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Overweight and Obesity Reduction Efficacy in Breast Cancer: A Letter to the Editor اثر بخشی اضافه وزن و چاقی در سرطان پستان: نامه ای به سردبیر 2 2 Dear Editor, According to the International Agency for Research on Cancer (IARC), Asia has the highest death rates and incidence of breast cancer; 27% of all cancers that occur among women in Iran are attributed to breast cancer. The role of obesity in breast cancer development has been known for decades. S strong evidence exists on the idea that obesity and weight gain during adulthood are associated with increased risk of postmenopausal breast cancer. Furthermore, growing evidence is available on the association of obesity with breast cancer and overall mortality rate in women’s premenopausal and postmenopausal periods (1). Evaluation of the breast cancer risk helps identification of the women with the high risk of developing breast cancer in the future. Some strategies to reduce this risk involve adopting a healthier lifestyle as well as involving diet and exercise in everyday life (2). Obesity and overweight are defined by Body Mass Index (BMI). The effect of high BMI on breast cancer was assessed in selected studies using the odds ratio (OR). The results of the data analysis using the random effects method showed that the risk of breast cancer was higher among the people with obesity (BMI ≥ 30): Pooled OR = 1.81, 95% CI = 1.24 - 2.64 and for overweight (30 > BMI ≥ 25): Pooled OR = 1.46, 95% CI = 1.13 - 1.89(3). According to the care plan for risk factors in non-communicable diseases (Steps 2016), the prevalence rates of obesity and overweight were 29.77% and 34.96% among Iranian women, respectively. Furthermore, population-attributable fractions of these diseases were 13.32% and 11.01%, respectively, which indicates that by eliminating obesity and overweight factors, we can expect 24.33% reduction in the population’s breast cancer. For instance, a well-designed randomized controlled trial in children with a particular disease found that 20% of the control group developed bad outcomes compared with only 12% of the individuals who received treatment. Absolute risk reduction (ARR) – also called risk difference (RD) – is the most useful way of presenting research results to help your decision-making. In this example, the ARR is 8% (20% - 12% = 8%), which means that, if 100 children were treated, 8 would be prevented from developing bad outcomes. Another way of expressing this is the number needed to treat (NNT); that is the number of people who must be treated to benefit one person. It is the inverse of absolute risk reduction. If 8 children out of 100 benefit from a treatment, the NNT for one child to benefit is about 13 (100 ÷ 8 = 12.5)(4). A randomized, controlled, primary prevention trial was conducted in 40 US clinical centers from 1993 to 2005. In this study, a total of 48,835 postmenopausal women, aged 50 to 79 years, without prior breast cancer were enrolled. Women were randomly assigned into the dietary modification intervention group (40% [n = 19,541]) and the control group (60% [n = 29,294]) (5). The baseline characteristics of BMI and breast cancer incidence indicated that overweight ARR rate equals 0.0025 that is 0.25% (NNT: 400), obesity ARR equals 0.0012 i.e., 0.12% (NNT: 833.33) and obesity grade 2 and more equals 0.0033 that is 0.33% (NNT: 303.03). In other words, by treating 400 patients suffering from overweight and 833.33 patients suffering from obesity, we can prevent one case of breast cancer. Overweight, obesity, and abdominal fat are associated with the risk of developing breast cancer in women during the premenopausal and postmenopausal periods. Therefore, in order to prevent breast cancer and its complications, an intervention program should be implemented to control obesity and a breast cancer screening program should be conducted among the obese and overweight women (6). Governments are responsible for maintaining, restoring, and promoting health in the community. In order to make the right decisions and direct resources of the health sector, the most common cancer in women should be investigated as a priority for the health system. Therefore, a special study of breast cancer is necessary considering the mortality rate and disability. In this regard, we decided to investigate the most relevant risk factor and evaluate the risk associated with breast cancer by reviewing articles related to breast cancer. Later, we examined the most effective interventional strategies in this area. Consequently, given high prevalence of the overweight and obesity, intervention plans should be implemented to reduce the risk factors of the breast cancer. 129 130 2019/02/20 1397/12/1 2019/10/21 1398/7/29 سیده مهدیه نماینده Seyedeh Mahdieh Namayandeh Department of epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran سیده سارا موسوی Seyedeh Sara Mousavi Department of epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran مینا عربیان Mina Arabian Department of epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran جواد خیراندیش Javad Kheirandish Department of epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran حبیب دهقانی اشکذری Habib Dehghani Ashkezari Department of epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran There are no keywords Bandera EV, John EM. Obesity, Body Composition, and Breast Cancer: An Evolving Science. JAMA oncology. 2018; 4(6):804-5.##Costa M, Saldanha P. Risk Reduction Strategies in Breast Cancer Prevention. European journal of breast health. 2017; 13(3):103-12.##3 Zahmatkesh BH, Alavi N, Keramat A, et al. Body Mass Index and Risk of Breast Cancer: A Systematic Review and Meta-Analysis in Iran. International Journal of Cancer Management. 2017;10(4).:5921.##Irwig L, Irwig J, Trevena L, et al. Smart Health Choices: Making Sense of Health Advice. London: Hammersmith Press. 2008.##Prentice RL, Caan B, Chlebowski RT, et al. Low-fat dietary pattern and risk of invasive breast cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. Jama. 2006; 295(6):629-42.##Hajian K, Gholizadehpasha A, Bozorgzadeh S. Association of obesity and central obesity with breast cancer risk in pre- and postmenopausal women. Journal of Babol University of Medical Sciences (Jbums). 2013 ;15(3):7-15.[Persian]##Bandera EV, John EM. Obesity, Body Composition, and Breast Cancer: An Evolving Science. JAMA oncology. 2018; 4(6):804-5.##Costa M, Saldanha P. Risk Reduction Strategies in Breast Cancer Prevention. European journal of breast health. 2017; 13(3):103-12.##3 Zahmatkesh BH, Alavi N, Keramat A, et al. Body Mass Index and Risk of Breast Cancer: A Systematic Review and Meta-Analysis in Iran. International Journal of Cancer Management. 2017;10(4).:5921.##Irwig L, Irwig J, Trevena L, et al. Smart Health Choices: Making Sense of Health Advice. London: Hammersmith Press. 2008.##Prentice RL, Caan B, Chlebowski RT, et al. Low-fat dietary pattern and risk of invasive breast cancer: the Women's Health Initiative Randomized Controlled Dietary Modification Trial. Jama. 2006; 295(6):629-42.##Hajian K, Gholizadehpasha A, Bozorgzadeh S. Association of obesity and central obesity with breast cancer risk in pre- and postmenopausal women. Journal of Babol University of Medical Sciences (Jbums). 2013 ;15(3):7-15.[Persian]## ##

The Study of General Health Status in the Students of Shahid Sadoughi University of Medical Sciences in Yazd بررسی وضعیت سلامت عمومی در دانشجویان دانشگاه علوم پزشکی یزد 2 1 زمینه و هدف: دانشجویان با توجه به شرایط خاص دوره دانشجویی مستعد از دست دادن سلامت عمومی هستند و با توجه به اینکه درصد قابل توجهی از جمعیت کشور را تشکیل می دهند، بررسی وضعیت سلامت عمومی آنان می تواند مبنای خوبی برای برنامه ریزی در جهت ارتقاء سلامت عمومی آنان باشد. بنابراین مطالعه حاضر با هدف بررسی وضعیت سلامت عمومی دانشجویان انجام شد. مواد و روش ها: در این پژوهش توصیفی-مقطعی، 272 نفر از دانشجویان دانشگاه علوم پزشکی یزد در سال 1395 به روش نمونه گیری تصادفی طیقه بندی شده انتخاب شدند. ابزار گردآوری داد ها پرسش نامه سه قسمتی شامل ویژگی های جمعیت شناختی، عوامل مربوط به عادات زندگی و پرسش نامه استاندارد سلامت عمومی (GHQ-28) بود. داده ها پس از جمع آوری وارد spss نسخه 16 شدند و با استفاده از آمار توصیفی، تی تست و آنالیز واریانس یک طرفه مورد تجزیه و تحلیل قرار گرفتند. یافته ها: یافته ها نشان داد4/54 درصد از دانشجویان دارای وضعیت سلامت عمومی نامطلوب بودند. وضعیت سلامت عمومی دانشجویان بر حسب جنسیت، مقطع تحصیلی، تحصیلات پدر و مادر، شغل پدر و مادر و وضعیت سکونت تفاوت معنی داری نداشت(05/0 p>)، ولی بر حسب مصرف سیگار تفاوت  معنی داری را نشان داد(03/0=p) که این تفاوت  بیشتر در حیطه افسردگی دیده شد(01/0=p). نتیجه گیری: با توجه به اثرات منفی افسردگی و مصرف سیگار بر سلامت عمومی دانشجویان، به نظر می رسد با ارائه خدمات مشاوره و طراحی و اجرای اقدامات پیشگیرانه می­توان سلامت عمومی دانشجویان را بهبود بخشید. 2   Introduction: Students are predisposed to loss of general health due to the special circumstances of the education period. Considering that they constitute a significant proportion of the population, their general health status can be considered as a good basis to plan for their general health. Therefore, the present study was conducted to investigate the general health status in students of Yazd University of Medical Sciences.  Methods: In this descriptive study, 272 students of Shahid Sadoughi University of Medical Sciences in 2016 were selected by stratified random sampling method. Data collection instrument was a three-section questionnaire including demographic characteristics, lifestyle-related habits, a standard health questionnaire, and a general health questionnaire (GHQ)-28. After data collection was done, the data were analyzed using SPSS software version 16, descriptive and Independent T-test and one-way ANOVAs. Results: Findings of the study showed that 54.4% of students had a non-favorable general health status. The general health status of the students was not significantly associated with gender, education level, parents’ education level and residence status (p > 0.05). However, there was a significant difference in the variable of smoking. (p = 0.03), and this difference was more pronounced in the areas related to depression. Conclusion:Regarding the negative effects of the students' depression and smoking on their general health status,  it seems that the general health of the students can be improved by providing consulting services and designing and implementing preventive action. 131 138 2019/02/202019/10/15 1398/7/23 2019/10/212019/10/15 1398/7/23 زهرا خزیر Zahra Khazir Department of Health Education and Health Promotion, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran سارا جام برسنگ sara Jambarsang 2. Department of Biostatistics and Epidemiology, School of health, Shahid Sadoughi university of medical sciences, Yazd, Iran Iran معصومه عباسی شوازی Masoumeh Abbasi-Shavazi Assistant Professor, Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mabbasishavazi@ssu.ac.ir General Health Depression Students سلامت عمومی افسردگی اضطراب دانشجویان Mehri A, Sadighi Someh Kochak Z. Investigating the status of mental health and some related factors in students Sabzevar Universities in 2009. Journal of Islamic Azad University of Medical Sciences 2011; 21(4):298-304.##Shojaee M, French C. The relationship between mental health components and locus of control in youth. Psychology. 2014;5(08):966.##Hashemi Nazari S, hosravi J, Faghizadeh S, et al. Investigation of mental health among fire stations' staff. Hakim. 2007; 10(2):56-64. .[persian]##Safdari Dah Cheshmeh F, Del Aram M, parvin N, et al. Factors affecting in academic achievement of students in nursing and midwifery school, Shahr-e-KordUniversity of Medical Sciences. Journal of ShahreKord University of Medical Sciences. 2007; 9(3): 71-77.[persian]##Bahreinian SA, Ghasemi M. The investigation of mental health among students at ShahidBeheshti University of Medical Science. Teb & Tazkieh. 2002; 43:65-75. .[persian]##Asadi M, Baratisede F, Bahamani B, et al. Investigation of mental health and self-esteem in male and sport studentswhod participated in the first sport Olympiad at Universities of country. Journal of Teb va Tazkieh. 2003; (44): 43-49.[persian]##Hoseini SH, Kazemi sh, Shahbaznejad L. The relationship between sport and mental health among students. Journal of Mazendaran University of Medical Science.2007; 53:97-104.##Poordehghan M, Danesh AR, Esmaeily HA. Job stress andhypertensionamong nurses. Journal of AndishevaRaftar. 2004; 11(1):81-88.[persian]##Cho YB, Haslam N. Suicidal Ideation and Distress amongmmigrantAdolescents: The Role of Acculturation, Life Stress, and Social Support. Journal of Youth and Adolescence. 2010; 39(4):370-379.##Soleymanjahi H. Inter-relation between occupational stress and job satisfaction among the employees of organizations in Ilam, 2001. 2004##Beddoe AE, Murphy So. Does mindfulness decress stress and foster empathy among nursing students? jnurs Educ.2004 ; 43(7): 305-120.##Nariman A, Akbarzadeh M, Hamzeh M. Evaluation of general health in medical students of AJA university of medical sciences, 2009 .Annals of Military and Health Sciences Research.2010; 8(1): 49-55. .[persian]##Yousefi F, Mohamadkhani M. Investigation of students' mental health at Kurdistan University of Medical Science and it related with age, gender and their academic courses. Medical Journal of Mashhad University of Medical Sciences. 2014; 56(6): 354-361.##Lane R,Mc Donald G. Reducing the economic burden of depression. Int Clin Psychopharmacol.1994; 9(4): 229-43.##Noorbala AA ,Bagheri yazdi S A, Mohammad K.The Validation of General Health Questionnaire- 28 as a Psychiatric Screening Tool. Hakim Research Journal. 2009; 11(4): 47- 53. .[persian]##Taghavi M R. Barresie Etebar va ravaei porseshnameye salamate omoomi (GHQ). Journal of psychology.2001;5(4): 381-398. [Persian]##Yaghoubi N, Nasr M, Shahmohammadi D. Epidemiological study of mental disorders in urban and urban areas of SoumaahSara city- Gilan. Andisheh and Raftar Journal.1995; 4: 55- 65. [Persian]##Alavi SS, Merasi MR, Janatifard F, et al. A survey of relationship between psychiatric symptoms and internet addiction in students of Isfahan Universities. Scientific Journal of Hamedan University of Medical Sciences and Health Services 2010; 17(2): 57-65. [Persian]##Mohammad Beigi AL, Mohamad salehi N, Ghamari F, et al. Depression symptoms prevalence, general health status and its factors in dormitory students of Arak Universities 2008. AMUJ. 2009; 12(3): 116-23.[Persian]##Banihashemian K, Seif M, Moazzen M. Relationship between pessimism, general health and emotional intelligence in college students at Shiraz University and Shiraz University of medical sciences. JBUMS. 2009;11(1): 49-56. [Persian]##Afshari Z, Rakhshani M. Factors Related to Mental Health of Students in Zabol University of Medical Sciences. Journal of Neyshabur University of Medical Sciences.2014:2(3):28-36.[Persian]##Rothenberg D. Supporting girls in early adolescence. [Eric Digest]. Eric clearing house on elementary and early childhood education urbane IL; 1995: 1-6. www.eric.ed.gov.##Karimi Zarchi AA, Tavallaii SA, Adibzadeh AR,et al. Prevalence rate and related factros of depression in medical students. Kowsar Medical Journal. 2003;8(3): 231-4.[persian]##Rafiei M, Mosavipour S , Aghanajafi M.Happiness, mental health, and their relationship among the students at Arak University of Medical Sciences in 2010. Journal of Arak University of Medical Sciences 2012,15(3):15-25 .[persian]##Adham D, Salem Safi P, Amiri M, et al, The Survey of Mental Health Status in Ardabil University of Medical Sciences Students in 2007-2008. J Ardabil Univ Med Sci . 2008;8(3); 229-234.[persian].##Namazi A, Alizadeh Sh, Kouchakzadeh talami S. General health in nursing and midwifery students and its relationship with academic achievement. 2015, 4(3): 11-18. .[persian]##Solgi Z, SaeediPoor B, Abdolmaleki P. Study of psychological well-being of physical education students of Razi university of Kermanshah. Behbood, The Scientific Quarterly.2009;13(2): 172-8.[persian]##Niknam M,Hejazi E.Fear of success and Psychological satisfaction in university students. Psychological studies. 2006-2007, 2 : (3-4); 57 - 74. .[persian]##Soltani N. General Health Status of Nursing Students in AJA University of Medical Sciences.journal of militar caring sciences.2016; 2(4): 191-196. .[persian]##Sharma, M., Atri, A. & Branscum, P. Foundations of Mental Health Promotion, Jones & Bartlett Learning, LLC. 2011##Horn K, Dino G, Kalsekar I, et al. Exploring the relationship between mental health and smoking cessation: A study of rural teens. Prev Sci. 2004; 5(2): 113-26.##Ratschen E, Britton J, McNeill A. "Implementation of smoke-free policies in mental health in patient settings in England". Br J Psychiatry. 2009; 194(6): 547-51.##Yousefi A, Baratali M, Erfan A. The relationship between Mental Health, Emploment and Having Higher Education among Female students of Isfahan University of Medical Sciences. Iranian Journal of Medical education 2011;10(5):748-54. .[persian]##Gholami M, Emkani M , Dehghan A, et al.Survey of general health status and the factors affecting in it among industry staffs in Kerma. J Neyshabur Univ Med Sci 2014, 1(1): 32-35. .[persian]##Yousefi F, Mohamadkhani M. Investigation of students' mental health at Kurdistan University of Medical Science and it related with age, gender and their academic courses. Medical journal of mashhad university of medical sciences.2014,56(6):354-361.[persian]##Zarei pour M, EftekharArdabili H, Azam K, et al. Study of Mental health and its Relationship with Family Welfare in Pre-university Students in Salmas City in 2010. Journal of Research Developing in Nursing and Midwifery. 2012, 9(1): 84-93.[persian]##Richards G, Smith A.Caffeine consumption and self-assessed stress, anxiety, and depression in secondary school children. Journal of Psychopharmacology.2015; 29(12):1236-1247.##Gilliland K , Andress D (1981) Ad lib caffeine consumption, symptoms of caffeinism, and academic performance. Am J Psychiatry.138: 512-514.##Pettit ML , DeBarr KA. Perceived stress, energy drink consumption, and academic performance among college students. J Am Coll Health. 2011; 59: 335-341.##Zareena S.Prevalence of stress among medical students and music to alleviate the stress. Int J Res Med Sci. 2017;5(6):2512-2515.##Thoma MV, La Marca R, Brönnimann R, et al. The Effect of Music on the Human Stress Response. PLoS ONE . 2013; 8(8):e70156.##Mehri A, Sadighi Someh Kochak Z. Investigating the status of mental health and some related factors in students Sabzevar Universities in 2009. Journal of Islamic Azad University of Medical Sciences 2011; 21(4):298-304.##Shojaee M, French C. The relationship between mental health components and locus of control in youth. Psychology. 2014;5(08):966.##Hashemi Nazari S, hosravi J, Faghizadeh S, et al. Investigation of mental health among fire stations' staff. Hakim. 2007; 10(2):56-64. .[persian]##Safdari Dah Cheshmeh F, Del Aram M, parvin N, et al. Factors affecting in academic achievement of students in nursing and midwifery school, Shahr-e-KordUniversity of Medical Sciences. Journal of ShahreKord University of Medical Sciences. 2007; 9(3): 71-77.[persian]##Bahreinian SA, Ghasemi M. The investigation of mental health among students at ShahidBeheshti University of Medical Science. Teb & Tazkieh. 2002; 43:65-75. .[persian]##Asadi M, Baratisede F, Bahamani B, et al. Investigation of mental health and self-esteem in male and sport studentswhod participated in the first sport Olympiad at Universities of country. Journal of Teb va Tazkieh. 2003; (44): 43-49.[persian]##Hoseini SH, Kazemi sh, Shahbaznejad L. The relationship between sport and mental health among students. Journal of Mazendaran University of Medical Science.2007; 53:97-104.##Poordehghan M, Danesh AR, Esmaeily HA. Job stress andhypertensionamong nurses. Journal of AndishevaRaftar. 2004; 11(1):81-88.[persian]##Cho YB, Haslam N. Suicidal Ideation and Distress amongmmigrantAdolescents: The Role of Acculturation, Life Stress, and Social Support. Journal of Youth and Adolescence. 2010; 39(4):370-379.##Soleymanjahi H. Inter-relation between occupational stress and job satisfaction among the employees of organizations in Ilam, 2001. 2004##Beddoe AE, Murphy So. Does mindfulness decress stress and foster empathy among nursing students? jnurs Educ.2004 ; 43(7): 305-120.##Nariman A, Akbarzadeh M, Hamzeh M. Evaluation of general health in medical students of AJA university of medical sciences, 2009 .Annals of Military and Health Sciences Research.2010; 8(1): 49-55. .[persian]##Yousefi F, Mohamadkhani M. Investigation of students' mental health at Kurdistan University of Medical Science and it related with age, gender and their academic courses. Medical Journal of Mashhad University of Medical Sciences. 2014; 56(6): 354-361.##Lane R,Mc Donald G. Reducing the economic burden of depression. Int Clin Psychopharmacol.1994; 9(4): 229-43.##Noorbala AA ,Bagheri yazdi S A, Mohammad K.The Validation of General Health Questionnaire- 28 as a Psychiatric Screening Tool. Hakim Research Journal. 2009; 11(4): 47- 53. .[persian]##Taghavi M R. Barresie Etebar va ravaei porseshnameye salamate omoomi (GHQ). Journal of psychology.2001;5(4): 381-398. [Persian]##Yaghoubi N, Nasr M, Shahmohammadi D. Epidemiological study of mental disorders in urban and urban areas of SoumaahSara city- Gilan. Andisheh and Raftar Journal.1995; 4: 55- 65. [Persian]##Alavi SS, Merasi MR, Janatifard F, et al. A survey of relationship between psychiatric symptoms and internet addiction in students of Isfahan Universities. Scientific Journal of Hamedan University of Medical Sciences and Health Services 2010; 17(2): 57-65. [Persian]##Mohammad Beigi AL, Mohamad salehi N, Ghamari F, et al. Depression symptoms prevalence, general health status and its factors in dormitory students of Arak Universities 2008. AMUJ. 2009; 12(3): 116-23.[Persian]##Banihashemian K, Seif M, Moazzen M. Relationship between pessimism, general health and emotional intelligence in college students at Shiraz University and Shiraz University of medical sciences. JBUMS. 2009;11(1): 49-56. [Persian]##Afshari Z, Rakhshani M. Factors Related to Mental Health of Students in Zabol University of Medical Sciences. Journal of Neyshabur University of Medical Sciences.2014:2(3):28-36.[Persian]##Rothenberg D. Supporting girls in early adolescence. [Eric Digest]. Eric clearing house on elementary and early childhood education urbane IL; 1995: 1-6. www.eric.ed.gov.##Karimi Zarchi AA, Tavallaii SA, Adibzadeh AR,et al. Prevalence rate and related factros of depression in medical students. Kowsar Medical Journal. 2003;8(3): 231-4.[persian]##Rafiei M, Mosavipour S , Aghanajafi M.Happiness, mental health, and their relationship among the students at Arak University of Medical Sciences in 2010. Journal of Arak University of Medical Sciences 2012,15(3):15-25 .[persian]##Adham D, Salem Safi P, Amiri M, et al, The Survey of Mental Health Status in Ardabil University of Medical Sciences Students in 2007-2008. J Ardabil Univ Med Sci . 2008;8(3); 229-234.[persian].##Namazi A, Alizadeh Sh, Kouchakzadeh talami S. General health in nursing and midwifery students and its relationship with academic achievement. 2015, 4(3): 11-18. .[persian]##Solgi Z, SaeediPoor B, Abdolmaleki P. Study of psychological well-being of physical education students of Razi university of Kermanshah. Behbood, The Scientific Quarterly.2009;13(2): 172-8.[persian]##Niknam M,Hejazi E.Fear of success and Psychological satisfaction in university students. Psychological studies. 2006-2007, 2 : (3-4); 57 - 74. .[persian]##Soltani N. General Health Status of Nursing Students in AJA University of Medical Sciences.journal of militar caring sciences.2016; 2(4): 191-196. .[persian]##Sharma, M., Atri, A. & Branscum, P. Foundations of Mental Health Promotion, Jones & Bartlett Learning, LLC. 2011##Horn K, Dino G, Kalsekar I, et al. Exploring the relationship between mental health and smoking cessation: A study of rural teens. Prev Sci. 2004; 5(2): 113-26.##Ratschen E, Britton J, McNeill A. "Implementation of smoke-free policies in mental health in patient settings in England". Br J Psychiatry. 2009; 194(6): 547-51.##Yousefi A, Baratali M, Erfan A. The relationship between Mental Health, Emploment and Having Higher Education among Female students of Isfahan University of Medical Sciences. Iranian Journal of Medical education 2011;10(5):748-54. .[persian]##Gholami M, Emkani M , Dehghan A, et al.Survey of general health status and the factors affecting in it among industry staffs in Kerma. J Neyshabur Univ Med Sci 2014, 1(1): 32-35. .[persian]##Yousefi F, Mohamadkhani M. Investigation of students' mental health at Kurdistan University of Medical Science and it related with age, gender and their academic courses. Medical journal of mashhad university of medical sciences.2014,56(6):354-361.[persian]##Zarei pour M, EftekharArdabili H, Azam K, et al. Study of Mental health and its Relationship with Family Welfare in Pre-university Students in Salmas City in 2010. Journal of Research Developing in Nursing and Midwifery. 2012, 9(1): 84-93.[persian]##Richards G, Smith A.Caffeine consumption and self-assessed stress, anxiety, and depression in secondary school children. Journal of Psychopharmacology.2015; 29(12):1236-1247.##Gilliland K , Andress D (1981) Ad lib caffeine consumption, symptoms of caffeinism, and academic performance. Am J Psychiatry.138: 512-514.##Pettit ML , DeBarr KA. Perceived stress, energy drink consumption, and academic performance among college students. J Am Coll Health. 2011; 59: 335-341.##Zareena S.Prevalence of stress among medical students and music to alleviate the stress. Int J Res Med Sci. 2017;5(6):2512-2515.##Thoma MV, La Marca R, Brönnimann R, et al. The Effect of Music on the Human Stress Response. PLoS ONE . 2013; 8(8):e70156.## ##

Assessment of mental workload, work ability and musculoskeletal disorders of firefighters ارزیابی بار کاری ذهنی، توانایی انجام کار و اختلالات اسکلتی عضلانی آتش نشانان 2 1 مقدمه: آتشنشــانی یکــی از مشــاغلی است کــه بــه دلیــل ماهیــت شــغل و خواســته های فیزیکــی بــالای ایــن حرفه، نیــاز بــه تــوان جســمانی و هــوازی بالایــی دارد. لذا مطالعه حاضر با هدف بررسی ارتباط بین توانایی انجام کار، بار کاری ذهنی، اختلالات اسکلتی عضلانی و فاکتورهای موثر بر آن ها در آتش نشانان انجام شد. روش کار: این پژوهش یک مطالعه مقطعی بود که بر روی 250 نفر از آتش نشانان  شهر تهران انجام شد. اطلاعات با استفاده از پرسشنامه های WAI، NASA-TLX وچارت ناراحتی بدن (BDC) جمع آوری گردید. تجزیه و تحلیل اطلاعات با استفاده از آمار توصیفی، رگرسیون خطی، آزمون آماری همبستگی پیرسون و اسپیرمن انجام شد. نتایج: بار کاری ذهنی کل 6.58±70.07 بود. همچنین میانگین (انحراف معیار) نمره کل WAI، 38.85 (1.17) بود. بعد بار کاری فیزیکی بالاترین مقدار را در بین ابعاد بار کاری ذهنی (93/8 ± 49/93) داشت. نتایج نشان داد که با افزایش یک واحد در مقطع تحصیلی دانشگاهی آتشنشانان، مقدار WAI، 0.14 افزایش می یابد (P=0.03). بیشترین میزان ناراحتی نیز به ترتیب در نواحی تحتانی (50 نفر (20%)) و فوقانی (42 نفر (16.8%)) کمر بود. ارتباط بین WAI کل و بار کاری ذهنی مثبت و غیر معنادار بود (p<0.05).  WAIبا میزان ناراحتی در مچ دست، پا و قوزک پا ارتباط معکوس و معناداری داشت. نتیجه گیری: علیرغم پایین بودن اختلالات اسکلتی عضلانی حتی علائم خفیف دردهای اسکلتی عضلانی باید در نظر گرفته شوند. با توجه به بالا بودن بارکاری ذهنی بهبود شرایط کاری فیزیکی و روانی اجتماعی در افزایش توانایی کارکنان و افزایش توانایی فعالیت شغلی آنها مهم است.   2 Introduction: Firefighting is one of the occupations that require high physical and aerobic power due to the nature of the job and the physical demands of this profession. Therefore, the present study aimed to investigate the relationship among Work ability index (WAI), mental workload, musculoskeletal disorders (MSDs) and their effective factors in firefighters. Methods:  This study was a cross-sectional study, which was carried out on 250 firefighters in Tehran. Data were collected using WAI, NASA-TLX and Body Discomfort Chart (BDC). Data analysis was carried out using descriptive statistics, linear regression, Pearson correlation and Spearman tests. Results: The mean and standard deviation of the total WAI score was 38.85±1.17. Also, the highest amount of mental workload was devoted to the physical load dimension (93.49±8.93). Meanwhile, the total mental load was also 70.07 ± 6.58. The results showed that the WAI is increased by 0.14 by augmentation of one unit at the academic level of firefighters (P = 0.03). The most common discomfort was reported in the lower (20%) and upper (16.8%) regions of the back. The total WAI relationship with total mental workload was positive and insignificant (P>0.05). There was a significant and reverse association between WAI and discomfort in wrist, leg and ankle. Conclusion: Despite the low rate of MSDs, even mild symptoms of musculoskeletal pain should be considered. Given the high level of mental workload, improving physical, psychosocial and social working conditions is important in increasing the ability of employees and augmenting the ability of their occupational activity.   139 147 2019/02/202019/10/152019/04/17 1398/1/28 2019/10/212019/10/152019/10/21 1398/7/29 مهناز صارمی Mahnaz Saremi Department of Ergonomics, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran روح الله فلاح مدواری Rohollah fallah Department of Occupational Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran فریدون لعل fereydoon Laal Corresponding Author: Student Research Committee, Department of occupational health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Iran fereydoonlaal@gmail.com نجف نوریزاده Najaf Noorizade School of Health, Abadan faculty of Medical Sciences, Abadan, Iran Iran ابراهیم رحیمی Ebrahim Rahimi Department of Public Health, Mamasani Higher Education Complex for Health, Shiraz University of Medical Sciences, Shiraz, Iran Iran fereydoonlaal@gmail.com WAI firefighters MSDs mental workload WAI آتشنشانان MSDs بارکاری ذهنی Jahnke SA, Hyder ML, Haddock CK,et al. High-intensity fitness training among a national sample of male career firefighters. Safety and health at work. 2015;6(1):71-4.##Kiss P, Walgraeve M, Vanhoorne M. Assessment of work ability in aging fire fighters by means of the Work Ability Index Preliminary results. Archives of public health. 2002;60(3-4):233-43.##Wagner SL, O'Neill M. Job, life, and relationship satisfaction for paid-professional firefighters. Journal of Loss and Trauma. 2012;17(5):423-38.##Davis PO, Dotson CO. Physiological aspects of fire fighting. Fire technology. 1987;23(4):280-91.##Fighters IAoF, Chiefs IAoF. The Fire Service Joint Labor Management Wellness-Fitness Initiative. IAFF; Washington, DC; 2008.##Roche AM. New horizons in AOD workforce development. Drugs: education, prevention and policy. 2009; 16(3):193-204.##Colburn D, Suyama J, Reis SE, et al. Cardiorespiratory fitness is associated with gait changes among firefighters after a live burn training evolution. Safety and health at work. 2017;8(2):183-8.##Firoozeh M, Saremi M, Kavousi A,et al. Demographic and occupational determinants of the work ability of firemen. Journal of occupational health. 2017;59(1):81-7.##Cao A, Chintamani KK, Pandya AK, et al. NASA TLX: Software for assessing subjective mental workload. Behavior research methods. 2009;41(1):113-7.##Safari S, Mohammadi-Bolbanabad H, Kazemi M. Evaluation Mental Work Load in Nursing Critical Care Unit with National Aeronautics and Space Administration Task Load Index (NASA-TLX). J Health Sys Res. 2013;9(6):613-9.##Webb HE, McMinn DR, Garten RS,et al. Cardiorespiratory responses of firefighters to a computerized fire strategies and tactics drill during physical activity. Applied ergonomics. 2010;41(3):376-81.##Tuomi K, Ilmarinen J, Jahkola A, et al. Work Ability Index (WAI). Helsinki: Finnish Institute of Occupational Health. 1998.##Alavinia SM, De Boer A, Van Duivenbooden J,et al. Determinants of work ability and its predictive value for disability. Occupational Medicine. 2008;59(1):32-7.##Tuomi K, Ilmarinen J, Seitsamo J, et al. Summary of the Finnish research project (1981-1992) to promote the health and work ability of aging workers. Scandinavian Journal of Work, Environment & Health. 1997:66-71.##Camerino D, Conway PM, Van der Heijden BIJ, et al. Low‐perceived work ability, ageing and intention to leave nursing: a comparison among 10 European countries. Journal of advanced nursing. 2006;56(5):542-52.##Habibi E. Relationship between work ability and mental workload with musculoskeletal disorders in industrial jobs. Journal of Preventive Medicine. 2016;2(4):29-38.##Bussières AE, Taylor JA, Peterson C. Diagnostic imaging practice guidelines for musculoskeletal complaints in adults-an evidence-based approach-part 3: spinal disorders. Journal of Manipulative & Physiological Therapeutics. 2008;31(1):33-88.##Smiley A, Brookhuis KA. Alcohol, drugs and traffic safety. road users and traffic safety. Publication of: VAN GORCUM & COMP BV. 1987..##Skinner JS. Exercise testing and exercise prescription for special cases: theoretical basis and clinical application: Lippincott Williams & Wilkins; 2005.##Wieder M. Operating a rehab area part 1. Firehouse; 1999.##Bugajska J, Sagan A. Chronic musculoskeletal disorders as risk factors for reduced work ability in younger and ageing workers. International Journal of Occupational Safety and Ergonomics. 2014;20(4):607-15.##van den Berg T, Elders L, de Zwart B, et al. The effects of work-related and individual factors on the Work Ability Index: a systematic review. Occupational and environmental medicine. 2008.##Smith D, Leggat P, Speare R. Musculoskeletal disorders and psychosocial risk factors among veterinarians in Queensland, Australia. Australian veterinary journal. 2009;87(7):260-5.##Mazloumi A, Rostamabadi A, Saraji GN, et al. Work ability index (WAI) and its association with psychosocial factors in one of the petrochemical industries in Iran. Journal of occupational health. 2012;54(2):112-8.##Hart SG, Staveland LE. Development of NASA-TLX (Task Load Index): Results of empirical and theoretical research. Advances in psychology. 52: Elsevier; 1988. p. 139-83.##Mohammadi M, Nasl Seraji J, Zeraati H. Developing and assessing the validity and reliability of a questionnaire to assess the mental workload among ICUs Nurses in one of the Tehran University of Medical Sciences hospitals, Tehran, Iran. J Sch Public Health Inst Public Health Res. 2013;11(2):87-96.##Laal F, Madvari RF, Balarak D, et al. Relationship between musculoskeletal disorders and anthropometric indices among bus drivers in Zahedan city. International Journal of Occupational Safety and Ergonomics. 2018;24(3):431-7.##Punakallio A, Lusa S, Luukkonen R. Functional, postural and perceived balance for predicting the work ability of firefighters. International archives of occupational and environmental health. 2004;77(7):482-90.##Punakallio A, Lusa S, Luukkonen R, et al. Musculoskeletal pain and depressive symptoms as predictors of trajectories in work ability among finnish firefighters at 13-year follow-up. Journal of occupational and environmental medicine. 2014;56(4):367-75.##Zamanian Z, Roshan Sarvestani M, Sedaghati M, et al. Assessment of the Relation between Subjective Workload and Job Satisfaction in University Faculty and Staff. Journal of Ergonomics. 2016;3(4):1-10.##Hoonakker P, Carayon P, Gurses AP, et al. Measuring workload of ICU nurses with a questionnaire survey: the NASA Task Load Index (TLX). IIE transactions on healthcare systems engineering. 2011;1(2):131-43.##Airila A, Hakanen J, Punakallio A, et al. Is work engagement related to work ability beyond working conditions and lifestyle factors? International archives of occupational and environmental health. 2012;85(8):915-25.##Ilmarinen J. Ageing workers in Finland and in the European :union:: their situation and the promotion of their working ability, employability and employment. The Geneva Papers on Risk and Insurance Issues and Practice. 2001;26(4):623-41.##Jahnke SA, Hyder ML, Haddock CK,et al. High-intensity fitness training among a national sample of male career firefighters. Safety and health at work. 2015;6(1):71-4.##Kiss P, Walgraeve M, Vanhoorne M. Assessment of work ability in aging fire fighters by means of the Work Ability Index Preliminary results. Archives of public health. 2002;60(3-4):233-43.##Wagner SL, O'Neill M. Job, life, and relationship satisfaction for paid-professional firefighters. Journal of Loss and Trauma. 2012;17(5):423-38.##Davis PO, Dotson CO. Physiological aspects of fire fighting. Fire technology. 1987;23(4):280-91.##Fighters IAoF, Chiefs IAoF. The Fire Service Joint Labor Management Wellness-Fitness Initiative. IAFF; Washington, DC; 2008.##Roche AM. New horizons in AOD workforce development. Drugs: education, prevention and policy. 2009; 16(3):193-204.##Colburn D, Suyama J, Reis SE, et al. Cardiorespiratory fitness is associated with gait changes among firefighters after a live burn training evolution. Safety and health at work. 2017;8(2):183-8.##Firoozeh M, Saremi M, Kavousi A,et al. Demographic and occupational determinants of the work ability of firemen. Journal of occupational health. 2017;59(1):81-7.##Cao A, Chintamani KK, Pandya AK, et al. NASA TLX: Software for assessing subjective mental workload. Behavior research methods. 2009;41(1):113-7.##Safari S, Mohammadi-Bolbanabad H, Kazemi M. Evaluation Mental Work Load in Nursing Critical Care Unit with National Aeronautics and Space Administration Task Load Index (NASA-TLX). J Health Sys Res. 2013;9(6):613-9.##Webb HE, McMinn DR, Garten RS,et al. Cardiorespiratory responses of firefighters to a computerized fire strategies and tactics drill during physical activity. Applied ergonomics. 2010;41(3):376-81.##Tuomi K, Ilmarinen J, Jahkola A, et al. Work Ability Index (WAI). Helsinki: Finnish Institute of Occupational Health. 1998.##Alavinia SM, De Boer A, Van Duivenbooden J,et al. Determinants of work ability and its predictive value for disability. Occupational Medicine. 2008;59(1):32-7.##Tuomi K, Ilmarinen J, Seitsamo J, et al. Summary of the Finnish research project (1981-1992) to promote the health and work ability of aging workers. Scandinavian Journal of Work, Environment & Health. 1997:66-71.##Camerino D, Conway PM, Van der Heijden BIJ, et al. Low‐perceived work ability, ageing and intention to leave nursing: a comparison among 10 European countries. Journal of advanced nursing. 2006;56(5):542-52.##Habibi E. Relationship between work ability and mental workload with musculoskeletal disorders in industrial jobs. Journal of Preventive Medicine. 2016;2(4):29-38.##Bussières AE, Taylor JA, Peterson C. Diagnostic imaging practice guidelines for musculoskeletal complaints in adults-an evidence-based approach-part 3: spinal disorders. Journal of Manipulative & Physiological Therapeutics. 2008;31(1):33-88.##Smiley A, Brookhuis KA. Alcohol, drugs and traffic safety. road users and traffic safety. Publication of: VAN GORCUM & COMP BV. 1987..##Skinner JS. Exercise testing and exercise prescription for special cases: theoretical basis and clinical application: Lippincott Williams & Wilkins; 2005.##Wieder M. Operating a rehab area part 1. Firehouse; 1999.##Bugajska J, Sagan A. Chronic musculoskeletal disorders as risk factors for reduced work ability in younger and ageing workers. International Journal of Occupational Safety and Ergonomics. 2014;20(4):607-15.##van den Berg T, Elders L, de Zwart B, et al. The effects of work-related and individual factors on the Work Ability Index: a systematic review. Occupational and environmental medicine. 2008.##Smith D, Leggat P, Speare R. Musculoskeletal disorders and psychosocial risk factors among veterinarians in Queensland, Australia. Australian veterinary journal. 2009;87(7):260-5.##Mazloumi A, Rostamabadi A, Saraji GN, et al. Work ability index (WAI) and its association with psychosocial factors in one of the petrochemical industries in Iran. Journal of occupational health. 2012;54(2):112-8.##Hart SG, Staveland LE. Development of NASA-TLX (Task Load Index): Results of empirical and theoretical research. Advances in psychology. 52: Elsevier; 1988. p. 139-83.##Mohammadi M, Nasl Seraji J, Zeraati H. Developing and assessing the validity and reliability of a questionnaire to assess the mental workload among ICUs Nurses in one of the Tehran University of Medical Sciences hospitals, Tehran, Iran. J Sch Public Health Inst Public Health Res. 2013;11(2):87-96.##Laal F, Madvari RF, Balarak D, et al. Relationship between musculoskeletal disorders and anthropometric indices among bus drivers in Zahedan city. International Journal of Occupational Safety and Ergonomics. 2018;24(3):431-7.##Punakallio A, Lusa S, Luukkonen R. Functional, postural and perceived balance for predicting the work ability of firefighters. International archives of occupational and environmental health. 2004;77(7):482-90.##Punakallio A, Lusa S, Luukkonen R, et al. Musculoskeletal pain and depressive symptoms as predictors of trajectories in work ability among finnish firefighters at 13-year follow-up. Journal of occupational and environmental medicine. 2014;56(4):367-75.##Zamanian Z, Roshan Sarvestani M, Sedaghati M, et al. Assessment of the Relation between Subjective Workload and Job Satisfaction in University Faculty and Staff. Journal of Ergonomics. 2016;3(4):1-10.##Hoonakker P, Carayon P, Gurses AP, et al. Measuring workload of ICU nurses with a questionnaire survey: the NASA Task Load Index (TLX). IIE transactions on healthcare systems engineering. 2011;1(2):131-43.##Airila A, Hakanen J, Punakallio A, et al. Is work engagement related to work ability beyond working conditions and lifestyle factors? International archives of occupational and environmental health. 2012;85(8):915-25.##Ilmarinen J. Ageing workers in Finland and in the European :union:: their situation and the promotion of their working ability, employability and employment. The Geneva Papers on Risk and Insurance Issues and Practice. 2001;26(4):623-41.## ##

Factors Influencing Skin Cancer Preventive Behaviors Based on the Extended Parallel Process Model in Yazd Medical Sciences Students فاکتورهای تاثیرگذار رفتارهای پیشگیری کننده از سرطان پوست براساس مدل فرآیندهای موازی توسعه یافته در دانشجویان علوم پزشکی شهر یزد 2 1 مقدمه: سرطان پوست به عنوان شایعترین سرطان ها است و مهمترین عامل خطر برای افزایش تمامی سرطانهای پوست تابش فرابنفش  می باشد، لذا این مطالعه با هدف بررسی فاکتورهای تاثیرگذار بر رفتارهای پیشگیری کننده از سرطان پوست در دانشجویان رشته های علوم پزشکی که خود در آینده مسئول حفظ سلامت جامعه هستند انجام شد.   روش بررسی:  این مطالعه در سال 96 بصورت مقطعی برروی 150 نفر از دانشجویان که بصورت تصادفی ساده انتخاب شدند انجام شد. داده ها توسط پرسشنامه مبتنی بر مدل فرآیندهای موازی توسعه یافته جمع آوری شده و پس از ورود به نرم افزار18 SPSS و کدگذاری داده ها با استفاده از آزمون­های آماری ناپارامتریک مناسب شامل من ویتنی، کروسکالوالیس، ضریب اسپیرمن و رگرسیون خطی تجزیه و تحلیل شدند.   نتایج: طبق یافته ها، میانگین سنی مشارکت کنندان 24/5±01/22 بود که بیش از نیمی از آنان (3/57%) ازکرم ضد آفتاب بعنوان رفتار خودمراقبتی برابر نورخورشید استفاده می کردند. سازه شدت درک شده بالاترین امتیاز را در بین سازه ها دارا بود. از بین متغیرهای زمینه ای جنسیت با سازه های ترس و قصد رفتاری و رفتارهای پیشگیری کننده و متغیر وضعیت اقتصادی در سازه پاسخ کارایی اختلاف معنی داری به لحاظ آماری دیده شد و در بین سازه های مدل قصد رفتاری قویترین پیش بینی کننده رفتاری پیشگیری کننده از سرطان پوست بود.    نتیجه گیری: با توجه به همبستگی  خودکارآمدی با رفتار و همچنین  همبستگی پاسخ کارایی  با قصد رفتاری لزوم برنامه ریزی در این زمینه احساس می شود تا با از بین بردن موانع موجود ازجمله مسایل فرهنگی، رفتارهای حفاظتی در مقابل نور خورشید و پیشگیری از ابتلا به سرطان پوست افزایش یابد.  2 Background: Skin cancer is one of the most common cancers and it is mostly caused by ultraviolet radiation. Therefore, this study aimed to investigate the factors affecting skin cancer preventive behaviors in medical sciences students who are responsible for the future health of the community. Methods: This descriptive cross-sectional study was carried out on 150 students who were selected by the simple random sampling method. The data were collected by translating the questionnaire based on the extended parallel process model and were analyzed using SPSS-18 software. Moreover, data coding was analyzed using appropriate nonparametric statistical tests. Results: The mean age of participants was 22.01 ± 5.24, more than half of whom (57.3%) used sunscreen as a self-protective behavior against the sunlight. The perceived severity construct had the highest score among the constructs. Among the background variables, gender had a significant statistical difference with the constructs of fear and behavioral intention, and preventive behaviors and economic status variable in the perceived response efficacy construct. Among the model constructs, the behavioral intention was the strongest behavioral predictor of skin cancer prevention. Conclusion: Considering the correlation between self-efficacy and behavior as well as the correlation between the perceived response efficacy and behavioral intentions, it seems necessary to plan in this field in order to increase protective behaviors against sunlight and skin cancer prevention by removing existing barriers including cultural issues. 148 155 2019/02/202019/10/152019/04/172018/12/31 1397/10/10 2019/10/212019/10/152019/10/212019/10/21 1398/7/29 سیدسعید مظلومی محمودآباد Seyed Saied Mazloomy Mahmoodabad Research Center on Social Determinants of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mazloomy@ssu.ac.ir سکینه گرایلو Sakineh Gerayllo Department of Health Education and Promotion,School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran gerayllo65@yahoo.com نفیسه میزانی Nafiseh Mizani Research Center on Social Determinants of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran n.mizani94@gmail.com Skin Cancer Self-care self-efficacy Students سرطان پوست خودمراقبتی خودکارآمدی دانشجویان Babazadeh T, Nadrian H, Banayejeddi M, et al. Determinants of skin cancer preventive behaviors among rural farmers in Iran: an application of protection motivation theory. Journal of Cancer Education. 2017;32(3):604-12.##Al-Dujaili Z, Henry M, Dorizas A, et al. Skin cancer concerns particular to women. International journal of women's dermatology. 2017;3(1):S49-S51.##Alberg AJ, Herbst RM, Genkinger JM,et al. Knowledge, attitudes, and behaviors toward skin cancer in Maryland youths. Journal of Adolescent Health. 2002;31(4):372-7.##Esteva A, Kuprel B, Novoa RA, et al. Dermatologist-level classification of skin cancer with deep neural networks. Nature. 2017;542(7639):115-8.##Segal R, Miller K, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7-30.##Janda M, Youl P, Marshall AL ,et al. The HealthyTexts study: A randomized controlled trial to improve skin cancer prevention behaviors among young people. Contemporary clinical trials. 2013;35(1):159-67.##Livingston PM, White V, Hayman J, et al. Australian adolescents' sun protection behavior: Who are we kidding? Preventive medicine. 2007;44(6):508-12.##Kim RH, Armstrong AW. Nonmelanoma skin cancer. Dermatologic clinics. 2012;30(1):125-39.##Mohebbipour A, F. A. Prevalence of melanoma and nonmelanoma malignancies in patients visiting dermatology clinics in Ardabil City, 2002-2013. International Journal of Advances in Medicine. 2015;2(1):38-43. [Persian]##Guy Jr GP, Thomas CC, Thompson T, et al. Vital signs: melanoma incidence and mortality trends and projections-United States, 1982-2030. MMWR Morbidity and mortality weekly report. 2015;64(21):591-96.##Afshari M, Bahrami M, Kangavari M. Factors preventing skin cancer in farmers from tuyserkan city based on protection motivation theory. Iran Occupational Health. 2016;13(1):80-90. [Persian]##Noorbala MT, Kafaie P. Analysis of 15 years of skin cancer in central Iran (Yazd). Dermatology online journal. 2007;13(4):1-4.##Nadrian H, Rahaee Z, Mazloomy Mahmoodabad SS, et al. Effects of educational intervention on promoting skin cancer preventive behaviors and its predisposing factors among female students in Yazd city: An application of some PRECEDE Model constructs. Razi Journal of Medical Sciences. 2014;21(126):55-64. [Persian]##Geller AC, Swetter SM, Brooks K, et al. Screening, early detection, and trends for melanoma: current status (2000-2006) and future directions. Journal of the American Academy of Dermatology. 2007;57(4):555-72.##Sandhu PK, Elder R, Patel M, et al. Community-wide interventions to prevent skin cancer: two community guide systematic reviews. American journal of preventive medicine. 2016;51(4):531-9.##Boniol M, Autier P, Boyle P, et al. Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis. Bmj. 2012;345:e4757.##MahmoodAbad SSM, Noorbala MT, Mohammadi M, et al. Knowledge, attitude, and performance of students toward skin cancer in Yazd, 2009. International journal of dermatology. 2011;50(10):1262-5.##Birmingham WC, Hung M, Boonyasiriwat W, et al. Effectiveness of the extended parallel process model in promoting colorectal cancer screening. Psycho Oncology. 2015;24(10):1265-78.##Witte K. Fear as motivator, fear as inhibitor: Using the extended parallel process model to explain fear appeal successes and failures. InHandbook of communication and emotion 1996: 423-450. Academic Press.##Basil M, Basil D, Deshpande S, et al. Applying the Extended Parallel Process Model to workplace safety messages. Health communication. 2013;28(1):29-39.##Jasemzadeh M, Jaafarzadeh N, Khafaie MA, et al. Predicator of pregnant women's self-care behavior against air pollution: an explanation based on the extended parallel process model (EPPM). Electronic physician. 2016;8(9):2871.##Jin SS, Kai B, Chen FF, et al. Correlates of condom-use self-efficacy on the EPPM-based integrated model among Chinese college students. Biomedical and Environmental Sciences. 2017;30(2):97-105.##https://msu.edu/~wittek/scale.htm.##Mohammadi S, Baghiani Moghadam MH, Noorbala MT, et al. Survey about the role of appearance concern with skin cancer prevention behavior based on protection motivation theory. Journal of Dermatology and Cosmetic. 2010;1(2):70-7. [Persian]##Davati A, Pirasteh A, Yahyaei M, et al. Skin protective behavior amongst girl students; based on health belief model. Acta Medica Iranica. 2013:626-32.##Lowe JB, Borland R, Stanton WR, et al. Sun-safe behaviour among secondary school students in Australia. Health Education Research. 2000;15(3):271-81.##Benvenuto‐Andrade C, Zen B, Fonseca G, et al. Sun Exposure and Sun Protection Habits Among High‐school Adolescents in Porto Alegre, Brazil¶. Photochemistry and photobiology. 2005;81(3):630-5.##Dalli D, Ogce F, Okcin FA. Knowledge of the effects of sun exposure of Turkish high school students and their sun bathing habits. Asian Pacific Journal of Cancer Prevention. 2004;5(4):366-9.##Aquilina S, Gauci AA, Ellul M, et al. Sun awareness in Maltese secondary school students. Journal of the European Academy of Dermatology and Venereology. 2004;18(6):670-5.##De Vries H, Lezwijn J, Hol M, et al. Skin cancer prevention: behaviour and motives of Dutch adolescents. European Journal of Cancer Prevention. 2005;14(1):39-50.##Allahverdipour H, Hidarnia A, Kazemnejad A, et al. Assessment of substance abuse behaviors in adolescents': integration of self-control into extended parallel process model. SSU_Journals. 2005;13(1):21-31. [Persian]##Savona M, Jacobsen M, James R, et al. Ultraviolet radiation and the risks of cutaneous malignant melanoma and non-melanoma skin cancer: perceptions and behaviours of Danish and American adolescents. European Journal of Cancer Prevention. 2005;14(1):57-62.##McQueen A, Vernon SW, Rothman AJ, et al. Examining the role of perceived susceptibility on colorectal cancer screening intention and behavior. Annals of Behavioral Medicine. 2010;40(2):205-17.##Novak CB, Young DS, Lipa JE, et al. Evaluation of sun protection behaviour in patients following excision of a skin lesion. Canadian Journal of Plastic Surgery. 2007;15(1):38-40.##Reinau D, Meier C, Gerber N, et al. Sun protective behaviour of primary and secondary school students in North-Western Switzerland. Swiss medical weekly. 2012;142(w13520).##Najafi A, Nadrian E, Bakri G, et al. Skin cancer preventive behaviors and its determinants among high school students in Sanandaj, Iran: an application of PRECEDE model. J Educ Community Health. 2017;4(1):1-11. [Persian]##Heckman CJ, Manne SL, Kloss JD, et al. Beliefs and intentions for skin protection and UV exposure in young adults. American journal of health behavior. 2011;35(6):699-711##Babazadeh T, Nadrian H, Banayejeddi M, et al. Determinants of skin cancer preventive behaviors among rural farmers in Iran: an application of protection motivation theory. Journal of Cancer Education. 2017;32(3):604-12.##Al-Dujaili Z, Henry M, Dorizas A, et al. Skin cancer concerns particular to women. International journal of women's dermatology. 2017;3(1):S49-S51.##Alberg AJ, Herbst RM, Genkinger JM,et al. Knowledge, attitudes, and behaviors toward skin cancer in Maryland youths. Journal of Adolescent Health. 2002;31(4):372-7.##Esteva A, Kuprel B, Novoa RA, et al. Dermatologist-level classification of skin cancer with deep neural networks. Nature. 2017;542(7639):115-8.##Segal R, Miller K, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7-30.##Janda M, Youl P, Marshall AL ,et al. The HealthyTexts study: A randomized controlled trial to improve skin cancer prevention behaviors among young people. Contemporary clinical trials. 2013;35(1):159-67.##Livingston PM, White V, Hayman J, et al. Australian adolescents' sun protection behavior: Who are we kidding? Preventive medicine. 2007;44(6):508-12.##Kim RH, Armstrong AW. Nonmelanoma skin cancer. Dermatologic clinics. 2012;30(1):125-39.##Mohebbipour A, F. A. Prevalence of melanoma and nonmelanoma malignancies in patients visiting dermatology clinics in Ardabil City, 2002-2013. International Journal of Advances in Medicine. 2015;2(1):38-43. [Persian]##Guy Jr GP, Thomas CC, Thompson T, et al. Vital signs: melanoma incidence and mortality trends and projections-United States, 1982-2030. MMWR Morbidity and mortality weekly report. 2015;64(21):591-96.##Afshari M, Bahrami M, Kangavari M. Factors preventing skin cancer in farmers from tuyserkan city based on protection motivation theory. Iran Occupational Health. 2016;13(1):80-90. [Persian]##Noorbala MT, Kafaie P. Analysis of 15 years of skin cancer in central Iran (Yazd). Dermatology online journal. 2007;13(4):1-4.##Nadrian H, Rahaee Z, Mazloomy Mahmoodabad SS, et al. Effects of educational intervention on promoting skin cancer preventive behaviors and its predisposing factors among female students in Yazd city: An application of some PRECEDE Model constructs. Razi Journal of Medical Sciences. 2014;21(126):55-64. [Persian]##Geller AC, Swetter SM, Brooks K, et al. Screening, early detection, and trends for melanoma: current status (2000-2006) and future directions. Journal of the American Academy of Dermatology. 2007;57(4):555-72.##Sandhu PK, Elder R, Patel M, et al. Community-wide interventions to prevent skin cancer: two community guide systematic reviews. American journal of preventive medicine. 2016;51(4):531-9.##Boniol M, Autier P, Boyle P, et al. Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis. Bmj. 2012;345:e4757.##MahmoodAbad SSM, Noorbala MT, Mohammadi M, et al. Knowledge, attitude, and performance of students toward skin cancer in Yazd, 2009. International journal of dermatology. 2011;50(10):1262-5.##Birmingham WC, Hung M, Boonyasiriwat W, et al. Effectiveness of the extended parallel process model in promoting colorectal cancer screening. Psycho Oncology. 2015;24(10):1265-78.##Witte K. Fear as motivator, fear as inhibitor: Using the extended parallel process model to explain fear appeal successes and failures. InHandbook of communication and emotion 1996: 423-450. Academic Press.##Basil M, Basil D, Deshpande S, et al. Applying the Extended Parallel Process Model to workplace safety messages. Health communication. 2013;28(1):29-39.##Jasemzadeh M, Jaafarzadeh N, Khafaie MA, et al. Predicator of pregnant women's self-care behavior against air pollution: an explanation based on the extended parallel process model (EPPM). Electronic physician. 2016;8(9):2871.##Jin SS, Kai B, Chen FF, et al. Correlates of condom-use self-efficacy on the EPPM-based integrated model among Chinese college students. Biomedical and Environmental Sciences. 2017;30(2):97-105.##https://msu.edu/~wittek/scale.htm.##Mohammadi S, Baghiani Moghadam MH, Noorbala MT, et al. Survey about the role of appearance concern with skin cancer prevention behavior based on protection motivation theory. Journal of Dermatology and Cosmetic. 2010;1(2):70-7. [Persian]##Davati A, Pirasteh A, Yahyaei M, et al. Skin protective behavior amongst girl students; based on health belief model. Acta Medica Iranica. 2013:626-32.##Lowe JB, Borland R, Stanton WR, et al. Sun-safe behaviour among secondary school students in Australia. Health Education Research. 2000;15(3):271-81.##Benvenuto‐Andrade C, Zen B, Fonseca G, et al. Sun Exposure and Sun Protection Habits Among High‐school Adolescents in Porto Alegre, Brazil¶. Photochemistry and photobiology. 2005;81(3):630-5.##Dalli D, Ogce F, Okcin FA. Knowledge of the effects of sun exposure of Turkish high school students and their sun bathing habits. Asian Pacific Journal of Cancer Prevention. 2004;5(4):366-9.##Aquilina S, Gauci AA, Ellul M, et al. Sun awareness in Maltese secondary school students. Journal of the European Academy of Dermatology and Venereology. 2004;18(6):670-5.##De Vries H, Lezwijn J, Hol M, et al. Skin cancer prevention: behaviour and motives of Dutch adolescents. European Journal of Cancer Prevention. 2005;14(1):39-50.##Allahverdipour H, Hidarnia A, Kazemnejad A, et al. Assessment of substance abuse behaviors in adolescents': integration of self-control into extended parallel process model. SSU_Journals. 2005;13(1):21-31. [Persian]##Savona M, Jacobsen M, James R, et al. Ultraviolet radiation and the risks of cutaneous malignant melanoma and non-melanoma skin cancer: perceptions and behaviours of Danish and American adolescents. European Journal of Cancer Prevention. 2005;14(1):57-62.##McQueen A, Vernon SW, Rothman AJ, et al. Examining the role of perceived susceptibility on colorectal cancer screening intention and behavior. Annals of Behavioral Medicine. 2010;40(2):205-17.##Novak CB, Young DS, Lipa JE, et al. Evaluation of sun protection behaviour in patients following excision of a skin lesion. Canadian Journal of Plastic Surgery. 2007;15(1):38-40.##Reinau D, Meier C, Gerber N, et al. Sun protective behaviour of primary and secondary school students in North-Western Switzerland. Swiss medical weekly. 2012;142(w13520).##Najafi A, Nadrian E, Bakri G, et al. Skin cancer preventive behaviors and its determinants among high school students in Sanandaj, Iran: an application of PRECEDE model. J Educ Community Health. 2017;4(1):1-11. [Persian]##Heckman CJ, Manne SL, Kloss JD, et al. Beliefs and intentions for skin protection and UV exposure in young adults. American journal of health behavior. 2011;35(6):699-711## ##

Epidemiological Study and Spatial Modeling of Cutaneous Leishmaniasis in Bushehr Province using the Geographic Information System (GIS) during 2011-2015 بررسی اپیدمیولوژیک و مدل سازی مکانی بیماری لیشمانیوز جلدی(سالک) در استان بوشهر با استفاده از سیستم اطلاعات جغرافیایی (GIS) طی سال های 1390 تا 1394 2 1 مقدمه: لیشمانیوز جلدی به عنوان یک مشکل بهداشتی در جهان اهمیت خاصی دارد.  که در اثر تک یاخته لیشمانیا ایجاد میشود. این بیماری در برخی از نقاط کشور از جمله استان  بوشهر، نیز به عنوان یک مشکل بهداشتی مطرح می باشد لذا مطالعه حاضر به بررسی پراکندگی جغرافیایی و خصوصیات اپیدمیولوژیک موارد مبتلا به لیشمانیوز جلدی دراین استان طی سال های 94- 1390 می پردازد. روش کار: در این مطالعه مقطعی که به روش تحلیلی انجام شد اطلاعات اپیدمیولوژیک شامل سن، جنس، محل سکونت، شهرستان های درگیر بیماری. از 663 بیمار که بین سال های 1390 تا 1394 تحت پیگیری و درمان قرار گرفته بودند، ثبت و آنالیز گردید. نتایج: 422(7/63درصد) نفر ساکن مناطق شهری و 241(3/36 درصد) ساکن مناطق روستایی بودند. 4/59درصد (394 نفر) از افراد مورد مطالعه مرد و 6/40 درصد(269 نفر) زن بودند. میانگین سنی افراد مورد مطالعه 01/17±91/21 (دامنه 80-1 سال) بود. دراین بین کنگان با متوسط بروز 5 ساله 72/17 درصدهزار دارای بیشترین بروز و تنگستان با بروز 47/8 در صدهزار دارای کمترین متوسط بروز بیماری بود. همچنین براساس نتایج             GIS  شهرستان جم که در سال های گذشته به عنوان کانون این بیماری شناخته نمی شد در این سال ها به عنوان یک کانون جدید از بیماری درنظر گرفته شده است. نتیجه گیری: سیستم اطلاعات جغرافیایی ابزاری کارا برای سازماندهی داده های بهداشتی و بیماریها می باشد با کشف تجمع مکانی بیماریها می توان بحران بوجود آمده را شناسایی و با تدبیر صحیح آن را مهار کرد. 2 Introduction: It is generally accepted that cutaneous leishmaniasis is an important health problem in the world which is caused by leishmaniasis protozoan. This disease is also considered as a health problem in some regions of Iran including Bushehr province. The present study investigated the geographical dispersion and epidemiological characteristics of subjects with the cutaneous leishmaniasis in this province during 2011-2015. Methods: In this cross-sectional and analytical study, the epidemiologic data including the age, gender, residential area, and counties with this disease was analyzed and collected from 663 patients who were followed up and treated during 2011 to 2015. Results: 422 (63.7%) of studied people were residents of urban areas and 241 (36.3%) lived in rural areas. 59.4% (394 people) were male and 40.6% (269) were female. The mean age of subjects was 21.91± 17.01 (ranging from 1 to 80 years). Kangan County with an average 5-year incidence of 17.72 per a hundred thousand people had the highest incidence, but Tangestan County with the incidence of 8.47 per a hundred thousand people had the lowest average incidence. Based on GIS results, Jam County, which was not recognized as the focus of this disease in the past, has been considered as a new focus of disease in recent years. Conclusion: The geographic information system (GIS) is an effective tool for the organization of diseases and health data. The crisis can be identified and controlled by taking proper measures with the discovery of spatial accumulation of diseases. 156 163 2019/02/202019/10/152019/04/172018/12/312018/07/1 1397/4/10 2019/10/212019/10/152019/10/212019/10/212019/01/30 1397/11/10 علی دهقانی Ali Dehghani Department of Statistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran adehghani42@gmail.com محمد حسن لطفی Mohamad Hasan Lotfi Department of Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Mhlotfi56359@gmail.com حسین فلاح زاده Hossein Falahzadeh Research Center of Prevention and Epidemiology of Non-Communicable Disease, Departments of Biostatistics and Epidemiology, School of Pablic Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran fallahzadeh.ho@gmail.com کتایون وحدت Katayon Vahdat The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Research Institute, Bushehr Iran vahdatk@gmail.com زهرا شبانی Zahra Shabani Department of Statistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran shabani1014@gmail.com Cutaneous Leishmaniasis Geographic Information System (GIS) Epidemiology لیشمانیوز جلدی سیستم اطلاعات جغرافیایی (GIS) اپیدمیولوژی سالک Bustos MFG, González-Prieto G, Ramos F, et al. Clinical and epidemiological features of leishmaniasis in northwestern-Argentina through a retrospective analysis of recent cases. Acta tropica. 2016;154:125-32.##Jayrvnd AA, Vaziri F. Epidemiology of cutaneous leishmaniasis in the city of Hawizeh in 2014-2015. Journal of Health in the Field. 2017;4(3).##Farahmand M, Nahrevanian H, Shirazi HA, et al. An overview of a diagnostic and epidemiologic reappraisal of cutaneous leishmaniasis in Iran. Brazilian Journal of Infectious Diseases. 2011;15(1):17-21.##Nazari M. Cutaneous leishmaniasis in Hamadan, Iran (2004-2010). Zahedan Journal of Research in Medical Sciences. 2012;13(9):39-42.##leishmaniasis updated April 2017. Available from: www.who.int/mediacentre/factsheets/fs375/en/.##Khajedaluee M, Yazdanpanah MJ, SeyedNozadi S, et al. Epidemiology of cutaneous leishmaniasis in population covered by Mashhad university of medical sciences in 2011. medical journal of mashhad university of medical sciences. 2014;57(4):647-54.##Nezhad HA, Mirzaie M, Sharifi I, et al. The prevalence of cutaneous leishmaniasis in school children in southwestern Iran, 2009. Comparative Clinical Pathology. 2012;21(5):1065-9.##Carnaúba Jr D, Konishi CT, Petri V, et alL. Atypical disseminated leishmaniasis similar to post-kala-azar dermal leishmaniasis in a Brazilian AIDS patient infected with Leishmania (Leishmania) infantum chagasi: a case report. International Journal of Infectious Diseases. 2009;13(6):e504-e7.##González U, Pinart M, Reveiz L, et al. Interventions for Old World cutaneous leishmaniasis. Cochrane Database Syst Rev. 2008;4(issue):CD005067.##Darvishi M, Jafari R, Darabi H,et al. Survey of Rodents Fauna Regarding to their Probabilistic Contamination to Leishmania (2013-2014). ISMJ. 2017;20(4):362-9.##Mohammadi Azni S, Nokandeh Z, Khorsandi A, et al. Epidemiology of cutaneous leishmaniasis in Damghan district. Journal Mil Med. 2010;12(3):131-5.##Alvar J, Velez ID, Bern C, et al. Leishmaniasis worldwide and global estimates of its incidence. PloS one. 2012;7(5):e35671.##Saatchi M, Salehinia H, Khazaei S, et al. Cutaneous leishmaniasis in Iran: Demographic description and therapeutic outcomes. Journal of Dermatology and Cosmetic. 2015;6(2):108-18.##Driedger SM, Kothari A, Morrison J, et al. Correction: Using participatory design to develop (public) health decision support systems through GIS. International Journal of Health Geographics. 2007;6(1):53.##Scotch M, Parmanto B, Gadd CS, et al. Exploring the role of GIS during community health assessment problem solving: experiences of public health professionals. International Journal of Health Geographics. 2006;5(1):39.##Haghdoost A, Kawaguchi L, Mirzazadeh A, et al. Using GIS in explaining spatial distribution of brucellosis in an endemic district in Iran. Iranian Journal of Public Health. 2007;36(1):27-34.##Lotfi M, Noori S, Firouze A, et al. Epidemiological study an outbreak of cutaneous leishmaniasis in five endemic foci, Yazd province, March 2015-March 2016. Journal of Community Health Research. 2017;6(2):77-84.##Nazari M, Nazari S, Hanafi-Bojd AA, et al. Situation analysis of cutaneous leishmaniasis in an endemic area, south of Iran. Asian Pacific journal of tropical medicine. 2017;10(1):92-7.##Khademvatan S, Salmanzadeh S, Foroutan-Rad M, et al. Spatial distribution and epidemiological features of cutaneous leishmaniasis in southwest of Iran. Alexandria Journal of Medicine. 2017;53(1):93-8.##Maia-Elkhoury ANS, Yadon ZE, Díaz MIS, et al. Exploring Spatial and Temporal Distribution of Cutaneous Leishmaniasis in the Americas, 2001-2011. PLoS neglected tropical diseases. 2016;10(11):e0005086.##Chaves LF, Calzada JE, Valderrama A, et al. Cutaneous leishmaniasis and sand fly fluctuations are associated with El Niño in Panamá. PLoS neglected tropical diseases. 2014;8(10):e3210.##Barati H, Barati M, Lotfi MH. Epidemiological study of cutaneous leishmaniasis in Khatam, Yazd province, 2004-2013. Paramedical Sciences and Military Health. 2015;10(2):1-5.##Caminade C, Kovats S, Rocklov J, et al. Impact of climate change on global malaria distribution. Proceedings of the National Academy of Sciences. 2014;111(9):3286-91.##Dujardin J-C, Campino L, Cañavate C, et al. Spread of vector-borne diseases and neglect of Leishmaniasis, Europe. Emerging infectious diseases. 2008;14(7):1013.##Dhimal M, Ahrens B, Kuch U. Climate change and spatiotemporal distributions of vector-borne diseases in Nepal-a systematic synthesis of literature. PLoS One. 2015;10(6):e0129869.##Siraj A, Santos-Vega M, Bouma M, et al. Altitudinal changes in malaria incidence in highlands of Ethiopia and Colombia. Science. 2014;343(6175):1154-8.##Rodríguez-Morales AJ. Ecoepidemiología y epidemiología satelital: nuevas herramientas en el manejo de problemas en salud pública. Revista peruana de medicina experimental y salud pública. 2005;22(1):54-63.##Bustos MFG, González-Prieto G, Ramos F, et al. Clinical and epidemiological features of leishmaniasis in northwestern-Argentina through a retrospective analysis of recent cases. Acta tropica. 2016;154:125-32.##Jayrvnd AA, Vaziri F. Epidemiology of cutaneous leishmaniasis in the city of Hawizeh in 2014-2015. Journal of Health in the Field. 2017;4(3).##Farahmand M, Nahrevanian H, Shirazi HA, et al. An overview of a diagnostic and epidemiologic reappraisal of cutaneous leishmaniasis in Iran. Brazilian Journal of Infectious Diseases. 2011;15(1):17-21.##Nazari M. Cutaneous leishmaniasis in Hamadan, Iran (2004-2010). Zahedan Journal of Research in Medical Sciences. 2012;13(9):39-42.##leishmaniasis updated April 2017. Available from: www.who.int/mediacentre/factsheets/fs375/en/.##Khajedaluee M, Yazdanpanah MJ, SeyedNozadi S, et al. Epidemiology of cutaneous leishmaniasis in population covered by Mashhad university of medical sciences in 2011. medical journal of mashhad university of medical sciences. 2014;57(4):647-54.##Nezhad HA, Mirzaie M, Sharifi I, et al. The prevalence of cutaneous leishmaniasis in school children in southwestern Iran, 2009. Comparative Clinical Pathology. 2012;21(5):1065-9.##Carnaúba Jr D, Konishi CT, Petri V, et alL. Atypical disseminated leishmaniasis similar to post-kala-azar dermal leishmaniasis in a Brazilian AIDS patient infected with Leishmania (Leishmania) infantum chagasi: a case report. International Journal of Infectious Diseases. 2009;13(6):e504-e7.##González U, Pinart M, Reveiz L, et al. Interventions for Old World cutaneous leishmaniasis. Cochrane Database Syst Rev. 2008;4(issue):CD005067.##Darvishi M, Jafari R, Darabi H,et al. Survey of Rodents Fauna Regarding to their Probabilistic Contamination to Leishmania (2013-2014). ISMJ. 2017;20(4):362-9.##Mohammadi Azni S, Nokandeh Z, Khorsandi A, et al. Epidemiology of cutaneous leishmaniasis in Damghan district. Journal Mil Med. 2010;12(3):131-5.##Alvar J, Velez ID, Bern C, et al. Leishmaniasis worldwide and global estimates of its incidence. PloS one. 2012;7(5):e35671.##Saatchi M, Salehinia H, Khazaei S, et al. Cutaneous leishmaniasis in Iran: Demographic description and therapeutic outcomes. Journal of Dermatology and Cosmetic. 2015;6(2):108-18.##Driedger SM, Kothari A, Morrison J, et al. Correction: Using participatory design to develop (public) health decision support systems through GIS. International Journal of Health Geographics. 2007;6(1):53.##Scotch M, Parmanto B, Gadd CS, et al. Exploring the role of GIS during community health assessment problem solving: experiences of public health professionals. International Journal of Health Geographics. 2006;5(1):39.##Haghdoost A, Kawaguchi L, Mirzazadeh A, et al. Using GIS in explaining spatial distribution of brucellosis in an endemic district in Iran. Iranian Journal of Public Health. 2007;36(1):27-34.##Lotfi M, Noori S, Firouze A, et al. Epidemiological study an outbreak of cutaneous leishmaniasis in five endemic foci, Yazd province, March 2015-March 2016. Journal of Community Health Research. 2017;6(2):77-84.##Nazari M, Nazari S, Hanafi-Bojd AA, et al. Situation analysis of cutaneous leishmaniasis in an endemic area, south of Iran. Asian Pacific journal of tropical medicine. 2017;10(1):92-7.##Khademvatan S, Salmanzadeh S, Foroutan-Rad M, et al. Spatial distribution and epidemiological features of cutaneous leishmaniasis in southwest of Iran. Alexandria Journal of Medicine. 2017;53(1):93-8.##Maia-Elkhoury ANS, Yadon ZE, Díaz MIS, et al. Exploring Spatial and Temporal Distribution of Cutaneous Leishmaniasis in the Americas, 2001-2011. PLoS neglected tropical diseases. 2016;10(11):e0005086.##Chaves LF, Calzada JE, Valderrama A, et al. Cutaneous leishmaniasis and sand fly fluctuations are associated with El Niño in Panamá. PLoS neglected tropical diseases. 2014;8(10):e3210.##Barati H, Barati M, Lotfi MH. Epidemiological study of cutaneous leishmaniasis in Khatam, Yazd province, 2004-2013. Paramedical Sciences and Military Health. 2015;10(2):1-5.##Caminade C, Kovats S, Rocklov J, et al. Impact of climate change on global malaria distribution. Proceedings of the National Academy of Sciences. 2014;111(9):3286-91.##Dujardin J-C, Campino L, Cañavate C, et al. Spread of vector-borne diseases and neglect of Leishmaniasis, Europe. Emerging infectious diseases. 2008;14(7):1013.##Dhimal M, Ahrens B, Kuch U. Climate change and spatiotemporal distributions of vector-borne diseases in Nepal-a systematic synthesis of literature. PLoS One. 2015;10(6):e0129869.##Siraj A, Santos-Vega M, Bouma M, et al. Altitudinal changes in malaria incidence in highlands of Ethiopia and Colombia. Science. 2014;343(6175):1154-8.##Rodríguez-Morales AJ. Ecoepidemiología y epidemiología satelital: nuevas herramientas en el manejo de problemas en salud pública. Revista peruana de medicina experimental y salud pública. 2005;22(1):54-63.## ##

Management Pattern of Health Benefactors’ collaboration in Medical Sciences Universities of Iran الگوی مدیریت مشارکت خیرین سلامت در دانشگاه های علوم پزشکی کشور 2 1 هدف: در سال‌های اخیر بخش بهداشت و درمان به سمت خلق سازمان های مردم نهاد رفته است. چرا که رویکردهای مشارکتی در این سازمان ها بیشتر است و جنبه های بهتری از خدمات را ارایه میدهند. بیمارستان‌ها و درمانگاه‌های خیریه یکی از بخش های سازمان های مردم نهاد هستند. این سازمان ها تحت تاثیر مدیریت های مشارکتی قرار دارند. این مشارکت به صور مختلفی صورت گرفته است که ضرورت بررسی یک پژوهش با عنوان الگوی مدیریت مشارکت خیرین سلامت را ضروری می سازد. روش‌ : این مطالعه به صورت کیفی و از نوع دلفی است. جامعه مطالعه حاضر تمام دانشگاه های علوم پزشکی کشور است. برای اخذ نظر خبرگان و اجماع از تکنیک دلفی یک پرسشنامه با طبقه ها و زیر طبقه های  اولیه به معاونت اجتماعی دانشگاههای علوم پزشکی به روش الکترونیکی در سه نوبت برای دانشگاه های علوم پزشکی کشور ارسال شد که نهایتا تعداد ۱۰ نفر در فرایند اجرای دلفی شرکت نمودند. نمونه تمام تعداد دانشگاه های علوم پزشکی کشور که در این پژوهش مشارکت کردند،  در نمونه مورد مطالعه دانشگاه ها به تیپ 1، تیپ 2 و تیپ 3 تقسیم شدند و شامل 13 دانشگاه بودند که در این مطالعه مشارکت کرده اند. جهت کسب اطمینان از هم نظر بودن متخصصان پاسخ‌نامه‌های آنها مورد تجزیه‌وتحلیل همبستگی کندال قرار گرفت.  یافته ها: یافته‌های مطالعه نشان داد که عوامل مؤثر بر مشارکت خیرین در دانشگاه های علوم پزشکی کشور عبارت‌اند از: برگزاری جلسات در بازه زمانی آغازین سال تحصیلی دانشگاه‌ها، برگزاری جلسات بازه زمانی خاص و استفاده از منابع مالی خیرین در حوزه پژوهش. نتایج ضریب کندال نشان می دهد که با تکامل روند پاسخگویی از مرحله اول تا مرحله سوم توافق و نظرات جامعه به صورت قابل قبول دریافت و تحلیل شده است، به طوری که ضریب کندال در مرحله اول برابر با 61 درصد بود، با بهبود پرسشنامه در دور دوم ضریب کندال به 86 درصد رسید و در دور سوم اعتبار سنجی این رقم به 91 درصد افزایش یافت. نتیجه‌گیری: با توجه به یافته های پژوهش عوامل مؤثر بر سازماندهی خیرین سلامت در دانشگاه‌های علوم پزشکی کشور عبارت‌اند از 1. بیمارستان‌های خیریه‌ای 2. تخت‌های فعال 3. تشکل‌های خیریه در شهرستان‌ها 4. رویکرد نوین ارتباط با دانشگاه و 5.اولویت‌های درمانی و پژوهشی در مشارکت خیرین در دانشگاه علوم پزشکی که یک  الگوی مدیریت مشارکتی مناسب را تبیین می کند. 2 Introduction: Recently, the health care sector has been moved towards establishing non-governmental organizations (NGOs); since collaborative approaches are more in these organizations and they provide better services. Hospitals and charity clinics are part of NGO's. These organizations are affected by collaborative management. This collaboration has been conducted in a variety of ways, requiring the investigation of a study with the aim of providing a management pattern of health benefactors’ collaboration in medical sciences universities of Iran.. Methodology: This is a qualitative and Delphi study conducted in 2017. The study population was all of 13 universities out of 57 universities of medical sciences in Iran which the questionnaire was sent. To obtain experts’ opinion and consensus, using Delphi technique, a questionnaire with initial classifications and subclasses was electronically sent to the social deputy of the universities of medical sciences for three times. Eventually, out of the 13 universities, 10 people collaborated in the Delphi model. The sample of all 13 medical sciences universities in the country that participated in this study was divided into type 1, type 2 and type 3. In order to ensure the consistency of the experts, their responses were analyzed by Kendall correlation analysis in 5 phases, including1. Investigating documents, 2. Determining the type and defining components, 3. Questionnaire results and data collection by using descriptive statistics and excel software, 4. Delphi technique, 5. Suggested pattern. SPSS and Excel software were used to analyze the data. Results: The findings of this study showed that the factors affecting the participation of the benefactors in the medical sciences universities of Iran include: holding meetings in the beginning of the academic year of the universities, holding meetings in special timeframe, and using benefactors’ financial resources in the research field. The results of Kendall coefficient indicate that by completing the response process from the first to the third stage, the agreement and community opinions were received and analyzed as acceptable, so that the Kendall coefficient was 61% in the first stage. By improving the questionnaire in the second stage, the Kendall coefficient reached 86%, and in the third stage of validation increased to 91%. Conclusion: According to the results, the factors affecting the organization of health benefactors in medical universities of the country include: 1. Charity hospitals 2. Activated beds, 3. Charity organizations in cities, 4. A new approach to communicate with the university, and 5. Medical and research priorities in benefactors’ collaboration in the university medical sciences that explain an appropriate collaborative management pattern. The management pattern of collaboration can be used to improve the management of health benefactors’ collaboration in Iran Universities of Medical Sciences, and the highest priority to improve its performance depends on the organization and guidance among its members.   164 176 2019/02/202019/10/152019/04/172018/12/312018/07/12019/03/12 1397/12/21 2019/10/212019/10/152019/10/212019/10/212019/01/302019/07/27 1398/5/5 محسن پاکدامن Mohsen Pakdaman Health Policy and Management Research Center, Department of Management and Health Services , School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran مجید ساری Majid Sari Department of Management and Health Services , School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran راضیه منتظرالفرج Razieh Montazeralfaraj Health Policy and Management Research Center, Department of Management and Health Services , School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran حسین فلاح زاده Hossein Fallahzadeh Research Center of Prevention and Epidemiology of Non-Communicable Disease, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Collaboration Health Benefactors Management Pattern Organization سازماندهی هدایت کنترل و نظارت برنامه‌ریزی BaharShabani G, Eiman M, Godarzi M, Honari H. Development of Structural Equation Models of Participative Management and Organizational Agility in Selected Iranian Sports Federations. Applied Research in Sport Management 2016;16(1):11-24. Persian##Hillis V, Lubell M, Hoffman M. Sustainability partnerships and viticulture management in California. Journal of Environmental Management 2018; 217:214-25.##Singh R, Baird A, Mathiassen L. Collaboration risk management in IT-enabled asymmetric partnerships: Evidence from telestroke networks. Information and Organization 2018; 28(4):170-91.##Nastizaee N, Abili Kh, Naderi A, OreyYazdani B. The Relationship of Collaborative Management with the Organizational Spirituality and Organizational Self-esteem of School Managers and Teachers of Zahedan City. Quarterly Journal Of Educational Leadership & Administration 2014; 8(1): 9-23. Persian##Koontz TM, Thomas CW. Use of science in collaborative environmental management: Evidence from local watershed partnerships in the Puget Sound. Environmental Science & Policy 2018; 88:17-23.##PezhmanFarh H. The Impact of Participatory Leadership Style on the Entrepreneurship of Governmental Organizations-Shavour Education and Education, Master's Degree in Educational Management, Payam Noor University, Tehran South Branch; 2015. Persian##Wilmer H, Derner JD, Fernández-Giménez ME, et al. Collaborative Adaptive Rangeland Management Fosters Management-Science Partnerships. Rangeland Ecology & Management 2018; 71(5):646-57.##Hosni Shelmani M. The Impact of School Administrator Participation on Programs and Duties of Participation of the Private-Governmental Sector. Education 2016, 126 (1): 47-68.##Robbins SP, Judge TA. Organizational Behavior. 13 Three Edition. USA: Pearson International Edition, Prentice-Hall; 2009.##Morrow PC, McElroy JC,Scheibe KP. Influencing organizational commitment through office redesign. Journal of Vocational Behavior.2012.81(1), 99-111.##Hermens N, Verkooijen KT, Koelen MA. Associations between partnership characteristics and perceived success in Dutch sport-for-health partnerships. Sport Management Review. 2019;22(1):142-52.##Ramezanian MR, Abdollahian F, Safardost A. Investigating the dimensions of managers' tendency toward participatory decision making and their impact on organizational commitment: Case study in service organizations of Guilan province. Journal of Improvement 2013; (19):86-109. Persian##Sobhaninejad M, Omidi M, Najafi H. Strategies for Managing Participatory Management in Universities Based on Islamic Foundations.Cultural Engineering 2015;(84):106-127. Persian##Imani J, ForjianNejad Gh. Study of the role of social interactivity in relation to participatory management and organizational development of Bandar Abbas high school principals, educational management innovations 2015; 38: 7-21. Persian##Heshmati MR, Kharakian A, Moharati Y. Improving participatory management in the university through the system of suggestions and justice by considering the status of participatory governance and justice in Islamic teachings, Management at Islamic University, 2014, 3(1): 71-94. Persian##Gharayi H, Bahrami MA, Hamidi Y, Askari R, Tapak L The Relationship between organizational climate and accountability in selected public, private and charity hospitals in Hamedan and Yazd 2013, 2012, 3(1,2): 35-47. Persian##Alidadiyani Sh. Assessment of the Impact of Participatory Management and Effectiveness on the Organizational Commitment of Bojnourd Education Staff, Psychology and Educational Studies 2016, 11(2): 170-177. Persian##ImaniBarandagh M, Bayat A, BahramBagheri Y. A Study on the Factors Affecting the Increasing Health of the Administrative System and Coping with Corruption, New Research in the Humanities 2016, 17(165-178). Persian##Hosni Shelmai M. The Impact of School Managers Participation in the Programs and Duties of Public-Private-Public-Participation, Education 2016. 126: 47-68. Persian##BaharShabani G, Eiman M, Godarzi M, Honari H. Development of Structural Equation Models of Participative Management and Organizational Agility in Selected Iranian Sports Federations. Applied Research in Sport Management 2016;16(1):11-24. Persian##Hillis V, Lubell M, Hoffman M. Sustainability partnerships and viticulture management in California. Journal of Environmental Management 2018; 217:214-25.##Singh R, Baird A, Mathiassen L. Collaboration risk management in IT-enabled asymmetric partnerships: Evidence from telestroke networks. Information and Organization 2018; 28(4):170-91.##Nastizaee N, Abili Kh, Naderi A, OreyYazdani B. The Relationship of Collaborative Management with the Organizational Spirituality and Organizational Self-esteem of School Managers and Teachers of Zahedan City. Quarterly Journal Of Educational Leadership & Administration 2014; 8(1): 9-23. Persian##Koontz TM, Thomas CW. Use of science in collaborative environmental management: Evidence from local watershed partnerships in the Puget Sound. Environmental Science & Policy 2018; 88:17-23.##PezhmanFarh H. The Impact of Participatory Leadership Style on the Entrepreneurship of Governmental Organizations-Shavour Education and Education, Master's Degree in Educational Management, Payam Noor University, Tehran South Branch; 2015. Persian##Wilmer H, Derner JD, Fernández-Giménez ME, et al. Collaborative Adaptive Rangeland Management Fosters Management-Science Partnerships. Rangeland Ecology & Management 2018; 71(5):646-57.##Hosni Shelmani M. The Impact of School Administrator Participation on Programs and Duties of Participation of the Private-Governmental Sector. Education 2016, 126 (1): 47-68.##Robbins SP, Judge TA. Organizational Behavior. 13 Three Edition. USA: Pearson International Edition, Prentice-Hall; 2009.##Morrow PC, McElroy JC,Scheibe KP. Influencing organizational commitment through office redesign. Journal of Vocational Behavior.2012.81(1), 99-111.##Hermens N, Verkooijen KT, Koelen MA. Associations between partnership characteristics and perceived success in Dutch sport-for-health partnerships. Sport Management Review. 2019;22(1):142-52.##Ramezanian MR, Abdollahian F, Safardost A. Investigating the dimensions of managers' tendency toward participatory decision making and their impact on organizational commitment: Case study in service organizations of Guilan province. Journal of Improvement 2013; (19):86-109. Persian##Sobhaninejad M, Omidi M, Najafi H. Strategies for Managing Participatory Management in Universities Based on Islamic Foundations.Cultural Engineering 2015;(84):106-127. Persian##Imani J, ForjianNejad Gh. Study of the role of social interactivity in relation to participatory management and organizational development of Bandar Abbas high school principals, educational management innovations 2015; 38: 7-21. Persian##Heshmati MR, Kharakian A, Moharati Y. Improving participatory management in the university through the system of suggestions and justice by considering the status of participatory governance and justice in Islamic teachings, Management at Islamic University, 2014, 3(1): 71-94. Persian##Gharayi H, Bahrami MA, Hamidi Y, Askari R, Tapak L The Relationship between organizational climate and accountability in selected public, private and charity hospitals in Hamedan and Yazd 2013, 2012, 3(1,2): 35-47. Persian##Alidadiyani Sh. Assessment of the Impact of Participatory Management and Effectiveness on the Organizational Commitment of Bojnourd Education Staff, Psychology and Educational Studies 2016, 11(2): 170-177. Persian##ImaniBarandagh M, Bayat A, BahramBagheri Y. A Study on the Factors Affecting the Increasing Health of the Administrative System and Coping with Corruption, New Research in the Humanities 2016, 17(165-178). Persian##Hosni Shelmai M. The Impact of School Managers Participation in the Programs and Duties of Public-Private-Public-Participation, Education 2016. 126: 47-68. Persian## ##

Evaluation of respiratory symptoms and lung function disorders of farmers in Yazd Province ارزیابی علائم تنفسی و اختلالات عملکرد ریه در کشاورزان و غیر کشاورزان شهر یزد 2 1 مقدمه: اختلالات تنفسی یک مشکل شایع در کشاورزان می باشد که مرگ و میر زیادی را به خود اختصاص داده است. این مطالعه با هدف ارزیابی و مقایسه پارامترهای تنفسی در گروه کشاورز و غیر کشاورز و همچنین شیوع علائم تنفسی در سه گروه سنی در کشاورز و غیر کشاورز انجام شده است.   روش اجرا: مطالعه به صورت مورد شاهدی در300 کشاورز و 300 غیر کشاورز در شهر یزد انجام شد. جهت همه شرکت کنندگان پرسشنامه ای شامل اطلاعات چمعیت شناختی و همچنین علائم بیماری های تنفسی تکمیل گردید و آزمایش های عملکرد ریه بعمل آمد. جهت آنالیز داده ها از آزمون t-student و آزمون مجذور کای یا آزمون دقیق فیشر استفاده شد.   نتایج: نتایج اسپیرومتری کاهش معنادار ظرفیت های تنفسی را در گروه کشاورز  در مقایسه با غیر کشاورز نشان داد. شیوع علائم تنفسی در هر 3 گروه سنی در کشاورزان بیش از شیوع آنها در گروه غیر کشاورز بود و با افزایش سن شیوع علائم نیزافزایش یافت. در گروه سنی بالای 55 سال ریسک سرفه، خلط، تنگی نفس و خس خس به ترتیب 17، 78/58،10/3 و 61/6 برابر غیر کشاورز بود که باتوجه به حدود اطمینان 95% معنی دار بودند ( 05/0(P value<.  در بین علائم تنفسی سرفه بالاترین و تنگی نفس پائین ترین شیوع را داشتند.   بحث و نتیجه گیری: با توجه به شیوع بالای اختلالات تنفسی در کشاورزان، مکانیزاسیون روشهای کشاورزی و ارتقا سطح آگاهی بهداشتی کشاورزان توسط متخصصین بهداشت با اجرای برنامه های مناسب آموزشی توسط معاونت بهداشتی و هم چنین سازمان جهاد کشاورزی که متولی این امر می باشندضروری بنظر میرسد 2 Abstract Introduction: Respiratory disorders are common problems in farmers which have a high mortality rate in Yazd city. The aim of this study was to evaluate and compare respiratory parameters as well as the prevalence of respiratory symptoms in three age groups in farmers and non-farmers. Methods: This case-control study was conducted on 300 farmers and 300 non-farmers in Yazd. Questionnaires including cognitive knowledge and symptoms of respiratory diseases were completed for all participants and lung function tests were also performed. Data were analyzed using T-student, Chi square test or Fisher's exact test. Results: Spirometric results showed a significant reduction in respiratory capacity in the farmer group compared to non-farmer. In all three age groups, the prevalence of respiratory symptoms in farmers were higher than non-farmer groups and as the age increased, the prevalence of symptoms also increased. In the age group over 55, the risk of cough, phlegm, dyspnea and wheezing were 17,10/ 78,3/58 and 6/61 times more than non-farmers respectively which were statistically significant at 95% confidence interval P value < (0.05). Among the symptoms of respiratory, cough had the highest and shortness of breath had the lowest prevalence. Discussion and conclusion: Regarding the prevention of high prevalence of respiratory disorders in farmers, the mechanization of agricultural practices, the promotion of health awareness of farmers by health professionals, appropriate implementation of training programs by the health department and assistance of Jihad-e-Agriculture are necessary   177 185 2019/02/202019/10/152019/04/172018/12/312018/07/12019/03/122019/10/7 1398/7/15 2019/10/212019/10/152019/10/212019/10/212019/01/302019/07/272019/10/7 1398/7/15 غلام حسین حلوانی Gholam Hossein Halvani Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran رضا جعفری ندوشن Reza Jafari Nodoushan Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran الهام حلوانی Elham Halvani Department of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran ویدا سادات انوشه Vida sadat Anoosheh Department of Occupational Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yad, Iran Iran anooshehvida@gmail.com Respiratory parameters Farmers Pulmonary function test پارامترهای تنفسی کشاورزان تست عملکرد ریوی Linaker C, Smedley J. Respiratory illness in agricultural workers. Occupational medicine. 2002;52(8):451-9.##Schenker M. Exposures and health effects from inorganic agricultural dusts. Environmental health perspectives. 2000;108(Suppl 4):661.##Omland O. Exposure and respiratory health in farming in temperate zones-a review of the literature. Annals of Agricultural and Environmental Medicine. 2002;9(2):119-36.##Schenker M, Christiani D, Cormier Y. Respiratory health hazards in agriculture. Occupational Health and Industrial Medicine. 1999;2(40):86.##Von Essen SG, McCurdy SA. Health and safety risks in production agriculture. Western Journal of Medicine. 1998;169(4):214.##Hoppin JA, Valcin M, Henneberger PK, et al. Pesticide use and chronic bronchitis among farmers in the Agricultural Health Study. American journal of industrial medicine. 2007;50(12):969-79.##Becklake MR. Occupational exposures: evidence for a causal association with chronic obstructive pulmonary disease. American Review of Respiratory Disease. 1989;140(3_pt_2):S85-S91.##Zock J-P, Sunyer J, Kogevinas M,et al. Occupation, chronic bronchitis, and lung function in young adults: an international study. American journal of respiratory and critical care medicine. 2001;163(7):1572-7.##Skórska C, Mackiewicz B, Dutkiewicz J, et al. Effects of exposure to grain dust in Polish farmers: work-related symptoms and immunologic response to microbial antigens associated with dust. Annals of Agricultural and Environmental Medicine. 1998;5:147-54.##Lacey J, Crook B. Fungal and actinomycete spores as pollutants of the workplace and occupational allergens. Annals of Occupational Hygiene. 1988;32(4):515-33.##Milanowski J, Dutkiewicz J, Potoczna H, et al. Allergic alveolitis among agricultural workers in eastern Poland: A study of twenty cases. Annals of Agricultural and Environmental Medicine. 1998;5(1):31-43.##Pepys J. Hypersensitivity diseases of the lungs due to fungi and organic dusts. Hypersensitivity diseases of the lungs due to fungi and organic dusts. 1969.##Dutkiewicz J. Studies on endotoxin of Erwinia herbicola and their biological activity. Zentralblatt fur Bakteriologie, Parasitenkunde, Infektionskrankheiten und Hygiene Erste Abteilung Originale Reihe A: Medizinische Mikrobiologie und Parasitologie. 1976;236(4):487-508.##Lacey J. Grain dust and health. Postharvest News and Information. 1990;1(2):113-7.##Olenchock SA, May JJ, Pratt DS,et al. Presence of endotoxins in different agricultural environments. American journal of industrial medicine. 1990;18(3):279-84.##Lacey J, Dutkiewicz J. Bioaerosols and occupational lung disease. Journal of Aerosol Science. 1994;25(8):1371-404.##Michel O, Ginanni R, Bon BL, et al. Inflammatory response to acute inhalation of endotoxin in asthmatic patients. American Review of Respiratory Disease. 1992;146(2):352-7.##Dosman J, Graham B, Hall D, et al. Respiratory symptoms and pulmonary function in farmers. Journal of occupational medicine: official publication of the Industrial Medical Association. 1987;29(1):38-43.##Langley RL. Consequences of respiratory exposures in the farm environment. North Carolina medical journal. 2011;72(6):477-80.##Sterling T, Weinkam J. Smoking patterns by occupation, industry, sex, and race. Archives of Environmental Health: An International Journal. 1978;33(6):313-7.##Paulin LM, Diette GB, Blanc PD, et al. Occupational exposures are associated with worse morbidity in patients with chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine. 2015;191(5):557-65.##Heller R, Kelson M. Respiratory disease mortality in agricultural workers in eight member countries of the European Community. International journal of epidemiology. 1982;11(2):170-4.##Toren K, Hörte L-G, Järvholm B. Occupation and smoking adjusted mortality due to asthma among Swedish men. Occupational and Environmental Medicine. 1991;48(5):323-6.##Disease GIfCOL. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2015.##Hogg JC, Macklem PT, Thurlbeck W. Site and nature of airway obstruction in chronic obstructive lung disease. New England Journal of Medicine. 1968;278(25):1355-60.##Cosio M, Ghezzo H, Hogg J, et al. The relations between structural changes in small airways and pulmonary-function tests. New England Journal of Medicine. 1978;298(23):1277-81.##Eduard W, Pearce N, Douwes J. Chronic Bronchitis, COPD, and Lung Function in FarmersThe Role of Biological Agents. CHEST Journal. 2009;136(3):716-25.##Blair A, Zahm SH. Agricultural exposures and cancer. Environmental Health Perspectives. 1995;103(Suppl 8):205.##Hernandez-Peck MC. Older farmers: Factors affecting their health and safety. Centre for Studies in Aging School of Social Work and Human Services, Estern Washington University Available at< http://www cdc gov/nasd/docs/d001701-d001800/d001760/d001760 pdf Accessed. 2008;2(12):2008.##Hosseini M, Ramazani A, Tavasolian H,et al. Survey of knowledge and attitude of farmers of Southern Khorasan province regarding agriculture related OHS issues in 2008. Iran Occupational Health. 2011;8(1):24-9.##Statistical Yearbook of 1395 [Internet]. CP&BO. 2016.##Stoleski S, Minov J, Mijakoski D,et al. Chronic Respiratory Symptoms and Lung Function in Agricultural Workers-Influence of Exposure Duration and Smoking. Open access Macedonian journal of medical sciences. 2015;3(1):158.##Stoleski S, Minov J, Karadzinska-Bislimovska J, et al. Chronic Respiratory Symptoms and Lung Function in a Sample of Agricultural Workers in Skopje Region. Macedonian Journal of Medical Sciences. 2014;7(2):329-36.##Stoleski S, Minov J, Mijakoski D. Bronchial hyperresponsiveness in farmers: severity and work-relatedness. Macedonian Journal of Medical Sciences. 2014;7(3):536-43.##Radon K, Danuser B, Iversen M, et al. Respiratory symptoms in European animal farmers. European Respiratory Journal. 2001;17(4):747-54.##Dalphin J-C, Dubiez A, Monnet E, et al. Prevalence of asthma and respiratory symptoms in dairy farmers in the French province of the Doubs. American journal of respiratory and critical care medicine. 1998;158(5):1493-8.##Dalphin J, Maheu M, Dussaucy A, et al. Six year longitudinal study of respiratory function in dairy farmers in the Doubs province. European Respiratory Journal. 1998;11(6):1287-93.##Dalphin J, Debieuvre D, Pernet D, et al. Prevalence and risk factors for chronic bronchitis and farmer's lung in French dairy farmers. British journal of industrial medicine. 1993;50(10):941-4.##Kimbell‐Dunn M, Fishwick R, Bradshaw L,et al. Work‐related respiratory symptoms in New Zealand farmers. American Journal of Industrial Medicine. 2001;39(3):292-300.##https://doi.org/10.1002/1097-0274(200103)39:33.0.CO;2-F##Tutluoǧlu B, Atış S, Anakkaya A,et al. Sensitization to horse hair, symptoms and lung function in grooms. Clinical & Experimental Allergy. 2002;32(8):1170-3.##Heller R, Hayward D, Farebrother M. Lung function of farmers in England and Wales. Thorax. 1986;41(2):117-21.##Dosman JA, Graham BL, Hall D, et al. Respiratory symptoms and alterations in pulmonary function tests in swine producers in Saskatchewan: results of a survey of farmers. Journal of occupational medicine: official publication of the Industrial Medical Association. 1988;30(9):715-20.##Cormier Y, Boulet L-P, Bedard G,et al. Respiratory health of workers exposed to swine confinement buildings only or to both swine confinement buildings and dairy barns. Scandinavian journal of work, environment & health. 1991:269-75.##Neghab M, Chobine A. The Relationship between occupational exposure to cement dust and prevalence of respiratory symptoms and disorders. Journal of Kermanshah University of Medical Sciences. 2007;11(2).##Danuser B, Weber C, KuÈnzli N, et al. Respiratory symptoms in Swiss farmers: an epidemiological study of risk factors. American journal of industrial medicine. 2001;39(4):410-8.##Dalphin J, Bildstein F, Pernet D, et al. Prevalence of chronic bronchitis and respiratory function in a group of dairy farmers in the French Doubs province. CHEST Journal. 1989;95(6):1244-7.##CHEN Y, HORNE SL, MCDUFFIE HH, et al. Combined effect of grain farming and smoking on lung function and the prevalence of chronic bronchitis. International journal of epidemiology. 1991;20(2):416-23.##Iversen M, Pedersen B. Relation between respiratory symptoms, type of farming, and lung function disorders in farmers. Thorax. 1990;45(12):919-23.##Omland Ø, Sigsgaard T, Hjort C, et al. Lung status in young Danish rurals: the effect of farming exposure on asthma‐like symptoms and lung function. European Respiratory Journal. 1999;13(1):31-7##Linaker C, Smedley J. Respiratory illness in agricultural workers. Occupational medicine. 2002;52(8):451-9.##Schenker M. Exposures and health effects from inorganic agricultural dusts. Environmental health perspectives. 2000;108(Suppl 4):661.##Omland O. Exposure and respiratory health in farming in temperate zones-a review of the literature. Annals of Agricultural and Environmental Medicine. 2002;9(2):119-36.##Schenker M, Christiani D, Cormier Y. Respiratory health hazards in agriculture. Occupational Health and Industrial Medicine. 1999;2(40):86.##Von Essen SG, McCurdy SA. Health and safety risks in production agriculture. Western Journal of Medicine. 1998;169(4):214.##Hoppin JA, Valcin M, Henneberger PK, et al. Pesticide use and chronic bronchitis among farmers in the Agricultural Health Study. American journal of industrial medicine. 2007;50(12):969-79.##Becklake MR. Occupational exposures: evidence for a causal association with chronic obstructive pulmonary disease. American Review of Respiratory Disease. 1989;140(3_pt_2):S85-S91.##Zock J-P, Sunyer J, Kogevinas M,et al. Occupation, chronic bronchitis, and lung function in young adults: an international study. American journal of respiratory and critical care medicine. 2001;163(7):1572-7.##Skórska C, Mackiewicz B, Dutkiewicz J, et al. Effects of exposure to grain dust in Polish farmers: work-related symptoms and immunologic response to microbial antigens associated with dust. Annals of Agricultural and Environmental Medicine. 1998;5:147-54.##Lacey J, Crook B. Fungal and actinomycete spores as pollutants of the workplace and occupational allergens. Annals of Occupational Hygiene. 1988;32(4):515-33.##Milanowski J, Dutkiewicz J, Potoczna H, et al. Allergic alveolitis among agricultural workers in eastern Poland: A study of twenty cases. Annals of Agricultural and Environmental Medicine. 1998;5(1):31-43.##Pepys J. Hypersensitivity diseases of the lungs due to fungi and organic dusts. Hypersensitivity diseases of the lungs due to fungi and organic dusts. 1969.##Dutkiewicz J. Studies on endotoxin of Erwinia herbicola and their biological activity. Zentralblatt fur Bakteriologie, Parasitenkunde, Infektionskrankheiten und Hygiene Erste Abteilung Originale Reihe A: Medizinische Mikrobiologie und Parasitologie. 1976;236(4):487-508.##Lacey J. Grain dust and health. Postharvest News and Information. 1990;1(2):113-7.##Olenchock SA, May JJ, Pratt DS,et al. Presence of endotoxins in different agricultural environments. American journal of industrial medicine. 1990;18(3):279-84.##Lacey J, Dutkiewicz J. Bioaerosols and occupational lung disease. Journal of Aerosol Science. 1994;25(8):1371-404.##Michel O, Ginanni R, Bon BL, et al. Inflammatory response to acute inhalation of endotoxin in asthmatic patients. American Review of Respiratory Disease. 1992;146(2):352-7.##Dosman J, Graham B, Hall D, et al. Respiratory symptoms and pulmonary function in farmers. Journal of occupational medicine: official publication of the Industrial Medical Association. 1987;29(1):38-43.##Langley RL. Consequences of respiratory exposures in the farm environment. North Carolina medical journal. 2011;72(6):477-80.##Sterling T, Weinkam J. Smoking patterns by occupation, industry, sex, and race. Archives of Environmental Health: An International Journal. 1978;33(6):313-7.##Paulin LM, Diette GB, Blanc PD, et al. Occupational exposures are associated with worse morbidity in patients with chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine. 2015;191(5):557-65.##Heller R, Kelson M. Respiratory disease mortality in agricultural workers in eight member countries of the European Community. International journal of epidemiology. 1982;11(2):170-4.##Toren K, Hörte L-G, Järvholm B. Occupation and smoking adjusted mortality due to asthma among Swedish men. Occupational and Environmental Medicine. 1991;48(5):323-6.##Disease GIfCOL. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. 2015.##Hogg JC, Macklem PT, Thurlbeck W. Site and nature of airway obstruction in chronic obstructive lung disease. New England Journal of Medicine. 1968;278(25):1355-60.##Cosio M, Ghezzo H, Hogg J, et al. The relations between structural changes in small airways and pulmonary-function tests. New England Journal of Medicine. 1978;298(23):1277-81.##Eduard W, Pearce N, Douwes J. Chronic Bronchitis, COPD, and Lung Function in FarmersThe Role of Biological Agents. CHEST Journal. 2009;136(3):716-25.##Blair A, Zahm SH. Agricultural exposures and cancer. Environmental Health Perspectives. 1995;103(Suppl 8):205.##Hernandez-Peck MC. Older farmers: Factors affecting their health and safety. Centre for Studies in Aging School of Social Work and Human Services, Estern Washington University Available at< http://www cdc gov/nasd/docs/d001701-d001800/d001760/d001760 pdf Accessed. 2008;2(12):2008.##Hosseini M, Ramazani A, Tavasolian H,et al. Survey of knowledge and attitude of farmers of Southern Khorasan province regarding agriculture related OHS issues in 2008. Iran Occupational Health. 2011;8(1):24-9.##Statistical Yearbook of 1395 [Internet]. CP&BO. 2016.##Stoleski S, Minov J, Mijakoski D,et al. Chronic Respiratory Symptoms and Lung Function in Agricultural Workers-Influence of Exposure Duration and Smoking. Open access Macedonian journal of medical sciences. 2015;3(1):158.##Stoleski S, Minov J, Karadzinska-Bislimovska J, et al. Chronic Respiratory Symptoms and Lung Function in a Sample of Agricultural Workers in Skopje Region. Macedonian Journal of Medical Sciences. 2014;7(2):329-36.##Stoleski S, Minov J, Mijakoski D. Bronchial hyperresponsiveness in farmers: severity and work-relatedness. Macedonian Journal of Medical Sciences. 2014;7(3):536-43.##Radon K, Danuser B, Iversen M, et al. Respiratory symptoms in European animal farmers. European Respiratory Journal. 2001;17(4):747-54.##Dalphin J-C, Dubiez A, Monnet E, et al. Prevalence of asthma and respiratory symptoms in dairy farmers in the French province of the Doubs. American journal of respiratory and critical care medicine. 1998;158(5):1493-8.##Dalphin J, Maheu M, Dussaucy A, et al. Six year longitudinal study of respiratory function in dairy farmers in the Doubs province. European Respiratory Journal. 1998;11(6):1287-93.##Dalphin J, Debieuvre D, Pernet D, et al. Prevalence and risk factors for chronic bronchitis and farmer's lung in French dairy farmers. British journal of industrial medicine. 1993;50(10):941-4.##Kimbell‐Dunn M, Fishwick R, Bradshaw L,et al. Work‐related respiratory symptoms in New Zealand farmers. American Journal of Industrial Medicine. 2001;39(3):292-300.##https://doi.org/10.1002/1097-0274(200103)39:33.0.CO;2-F##Tutluoǧlu B, Atış S, Anakkaya A,et al. Sensitization to horse hair, symptoms and lung function in grooms. Clinical & Experimental Allergy. 2002;32(8):1170-3.##Heller R, Hayward D, Farebrother M. Lung function of farmers in England and Wales. Thorax. 1986;41(2):117-21.##Dosman JA, Graham BL, Hall D, et al. Respiratory symptoms and alterations in pulmonary function tests in swine producers in Saskatchewan: results of a survey of farmers. Journal of occupational medicine: official publication of the Industrial Medical Association. 1988;30(9):715-20.##Cormier Y, Boulet L-P, Bedard G,et al. Respiratory health of workers exposed to swine confinement buildings only or to both swine confinement buildings and dairy barns. Scandinavian journal of work, environment & health. 1991:269-75.##Neghab M, Chobine A. The Relationship between occupational exposure to cement dust and prevalence of respiratory symptoms and disorders. Journal of Kermanshah University of Medical Sciences. 2007;11(2).##Danuser B, Weber C, KuÈnzli N, et al. Respiratory symptoms in Swiss farmers: an epidemiological study of risk factors. American journal of industrial medicine. 2001;39(4):410-8.##Dalphin J, Bildstein F, Pernet D, et al. Prevalence of chronic bronchitis and respiratory function in a group of dairy farmers in the French Doubs province. CHEST Journal. 1989;95(6):1244-7.##CHEN Y, HORNE SL, MCDUFFIE HH, et al. Combined effect of grain farming and smoking on lung function and the prevalence of chronic bronchitis. International journal of epidemiology. 1991;20(2):416-23.##Iversen M, Pedersen B. Relation between respiratory symptoms, type of farming, and lung function disorders in farmers. Thorax. 1990;45(12):919-23.##Omland Ø, Sigsgaard T, Hjort C, et al. Lung status in young Danish rurals: the effect of farming exposure on asthma‐like symptoms and lung function. European Respiratory Journal. 1999;13(1):31-7## ##

Status of Health, Education and Income Inequality in Iran وضعیت سلامت، آموزش و نابرابری در درآمد در ایران 2 1 مقدمه: آموزش و نابرابری در درآمد هر دو از تعیین کننده های اجتماعی نابرابری در سلامت هستند. هر جامعه ای برای بهبود وضعیت سلامت خو، باید بر برابری درآمد و آموزش تمرکز کند. مروری بر وضعیت فعلی میتواند نقاط ضعف را نشان داده و آن را بهبود بخشد. روش:  این مطالعه از نوع توصیفی بوده و جمع آوری داده از روش مطالعه اسنادی صورت گرفته است. در این مطالعه سعی شده با استفاده از بانک های اطلاعاتی مختلف، مطالعات صورت گرفته و گزارشهای جهانی، وضعیت ایران در زمینه های محیط زیست، آموزش، سلامت، نابرابری اقتصادی و شکاف جنسیتی مورد بررسی قرار گیرد. مطالعات نشان داد در زمینه نابرابری در درآمد و ثروت اگر چه وضع ایران از کشورهای خاشیه خلیج فارس بهتر بوده اما نسبت به دیگر مناطق جهان از جمله ایالات متحده، اروپای غربی نابرابری بیشتری در ایران دیده می شود. در زمینه سلامت ، در بین پنجاه دلیل عمده مرگ و میر، ایران از نظر تعداد مرگ و میر بر اثر تصادفات جاده ای و بر اثر مصرف مواد مخدر در وضعیت بدی قرار دارد و به ترتیب رتبه اول و چهارم جهانی را دارد. در عین حال در زمینه مرگ و میر بر اثر سرطان کبد، سرطان پوست، صرع، سرطان دهانه رحم، سرطان زبان و سرطان کلیه در وضعیت خوبی نسبت به دیگر کشورهای جهان و در رتبه های اخر جا دارد و در دیگر موارد وضعیت ایران متوسط و در میانه کشورهای جهان است.  در زمینه آموزش، وضعیت ایران در زمینه های آموزش ابتدایی، محروم نماندن کودکان از تحصیل در مقطع ابتدایی، تضمین دسترسی برابر زنان و مردان به آموزش عالی و ریشه کنی نابرابری جنسیتی در مشارکت در آموزش وضعیت خوبی نسبت به دیگر مناطق جهان دارد اما در زمینه تعداد سالهای پیش دبستانی و آموزشهای قبل از دوران مدرسه وضعیت ایران نسبت به دیگر مناطق جهان ضعیف تر بوده است. نتیجه گیری: بررسی وضعیت ایران در زمینه آموزش و درآمد نشانهای مشکلاتی است که باید برطرف شوند. با توجه به این که هر دو جزو تعیین کننده های اجتماعی نابرابری در سلامت هستند، اهداف توسعه پایدار میتواند راهممایی برای بهبود این وضعیت باشد. 2 Abstract In the age of globalization, development and progress are a multidimensional and complex problem that is not measured by economic measures alone, and various issues related to people's welfare, governance, attention to the planet and the environment, the participation of various groups also considered. In this study, we tried to investigate this issue in several aspects of Iran's global situation. This study was descriptive and data collection was done by documentary study method. In this study, we have tried to study various global databases, studies and global reports, the status of Iran in the fields of environment, children education, health, economic inequality and gender divide. Studies have shown that inequality in income and wealth, although the situation in Iran is better than the Persian Gulf countries but more inequality than other parts of the world, including the United States and Western Europe. In terms of health, among the fifty major causes of death, Iran is ranked first and fourth in global terms due to road accidents and illicit drug use. At the same time, mortality from liver cancer, skin cancer, epilepsy, cervical cancer, kidney cancer and cancer are in a good condition compared to other countries in the world. In the field of education, the state of Iran in primary education, the exclusion of children from primary education, the guarantee of equal access for women and men to higher education and the eradication of gender inequality in participating in education is a good situation than in other parts of the world, but in The number of preschool years and pre-school education has been weaker than many other countries. In the field of environmental protection in Iran, it has a bad record. Based on various indicators such as air quality, water, health, heavy metals, biodiversity, forest protection, fisheries, climate and energy, air pollutants, water resources, Iran has poor ranking in the world. In the context of the gender gap, Iran has ranked poorly in 140 out of 144 countries with indicators of opportunity and economic participation, education, health and life and political rehabilitation 186 193 2019/02/202019/10/152019/04/172018/12/312018/07/12019/03/122019/10/72019/10/7 1398/7/15 2019/10/212019/10/152019/10/212019/10/212019/01/302019/07/272019/10/72019/10/7 1398/7/15 حامد صدیقی Hamed Seddighi Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran Hseddighi@gmail.com میرطاهر موسوی Mir-Taher Mousavi Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran Inequality Health Education Sustainable development goals Social determinants of health نابرابری سلامت اهداف توسعه پایدار آموزش تعیین کننده های اجتماعی سلامت Fukuda-Parr S. From the Millennium Development Goals to the Sustainable Development Goals: shifts in purpose, concept, and politics of global goal setting for development. Gender & Development. 2016;24(1):43-52.##Gupta J, Vegelin C. Sustainable development goals and inclusive development. International environmental agreements: Politics, law and economics. 2016;16(3):433-48.##Hák T, Janoušková S, Moldan B. Sustainable Development Goals: A need for relevant indicators. Ecological Indicators. 2016;60:565-73.##World health Organization. World health statistics 2016: monitoring health for the SDGs sustainable development goals: World Health Organization; 2016.##Seddighi H, Salmani I. Gender Differences in Children Mental Health Disorders after Earthquakes in Iran: A Systematic Review. JCHR. 2019; 8 (1) :54-64##Kumar S, Kumar N, Vivekadhish S. Millennium development goals (MDGS) to sustainable development goals (SDGS): Addressing unfinished agenda and strengthening sustainable development and partnership. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2016;41(1):1.##Bebbington J, Unerman J. Achieving the United Nations Sustainable Development Goals: an enabling role for accounting research. Accounting, Auditing & Accountability Journal. 2018;31(1):2-24.##Singh GG, Cisneros-Montemayor AM, Swartz W, et al. A rapid assessment of co-benefits and trade-offs among Sustainable Development Goals. Marine Policy. 2018;93(2):23-31.##Hsu A, Zomer A. Environmental performance index. Wiley StatsRef: Statistics Reference Online. 2016.##Alvaredo F, Chancel L, Piketty T, et al. World inequality report 2018: Belknap Press of Harvard University Press; 2018.##Seddighi H, Salmani I. Online Volunteering, A Way to Reduce Health Inequalities: A Review Study. Health Research. 2018;7(4):256-64.##Duru-Bellat M. Less Inequality for a Liveable World. Revue française des affaires sociales. 2015(1):33-49.##Garbinti B, Goupille-Lebret J, Piketty T. Appendix to" Income Inequality in France, 1900-2014: Evidence from Distributional National Accounts". 2017.##World health Organization. Global Health Observatory database. In: World health Organization, editor. 2016##World health Organization. Noncommunicable diseases: progress monitor 2017. 2017.##World health Organization. World health statistics 2015: World Health Organization; 2015.##Statistics UIf. Education Indicators. 2016##World Bank. 2018. Atlas of Sustainable Development Goals 2018 : From World Development Indicators. World Bank Atlas;. Washington, DC: World Bank. © World Bank. https://openknowledge.worldbank.org/handle/ 10986/ 29788 License: CC BY 3.0 IGO.##Solar O, Irwin A. (2010). A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). Geneva; World Health Organization.##McCracken K, Phillips DR. Global health: An introduction to current and future trends: Routledge; 2017.##World health Organization. Closing the gap in a generation: Health equity through action on the social determinants of health: World Health Organization; 2008.##Williams-Brennan L, Gastaldo D, Cole DC, Paszat L. Social determinants of health associated with cervical cancer screening among women living in developing countries: a scoping review. Archives of gynecology and obstetrics. 2012;286(6):1487-505.##Blas E, Kurup AS. Equity, social determinants and public health programmes: World Health Organization; 2010.##Braveman P, Gruskin S. Defining equity in health. Journal of Epidemiology & Community Health. 2003;57(4):254-8.##Kickbusch I. The contribution of the World Health Organization to a new public health and health promotion. American journal of public health. 2003;93(3):383-8.##Marmot M, Allen JJ. Social determinants of health equity. American Public Health Association; 2014.##Delara M. Social determinants of immigrant women's mental health. Advances in Public Health. 2016;2016.##Chung RY, Mercer S, Lai FT, et al. Socioeconomic determinants of multimorbidity: a population-based household survey of Hong Kong Chinese. PLoS One. 2015;10(10):e0140040.##Barnett WS, Epstein DJ, Carolan ME, et al. The State of Preschool 2010: State Preschool Yearbook: ERIC; 2010.##Magnuson KA, Meyers MK, Ruhm CJ, et al. Inequality in preschool education and school readiness. American educational research journal. 2004;41(1):115-57.##Barnett WS. Preschool education and its lasting effects: Research and policy implications. 2008.##Fukuda-Parr S. From the Millennium Development Goals to the Sustainable Development Goals: shifts in purpose, concept, and politics of global goal setting for development. Gender & Development. 2016;24(1):43-52.##Gupta J, Vegelin C. Sustainable development goals and inclusive development. International environmental agreements: Politics, law and economics. 2016;16(3):433-48.##Hák T, Janoušková S, Moldan B. Sustainable Development Goals: A need for relevant indicators. Ecological Indicators. 2016;60:565-73.##World health Organization. World health statistics 2016: monitoring health for the SDGs sustainable development goals: World Health Organization; 2016.##Seddighi H, Salmani I. Gender Differences in Children Mental Health Disorders after Earthquakes in Iran: A Systematic Review. JCHR. 2019; 8 (1) :54-64##Kumar S, Kumar N, Vivekadhish S. Millennium development goals (MDGS) to sustainable development goals (SDGS): Addressing unfinished agenda and strengthening sustainable development and partnership. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2016;41(1):1.##Bebbington J, Unerman J. Achieving the United Nations Sustainable Development Goals: an enabling role for accounting research. Accounting, Auditing & Accountability Journal. 2018;31(1):2-24.##Singh GG, Cisneros-Montemayor AM, Swartz W, et al. A rapid assessment of co-benefits and trade-offs among Sustainable Development Goals. Marine Policy. 2018;93(2):23-31.##Hsu A, Zomer A. Environmental performance index. Wiley StatsRef: Statistics Reference Online. 2016.##Alvaredo F, Chancel L, Piketty T, et al. World inequality report 2018: Belknap Press of Harvard University Press; 2018.##Seddighi H, Salmani I. Online Volunteering, A Way to Reduce Health Inequalities: A Review Study. Health Research. 2018;7(4):256-64.##Duru-Bellat M. Less Inequality for a Liveable World. Revue française des affaires sociales. 2015(1):33-49.##Garbinti B, Goupille-Lebret J, Piketty T. Appendix to" Income Inequality in France, 1900-2014: Evidence from Distributional National Accounts". 2017.##World health Organization. Global Health Observatory database. In: World health Organization, editor. 2016##World health Organization. Noncommunicable diseases: progress monitor 2017. 2017.##World health Organization. World health statistics 2015: World Health Organization; 2015.##Statistics UIf. Education Indicators. 2016##World Bank. 2018. Atlas of Sustainable Development Goals 2018 : From World Development Indicators. World Bank Atlas;. Washington, DC: World Bank. © World Bank. https://openknowledge.worldbank.org/handle/ 10986/ 29788 License: CC BY 3.0 IGO.##Solar O, Irwin A. (2010). A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). Geneva; World Health Organization.##McCracken K, Phillips DR. Global health: An introduction to current and future trends: Routledge; 2017.##World health Organization. Closing the gap in a generation: Health equity through action on the social determinants of health: World Health Organization; 2008.##Williams-Brennan L, Gastaldo D, Cole DC, Paszat L. Social determinants of health associated with cervical cancer screening among women living in developing countries: a scoping review. Archives of gynecology and obstetrics. 2012;286(6):1487-505.##Blas E, Kurup AS. Equity, social determinants and public health programmes: World Health Organization; 2010.##Braveman P, Gruskin S. Defining equity in health. Journal of Epidemiology & Community Health. 2003;57(4):254-8.##Kickbusch I. The contribution of the World Health Organization to a new public health and health promotion. American journal of public health. 2003;93(3):383-8.##Marmot M, Allen JJ. Social determinants of health equity. American Public Health Association; 2014.##Delara M. Social determinants of immigrant women's mental health. Advances in Public Health. 2016;2016.##Chung RY, Mercer S, Lai FT, et al. Socioeconomic determinants of multimorbidity: a population-based household survey of Hong Kong Chinese. PLoS One. 2015;10(10):e0140040.##Barnett WS, Epstein DJ, Carolan ME, et al. The State of Preschool 2010: State Preschool Yearbook: ERIC; 2010.##Magnuson KA, Meyers MK, Ruhm CJ, et al. Inequality in preschool education and school readiness. American educational research journal. 2004;41(1):115-57.##Barnett WS. Preschool education and its lasting effects: Research and policy implications. 2008.## ##