk of rodent infestation and Lassa fever in refugee camps of Sierra Leone. The American Journal of Tropical Medicine and Hygiene. 2007;77(1):169–175.##20. Tobin EA, Asogun DA, Isah EC,et al. Assessment of knowledge and attitude towards Lassa fever among Primary care providers in an endemic suburban community of Edo state: implications for control. Journal of Medicine and Medical Sciences. 2013;4(8):311-318.##21. Titus I. Lassa fever: the challenges of curtailing a deadly disease. The Pan African Medical Journal. 2012;11(55) PMCID: PMC3343683##22. Moses L, Kargbo K, Koninga J, et al. Household predictors of abundance of the Lassa virus reservoir, Mastomys natalensis, in the Eastern Province of Sierra Leone. Abstract, 58th annual meeting of the American Society of Tropical Medicine and Hygiene. Washington: DC; 2009. ##23. Kelly JD, Barrie MB, Ross RA, et al. Housing equity for health equity: a rights-based approach to the control of Lassa fever in post-war Sierra Leone. BMC International Health and Human Rights. 2013,13:2 doi:10.1186/1472-698X-13-2##24. Ter Meulen J, Lukashevich I, Sidibe K, et al. Hunting of peridomestic rodents and consumption of their meat as possible risk factors for rodent-to-human transmission of Lassa virus in the Republic of Guinea. The American Journal of Tropical Medicine and Hygiene. 1996;55(6):661-66##25. Asogun D, Okokhere P, Okogbenin S, et al. Lassa fever awareness and practices in a Nigerian rural community. International Journal of Infectious Diseases March. 2010;14(1):e191-e335#### ##

The Role of Women's Employment on Family Social Health Case study –Tehran, Districts 1, 2, 19 & 20 نقش اشتغال زنان بر سلامت اجتماعی خانواده ،مطالعه موردی در مناطق 1، 2، 19و 20 تهران 2 1 مقدمه: افزایش مشارکت زنان در زمینه اشتغال و فعالیت های اقتصادی باعث افزایش رفاه اجتماعی، سطح تولید و کیفیت زندگی می گردد. هدف پژوهش بررسی نقش اشتغال زنان بر سلامت اجتماعی خانواده در مناطق 1 و 2و 19و 20 تهران می باشد. روش پژوهش: پژوهش از نظر هدف کاربردی، از نوع توصیفی - علی، مقایسه ای می باشد. جامعه پژوهش خانوارهای شهر تهران بود که 3000850 خانوار بودند. نمونه با روش نمونه گیری خوشه ای چند مرحله ای انتخاب شده بود و با کمک فرمول کوکران 384 شد. از پرسشنامه استاندارد (کییز) برای سنجش سلامت اجتماعی استفاده شد. برای تجزیه و تحلیل داده ها از شاخص های آمار توصیفی و آمار استنباطی مثل (آزمون خی دو ،t ، تحلیل واریانس) استفاده شد. یافته ها: بین اشتغال زنان و سلامت اجتماعی خانواده رابطه مثبت و معناداری وجود دارد. بین مولفه های سلامت اجتماعی و اشتغال زنان رابطه معنادار و مثبت وجود. اشتغال زنان تاثیری بر انسجام اجتماعی و مشارکت اجتماعی خانواده ندارد. نتیجه گیری: اشتغال زنان نقش اثرگذاری بر سلامت اجتماعی خانواده می گذارد، لازم است سیاستگذاران و برنامه ریزان با فرهنگ سازی در سطح جامعه بستر ساز فضای سالم در جامعه باشند. 2 Introduction: Increasing women's employment and economic activity increases social welfare, productivity and enhance the quality of life. The aim of this study was to investigate the role of women's employment and social health of families in Regions 1, 2, 19 and 20 in Tehran. Material ;Methods: The study was applied research, descriptive and causal - comparative or retrospective The study sample included all households in Tehran who were 3000850 The sample was selected using a multistage cluster sampling and by helping formulation Cochran was 384. Standardized questionnaire (Keyes) was used to measure social health. For data analysis, descriptive statistical criteria (mean, median, mode and standard deviation) and inferential statistics such as (chi-square test, t, and analysis of variance) were used. Results: Findings showed a significant positive relationship between women's employment and social health of the family. There are significantly and positively relation between Component of social health (social acceptance, social adaptation, social prosperity) and women's employment. There isn’t relationship between Women's employment and social cohesion and social participation. Conclusions: Woman employment affects family social health. Managers must have attention to Woman employment in their strategic plan to creating healthy socia 11 18 2015/02/62015/06/14 1394/3/24 2015/06/92015/06/14 1394/3/24 سعید هیئتی کادیجانی Saeid Hayati Kadijani Department of Social Sciences, faculty of Social Sciences, Roudehen Branch, Islamic Azad University, Roudehen, Iran. ایران مهرنوش جعفری Mehrnoush Jafari Department of Social Sciences, faculty of Social Sciences, Roudehen Branch, Islamic Azad University, Roudehen, Iran. ایران mehr_j134@yahoo.com Women's employment Family Social Health سلامت اجتماعی اشتغال زنان خانواده -Kadkhodaee F,Lotfi Sh. Measure social well-being of the city high school students Shiraz and factors affecting it, Social Research Quarterly. 2012;5(20):184-207.(Persian).##2-Fathi M, Ajamnezhad R , Khakrangin M. Factors related to social health of teachers in Maragheh city. Welfare Social Research Journal. 2011;12(47):225-243 (Persian).##3-Samiei M. Social health of Iran: From social oriented definition to evidence oriented index. Quarterly of Iran Social Issues. 2010;1(2):33 (Persian).##4-Alizadeh M. The role of women’s employment on development. Quarterly on Women and Culture. 2010; 2(5):49-59 (Persian).##5-Shaditalab J. Employment of women and the role of cooperatives. Quarterly of Social Sciences. 1995; 7(8):152-3 (Persian).##6-Jarollahi A. The impact of women’s employment on participation of couples in family affaires. Quarterly of Social Sciences. 2010;2:7-8 (Persian).##7-Tabarizade hadi A, Kaldi A, Mohagheghi Kamal S.H, et al. Investigation of social health of students. Social Welfare. 2007;8(30-31):171-189 (Persian).##8-Hemati E, Mahdavi M S, Baghaiee Sarabi A. The effects of social support on the health of women heads of households in Roudehen. Social Research. 2012;6(18):45-61 (Persian).##9-Keyes CM, Shmotkin D, Ryff D. optimizing well-being : The Empirical Encounter of Two Traditions. Journal of Personality and Social Psychology. 2002;82(6):1002 –22.##10-Azizi P, Azarkamand R. Study of the effect of education on women’s employment with emphasis on Iran. Quarterly of Amayesh Geography. 2010;8:1-23 (Persian).##11-Bagheri M, Moltafet H , Sharifian H. Study of the effect of women employment on power pyramid in family. Quarterly of Family Studies. 2009;5(2):247-62 (Persian).##12-Jawaheri F, Seraj Zadeh SH ,Rahmani R. Analysis of the effect of women’s employment on their life quality (case study: Women employed in Ministry of Agriculture). Women in Development and Politics (Women Studies). 2010;8(2):143-62 (Persian)##14-Cubillo L, Brown M. Women into educational Leadership and Management: international differences? Journal of Educational Administration. 2003;41(3):278-91.##15-Fritzell S, Ringback Weitoft G, Fritzell J, et al. From Macro to Micro: the Health of Swedish lone mothers during changing economic and social circumstances. Social Science and Medicine. 2007;65:2474-8.##16-Stoilova M. Post- socialist gender transformations and women’s experiences of employment. Journal of Organizational Change Management. 2010;23(6):731-54. ##17-Shapira T, Arar Kh, Aziaza F. Arab women principals empowerment and leadership in Israel. Journal of Educational Administration. 2010;48(6):704-15.##18-Elamin AM, Omair K. Males Attitudes towards Working Females in Saudi Arabia. Personal Review. 2010;39(6):746-66.##19-Yousefi A, Maryam B. Women, Employment and Higher education schoolings. Social and Behavioral Sciences. 2011;15:3861-69 (Persian).##20-Bartley M, Sacker A, Firth D, et al. Social position, social roles and woman health in England: Changing relationships 1984-1993. Social Science and Medicine. 1999;48:99-115.##21-Worts D, Sacker A, Mcmunn A, et al. Individualization, opportunity and jeopardy in American Woman’s work and family lives: A multi-state Sequence Analysis. Advance in Life Course Research. 2013;18(4):296-318.##22-Garmaroudi Gh, Sadat Vahdaninia M. Social health: investigation of students' social skills. Payesh. 2005;5(2):147-153 (Persian).## ##

Prevalence Unintended Pregnancy and its Related Factors Among Currently Pregnant Women in Kangavar City (West Iran) بارداری ناخواسته و عوامل مرتبط با آن در کرمانشاه، کنگاور 2 1 مقدمه: بارداری ناخواسته یک عامل استرس در میان زنان سنین باروری به ویژه در کشورهای در حال توسعه است. مقاله ی حاضر تلاش نموده است تا میزان شیوع بارداری ناخواسته، عوامل موثر بر آن و علل درک شده ی این بارداری ناخواسته از سوی خود زنان را در میان زنان متاهل شهرستان کنگاور بررسی کند روش شناسی: این مطالعه روی 248 مادر مراجعه کننده به مراکز بهداش کنگاور که به صورت تصادفی انتخاب شدند، صورت گرفت. داده ها به وسله ی پرسشنامه جمع آوری شده و با بسته ی نرم افزاری spss 17 مورد تحلیل قرار گرفت. نتایج: شیوع بارداری ناخواسته حدود 21.2 درصد برآورد شدو حدود 21.2 درصد از زنان اظهار داشتند که بارداری آنان بدون برنامه ریزی قبلی بوده است، دو پنجم این مادران بیان کردند که بارداری آنها در زمان نامناسبی صورت گرفته است و سه پنجم بقیه نیز اظهار کردند که بارداری آنان به صورت کلی ناخواسته بوده است. بین سن مادران و نوع بارداری (p<0.001)، روش های پیشگیری از بارداری و بارداری ناخواسته(p<0.001) رابطه ی معناداری به دست آمد. همچنین نتایج نشان داد که بین سن زنان و نوع استفاده از روش های پیشگیری از بارداری که آنها استفاده میکرند، رابطه ی معناداری (p<0.001) وجود دارد. نتیجه گیری: از یافته ها میتوان چنین نتیجه گرفت که سن زنان و نوع روش های پیشگیری تاثیر مهمی بر بارداری ناخواسته دارند. بنابراین با افزایش آگاهی زنان در مورد این روش ها میتوان وقوع این نوع بارداری را کاهش داد. 2 Background: Unintended or unplanned pregnancy has been a distressing reality among females in the reproductive age group particularly in developing countries. The current study aimed to determine the prevalence of unintended pregnancy among married women in an urban community in Kangavar city state, to determine the associated factors of unintended pregnancy and to verify the reasons behind unintended pregnancy as perceived by the married women in the area. Materials and Methods: This study was carried out on 248 mothers who referred to health centers of Kangavar, and they were selected randomly. Data was collected by valid and reliable questionnaire. Results were analyzed in spss17. Results: The prevalence of unwanted pregnancy was estimated to be 21/2 percent .About 21.2 of women stated that their pregnancy was unplanned, two fifth of these mothers mentioned that their pregnancy was mistimed and the other three-fifth reported that they had Unwanted. There was a significant relationship between age and type of pregnancy (p<0.001), contraception methods and unintended pregnancy (p<0.001). Also results showed that there was a significant between age of women and kind of contraception methods, which they had used (p<0.001). Conclusion: It can be concluded that age and contraception methods have main effect on unintended pregnancy. So that by increasing the awareness of women about these methods can reduce the occurrence of this type of pregnancy. 19 28 2015/02/62015/06/142015/04/17 1394/1/28 2015/06/92015/06/142015/06/9 1394/3/19 سعیده شهبازین Saeedeh Shahbazin دانشگاه یزد. دانشکده ی علوم اجتماعی saeedehshahbazin@yahoo.com آزاده غلامی Azadeh Gholamy Unwanted pregnancy Prevalence Contraception methods Kangavar city بارداری ناخواسته شیوع پیشگیری از بارداری کنگاور 1. Santelli, J, Roger R, Kendra H, et al. Unintended pregnancy working group. The measurement and meaning of unintended pregnancy. Perspectives on Sexual and Reproductive Health. 2003;35(2):94-101.##2. León Aguirre DG, Billings D. Unwanted pregnancy and unsafe abortion: women and health learning package developed by the network: TUFH Women and Health Taskforce 3th, 2007. Available in http://www.thenetworktufh.org/sites/default/files/attachments/basic_pages/pdf##3. Ghazizadeh S, Lessan-Pezeshki M, Khatami M, et al. Unwanted pregnancy among Kidney transplant recipients in Iran. Transplantation Proceeding 2005;37: 085-3086.##4. Sanaei nasab H, Tavakoli R, Tavakoli H, et al. Unwanted pregnancy and Factors Influencing it in Pregnant Mothers referring to Semnan’s health centers. World Applied Sciences Journal.2010;9(2):199-203.##5. Sadat-Hashemi SM, Ghorbani R, Majdabadi HA, et al. Factors associated with contraceptive use in Tehran,Iran. The European Journal of Contraception and Reproductive Health Care. 2007;12(2):148-153.##6. Vizshafar F, Mehdizadeh Naderi KH. Prevalence of unwanted pregnancy and its relevant factors in patients referred to Lar and Grash hospital. Iranian Journal of Obstetrics, Gynecology and Infertility. 2005;8:101-110 (Persian).##7. Health vice-chancellor of Arak medical university. Why unwanted pregnancy? Determination of unwanted pregnancy in province base of IMES result in 2005. Health proclamation. 2008;(16):2-4 (Persian).##8. Shokravi A, Howden F, Champan PH. A study on the effective factors of unwanted pregnancies in pregnant women of Tehran city. Reproduction and Infertility: 2004;5:249-258 (Persian).##9. Nojoumi M, Zeinali Z. Study of Unwanted Pregnancy Prevalence and Related Factors inWomen Referred to Prenatal Clinics of Akbar Abadi and Rasoul-e-Akram Hospitals in 2002. Journal of Iran Univercity Medical Science. 2005;12:195-200 (Persian).##10. Pour Heidari M, Sozany A, Shamallan N. Prevalence of Unwanted Pregnancies and 428 their correlates in pregnant women in Shahrood, Iran. Payesh 2007;6(1):63-70 (Persian).##11. Peyman N, Hidarnia AR, Ghofrani Pour F, et al. The relationship between perceived self-efficacy and contraceptive behaviors among Iranian women referring to health centers in Mashhad in order to decrease unwanted Pregnancies. Reproduction and Infertility. 2007;8:78-90 (Persian).##12. Bankole A, Oye-Adeniran B. A, Singh S, et al. Unwanted Pregnancy and Induced Abortion In Nigeria: Causes And Consequences.Newyork: Guttmacher institute; 2006.##13. Geog 102. Population, Resources and the Environment. Available from: // people Hofstra. Edu//faculty/jean-PaulRodrigue.##14. Who. 2005. Making pregnancy safer. Available from: www.who.int.##15. Hromi-Fiedle AJ, Perez-Escamilla R. Unintended pregnancies are associated with less likelihood of prolonged breast-feeding: An Analysis of 18 Demographic and Health Surveys. Public Health Nutrition 2006;9(3):306-12.##16. Johnson K, Zoubi O, Wulfe M. Mistimed and Unwanted Pregnancies in Jordan. Department of Statistics Amman, Jordan. ORC Macro Calverton, Maryland, USA ;2004. Available in http://pdf.usaid.gov/pdf_docs/PNADA695.pdf##17. Mosher W.D, Jones J, Abma J.C. Intended and Unintended Births in the United States: 1982–2010. Journal of National Health Statistics Reports. 2012;55:24.##18. Adhikari R, Soonthorndhada K, Prasartkul P. Determinants of Unintended pregnancy among currently pregnant married women in Nepal. BMC International Health and Human Rights. 2009;9:17##19. Roudi-Fahimi F, Abdul Monem A. Unintended Pregnancies in the Middle East and North Africa. Population Reference Bureau. Available in ./www.prb. org/ Publications /Reports /2010/unintendedpregnancies.aspx##20. Kiani MA, Khakshour A, Vakili R, et al. Prevalence of Unwanted Pregnancy and its Related Factors in Women Mashhad City in 2013, Journal of North Khorasan University of Medical Sciences. 2013;5(2):430.##21. Asfya A. Application of health Belief Model in the prevention of unwanted pregnancies in women's health study covered the area south of Tehran 2001-2002 (thesis). Tehran:Tehran University of Medical Sciences;2003:191(Persian).##22. Bashardoost N, Eftekhar H, Zamani F, et al. How to treat with unwanted pregnancies?.Journal of research in Medical Science. 2000;5(10):27-30 ( Persian).##23. Rakhshani F, Ansari Moghaddam AR, Tehrani H. Prevalence of unwanted pregnancy and associated factors in Zahedan, 1999. Journal of research in Medical Science 2003; 8(3):40-3 (Persian).##24. Zamani F, Eftekhar Ardebili H, Bashar Doost N, et al. The behavior of women confronted with unwanted pregnancies. Journal of Health Faculty Health Research Institute 2003;6(2):55-62 (Persian).##25. Kasmaei P. Study of prevalence and some correlative factors with unwanted pregnancies. Journal of Gilan University of Medical Science. 2004;12(48):61-6 (Persian).##26. Fallah Zadeh H. Survey on unplanned pregnancies in pregnant women in Yazd. Journal of Shahid Sadoghi University Medical Science Health Services. 2001;4(9):98-102 (Persian).##27. Hajian K. The prevalence of unwanted children and its affecting factors in Babol. Journal of Mazandaran University Medical Science. 2004 45(14):35-42(Persian).##28. Abazari F, Arab M, Abbasszadeh A. Relationship of unwanted pregnancy and fertility behavior in pregnant women who visited maternity wards of Kerman hospitals. Journal of Reproductive Infertility. 2003;4(1):39-46.##29. Hamdela B, Abebe GM, TilahunT. Unwanted Pregnancy and Associated Factors among Pregnant Married Women in Hosanna Town, Southern Ethiopia. PLoS One.2012;7(6). Available from: http://www.plosone.org/article/info:doi/10.1371/journ al.pone.0039074.##30. WHO. Regional Office for the East Mediterranean. Country Cooperation Strategy for WHO and Sudan 2008-2013. Sudan. Available from http://www.emro.who.int/about-who/country-cooperation-strategy/##31. Kassa N, Berhane Y, Worku A. Predictors of unintended pregnancy in Kersa, eastern Ethiopia, 2010. Reprod Health. 2012;12(9):1.##32. Exavery A, Malick Kanté A, Njozi M, et al. Predictors of mistimed, and unwanted pregnancies among women of childbearing age in Rufiji, Kilombero, and Ulanga districts of Tanzania. Journal of Reproductive Health. 2014;11:63##33. Abbasi-Shavazi MJ, Hosseini-chavoshi M, Aghajanian A, et al. Unintended pregnancies in the Islamic Republic of Iran: Level and Correlates. Asia-Pacific Population Journal. 2004;19(1):27-38.##34. Okonofua E F, Clifford O, Halen A, et al. Assessing the prevalence and determinants of unwanted pregnancy and induced abortion in Nigeria. Studies in Family Planning. 1999;30(1),67-77.##35. Kasmaei P, Atrkar Roushan Z. Study of prevalence and some correlative factors with unwanted pregnancies. Journal of Guilan University of Medical Science. 2004;12(48):61-6 (Persian).##36. Cheng D, Schwarz EB, Douglas E, et al. Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception. 2009;79(3):194-8.##37. Delaram M, Sereshti M, Rafieian M. The causes of unwanted pregnancy in oral contraceptive pills users. Journal of Shahrekord University of Medical Science. 2004;6(3):55-61 (Persian).## ##

Examining the Factors Related to Mortality Aamongst One Year Old and Younger Children in Yazd City During 2011 to 2013 Period بررسی عوامل مرتبط با مرگ‌ومیر کودکان زیر یک‌سال در شهرستان یزد بین سال‌های 1390، 1391 و 1392 2 1 مقدمه: تأمین، حفظ و ارتقاء سطح سلامت کودکان زیر یکسال به عنوان یک گروه آسیب‌پذیر در خدمات بهداشتی - درمانی جایگاه ویژه‌ای دارد. ﻣﺮگ-وﻣﻴﺮ ﻛﻮدﻛﺎن زﻳﺮ ﻳﻜﺴﺎل ﻳﻜﻲ از ﻣﻬﻤﺘﺮﻳﻦ ﺷﺎﺧﺺ‌ﻫﺎی ﺑﻬﺪاﺷﺘﻲ ﻣﻲ‌ﺑﺎﺷﺪ و ﻣﻬﻤﺘﺮﻳﻦ ﺷﺎﺧﺺ ﺗﻌﻴﻴﻦ وﺿﻌﻴﺖ ﺑﻬﺪاﺷﺘﻲ ﻳﻚ ﺟﺎﻣﻌﻪ و ﺳﻄﺢ زﻧﺪﮔﻲ ﻳﻚ ﻣﻨﻄﻘﻪ ﻣﺤﺴﻮب ﻣﻲﺷﻮد. مطالعه حاضر با هدف بررسی علل مرگ‌ومیر کودکان زیر یک‌سال تحت پوشش مرکز بهداشت شهرستان یزد طی سال‌های 90-92 صورت گرفت. روش: در این مطالعۀ توصیفی – تحلیلی که به روش گروه‌های کنترل- شاهد انجام شد، پروندۀ کلیه کودکان فوت شده زیر یک‌سال در شهرستان یزد به عنوان جامعۀ آماری در نظر گرفته شد و به ازای هر پروندۀ کودک فوت شده، پروندۀ دو کودک زنده نیز بررسی شد. اطلاعات از طریق مراجعه به پایگاه-های بهداشت شهرستان و با بررسی پروندۀ کودکان، به دست آمد. داده‌ها با نرم‌افزار SPSS20 مورد تجزیه و تحلیل قرار گرفت. نتایج: در مجموع 116 پروندۀ کودک فوت شده که بررسی شد؛ 4/41 درصد کودکان فوت شده پسر و 6/58 درصد دختر بوده‌اند. متغیرهایی همچون نوع ازدواج والدین، تحصیلات پدر و مادر، نوع زایمان و تعداد حاملگی،های قبلی با مرگ‌ومیر کودکان رابطۀ معناداری دارند. نتیجه‌گیری: به نظر می‌رسد توجه خاص به نوزادان به هنگام تولد، افزایش سطح آگاهی بهداشتی مادران و خانواده‌ها، ارائۀ مراقبت‌های استاندار قبل و حین بارداری، تدوین برنامه‌هایی جهت ارتقاء وضعیت اقتصادی - اجتماعی و فرهنگی زنان و مردان نقش مؤثری در کاهش مرگ‌ومیر کودکان داشته باشد. 2 Background: Provision, maintaining and improving health status of one year old and younger children as a vulnerable group has been considered as an important issue pertaining to healthcare/medical services. Index of mortality of under one year old children is among most important healthcare indices and is known as the most important index of healthcare status of any society as well as the quality of life in any region. The present study aims for examining causes of mortality amongst one year old and younger children who were covered by health centers in Yazd city during 2011 to 2013 period. Materials and Methods: This descriptive-analytical study was conducted using control-test group method. All recorded cases of mortality for children in Yazd city during the first year of their life were included in statistical population, while for each case of mortality two cases of living children were examined as control group. The data were collected by direct visits on healthcare centers in the city and examining case files for children. Obtained data were analyzed using SPSS 20 software package. Results: 116 mortality cases were examined in total which included 41.4% boys and 58.6% girls. Some variables such as type of marriage between parents, mother and father’s education level, type of labor and number of previous pregnancies were significantly related to children’s mortality rate. Conclusion: suggest that paying specific attention to infants at the time of birth, improving knowledge level amongst mothers and families, providing standard level healthcare prior to pregnancy and after that, and also developing programs which aim for improving economic-social and cultural status amongst women and men would be effective on reducing children mortality rates. 29 37 2015/02/62015/06/142015/04/172015/03/2 1393/12/11 2015/06/92015/06/142015/06/92015/06/9 1394/3/19 عباس عسکری ندوشن Abbas Askari Nodoushan Yazd university aaskarian@yazd.ac.ir حسین فلاح زاده ابرقویی Hossein Fallah zade Medical science univesity of yazd hofaab@yahoo.com حسن فلاح مدواری Hassan Fallah madvari Yazd university hassan67_2012@yahoo.com Infant mortality Susceptibility factors Premature labor Suffocation Abnormality مرگ‌ و میر نوزادی عوامل مستعد کننده زایمان زودرس خفگی ناهنجاری 1. Tamanna S. Basics of Demography. Tehran :Payam-e Nour University Press, 3rd Ed; 2007 (Persian). ##2. Amani F, Barak M, Aminisani N, et al. Neonatal Mortality and Its Related Factors in Hospitals of Ardabil, 2002-2003 . Journal of Ardabil Univercity Medical Science. 2005;5(4):305-310 (Persian).##3. Faraji R, Zarkesh M, Ghanbari A, et al. Assessment of the Causes and Risk Factors Associated with Neonatal Mortality Based on International Coding Diseases. Journal of Guilan University of Medical Sciences. 2012;21(84):42-46 (Persian).##4. Namakin K, Sharifzadeh G. Examining mortality amongst children under one year old and effective factors in Birjand city. Journal of Knowledge and health. 2008;3(1):16-21(Persian). available in http://knh.shmu.ac.ir/index.php/site/article/view/199##5. Fallahi M , Joudaki N , Mohseni Bandpey H . Evaluation of Causes of Neonatal Mortality in Shohadaye Tajrish Hospital, during Years 2004-2007. Pajoohandeh Journal. 2009;14(1):43-46 (Persian).##6. Giashuddin MS, Hosain, MM. Factors associated with child health in urban areas of Bangladesh. Bangladesh Journal of Scientific Research; 2011;24(2):145-154##7. Davazdahemami S, Abd Yazdian Z, Montazari M, et al. Social factors associated with infants’ mortality. Journal of Shahrekord University of Medical Science. 2001;3(2):67-72 (Persian).##8. Mohagheghi P, Hashemzadeh Esfahani M, Mosavi Kani K. Determining the frequency of infants mortality cases in Tehran during 2009. Razi Journal Medical Science. 2013;19(103):41-47 (Persian).##9. Omran A. The epidemiologic transition: a theory of the epidemiology of population change. The Milbank Memorial Fund Quarterly change.1971;49(4):509-538##10. United Nation economic and social commission for western Asia. infant and child mortality in western Asia. Baghdad: United Nation economic and social commission for western Asia;1989.##11. Hadavi M, Alidalaki S, Abedini nejad M, et al. Effective Factors on Perinatal Mortality in Rafsanjan Hospitals (2004-2006). Journal of Rafsanjan University of Medical Sciences. 2009;8(2):117-126 (Persian).## ##

Population Attributable Fraction of Ischemic Heart Disease Associated to Hypertension in the Middle East and North Africa کسر منتسب جمعیت بیماری ایسکمیک قلبی وابسته به فشارخون در منطقه خاورمیانه و شمال آفریقا 2 1 مقدمه:بیماری ایسکمیک قلبی در منطقه خاورمیانه و شمال آفریقا رو به افزایش است و پرفشار خون به عنوان یکی از مهمترین عوامل خطر قابل تغییر نقش مهمی را دراپیدمی این بیماری ایفا می نماید. پرفشاری خون دلیل 45% از مرگ و میر ناشی از بیماری ایسکمیک قلبی می باشد وپرفشاری خون بیش از یک میلیارد نفر را در سراسر جهان تحت تاثیر قرارداده است. هدف: هدف از این مطالعه اندازه گیری کسرمنتسب جمعیت بیماری ایسکمیک قلبی وابسته به فشار خون در منطقه خاورمیانه و شمال آفریقا می باشد. مواد وروش ها:جهت محاسبه کسر منتسب جمعیت میزان شیوع پر فشاری خون وابسته به جنس از مقالات متعدد ملی و بین المللی استخراج گردید و میزان استاندارد شده خطربیماری ایسکمیک قلبی و فشار خون از مطالعه آینده نگر قند و لیپید تهران گرفته شد و در نهایت در محاسبه کسر منتسب جمعیت بکار گرفته شدند. یافته ها:میزان شیوع پرفشاری خون وابسته به جنس در هفده کشور از منطقه خاورمیانه و شمال افریقا که در بین سالهای 1996 تا 2013 در دسترس می باشد. و میزان شیوع پرفشاری خون از 5/4% در فلسطین تا 47% در الجزیره در بین زنان گزارش گردیده است. همچنین شیوع این میزان در مردان از 2/2%در فلسطین تا 7/50% در عمان متفاوت است و کسرمنتسب جمعیت بیماری ایسکمیک قلبی وابسته به پرفشاری خون از 3/4% در فلسطین تا 32% در الجزایر در میان زنان متفاوت بود و همچنین کسر منشب جمعیت در مردان از 2/2%در فلسطین تا 7/33% گزارش گردیده است . نتیجه گیری:بیش از 33% مرگ و میر ناشی از بیماری ایسکمیک قلبی مردان مربوط به پرفشاری خون می باشد. به نظر می رسد شیوع پرفشاری خون در منطقه خاورمیانه و شمال آفریقا رو به افزایش است.لذا برنامه های جامع کنترل و پیشگیری از بیماری ایسکمیک قلبی در کشورهای منطقه مورد نیاز است. 2 Background: Ischemic Heart Disease has been increasing in the Middle East and North Africa. Hypertension is an important modifiable risk factor of IHD and play an important role in the epidemic of IHD. Hypertension is responsible for about 45% of IHD mortality and affects more than one billion people around the world. Objective: This study aims to quantify the population attributable fraction of IHD due to hypertension in the Middle East and North Africa. Methods: Sex-specific prevalence of hypertension was obtained from national and international studies. Moreover, age-adjusted hazard ratio (HR) of IHD and hypertension was extracted from the Tehran Lipid and Glucose Study (TLGS). HR and sex-specific prevalence of hypertension were used to calculate PAF of IHD due to hypertension in various countries of the region. Results: The sex-specific prevalence of hypertension was available for seventeen countries of the region. Hypertension ranged from 4.5% in Palestine to 47% in Algeria in females and from 2.2%in Palestine to 50.7% in Oman in males. The fraction of IHD attributable to hypertension ranged from 4.3%in Palestine to 32%in Algeria in females and from 2.2% in Palestine to 33.7%in Oman males. Conclusion: Up to 33% IHD males mortality attributable to hypertension. It seems that hypertension is increasing in MENA and prevention programs is needed to control prevalence IHD. 38 46 2015/02/62015/06/142015/04/172015/03/22015/05/17 1394/2/27 2015/06/92015/06/142015/06/92015/06/92015/06/9 1394/3/19 مرضیه میرزاجانی Marzieh Mirzajani Zanjan University of Medical Sciences, Zanjan, Iran marzieh.mirzajani@hotmail.com مسعود میرزایی Masoud Mirzaei Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd , Iran mmirzaei@ssu.ac.ir Population attributable fraction Ischemic Heart Disease Hypertension Middle East North Africa کسر منتسب جمعیت فشار خون بیماری ایسکمیک قلبی خاورمیانه و شمال آفریقا 1. Moran AE, Forouzanfar MH, Roth G, et al. 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Journal of Hypertension. 2007;25(1):73-9.##38. Gaziano TA, Bitton A, Anand S, al e. Growing epidemic of coronary heart disease in low-and middle-income countries. Current Problems in Cardiology. 2010;35(2):72-115.##39. Danaei G, Ding EL, Mozaffarian D, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS medicine. 2009;6(4):e1000058.##40. Grau M, Subirana I, Elosua R, et al. Why should population attributable fractions be periodically recalculated?: An example from cardiovascular risk estimation in southern Europe. Preventive Medicine. 2010;51(1):78-84.##41. Hozawa A. Attributable fractions of risk factors for cardiovascular diseases. Journal of Epidemiology (Japan Epidemiological Association). 2010;21(2):81-6.##42. Abdulle AM, Nagelkerke NJ, Abouchacra S, et al. Under-treatment and under diagnosis of hypertension: a serious problem in the United Arab Emirates. BMC cardiovascular disorders. 2006;6(1):24.##43. Whelton P, He J, Muntner P. Prevalence, awareness, treatment and control of hypertension in North America, North Africa and Asia. Journal of Human Hypertension. 2004;18(8):545-51. ## ##

Toxoplasmosis Seroepidemiology in Serum of Suspected Patients Referring to Medical Lab, 2013 سرواپیدمیولوزی توکسوپلاسموزیس در سرم خون مراجعین مشکوک به آزمایشگاه تشخیص طبی، 1392 2 1 مقدمه: توکسوپلاسموز یک عفونت مشترک شایع بین انسان و حیوان است. عفونت اکتسابی بر اثر خوردن اووسیستهایی است که گربه دفع می کند و یا از طریق گوشت آلوده به کیستهای نسجی صورت می گیرد. فرم اکتسابی بیماری اغلب بدون علامت است و یا با احساس ناراحتی عمومی، تورم غدد لنفاوی و کوریورتینت همراه می باشد. در شکل مادرزادی عامل بیماری از طریق جفت مادر به جنین منتقل می شود. عفونت مادرزادی ممکن است سبب سقط جنین، آسیبهای سیستم اعصاب مرکزی و یا ناراحتی چشم می شود. هدف از این مطالعه تعیین سرواپیدمیولوزی توکسوپلاسموزیس در سرم خون مراجعین مشکوک به آزمایشگاه تشخیص طبی بود، 1392. مواد و روشها: در این مطالعه توصیفی- تحلیلی و به شیوه مقطعی است. از کل712 نفر که در طی سال 1390 در معاینات بالینی مشکوک به عفونت توکسوپلاسموز تشخیص داده شد، جهت بررسی سرولوژیک به آزمایشگاه تشخیص طبی ارجاع داده شدند. در آزمایشگاه از بیماران نمونه سرم تهیه و به روش ELISA با استفاده از کیتهای CHORUS TOXOPLA از نظر آنتی بادی های ضد توکسوپلاسما گوندی IgG , IgM آزمایش شدند. اطلاعات مربوط به سن، جنس، زمان مراجعه و نتیجه تست آزمایشگاهی در چک لیست ثبت گردید و سپس با استفاده از نرم افزار SPSS تجزیه و تحلیل گردید. نتایج: از مجموع 712سرم افراد مورد آزمایش 649 نفر (91.2%) زن و 63 نفر ( (8.8%مرد بودند. 171 نفر (24.3% ) از نظر آنتی بادیIgG و 25 نفر ((3.5% ازنظر آنتی بادی IgM سرم مثبت بودند. در جنس مونث 159 نفر(93%)) ودر جنس مذکر 12 نفر(7%) IgG مثبت بودند . در جنس مونث 24 نفر(96%)) ودر جنس مذکر 1 نفر(4%) IgM مثبت بودند . بیشترین موارد تست مثبت به نسبت 9/5 درصد در سنین بالای 50 سالگی مشاهده گردید. پایین ترین درصد موارد سرم مثبت در گروه سنی زیر 20 سال( 20%) و بالاترین درصد در بیماران بالای 60 سال(8/47 درصد) مشاهده شد. بحث و نتیجه‌گیری: بین فراوانی آنتی بادیهای ویژه IgM و IgG درسرم خون مراجعین مشکوک و شاهد اختلاف معنی داری نیست، ولی سقط جنین در زنان با توکسوپلاسموزیس مزمن در ارتباط است. 2 Introduction: Toxoplasmosis is Zoonoses among humans and animals with cosmopolitan distribution. Acquired form of the disease often has no symptoms or discomfort of swollen lymph nodes and associated Chorioretinitis. The congenital form of the disease from mother to fetus via the placenta is delivered. Congenital infection may cause abortion or damage the central nervous system and eye disorders. The aim of this study was to determine toxoplasmosis Seroepidemiologyin serum of suspected patients referring to medical lab, 2013. Materials and Methods: This study is cross- sectional. Of the total 712 cases during 2013 in the physical examination was diagnosed with suspected toxoplasmosis infection, were referred for evaluation of serological diagnostic laboratories. Produced in the laboratory from patients' serum samples by ELISA method using kits of anti-Toxoplasma gondii antibodies Chorus Toxoplasma IgG, IgM were tested. Data on age, sex and time of the visit and laboratory test results were recorded in the Czech list, and then were analyzed using SPSS software. Results: A total of 712 sera tested 649 patients (91.2%) were female and 63 ((8.8% were male. 171 (24.3%) of the antibody IgG and 25 ((3.5% in terms of IgM in serum were positive. In sex 159 women (93%)) and 12 males (7%) IgG were positive. In females, 24 (96%)) and 1 male (4%) IgM were positive. Most positive tests than 9.5% in those aged over 50 years were observed. The lowest percentage of positive samples in the age group less than 20 years (20%) and highest in patients older than 60 years (8/47 percent) was observed. Conclusion: As a general conclusion, it can be stated that the frequency of specific IgM and IgG antibodies in toxoplasmosis, in the suspected-to-have toxoplasmosis and control groups was not statistically significant. Also, we can conclude that abortion is involved in the development of chronic toxoplasmosis. 47 54 2015/02/62015/06/142015/04/172015/03/22015/05/172015/06/14 1394/3/24 2015/06/92015/06/142015/06/92015/06/92015/06/92015/06/14 1394/3/24 علی فتاحی بافقی Ali Fattahi Bafghi رویا انوری Roya Anvari محمدحسین انوری تفتی Mohammad Hossein Anvari Toxoplasmosis Seroepidemiology IgG IgM Medical lab توکسوپلاسموزیس سرواپیدمیولوژی IgG IgM آزمایشگاه تشخیص طبی Ebrahimzadeh A, Mohammadi S, Salimi-Khorashad A, et al. Seroprevalence of Toxoplasmosis among pregnant women referring to the reference laboratory of Zahedan, Iran Zahedan Journal of Research in Medical Sciences. 2013;15(12):32–5. ##2. Fayer R, Dubey JP, Lindsay DS. Zoonotic protozoa: from land to sea. Trends in Parasitology 2004;20(11):531-536.##3. Heidari H, Gharekhani J, Tavoosidana G. Role of toxoplasmosis in abortion of ewes in western Iran: A serological study. Scientia Parasitology. 2013;14:99–103.##4. Eskandarian AA, Jafarnezghad GA, Akbarib M. Seroprevalence of Toxoplasma-specific antibodies in patients suspected to have active toxoplasmosis: A cross-sectional survey, Advance Biomedical Research. 2014; 3(1): 236.##5. Gautam B, Singh G, Singh S. Virtual screening of threonine synthase as a target for antimicrobial resistance in Toxoplasma gondii. Elixir Appl Biology. 2012;48:9542–5.##6. Pratama DA, Artama WT. Analysis of Toxoplasma gondii Repeat Region 529 bp (NCBI Acc. No. AF146527) as a probe candidate for molecular diagnosis of toxoplasmosis. Indonesian Journal of Biotechnology. 2013;14:1124–1131.##7. Uttah E, Ogban E, Okonofua C. Toxoplasmosis: A global infection, so widespread, so neglected. International Journal of Scientific and Research Publications. 2013;3:1–6.##8. Edwards JF, Dubey JP. Toxoplasma gondii abortion storm in sheep on a Texas farm and isolation of mouse virulent atypical genotype T. gondii from an aborted lamb from a chronically infected ewe. Veterinary Parasitology. 2013;192:129–36.##9. Heidari H, Gharekhani J, Tavoosidana G. Role of toxoplasmosis in abortion of ewes in western Iran: A serological study. Scientia Parasitology. 2013;14:99–103.##10. Habibi G, Imani A, Gholami M, et al. Detection and identification of Toxoplasma gondii type one infection in sheep aborted fetuses in Qazvin province of Iran. Iranian Journal Parasitology. 2012;7:64–72.##11. Pfaff AW, Abou-Bacar A, Letscher-Bru V, et al. Cellular and molecular physiopathology of congenital toxoplasmosis: the dual role of IFN-gamma. Parasitology.2007;134(13):1895–1902.##12. Villena I, Ancelle T, Delmas C, et al. Toxosurv network and National Reference Centre for Toxoplasmosis. Congenital toxoplasmosis in France in 2007: first results from a national surveillance system. Euro Surveill.2010;15(25):pii=19600.##13. Robert-Gangneux F, Dardé ML. Epidemiology of and Diagnostic Strategies for Toxoplasmosis. Clinical Microbiology Review. 2012;25(2):264-296 .##14. Jones JL, Dargelas V, Roberts J, et al. Risk factors for Toxoplasma gondii infection in the United States. Clinical Infection Disease. 2009;49(6):878–884.##15. Pfefferkorn ER. Interferon gamma blocks the growth of Toxoplasma gondii in human fibroblasts by inducing the host cells to degrade tryptophan. Proceedings of the National Academy of Sciences of the United States of America. 1984;81(3):908–912.##16. Ryning FW, McLeod R, Maddox JC, et al. Probable transmission of Toxoplasma gondii by organ transplantation. Annals of Internal Medicine. 1979;90(1):47-9.##17. Derouin F, Pelloux H. Prevention of toxoplasmosis in transplant patients. Clinical Microbiology and Infection 2008;14:1089–1101##18. Gourishankar S1, Doucette K, Fenton J, et al. The use of donor and recipient screening for Toxoplasma in the era of universal trimethoprim sulfamethoxazole prophylaxis. Transplantation. 2008;85(7):980–5.##19. Kijlstra A, Jongert E. Toxoplasma-safe meat: close to reality?. Trends Parasitology. 2009;25(1):18–22.##20. Hill D, Coss C, Dubey JP, et al. Identification of a sporozoite-specific antigen from Toxoplasma gondii. Journal of Parasitology. 2011;7(2):328–337.##21. Hill DE, Benedetto MC, Coss C, et al. Effects of time and temperature on the viability of Toxoplasma gondii tissue cysts in enhanced pork loin. Journal Food Protection. 2006;69:1961–1965.## ##

Role of Feeling of Loneliness and Emotion Regulation Difficulty on Drug Abuse نقش احساس تنهایی و دشواری در تنطیم هیجانی در سوء مصرف مواد 2 1 مقدمه: رفتارهای پرخطر از جمله سوء مصرف مواد در نوجوانان و جوانان به طور نگران کننده ای بالا است. بنابر این مطالعه و فهم رفتارهای پرخطر با اهمیت می باشد. هدف از این مطالعه بررسی رابطه احساس تنهایی و دشواری در تنظیم‌ هیجانی با سوء مصرف مواد بود. مواد و روش ها: نوع مطالعه توصیفی - همبستگی بود. نمونه پژوهش شامل 452 دانشجوی دانشگاه سیستان و بلوچستان بود که به روش نمونه گیری خوشه‌ای انتخاب شدند. ابزارهای جمع آوری اطلاعات مقیاس احساس تنهایی ، دشواری در تنظیم هیجانی و سوء مصرف مواد بودند. از روشهای آماری همبستگی پیرسون و رگرسیون جهت تجزیه و تحلیل اطلاعات استفاده شد. یافته ها: نتایج نشان داد که بین استعمال مواد مخدر با احساس تنهایی و دشواری تنظیم هیجانی رابطه مثبت و معناداری وجود دارد. نتایج رگرسیون همزمان نشان داد متغیر احساس تنهایی به میزان 09/0 استعمال مواد مخدر را پیش بینی می کند و دشواری تنظیم هیجانی به میزان 08/0 تغییرات مربوط به استعمال مواد مخدر را تبیین می‌کند (05/0P≤). نتیجه گیری: بنابر این پیشنهاد می‌شود تا برنامه‌ریزان آموزشی و فرهنگی دانشگاه به عوامل خطرساز سوء مصرف مواد از جمله مدیریت هیجانات و احساس تنهایی توجه کنند و با انجام اقدامات مناسب و پیشگیرانه به این مهم بپردازند. 2 Introduction: The Risk behaviors such as drug abuse are prevalent anxiously in youth. Thus investigation and recognition of risk behaviors are important. The aim of the present study is to investigate on relationship between loneliness and the difficulty in emotional regulation with drug abuse. Materials and Methods: this research was descriptive- correlation. The sample was comprised of 452 students of University of Sistan and Baluchestan, Iran. Participants were selected by cluster sampling. The instruments were the Loneliness Scale , the Difficulty in Emotion Regulation Scale and the Drug Abuse . For statistical analysis, Pearson correlation and regression analysis methods were used. Results: The results show that there is a positive and significant relationship between loneliness and the difficulty in emotion regulation with drug abuse. The Enter regression analysis for prediction of the drug abuse shows that the loneliness predicts .09 and the difficulty in emotional regulation predicts .08 of the drug abuse variances (P≤ .05). Conclusion: Therefore, it is recommended to university and cultural instructional planners to pay attention to variables of loneliness and emotional regulation as drug abuse risk factors and introduce especial and preventer programs in this subject. 55 64 2015/02/62015/06/142015/04/172015/03/22015/05/172015/06/142015/04/14 1394/1/25 2015/06/92015/06/142015/06/92015/06/92015/06/92015/06/142015/06/9 1394/3/19 زهرا نیک منش Zahra Nikmanesh University of Sistan and Baluchestan zahranikmanesh@yahoo.com یحیی کاظمی Yahya Kazemi University of Sistan and Baluchestan yahya_kazemi@yahoo.com معصومه خسروی Masoume Khosravi Prisons Office Zahedan, Zahedan, Iran masome.khosravy@gmail.com Loneliness Emotion Regulation Drug abuse احساس تنهایی خود تنظیمی هیجانی سوء مصرف مواد 1. Harriette B, Fox M, Mcmanus A, et al. Significant multiple risk behaviors. The National Alliance to Advance adolescent Health. 2010;8:1-10.##2. Stoiber K, Good B. Risk and Resilience Factors Linked to Problem Behavior among Urban, Culturally Diverse Adolescents. School Psychology Review. 1995;27:1-18. ##3. Mancini J A, Huebner A J. Adolescent risk behavior patterns: effects structured time-use, interpersonal connections, self-system characteristics, and socio-demographic influences. Child and Adolescents Social Work Journal. 2004;21:647-668.##4. Springer A, Parcel G, Baumler E, et al. Supportive social relationships and adolescent health risk behavior among secondary school students in El salvador. Social Science & medicine. 2005;62:1628-1640.##5. Baumagartner S E , Valkenburg P M , Peter J. Assessing Causality in the Relationship Between Adolescents’ Risky Sexual Online Behavior and Their Perceptions of this Behavior. Journal Youth Adolescent. 2010;39(10):1226–1239.##6. Everet S, Malarcher, A. Relationships between cigarette, smokeless Tobaceo and cigar use and other health risk behaviors amony us highschool students. Journal of School Health. 2000;70:234-40##7. Antognoli-Toland,P L. Adolescent loneliness: Testing a predictive model. Journal of Theory Construction & Testing .2000;4:7-13.##8. Wright S L. Loneliness in the workplace. Unpublished Doctoral dissertation. University of Canterbury. 2005.48##9. Page R M. High school size as a factor in adolescent loneliness. High School Journal. 1990;73,150-153.##10. Asher S R, paquette J A. Loneliness and peer relations in childhood. Current Directions in Psychological Science. 2003;12:75-78.##11. Seghati T, Shafiabady A, Sodani M, et al. Effectiveness of group training based on transactional analysis in reducing loneliness girl students of high school first grade in rasht . Indian Journal Science Research. 2014;4(3):422-429(Persian) . ##12. Cacioppo J, William P. Loneliness: human nature and the need for social connection. New York: Norton 2008.##13. Shute N. Why loneliness is bad for your health. U.S. News and World Report. 2008. Available in http://health.usnews.com/articles/ health/ 2008/11/12/why-loneliness-is-bad-for-your-health.html.##14. Zare H, solgi Z. Investigation of the Relationship between Cognitive Emotion Regulation Strategies with Depression, Anxiety and Stress in Students. Journal of Research in mental health. 2013;6(3),19-29 (Persian) . ##15. Hofmann W, Brandon J, BaddeleyAD. Executive function and self- regulation. Trends in Cognitive Sciences. 2012;16(3):174-180##16. Ghalehban M. Examination and comparison of Alexithymia and self- regulation in patients with substance abuse disorder and normal individuals. MS Thesis,University of Tehran. 2009;15(Persian). ##17. Liebermann D , Giesbrecht G F, Muller U. Cognitive and emotional aspect of self-regulation in preschoolers. Cognitive development. 2007;22:511-529.##18. Loas G , Otmani O , Lecercle C, et al. The relationships between the emotional and cognitive components of alexithymia and dependency in alcoholics. Psychiatry research. 2000;96:63-74##19. Claes L, Bijttebier P, Van den Eynde F, et al. Emotional reactivity and self- regulation in relation to compulsive buying. Personality and Individual Difference. 2010;49:526-530##20. Boyer T W, Byrnes J P. Adolescent risk-taking: Integrating personal, Cognitive, and social aspects of judgment. Journal of Applied Developmental Psychology. 2008;30:23-33##21. Schmidt N, Sermat V. Measuring Loneliness in different relationships. Journal of personality and social psychology. 1983;44:1038-1047##22. McWhirter B T. Factor analysis of the revised UCLA Loneliness Scale. Current Psychology: Research and Review. 1990;9(1):56-68##23. Khoynezhad G R, Rajaei A R, Moheb-e- Raad T. To Investigate Mathematical Cognitive Abilities (Spatial and Numerous) and Their Correlation With Educational Development, Mental Age and Gender. Knowledge & Research in Applied Psychology. 2008;9(34):75-92 (Persian). ##24. Gratz K L, Roemer L. Multidimensional assessment of emotion regulation and dysregulation development, factor structure and initial validation of the difficulties in emotion regulation scale. Journal of psychopathology and behavioral assessment. 2004;26(1):41-54##25. Alavi KH, Modares Gharavi M, Izadi A, et al. Effectiveness of group dialectical behavior therapy(based on core mindfulness, distress tolerance and emotion regulation components) on depressive symptoms in university students. Journal of Fundamentals and Mental Health. 2011;2(50):124-135 (Persian).##26. Kazemi Y, Nikmanesh Z. The relationship between religiosity, self -control and drug abuse. Journal of Urmia Nursing and Midwifery Faculty 2011; 9(3): 174 (Persian). ##27. Tapert S F, Aarons AG, Sedlar GR, et al. Adolescent Substance Use and Sexual Risk- Taking Behavior. Journal of Adolescent Health 2001; 28(7): 181##28. Dawes M A, Mathias Ch W, Richard D M, et al. Adolescent suicidal behavior and substance use: Developmental Mechanisms. Subst Abuse 2008; 31(2): 13-28 ##29. Row J, Kahn R. Successful aging. The Gerontologist 1997; 37: 443- 440. ##30. Van Tilburg T. Loosing and gaining in old age: Changes in personal network size and social support in a four-year longitudinal study. Journals of Gerontology Series B-Psychological Sciences & Social Sciences 1998; 53: 313-323.##31. Henrich L M, Gullone E. The clinical significance of loneliness: A literature review. Clinical Psychology Review 2006; 26: 695-718.##32. Hawkley L C, Burleson M H , Bernston G G , et al. Loneliness in everyday life: Cardiovascular activity, psychosocial context, and health behaviors. Journal of Personality andSocial Psychology 2003; 85: 105-120.##33. Jones W, Hebb L. The experience of loneliness: objective and subjective Factors. The International Scope Review. 2003; 5 (9): 41-68##34. Hendershot CH S, Witkiewitz K, George W H, et al. Relapse prevention for addictive behaviors.Substance Abuse Treatment, Prevention, and Policy.2011; 6:17##35. Bridge JA, Goldstein TR, Brent DA. Adolescent suicide and suicideal behavior. J child psychol psychiatry. 2006; 47:372-94.##36. Dalton EJ, Cate-Carter TD, MunDo E.Suicide risk in bipolar patients: The role of co-morbid substance use disorder. Bipolar disorder. 2005; 5: 58-61##37. Maharaj R, Nunes P, Renwick SH. Health risk behaviors among adolescents in the English-speaking Caribbean: a review. Child and Adolescent Psychiatry and Mental Health. 2009; 3:10.##38. Thorberg F A, Lyvers M. Negative mood regulation (NMR) expectancies, mood, and affect intensity among clients in substance disorder treatment facilities. Addictive behaviors 2006; 31:811-820##39. Cheethama A, Allen N B, Yücel M, et al. The role of affective dysregulation in drug addiction. Clinical Psychology Review. 2010; 30: 621–634##40. Tull M T, Weiss N H, Adams C E, et al. The contribution of emotion regulation difficulties to risky sexual behavior within a sample of patients in residential substance abuse treatment. 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Evaluation of 5 Years Trend of Occurrence for the Genital System Carcinoma Amongst Women Yazd Province -2006-2010 بررسی روند 5 ساله سرطانهای دستگاه ژنیتال در زنان مبتلا استان یزد طی سال های 1389-1385 2 1 زمینه و هدف: سرطان های دستگاه ژنیتال بر طبق آمارهای غربی،7/12% از کل بدخیمی های زنان را به خود اختصاص داده است و 8/9% از کل مرگ و میر زنان بر اثر سرطان مربوط به این بدخیمی ها میباشد.  روش اجرا: این مطالعه به روش مقطعی- تحلیلی وبا هدف شناخت روند سرطان های دستگاه ژنیتال در استان یزد طی سالهای 1385-89 انجام گرفته است . تمامی موارد سرطانهای دستگاه ژنیتال ثبت شده در مرکز ثبت سرطان استان یزد طی سال های 1385 الی 1389 مورد بررسی قرار گرفت و میزان بروز برحسب سن، محل سکونت و سال بروز ، شغل، درامد وسابقه فامیلی محاسبه شد. داده ها با استفاده از ازمون های توصیفی، کای دو،student t-test مورد تجزیه و تحلیل قرار گرفت.  یافته ها: سرطان های دستگاه ژنیتال در سنین بالاتر از 50 سال و در زنان خانه دار و متاهل شایع تر می باشد. سطح تحصیلات اکثر انها در حد ابتدایی (40.5%) و درامد اغلب انان (49.6%) در رنج متوسط قرارداشت. بیشترین امار ابتلا (30%) مربوط به سال 89 می باشد. از بین سرطان های دستگاه ژنیتال ، سرطان رحم (جسم رحمی و آندومتر رحم) بیشترین درصد فراوانی (42.73%) را به خود اختصاص داده است . نتایج نشان داد که تنها رابطه بین وضعیت تاهل و بروز بیماری (p-value=.034) و همچنین رابطه بین سن و بروز بیماری (p-value=.000)معنی دار بود. سرطان سرویکس و رحم در سنین بالای 50 سال وسرطان تخمدان در سنین کمتر از 30 سال شایع تر بوده است.  نتیجه گیری: نتایج مطالعه حاضر نشان داد که میزان بروز سرطان دستگاه ژنتیال در میان زنان یزدی یک روند افزایشی طی سالهای 1385 تا 1389 داشته است و فاکتورهای اقتصادی اجتماعی نقش مهم و معناداری داشته اند. این نتایج، مشابه نشانگرها وشاخص های سلامت جوامع کشورهای در حال توسعه است که تحت تاثیر تغییرات فاکتورهای محیطی ، اقتصادی و اجتماعی قرار گرفته است. 2 Background: According to some studies in the western countries, %12.7 of total female cancers and %9.8 of all deaths resulted from cancers in the females are due to genital system carcinoma. Methods: The present analytic cross sectional study was done on the cancer registry data of Yazd province for the evaluation of trend of genital carcinoma occurrence amongst females from 2006 to 2010. The trend of cancer incidence was calculated according to age, year of occurrence, family history, income, and job and residence place. Data was analyzed using student T-test and chi-square test. Findings: There were seen higher percentages of cancer amongst age above 50 years, married women and householders. Majority of those had education level of primary (%40.5) and moderate income level (%49.6). The highest incidence rate was related to year 2010 (%30) and uterus cancers including body & endometrial was more common than others ( %42.7). The association between cancer incidence and age (p<.001) also disease occurrence and marital status (p=.03) were seen statistically significant. Cancers of uterus and cervix among subjects with age above 50 and cancer of ovary among females under 30 years was more common. Conclusion: our results showed that the incidence rate of genital carcinoma amongst Yazdi females has had a increasing trend from 2006 to 2010 and socio- economic factors had significant role in the causation of cancer. This is the same indicators coming from developing countries where community health is influencing from socio-economic and environmental changes. 65 73 2015/02/62015/06/142015/04/172015/03/22015/05/172015/06/142015/04/142015/05/31 1394/3/10 2015/06/92015/06/142015/06/92015/06/92015/06/92015/06/142015/06/92015/06/9 1394/3/19 محمدحسن لطفی Mohammadhasan Lotfi mhlotfi56359i@yahoo.com فاطمه امیری Fatemeh Amiri Cancer Genital Female Trend Yazd سرطان ژنیتال روند زنان یزد ایران ##1. Koosha A, Farahbakhsh M, Hakimi S,et al. Epidemiologic assessment of cancer disease in east Azerbaijan 2007. Medical Journal of Tabriz University of Medical Sciences. 2010;4(32):74-9.(Persian)##2. Haghighi F, Saadatjoo S, Fanoodi F, et al. The epidemiologic study of the neoplasms in the internal genital system of women referring to pathologic centers in Birjand (1996-2006). Journal of Birjand University of Medical Sciences. 2009;15(4):75-83(Persian).##3. Shahzad B, Mortazavi SH, Aminian S. study of 1698 cases of cancer of genital Jarjani Hospital,1351-77. Research Journal of shahid beheshti university of medical sciences. 2002;2:115-7.##4. Azizi F, Hatami H, Janghorbani M. Epidemiology and control of common diseases in Iran. Tehran: Eshtiagh Publications. 2000:602-16.##5. Jafari M, Halimi M, Dastranj Tabrizi A, et al. Prevalence of for Precancerous and Invasive Cancer Lesions of Cervix Tabriz 2003-2005. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2008;10(2):63-78.##6. Permuth-Wey J, Sellers TA. Epidemiology of ovarian cancer. Methods in molecular biology; 2009;472: 413-37.##7. Bray F, Loos AH, Tognazzo S, et al. Ovarian cancer in Europe: Cross‐sectional trends in incidence and mortality in 28 countries, 1953–2000. International Journal of Cancer. 2005;113(6):977-90.##8. Ghayourl AE, Behtash N, Fakhr Jahani F. Symptoms of ovarian cancer in young patients: a case control study in Iran, 1998-2005. Journal Of Medical Council Of IRI. 2006;24(3):240-249##9. Lindemann K, Eskild A, Vatten LJ, Bray F. Endometrial cancer incidence trends in Norway during 1953–2007 and predictions for 2008–2027. International Journal of Cancer. 2010;127(11):2661-8.##10. Schottenfeld D. Epidemiology of endometrial neoplasia. Journal of Cellular Biochemistry. 1995;59(S23):151-9.##11. Almassi Nokiani F, Akbari H. Prevalence of invasive and pre-invasive cervical lesions in Kermanshah (2003-2007). The Journal of Qazvin University of Medical Sciences. 2009;13(1):42-8.##12. Aghajani H, Eatemad K, Goya M, et al. Iranian Annual of National Cancer Registration Report 2008-2009: Center for Disease And Prevention Noncommunicable Disease Unit Cancer Office; 2011.##13. Perez C, Brady L. Principles and practice of radiation oncology. Journal of Pediatric Hematology/Oncology. 1999;21(6):560.##14. . Iran Scientific Association of Woman's Cancer. Abstract Book of First Congress of Iran Scientific Association of Woman's Cancer.1st ed. Tehran:Tehran university of Medical Sciences.2007##15. Yusfi Z, Ahmadi S. A Prospective study of female genital cancers at Ghaem hospital in Mashhad. Journal of Sabzevar University of Medical Sciences. 2002;4:8-15.##16. Park B, Park S, Kim T-J, et al. Epidemiological characteristics of ovarian cancer in Korea. Journal of Gynecologic Oncology. 2010;21(4):241-7.##17. Crist C, Ros AMV. Florida Annual Cancer Report. http://get.adobe.com/reader/.##18. Nikolova Z, Ananoshtev N, Karnolski I. Female sex organs malignancies incidence in Plovdiv district for the period 1986-1996. Folia medica. 1998;40(3B Suppl 3):61.#### ##

Training Methods of Clinical Breast Examination روش های آموزش معاینه بالینی پستان 2 1 سابقه و اهداف: با توجه به نقش مهم معاینه بالینی در تشخیص توده های پستان، آموزش معاینه بالینی (CBE) به پزشکان در حال تحصیل بسیار حائز اهمیت می باشد. با وجود روش های متعدد برای آموزش معاینه فیزیکی، روش های رایج مثل استفاده از بیماران به خصوص در زمینه پستان به دلایل مختلف مقبولیت ندارد. تاکنون در رابطه با روش بهینه آموزش معاینه بالینی پستان مطالعه ی مروری صورت نگرفته است. هدف از انجام این مطالعه، بررسی مزایا و معایب روش های موجود و در نهایت انتخاب بهترین روش می باشد. روش بررسی: یک جست و جوی رایانه ای در سایت Google Scholar با استفاده از کلمات کلیدی زیر انجام شد: آموزش، معاینه بالینی و پستان. آخرین جست و جوی انجام شده در آبان ماه 1392 انجام و زبان مقالات به صورت فارسی و انگلیسی محدود شد. هر نوع مطالعه مروری، نامه به سردبیر، تحقیقی اصیل و ... وارد مطالعه شد. یافته ها: 11 مطالعه برای بررسی روش های آموزش معاینه بالینی پستان انتخاب شد که این مقالات در سال های 2011-2000 به چاپ رسیده است. بحث و نتیجه گیری: برای روش های آموزش معاینه بالینی به طور کلی 6 روش وجود دارد که شامل: 1) معاینه طبیعی در گروه های کوچک با تمرین روی یکدیگر: این روش برای بعضی اندام ها من جمله پستان مناسب نمی باشد و اصلا در CBE مطرح نمی باشد. 2) لوح فشرده (CD) و چند رسانه ای: به تنهایی کافی نمی باشد و ممکن است بین کتاب مرجع و منبع رایانه ای هم خوانی نباشد. 3) استفاده از بیماران: از طرفی با حقوق بیمار تضاد دارد و از طرف دیگر از منابع مستند اضطراب دانشجویان موقع یادگیری به دلیل انتطارات تشخیصی اطرافیان است. علاوه بر این ها ممکن است بیماران توده پستانی نداشته باشند. 4) استفاده از شبیه ساز: تنها روش بهبود مهارت لمس در تشخیص و آموزش معاینه بالینی است که به نوبه خود دارای چالش هایی نیز می باشد. هم چنین هنگام استفاده از آن ها بایستی نکاتی را مد نظر قرار داد. 5) تصویر برداری تماس الکترونیک: بر اساس اندازه گیری مکانیکی فشار و استفاده از کاوشگر کامپیوتری و سنسور فشاری است. این دستگاه زمان مورد نیاز برای آموزش را کاهش می دهد، اما مطالعات در این زمینه هنوز به پایان نرسیده است. 6) تلفیقی از روش های فوق: رویکرد ترکیبی باعث آسان شدن یادگیری فعال و عمیق می شود. با توجه به بررسی های انجام شده، آموزش رسمی با استفاده از ویدئو و شبیه ساز به صورت ترکیبی جهت آموزش معاینه بالینی پستان پیشنهاد می شود. 2 With respect to the important role of clinical examination in breast lesion diagnosis, training of Clinical Breast Examination (CBE) to medical students are very critical. Despite the various method of physical examination, the current methods like using patients especially about breast aren’t accepted because of various reasons. Until now, any review studies about the optimum method of CBE haven't yet performed. The objective of this study is the survey of disadvantages and advantages of the existing method and finally choosing the best method. A computer search was performed in Google Scholar site by the following key words: education, clinical examination, and breast. 11 studies published in 2000-2011, were selected for survey of CBE method. There are 6 methods of clinical examination, generally, include 1) naturally physical examination in small groups by exercising each other 2) Compact disk (CD) and multimedia 3) Use of live patients 4) Use of simulators 5) Electronic Palpation Imaging (EPI) and 6) Combination of the above methods: The combination approach make active and deep learning easy. With respect to our investigation, formal education by using video and simulators as a combined method is suggested in order to train CBE 74 78 2015/02/62015/06/142015/04/172015/03/22015/05/172015/06/142015/04/142015/05/312015/05/27 1394/3/6 2015/06/92015/06/142015/06/92015/06/92015/06/92015/06/142015/06/92015/06/92015/06/9 1394/3/19 سیدمصطفی شیریزدی Seyed Mostafa Shiryazdi Department of General Surgery, Breast Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran smshiryazdi@yahoo.com محدثه ابوئیان جهرمی Mohaddeseh Aboueian-Jahromi مرکز تحقیقات بیماری های پستان، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی شهید صدوقی یزد، ایران mohaddesehabooean791@gmail.com Training Clinical Examination Breast Simulator. آموزش معاینه بالینی پستان شبیه سازی. ##1. Madan AK, Aliabadi-Wahle S, Babbo AM, et al. Education of medical students in clinical breast examination during surgical clerkship. American Journal Surgery. 2002;184:637-40.##2. Gerling GJ, Weissman AM, Thomas GW, et al. Effectiveness of a dynamic breast examination training model to improve clinical breast examination (CBE) skills. Cancer Detective Prevention. 2003;27:451-6.##3. Ziv SDS, Root P, Amitai W. Patient safety and simulation-based medical education. Med Teach. 2000;22:489-95.##4. Pugh CM, Salud LH. Fear of missing a lesion: use of simulated breast models to decrease student anxiety when learning clinical breast examinations. American Journal Surgery. 2007;193:766-70.##5. Vafamehr V. Comparing the Effectiveness of Two Educational Approaches of “Electronic Learning and Training in Small Groups” and" Training Only in Small Groups" in Teaching Physical Examination. Iran Journal Medicin Education. 2010;10:11-8.##6. Chang EH, Power DV. Are medical students comfortable with practicing physical examinations on each other? Acad Med. 2000;75:384-9.##7. Ables DC, Son JS, Kaufman CS, et al. Quantifying the sense of touch and reducing training time for the clinical breast exam using electronic palpation imaging. Sigma.2013;4:5.9.##8. Pugh CM, Domont ZB, Salud LH, et al. A simulation-based assessment of clinical breast examination technique: do patient and clinician factors affect clinician approach? American Journal Surgery. 2008;195:874-80.##9. Pazargadi M, Sadeghi R. Simulation in nursing education. Bimonthly Education Strateg Med Science. 2011;3:161-7.#### ##