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Necessity of Paying Attention to Sesame Oil Production Safety لزوم توجه به ایمنی تولید روغن کنجد 2 1 روغن کنجد معروف به ملکه روغن­ها یکی از منابع با ارزش غذایی بالا به شمار می­رود. روغن خام کنجد دارای ترکیباتی همچون موم­ها، اسید­های چرب آزاد و غیر اشباع، آنتی­اکسیدان­هایی نظیر ویتامین E، صمغ، ذرات ریز و... می­باشد. اگرچه وجود ترکیباتی مانند آنتی­اکسیدان­ها این ماده غذایی را به ترکیبی ضد سرطان تبدیل نموده است و همچنین به واسطه وجود اسید­های چرب غیر اشباع به بیماران قلبی نیز توصیه می­گردد .اما می­بایست توجه نمودکه این روغن هم مانند سایر روغن­ها­ی مایع دارای پتانسیل فساد بالاییست و به واسطه­ی عواملی مانند نور، مجاورت با هوا، دما و رطوبت موجود در محیط و عوامل میکروبی دچار فساد شیمیایی و میکروبی می­گردد و سبب فرایند هیدرولیز و اکسیداسیون می­شود. که لزوم رعایت نکات ضروری در طی تولید و نگهداری را دو چندان می­کند. به طور کلی تولید رادیکال­های آزاد طی فرایند هیدرولیز بسیار مضر بوده و سبب ایجاد بیماری­هایی همچون سرطان می­گردد. لازم به ذکر است این روغن هم اکنون به صورت صنعتی و دستی در حضور مشتری تولید می­شود. در فرایند تولید صنعتی با انجام فرایند تصفیه سهم زیادی از عوامل دخیل در فرایند فساد حذف و یا کنترل می­گردد و برخی از آنتی اکسیدان­های طبیعی مانند ویتامینE  و  Aکه طی تصفیه کاهش پیدا کرده به عنوان آنتی اکسیدان و جلوگیری از فساد به روغن افزوده می­شود اما در روش­های دستی یا به اصطلاح سنتی و در حضور مشتری درطی تولید مواجهه روغن با عوامل مخاطره آمیز افزایش یافته و گاها روغن در ظروف غیر استاندارد بسته بندی می­گردد.حذف یا کاهش عوامل مضر نیز امکان پذیر نبوده و در نهایت سلامت مصرف کننده به خطر می­افتد. لذا نظارت و توجه بیشتر و آگاه سازی مراکز تولید سنتی و مصرف کنندگان در خصوص ایمنی تولیدروغن کنجد جهت سلامت مصرف کنندگان بسیار حائز اهمیت است. 2  Sesame oil, known as Queen Oil, is one of the most nutritious sources. Raw sesame oil contains compounds, such as waxes, free fatty acids, and unsaturated fatty acids. It also contains antioxidants such as vitamin E, gum, small particles, etc. (1, 2). Given the presence of anticancer compounds, such as antioxidants and unsaturated fatty acids, this foodstuff is recommended to patients with cardiovascular diseases (3). However, it should be considered that this oil, similar to all other liquid oils, has high potential for chemical and microbial spoilage due to factors, such as light, exposure to air, temperature, humidity of the environment, and microbial agents. Furthermore, Sesame oil causes hydrolysis and oxidation processes, which increases the necessity of observing the essential points during the production and maintenance. Generally, production of free radicals during the hydrolysis process is very harmful and causes diseases like cancer (4, 5). It should be noted that this oil is produced industrially and manually (in the presence of the customer) 65 66 2019/01/13 1397/10/23 2019/05/19 1398/2/29 مهرنوش شیردلی Mehrnoosh Shirdeli Department of Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran سعیده السادات حسینی Saeede Sadat Hosseini Department of Microbiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran مطهره السادات حسینی Motahareh Sadat Hosseini Department of Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran There are no keywords Ji J, Liu Y, Shi L, et al. Effect of roasting treatment on the chemical composition of sesame oil. LWT. 2019;101: 191-200.##Brühl L. Fatty acid alterations in oils and fats during heating and frying. European Journal of Lipid Science and Technology. 2014; 116(6): 707-715.##Chen Y, Wu YJ, Deng TT. Detection and control of mustard and sesame as food allergens. In Handbook of Food Allergen Detection and Control. Woodhead Publishing Series in Food Science, Technology and Nutrition; 2015:391-408.##Dobarganes C, Marquez-Ruiz G. Oxidized fats in foods. Current Opinion in Clinical Nutrition & Metabolic Care.2003; 6(2): 157-163.##Hosseini H, Ghorbani M, Meshginfar N, et al. A review on frying: procedure, fat, deterioration progress and health hazards. Journal of the American Oil Chemists' Society. 2016; 93(4): 445-466.##Hu R, He T, Zhang Z, et al. Safety analysis of edible oil products via Raman spectroscopy. Talanta. 2018; 191:324-332.##Shahidi F, Wanasundara UN. Methods for measuring oxidative rancidity in fats and oils. In: Akoh CC, Min DB, Eds. Food Lipids, Chemistry, Nutrition, and Biotechnology. 2th ed. Boca Raton: CRC Press; 2002: 465-505.##Zhang L, Huang X, Li P, et al. Multivariate adulteration detection for sesame oil. Chemometrics and Intelligent Laboratory Systems. 2017; 161: 147-150.##Zhao F, Liu J, Wang X, et al. Detection of adulteration of sesame and peanut oils via volatiles by GC× GC- TOF/MS coupled with principal components analysis and cluster analysis. European Journal of Lipid Science and Technology. 2013; 115(3): 337-347.##Zhao X, Dong D, Zheng W, et al. Discrimination of adulterated sesame oil using mid-infrared spectroscopy and chemometrics. Food Analytical Methods. 2015; 8(9): 2308-2314.##Ji J, Liu Y, Shi L, et al. Effect of roasting treatment on the chemical composition of sesame oil. LWT. 2019;101: 191-200.##Brühl L. Fatty acid alterations in oils and fats during heating and frying. European Journal of Lipid Science and Technology. 2014; 116(6): 707-715.##Chen Y, Wu YJ, Deng TT. Detection and control of mustard and sesame as food allergens. In Handbook of Food Allergen Detection and Control. Woodhead Publishing Series in Food Science, Technology and Nutrition; 2015:391-408.##Dobarganes C, Marquez-Ruiz G. Oxidized fats in foods. Current Opinion in Clinical Nutrition & Metabolic Care.2003; 6(2): 157-163.##Hosseini H, Ghorbani M, Meshginfar N, et al. A review on frying: procedure, fat, deterioration progress and health hazards. Journal of the American Oil Chemists' Society. 2016; 93(4): 445-466.##Hu R, He T, Zhang Z, et al. Safety analysis of edible oil products via Raman spectroscopy. Talanta. 2018; 191:324-332.##Shahidi F, Wanasundara UN. Methods for measuring oxidative rancidity in fats and oils. In: Akoh CC, Min DB, Eds. Food Lipids, Chemistry, Nutrition, and Biotechnology. 2th ed. Boca Raton: CRC Press; 2002: 465-505.##Zhang L, Huang X, Li P, et al. Multivariate adulteration detection for sesame oil. Chemometrics and Intelligent Laboratory Systems. 2017; 161: 147-150.##Zhao F, Liu J, Wang X, et al. Detection of adulteration of sesame and peanut oils via volatiles by GC× GC- TOF/MS coupled with principal components analysis and cluster analysis. European Journal of Lipid Science and Technology. 2013; 115(3): 337-347.##Zhao X, Dong D, Zheng W, et al. Discrimination of adulterated sesame oil using mid-infrared spectroscopy and chemometrics. Food Analytical Methods. 2015; 8(9): 2308-2314.## ##

The Relationship between Mother-Child Interaction and Mental Health of Adolescent Girls: The Mediating Role of Religious Identity رابطه تعامل مادر_ فرزند و سلامت روان دختران نوجوان : نقش واسطه ای هویت دینی 2 1 مقدمه: سلامت روان دختران نوجوان به عنوان مادران آینده از مسائل حائز اهمیت است. پژوهش حاضر با هدف بررسی نقش واسطه ای هویت دینی در ارتباط تعامل مادر-فرزند و سلامت روان دختران نوجوان در شهر یزد انجام شده است. روش ها: این پژوهش برروی  319 نفر از نوجوانان دختر پایه دهم تا دوازدهم دوره دبیرستان شهر یزد انجام شد. ابزارهای به‌کاررفته در پژوهش شامل پرسشنامه رابطه والد فرزندی (PCRS)، و پرسشنامه استاندارد سلامت عمومی گلدبرگ (GHQ-28)  و پرسشنامه هویت دینی ملی  لطف آبادی بود و داده ها با استفاده از روش مدل معادله ساختاری در نرم افزار AMOS نسخه 25  تجزیه و تحلیل شدند. یافته ها: یافته­های پژوهش با استفاده از روش معادلات ساختاری، حاکی از آن بود که کیفیت تعامل مادر-فرزند بر اختلال در سلامت روان (16/0- = β , 001/0 >P) و هویت دینی(31/0 = β , 001/0 >P)  تاثیر مستقیم و معناداری دارد. همچنین نتایج نشان داد هویت دینی بر اختلال در سلامت روان تاثیر مستقیم و معنادار دارد(16/0- = β و 001/0 >P). در نهایت نتایج نشان داد که هویت دینی توانسته نقش واسطه­ای در ارتباط بین کیفیت تعامل با مادر و اختلال در سلامت روان (05/0- = β و 05/0 >P) ایفا کند. برای ارزیابی مدل از شاخص­های چندگانه استفاده شد و نتایج نشان داد مدل پیشنهادی از برازش مناسبی برخوردار است. نتیجه گیری: هویت دینی به عنوان یک منبع حمایتی نوجوانان را در برابر استرس ها و خطرات ناشی از مشکلات دوره بلوغ  یاری داده  و از این طریق باعث افزایش سلامت روان نوجوانان می شود. تعامل مطلوب مادر فرزند رابطه معنادار و مستقیم با هویت دینی   دختران نوجوانان دارد.؛ بنابراین کیفیت رابطه با مادر به صورت غیرمستقیم و به واسطه افزایش هویت دینی، باعث افزایش سلامت روان در دختران نوجوان می­شود. 2 Introduction: Mental health of adolescent girls as future mothers is of great importance. The purpose of this study was to investigate the mediating role of religious identity in the relationship between mother-child interaction and mental health of adolescent girls in Yazd, Iran. Method: This study was conducted on 319 female students, studying at the tenth to twelfth grades of high schools in Yazd. In this study, Parent-Child Relationship Survey (PCRS), the Goldberg General Health Questionnaire (GHQ-28), and Lotf-Abadi National-Religious Identity Questionnaire were used. The structural equation modeling was used to analyze data using AMOS software version 25. Results: The findings of this study, using the method of structural equation modeling, showed that the quality of mother-child interaction had a direct and significant effect on both mental health disorder (β = -0.16, P< 0.001) and religious identity (β = 0.31, P< 0.001). In addition, the results showed that religious identity had a direct and significant effect on mental health disorder (β = -0.16, P< 0.001). Furthermore, religious identity played a mediator role in the relationship between mother-child interaction and mental health disorder (β = -0.05, P< 0.05).Multiple indices were used to evaluate the model and the results showed that the proposed model had goodness-of-fit. Conclusion: Religious identity, as a protecting resource, helps adolescents against the stress and dangers, which arise from the puberty-related problems and increases their mental health. A good mother-child relationship has direct and significant relationship with the religious identity of adolescent girls. Therefore, the quality of relationship with mother, as a result of the religious identity development, can increase the mental health of female adolescents. 67 75 2019/01/132019/03/12 1397/12/21 2019/05/192019/05/21 1398/2/31 مریم کریمی Maryam Karimi Department of Family Counseling, Faculty of Psychology and Education, Allameh Tabatabaei University, Tehran, Iran Iran maryam_karimi79@yahoo.com مهدیه استبرقی Mahdieh Estabraghi Department of Educational Psychology, Yazd University, Yazd, Iran Iran estabraghi87@yahoo.com علی حسین زاده اسکوئی Ali Hosseinzadeh Oskouee Department of Family Counseling, Shahid Beheshti University, Tehran, Iran Iran hosseinzadeh.aliso@gmail.com سمیه کاظمیان Somayeh kazemian Department of Counseling, Faculty of Psychology and Education, Allameh Tabatabaie University, Tehran, Iran Iran s.kazemian@atu.ac.ir Mother-Child Relations Religious Identity Mental Health Adolescent Girls روابط مادر- فرزند هویت دینی سلامت روان دختران نوجوان Keil F. Developmental psychology: the growth of mind and behavior. WW Norton & Company; 2013.##Walker SP, Wachs TD, Grantham-McGregor S, et al. Inequality in early childhood: risk and protective actors for early child development. The Lancet. 2011; 378(9799): 1325-1338.##Badr HE, Naser J, Al-Zaabi A, et al. Childhood maltreatment: A predictor of mental health problems among adolescents and young adults. Child Abuse & Neglect. 2018; 80: 161-171.##Carnes-Holt K. Child-parent relationship therapy for adoptive families. The Family Journal. 2012; 20(4): 419-426.##Satoorian SA, Tahmassian K, Ahmadi MR. The role of parenting dimensions and child-parent relationship in children's internalized and externalized behavioral problems. Journal of Family Research. 2017; 12(4): 683-705. [Persian].##Joshan-Poush S, Fazilat-Pour M, Rahmati A. The effectiveness of parent-child relationship training based on ACT on the parent-adolescent conflict of mothers with epileptic child. Journal of Researches of Cognitive and Behavioral Sciences. 2017; 7(2): 39-50. [Persian].##Levin KA, Currie C. Family structure, mother-child communication, father-child communication, and adolescent life satisfaction: A cross-sectional multilevel analysis. Health Education. 2010; 110(3): 152-168.##KhajeNoori B, Dehghani R. Adolescents' problems and their relationship with family institution: the case study of parental conflicts and adolescents' mental health. Journal of Sociology of Social Institutions. 2016; 3(7): 37-66. [Persian].##Amin-Khandaghi M, Pakmehr H. The relationship between students' critical thinking and mental health in Mashhad University of Medical Sciences. The Quarterly Journal of Fundamentals of Mental Health.2011; 13(2): 114-123. [Persian].##Onayli SE. The relation between mother-daughter relationship and daughter's well being. [Master Thesis].Turkey. Middle East Technical University, School of Social Sciences; 2010.##Pyun YS. The influence of father-child relationship on adolescents' mental health. [Doctoral dissertation].Minnesota. Minnesota State University, Clinical Psychology; 2014.##Sahraian A, Gholami A, Omidvar B. The relationship between religious attitude and happiness in medical students in Shiraz University of Medical Sciences. Quarterly of the Horizon Medical Sciences. 2011; 17 (1): 69-74. [Persian].##Jackson JC, Jong J, Bluemke M, et al. Testing the causal relationship between religious belief and death anxiety. Religion, Brain & Behavior. 2018; 8(1): 57-68.##Galek K, Flannelly KJ, Ellison CG, et al. Religion, meaning and purpose, and mental health. Psychology of Religion and Spirituality. 2015; 7(1):1-12.##Darvishi M, GhaziVakili Z, Mohammadi A. The relationship between religious beliefs and mental health in students of Alborz University of Medical Sciences and Health Services and Karaj Islamic Azad University in 92-93. Alborz University Medical Journal. 2017;6(2):145-152. [Persian].##Esmeri-BareZard Y, Mahmudi A, Motevali M. The relationship between religious and national identity and depression and quality of life in first high school students. Third Interational Conference on Recent Innovations in Psychology, Counseling and Behavioral Science; 2016 Nov. 10; Tehran, Nikan Institute of Higher Education. [Persian].##Rahpeima S, Sheykholeslami R. The mediating role of spiritual identity on the relationship between parent and peer attachment with resilience. Contemporary Psychology.2016; 11 (1): 47-62. [Persian].##BagherPur-Kamalchli S,Bahrami-Ehsan H,Fathi-Ashtiyani A, et al. Study of relationship between parenting patterns and mental health and educational achievement of children. Journal ofBehavioral Sciences. 2007;1(1): 33-40. [Persian].##Abareshi Z, Tahmasian K, Mazaheri MA, et al. The effect of education on the promotion of child psychosocial development through improving mother-child interaction on parenting self-efficacy and relationship between mother and child under the age of three. Journal of Research in Psychological Health. 2009; 3(3): 49-58. [Persian].##ParsaMehr M, AsghariYangje V. The relationship between psycho-social health and national-religious identity amongYazdi High School Students. Quarterly Journal of Education. 2016; 32 (126):31-46. [Persian].##Khanjani Z, Peymannia B, Hashemi T. Prediction of quality of interaction mother-child with anxiety disorders in children According to cultural characteristics of Iranian mothers. Journal of New thoughts on Education. 2016; 12(2): 239- 260. [Persian].##Raufi M. Religious identity components. Religion & Communication. 2011; 17(1): 91-112. [Persian]##Fabricatore AN, Handal PJ, Rubio DM, et al. Stress, religion, and mental health: Religious coping in mediating and moderating roles. The International Journal for the Psychology of Religion. 2004; 14(2): 91-108.##Kézdy A, Martos T, Boland V, et al. Religious doubts and mental health in adolescence and young adulthood: The association with religious attitudes. Journal of Adolescence. 2011; 34(1): 39-47.##Sharifi T, shokrkon H, Ahmadi H, et al. Investigating the relationship between religious and national identities and students' mental health. New Findings in Psychology. 2010; 4(11): 125- 142. [Persian].##ZareBahramAbadi M, Zahrakar K, SalehianBoroujerdi H, et al. The effectiveness of the relationship improvement program on the quality of parent-child interaction among adolescent girls - single parent families, with mother as the supervisor. Clinical Psychology. 2013; 5(2): 13-23.[Persian].##Karimi M, FatemiAghdaN. Investigating the relationship between the quality of parent-child interaction and critical thinking dispositions with mental health components among adolescent girls. Journal of Counseling Research. 2019; 17(68):192-210. [Persian].##Keil F. Developmental psychology: the growth of mind and behavior. WW Norton & Company; 2013.##Walker SP, Wachs TD, Grantham-McGregor S, et al. Inequality in early childhood: risk and protective actors for early child development. The Lancet. 2011; 378(9799): 1325-1338.##Badr HE, Naser J, Al-Zaabi A, et al. Childhood maltreatment: A predictor of mental health problems among adolescents and young adults. Child Abuse & Neglect. 2018; 80: 161-171.##Carnes-Holt K. Child-parent relationship therapy for adoptive families. The Family Journal. 2012; 20(4): 419-426.##Satoorian SA, Tahmassian K, Ahmadi MR. The role of parenting dimensions and child-parent relationship in children's internalized and externalized behavioral problems. Journal of Family Research. 2017; 12(4): 683-705. [Persian].##Joshan-Poush S, Fazilat-Pour M, Rahmati A. The effectiveness of parent-child relationship training based on ACT on the parent-adolescent conflict of mothers with epileptic child. Journal of Researches of Cognitive and Behavioral Sciences. 2017; 7(2): 39-50. [Persian].##Levin KA, Currie C. Family structure, mother-child communication, father-child communication, and adolescent life satisfaction: A cross-sectional multilevel analysis. Health Education. 2010; 110(3): 152-168.##KhajeNoori B, Dehghani R. Adolescents' problems and their relationship with family institution: the case study of parental conflicts and adolescents' mental health. Journal of Sociology of Social Institutions. 2016; 3(7): 37-66. [Persian].##Amin-Khandaghi M, Pakmehr H. The relationship between students' critical thinking and mental health in Mashhad University of Medical Sciences. The Quarterly Journal of Fundamentals of Mental Health.2011; 13(2): 114-123. [Persian].##Onayli SE. The relation between mother-daughter relationship and daughter's well being. [Master Thesis].Turkey. Middle East Technical University, School of Social Sciences; 2010.##Pyun YS. The influence of father-child relationship on adolescents' mental health. [Doctoral dissertation].Minnesota. Minnesota State University, Clinical Psychology; 2014.##Sahraian A, Gholami A, Omidvar B. The relationship between religious attitude and happiness in medical students in Shiraz University of Medical Sciences. Quarterly of the Horizon Medical Sciences. 2011; 17 (1): 69-74. [Persian].##Jackson JC, Jong J, Bluemke M, et al. Testing the causal relationship between religious belief and death anxiety. Religion, Brain & Behavior. 2018; 8(1): 57-68.##Galek K, Flannelly KJ, Ellison CG, et al. Religion, meaning and purpose, and mental health. Psychology of Religion and Spirituality. 2015; 7(1):1-12.##Darvishi M, GhaziVakili Z, Mohammadi A. The relationship between religious beliefs and mental health in students of Alborz University of Medical Sciences and Health Services and Karaj Islamic Azad University in 92-93. Alborz University Medical Journal. 2017;6(2):145-152. [Persian].##Esmeri-BareZard Y, Mahmudi A, Motevali M. The relationship between religious and national identity and depression and quality of life in first high school students. Third Interational Conference on Recent Innovations in Psychology, Counseling and Behavioral Science; 2016 Nov. 10; Tehran, Nikan Institute of Higher Education. [Persian].##Rahpeima S, Sheykholeslami R. The mediating role of spiritual identity on the relationship between parent and peer attachment with resilience. Contemporary Psychology.2016; 11 (1): 47-62. [Persian].##BagherPur-Kamalchli S,Bahrami-Ehsan H,Fathi-Ashtiyani A, et al. Study of relationship between parenting patterns and mental health and educational achievement of children. Journal ofBehavioral Sciences. 2007;1(1): 33-40. [Persian].##Abareshi Z, Tahmasian K, Mazaheri MA, et al. The effect of education on the promotion of child psychosocial development through improving mother-child interaction on parenting self-efficacy and relationship between mother and child under the age of three. Journal of Research in Psychological Health. 2009; 3(3): 49-58. [Persian].##ParsaMehr M, AsghariYangje V. The relationship between psycho-social health and national-religious identity amongYazdi High School Students. Quarterly Journal of Education. 2016; 32 (126):31-46. [Persian].##Khanjani Z, Peymannia B, Hashemi T. Prediction of quality of interaction mother-child with anxiety disorders in children According to cultural characteristics of Iranian mothers. Journal of New thoughts on Education. 2016; 12(2): 239- 260. [Persian].##Raufi M. Religious identity components. Religion & Communication. 2011; 17(1): 91-112. [Persian]##Fabricatore AN, Handal PJ, Rubio DM, et al. Stress, religion, and mental health: Religious coping in mediating and moderating roles. The International Journal for the Psychology of Religion. 2004; 14(2): 91-108.##Kézdy A, Martos T, Boland V, et al. Religious doubts and mental health in adolescence and young adulthood: The association with religious attitudes. Journal of Adolescence. 2011; 34(1): 39-47.##Sharifi T, shokrkon H, Ahmadi H, et al. Investigating the relationship between religious and national identities and students' mental health. New Findings in Psychology. 2010; 4(11): 125- 142. [Persian].##ZareBahramAbadi M, Zahrakar K, SalehianBoroujerdi H, et al. The effectiveness of the relationship improvement program on the quality of parent-child interaction among adolescent girls - single parent families, with mother as the supervisor. Clinical Psychology. 2013; 5(2): 13-23.[Persian].##Karimi M, FatemiAghdaN. Investigating the relationship between the quality of parent-child interaction and critical thinking dispositions with mental health components among adolescent girls. Journal of Counseling Research. 2019; 17(68):192-210. [Persian].## ##

Prioritizing the Factors Affecting Evidence-based Medicine in Physicians Affiliated to Iranian Health Insurance اولویت بندی عوامل موثر بر انجام پزشکی مبتنی بر شواهد در پزشکان طرف قرارداد بیمه سلامت ایران 2 1 مقدمه و هدف: بکارگیری نتایج تحقیقات در پزشکی یکی از مهم ترین شاخص های توسعه این حرفه محسوب می شود که باعث ارائه مراقبت کارا و مؤثر به بیماران و بهبود کیفیت مراقبت ها می گردد. با این حال انتقال نتایج مبتنی بر شواهد به عرصه عملی کند و در مواردی ناموفق است. این مطالعه با هدف بررسی و اولویت بندی عوامل موثر بر انجام پزشکی مبتنی بر شواهد در پزشکان طرف قرارداد بیمه سلامت ایران انجام گرفت. روش ها : پژوهش حاضر یک مطالعه توصیفی-مقطعی است که بر روی 150 نفر از پزشکان طرف قرارداد بیمه سلامت ایران انجام شده است. روش نمونه گیری تصادفی ساده بود. ابزار گردآوری اطلاعات پرسشنامه ای  مشتمل بر سه قسمت مشخصات دموگرافیک پاسخگویان، پرسشنامه استاندارد بررسی موانع پزشکی مبتنی بر شواهد فونک (1995) در 4 حیطه و 25 سوال و پرسشنامه محقق ساخته اولویت بندی عوامل موثر بر اجرای پزشکی مبتنی بر شواهد بود. تجزیه و تحلیل اطلاعات با نرم افزار SPSS ویرایش 21 و نرم افزار Expert Choice و به کمک آزمون های آماری تی مستقل، آنالیز واریانس یک طرفه و روش تحلیل سلسله مراتبی انجام شد. یافته ها: بیشتر پزشکان مرد (53.3 درصد) و شاغل رسمی بودند. از بین 4 مولفه مورد بررسی بیشترین میانگین و انحراف معیار مربوط به بعد تاثیرات سازمانی و کمترین میانگین و انحراف معیار مربوط به بعد کیفیت تحقیق و نتایج احتمالی بود. در عوامل تاثیرات سازمانی، بالاترین وزن یا اولویت مربوط به عامل احساس عدم استقلال کافی برای تغییر درروشهای مراقبتی با وزن 0.259 بود. در بین عوامل مربوط به کیفیت تحقیق ونتایج احتمالی بالاترین وزن و اولویت مربوط به عامل وجود نقایص متدولوژی در تحقیق با وزن 0.192، در بین عوامل مرتبط با مهارت های انجام تحقیق، بالاترین اولویت و وزن مربوط به وجود نداشتن مدارک مستند برای تغییرعملکرد با وزن 0.320 و در خصوص عوامل مربوط به ارتباط ودسترسی به یافته های تحقیق نیز بالاترین وزن و اولویت در عامل در دسترس نبودن مقالات حقیقی (0.475) بود. نتیجه گیری: یافته های مطالعه نشان داد که پزشکان مشکلات و موانع را مربوط به سازمان، فرد و کیفیت تحقیقات می دانند، لذا باید تسهیلاتی جهت بکارگیری یافته های تحقیق ایجاد شود و زمینه های بکارگیری از نتایج تحقیقات ضمن به روز رسانی دانش، مهارت و نگرش مثبت پزشکان به تحقیقات، فراهم اید. 2 Introduction: The utilization of the medical research results is one of the most important indicators in the development of this profession, which provides effective care to patients and improves the quality of care. However, performing based on the evidence-based results has been unsuccessful in some cases. This study aimed to investigated and prioritize the factors affecting evidence-based medicine among physicians affiliated to Iranian Health insurance. Methods: This descriptive cross-sectional study was conducted on 150 physicians affiliated to Iranian Health insurance in Tehran city in 2018. The simple random sampling method was used to collect the data. The data collection tool was a questionnaire containing of three parts: demographic questionnaire, Fonk (1995) evidence-based medical barriers questionnaire that included four domains and 25 questions, as well as a researcher-made questionnaire that prioritized the factors influencing evidence-based medicine implementation. Data were analyzed by SPSS version 21 and Expert Choice software using hierarchical analysis method. Results: Most physicians were male (53.3%) and worked as an official employee. Among four dimensions, the highest mean and standard deviation was related to organizational impact, while the lowest was related to the quality of research and possible outcomes. Regarding the factors of organizational impacts, the highest weight or priority was attributed to the feeling of insufficient independence to change care methods with a weight of 0.259. Among the factors related to the research quality, the highest weight and priority was related to the factor of methodological defects in the research with a weight of 0.192. Considering the factors related to the skills of conducting research, the highest priority and weight was attributed to the lack of documentary evidence for the performance change with a weight of 0.320. Moreover, regarding the factors related to communication and access to the findings of the research, the highest weight and priority was in the factor of unavailability of actual articles (0.475). Conclusion: The findings of this study showed that physicians considered problems and barriers related to organization, individual, and quality of research studies. Therefore, facilities should be created for using research findings as well as the conditions for updating physicians' knowledge, skills, and attitudes to use the research results. 76 82 2019/01/132019/03/122018/04/30 1397/2/10 2019/05/192019/05/212019/07/1 1398/4/10 فرناز محمدحسین زاده هاشمی Farnaz Mohamadhoseinzadeh Hashemi Department of Health Services Management, School of Management and Social Science, North Tehran Branch, Islamic Azad University, Tehran, Iran Iran farnazhashemi66@yahoo.com مهرنوش جعفری Mehrnoosh Jafari Department of Healthcare Management, School of Management and Human Sciences, North Tehran Branch, Islamic Azad University, Tehran, Iran Iran mehr_j134@yahoo.com سیدمجتبی حسینی Seyed Mojtaba Hosseini Department of Health Services Management, School of Management and Social Science, North Tehran Branch, Islamic Azad University, Tehran, Iran Iran Hosseinisch@yahoo.com Evidence-Based Medicine Physicians Insurance پزشکی مبتنی بر شواهد پزشک بیمه Bryar RM, Closs SJ, Baum G, et al. The Yorkshire barriers project: diagnostic analysis of barriers to research utilisation. International Journal of Nursing Studies. 2003; 40(1): 73-84.##Esenay FI, Calik C, Doru O, et al. Utilization of research findings and barriers in pediatric surgical nurses in Turkey.Journal of Pediatric Surgical Nursing. 2017; 6(4): 94-102.##Rodgers SE. The extent of nursing research utilization in general medical and surgical wards. Journal of Advanced Nursing. 2000; 32(1):182-193.##Sommerbakk R, Haugen DF, Tjora A, et al. Barriers to and facilitators for implementing quality improvements in palliative care-results from a qualitative interview study in Norway. BMC Palliative Care. 2016; 15(1): 1-17.##Estabrooks CA, Derksen L, Winther C, et al. The intellectual structure and substance of the knowledge utilization field: A longitudinal author co-citation analysis, 1945 to 2004. Implementation Science. 2008; 3(1): 1-22.##Brown CE, Wickline MA, Ecoff L, et al. Nursing practice, knowledge, attitudes and perceived barriers to evidence‐based practice at an academic medical center. Journal of Advanced Nursing. 2009; 65(2): 371-381.##Solomons NM, Spross JA. Evidence‐based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review. Journal of Nursing Management. 2011; 19(1): 109-120.##Varaei S, Salsali M, Cheraghi MA. Implementation of evidence‐based nursing practice for diabetic patients: An Iranian experience. International Journal of Nursing Practice. 2013; 19(Suppl. 3): 73-80.##Sadeghi‐Bazargani H, Tabrizi JS, Azami‐Aghdash S. Barriers to evidence‐based medicine: a systematic review.Journal of Evaluation in Clinical Practice. 2014; 20(6): 793-802.##Century J, Cassata A. Implementation research: finding common ground on what, how, why, where, and who.Review of Research in Education. 2016; 40(1): 169-215.##Nkrumah I, Atuhaire C, Priebe G, et al. Barriers for nurses' participation in and utilisation of clinical research in three hospitals within the Kumasi Metropolis, Ghana. The Pan African Medical Journal. 2018; 30: 24.##Mehrdad N, Salsalhi M, Kazemnejad A. The facillative and preventive factors of implementation of research finding in nursing clinical practice. Journal of Gorgan University of Medical Science. 2007; 9(1): 63-72. [Persian].##Shayestehfard M, Houshyari H, Cheraghian B, et al. Nurses' opinion towards barriers and facilitators of clinical utilization of research results in Abadan and Khorramshahr hospitals. Iranian Journal of Medical Education. 2011;10(4): 340-349.##Funk SG, Tornquist EM, Champagne MT. Barriers and facilitators of research utilization. Nursing Clinics of North America. 1995; 30(3):395-407.##Tan M, Sahin ZA, Özdemir FK. Barriers of research utilization from the perspective of nurses in Eastern Turkey. Nursing Outlook. 2012; 60(1): 44-50.##Oh EG. Research activities and perceptions of barriers to research utilization among critical care nurses in Korea. Intensive and Critical Care Nursing. 2008; 24(5): 314-322.##Chien W-T, Bai Q, Wong W-K, et al. Nurses' perceived barriers to and facilitators of research utilization in mainland China: a cross-sectional survey. The Open Nursing Journal. 2013; 7: 96-106.##Kadu MK, Stolee P. Facilitators and barriers of implementing the chronic care model in primary care: a systematic review. BMC Family Practice. 2015; 16(1): 12.##Bahadori M, Raadabadi M, Ravangard R, et al. The barriers to the application of the research findings from the nurses' perspective: A case study in a teaching hospital. Journal of Education and Health Promotion. 2016; 5: 14.##Bryar RM, Closs SJ, Baum G, et al. The Yorkshire barriers project: diagnostic analysis of barriers to research utilisation. International Journal of Nursing Studies. 2003; 40(1): 73-84.##Esenay FI, Calik C, Doru O, et al. Utilization of research findings and barriers in pediatric surgical nurses in Turkey.Journal of Pediatric Surgical Nursing. 2017; 6(4): 94-102.##Rodgers SE. The extent of nursing research utilization in general medical and surgical wards. Journal of Advanced Nursing. 2000; 32(1):182-193.##Sommerbakk R, Haugen DF, Tjora A, et al. Barriers to and facilitators for implementing quality improvements in palliative care-results from a qualitative interview study in Norway. BMC Palliative Care. 2016; 15(1): 1-17.##Estabrooks CA, Derksen L, Winther C, et al. The intellectual structure and substance of the knowledge utilization field: A longitudinal author co-citation analysis, 1945 to 2004. Implementation Science. 2008; 3(1): 1-22.##Brown CE, Wickline MA, Ecoff L, et al. Nursing practice, knowledge, attitudes and perceived barriers to evidence‐based practice at an academic medical center. Journal of Advanced Nursing. 2009; 65(2): 371-381.##Solomons NM, Spross JA. Evidence‐based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review. Journal of Nursing Management. 2011; 19(1): 109-120.##Varaei S, Salsali M, Cheraghi MA. Implementation of evidence‐based nursing practice for diabetic patients: An Iranian experience. International Journal of Nursing Practice. 2013; 19(Suppl. 3): 73-80.##Sadeghi‐Bazargani H, Tabrizi JS, Azami‐Aghdash S. Barriers to evidence‐based medicine: a systematic review.Journal of Evaluation in Clinical Practice. 2014; 20(6): 793-802.##Century J, Cassata A. Implementation research: finding common ground on what, how, why, where, and who.Review of Research in Education. 2016; 40(1): 169-215.##Nkrumah I, Atuhaire C, Priebe G, et al. Barriers for nurses' participation in and utilisation of clinical research in three hospitals within the Kumasi Metropolis, Ghana. The Pan African Medical Journal. 2018; 30: 24.##Mehrdad N, Salsalhi M, Kazemnejad A. The facillative and preventive factors of implementation of research finding in nursing clinical practice. Journal of Gorgan University of Medical Science. 2007; 9(1): 63-72. [Persian].##Shayestehfard M, Houshyari H, Cheraghian B, et al. Nurses' opinion towards barriers and facilitators of clinical utilization of research results in Abadan and Khorramshahr hospitals. Iranian Journal of Medical Education. 2011;10(4): 340-349.##Funk SG, Tornquist EM, Champagne MT. Barriers and facilitators of research utilization. Nursing Clinics of North America. 1995; 30(3):395-407.##Tan M, Sahin ZA, Özdemir FK. Barriers of research utilization from the perspective of nurses in Eastern Turkey. Nursing Outlook. 2012; 60(1): 44-50.##Oh EG. Research activities and perceptions of barriers to research utilization among critical care nurses in Korea. Intensive and Critical Care Nursing. 2008; 24(5): 314-322.##Chien W-T, Bai Q, Wong W-K, et al. Nurses' perceived barriers to and facilitators of research utilization in mainland China: a cross-sectional survey. The Open Nursing Journal. 2013; 7: 96-106.##Kadu MK, Stolee P. Facilitators and barriers of implementing the chronic care model in primary care: a systematic review. BMC Family Practice. 2015; 16(1): 12.##Bahadori M, Raadabadi M, Ravangard R, et al. The barriers to the application of the research findings from the nurses' perspective: A case study in a teaching hospital. Journal of Education and Health Promotion. 2016; 5: 14.## ##

Students’ Smoking Abstinence Self-efficacy toward Early Maladaptive Schemas خودکارآمدی پرهیز از سیگار بر اساس طرحواره های ناسازگار اولیه 2 1 زمینه و هدف: خودکارآمدی پرهیز از سیگار عاملی است که در جلوگیری از اعتیاد یا بازگشت مجدد به آن پس از ترک سیگارنقش اساسی ایفا می کند. پژوهش حاضرباهدف پیش بینی خودکارآمدی پرهیز از سیگار بر اساس طرحواره های ناسازگار اولیه در دانش آموزان متوسطه دوم شهرگرگان انجام شده است. روش ها: روش پژوهش، توصیفی است و جامعه آماری (به تعداد 9955) شامل کلیه ی دانش آموزان متوسطه دوره دوم شهرستان گرگان در سال تحصیلی 95-1394 می باشد. روش نمونه گیری از نوع نمونه گیری خوشه ای چند مرحله ای و حجم نمونه 369 نفر انتخاب شد. ابزارهای گردآوری اطلاعات شامل پرسشنامه های طرحواره های ناسازگار و پرسشنامه خودکار آمدی پرهیز از سیگار بود. از روش همبستگی پیرسون رگرسیون چند متغیره برای تجزیه و تحلیل داده ها استفاده شد. یافته ها: نتایج پژوهش حاضر نشان داد بین همه مؤلفه های طرحواره های ناسازگاراولیه و نمره کل خودکارآمدی گرایش به سیگار رابطه منفی و معناداری وجود درد.علاوه بر این 51 درصدتغییردرمتغیر خودکارآمدی پرهیزازسیگار حاصل مؤلفه های طرحواره های ناسازگار اولیه می باشد. در میان مؤلفه های طرح های ناسازگار اولیه، مؤلفه رها سازی / بیگانگی، قوی ترین پیش بینی کننده خودکارآمدی پرهیز از سیگار دانش آموزان بود. نتیجه گیری: طرحواره­ها ی ناسازگاراولیه ازجمله علل فردی وروانشناختی هستندکه درمطالعه­ی مصرف سیگار از اهمیت ویژه ای برخوردارند، طرحواره­ها موجب سوگیری در تفسیرهای فرد از رویدادها شده و این سوگیری ها خود را به صورت نگرش های تحریف شده، گمانه­های نادرست و رفتار های پرخطر از جمله مصرف سیگار نشان می­دهند.  2 Introduction: Smoking abstinence self-efficacy is a factor that plays a key role in preventing addiction or its revival tendency after quitting. This study attempted to analyze the relationship between the early maladaptive schemas and smoking abstinence self-efficacy among the sophomore high school students in the city of Gorgan, Iran. Methods:This was a descriptive study and its population (n= 9955) included all second grade high school students in the city of Gorgan in the school year 2015-2016. The multi- stage cluster sampling method was used to select 369 participants. The required data were collected using the maladaptive schema questioners and the smoking abstinence self-efficacy questionnaire. Pearson correlation and Multi- variable regression methods were also used to analyze data. Results: The results of the current study indicated a significant, yet reverse relationship of the early maladaptive schemas with smoking abstinence self-efficacy. Furthermore, 51 percent change in self-efficacy variance is derived from the components of early maladaptive schemas. Among components of the early maladaptive schemas, components of the abandonment / aalienation, the strongest predictor was Students smoking abstinence self-efficacy.  Conclusion: Early self- efficacy schemas are among the individual and psychological causes with especial importance in studies on smoking dependency and its consumption. Such early schemas lead to biases in an individual’s interpretation of the events. These biases are represented as distorted attitudes, false speculations, unrealistic aims and perspectives, and high- risk behaviors such as smoking.   83 91 2019/01/132019/03/122018/04/302018/06/7 1397/3/17 2019/05/192019/05/212019/07/12019/01/28 1397/11/8 چعفر شعبانی Jafar Shabani Department of Psychology, Payam Noor University, Tehran, Iran Iran jshabanipnu@gmail.com ابوالحسن جافر نوده AbolHassan JaferNodeh Department of Psychology, Faculty of Human Sciences, Gorgan Branch, Islamic Azad University, Gorgan, Iran Iran jslhabanipnu@gmail.com Adolescent Schemas Self Efficacy Smoking Students نوجوانان طرحواره ها خودکارآمدی سیگار دانش آموزان Aminoroaia M, Attari A, Maracy M. Factor's affecting medical students' tendency to smoke cigarettes. Jornal of Research Behavior Sciences. 2013; 10 (7): 726-734. [Persian]##WHO report on the global tobacco epidemic, 2011. Warning about the dangers of tobacco. Geneva: World Health Organization; 2011.##Momoh So, Imhond Ho, Omagbe.E. The role of gender, self- studi-efficacy, age and extroversion on smoking behaviour among Ambrose Alli University Students, Ekpoma, Nigeria. Journal of International Women's Studies.2008; 10(2): 134-140.##Wong CJ, Anthony S, Sigmon SC, et al. Examining interrelationships between abstinence and coping self-efficacy in cocaine-dependent outpatients. Experimental and Clinical Psychopharmacology. 2004; 21(3): 190- 199.##Mohamdkhani Sh, Jazayeri A, Mohamdkhani P, et al. Direct and indirect impact of attitude, locus of control, selfmanagement skills and so commences on drug use among at risk adolescents. Contemporary Psychology. 2004; 2(3):3-10. [Persian]##Copeland AL, Brandon TH. Testing the causal role of expectancies in smoking motivation and behavior. Journal of Addictive Behaviors. 2000; 25(3): 445-449.##Noranipour R. Investigate the causes of addiction to substances changing the mood and behavior and effective and efficient method of drug addiction counseling. Journal of Research on Adiction. 2004; 2(6): 13- 54. [Persian]##Boardman T, Catley D, Mayo MS, et al. Self-efficacy and motivation to quit during participation in a smoking cessation program. International Journal of Behavioral Medicine. 2005; 12(4): 266-272.##Chang FC, Lee CM, Lai HR, et al. Social influences and self-efficacy as predictors of youth smoking initiation and cessation: a 3-year longitudinal study of vocational high school students in Taiwan. Addiction. 2006; 101(11): 1645-1655.##Zhang D, He H. Personality traits and life satisfaction: A Chinese case study. Social Behavior and Personality: An International Journal. 2010; 38(8): 1119-1123.##Young JE. Young schema questionnaire: short form 3 (YSQ-S3). New York: Schema Therapy Institute; 2005.##DeBono A, Muraven M. Rejection perceptions: feeling disrespected lead to greateraggression than feeling disliked.Journal of Experimental Social Psychology. 2014; 55: 43-52.##Young JE, Kolsko JS, Wisshar ME. Shema therapy: A praticitionerers guide. New York: Guilford Press; 2003.##Yang J, McCrae RR, Costa Jr PT, et al. Cross-cultural personality assessment in psychiatric populations: The NEOPI-R in the people's Republic of China. Psychological Assessment. 1999; 11(3): 359-368.##Shorey RC, Anderson SE, Stuart GL. Gender differences in early maladaptive schemas in a treatment-seeking sample of alcohol-dependent adults. Substance Use & Misuse. 2012; 47(1): 108-116.##Shorey RC, Stuart GL, Anderson S, et al. Changes in early maladaptive schemas after residential treatment for substance use. Journal of Clinical Psychology. 2013; 69(9): 912- 922.##Young JE. Young schema questionnaire short Form. 1st ed. New York: Cognitive Therapy Center; 1998.##Baranoff J, Oei TP, Cho SH, et al. Factor structure and internal consistency of the Young Schema Questionnaire (Short Form) in Korean and Australian samples. Journal of Affective Disorders. 2006; 93(1-3): 133-140.##Ebrahimi H, Khamesan A, Pakdaman M. Construction and validation of smoking abstinence self - efficacy scale.Applied Psychological Research Quarterly. 2014; 5(3): 95- 110.##Riso LP, Du Toit PL, Stein DJ, et al. Cognitive schemas and core beliefs in psychological problems: A scientistpractitioner guide. Washington, DC, US: American Psychological Association; 2007.##Johnson MP, Leone JM. The differential effects of intimate terrorism and situational couple's violence: findings from the national violence against women survey. Journal of Family Issues. 2005; 26(3): 322- 349.##Osrowsky MK. Are violent people more likely to have low self-esteem or high self-esteem?. Aggression and Violent Behavior. 2010; 15(1): 69-75.##Aminoroaia M, Attari A, Maracy M. Factor's affecting medical students' tendency to smoke cigarettes. Jornal of Research Behavior Sciences. 2013; 10 (7): 726-734. [Persian]##WHO report on the global tobacco epidemic, 2011. Warning about the dangers of tobacco. Geneva: World Health Organization; 2011.##Momoh So, Imhond Ho, Omagbe.E. The role of gender, self- studi-efficacy, age and extroversion on smoking behaviour among Ambrose Alli University Students, Ekpoma, Nigeria. Journal of International Women's Studies.2008; 10(2): 134-140.##Wong CJ, Anthony S, Sigmon SC, et al. Examining interrelationships between abstinence and coping self-efficacy in cocaine-dependent outpatients. Experimental and Clinical Psychopharmacology. 2004; 21(3): 190- 199.##Mohamdkhani Sh, Jazayeri A, Mohamdkhani P, et al. Direct and indirect impact of attitude, locus of control, selfmanagement skills and so commences on drug use among at risk adolescents. Contemporary Psychology. 2004; 2(3):3-10. [Persian]##Copeland AL, Brandon TH. Testing the causal role of expectancies in smoking motivation and behavior. Journal of Addictive Behaviors. 2000; 25(3): 445-449.##Noranipour R. Investigate the causes of addiction to substances changing the mood and behavior and effective and efficient method of drug addiction counseling. Journal of Research on Adiction. 2004; 2(6): 13- 54. [Persian]##Boardman T, Catley D, Mayo MS, et al. Self-efficacy and motivation to quit during participation in a smoking cessation program. International Journal of Behavioral Medicine. 2005; 12(4): 266-272.##Chang FC, Lee CM, Lai HR, et al. Social influences and self-efficacy as predictors of youth smoking initiation and cessation: a 3-year longitudinal study of vocational high school students in Taiwan. Addiction. 2006; 101(11): 1645-1655.##Zhang D, He H. Personality traits and life satisfaction: A Chinese case study. Social Behavior and Personality: An International Journal. 2010; 38(8): 1119-1123.##Young JE. Young schema questionnaire: short form 3 (YSQ-S3). New York: Schema Therapy Institute; 2005.##DeBono A, Muraven M. Rejection perceptions: feeling disrespected lead to greateraggression than feeling disliked.Journal of Experimental Social Psychology. 2014; 55: 43-52.##Young JE, Kolsko JS, Wisshar ME. Shema therapy: A praticitionerers guide. New York: Guilford Press; 2003.##Yang J, McCrae RR, Costa Jr PT, et al. Cross-cultural personality assessment in psychiatric populations: The NEOPI-R in the people's Republic of China. Psychological Assessment. 1999; 11(3): 359-368.##Shorey RC, Anderson SE, Stuart GL. Gender differences in early maladaptive schemas in a treatment-seeking sample of alcohol-dependent adults. Substance Use & Misuse. 2012; 47(1): 108-116.##Shorey RC, Stuart GL, Anderson S, et al. Changes in early maladaptive schemas after residential treatment for substance use. Journal of Clinical Psychology. 2013; 69(9): 912- 922.##Young JE. Young schema questionnaire short Form. 1st ed. New York: Cognitive Therapy Center; 1998.##Baranoff J, Oei TP, Cho SH, et al. Factor structure and internal consistency of the Young Schema Questionnaire (Short Form) in Korean and Australian samples. Journal of Affective Disorders. 2006; 93(1-3): 133-140.##Ebrahimi H, Khamesan A, Pakdaman M. Construction and validation of smoking abstinence self - efficacy scale.Applied Psychological Research Quarterly. 2014; 5(3): 95- 110.##Riso LP, Du Toit PL, Stein DJ, et al. Cognitive schemas and core beliefs in psychological problems: A scientistpractitioner guide. Washington, DC, US: American Psychological Association; 2007.##Johnson MP, Leone JM. The differential effects of intimate terrorism and situational couple's violence: findings from the national violence against women survey. Journal of Family Issues. 2005; 26(3): 322- 349.##Osrowsky MK. Are violent people more likely to have low self-esteem or high self-esteem?. Aggression and Violent Behavior. 2010; 15(1): 69-75.## ##

Health Workers' Knowledge and Attitude about Ebola Virus Disease 2 2 Introduction: Ebola is a viral infection with a high mortality risk and health workers are considered as an at-risk group. The main aim of this study was to determine the knowledge and attitude of health workers about Ebola virus disease (EVD) in Yazd city, Iran. Methods: This cross-sectional study was carried out on 110 health workers in health centres of Yazd city, Iran in 2015, who were selected by cluster random sampling method. The tool for data collection was a researcher-made questionnaire including demographic information as well as knowledge and attitude questions about EVD with confirmed validity and reliability. Data were analysed by statistical tests of Student’s T-test, Chi-square, ANOVA, and Pearson correlation coefficient. Results: The mean score of the participants' knowledge and attitude were 25.16± 3.58 (range 0-46) and 46.59±4.05 (range 13-65), respectively. More than half of the health workers did not know transmission routes of EVD. However, 59.6% of them were aware that the one way to prevent the disease was to avoid contact with an infected person. A significant correlation was also found between knowledge and attitude scores (P< 0.001, r= 0.384). Conclusion: Since knowledge of the health workers was at the moderate level, training courses and interventional programs are recommended for health care workers especially about transmission routes and signs of EVD to increase the Knowledge and attitude of the participants. 92 100 2019/01/132019/03/122018/04/302018/06/72018/08/20 1397/5/29 2019/05/192019/05/212019/07/12019/01/282018/11/13 1397/8/22 حسن رضایی پنداری Hassan Rezaeipandari Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz , Iran Iran ولی بهره ور Vali Bahrevar Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran علیرضا بابایی مرزنو Alireza Babaei Mazreno Department of Sport Sciences, Islamic Azad University, Khorasgan Branch, Isfahan, Iran Iran زهره رهایی Zohreh Rahaei Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran سعیده زارع جمال آبادی Saeedeh Zare Jamalabadi Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran مریم جداری اقبالی Maryam Jedari Eghbali Deputy of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Ebolavirus Knowledge Attitude Health Personnel Gatherer D. The 2014 Ebola virus disease outbreak in West Africa. Journal of General Virology. 2014;95(8):1619-24.##Maganga GD, Kapetshi J, Berthet N, et al. Ebola virus disease in the Democratic Republic of Congo. New England Journal of Medicine. 2014;371(22):2083-91.##Jarrett A. Ebola: A practice summary for nurse practitioners. The Journal for Nurse Practitioners. 2015;11(1):16-26.##Vailaya C, Kumar S, Moideen S. Ebola Virus Disease: Practices Health Care Professionals in a Tertiary Care Hospital. J Pub Health Med Res. 2014;2(2):13-8.##Frieden T. Ebola Hemorrhagic Fever Ebola Virus Disease (EVD). The bottom line. 2014;12:01##Heymann DL. Control of communicable diseases manual. Washington: American PublicHealth Association; 2008.##Rodriguez L, De Roo A, Guimard Y, et al. Persistence and genetic stability of Ebola virus during the outbreak in Kikwit, Democratic Republic of the Congo, 1995. Journal of Infectious Diseases. 1999;179(Supplement 1):S170-S6.##Rowe AK, Bertolli J, Khan AS, et al. Clinical, virologic, and immunologic follow-up of convalescent Ebola hemorrhagic fever patients and their household contacts, Kikwit, Democratic Republic of the Congo. Journal of Infectious Diseases. 1999;179(Supplement 1):S28-S35.##Omidian P, Tehoungue K, Monger J. Medical anthropology study of the Ebola virus disease (EVD) outbreak in Liberia/West Africa. WHO Field Report. Monrovia Liberia. 2014##Waheed Y. Ebola in West Africa: an international medical emergency. Asian Pacific Journal of Tropical Biomedicine. 2014;4(9):673-4.##Iliyasu G, Ogoina D, Otu AA, et al. A multi-site knowledge attitude and practice survey of Ebola virus disease in Nigeria. PloS one. 2015;10(8):e0135955.##Jamal A, Startsman K, Guy J, et al. Assessing Knowledge and Attitude about ebola in the US: a Cross Sectional Survey. Value in Health. 2015;18(3):A246.##Ahmad A, Khan MU, Jamshed SQ, et al. Are healthcare workers ready for Ebola? An assessment of their knowledge and attitude in a referral hospital in South India. The Journal of Infection in Developing Countries.2016;10(07):747-54.##Rezaeipandari H, Mirkhalili SM, MorowatiSharifabad MA, et al. Study of H1N1 Influenza Preventive Behaviors Predictors Based on Health Belief Model in Jiroft People. Qom Universityof Medical Science Journal. 2018; 12 (3) :76-86.[Persian]##Olowookere SA, Abioye-Kuteyi EA, Adepoju OK, et al. Knowledge, Attitude, and Practice of Health Workers in aTertiary Hospital in Ile Ife,Nigeria, towards Ebola Viral Disease. Journal of Tropical Medicine. 2015; 1-8.##Touré A, Traoré F. A, Sako F.B, et al. Knowledge, attitudes, and practices of health careworkers on Ebola virus disease in Conakry, Guinea: Across-sectional study. Journal of Public Health andEpidemiology. 2016; 8(2):12-16.##Monasch R. Study on public knowledge, attitudes, and practices relating to Ebola virus disease (EVD) prevention and medical care in Sierra Leone. Free Town: UNICEF, Catholic Relief Service and Focus. 2014;10002014.##Holakouie-Naieni K , Ahmadvand A, Raza O, et al. Assessing the Knowledge, Attitudes, and Practices of Students Regarding Ebola Virus Disease Outbreak. Iran J Public Health. 2015; 44(12):1670-1676##Mahwish R, Khan A, Fatima M, et al. Knowledge and Awareness of Ebola Virus Disease among Medical Students.Pakistan Journal of Medical & Health Science. 2015; 9(3):852-55.##Jiang H, Shi GQ, Tu WX, et al. Rapid assessment of knowledge, attitudes, practices, and risk perception related to the prevention and control of Ebola virus disease in three communities of Sierra Leone. Infectious diseases of poverty. 2016;5(1):53.##Idris B J, InemV, Balogun M. Comparing the knowledge, attitude and practices ofhealth care workers in public and private primary carefacilities in Lagos State on Ebola virus disease. The Pan African Medical Journal. 2015;22(Supp1):19##Gatherer D. The 2014 Ebola virus disease outbreak in West Africa. Journal of General Virology. 2014;95(8):1619-24.##Maganga GD, Kapetshi J, Berthet N, et al. Ebola virus disease in the Democratic Republic of Congo. New England Journal of Medicine. 2014;371(22):2083-91.##Jarrett A. Ebola: A practice summary for nurse practitioners. The Journal for Nurse Practitioners. 2015;11(1):16-26.##Vailaya C, Kumar S, Moideen S. Ebola Virus Disease: Practices Health Care Professionals in a Tertiary Care Hospital. J Pub Health Med Res. 2014;2(2):13-8.##Frieden T. Ebola Hemorrhagic Fever Ebola Virus Disease (EVD). The bottom line. 2014;12:01##Heymann DL. Control of communicable diseases manual. Washington: American PublicHealth Association; 2008.##Rodriguez L, De Roo A, Guimard Y, et al. Persistence and genetic stability of Ebola virus during the outbreak in Kikwit, Democratic Republic of the Congo, 1995. Journal of Infectious Diseases. 1999;179(Supplement 1):S170-S6.##Rowe AK, Bertolli J, Khan AS, et al. Clinical, virologic, and immunologic follow-up of convalescent Ebola hemorrhagic fever patients and their household contacts, Kikwit, Democratic Republic of the Congo. Journal of Infectious Diseases. 1999;179(Supplement 1):S28-S35.##Omidian P, Tehoungue K, Monger J. Medical anthropology study of the Ebola virus disease (EVD) outbreak in Liberia/West Africa. WHO Field Report. Monrovia Liberia. 2014##Waheed Y. Ebola in West Africa: an international medical emergency. Asian Pacific Journal of Tropical Biomedicine. 2014;4(9):673-4.##Iliyasu G, Ogoina D, Otu AA, et al. A multi-site knowledge attitude and practice survey of Ebola virus disease in Nigeria. PloS one. 2015;10(8):e0135955.##Jamal A, Startsman K, Guy J, et al. Assessing Knowledge and Attitude about ebola in the US: a Cross Sectional Survey. Value in Health. 2015;18(3):A246.##Ahmad A, Khan MU, Jamshed SQ, et al. Are healthcare workers ready for Ebola? An assessment of their knowledge and attitude in a referral hospital in South India. The Journal of Infection in Developing Countries.2016;10(07):747-54.##Rezaeipandari H, Mirkhalili SM, MorowatiSharifabad MA, et al. Study of H1N1 Influenza Preventive Behaviors Predictors Based on Health Belief Model in Jiroft People. Qom Universityof Medical Science Journal. 2018; 12 (3) :76-86.[Persian]##Olowookere SA, Abioye-Kuteyi EA, Adepoju OK, et al. Knowledge, Attitude, and Practice of Health Workers in aTertiary Hospital in Ile Ife,Nigeria, towards Ebola Viral Disease. Journal of Tropical Medicine. 2015; 1-8.##Touré A, Traoré F. A, Sako F.B, et al. Knowledge, attitudes, and practices of health careworkers on Ebola virus disease in Conakry, Guinea: Across-sectional study. Journal of Public Health andEpidemiology. 2016; 8(2):12-16.##Monasch R. Study on public knowledge, attitudes, and practices relating to Ebola virus disease (EVD) prevention and medical care in Sierra Leone. Free Town: UNICEF, Catholic Relief Service and Focus. 2014;10002014.##Holakouie-Naieni K , Ahmadvand A, Raza O, et al. Assessing the Knowledge, Attitudes, and Practices of Students Regarding Ebola Virus Disease Outbreak. Iran J Public Health. 2015; 44(12):1670-1676##Mahwish R, Khan A, Fatima M, et al. Knowledge and Awareness of Ebola Virus Disease among Medical Students.Pakistan Journal of Medical & Health Science. 2015; 9(3):852-55.##Jiang H, Shi GQ, Tu WX, et al. Rapid assessment of knowledge, attitudes, practices, and risk perception related to the prevention and control of Ebola virus disease in three communities of Sierra Leone. Infectious diseases of poverty. 2016;5(1):53.##Idris B J, InemV, Balogun M. Comparing the knowledge, attitude and practices ofhealth care workers in public and private primary carefacilities in Lagos State on Ebola virus disease. The Pan African Medical Journal. 2015;22(Supp1):19## ##

An Analysis of Factors Affecting the Creation of Tension and Chaos among Nurses (Case Study: Public and Private Hospitals of Yazd Province) 2 2 Introduction: Tension and chaos are considered as a socioeconomic phenomenon that can have adverse effects on individuals, organizations, and the community if not properly managed. Therefore, this study was aimed to investigate the factors affecting the formation of tension and chaos among nurses of Yazd Province, Iran. Methods: This exploratory mixed methods research was conducted on nurses selected from 10 out of 31 hospitals of the province through cluster sampling and proportionate stratified random sampling. Data were collected using interview and a researcher-developed questionnaire. In total, 376 individuals were enrolled. The validity of the questionnaires was evaluated by face and content validity, and its reliability was verified using Cronbach's alpha test. Results: Out of 47 factors identified, 44 factors explained 70% of the tension construct. These factors were classified into seven categories and confirmatory factor analysis was used to verify the construct validity of the categories. The results showed acceptable initial clustering. Moreover, financial and economic factors, work conditions and job security were identified as the most important factors for explaining the studied construct. Conclusion: Given the issues discussed and viewpoints expressed about the seven categories identified regarding the strike by hospital directors, human resources area must be paid special attention and measures beyond changing the name of the administrative unit to human resources or human capital must be taken. 101 112 2019/01/132019/03/122018/04/302018/06/72018/08/202019/06/30 1398/4/9 2019/05/192019/05/212019/07/12019/01/282018/11/132019/06/30 1398/4/9 غلامرضا بردبار Gholamreza Bordbar Department of Business Administration, Faculty of Economics, Management and Accounting, Yazd University, Yazd, Iran Iran رضا ابراهیم زاده پزشکی Reza Ebrahimzadeh Pezeshki Department of Organization Behavior and Resources, Faculty of Economics, Management and Accounting, Yazd University, Yazd, Iran Iran Strikes Employee Nurses Hospitals Luo S. Agendas, alternatives, and collective labour law: A case study of local collective bargaining legislation in South China. Employee Relations. 2017; 39(4): 541-560.##Whitehead S. A rational response to Taser strikes. Jems. 2005; 30(5): 56-66.##Wang K. Labour resistance and worker attitudes towards trade :union: reform in China. Employee Relations. 2016;38(5): 724-740.##Hicks JR. Marginal productivity and the principle of variation. Economica. 1932; (35): 79-88.##Bithymitris G. Socio-cultural aspects of neo-nationalism in crisis contexts: an empirical analysis of liminal workers' perceptions in Greece (2011-2015). Acta Politologica. 2017; 9(1): 61-74.##Maloni MJ, Campbell SM, Gligor DM, et al. Exploring the effects of workforce level on supply chain job satisfaction and industry commitment. The International Journal of Logistics Management. 2017; 28(4): 1294-1318.##Bordogna L. Strikes in Europe: still a decade of decline or the eve of a new upsurge?. Indian Journal of Industrial Relations. 2010; 45(4): 658-670.##Harvey RG. Why is labour strife so persistent in South Africa's mining industry?. The Extractive Industries Society.2016; 3(3): 832-842.##Cowman J, Keating MA. Industrial relations conflict in Irish hospitals: a review of Labour Court cases. Journal of Health Organization Management. 2013; 27(3): 368-389.##Duffield C, Diers D, O'Brien-Pallas L, et al. Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research. 2011; 24(4): 244-255.##Aiken LH, Sloane DM, Bruyneel L, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet. 2014; 383(9931): 1824-1830.##Wolf LD, Potter P, Sledge JA, et al. Describing nurses' work: combining quantitative and qualitative analysis.Human Factors. 2006; 48(1): 5-14.##Borimnejad L, Valizadeh S, Rahmani A, et al. Attributes of Iranian new nurse preceptors: A phenomenological study. Nurse Education in Practice. 2018; 28: 121-126.##Dehghan-Nayeri N, Shali M, Navabi N, et al. Perspectives of oncology unit nurse managers on missed nursing care: a qualitative study. Asia-Pacific Journal of Oncology Nursing. 2018; 5(3): 327-336.##Rivaz M, Ebadi A, Momennasab M. The role of Magnet hospitals in making the nursing practice environment attractive. Journal of Hayat. 2018; 23(4): 290-294.##San Park J, Hyun Kim T. Do types of organizational culture matter in nurse job satisfaction and turnover intention?. Leadership in Health Services. 2009; 22(1): 20-38.##Lo WY, Chien LY, Hwang FM, et al. From job stress to intention to leave among hospital nurses: A structural equation modelling approach. Journal of Advanced Nursing. 2018; 74(3): 677-688.##Clarke J, O'Neill CS. An analysis of how the Irish Times portrayed Irish nursing during the 1999 strike. Nursing Ethics. 2001; 8(4): 350-359.##Briskin L. Resistance, mobilization and militancy: nurses on strike. Nursing Inquiry. 2012; 19(4): 285-296.##Mudaly P, Nkosi Z. Factors influencing nurse absenteeism in a general hospital in D urban, S outh A frica. Journal of Nursing Management. 2015; 23(5): 623-631.##Adam MB, Muma S, Modi JA, et al. Paediatric and obstetric outcomes at a faith-based hospital during the 100-day public sector physician strike in Kenya. BMJ Global Health. 2018; 3(2): e000665.##Thompson B. Exploratory and confirmatory factor analysis: Understanding concepts and applications. Washington,DC, US: American Psychological Association; 2004.##Mikkelsen F. Denmark 1700-1849: crowds, movements and absolute monarchy. In: Mikkelsen F, Kjeldstadli K,Nyzell S, editors. Popular Struggle and Democracy in Scandinavia. Palgrave Studies in European Political Sociology.London: Palgrave Macmillan; 2018: 13-33.##Chang C, Cooke FL. Layers of :union: organising and representation: the case study of a strike in a Japanese‐funded auto plant in China. Asia Pacific Journal of Human Resources. 2018; 56(4): 492-517.##Gose K, Sadrieh A. Strike, coordination, and dismissal in uniform wage settings. European Economic Review.2014; 70: 145-158.##Lieberman DE, Venkadesan M, Werbel WA, et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010; 463(7280): 531-535.##McKee Y. Strike art: Contemporary art and the post-occupy condition. Verso Books; 2016.##Gourevitch A. Quitting work but not the job: Liberty and the right to strike. Perspectives on Politics. 2016; 14(2):307-323.##Hersey P, Blanchard KH. Management of organizational behavior: Utilizing human resources. Academy of Management Journal. 1969; 12(4).##Adams JS, Freedman S. Equity theory revisited: Comments and annotated bibliography. Advances in Experimental Social Psychology.1976; 9: 43-90.##Lopez M, Mills B. Opportunistic shirking behavior during unpaid overtime. Applied Economics Letters. 2019;26(7): 608-612.##Bordia P, Restubog SLD, Tang RL. When employees strike back: investigating mediating mechanisms between psychological contract breach and workplace deviance. Journal of Applied Psychology. 2008; 93(5): 1104-1117.##Hackman JR. Work redesign and motivation. Professional Psychology. 1980; 11(3): 445-455.##Haimson LH, Tilly C. Strikes, wars, and revolutions in an international perspective: Strike waves in the late nineteenth and early twentieth centuries. Cambridge University Press; 2002.##Huang Q, Jiang F, Lie E, et al. The effect of labor :union:s on CEO compensation. Journal of Financial Quantitative Analysis. 2017; 52(2): 553-582.##Luo S. Agendas, alternatives, and collective labour law: A case study of local collective bargaining legislation in South China. Employee Relations. 2017; 39(4): 541-560.##Whitehead S. A rational response to Taser strikes. Jems. 2005; 30(5): 56-66.##Wang K. Labour resistance and worker attitudes towards trade :union: reform in China. Employee Relations. 2016;38(5): 724-740.##Hicks JR. Marginal productivity and the principle of variation. Economica. 1932; (35): 79-88.##Bithymitris G. Socio-cultural aspects of neo-nationalism in crisis contexts: an empirical analysis of liminal workers' perceptions in Greece (2011-2015). Acta Politologica. 2017; 9(1): 61-74.##Maloni MJ, Campbell SM, Gligor DM, et al. Exploring the effects of workforce level on supply chain job satisfaction and industry commitment. The International Journal of Logistics Management. 2017; 28(4): 1294-1318.##Bordogna L. Strikes in Europe: still a decade of decline or the eve of a new upsurge?. Indian Journal of Industrial Relations. 2010; 45(4): 658-670.##Harvey RG. Why is labour strife so persistent in South Africa's mining industry?. The Extractive Industries Society.2016; 3(3): 832-842.##Cowman J, Keating MA. Industrial relations conflict in Irish hospitals: a review of Labour Court cases. Journal of Health Organization Management. 2013; 27(3): 368-389.##Duffield C, Diers D, O'Brien-Pallas L, et al. Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research. 2011; 24(4): 244-255.##Aiken LH, Sloane DM, Bruyneel L, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet. 2014; 383(9931): 1824-1830.##Wolf LD, Potter P, Sledge JA, et al. Describing nurses' work: combining quantitative and qualitative analysis.Human Factors. 2006; 48(1): 5-14.##Borimnejad L, Valizadeh S, Rahmani A, et al. Attributes of Iranian new nurse preceptors: A phenomenological study. Nurse Education in Practice. 2018; 28: 121-126.##Dehghan-Nayeri N, Shali M, Navabi N, et al. Perspectives of oncology unit nurse managers on missed nursing care: a qualitative study. Asia-Pacific Journal of Oncology Nursing. 2018; 5(3): 327-336.##Rivaz M, Ebadi A, Momennasab M. The role of Magnet hospitals in making the nursing practice environment attractive. Journal of Hayat. 2018; 23(4): 290-294.##San Park J, Hyun Kim T. Do types of organizational culture matter in nurse job satisfaction and turnover intention?. Leadership in Health Services. 2009; 22(1): 20-38.##Lo WY, Chien LY, Hwang FM, et al. From job stress to intention to leave among hospital nurses: A structural equation modelling approach. Journal of Advanced Nursing. 2018; 74(3): 677-688.##Clarke J, O'Neill CS. An analysis of how the Irish Times portrayed Irish nursing during the 1999 strike. Nursing Ethics. 2001; 8(4): 350-359.##Briskin L. Resistance, mobilization and militancy: nurses on strike. Nursing Inquiry. 2012; 19(4): 285-296.##Mudaly P, Nkosi Z. Factors influencing nurse absenteeism in a general hospital in D urban, S outh A frica. Journal of Nursing Management. 2015; 23(5): 623-631.##Adam MB, Muma S, Modi JA, et al. Paediatric and obstetric outcomes at a faith-based hospital during the 100-day public sector physician strike in Kenya. BMJ Global Health. 2018; 3(2): e000665.##Thompson B. Exploratory and confirmatory factor analysis: Understanding concepts and applications. Washington,DC, US: American Psychological Association; 2004.##Mikkelsen F. Denmark 1700-1849: crowds, movements and absolute monarchy. In: Mikkelsen F, Kjeldstadli K,Nyzell S, editors. Popular Struggle and Democracy in Scandinavia. Palgrave Studies in European Political Sociology.London: Palgrave Macmillan; 2018: 13-33.##Chang C, Cooke FL. Layers of :union: organising and representation: the case study of a strike in a Japanese‐funded auto plant in China. Asia Pacific Journal of Human Resources. 2018; 56(4): 492-517.##Gose K, Sadrieh A. Strike, coordination, and dismissal in uniform wage settings. European Economic Review.2014; 70: 145-158.##Lieberman DE, Venkadesan M, Werbel WA, et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010; 463(7280): 531-535.##McKee Y. Strike art: Contemporary art and the post-occupy condition. Verso Books; 2016.##Gourevitch A. Quitting work but not the job: Liberty and the right to strike. Perspectives on Politics. 2016; 14(2):307-323.##Hersey P, Blanchard KH. Management of organizational behavior: Utilizing human resources. Academy of Management Journal. 1969; 12(4).##Adams JS, Freedman S. Equity theory revisited: Comments and annotated bibliography. Advances in Experimental Social Psychology.1976; 9: 43-90.##Lopez M, Mills B. Opportunistic shirking behavior during unpaid overtime. Applied Economics Letters. 2019;26(7): 608-612.##Bordia P, Restubog SLD, Tang RL. When employees strike back: investigating mediating mechanisms between psychological contract breach and workplace deviance. Journal of Applied Psychology. 2008; 93(5): 1104-1117.##Hackman JR. Work redesign and motivation. Professional Psychology. 1980; 11(3): 445-455.##Haimson LH, Tilly C. Strikes, wars, and revolutions in an international perspective: Strike waves in the late nineteenth and early twentieth centuries. Cambridge University Press; 2002.##Huang Q, Jiang F, Lie E, et al. The effect of labor :union:s on CEO compensation. Journal of Financial Quantitative Analysis. 2017; 52(2): 553-582.## ##

A Study of Risk Factors related to Water and Sanitation in Pune, west India 2 2 Introduction: Piped water systems are considered to be the gold standard for drinking water according to the Joint Water Monitoring Study. However, poor maintenance of distribution pipes, intermittency of water supply, and sewage water intrusion have contributed to a number of water-borne disease episodes in developed and developing countries. Methods: This study investigated the risk burden related to drinking water and sanitation in population clusters of Pune, western India that are being served by a piped distribution system through a cross-sectional survey. Two-stage stratified convenience sampling was carried out. The city was divided into administrative wards of which the city center, the neo-urban and the peri-urban settlement were selected. In the second step a higher (HSG) and a lower socioeconomic group (LSG) were selected from each of the three studied wards. A questionnaire including close-ended items was used to conduct the survey. Results: In 2711 individuals studied, risk burden related to drinking water and sanitation was found to be higher in the LSG; 60% (677 of 1121), 70% (1029 of 1473) , 74% (1325 of 1791) from the LSGs did not have a private water tap and continuous water supply, and did not treat the water at the household level, respectively. 98% (1403 of 1426) had neither a private water tap nor a private sanitary facility. The socioeconomic difference was significant (p<0.0001). 51 (3.5%) individuals from the LSGs and 42 (3.49%) ones from HSGs reported having suffered from severe diarrhea in the recall period of 2 years. Although the number of disease cases was lower than the overall risk burden, the potential of the latter to cause a disease outbreak cannot be eliminated. Conclusion: The study highlights that piped drinking water system which is considered as a safe source can become a source of pathogenic microorganisms if not properly maintained. A holistic approach to risk assessment, i.e., from the catchment and its source water to the consumer, is required. 113 120 2019/01/132019/03/122018/04/302018/06/72018/08/202019/06/302019/06/30 1398/4/9 2019/05/192019/05/212019/07/12019/01/282018/11/132019/06/302019/06/30 1398/4/9 Sayani Dutta Sayani Dutta Institute of Environment Education and Research, Bharati Vidyapeeth University, Pune, India India Erach Bharucha Erach Bharucha Institute of Environment Education and Research, Bharati Vidyapeeth University, Pune, India India Diarrhea Risk Factors Drinking Water Sanitation World Health Organization. Risk Factors in WHO regions. Available at: URL: www.who.int/topics/risk_factors/en/##Bartram J, Cairncross S. Hygiene, sanitation, and water: forgotten foundations of health. PLoS Medicine. 2010; 7(11):e1000367.##Tendick-Matesanz F. Integrated Evaluation of a Community-Based Safe Drinking-Water Project in Rural Guatemala (Doctoral dissertation); 2013.##Lakshminarayanan S, Jayalakshmy R. Diarrheal diseases among children in India: Current scenario and future perspectives. Journal of Natural Science, Biology, and Medicine. 2015; 6(1): 24-28.##World Health Organization. The management and prevention of diarrhoea: practical guidelines; 1993. Avalable at:URL: https://apps.who.int/iris/bitstream/handle/10665/37036/9241544546_eng.pdf.##Ashbolt NJ. Microbial contamination of drinking water and disease outcomes in developing regions. Toxicology. 2004; 198(1-3): 229-238.##World Health Organization, WHO/UNICEF Joint Water Supply, Sanitation Monitoring Programme. Progress on sanitation and drinking water: 2015 update and MDG assessment. World Health Organization; 2015.##Majorin F, Nagel CL, Torondel B, et al. Determinants of disposal of child faeces in latrines in urban slums of Odisha,India: a cross-sectional study. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2019; 113(5):263-272.##Omran AR. The epidemiologic transition: a theory of the epidemiology of population change. The Milbank Quarterly.2005; 83(4): 731-757.##Mushtaq MU. Public health in British India: A brief account of the history of medical services and disease prevention in colonial India. Indian Journal of Community Medicine. 2009; 34(1): 6-14.##Polu SL. Infectious disease in India, 1892-1940: policy-making and the perception of risk. Palgrave Macmillan;2012##John TJ, Dandona L, Sharma VP, et al. Continuing challenge of infectious diseases in India. The Lancet. 2011;377(9761): 252-269.##Moe CL, Rheingans RD. Global challenges in water, sanitation and health. Journal of Water and Health. 2006;4(S1): 41-57.##Ercumen A, Arnold BF, Kumpel E, et al. Upgrading a piped water supply from intermittent to continuous delivery and association with waterborne illness: a matched cohort study in urban India. PLoS Medicine. 2015; 12(10):e1001892.##World Health Organization. The world health report 2000: health systems: improving performance. World Health Organization; 2000.##Lee EJ, Schwab KJ. Deficiencies in drinking water distribution systems in developing countries. Journal of Water and Health. 2005; 3(2): 109-127.##Kelkar PS, Talkhande AV, Joshi MW, et al. Water quality assessment in distribution system under intermittant and continuous modes of water supply. Journal of Indian Water Works Association. 2001; 33(1): 39-43.##Kelkar PS, Andey SP, Pathak SK, et al. Evaluation of water distribution system for water consumption, flow pattern and pressure survey during intermittant vis-à-vis continuous water supply in Panaji city. Journal of Indian Water Works Association. 2002; 34: 27-36.##Andey SP, Kelkar PS. 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Extraintestinal pathogenic escherichia coli and antimicrobial drug resistance in a maharashtrian drinking water system. The American Journal of Tropical Medicine and Hygiene. 2019; 100(5):1101-1104.##Bapat M, Crook N. The environment, health, and nutrition: an analysis of interrelationships from a case-study of hutment settlements in the city of Poona. Habitat International. 1984; 8(3-4): 115-126.##Rode S. Sustainable drinking water supply in Pune metropolitan region: alternative policies. Theoretical and Empirical Researches in Urban Management. 2009; 4(1S): 48-59.##Unhealthy water fear lurks in pipeline overhaul delay. Times of India. Aug 5, 2017. Available at: https://timesofindia.indiatimes.com/city/pune/unhealthy-water-fear-lurks-in-pipeline-overhauldelay/articleshow/59937913.cms.##Nelson KE, Williams CM. Early history of infectious disease: epidemiology and control of infectious diseases. In: Nelson KE, Williams CM, editors. 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Indian Journal of Community Medicine. 2009; 34(1): 6-14.##Polu SL. Infectious disease in India, 1892-1940: policy-making and the perception of risk. Palgrave Macmillan;2012##John TJ, Dandona L, Sharma VP, et al. Continuing challenge of infectious diseases in India. The Lancet. 2011;377(9761): 252-269.##Moe CL, Rheingans RD. Global challenges in water, sanitation and health. Journal of Water and Health. 2006;4(S1): 41-57.##Ercumen A, Arnold BF, Kumpel E, et al. Upgrading a piped water supply from intermittent to continuous delivery and association with waterborne illness: a matched cohort study in urban India. PLoS Medicine. 2015; 12(10):e1001892.##World Health Organization. The world health report 2000: health systems: improving performance. World Health Organization; 2000.##Lee EJ, Schwab KJ. Deficiencies in drinking water distribution systems in developing countries. Journal of Water and Health. 2005; 3(2): 109-127.##Kelkar PS, Talkhande AV, Joshi MW, et al. Water quality assessment in distribution system under intermittant and continuous modes of water supply. Journal of Indian Water Works Association. 2001; 33(1): 39-43.##Kelkar PS, Andey SP, Pathak SK, et al. Evaluation of water distribution system for water consumption, flow pattern and pressure survey during intermittant vis-à-vis continuous water supply in Panaji city. Journal of Indian Water Works Association. 2002; 34: 27-36.##Andey SP, Kelkar PS. Influence of intermittent and continuous modes of water supply on domestic water consumption. Water Resources Management. 2009; 23(12): 2555-2566.##Gaytán M, Castro T, Bonilla P, et al. Preliminary study of selected drinking water samples in Mexico City. Revista Internacional De Contaminación Ambiental. 1997; 13(2): 73-78.##Agard L, Alexander C, Green S, et al. Microbial quality of water supply to an urban community in Trinidad. Journal of Food Protection. 2002; 65(8): 1297-1303.##Mermin JH, Villar R, Carpenter J, et al. A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water. The Journal of Infectious Diseases. 1999; 179(6): 1416-1422.##Dany V, Visvanathan C, Thanh NC. Evaluation of water supply systems in Phnom Penh City: a review of the present status and future prospects. International Journal of Water Resources Development. 2000; 16(4): 677-689.##Rayasam SD, Ray I, Smith KR, et al. Extraintestinal pathogenic escherichia coli and antimicrobial drug resistance in a maharashtrian drinking water system. The American Journal of Tropical Medicine and Hygiene. 2019; 100(5):1101-1104.##Bapat M, Crook N. The environment, health, and nutrition: an analysis of interrelationships from a case-study of hutment settlements in the city of Poona. Habitat International. 1984; 8(3-4): 115-126.##Rode S. Sustainable drinking water supply in Pune metropolitan region: alternative policies. Theoretical and Empirical Researches in Urban Management. 2009; 4(1S): 48-59.##Unhealthy water fear lurks in pipeline overhaul delay. Times of India. Aug 5, 2017. Available at: https://timesofindia.indiatimes.com/city/pune/unhealthy-water-fear-lurks-in-pipeline-overhauldelay/articleshow/59937913.cms.##Nelson KE, Williams CM. Early history of infectious disease: epidemiology and control of infectious diseases. In: Nelson KE, Williams CM, editors. Infectious Disease Epidemiology: Theory and Practice. 3rd ed. Jones & Bartlett Learning; 2007: 1-15.##Craun GF, Calderon RL. Waterborne disease outbreaks caused by distribution system deficiencies. JournalAmerican Water Works Association. 2001; 93(9): 64-75.## ##

Prevalence of Hemoglobin Anemia among Pregnant Women in the Northeast of Iran بررسی شیوع کم خونی در بین زنان باردار شمال شرق کشور 2 1 هدف: کم خون یکی از مهمترین مشکلات بهداشت عمومی در جهان است و بیشتر در زنان باردار است. این باعث وزن کم هنگام تولد و مرگ و میر مادران در دوران بارداری می شود. این مطالعه با هدف تعیین شیوع آنمی و عوامل مرتبط با آن در زنان باردار انجام شده است. روش ها: این مطالعه مقطعی بر روی 400 خانم باردار شهرستان شیروان در سال 1385 انجام شد. داده ها از پرونده های سلامت از طریق فهرستی از خانواده ها با استفاده از چک لیست جمع آوری و با استفاده از آمار توصیفی و آزمون های آماری مناسب کریستال، دقیق فیشر و تست McNemar تجزیه تحلیل کردیم. یافته ها: میانگین سن انسولین زنان باردار 5/29 ± 9/29 و دامنه 16 تا 40 سال بود. اکثر زنان باردار در گروه سنی 18 تا 35 سال (84.5 درصد)، تحصیلات دبیرستانی (8.68 درصد) و زنان خانه دار (87.8 درصد) داشتند. شیوع آنمی در زنان باردار در سه ماهه اول و سوم، به ترتیب 4.75٪ (CI 95٪: 2.66٪ - 6.84٪) و 16٪ (CI 95٪: 12.40٪ - 19.60٪) بود. شیوع آنمی در سه ماهه سوم افزایش یافت (p <0.01). نتیجه گیری: در مطالعه جمعیت ما، آنمی به عنوان یک مشکل بهداشتی متوسط ​​بوده و بنابراین مداخلات مبتنی بر جامعه با توجه به عوامل مرتبط شناسایی شده باید افزایش یابد. 2 Introduction: Anemia is one of the major public health problems among pregnant women in the world. It causes low birth weight and maternal mortality during pregnancies. This study aimed to determine the prevalence of anemia and its associated factors among pregnant women. Methods: This cross-sectional study was conducted on 400 pregnant women in Shirvan city, Iran in 2015. For sampling, each of the three centers in this city were considered as a single cluster and the number of required participants from each center was selected proportional to the number of pregnant women covered by each center using systematic approach. Data collected from health records of families using a checklist were analyzed by descriptive statistics and appropriate statistical tests including chi- square, Fisher's exact, and McNemar's test. Results: The age mean ± SD of the pregnant women was 29.9 ± 5.3 with a range of 16-40 years. Most of pregnant women were in the age group of 18-35 (84.5%) years, had high school education (65.8%), and were housewives (87.8%). The prevalence of anemia in pregnant women in the first and third trimester were 4.75% (CI95%: 2.66%-6.84%) and 16% (CI95%: 12.40%- 19.60%), respectively. Prevalence of anemia increased in the third trimester (p<0.01). Conclusion: Shirvan is one of the areas with a mild prevalence of anemia. However, iron deficiency anemia, as a nutritional disorder can be prevented. Therefore, community-based interventions should be implemented considering the identified associated factors. 121 128 2019/01/132019/03/122018/04/302018/06/72018/08/202019/06/302019/06/302019/01/11 1397/10/21 2019/05/192019/05/212019/07/12019/01/282018/11/132019/06/302019/06/302019/07/1 1398/4/10 حسین لشکردوست Hossein Lashkardoost Department of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran Iran doostaria@gmail.com هادی محمد دوست Hadi Mohammad Doust Department of Internal Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran Iran hadi81938@gmail.com حسن سعادتی Hassan Saadati Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Iran hasansaadati1391@gmail.com زهرا نظری Zahra Nazari Student Research Committee, North Khorasan University of Medical Sciences, Bojnurd, Iran Iran z.nazari1829@yahoo.com معصومه صناعی جوشقان Masoumeh Sanayee Joshaghan Student Research Committee, North Khorasan University of Medical Sciences, Bojnurd, Iran Iran m.sanayi1371@gmail.com اندیشه حامدی Andishe hamedi Department of Epidemiology, Shirvan Center of Higher Health Education, North Khorasan University of Medical Sciences, Bojnurd, Iran Iran ahamedi1364@gmail.com Prevalence Pregnancy Iran شیوع بارداری ایران Khan MS, Srivastav A, Dixit AK. The study of anaemia & its related socio-demographic factors amongst pregnant women in rural community of Uttar Pradesh. Journal of Evolution of Medical and Dental Sciences. 2014; 3(1): 14-19.##Alem M, Enawgaw B, Gelaw A, et al. Prevalence of anemia and associated risk factors among pregnant women attending antenatal care in Azezo Health Center Gondar town, Northwest Ethiopia. Journal of Interdiscipl Histopathol. 2013; 1(3): 137-144.##Lokare PO, Karanjekar VD, Gattani PL, et al. A study of prevalence of anemia and sociodemographic factors associated with anemia among pregnant women in Aurangabad city, India. Annals of Nigerian Medicine. 2012; 6(1):30-34.##Organization WH. WHO guidelines: daily iron and folic acid supplementation in pregnant women. Geneva(Switzerland): World Health Organization; 2012.##Pasricha SR, Caruana SR, Phuc TQ, et al. Anemia, iron deficiency, meat consumption, and hookworm infection in women of reproductive age in northwest Vietnam. The American Journal of Tropical Medicine and Hygiene. 2008;78(3): 375-381.##Stoltzfus RJ. Rethinking anaemia surveillance. The Lancet. 1997; 349(9067): 1764-1766.##Abriha A, Yesuf ME, Wassie MM. Prevalence and associated factors of anemia among pregnant women of Mekelle town: a cross sectional study. BMC Research Notes. 2014; 7(1): 888-893.##Bateni J, SHoghli A. The prevalence of iron deficiency anemia based on hematological parameters in nonpregnant women 15 to 45years Zanjan. Journal of Zanjan University of Medical Sciences. 2006; 14(55): 39-46.[Persian].##Dim CC, Onah HE. The prevalence of anemia among pregnant women at booking in Enugu, South Eastern Nigeria. Medscape General Medicine. 2007; 9(3): 11.##Khademi Z, Shahi A, Farshidfar Gh, et al. Prevalence of iron deficiency anemia in pregnant women referred to Shariati hospital in Bandar Abbas, Iran. Hormozgan Medical Journal. 2004; 8(1): 27-31. [Persian].##Navidian A, Ebrahimi Tabas E, Sarani H, et al. The prevalence of Iron-deficiency anemia in the pregnant women referring to health centers in Zahedan. Medical Journal of Reproduction & Infertility. 2006; 7(2): 132-138. [Persian].##Davaritanha F, Kaveh M, Salehi B. Incidence of anemia in pregnancy and its relationship with maternal characteristics and pregnancy outcome. Journal of Hayat. 2005; 11(24,25): 23-31. [Persian].##Safavi M, Sheikholeslam R, Abdollahi Z, et al. Prevalence of iron deficiency anemia among Iranian pregnant women, Spring 2001. Iranian Journal of Epidemiology. 2006; 2(3): 1-10. [Persian].##Mostajeran M, Hassanzadeh A, Tolei A, et al. Prevalence of iron deficiency anemia in unwanted and high risk pregnancies in Isfahan Province, Iran. Health System Research. 2013; 9(1): 66-75.##Sukrat B, Suwathanapisate P, Siritawee S, et al. The prevalence of iron deficiency anemia in pregnant women in Nakhonsawan, Thailand. Medical Journal of the Medical Association of Thailand. 2010; 93(7): 765-770.##Vera GL, Quintal DR, González MP, et al. Prevalence of iron-deficient anemia in rural pregnant women in Valldolid, Yucatan, Mexico. Ginecologia y obstetricia de Mexico. 2009; 77(12): 544-549.##Arija V, Ribot B, Aranda N. Prevalence of iron deficiency states and risk of haemoconcentration during pregnancy according to initial iron stores and iron supplementation. Public Health Nutrition. 2013; 16(8): 1371-1378.##Hernández-Martínez C, Canals J, Aranda N, et al. Effects of iron deficiency on neonatal behavior at different stages of pregnancy. Early Human Development. 2011; 87(3): 165-169.##Rizwan F, Memon A. Prevalence of anemia in pregnant women and its effects on maternal and fetal morbidity and mortality. Pakistan Journal of Medical Sciences. 2010; 26(1): 92-95.##Ahmed F, Al-Sumaie MA. Risk factors associated with anemia and iron deficiency among Kuwaiti pregnant women. International Journal of Food Sciences and Nutrition. 2011; 62(6): 585-592.##Yaghoobi H, Zolfizadeh F, Asadollahi Z, et al. Prevalence of iron deficiency anemia and some related factors among pregnant women referred to healthcare centers in Bandar Lengeh, Iran, in 2015. Journal of Occupational Health and Epidemiology. 2015; 4(2): 92-100.##Rahbar N, Ghorbani R, Rezaei Ahvanoei F. Prevalence of iron deficiency anemia and its complications in pregnant women referred to medical-health centers in Semnan. The Iranian Journal of Obstetrics, Gynecology and Infertility.2014; 17(128): 12-17.##Benoist Bd, McLean E, Egll I, et al. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia; 2008.##Sharifi N, Majlesi F. A survey on iron-deficiency anemia in pregnant women with presentation of an educational program. Zahedan Journal of Research Medical Sciences. 2012; 13(10): 42.##Obai G, Odongo P, Wanyama R. Prevalence of anaemia and associated risk factors among pregnant women attending antenatal care in Gulu and Hoima Regional Hospitals in Uganda: A cross sectional study. BMC Pregnancy and Childbirth. 2016; 16(1): 1-7.##Khan MS, Srivastav A, Dixit AK. The study of anaemia & its related socio-demographic factors amongst pregnant women in rural community of Uttar Pradesh. Journal of Evolution of Medical and Dental Sciences. 2014; 3(1): 14-19.##Alem M, Enawgaw B, Gelaw A, et al. Prevalence of anemia and associated risk factors among pregnant women attending antenatal care in Azezo Health Center Gondar town, Northwest Ethiopia. Journal of Interdiscipl Histopathol. 2013; 1(3): 137-144.##Lokare PO, Karanjekar VD, Gattani PL, et al. A study of prevalence of anemia and sociodemographic factors associated with anemia among pregnant women in Aurangabad city, India. Annals of Nigerian Medicine. 2012; 6(1):30-34.##Organization WH. WHO guidelines: daily iron and folic acid supplementation in pregnant women. Geneva(Switzerland): World Health Organization; 2012.##Pasricha SR, Caruana SR, Phuc TQ, et al. Anemia, iron deficiency, meat consumption, and hookworm infection in women of reproductive age in northwest Vietnam. The American Journal of Tropical Medicine and Hygiene. 2008;78(3): 375-381.##Stoltzfus RJ. Rethinking anaemia surveillance. The Lancet. 1997; 349(9067): 1764-1766.##Abriha A, Yesuf ME, Wassie MM. Prevalence and associated factors of anemia among pregnant women of Mekelle town: a cross sectional study. BMC Research Notes. 2014; 7(1): 888-893.##Bateni J, SHoghli A. The prevalence of iron deficiency anemia based on hematological parameters in nonpregnant women 15 to 45years Zanjan. Journal of Zanjan University of Medical Sciences. 2006; 14(55): 39-46.[Persian].##Dim CC, Onah HE. The prevalence of anemia among pregnant women at booking in Enugu, South Eastern Nigeria. Medscape General Medicine. 2007; 9(3): 11.##Khademi Z, Shahi A, Farshidfar Gh, et al. Prevalence of iron deficiency anemia in pregnant women referred to Shariati hospital in Bandar Abbas, Iran. Hormozgan Medical Journal. 2004; 8(1): 27-31. [Persian].##Navidian A, Ebrahimi Tabas E, Sarani H, et al. The prevalence of Iron-deficiency anemia in the pregnant women referring to health centers in Zahedan. Medical Journal of Reproduction & Infertility. 2006; 7(2): 132-138. [Persian].##Davaritanha F, Kaveh M, Salehi B. Incidence of anemia in pregnancy and its relationship with maternal characteristics and pregnancy outcome. Journal of Hayat. 2005; 11(24,25): 23-31. [Persian].##Safavi M, Sheikholeslam R, Abdollahi Z, et al. Prevalence of iron deficiency anemia among Iranian pregnant women, Spring 2001. Iranian Journal of Epidemiology. 2006; 2(3): 1-10. [Persian].##Mostajeran M, Hassanzadeh A, Tolei A, et al. Prevalence of iron deficiency anemia in unwanted and high risk pregnancies in Isfahan Province, Iran. Health System Research. 2013; 9(1): 66-75.##Sukrat B, Suwathanapisate P, Siritawee S, et al. The prevalence of iron deficiency anemia in pregnant women in Nakhonsawan, Thailand. Medical Journal of the Medical Association of Thailand. 2010; 93(7): 765-770.##Vera GL, Quintal DR, González MP, et al. Prevalence of iron-deficient anemia in rural pregnant women in Valldolid, Yucatan, Mexico. Ginecologia y obstetricia de Mexico. 2009; 77(12): 544-549.##Arija V, Ribot B, Aranda N. Prevalence of iron deficiency states and risk of haemoconcentration during pregnancy according to initial iron stores and iron supplementation. Public Health Nutrition. 2013; 16(8): 1371-1378.##Hernández-Martínez C, Canals J, Aranda N, et al. Effects of iron deficiency on neonatal behavior at different stages of pregnancy. Early Human Development. 2011; 87(3): 165-169.##Rizwan F, Memon A. Prevalence of anemia in pregnant women and its effects on maternal and fetal morbidity and mortality. Pakistan Journal of Medical Sciences. 2010; 26(1): 92-95.##Ahmed F, Al-Sumaie MA. Risk factors associated with anemia and iron deficiency among Kuwaiti pregnant women. International Journal of Food Sciences and Nutrition. 2011; 62(6): 585-592.##Yaghoobi H, Zolfizadeh F, Asadollahi Z, et al. Prevalence of iron deficiency anemia and some related factors among pregnant women referred to healthcare centers in Bandar Lengeh, Iran, in 2015. Journal of Occupational Health and Epidemiology. 2015; 4(2): 92-100.##Rahbar N, Ghorbani R, Rezaei Ahvanoei F. Prevalence of iron deficiency anemia and its complications in pregnant women referred to medical-health centers in Semnan. The Iranian Journal of Obstetrics, Gynecology and Infertility.2014; 17(128): 12-17.##Benoist Bd, McLean E, Egll I, et al. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia; 2008.##Sharifi N, Majlesi F. A survey on iron-deficiency anemia in pregnant women with presentation of an educational program. Zahedan Journal of Research Medical Sciences. 2012; 13(10): 42.##Obai G, Odongo P, Wanyama R. Prevalence of anaemia and associated risk factors among pregnant women attending antenatal care in Gulu and Hoima Regional Hospitals in Uganda: A cross sectional study. BMC Pregnancy and Childbirth. 2016; 16(1): 1-7.## ##