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The Use of Population Attributable Risk to Estimate The Impact of Preventive Interventions of Smoking Cessation in Chronic Obstructive Pulmonary Disease(COPD) استفاده از خطر منتسب جمعیت (APR)، برای برآورد تاثیر مداخلات پیشگیرانه ی ترک سیگار در بیماری مزمن انسدادی ریه (COPD) 2 1 اختلالات مزمن ریوی مجموعه ای از بیماری هاست که جریان هوا در تنفس را محدود می کند (1). بیشتر این بیماری ها بیماری انسداد مزمن ریوی (COPD) است (1). براساس گزارش WHO ، مرگ و میر ناشی از COPD در سراسر جهان در حال افزایش است. پیش بینی می شود تا سال 2030 سومین علت اصلی مرگ و میر در جهان باشد (2) (ششمین علت اصلی مرگ در سال 1990 (3). این بیماری هزینه های قابل توجهی را برای سیستم های بهداشتی به همراه دارد (4). شواهد زیادی بین COPD و سیگار وجود دارد ترک سیگار موثرترین اقدام برای جلوگیری یا کند شدن پیشرفت COPD است (2،5). 2 Chronic pulmonary disorders are a set of diseases that restrict respiration airflow(1).Most of these diseases are chronic obstructive pulmonary disease (COPD)(1). According to the WHO  report, mortality from COPD is increasing worldwide. It is expected to be the third leading cause of death worldwide by 2030(2) (the sixth leading cause of death in 1990(3). This disease causes significant costs for health systems(4). There is strong evidence between COPD and smoking as a major risk factor. Smoking cessation is the most effective measure to prevent or slow COPD progression (2,5). The effect of smoking on COPD was assessed in selected studies using the odds ratio (OR). The data analysis results using the random effects method showed that the risk of COPD was higher in smokers and those exposed to cigarette smoke.(current smoker; 95% CI: 0.78 – 4.31, OR: 1.83, Ex-smoker; CI: 1.05 - 4.98, OR: 2.29, passive smoker; CI: 0.43_3.08 , OR: 1.15)(3,6). According to the results of the 7th national survey of non-communicable disease risk factors (Steps 2016),the distribution of current smokers, ex-smokers, and passive smokers were 9.71, 14.63,and 31.53 among over 18 years old, respectively(7). Furthermore, the population attributed risk (PAR) of each factor with Levin formula (PAR=P(OR-1)/P(OR-1)+1) is 0.89%, 0.95%, and 82.5%, respectively, which indicates when smoking would eradicate in populations, we can propose to lower up to almost 90 % in the population’s  COPD. 213 214 2020/09/21 1399/6/31 2020/12/20 1399/9/30 مهدیه نماینده Mahdieh Namayandeh 1. Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of statistics and Epidemiology, School of public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2. Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Drnamayandeh@gmail.com زهرا جعفرآبادی Zahra Jafarabadi 2. Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of statistics and Epidemiology, School of public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran jafarabadi14@gmail.com ساناز آزادی Sanaz Azadi 3. Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of statistics and Epidemiology, School of public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran sanazazadi22@gmail.com Population attributable risk preventive interventions smoking cessation COPD خطر منتسب جمعیتی مداخلات پیشگیرانه ترک سیگار COPD 1. Barnes PJ, Burney PG, Silverman EK, et al. Chronic Obstructive Pulmonary Disease. Nature Reviews Disease Primers. 2015;1:15076.##Morjaria JB, Mondati E, Polosa R.E-Cigarettes in Patients with COPD: Current Perspectives. International Journal of Chronic Obstructive Pulmonary Disease. 2017;12:3203-10.##Sharifi H, Masjedi MR, Emami H, et al. Burden of Obstructive Lung Disease Study in Tehran: Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease. Lung India: Official Organ of Indian Chest Society. 2015;32(6):572-7.##Ur Rehman A, Ahmad Hassali MA, Muhammad SA, et al. The Economic Burden of Chronic Obstructive Pulmonary Disease (COPD) in The USA, Europe, and Asia: Results from A Systematic Review of The Literature. Expert Review of Pharmacoeconomics & Outcomes Research. 2020; 20(6): 661-72.##Bai JW, Chen XX, Liu S, et al. Smoking Cessation Affects The Natural History of COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2017;12:3323-8.##Golshan M, Amra B, Welte T. Sample Survey of Chronic Obstructive Pulmonary Disease and Associated Risk Factors in Isfahan,Iran. Tanaffos. 2011;10(3):32-6.##Ministry of Health and Medical Education . National Non Communicable Diseases Surveillance Survey: NCDSS (STEPs 2016). Tehran: National Institute for Health Research Islamic Repulic of IRAN. 2016. Available from: https://nih.tums.ac.ir/UpFiles/Documents/34d5ee8d-864e-46df-be72-83de3178f833.pdf##P T, . Smoking cessation and COPD. European respiratory review : an official journal of the European Respiratory Society. 2013;22(127):37-43.##Jordan CJ, Xi ZX. Discovery and development of varenicline for smoking cessation. Expert opinion on drug discovery. 2018;13(7):671-83.##1. Barnes PJ, Burney PG, Silverman EK, et al. Chronic Obstructive Pulmonary Disease. Nature Reviews Disease Primers. 2015;1:15076.##Morjaria JB, Mondati E, Polosa R.E-Cigarettes in Patients with COPD: Current Perspectives. International Journal of Chronic Obstructive Pulmonary Disease. 2017;12:3203-10.##Sharifi H, Masjedi MR, Emami H, et al. Burden of Obstructive Lung Disease Study in Tehran: Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease. Lung India: Official Organ of Indian Chest Society. 2015;32(6):572-7.##Ur Rehman A, Ahmad Hassali MA, Muhammad SA, et al. The Economic Burden of Chronic Obstructive Pulmonary Disease (COPD) in The USA, Europe, and Asia: Results from A Systematic Review of The Literature. Expert Review of Pharmacoeconomics & Outcomes Research. 2020; 20(6): 661-72.##Bai JW, Chen XX, Liu S, et al. Smoking Cessation Affects The Natural History of COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2017;12:3323-8.##Golshan M, Amra B, Welte T. Sample Survey of Chronic Obstructive Pulmonary Disease and Associated Risk Factors in Isfahan,Iran. Tanaffos. 2011;10(3):32-6.##Ministry of Health and Medical Education . National Non Communicable Diseases Surveillance Survey: NCDSS (STEPs 2016). Tehran: National Institute for Health Research Islamic Repulic of IRAN. 2016. Available from: https://nih.tums.ac.ir/UpFiles/Documents/34d5ee8d-864e-46df-be72-83de3178f833.pdf##P T, . Smoking cessation and COPD. European respiratory review : an official journal of the European Respiratory Society. 2013;22(127):37-43.##Jordan CJ, Xi ZX. Discovery and development of varenicline for smoking cessation. Expert opinion on drug discovery. 2018;13(7):671-83.## ##

An Evaluation of Internet Addiction and Its Related Factors among the Students of Yazd University of medical Science in 2016 بررسی اعتیاد به اینترنت در دانشجویان پزشکی دانشگاه علوم پزشکی شهید صدوقی یزد و عوامل مرتبط با آن در سال1395 2 1 چکیده مقدمه: اینترنت از پیشرفته ترین دستاوردهای اخیر بشر است که شبکه گسترده و بی حد و حصری از پیوندهای متعدد را در بر می گیرد.کاربردهای فراوان اینترنت و جذابیت های آن سبب شده است که در سالهای اخیر پدیده ای با عنوان اعتیاد به اینترنت ظهور یابد؛به طوری که در دهه های اخیر میزان استفاده از اینترنت چند برابر شده و تعداد کاربران آن در دنیا در حال افزایش است و اینترنت به یکی از ضرورت های زندگی تبدیل شده است. با توجه به افزایش میزان اعتیاد به اینترنت ما بر آن شدیم تا میزان اعتیاد به اینترنت را در بین دانشجویان پزشکی دانشگاه علوم پزشکی شهید صدوقی یزد در سال 1395 بررسی کنیم. مواد و روش ها: این مطالعه یک مطالعه تحلیلی-مقطعی بوده که بر روی 350 نفر از دانشجویان دانشکده پزشکی دانشگاه علوم پزشکی شهید صدوقی یزد انجام شد.روش نمونه گیری،نمونه گیری تصادفی بود. ابزار گردآوری داده ها شامل یک پرسشنامه جهت سوالات دموگرافیک و پرسشنامه اعتیاد به اینترنت یانگ بود؛این پرسشنامه دارای 20 سوال است که بر اساس آن فرد در یکی از 4 طبقه عادی،خفیف،متوسط و شدید قرار می گیرد. پس از جمع آوری اطلاعات، داده ها وارد نرم افزار SPSS 16 شده و به کمک آزمون های آماری کای دو و t مستقل تجزیه و تحلیل شد.   یافته ها: نتایج مطالعه نشان داد که که از بین 350 نفر 183 نفر(3/52%)دختر و تعداد 167 نفر (7/47%)پسر بوده اند.بر حسب اعتیاد به اینترنت بین دانشجویان 65% نرمال،2/33 % لب مرز و 7/1% معتاد به اینترنت بوده اند. همچنین نتایج نشان داد بین شیوع اعتیاد به اینترنت بین دانشجویان و جنسیت،مصرف سیگار و ثبت نام در فضای مجازی رابطه آماری معنادار،و بین شیوع اعتیاد به اینترنت و وضعیت تاهل،محل سکونت و زادگاه رابطه آماری معناداری وجود نداشت. بحث و نتیجه گیری:با توجه به اهمیت رشته پزشکی و ارتباط آن با جان افراد،اعتیاد به اینترنت به هر میزان بین دانشجویان پزشکی قابل تامل بوده و باید با اتخاذ برنامه هایی از قبیل برگزاری کارگاه های آموزشی در مورد مزایا و معایب استفاده از اینترنت و عواقب بعدی آن،آگاهی دانشجویان را نسبت به خطرات اعتیاد به اینترنت افزایش داد. 2 Introduction: The Internet is one of the most advanced human achievements that encompasses a wide and unbroken network of multiple links. The vast Internet usage and appetite has led to the emergence of a phenomenon called Internet addiction in recent years; As Internet usage has multiplied in recent decades and its users have grown exponentially, the Internet has become a necessity for life. Considering the increase in the rate of Internet addiction, we tried to investigate the rate of internet addiction among medical students of Shahid Sadoughi University of Medical Sciences in Yazd in 1395.   Materials & Methods: This analytic-cross-sectional study was performed on 350 students of Shahid Sadoughi University of Medical Sciences in Yazd. The sampling was random sampling. The data collection tool was a demographic questionnaire and Yang's Internet addiction inventory. The questionnaire contains 20 questions, according to which the person is placed in one of four classes: normal, mild, moderate and severe. After collecting the data, the data were entered into SPSS 16 software and analyzed using Chi-square and independent t tests.   Results: The results of the study showed that out of 350, 183 (52.3%) were female and 167 (47.7%) were male. According to Internet addiction, students were 65% normal, 33.3% border lip And 1.7% were addicted to the Internet. The results also showed that there was a significant statistical relationship between the prevalence of internet addiction among students and sex, smoking and registration in cyberspace, and there was no significant statistical relationship between the prevalence of internet addiction and marital status, place of residence and birth place.   Conclusion:. Given the importance of the field of medicine and its connection with the lives of people, Internet addiction is at all possible thoughtful among medical students and should be taken by adopting programs such as holding workshops on the advantages and disadvantages of using the Internet and its subsequent consequences, Increased student awareness of the dangers of internet addiction. 215 221 2020/09/212020/06/8 1399/3/19 2020/12/202020/12/20 1399/9/30 نسیم نمیرانیان Nasim Namiranian 1. Department of Community & Preventive Medicine ,Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran سید سامان منصوری Seied Saman Mansouri 2. General Practitioner ,Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran محمد شفیعی Mohammad Shafiee 2. General Practitioner ,Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran addiction Internet medical student اعتیاد اینترنت دانشجو پزشکی Aboujaoude E, Koran LM, Gamel N, et al. Potential Markers for Problematic Internet Use: A Telephone Survey of 2,513 Adults. CNS Spectrums 2006; 11(10): 750-5.##Claffy KC, Braun H, Polyzos G.Internet Traffic Flow Profiling." San Diego Supercomputer Center.1994.##Yellowlees PM, Marks S. Problematic Internet Use or Internet Addiction?. Computers in Human Behavior. 2007; 23(3): 1447-53.##Stefanescu C, Chele G, Chirita R, et al. The Relationship Between Development Identity and Internet Addiction. European Psychiatry. 2007; 22: S200.##Tsai HF, Cheng SH, Yeh TL, et al. The Risk Factors of Internet Addiction-A Survey of University Freshmen. Psychiatry Research. 2009; 167(3): 294-9.##Young KS, Yue XD, Ying L. Prevalence Estimates and Etiologic Models of Internet Addiction. Internet Addiction: A Handbook and Guide to Evaluation and Treatment. 2011:3-17.##Kardefelt-Winther D. A Conceptual and Methodological Critique of Internet Addiction Research: Towards A Model of Compensatory Internet Use. Computers in Human Behavior. 2014; 31: 351-4.##Kraut R, Patterson M, Lundmark V, et al. Internet Paradox: A Social Technology That Reduces Social Involvement and Psychological Well-Being?. American Psychologist. 1998; 53(9): 1017.##Hajehmougahi N, Alasvand M. The Studying of Predictor Personality Variables of Internet Addiction. Jundishapur Scientific Medical Journal. 2010;9(4):359-66. [Persian]##King DL, Delfabbro PH, Griffiths MD, et al. Assessing Clinical Trials of Internet Addiction Treatment: A Systematic Review and CONSORT Evaluation. Clinical Psychology Review. 2011; 31(7): 1110-6.##Nastizai N. The Relationship Between General Health and Internet Addiction. Zahedan Journal of Research in Medical Sciences. 2009; 11(1): 57-63. [Persian]##Kuss DJ, Griffiths MD, Binder JF. Internet Addiction in Students: Prevalence and Risk Factors. Computers in Human Behavior. 2013; 29(3): 959-66.##Kuss DJ, Van Rooij AJ, Shorter GW, et al. Internet Addiction in Adolescents: Prevalence and Risk Factors. Computers in Human Behavior. 2013; 29(5): 1987-96.##Wang W.Internet dependency and psychosocial maturity among college students.International Journal of Human-Computer Studies. 2001; 55:919-938.##Moayedfar S, Habibpoor-Gatabi K, Ganji A. Study of Internet Addiction among Adolescents and Young Adultsaged 15-25 in Tehran. Rasane Journal. 2007; 1(4): 3-4. [Persian]##Navabakhsh M HnF, Zadesham pour V‎. Effects of the Internet and the mobile identity of youth 15-29 years of Mazandaran province. J sociol‎. 2010;1(1):145-70. [Persian]##Gonzalez NA. Internet Addiction Disorder and Its Relation to Impulse Control 2002.##Danaei Moghaddam D, Khosravi F, Afshar E. The Effect of Internet Addiction on The Amount of Time Spent on Reading by Post-Graduate Students. National Studies on Librarianship and Information Organization. 2013; 24(3): 26-37. [Persian]##Solhi M, Farhandi H, Armoon B. Internet Addiction among B. Sc. Students in Health Faculty, Tehran University of Medical Sciences. Razi Journal of Medical Sciences. 2013; 20(106): 40-7. [Persian]##Pirzadeh A. The Relation between General Health and Internet Addiction in Medical Students, Isfahan, Iran. Health System Research. 2012; 8(1): 52-58. [Persian]##Khatib Zanjani N, Agahharis M. The Prevalence of Internet Addiction smong The Students of Payam Noor University, Semnan Province. Interdisciplinary Journal of Virtual Learning in Medical Sciences. 2014; 5(2):1-7. [Persian]##Vahabi A,Vahabi B,Rajabi N. An Evaluation of Internet Addiction and Its Related Factors among The Students of Kurdistan University of Medical Science in 2015. Journal of Medical Education Development. 2014; 8(19): 99-111. .[Persian]##Lanthier RP, Windham RC. Internet Use and College Adjustment: The Moderating Role of Gender. Computers in Human Behavior. 2004; 20(5): 591-606.##Sepehrian F, Jokar L. Surveying internet addiction prevalence rate among Orumiyeh Universities' students and its predicting factors. Traning & Learning Researches. 2011; 1(45): 51- 60. [Persian]##Schoenfeld D, Yan ZH. Prevalence and correlates of internet addiction in undergraduate students : Assessing with Two Major Measures. International Journal of Cyber Behavior, Psychology & Learning. 2012; 2(2): 19.##Jafary Nodoushan MA, Alipour Nodoushan KH, Mirizadeh M, Et Al. The Survey of Relationship General Health Status between Internet Addiction in Qom University of Medical Sciences Student in 2010-2011. Qom University of Medical Sciences Journal. 2012; 6(3): 86-90. [Persian]##Amidi Mazaheri M, Rahmati Najarkolaei F. Cell Phone and Internet Addiction among Students in Isfahan University of Medical Sciences (Iran). Journal of Health Policy and Sustainable Health. 2014; 1(3): 101-105.##Salehi M, Norozi Khalili M, Hojjat SK, et al. Prevalence of internet addiction and associated factors among medical students from Mashhad, Iran in 2013. Iran Red Crescent of Medical Journal. 2014; 16(5):e17256.##Canan F, Ataoglu A, Ozcetin A, et al. The Association between Internet Addiction and Dissociation among Turkish College Students. Comprehensive Psychiatry. 2012; 53(5): 422-426.##Jelenchick LA, Becker T, Moreno MA. Assessing the psychometric properties of the internet addiction test (IAT) in US college students. Psychiatry research. 2012; 196(2-3): 296- 301.##Mohammady Z, Khatony A, Hydary M, et al. Internet Dependency in Students of Kermanshah University of Medical Sciences. Iranian Journal of Medical Education. 2014; 13(12):1019- 1030. [Persian]##Soleimani sefat E, Sa'adati H, Azimian S, et al. Psychometric Properties of Persian Version of Young-Rygh Avoidance Inventory. Iranian Journal of Psychiatry and Clinical Psychology. 2017; 23 (2) :232-243. [Persian]##Aboujaoude E, Koran LM, Gamel N, et al. Potential Markers for Problematic Internet Use: A Telephone Survey of 2,513 Adults. CNS Spectrums 2006; 11(10): 750-5.##Claffy KC, Braun H, Polyzos G.Internet Traffic Flow Profiling." San Diego Supercomputer Center.1994.##Yellowlees PM, Marks S. Problematic Internet Use or Internet Addiction?. Computers in Human Behavior. 2007; 23(3): 1447-53.##Stefanescu C, Chele G, Chirita R, et al. The Relationship Between Development Identity and Internet Addiction. European Psychiatry. 2007; 22: S200.##Tsai HF, Cheng SH, Yeh TL, et al. The Risk Factors of Internet Addiction-A Survey of University Freshmen. Psychiatry Research. 2009; 167(3): 294-9.##Young KS, Yue XD, Ying L. Prevalence Estimates and Etiologic Models of Internet Addiction. Internet Addiction: A Handbook and Guide to Evaluation and Treatment. 2011:3-17.##Kardefelt-Winther D. A Conceptual and Methodological Critique of Internet Addiction Research: Towards A Model of Compensatory Internet Use. Computers in Human Behavior. 2014; 31: 351-4.##Kraut R, Patterson M, Lundmark V, et al. Internet Paradox: A Social Technology That Reduces Social Involvement and Psychological Well-Being?. American Psychologist. 1998; 53(9): 1017.##Hajehmougahi N, Alasvand M. The Studying of Predictor Personality Variables of Internet Addiction. Jundishapur Scientific Medical Journal. 2010;9(4):359-66. [Persian]##King DL, Delfabbro PH, Griffiths MD, et al. Assessing Clinical Trials of Internet Addiction Treatment: A Systematic Review and CONSORT Evaluation. Clinical Psychology Review. 2011; 31(7): 1110-6.##Nastizai N. The Relationship Between General Health and Internet Addiction. Zahedan Journal of Research in Medical Sciences. 2009; 11(1): 57-63. [Persian]##Kuss DJ, Griffiths MD, Binder JF. Internet Addiction in Students: Prevalence and Risk Factors. Computers in Human Behavior. 2013; 29(3): 959-66.##Kuss DJ, Van Rooij AJ, Shorter GW, et al. Internet Addiction in Adolescents: Prevalence and Risk Factors. Computers in Human Behavior. 2013; 29(5): 1987-96.##Wang W.Internet dependency and psychosocial maturity among college students.International Journal of Human-Computer Studies. 2001; 55:919-938.##Moayedfar S, Habibpoor-Gatabi K, Ganji A. Study of Internet Addiction among Adolescents and Young Adultsaged 15-25 in Tehran. Rasane Journal. 2007; 1(4): 3-4. [Persian]##Navabakhsh M HnF, Zadesham pour V‎. Effects of the Internet and the mobile identity of youth 15-29 years of Mazandaran province. J sociol‎. 2010;1(1):145-70. [Persian]##Gonzalez NA. Internet Addiction Disorder and Its Relation to Impulse Control 2002.##Danaei Moghaddam D, Khosravi F, Afshar E. The Effect of Internet Addiction on The Amount of Time Spent on Reading by Post-Graduate Students. National Studies on Librarianship and Information Organization. 2013; 24(3): 26-37. [Persian]##Solhi M, Farhandi H, Armoon B. Internet Addiction among B. Sc. Students in Health Faculty, Tehran University of Medical Sciences. Razi Journal of Medical Sciences. 2013; 20(106): 40-7. [Persian]##Pirzadeh A. The Relation between General Health and Internet Addiction in Medical Students, Isfahan, Iran. Health System Research. 2012; 8(1): 52-58. [Persian]##Khatib Zanjani N, Agahharis M. The Prevalence of Internet Addiction smong The Students of Payam Noor University, Semnan Province. Interdisciplinary Journal of Virtual Learning in Medical Sciences. 2014; 5(2):1-7. [Persian]##Vahabi A,Vahabi B,Rajabi N. An Evaluation of Internet Addiction and Its Related Factors among The Students of Kurdistan University of Medical Science in 2015. Journal of Medical Education Development. 2014; 8(19): 99-111. .[Persian]##Lanthier RP, Windham RC. Internet Use and College Adjustment: The Moderating Role of Gender. Computers in Human Behavior. 2004; 20(5): 591-606.##Sepehrian F, Jokar L. Surveying internet addiction prevalence rate among Orumiyeh Universities' students and its predicting factors. Traning & Learning Researches. 2011; 1(45): 51- 60. [Persian]##Schoenfeld D, Yan ZH. Prevalence and correlates of internet addiction in undergraduate students : Assessing with Two Major Measures. International Journal of Cyber Behavior, Psychology & Learning. 2012; 2(2): 19.##Jafary Nodoushan MA, Alipour Nodoushan KH, Mirizadeh M, Et Al. The Survey of Relationship General Health Status between Internet Addiction in Qom University of Medical Sciences Student in 2010-2011. Qom University of Medical Sciences Journal. 2012; 6(3): 86-90. [Persian]##Amidi Mazaheri M, Rahmati Najarkolaei F. Cell Phone and Internet Addiction among Students in Isfahan University of Medical Sciences (Iran). Journal of Health Policy and Sustainable Health. 2014; 1(3): 101-105.##Salehi M, Norozi Khalili M, Hojjat SK, et al. Prevalence of internet addiction and associated factors among medical students from Mashhad, Iran in 2013. Iran Red Crescent of Medical Journal. 2014; 16(5):e17256.##Canan F, Ataoglu A, Ozcetin A, et al. The Association between Internet Addiction and Dissociation among Turkish College Students. Comprehensive Psychiatry. 2012; 53(5): 422-426.##Jelenchick LA, Becker T, Moreno MA. Assessing the psychometric properties of the internet addiction test (IAT) in US college students. Psychiatry research. 2012; 196(2-3): 296- 301.##Mohammady Z, Khatony A, Hydary M, et al. Internet Dependency in Students of Kermanshah University of Medical Sciences. Iranian Journal of Medical Education. 2014; 13(12):1019- 1030. [Persian]##Soleimani sefat E, Sa'adati H, Azimian S, et al. Psychometric Properties of Persian Version of Young-Rygh Avoidance Inventory. Iranian Journal of Psychiatry and Clinical Psychology. 2017; 23 (2) :232-243. [Persian]## ##

Health Information-Seeking Behavior of Iranian first-time Mothers and First-Time Pregnant Women in Northwest Health Centers of Tehran بررسی رفتار اطلاع یابی سلامت زنان نخست باردار و نخست زای مراکز سلامت شمال غرب تهران 2 1 مقدمه: دوران بارداری و پس از زایمان یکی از مهم­ترین مراحل زندگی زنان است. افزایش سطح آگاهی و ارتقاء رفتار اطلاع­یابی زنان نخست باردار و نخست­زا سبب بهبود دسترسی به اطلاعات موردنیاز در دوران بارداری و پس از زایمان می­شود. هدف از پژوهش حاضر بررسی رفتار اطلاع­یابی سلامت زنان نخست باردار و نخست­زای مراکز سلامت شمال غرب تهران می­باشد. روش: پژوهش یک مطالعه توصیفی- مقطعی بود. پرسشنامه خوداظهاری بین 358 زن نخست باردار و نخست زای 9 مرکز سلامت شمال غرب تهران- ایران درسال 2017 توزیع گردید. داده ها با استفاده از نرم افزار SPSS نسخه 24 و با استفاده از آمار توصیفی و آزمون های Kruskal-Wallis و Man-Whitney U در سطح معناداری 0/05 مورد تجزیه و تحلیل قرار گرفت. یافته­ ها:  نتایج نشان داد مهم­ترین نیاز اطلاعاتی زن نخست باردار و نخست­زا "چگونگی داشتن فرزندی سالم" ؛ مهم­ترین منابع اطلاعاتی مورد استفاده "پزشک متخصص زنان وزایمان"؛ مهم­ترین شیوه دسترسی به منابع "ملاقات حضوری با پزشک" و مهم­ترین موانع اطلا­ع­یابی "هزینه­ های بالای مشاوره با پزشک" بود. آزمون فرضیه تفاوت معناداری بین مولفه های رفتار اطلاع یابی و ویژگی های دموگرافیک پاسخ دهندگان نشان داد. همچنین نتایج نشان داد بین مولفه های رفتار اطلاع یابی در بین دو گروه زنان نخست باردار و نخست زا اختلاف معناداری وجود ندارد (05 / 0p>). نتیجه گیری:  در دسترس قرار دادن اطلاعات سلامت بارداری و ارائه برنامه های آموزشی با کیفیت بالا با هزینه مقرون به صرفه در مراکز بهداشتی برای زنان نخست باردار و نخست زا می تواند به آنها کمک کند تا سواد اطلاعاتی خود را بهبود بخشند و از بسیاری از عوارض شایع مربوط به بارداری و سلامت کودک جلوگیری نماید.   2 Introduction: Pregnancy, especially the first pregnancy and childbirth, affects the women’s quality of life. Improving information-seeking behavior facilitates the decision-making process of women during pregnancy and postpartum. The aim of this study was to investigate the health information-seeking behavior of Iranian first-time mothers and first-time pregnant women. Methods: This research was a cross-sectional-descriptive survey .A self-administered questionnaire was distributed among 358 first-time mothers and first-time pregnant women who attended 9 health centers in the northwest of Tehran, Iran, in 2017. Data were analyzed using SPSS version 24 and by conducting descriptive statistics and Kruskal-Wallis and Mann-Whitney U tests at .05 significance level. Result: The most important information need of the first- time mothers and first-time pregnant women was "Fetal/newborn health"; the most important source of information used was "gynecologist"; the most important way to access the resources was "visiting a doctor in person," and the most critical barrier to access information was "high costs of visiting a doctor, midwife, or nurse." Testing the hypotheses showed significant differences between information seeking components and demographic characteristics of the respondents. It was also found that there was no significant difference between the components of information-seeking behavior among two groups of first-time mothers and first-time pregnant women (p>0.05). Conclusion:  Making pregnancy-related health information more available and accessible and providing high-quality educational programs at affordable cost in health centers for first-time mothers and first-time pregnant women can help them increase their health literacy and prevent many common complications associated with pregnancy and child health. 222 232 2020/09/212020/06/82019/10/28 1398/8/6 2020/12/202020/12/202020/12/20 1399/9/30 سیروس پناهی sirous panahi 1. Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Iran فرزانه محمودوند Farzaneh Mahmoudvand 1. Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Iran شهرام صدقی Shahram Sedghi 1. Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Iran Information seeking behavior Pregnant women Pregnancy Primigravida Primipara رفتار اطلاع ­یابی زنان باردار بارداری زنان نخست باردار زنان نخست زا 1. Onuoha UD, Amuda AA. Information Seeking Behaviour of Pregnant Women in Selected Hospitals of Ibadan Metropolis. Information Impact: Journal of Information and Knowledge Management. 2013; 4(1): 76-91.##Borghei NS, Taghipour A, Latifnejad Roudsari R. Pregnant mothers' strategies for the management of pregnancy concerns. Journal of Hayat. 2017; 23(2): 106-25. [Persian]##Bastola K. Health of Pregnant Migrant Women and their Newborns in Finland. 2020.##Loudon K, Buchanan S, Ruthven I. The Everyday Life Information Seeking Behaviours of First-Time Mothers. Journal of Documentation. 2016; 72(1): 24-46.##Yari S, Ahmadi H. A Review on Information Seeking Behaviour Literature in Iran. Journal of Information Processing and Management. 2014; 30(1): 173-97.##Sutan R, Hassan H, Shamsuddin K. Health Information Seeking Behaviour among Hypertensive Disorder in Pregnancy (HDP) High Risks Antenatal Mothers. Womens Health Gynecol. 2016; 2(7): 2-6.##World Health Organization, United Nations Statistics Division- Demographic and Social Statistics. Demographic Yearbook 2009-2010, fertility section, tables 10 and 10a. Live births by age of mother and sex of child, general and age- specific fertility rates. Available from: http://unstats.un.org/unsd/demographic/products/dy b/dyb2009-2010.htm##Pasinlioğlu T. Health Education for Pregnant Women: The Role of Background Characteristics. Patient Education and Counseling. 2004; 53(1): 101-6.##Nakku J, Nakasi G, Mirembe F. Postpartum Major Depression at Six Weeks in Primary Health Care: Prevalence and Associated Factors. African Health Sciences. 2006; 6(4).##Pourkhaleghi N, Askarizadeh G, Fazilat-Pour M. Predicting Post-Partum Depression of Nulliparous Women: Role of Social Support and Delivery Type. Journal of Health and Care. 2017;19(1):18-29. [Persian]##Renbarger KM, Shieh C, Moorman M, et al. Health Care Encounters of Pregnant and Postpartum Women with Substance Use Disorders. Western Journal of Nursing Research. 2020; 42(8): 612-28##Levy V. Maintaining equilibrium: A Grounded Theory Study of The Processes Involved when Women Make Informed Choices During Pregnancy. Midwifery. 1999;15(2): 109-19.##Cheyne H, Skår S, Paterson A, et al. Having a Baby in Scotland 2013: Women's Experiences of Maternity Care National Report . National Results. An Official Statistics Publication for Scotland. 2013; 1.##Matlin SA. The Scope and Potential of Innovation for Health and Health Equity. Inglobal Forum Update on Research for Health. 2008; 5:13-20.##GHolami-Taramsari M. Ten-Year Evaluation of maternal mortalities in Kohgiluyeh and Boyerahmad province. Knowledge & Health Journal. 2008; 3(2): 33-7. [Persian]##Malek Ah, Holakouei Nk, Rashidian A, et al. Tracking The Maternal Mortality in Economic Cooperation Countries; Achievement and Gaps Toward Millennium Development Goals. Journal of Family and Reproductive Health. 2010: 4(1): 9-14.##Tsehay AB. Seeking Health Information in Rural Context: Exploring Sources of Maternal Health Information in Rural Ethiopia: Master's Thesis, The University of Bergen. 2014.##World Health Organization. Reduction of Maternal Mortality: A Joint WHO/UNFPA/UNICEF/World Bank Statement. World Health Organization. 1999.##Abedini L, Nekuei N, Kianpour M, et al. The Viewpoints of Managers and Healthcare Providers on Individual Barriers to Perform Preconception Care for Diabetic Women. Iranian Journal of Nursing and Midwifery Research. 2018; 23(5): 338-343.##Aghababaei S, Bakht R, Bahmanzadeh M. Effects of Breastfeeding Education among Primiparous Women Referring to Fathemieh Hospital in Hamadan, Iran. Avicenna Journal of Nursing and Midwifery Care. 2009; 17(12): 41-51. [Persian]##Biglarifar F, Veisani Y, Delpisheh A. Women's Knowledge and Attitude Towards Choosing Mode of Delivery in The First Pregnancy. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2015; 17(136): 19-24. [Persian]##Nourizadeh R, Danesh-Kohan A, Bakhtari aghdam F. Women's Rights in Pregnancy and Child Birth. The Iranian Journal of Medical Law. 2012; 6(21): 171-86. [Persian]##Sabzevari S, Nikbakht Nasrabadi A, Negahban Bonabi T. Sources of Women's Health Information: A Qualitative Study. Jornal of Qualitative Research in Health Science. 2015; 3(4): 349-62. [Persian]##Savage W. A savage enquiry who controls childbirth? London, England: Virago. 1986.##Firouzbakht M, Nikpour M, Khafri S. The Effect of Prenatal Education Classes on the Process of Delivery. Scimetr. 2014; 2(4). [Persian]##Mander R. Choosing the Choices in the USA: Examples in the Maternity Area. Journal of Advanced Nursing. 1997; 25(6): 1192-7.##Gholami K, Mohammadi S. Information Interaction of Pregnant Women in Ninisite. Human Information Interaction. 2014; 1(4): 305-18. [Persian]##Lotfi R, Goshtasbi A. Quality Assessment of Prenatal Care Using LQAS in Urban Health Centers and Health Houses of Astara, 2004. Journal of Guilan University of Medical Sciences. 2006;15(58): 33-40. [Persian]##Ansari Niaki M, Izadi Sabet F. The Quality of Prenatal Care Performance on The Basis Of Existing Care Standards in Health Centers. Koomesh. 2004; 5(1): 83-8. [Persian]##Simbar M, Nahidi F, Akbarzadeh A. Assessment of Quality of Prenatal Care in Shahid Beheshti University of Medical Sciences Health Centers. Payesh Journal. 2012; 11(4): 529-44. [Persian]##Lin M-L, Wang H-H. Prenatal Examination Behavior of Southeast Asian Pregnant Women in Taiwan: A Questionnaire Survey. International Journal of Nursing Studies. 2008; 45(5): 697-705.##Hasani M, Kermanshahi S. Assessing Health Care Providers' Views in Health Centers About Barriers to The Implementation of Maternal Care Package in The Third Trimester: Case Study. Quarterly Journal of Nursing Management. 2013; 2(3): 60-8. [Persian]##Das A. Information-Seeking among Pregnant Women: A Mixed Method Approach: The Florida State University; 2013.##McDougall R, Ecclestone K. Information Seeking During Pregnancy: Exploring The Changing Landscape and Planning for The Future. Wellington-Dufferin-Guelph Public Health. 2015.##Nasrollahzadeh S. Health Information-Seeking Behavior of Pregnant Women: A Grounded Theory Study. Human-Information Interaction. 2015; 1(4): 270-81. [Persian]##Das A, Sarkar M. Pregnancy-Related Health Information-Seeking Behaviors Among Rural Pregnant Women in India: Validating The Wilson Model in The Indian Context. The Yale Journal of Biology and Medicine. 2014; 87(3): 251.##Chalak AM, Riahi A. Information Needs of Pregnant Women Referred to Health Centers in Behshahr City within 2016-2017. Journal of Community Health Research. 2017; 6(3): 165-74.##Al Qadire M. Jordanian Cancer Patients' Information Needs and Information-Seeking Behaviour: A Descriptive Study. European Journal of Oncology Nursing. 2014; 18(1): 46-51.##Zamani M, Soleymani MR, Afshar M, et al. Information-Seeking Behavior of Cardiovascular Disease Patients in Isfahan University of Medical Sciences Hospitals. Journal of Education And Health Promotion. 2014; 3: 83.##Riahi A, Hariri N, Nooshinfard F. Health information needs of immigrant patients with cancer in Iran. Journal of Modern Medical Information Sciences. 2016; 2(1): 21-30. [Persian]##Szwajcer E, Hiddink G, Koelen M, et al. Nutrition-related information-seeking behaviours before and throughout the course of pregnancy: Consequences for nutrition communication. European Journal of Clinical Nutrition. 2005; 59(1): 57-65. [Persain]##Bernhardt JM, Felter EM. Online Pediatric Information Seeking among Mothers of Young Children: Results from A Qualitative Study Using Focus Groups. Journal of Medical Internet Research. 2004; 6(1): 7.##Lewallen LP. Healthy Behaviors and Sources of Health Information among Low‐Income Pregnant Women. Public Health Nursing. 2004; 21(3): 200-6.##Lee S, Holden D, Ayers S. How Women with High Risk Pregnancies Use Lay Information when Considering Place of Birth: A Qualitative Study. Women and Birth. 2016; 29(1): e13-e7.##Sayakhot P, Carolan-Olah M. Internet Use by Pregnant Women Seeking Pregnancy-Related Information: A Systematic Review. BMC Pregnancy and Childbirth. 2016; 16(1):65.##Almoajel A, Almarqabi N. Online Health-Information Seeking Behavior among Pregnant Women in Prenatal Clinics at King Saud Medical City, Riyadh. Journal of Womens Health, Issues and Care. 2016; 3: 2##Song H, Cramer EM, Mcroy S, et al. Information Needs, Seeking Behaviors, and Support among Low-Income Expectant Women. Women & Health. 2013; 53(8): 824-42.##Lalazaryan A, Zare Farashbandi F, Rahimi A, et al. The Impact of Personal Factors on Diabetic Patient's Health Information Seeking Behavior. Journal of Health Administration. 2015;17(58): 97-108. [Persain]##Rutten LJF, Arora NK, Bakos AD, et al. Information Needs and Sources of Information among Cancer Patients: A Systematic Review of Research (1980-2003). Patient Education and Counseling. 2005; 57(3): 250-61.##Lagan BM, Sinclair M, George Kernohan W. Internet Use in Pregnancy Informs Women's Decision Making: A Web‐Based Survey. Birth. 2010; 37(2): 106-15.##1. Onuoha UD, Amuda AA. Information Seeking Behaviour of Pregnant Women in Selected Hospitals of Ibadan Metropolis. Information Impact: Journal of Information and Knowledge Management. 2013; 4(1): 76-91.##Borghei NS, Taghipour A, Latifnejad Roudsari R. Pregnant mothers' strategies for the management of pregnancy concerns. Journal of Hayat. 2017; 23(2): 106-25. [Persian]##Bastola K. Health of Pregnant Migrant Women and their Newborns in Finland. 2020.##Loudon K, Buchanan S, Ruthven I. The Everyday Life Information Seeking Behaviours of First-Time Mothers. Journal of Documentation. 2016; 72(1): 24-46.##Yari S, Ahmadi H. A Review on Information Seeking Behaviour Literature in Iran. Journal of Information Processing and Management. 2014; 30(1): 173-97.##Sutan R, Hassan H, Shamsuddin K. Health Information Seeking Behaviour among Hypertensive Disorder in Pregnancy (HDP) High Risks Antenatal Mothers. Womens Health Gynecol. 2016; 2(7): 2-6.##World Health Organization, United Nations Statistics Division- Demographic and Social Statistics. Demographic Yearbook 2009-2010, fertility section, tables 10 and 10a. Live births by age of mother and sex of child, general and age- specific fertility rates. Available from: http://unstats.un.org/unsd/demographic/products/dy b/dyb2009-2010.htm##Pasinlioğlu T. Health Education for Pregnant Women: The Role of Background Characteristics. Patient Education and Counseling. 2004; 53(1): 101-6.##Nakku J, Nakasi G, Mirembe F. Postpartum Major Depression at Six Weeks in Primary Health Care: Prevalence and Associated Factors. African Health Sciences. 2006; 6(4).##Pourkhaleghi N, Askarizadeh G, Fazilat-Pour M. Predicting Post-Partum Depression of Nulliparous Women: Role of Social Support and Delivery Type. Journal of Health and Care. 2017;19(1):18-29. [Persian]##Renbarger KM, Shieh C, Moorman M, et al. Health Care Encounters of Pregnant and Postpartum Women with Substance Use Disorders. Western Journal of Nursing Research. 2020; 42(8): 612-28##Levy V. Maintaining equilibrium: A Grounded Theory Study of The Processes Involved when Women Make Informed Choices During Pregnancy. Midwifery. 1999;15(2): 109-19.##Cheyne H, Skår S, Paterson A, et al. Having a Baby in Scotland 2013: Women's Experiences of Maternity Care National Report . National Results. An Official Statistics Publication for Scotland. 2013; 1.##Matlin SA. The Scope and Potential of Innovation for Health and Health Equity. Inglobal Forum Update on Research for Health. 2008; 5:13-20.##GHolami-Taramsari M. Ten-Year Evaluation of maternal mortalities in Kohgiluyeh and Boyerahmad province. Knowledge & Health Journal. 2008; 3(2): 33-7. [Persian]##Malek Ah, Holakouei Nk, Rashidian A, et al. Tracking The Maternal Mortality in Economic Cooperation Countries; Achievement and Gaps Toward Millennium Development Goals. Journal of Family and Reproductive Health. 2010: 4(1): 9-14.##Tsehay AB. Seeking Health Information in Rural Context: Exploring Sources of Maternal Health Information in Rural Ethiopia: Master's Thesis, The University of Bergen. 2014.##World Health Organization. Reduction of Maternal Mortality: A Joint WHO/UNFPA/UNICEF/World Bank Statement. World Health Organization. 1999.##Abedini L, Nekuei N, Kianpour M, et al. The Viewpoints of Managers and Healthcare Providers on Individual Barriers to Perform Preconception Care for Diabetic Women. Iranian Journal of Nursing and Midwifery Research. 2018; 23(5): 338-343.##Aghababaei S, Bakht R, Bahmanzadeh M. Effects of Breastfeeding Education among Primiparous Women Referring to Fathemieh Hospital in Hamadan, Iran. Avicenna Journal of Nursing and Midwifery Care. 2009; 17(12): 41-51. [Persian]##Biglarifar F, Veisani Y, Delpisheh A. Women's Knowledge and Attitude Towards Choosing Mode of Delivery in The First Pregnancy. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2015; 17(136): 19-24. [Persian]##Nourizadeh R, Danesh-Kohan A, Bakhtari aghdam F. Women's Rights in Pregnancy and Child Birth. The Iranian Journal of Medical Law. 2012; 6(21): 171-86. [Persian]##Sabzevari S, Nikbakht Nasrabadi A, Negahban Bonabi T. Sources of Women's Health Information: A Qualitative Study. Jornal of Qualitative Research in Health Science. 2015; 3(4): 349-62. [Persian]##Savage W. A savage enquiry who controls childbirth? London, England: Virago. 1986.##Firouzbakht M, Nikpour M, Khafri S. The Effect of Prenatal Education Classes on the Process of Delivery. Scimetr. 2014; 2(4). [Persian]##Mander R. Choosing the Choices in the USA: Examples in the Maternity Area. Journal of Advanced Nursing. 1997; 25(6): 1192-7.##Gholami K, Mohammadi S. Information Interaction of Pregnant Women in Ninisite. Human Information Interaction. 2014; 1(4): 305-18. [Persian]##Lotfi R, Goshtasbi A. Quality Assessment of Prenatal Care Using LQAS in Urban Health Centers and Health Houses of Astara, 2004. Journal of Guilan University of Medical Sciences. 2006;15(58): 33-40. [Persian]##Ansari Niaki M, Izadi Sabet F. The Quality of Prenatal Care Performance on The Basis Of Existing Care Standards in Health Centers. Koomesh. 2004; 5(1): 83-8. [Persian]##Simbar M, Nahidi F, Akbarzadeh A. Assessment of Quality of Prenatal Care in Shahid Beheshti University of Medical Sciences Health Centers. Payesh Journal. 2012; 11(4): 529-44. [Persian]##Lin M-L, Wang H-H. Prenatal Examination Behavior of Southeast Asian Pregnant Women in Taiwan: A Questionnaire Survey. International Journal of Nursing Studies. 2008; 45(5): 697-705.##Hasani M, Kermanshahi S. Assessing Health Care Providers' Views in Health Centers About Barriers to The Implementation of Maternal Care Package in The Third Trimester: Case Study. Quarterly Journal of Nursing Management. 2013; 2(3): 60-8. [Persian]##Das A. Information-Seeking among Pregnant Women: A Mixed Method Approach: The Florida State University; 2013.##McDougall R, Ecclestone K. Information Seeking During Pregnancy: Exploring The Changing Landscape and Planning for The Future. Wellington-Dufferin-Guelph Public Health. 2015.##Nasrollahzadeh S. Health Information-Seeking Behavior of Pregnant Women: A Grounded Theory Study. Human-Information Interaction. 2015; 1(4): 270-81. [Persian]##Das A, Sarkar M. Pregnancy-Related Health Information-Seeking Behaviors Among Rural Pregnant Women in India: Validating The Wilson Model in The Indian Context. The Yale Journal of Biology and Medicine. 2014; 87(3): 251.##Chalak AM, Riahi A. Information Needs of Pregnant Women Referred to Health Centers in Behshahr City within 2016-2017. Journal of Community Health Research. 2017; 6(3): 165-74.##Al Qadire M. Jordanian Cancer Patients' Information Needs and Information-Seeking Behaviour: A Descriptive Study. European Journal of Oncology Nursing. 2014; 18(1): 46-51.##Zamani M, Soleymani MR, Afshar M, et al. Information-Seeking Behavior of Cardiovascular Disease Patients in Isfahan University of Medical Sciences Hospitals. Journal of Education And Health Promotion. 2014; 3: 83.##Riahi A, Hariri N, Nooshinfard F. Health information needs of immigrant patients with cancer in Iran. Journal of Modern Medical Information Sciences. 2016; 2(1): 21-30. [Persian]##Szwajcer E, Hiddink G, Koelen M, et al. Nutrition-related information-seeking behaviours before and throughout the course of pregnancy: Consequences for nutrition communication. European Journal of Clinical Nutrition. 2005; 59(1): 57-65. [Persain]##Bernhardt JM, Felter EM. Online Pediatric Information Seeking among Mothers of Young Children: Results from A Qualitative Study Using Focus Groups. Journal of Medical Internet Research. 2004; 6(1): 7.##Lewallen LP. Healthy Behaviors and Sources of Health Information among Low‐Income Pregnant Women. Public Health Nursing. 2004; 21(3): 200-6.##Lee S, Holden D, Ayers S. How Women with High Risk Pregnancies Use Lay Information when Considering Place of Birth: A Qualitative Study. Women and Birth. 2016; 29(1): e13-e7.##Sayakhot P, Carolan-Olah M. Internet Use by Pregnant Women Seeking Pregnancy-Related Information: A Systematic Review. BMC Pregnancy and Childbirth. 2016; 16(1):65.##Almoajel A, Almarqabi N. Online Health-Information Seeking Behavior among Pregnant Women in Prenatal Clinics at King Saud Medical City, Riyadh. Journal of Womens Health, Issues and Care. 2016; 3: 2##Song H, Cramer EM, Mcroy S, et al. Information Needs, Seeking Behaviors, and Support among Low-Income Expectant Women. Women & Health. 2013; 53(8): 824-42.##Lalazaryan A, Zare Farashbandi F, Rahimi A, et al. The Impact of Personal Factors on Diabetic Patient's Health Information Seeking Behavior. Journal of Health Administration. 2015;17(58): 97-108. [Persain]##Rutten LJF, Arora NK, Bakos AD, et al. Information Needs and Sources of Information among Cancer Patients: A Systematic Review of Research (1980-2003). Patient Education and Counseling. 2005; 57(3): 250-61.##Lagan BM, Sinclair M, George Kernohan W. Internet Use in Pregnancy Informs Women's Decision Making: A Web‐Based Survey. Birth. 2010; 37(2): 106-15.## ##

Investigating the Relation between Religious Orientation and Locus of Control with Tendency toward Substance Abuse, Case study: Addicts and Non-Addicts Men, Isfahan, 2018 بررسی رابطه جهت گیری مذهبی و منبع کنترل باگرایش به سوء مصرف مواد، مطالعه موردی: مردان معتاد و غیر معتاد اصفهان، در سال 1397 2 1 چکیده: مقدمه:اعتیاد به موادمخدر به عنوان یکی از چالش های بزرگ در جوامع بشری، دارای ابعاد و زوایای پیدا و پنهان بسیاری است.هدف از این پژوهش بررسی رابطه نگرش مذهبی ، منبع کنترل وگرایش به سوء مصرف در افراد معتاد و غیر معتاد شهر اصفهان  بود. روش: روش تحقیق توصیفی-  همبستگی و جامعه مورد پژوهش 200 نفر مرد (100 نفر وابسته به اعتیاد و 100 نفر افراد عادی) در بازه زمانی تیر تا شهریور ماه 1397 در شهر اصفهان بود. در انتخاب نمونه از جامعه مردان وابسته به مواد و عادی از روش نمونه گیری در دسترس استفاده شد. جهت جمع­آوری اطلاعات از سه پرسشنامه جهت گیری مذهبی آلپورت، منبع کنترل راتر و گرایش به سوء مصرف استفاده گردید. یافته ها:یافته­ها نشان داد که بین نگرش مذهبی ، منبع کنترل وگرایش به سوء مصرف رابطه معناداری وجود دارد. همچنین نتایج نشان داد افرادی با منبع کنترل درونی گرایش کمتری به سوء مصرف مواد دارند و نیز افرادی که نگرش مذهبی درونی دارند؛ گرایش کمتری به سوء مصرف مواد دارندو در نهایت اینکه نگرش مذهبی و منبع کنترل نقش کلیدی در گرایش به سوء مصرف مواد دارند. نتیجه گیری: از این رو می­توان نتیجه گرفت که نگرش مذهبی ضعیف و نیز فقدان منبع کنترل درونی از علل مهم گرایش به اعتیاد  است که می بایست در این زمینه اقداماتی انجام شود.   2 Introduction: Drug addiction as one of the major challenges in human societies has many hidden aspects. The purpose of this study was to investigate the relationship between religious attitude, locus of control and tendency to abuse in addicts and non-addicts in Isfahan. Method: The research method was descriptive-correlational and the study population was 200 men (100 addicts and 100 normal people) from July to September 2018 in Isfahan. Samples were selected from the population of drug-dependent and normal men using available sampling method. Allport's Religious Orientation Questionnaire, Rutter Control Source, and Abuse Trend Questionnaire were used for data collection Results: Findings showed that there is a significant relationship between religious attitude, locus of control and tendency to abuse. The results also showed that people with internal control locus of control tend to be less likely to abuse drugs, as well as those with an internal religious attitude; less tendency to substance abuse, and finally, religious attitude and locus of control have a key role in drug abuse tendency .   Conclusion: It can be concluded that poor religious attitude and lack of internal control are important causes of addiction tendency.     233 240 2020/09/212020/06/82019/10/282020/01/23 1398/11/3 2020/12/202020/12/202020/12/202020/12/20 1399/9/30 حسن زارعی محمودآبادی Hassan Zareei Mahmood Abadi 1. Department of Psychology, Faculty of Psychology and Educational Sciences, Yazd University, Yazd , Iran Iran zareei_h@yahoo.com راضیه حیدری سورشجانی Razieh Hidari Sooreshjani 1. Department of Psychology, Faculty of Psychology and Educational Sciences, Yazd University, Yazd , Iran Iran hidar@yahoo.com فاطمه رجایی ریزی Fatemeh Rajaei Rizi 1. Department of Psychology, Faculty of Psychology and Educational Sciences, Yazd University, Yazd , Iran Iran rajaaa@u.com لیلا اکرمی Leila Akrami 2. Department of Psychology and Education of Children with Special Needs, Isfahan University, Isfahan, Iran Iran Religious orientation Locus of control Substance abuse Addict جهت گیری مذهبی منبع کنترل سوء مصرف مواد معتاد 1. Yazdani HR, Kazemi Najaf Abadi MR, Saidi GhR. Investigating the Mediating Role of Spirituality in the Relationship between Dimensions of Organizational Justice and Spiritual Outcomes. Journal of Business Management Perspective. 2010; 9(3):117-133. [Persian]##Raiisi F, Anisi J, Yazdi SM, et al. Mental health and child-rearing styles between candidate adult for addiction withdrawal in comparison with non-addict adults. Journal of Behavioral Sciences. 2008; 2(1): 33-41. [Persian]##Mahmoodabadi HZ, Bahrami F, Ahmadi A, et al. The Effectiveness of Retraining Attribution Styles (Cognitive Therapy) on Dimensions of Family Functioning in Divorce Applicant Couples. International Journal of Psychological Studies. 2012; 4(2). 257. [Persian]##Makarem S, Zanjani Z. The Relationship Between Individual and Family Religiosity with Substance Abuse. Research on Addiction. 2014; 7(28): 75-88. [Persian]##Young K.S, Rodgers R. The Relationship between Depression and Internet Addiction. Cyberpsychology& Behavior. 1998; 1 (1): 25-34.##Bhagwan R. Spirituality in Social Work in South Africa: Insights from a Survey with Academics. International Social Work. 2013; 56(3): 276-289.##Yavari S, Nuri R, Hasan Abadi HR. Structural Model of Drug Use Among Students: The Role of Spirituality, Social Modeling and Attitude to Drugs. Research on Addiction. 2015; 9(33): 145-165. [Persian]##Zargar Y, Najarian B, Naami A. The Relationship between Personality Traits (Sensation Seeking, Assertiveness, Psychological Hardiness), The Religious Attitude and Marital Satisfaction with Readiness for Drug Abuse. Journal of Education and Psychology Chamran University. 2008; 1(3): 99-120. [Persian]##Johnson TJ, Carlisle R, Sheets VL, et al. Prospective Examination of the Relationship between Religious Struggle and Alcohol Problems in a College Sample. Psychology of Religion. 2008; 63. 117- 127.##Imanzad M, Atabeigi Momtaz G, Mousavimoghadam SR, et al. The Effect of Religious Attitude and Spirituality Orientation on Defense Mechanisms. Medical Science Journal of Islamic Azad Univesity-Tehran Medical Branch. 2014; 23 (4) :54-58 [Persian]##Sadryedairchi A, Mohamadi N, Fayazi M, Afsar A. Examining The Relationship of Psychological Well-Being with Religious Orientation and Forgiveness among Students at The University of Mohaghegh Ardabili. Journal of Research on Religion and Health. 2017; 3(2): 20-30.##Flere S, Lavric M. Is Intrinsic Religious Orientation a Culturally Specific American Protestant Concept? The Fusion of Intrinsic and Extrinsic Religious Orientation among non-Protestants. European Journal of Social Psychology. 2008; 38(3): 521-530. [Persian]##Hariri N, Abazari Z, Golsefid V, et al. The Relationship between Religious Orientation and Organizational Loyalty Among The Librarians of The Academic Libraries Located in Karaj. Theological- Doctrianal Research (The Islamic Science Quarterly). 2014; 4(13). 53-71. [Persian]##Mousavimoghadam Sayed RA, Bagheri F, Zahirikhah N. The Relationship between Religious Orientation, Personality Traits and Spiritual Well-Being and Quality of Life for Students. International Journal of Psychology and Behavioral Research. 2015; 4(1): 22-29. [Persian]##Faigin CF. Filling the Spiritual Void Spiritual Struggles as a Risk Factor for Addiction. College of Bowling Green State University. 2008##Hajjarian A, Ghanbari Y. Recognition and Analysis of the Effective Social Dimensions on the Tendency of Rural Youths to Addiction in Rural Areas of Isfahan City. Research on Addiction. 2013; 7 (27): 67-78. [Persian]##Miller L, Davies M, Greenwald S. Religiosity and Substance Use and Abuse among Adolescents in the National Comorbidity Survey. Journal of the American Academy of Child & Adolescent Psychiatry. 2000; 39(9): 1190-7.##Brown T, Parks GS, Zimmerman RS, et al. The Role of Religion in Predicting Adolescent Alcohol Use and Problem Drinking. Journal of Studies on Alcohol. 2001; 62(5): 695-705.##Khoshnood G, Shayan N, Babaie Amiry N, et al. Rrelationship between Religious Orientation, Happiness, Locus of Control and Coping Strategies, and Spiritual Well-being Among Nursing Students. Journal of Research Development in Nursing and Midwifery. 2016; 12(3): 9-18. [Persian]##Demir S, Demir SG, Bulut H, et al. Effect of Mentoring Program on Ways of Coping with Stress and Locus of Control for Nursing Students. Asian Nursing Research. 2014; 8(4): 254-60.##Pourmovahed Z, Mahmoodabad SS, Zareei Mahmoodabadi H, et al. Family stability and conflict of spiritual beliefs and superstitions among Yazdi people in Iran: A qualitative study. World Family Medicine Journal: Incorporating the Middle East Journal of Family Medicine. 2017; 7(10): 97.##Almasi A. Investigating and Comparing The Source of Control of Addicted and Non-Addicted People. Thesis of Master, Tehran, Free Road Hon University. 1998. [Persian]##Asghari F, Kurdmirza EO, Ahmadi L. The Relationship between Religious Attitudes, Locus of Control and Tendency to Substace Abuse in University Students. Research On Addiction. 2013;7 (25): 103-112. [Persian]##Kaldi A, Mahdavi R. The Role of Internal and External Locus of Control in Relapse of Addiction in Occupational Therapy Camp of Zanjan. Social Welfare Quarterly. 2003; 3 (9): 307-334. [Persian]##Delavar A. Theoretical and practical foundations of research in humanities and social sciences. Roshd Publications. 2010. [Persian]##Janbozorgi M. 1999. The study of effectiveness of psychotherapy with and without religious orientations on reducing of anxiety and stress. [Thesis]. Tehran: Tarbiat Modares University. 1999. [Persian]##Barzegar Befroui F, Salehpour M, Imam Juma MR. The Relationship Between Locus of Control and Self-Esteem with Creativity in Ardekan City High Schools Studenst. Journal of School Psychology. 2015; 3(4): 6-21. [Persian]##Demir S, Demir SG, Bulut H, et al. Effect of Mentoring Program on Ways of Coping with Stress and Locus of Control for Nursing Students. Asian Nursing Research.2014 ;8(4): 254-60.##Dehghani F, Zareei Mahmoodabadi H. The Effect of Using Virtual Social Networks on Depression, Anxiety, and Stress among Young Adults. Social Behavior Research & Health. 2018; 2(1). 174-180.##Farasatkish F, Pirani Z, Khodabakhshi Koolaee A. Relationship of Psychological Well-being and Happiness with Religious Orientation among Female Students. Religion and Health. 2017;4(1):36-46 .[Persian]##Zareei Mahmoodabadi H, Younesi J. The Effectiveness of Cognitive Techniques on Improvement of Family Function in Mal-Adjusted Couples. Journal of Daneshvar Raftar.2009; 29. 35-52. [Persian]##Haghighi M, Alizadeh F, Rezaei T. Environmental and Personal Factors Associated with Addiction Relapse in Referral patients to Marand Treatment Centers. Journal of Community Health Research. 2018; 7 (2) :63-73.##1. Yazdani HR, Kazemi Najaf Abadi MR, Saidi GhR. Investigating the Mediating Role of Spirituality in the Relationship between Dimensions of Organizational Justice and Spiritual Outcomes. Journal of Business Management Perspective. 2010; 9(3):117-133. [Persian]##Raiisi F, Anisi J, Yazdi SM, et al. Mental health and child-rearing styles between candidate adult for addiction withdrawal in comparison with non-addict adults. Journal of Behavioral Sciences. 2008; 2(1): 33-41. [Persian]##Mahmoodabadi HZ, Bahrami F, Ahmadi A, et al. The Effectiveness of Retraining Attribution Styles (Cognitive Therapy) on Dimensions of Family Functioning in Divorce Applicant Couples. International Journal of Psychological Studies. 2012; 4(2). 257. [Persian]##Makarem S, Zanjani Z. The Relationship Between Individual and Family Religiosity with Substance Abuse. Research on Addiction. 2014; 7(28): 75-88. [Persian]##Young K.S, Rodgers R. The Relationship between Depression and Internet Addiction. Cyberpsychology& Behavior. 1998; 1 (1): 25-34.##Bhagwan R. Spirituality in Social Work in South Africa: Insights from a Survey with Academics. International Social Work. 2013; 56(3): 276-289.##Yavari S, Nuri R, Hasan Abadi HR. Structural Model of Drug Use Among Students: The Role of Spirituality, Social Modeling and Attitude to Drugs. Research on Addiction. 2015; 9(33): 145-165. [Persian]##Zargar Y, Najarian B, Naami A. The Relationship between Personality Traits (Sensation Seeking, Assertiveness, Psychological Hardiness), The Religious Attitude and Marital Satisfaction with Readiness for Drug Abuse. Journal of Education and Psychology Chamran University. 2008; 1(3): 99-120. [Persian]##Johnson TJ, Carlisle R, Sheets VL, et al. Prospective Examination of the Relationship between Religious Struggle and Alcohol Problems in a College Sample. Psychology of Religion. 2008; 63. 117- 127.##Imanzad M, Atabeigi Momtaz G, Mousavimoghadam SR, et al. The Effect of Religious Attitude and Spirituality Orientation on Defense Mechanisms. Medical Science Journal of Islamic Azad Univesity-Tehran Medical Branch. 2014; 23 (4) :54-58 [Persian]##Sadryedairchi A, Mohamadi N, Fayazi M, Afsar A. Examining The Relationship of Psychological Well-Being with Religious Orientation and Forgiveness among Students at The University of Mohaghegh Ardabili. Journal of Research on Religion and Health. 2017; 3(2): 20-30.##Flere S, Lavric M. Is Intrinsic Religious Orientation a Culturally Specific American Protestant Concept? The Fusion of Intrinsic and Extrinsic Religious Orientation among non-Protestants. European Journal of Social Psychology. 2008; 38(3): 521-530. [Persian]##Hariri N, Abazari Z, Golsefid V, et al. The Relationship between Religious Orientation and Organizational Loyalty Among The Librarians of The Academic Libraries Located in Karaj. Theological- Doctrianal Research (The Islamic Science Quarterly). 2014; 4(13). 53-71. [Persian]##Mousavimoghadam Sayed RA, Bagheri F, Zahirikhah N. The Relationship between Religious Orientation, Personality Traits and Spiritual Well-Being and Quality of Life for Students. International Journal of Psychology and Behavioral Research. 2015; 4(1): 22-29. [Persian]##Faigin CF. Filling the Spiritual Void Spiritual Struggles as a Risk Factor for Addiction. College of Bowling Green State University. 2008##Hajjarian A, Ghanbari Y. Recognition and Analysis of the Effective Social Dimensions on the Tendency of Rural Youths to Addiction in Rural Areas of Isfahan City. Research on Addiction. 2013; 7 (27): 67-78. [Persian]##Miller L, Davies M, Greenwald S. Religiosity and Substance Use and Abuse among Adolescents in the National Comorbidity Survey. Journal of the American Academy of Child & Adolescent Psychiatry. 2000; 39(9): 1190-7.##Brown T, Parks GS, Zimmerman RS, et al. The Role of Religion in Predicting Adolescent Alcohol Use and Problem Drinking. Journal of Studies on Alcohol. 2001; 62(5): 695-705.##Khoshnood G, Shayan N, Babaie Amiry N, et al. Rrelationship between Religious Orientation, Happiness, Locus of Control and Coping Strategies, and Spiritual Well-being Among Nursing Students. Journal of Research Development in Nursing and Midwifery. 2016; 12(3): 9-18. [Persian]##Demir S, Demir SG, Bulut H, et al. Effect of Mentoring Program on Ways of Coping with Stress and Locus of Control for Nursing Students. Asian Nursing Research. 2014; 8(4): 254-60.##Pourmovahed Z, Mahmoodabad SS, Zareei Mahmoodabadi H, et al. Family stability and conflict of spiritual beliefs and superstitions among Yazdi people in Iran: A qualitative study. World Family Medicine Journal: Incorporating the Middle East Journal of Family Medicine. 2017; 7(10): 97.##Almasi A. Investigating and Comparing The Source of Control of Addicted and Non-Addicted People. Thesis of Master, Tehran, Free Road Hon University. 1998. [Persian]##Asghari F, Kurdmirza EO, Ahmadi L. The Relationship between Religious Attitudes, Locus of Control and Tendency to Substace Abuse in University Students. Research On Addiction. 2013;7 (25): 103-112. [Persian]##Kaldi A, Mahdavi R. The Role of Internal and External Locus of Control in Relapse of Addiction in Occupational Therapy Camp of Zanjan. Social Welfare Quarterly. 2003; 3 (9): 307-334. [Persian]##Delavar A. Theoretical and practical foundations of research in humanities and social sciences. Roshd Publications. 2010. [Persian]##Janbozorgi M. 1999. The study of effectiveness of psychotherapy with and without religious orientations on reducing of anxiety and stress. [Thesis]. Tehran: Tarbiat Modares University. 1999. [Persian]##Barzegar Befroui F, Salehpour M, Imam Juma MR. The Relationship Between Locus of Control and Self-Esteem with Creativity in Ardekan City High Schools Studenst. Journal of School Psychology. 2015; 3(4): 6-21. [Persian]##Demir S, Demir SG, Bulut H, et al. Effect of Mentoring Program on Ways of Coping with Stress and Locus of Control for Nursing Students. Asian Nursing Research.2014 ;8(4): 254-60.##Dehghani F, Zareei Mahmoodabadi H. The Effect of Using Virtual Social Networks on Depression, Anxiety, and Stress among Young Adults. Social Behavior Research & Health. 2018; 2(1). 174-180.##Farasatkish F, Pirani Z, Khodabakhshi Koolaee A. Relationship of Psychological Well-being and Happiness with Religious Orientation among Female Students. Religion and Health. 2017;4(1):36-46 .[Persian]##Zareei Mahmoodabadi H, Younesi J. The Effectiveness of Cognitive Techniques on Improvement of Family Function in Mal-Adjusted Couples. Journal of Daneshvar Raftar.2009; 29. 35-52. [Persian]##Haghighi M, Alizadeh F, Rezaei T. Environmental and Personal Factors Associated with Addiction Relapse in Referral patients to Marand Treatment Centers. Journal of Community Health Research. 2018; 7 (2) :63-73.## ##

Investigating the Level of Access to Hospital Medical Facilities Using the Geographical Information System (GIS) in Yazd, Iran, in 2019 بررسی وضعیت دسترسی به امکانات درمانی بیمارستانی با استفاده ازسیستم اطلاعات جغرافیایی (GIS) در شهر یزد سال 1398 2 1 زمینه و هدف: دسترسی جغرافیایی مناسب به امکانات درمانی بیمارستانی منجر به افزایش مراجعه افراد جهت دریافت خدمات غیر اورژانسی و عدم تاخیر در ارایه خدمات اورژانسی خواهد شد. هدف این پژوهش، تعیین وضعیت دسترسی به امکانات درمانی بیمارستانی و مکان یابی بهینه بیمارستانها در شهر یزد در سال 2019 بود. روش تحقیق: این پژوهش از نظرنوع  توصیفی و از نظر اهداف یک مطالعه کاربردی است. داده های مورد نیاز تحلیل دسترسی شامل اطلاعات مربوط به کلیه مراکز بیمارستانی موجود، اطلاعات جمعیتی، نقشه ی کاربری نظامی، مسکونی، ورزشی، صنعتی، فضای سبز، آموزشی،  تراکم جمعیت، راه های ارتباطی و لایه  بلوک های جمعیتی شهر یزد بود. تحلیل داده ها در نرم افزار GISورژن 10.3انجام گرفت. یافته ها:  شهر یزد دارای 11 بیمارستان و 1915 تخت فعال است. تعداد بیمارستانها متناسب با کل جمعیت بود ، اما کمبود 147 تخت فعال وجود داشت. سرانه فضای بیمارستان 0.40 متر مربع بود که بیشتر از حد استاندارد (0.37 مترمربع) است. توزیع بیمارستان و تختخواب در مناطق مختلف یزد نابرابر بود.درصد جمعیت با دسترسی زیاد یا مطلوب  (جمعیت داخل شعاع 1500 متری پیرامون بیمارستانها) به بیمارستانهای دارای  بخش های اورژانس، داخلی وجراحی، اطفال و زنان وزایمان به ترتیب 54.12 ، 41.92، 44.44 و 48.34 درصد جمعیت شهریزد است. همچنین ، جمعیت با دسترسی محدود (جمعیت خارج از شعاع 3000 متری بیمارستان ها) به بیمارستان های دارای واحدهای اورژانس ، داخلی و جراحی ، کودکان و زنان به ترتیب 15.40، 31.72 ، 21.78 و 18.89 درصد از جمعیت یزد را تشکیل می دهند. نقشه طبقه بندی شده پهنه های شهر یزد برای احداث بیمارستان در 5 دسته بسیار مناسب تا بسیار نامناسب نشان داد که نزدیک به 34 درصد منطقه مورد مطالعه، جهت احداث بیمارستان مناسب است. نتیجه گیری: با توجه به نتایج بدست آمده ، کمبود بیمارستان و فضای بیمارستانی در  شهر یزد وجود ندارد و تعداد تخت ها کمتر از استاندارد بین المللی نیست. با این حال ، مکان یابی بیمارستان ها به گونه ای نیست که بخش عمده ای از جمعیت در شعاع دسترسی زیاد یا مطلوب بیمارستان ها قرار گیرند. 2 Introduction: proper geographical access to hospital medical facilities will increase people’s visits to receive non-emergency services and no delay in providing emergency services. This research aimed to determine the level of access to hospital medical facilities with Geographical Information System in Yazd in 2019. Methods: This research is descriptive and applied. The required data for analyzing access included the information related to all existing hospitals, demographic data, and the layer of Yazd’s population blocks. Data analysis was carried out with GIS10.3 software. Results: Yazd city has 11 hospitals and 1915 active beds. The number of hospitals was proportional to the total population, but there was a shortage of 147 active beds. The per capita hospital space was 0.40 square meters, which is more than the standard (0.37 m2). The distribution of hospitals and beds in different regions of Yazd was inequitable. The population with high or desirable access (the population within a 1500-meter radius of the hospitals) to the hospitals with emergency, internal and surgery, pediatric, and gynecology units made up 54.12, 41.92, 44.44, and 48.34 percent of the Yazd’s population, respectively. Also, the population with limited access (the population out of a 3000-meter radius of hospitals) to the hospitals with emergency, internal and surgery, pediatric, and gynecology units made up 15.40,   31.72, 21.78, and 18.89 percent of the Yazd’s population, respectively. Conclusion: Regarding the obtained results, it is concluded that there is no shortage of hospitals and hospital space in Yazd, and the number of beds is not way below the international standard. However, locating the hospitals is not so that a large proportion of the population is placed within the radius of high or desirable access to hospitals.   241 255 2020/09/212020/06/82019/10/282020/01/232019/12/3 1398/9/12 2020/12/202020/12/202020/12/202020/12/202020/12/20 1399/9/30 روح الله عسکری Roohollah Askari 1. Health Policy and Management Research Center, Department of Health Services Management, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd , Iran Iran میلاد شفیعی Milad Shafiee 1. Health Policy and Management Research Center, Department of Health Services Management, School of Public Health, Shahid Sadoughi University of Medical Sciences , Yazd , Iran Iran ذبیح الله چارراهی Zabihollah Charrahi 2. Faculty of Geography, Department of Remote Sensing and GIS, Tehran University, Tehran, Iran Iran سیدعلی المدرسی Seyed Ali Almodarresi 3. Department of Remote Sensing, Islamic Azad University of Yazd, Yazd, Iran Iran سیدمحمد افرازنده Seyed Mohammad Afrazandeh Department of Healthcare Management, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran m_afrazandeh@bums.ac.ir Health Services Accessibility Hospital Spatial distribution Locating geographical information system Yazd دسترسی به خدمات بهداشتی بیمارستان مکان یابی سیستم اطلاعات جغرافیایی شهر یزد Tatari E. Spatial Analysis of Access to Health Services in Rural Areas of the Zabul Zone. University of Zabol. 2012[Msc Thesis].##Reshadat S, zangeneh A, Saeidi S, et al. Investigating Inequalities in Access to Hospital Medical Facilities Using Geographical Information System in Kermanshah's Metropolitan Area. Journal of Hospital. 2016;15(2): 9-22.[Persian]##Varesi HR, Sharifi N, Shahsavani MJ. Locating Sanitary- Therapeutic Centers Using Geographic Information System (GIS) and Analytical Hierarchy Process (AHP) (Case study: Najaf Abad city). 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[Persian]##Khakpoor B, Purghayoomi H, Ghanbari M. Location Health-Therapeutic Centers of Nourabad by use Analytical Hierarchy Process in GIS. Health information management. 2014; 11(2): 221-33. [Persian]##Pan J, Shallcross D. Geographic Distribution of Hospital Beds Throughout China: A County-Level Econometric Analysis. International Journal for Equity in Health. 2016;15(1):179-88.##Masoodi M, Rahimzadeh M. Measuring Access to Urban Health Services Using Geographical Information System (GIS): A Case Study of Health Service Management in Bandar Abbas, Iran. International Journal of Health Policy and Management. 2015; 4(7): 439- 45.##Mansour S. Spatial Analysis of Public Health Facilities in Riyadh Governorate, Saudi Arabia: A GIS-Based Study To Assess Geographic Variations of Service Provision and Accessibility. Geo-Spatial Information Science. 2016; 19(1): 26-38.##Zhang P, Ren X, Zhang Q, et al. Spatial Analysis of Rural Medical Facilities Using Huff Model: A Case Study of Lankao County, Henan Province. International Journal of Smart Home. 2015; 9(1):161-8.##Merciu C, Stoian D, Merciu G, et al. Using GIS for Calculating The Accessibility to Hospitals in The City of Bucharest and Its Metropolitan Area (Romania). Geographica Pannonica. 2013; 17(4): 106-13.##Yang N, Chen S, Hu W, et al. Spatial Distribution Balance Analysis of Hospitals in Wuhan. International Journal of Environmental Research and Public Health. 2016; 13(10): 971.##28 Brabyn L, Skelly C. Modeling Population Access to New Zealand Public Hospitals. International Journal of Health Geographics. 2002;1(1): 3.##Rosero-Bixby L. Spatial Access to Health Care in Costa Rica and Its Equity: A GIS-Based Study. Social Science & Medicine. 2004; 58(7): 1271-84.##Wiśniewski S. Spatial Accessibility of Hospital Healthcare in Łódź Voivodeship. Quaestiones Geographicae. 2016;35(4):157-66.##Tatari E. Spatial Analysis of Access to Health Services in Rural Areas of the Zabul Zone. University of Zabol. 2012[Msc Thesis].##Reshadat S, zangeneh A, Saeidi S, et al. Investigating Inequalities in Access to Hospital Medical Facilities Using Geographical Information System in Kermanshah's Metropolitan Area. Journal of Hospital. 2016;15(2): 9-22.[Persian]##Varesi HR, Sharifi N, Shahsavani MJ. Locating Sanitary- Therapeutic Centers Using Geographic Information System (GIS) and Analytical Hierarchy Process (AHP) (Case study: Najaf Abad city). Health information management. 2015; 11(7): 851-64. [Persian]##Malek Hosseini A, Shokri S. Investigating Spatial Distribution of Health Services (Hospital) Using GIS and AHP (Case Study: Hamedan City). First National Conference on Geography, Urban Development and Sustainable Development. Tehran: Living Environment Community. Koomesh. 2014. Available from: https://civilica.com/ doc/266262/.##Hatami Nejad H, Mahdian Bahmaniri M, Mahdi A. Investigation and Analysis of Spatial Justice in Health Care Services Using Topsis, Mourice and Taxonomy Model. Geographichal Planning of Space Quarterly Journal. 2012; 2(5):75-98. [Persian]##Ebrahimzadeh i, Ahadnejad M, Ebrahimzadeh Asmin H, et al. Spatial Organization and Planning of Health Services by the Use of GIS; The Case of Zanjan City. Human Geography Research. 2010;73: 39-58. [Persian]##Ebrahimzadeh i, Ahadinejad M, Zarei S. Study of spatial distribution of health services in Firoozabad and its optimization using the Geographic Information System. 2010:1. Available from: https://www.virascience. com/ thesis/522046/.##feli M, Sajjad A, Hatami Nejad H. Locating Health Centers Using Geographic Information System (Case Study: Shiraz Fourth District). Fourth Conference on Urban Planning and Management; Mashhad. 2012. Available from: https://civilica.com/doc/164780/.##Danaie Fard A, Shokouhi Ma, Khakpoor B. Analysis of the spatial distribution of health centers (hospitals) in Mashhad. 2011:3. [ Msc Thesis]##Ishikawa T, Mizuguchi H, Murayama H, et al. Relationship between Accessibility and Resources to Treat Acute Ischemic Stroke. Hokkaido, Japan: Analysis Of Inequality and Coverage Using Geographic Information Systems. Health Policy and Technology. 2019; 8(4): 337-42.##Jamali f, Sadrmousavi M, Eshlaghi M. An Evaluation of Hospitals Site Selection Patterns in Tabriz, Iran. Geography and Planning. 2014;18(47): 25-53. [Persian]##Ibrahim Sa. Comparing Alternative Methods of Measuring Geographic Access to Health Services: An Assessment of People's Access to Specialist Hospital in Kebbi State. Academic Journal of Interdisciplinary Studies. 2013; 2(12): 16-109.##Pourmohammadi MR. Urban Land Use Planning. Publication Samt. 2010.##Sahraeian Z, Zangiabadi A, Khosravi F. Spatial Analysis and Site Selection of Health Medical and Hospital Centers Using (GIS)(Case Study: Jahrom City). Geographic Space . 2013;13(43): 153-70. [Persian]##Fallahi GR, Teimuri N. Location of treatment centers using Geographical information system and hierarchical analysis (case area: Kabul-Afghanistan). National Conference on Spatial Information Technology Engineering. 2017.##Moradi H, Shetab Boshehri N, Kornak Beheshti A, et al. Location of Competitive Service Centers for Reducing City Traffic (Case Study: Health Centers of The City of Isfahan). Production and Operations Management. 2011;1(1): 31-52. [Persian]##Bazargan M. A Case Study on Accessibility of Medical and Healthcare Facilities in Mashhad using GIS. Studies of Architecture, Urbanism and Environmental Sciences Journal. 2018;1(1): 39-48.##Taghvaye m, Zakeri e. Analysis of the spatial distribution of hospital and clinic services using GIS and models Tapsis (The study: City of Esfahan). Health information management. 2013;10(4): 581-591. [Persian]##sadeghi s, eslahchi e, saniee m. 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Measuring Access to Urban Health Services Using Geographical Information System (GIS): A Case Study of Health Service Management in Bandar Abbas, Iran. International Journal of Health Policy and Management. 2015; 4(7): 439- 45.##Mansour S. Spatial Analysis of Public Health Facilities in Riyadh Governorate, Saudi Arabia: A GIS-Based Study To Assess Geographic Variations of Service Provision and Accessibility. Geo-Spatial Information Science. 2016; 19(1): 26-38.##Zhang P, Ren X, Zhang Q, et al. Spatial Analysis of Rural Medical Facilities Using Huff Model: A Case Study of Lankao County, Henan Province. International Journal of Smart Home. 2015; 9(1):161-8.##Merciu C, Stoian D, Merciu G, et al. Using GIS for Calculating The Accessibility to Hospitals in The City of Bucharest and Its Metropolitan Area (Romania). Geographica Pannonica. 2013; 17(4): 106-13.##Yang N, Chen S, Hu W, et al. Spatial Distribution Balance Analysis of Hospitals in Wuhan. International Journal of Environmental Research and Public Health. 2016; 13(10): 971.##28 Brabyn L, Skelly C. Modeling Population Access to New Zealand Public Hospitals. International Journal of Health Geographics. 2002;1(1): 3.##Rosero-Bixby L. Spatial Access to Health Care in Costa Rica and Its Equity: A GIS-Based Study. Social Science & Medicine. 2004; 58(7): 1271-84.##Wiśniewski S. Spatial Accessibility of Hospital Healthcare in Łódź Voivodeship. Quaestiones Geographicae. 2016;35(4):157-66.## ##

Relationship between Self-efficacy and Mental Health with Health Literacy in Patients with Diabetes in Kazerun City, Shiraz, Iran رابطه بین خودکارآمدی و سلامت روان با سواد سلامت در بیماران دیابتی در شهر کازرون ، شیراز ، ایران 2 1 زمینه و هدف : دیابت و کنترل آن متأثر از شبکه پیچیده ای از  عوامل روانی ، رفتاری، نگرش و  مراقبت های سلامتی است. هدف این مطالعه بررسی ارتباط بین سلامت روان و خودکارآمدی باسواد سلامت  دربیماران دیابتی نوع دو انجام شد. روش:  این مطالعه از نوع تحلیلی همبستگی بود که بر روی 60نفراز بیماران دیابتی مراجعه کننده به مراکز بهداشتی ودرمانی شهر کازرون در سال 1397انجام شد .نمونه ها با روش نمونه گیری دردسترس انتخاب شدند .جمع آوری داده ها با استفاده از پرسشنامه  مشخصات فردی  ، مقیاسخودکارآمدی عمومی(GSES) شرر و همکاران ،سواد سلامت منتظری وهمکاران  (HELA ) و پرسشنامه سلامت روان کیز  (MHC-SF)است .تجزیه و تحلیل داده ها در APSS v21 و از آمار توصیفی شامل میانگین و انحراف معیار و با استفاده از آزمون های آماری ضریب همبستگی اسپیرمن و تحلیل رگرسیون چندگانه انجام گردید (P<0.01). .یافته ها : سلامت روان با سواد سلامت رابطه مثبت و معناداری دارد (p <0.001) بنابراین ، افراد با سلامت روان بهتر سطح سواد سلامت خود را بهتر ارزیابی می کنند. با این حال ، هیچ ارتباطی بین خودکارآمدی و سواد سلامت یافت نشد (r = -0.19 p> 0.001) ، علاوه بر این ، نتایج رگرسیون نشان داد که سلامت روان می تواند 54 درصد واریانس سواد سلامت را پیش بینی کند (R2= 0.54, p <0.001). . نتیجه گیری : . نتایج این مطالعه نشان داد که بهبود سلامت روان، افزایش سواد سلامت در بیماران دیابتی را درپی دارد که این امر می تواند در مقابله با مشکلات به فرد کمک کند. 2 IntroductionSince diabetes is a complex network of psychological and healthcare factors, this paper aims to investigate the relation between type 2 diabetes and mental health Method: This study was analytical cross-sectional research on 60 diabetic patients referring to Kazerun health care centers, southwest of Iran, in 2018. The samples were selected by convenience sampling method. The data were collected using the Demographic Profile Questionnaire, General Self-Efficacy Scale  (GSES), Health Literacy Questionnaire  (HELA), and Mental Health Continuum (MHC-SF). Data analysis was performed in APSS v21 and from descriptive statistics including mean and standard deviation and using the statistical tests of Spearman correlation coefficient and multiple regression analysis (P <0.01). Findings:   Mental health has a significant positive relationship with health literacy (p <0.001). Thus, individuals with better mental health evaluate their level of health literacy better. However, no relationship was found between self-efficacy and health literacy(r= -0.19, p >0.001). Besides, regression results indicated that mental health can predict a 54% variance of health literacy (R2= 0.54, p <0.001). Conclusion: The findings of this study shows that boosting an individual’s mental health leads to an increase in health awareness in patients afflicted with diabetes which after all, can cause a better coping capability in these people. 256 264 2020/09/212020/06/82019/10/282020/01/232019/12/32020/03/29 1399/1/10 2020/12/202020/12/202020/12/202020/12/202020/12/202020/12/20 1399/9/30 محمد تقی سهرابی رنانی Mohammad Taghi Sohrabi renani 1. Department of PsyChology, School of Psychology, University of Islamic Azad branch Arak, Arak, Iran Iran Sohrabimohamad59@gmail.com فهیمه نورافکن Fahimeh Nourafkan 2. Department of PsyChology, School of Psychology ,Tabriz university,Tabriz , Iran. Iran ff.nourafkan@gmail.com فریبا فتحی مرد Fariba FathiMard 1. Department of PsyChology, School of Psychology, University of Islamic Azad branch Arak, Arak, Iran Iran fathimard8716@yahoo.com کاوه صادقیان خشوئی Kaveh Sadegheyan khashoei 1. 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Social Support or Organizational Support: Which One Is More Predictive of Job Burnout in workers? حمایت اجتماعی یا حمایت سازمانی: کدام یک بیشتر فرسودگی شغلی را پیش بینی می کنند؟ 2 1 مقدمه: حمایت اجتماعی و سازمانی از عوامل موثری هستند که ارتباط تنگاتنگی با فرسودگی شغلی دارند و با توجه به محدود بودن این نوع مطالعات بر روی کارگران ایرانی، این مطالعه با هدف تعیین وضعیت پیش بینی کنندگی حمایت اجتماعی و حمایت سازمانی در فرسودگی شغلی کارگران در شهر یزد انجام گردید. روش‌ها: این مطالعه مقطعی در بین200 نفر از کارگران نساجی شهر یزد با روش نمونه گیری طبقه ای انجام گرفت.  داده ها توسط ابزاری مشتمل بر مشخصات دموگرافیک، پرسشنامه حمایت اجتماعی ، حمایت سازمانی و فرسودگی شغلی Maslach  جمع آوری شدند. داده ها توسط نرم افزار SPSS  با استفاده از ضریب همبستگی پیرسون و رگرسیون خطی چندمتغیره مورد تجزیه و تحلیل قرار گرفتند. سطح معنی داری آزمون ها p<0.05 در نظر گرفته شد. یافته‌ها: رابطه قوی، مثبت و معناداری بین فرسودگی شغلی و خستگی هیجانی وجود داشت (0/88r=)(001/ 0p <) و رابطه منفی معناداری بین فرسودگی شغلی و حمایت اجتماعی(0/390r =)، حمایت دوستان (401/ 0r=-)، حمایت خانواده (218/ 0r=-) و حمایت دیگران مهم (283/ 0r=-) وجود داشت (001/ 0 p <). تحلیل رگرسیون خطی چندمتغیره نشان داد که 17/8 درصد از تغییرات در فرسودگی شغلی، توسط حمایت دوستان، خانواده و افراد مهم تبیین می شد( , p <0.001R2=0.178) و حمایت دوستان، بیشترین تأثیرگذاری را بر فرسودگی شغلی داشت (, p <0.001 β =-0.338). حمایت اجتماعی و حمایت سازمانی، 35/9 درصد از تغییرات در فرسودگی شغلی را تبیین می کردند (, p<0.001R2=-0.359) و حمایت سازمانی، بیشترین تأثیرگذاری را برفرسودگی شغلی داشت (, p <0.001 β =-0.472). نتیجه گیری: با توجه به اینکه حمایت سازمانی، قوی ترین پیشگویی کننده معنادار فرسودگی شغلی در کارگران بود، توسعه مداخلات سازمانی برای افزایش حمایت در محیط کار می تواند به عنوان استراتژی موثری برای کاهش یا کند نمودن فرسودگی شغلی در بین کارگران در نظر گرفته شود. 2   Introduction: Social and organizational supports are effective factors closely related to job burnout and Due to the limited studies in this area on Iranian workers, this study aims to determine the predictability of social support and organizational support in  job burnout for workers in Yazd. Methods: This cross-sectional study was carried out among 200 textile workers in Yazd through stratified random sampling. The data were collected by the tools including demographic characteristics, questionnaires of social support, organizational support, and Maslach's job burnout. The data were analyzed by SPSS using the Pearson correlation coefficient and the multiple linear regressions. The Significance level of tests was considered as p <0.05.  Results: There was a significant strong positive relationship between job burnout and emotional exhaustion (r= 0.88) (p <0.001 (. There was found a significant negative correlation between job burnout and social support (r =- 0.390), friend support (r= -0.401), family supoert (r= -0.218), important others support (r= - 0.283) (p <0.001 (. Multiple linear regression analysis showed that 17.8% of the changes in job burnout were explained by friends, family, and important others support (R2=0.178, p<0.001) whereas support from friends was the strongest predictor of job burnout (β= - 0.338, p <0.001). Social and organizational support explained 35.9% of the changes in job burnout (R2= 0.359, p<0.001) with organizational support being the strongest predictor of  job burnout (β= - 0.472, p<0.001). Conclusion: Given that organizational support was the most significant predictor of job burnout in workers, developing organizational interventions to increase support in workplace can be regarded as effective strategy to reduce or slow down job burnout among workers. 265 272 2020/09/212020/06/82019/10/282020/01/232019/12/32020/03/292020/03/25 1399/1/6 2020/12/202020/12/202020/12/202020/12/202020/12/202020/12/202020/12/20 1399/9/30 فرخ لقا ثروت Farokhlegha Servat 1. Department of Health Education and Health Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran fservat2006@yahoo.com سید سعید مظلومی محمود آباد Seyed Saeed Mazloomy Mahmoodabad 1. Department of Health Education and Health Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mazloomy.mm@gmail.com معصومه عباسی شوازی Masoumeh Abbasi- Shavazi 1. Department of Health Education and Health Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mabbasishavazi@gmail.com علی دهقانی Ali Dehghani 2. Department of Biostatistics and Epidemiology, School of public Health, Shahid Sadoughi University of Medical Sciences,Yazd, Iran Iran Job burnout Social support Organizational support Workers فرسودگی شغلی حمایت اجتماعی حمایت سازمانی کارگران 1. 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The Effect of Eight Weeks of Aerobic Exercise on Balance Function and Physiological Cost Index in Multiple Sclerosis Patients تاثیر هشت هفته تمرین هوازی بر عملکرد تعادلی و شاخص هزینه فیزیولوژیک بیماران زن مبتلا به ام.اس 2 1 چکیده مقدمه: ضعف عضلانی و مشکلات تعادلی به عنوان عامل محدودکننده در بیماران ام اس به شمار می رود که می تواند با فعالیت بدنی بهبود یابد. هدف پژوهش حاضر بررسی تاثیر هشت هفته ورزش‌ هوازی بر عملکرد تعادلی و شاخص هزینه فیزیولوژیک بیماران مبتلا به ام.اس شهرستان یزد در سال 1394، بود. روش کار: تحقیق حاضر از نوع نیمه تجربی و به صورت طرح پیش آزمون و پس آزمون انجام گرفت. نمونه‌های تحقیق به صورت هدفمند در دسترس شامل 30 نفر (15 نفر گروه تمرین و 15 نفر گروه کنترل)  از بیماران زن مبتلا به ام.اس عضو انجمن ام.اس بیمارستان شهید صدوقی یزد که بیماری آنها توسط متخصص مغز و اعصاب و با استفاده از امتیاز مقیاس EDSS کمتر از 4/5، تشکیل می‌دادند. آزمودنی های به صورت هدفمند در دسترس و به  صورت تصادفی ساده به دو گروه تمرین و کنترل تقسیم شدند. گروه تمرین به مدت 8 هفته، 3 روز در هفته، هر جلسه 90-60 دقیقه با شدت 70-50 درصد با حداکثر ضربان قلب در یک برنامه تمرین هوازی شرکت کردند. از آزمون­های شارپند رومبرگ برای تعادل ایستا، آزمون بلند شدن و راه رفتن زمان­دار برای تعادل پویا و آزمون هزینه فیزیولوژیک برای تعیین شاخص هزینه فیزیولوژیک بیماران استفاده گردید. جهت تحلیل آماری از میانیگین انحراف استاندارد و همچنین از آزمون های شاپیروویلک، تی مستقل و تحلیل کوواریانس از نرم‌افزارSPSS  نسخه 25 در سطح (0/05 > P) استفاده گردید.  یافته‌‌ها: نتایج آزمون تحلیل کوواریانس نشان داد که تمرین منتخب هوازی موجب افزایش معنی­دار در میزان تعادل ایستا (07/ = 0P) و افزایش معنی‌دار در میزان تعادل پویا (0/001 > P) و همچنین موجب بهبود شاخص هزینه فیزیولوژیک (0/001=P  ) بیماران زن مبتلا به ام اس در گروه تمرین در مقایسه با گروه کنترل گردید. نتیجه ‌گیری: با توجه به یافته‌های مطالعه حاضر تمرینات هوازی می‌تواند منجر به بهبود تعادل ایستا و پویا، همچنین بهبود شاخص هزینه فیزیولوژیک در بیماران مبتلا به ام. اس گردد. لذا استفاده از این تمرینات برای بیماران مبتلا به ام اس توصیه می‌گردد. 2 Introduction:   Muscle weakness and balance problems are limiting factors in Multiple sclerosis patients that can be improved due to physical activity. The purpose of this study was to investigate the effect of 8 weeks of aerobic exercise on balance function and Physiological Cost Index in patients with MS in Yazd city in 1394. Methods: This quasi-experimental study was conducted in two stages: pretest and post-test. The subjects were selected by targeted and available sampling and randomly divided into training and control groups that included 30 patients (15 in the experimental group and 15 in the control group). The subjects were randomly divided into two groups of experimental and control. Subjects in the experimental group participated in an aerobic exercise program for eight weeks, three days a week, each session of 60-90 minutes with an intensity of  50-70% of maximum heart rate. For statistical analysis we used descriptive statistics such as mean, standard deviation, and the Shapiro-Wilk test used to measure the normality of the data, independent t-test and the covariance (ANCOVA). The significance level of the tests was p < 0.05 by using the SPSS-25 software. Results:   ANCOVA results revealed that the selected aerobic training significantly increased both static balance (p = 0.007) and dynamic balance (p = 0.001). Moreover, aerobic training positively influenced the physiological cost index (P = 0.001.  Conclusion: aerobic exercise can improve both static and dynamic balance and increase the Physiological Cost Index in M.S patients. Therefore, these exercises are recommended for patients with MS. 273 281 2020/09/212020/06/82019/10/282020/01/232019/12/32020/03/292020/03/252020/06/19 1399/3/30 2020/12/202020/12/202020/12/202020/12/202020/12/202020/12/202020/12/202020/12/20 1399/9/30 محمد رضا ساده Mohammad Reza Sadeh 1. Department of Physical Education of University of Najafabad, Branch of Azad University, Isfahan, Iran Iran sadeh615@gmail.com رضا شریفات پور Reza Sharifatpour 2. Department of Sports Sciences, Faculty of Psychology and Educational Sciences, University of Yazd, Yazd, Iran Iran reza.sharifatpour2013@gmail.com Aerobic exercise Balance MS patients Physiological cost index تمرین هوازی بیماران ام اس تعادل شاخص هزینه فیزیولوژیک 1. Nilsagård Y. Walking Ability, Balance and Accidental Falls in Persons with Multiple Sclerosis. 2008.##Freeman J, Fox E, Gear M, et al. Pilates Based Core Stability Training in Ambulant Individuals with Multiple Sclerosis: Protocol for A Multi-Centre Randomised Controlled Trial. BMC Neurology. 2012; 12(1):19.##Dalgas U, Stenager E, Ingemann-Hansen T. Multiple Sclerosis and Physical Exercise: Recommendations for The Application of Resistance-, Endurance-and Combined Training. Multiple Sclerosis Journal. 2008; 14(1):35-53.##Horton S, MacDonald DJ, Erickson KMS. Exercise, and the Potential for Older Adults. European Review of Aging and Physical Activity. 2010; 7(1): 49-57.##Taraghi Z, Eleiae M. Quality of Life of Patient Member of MS Society of Mazandaran. Iranian Journal of Neurology. 2007; 20(55):51-60.##Sarvari F, Ebrahimi Atri A, Khorshid Sokhangooy M. The Comparison of Resistance and Endurance Exercises on Fatigue Severity and Balance in Women with Multiple Sclerosis. Sport medicine. 2013; 5(10):89-102. [Persian]##Doucett A, Seminary J. Pilates Adapted for Parkinson's disease and Multiple Sclerosis. 2013.##Salavati M, Negahban H, Soleimanifar M, et al. The Persion Version of the Berg Balance Scale: Inter and Intra Rater Reliability and Construction Validity in Elderly Adults. Disability and Rehabilitation. 2012; 34(20):34-48.##Annovazzi P, Tomassini V, Bodini B, et al. A Cross-Sectional, Multicentre Study of the Therapeutic Management of Multiple Sclerosis Relapses in Italy. Neurological Sciences. 2013; 34(2):197-203.##Coote S, Hogan N, Franklin S. Falls in People with Multiple Sclerosis who Use A Walking Aid: Prevalence, Factors, and Effect of Strength and Balance Interventions. Archives of Physical Medicine and Rehabilitation. 2013; 94(4):616-21.##Mariotti C, Fancellu R, Di Donato S. An overview of the patient with ataxia. Journal of neurology. 2005; 252(5):511-8.##Silkwood-Sherer D, Warmbier H. Effects of Hippotherapy on Postural Stability, In Persons with Multiple Sclerosis: A Pilot Study. Journal of Neurologic Physical Therapy. 2007; 31(2):77-84.##Cattaneo D, Jonsdottir J, Zocchi M, et al. Effects of Balance Exercises on People with Multiple Sclerosis: A Pilot Study. Clinical Rehabilitation. 2007; 21(9):771-81.##Olgiati R, Burgunder JM, Mumenthaler M. Increased Energy Cost of Walking in Multiple Sclerosis: Effect of Spasticity, Ataxia, and Weakness. Archives of Physical Medicine and Rehabilitation. 1988; 69(10): 846-9.##Waters RL, Mulroy S. The Energy Expenditure of Normal and Pathologic Gait. Gait Posture. 1999; 9(3): 207-31.##Nene AV, Jennings SJ. Physiological Cost Index of Paraplegic Locomotion Using the ORLAU ParaWalker. Spinal Cord. 1992; 30(4): 264-52.##Rose J, Gamble JG, Medeiros J, et al. Energy cost of walking in normal children and in those with cerebral palsy. Comparison of heart rate and oxygen uptake. Journal of Pediatric Orthopaedics. 1989; 9(3): 2769.##17- MacGregor J. Rehabilitation ambulatory monitoring. Palgrave Macmillan, London .1979: 159-72.##Rampello A, Franceschini M, Piepoli M, et al. Effect of Aerobic Training on Walking Capacity and Maximal Exercise Tolerance in Patients with Multiple Sclerosis: A Randomized Crossover Controlled Study. Physical therapy. 2007; 87(5):545-55.##Halabchi F, Alizadeh Z, Sahraian MA, et al. Exercise Prescription for Patients with Multiple Sclerosis Potential Benefits and Practical Recommendations. BMC Neurology. 2017; 17(1):185.##Dalgas U, Stenager E, Jakobsen J, et al. Resistance Training Improves Muscle Strength and Functional Capacity in Multiple Sclerosis. Neurology. 2009; 73(3):1478-84.##Dalgas U, Stenager E, Jakobsen J, et al. Fatigue, Mood and Quality of Life Improve in MS Patients after Progressive Resistance Training. Multiple Sclerosis Journal. 2010; 16(4):480-90.##Dalgas U, Stenager E, Jakobsen J, et al. Muscle Fiber Size Increases Following Resistance Training in Multiple Sclerosis. Multiple Sclerosis Journal. 2010; 16(11): 1367-76.##Dalgas U, Stenager E, Lund C, et al. Neural Drive Increases Following Resistance Training in Patients with Multiple Sclerosis. Journal of Neurology. 2013; 260(7): 1822-32.##Mostert S, Kesselring J. Effect of A Short-Term Exercise Training Program on Aerobic Fitness, Fatigue, Health Perception and Activity Level of Subjects with Multiple Sclerosis. Multiple Sclerosis Journal. 2002; 8(2): 61-168.##Newman MA, Dawes H, van den Berg M, et al. Can Aerobic Treadmill Training Reduce The Effort of Walking and Fatigue in People with Multiple Sclerosis: A Pilot Study. Multiple Sclerosis Journal. 2007; 13(1):113-9.##Pazokian M, Shabani M, Zakerimoghdam M, et al. The Effect of Stretching Together Aerobic Exercise on Fatigue Level in Multiple Sclerosis Patients Refer to MS Society of Iran Those Suffer From Fatigue. Journal of Holistic Nursing and Midwifery. 2012; 22(2):18-24. [Persian]##Shanazari Z, Marandi M, Minasian V. Effect of 12 Week Pilates and Aquatic Traianing on Fatigue in Women with Multiple Sclerosis. Journal of Mazandaran University of Medical Sciences. 2013; 23(98): 257-64. [Persian]##Bolouchi R, Ghyasi A, Naderi A, et al. The Survey of Cawthorne and Cooksey Exercise on the Quality of Life, Balance and Fatigue in Patients with Multiple Sclerosis. Journal of Ilam University of Medical Sciences. 2014; 21(7): 43-53. [Persian]##Taheri Torbati H, Mahjor M, Enferadi A. Comparison of Single and Dual Task Balance Training on Balance in the Women with Multiple Sclerosis. Journal of Kurdistan University of Medical Sciences. 2016; 20(6): 34-43. [Persian]##Farsi A, Akbar PS, Mosavi MK.V, et al. Effect of Pilates Training Based on Core Stability on Balance and Electromyography of Women with Multiple Sclerosis. The Scientific Journal of Rehabilitation Medicine. 2017; 6(3): 165-173. [Persian]##Sarvari, Fatemeh, Ebrahimi Atri, Ahmad, Saeedi, Morteza, Khorshid Sokhangooy, Maryam. The relationship between lower extremity strength and dynamic balance in patients with multiple sclerosis. Eighth International Conference on MS. 2011: 1-17.##Kurdi M, Anoosheh L, Khodadadh S, et al. The Effect of Selected Combined Training on Strength, Balance and Life Quality of Patients Multiple Sclerosis. Journal of Sport Medicine. 2011; 2(5): 46-59. [Persian]##Cattaneo D, Jonsdottir J, Zocchi M, et al. Effect of balance exercise on people with multiple sclerosis, a pilot study. Clinical rehabilitation. 2007; 21(9): 771-81.##Karpatkin HI, Cohen ET, Klein S, et al. The effect of maximal strength training on strength, walking, and balance in people with multiple sclerosis: a pilot study. Multiple sclerosis international. 2016: 5235971.##Rietberg MB, Brooks D, Uitdehaag BM, et al. Exercise Therapy for Multiple Sclerosis. Cochrane Database of Systematic Reviews. 2005; (1).##Kargarfard M, Mehrabi M, Hamidi-Tehrani J, et al. Changes in speed, Endurance and Balance in Women with Multiple Sclerosis after 4 and 8 weeks of Aquatic Exercise Training. Journal of Isfahan Medical School. 2013; 31(256): 1628-1639. [Persian]##White LJ, Dressendorfer RH. Exercise and Multiple Sclerosis. Sports Medicine. 2004; 34(15):1077-100.##Freal JE, Kraft GH, Coryell JK. Symptomatic Fatigue in Multiple Sclerosis. Archives of Physical Medicine and Rehabilitation. 1984; 65(3): 135-8.##Fragoso YD, Santana DL, Pinto RC. The Positive Effects of A Physical Activity Program for Multiple Sclerosis Patients with Fatigue. NeuroRehabilitation. 2008; 23(2):153-7.##Arastu A.A, Ahmadi A, Zahednejad Sh. The Comparision of Effect of 8 Weeks Aerobic and Yoga Training on Physiological Cost Index in Multiple Sclerosis Patients. Jundishapur Scientific Medical Journal. 2011; 10(2): 153-162. [Persian]##Mostert S, Kesselring J. Effects of a Short-Term Exercise Training Program on Aerobic Fitness, Fatigue, Health Perception and Activity Level of Subjects with Multiple Sclerosis. Multiple Sclerosis Journal. 2002; 8(2): 161-8.##Pariser G, Madras D, Weiss E. Outcomes of An Aquatic Exercise Program Including Aerobic Capacity, Lactate Threshold, and Fatigue in Two Individuals with Multiple Sclerosis. Journal of Neurologic Physical Therapy. 2006; 30(2): 82-90.##Ahmadi A, Nikbakht M, Arastoo AA. The Effects of A Yoga Intervention on Balance, Speed and Endurance of Walking, Fatigue and Quality of Life in People with Multiple Sclerosis. Journal of Human Kinetics. 2010; 23(1): 71-8.##Khammar A, Yarahmadi M, Madadizadeh F. What Is Analysis of Covariance (ANCOVA) and How to Correctly Report Its Results in Medical Research? Iran Journal Public Health. 2020; 49(5): 1016-1017##1. Nilsagård Y. Walking Ability, Balance and Accidental Falls in Persons with Multiple Sclerosis. 2008.##Freeman J, Fox E, Gear M, et al. Pilates Based Core Stability Training in Ambulant Individuals with Multiple Sclerosis: Protocol for A Multi-Centre Randomised Controlled Trial. BMC Neurology. 2012; 12(1):19.##Dalgas U, Stenager E, Ingemann-Hansen T. Multiple Sclerosis and Physical Exercise: Recommendations for The Application of Resistance-, Endurance-and Combined Training. Multiple Sclerosis Journal. 2008; 14(1):35-53.##Horton S, MacDonald DJ, Erickson KMS. Exercise, and the Potential for Older Adults. European Review of Aging and Physical Activity. 2010; 7(1): 49-57.##Taraghi Z, Eleiae M. Quality of Life of Patient Member of MS Society of Mazandaran. Iranian Journal of Neurology. 2007; 20(55):51-60.##Sarvari F, Ebrahimi Atri A, Khorshid Sokhangooy M. The Comparison of Resistance and Endurance Exercises on Fatigue Severity and Balance in Women with Multiple Sclerosis. Sport medicine. 2013; 5(10):89-102. [Persian]##Doucett A, Seminary J. Pilates Adapted for Parkinson's disease and Multiple Sclerosis. 2013.##Salavati M, Negahban H, Soleimanifar M, et al. The Persion Version of the Berg Balance Scale: Inter and Intra Rater Reliability and Construction Validity in Elderly Adults. Disability and Rehabilitation. 2012; 34(20):34-48.##Annovazzi P, Tomassini V, Bodini B, et al. A Cross-Sectional, Multicentre Study of the Therapeutic Management of Multiple Sclerosis Relapses in Italy. Neurological Sciences. 2013; 34(2):197-203.##Coote S, Hogan N, Franklin S. Falls in People with Multiple Sclerosis who Use A Walking Aid: Prevalence, Factors, and Effect of Strength and Balance Interventions. Archives of Physical Medicine and Rehabilitation. 2013; 94(4):616-21.##Mariotti C, Fancellu R, Di Donato S. An overview of the patient with ataxia. Journal of neurology. 2005; 252(5):511-8.##Silkwood-Sherer D, Warmbier H. Effects of Hippotherapy on Postural Stability, In Persons with Multiple Sclerosis: A Pilot Study. Journal of Neurologic Physical Therapy. 2007; 31(2):77-84.##Cattaneo D, Jonsdottir J, Zocchi M, et al. Effects of Balance Exercises on People with Multiple Sclerosis: A Pilot Study. Clinical Rehabilitation. 2007; 21(9):771-81.##Olgiati R, Burgunder JM, Mumenthaler M. Increased Energy Cost of Walking in Multiple Sclerosis: Effect of Spasticity, Ataxia, and Weakness. Archives of Physical Medicine and Rehabilitation. 1988; 69(10): 846-9.##Waters RL, Mulroy S. The Energy Expenditure of Normal and Pathologic Gait. Gait Posture. 1999; 9(3): 207-31.##Nene AV, Jennings SJ. Physiological Cost Index of Paraplegic Locomotion Using the ORLAU ParaWalker. Spinal Cord. 1992; 30(4): 264-52.##Rose J, Gamble JG, Medeiros J, et al. Energy cost of walking in normal children and in those with cerebral palsy. Comparison of heart rate and oxygen uptake. Journal of Pediatric Orthopaedics. 1989; 9(3): 2769.##17- MacGregor J. Rehabilitation ambulatory monitoring. Palgrave Macmillan, London .1979: 159-72.##Rampello A, Franceschini M, Piepoli M, et al. Effect of Aerobic Training on Walking Capacity and Maximal Exercise Tolerance in Patients with Multiple Sclerosis: A Randomized Crossover Controlled Study. Physical therapy. 2007; 87(5):545-55.##Halabchi F, Alizadeh Z, Sahraian MA, et al. Exercise Prescription for Patients with Multiple Sclerosis Potential Benefits and Practical Recommendations. BMC Neurology. 2017; 17(1):185.##Dalgas U, Stenager E, Jakobsen J, et al. Resistance Training Improves Muscle Strength and Functional Capacity in Multiple Sclerosis. Neurology. 2009; 73(3):1478-84.##Dalgas U, Stenager E, Jakobsen J, et al. Fatigue, Mood and Quality of Life Improve in MS Patients after Progressive Resistance Training. Multiple Sclerosis Journal. 2010; 16(4):480-90.##Dalgas U, Stenager E, Jakobsen J, et al. Muscle Fiber Size Increases Following Resistance Training in Multiple Sclerosis. Multiple Sclerosis Journal. 2010; 16(11): 1367-76.##Dalgas U, Stenager E, Lund C, et al. Neural Drive Increases Following Resistance Training in Patients with Multiple Sclerosis. Journal of Neurology. 2013; 260(7): 1822-32.##Mostert S, Kesselring J. Effect of A Short-Term Exercise Training Program on Aerobic Fitness, Fatigue, Health Perception and Activity Level of Subjects with Multiple Sclerosis. Multiple Sclerosis Journal. 2002; 8(2): 61-168.##Newman MA, Dawes H, van den Berg M, et al. Can Aerobic Treadmill Training Reduce The Effort of Walking and Fatigue in People with Multiple Sclerosis: A Pilot Study. Multiple Sclerosis Journal. 2007; 13(1):113-9.##Pazokian M, Shabani M, Zakerimoghdam M, et al. The Effect of Stretching Together Aerobic Exercise on Fatigue Level in Multiple Sclerosis Patients Refer to MS Society of Iran Those Suffer From Fatigue. Journal of Holistic Nursing and Midwifery. 2012; 22(2):18-24. [Persian]##Shanazari Z, Marandi M, Minasian V. Effect of 12 Week Pilates and Aquatic Traianing on Fatigue in Women with Multiple Sclerosis. Journal of Mazandaran University of Medical Sciences. 2013; 23(98): 257-64. [Persian]##Bolouchi R, Ghyasi A, Naderi A, et al. The Survey of Cawthorne and Cooksey Exercise on the Quality of Life, Balance and Fatigue in Patients with Multiple Sclerosis. Journal of Ilam University of Medical Sciences. 2014; 21(7): 43-53. [Persian]##Taheri Torbati H, Mahjor M, Enferadi A. Comparison of Single and Dual Task Balance Training on Balance in the Women with Multiple Sclerosis. Journal of Kurdistan University of Medical Sciences. 2016; 20(6): 34-43. [Persian]##Farsi A, Akbar PS, Mosavi MK.V, et al. Effect of Pilates Training Based on Core Stability on Balance and Electromyography of Women with Multiple Sclerosis. The Scientific Journal of Rehabilitation Medicine. 2017; 6(3): 165-173. [Persian]##Sarvari, Fatemeh, Ebrahimi Atri, Ahmad, Saeedi, Morteza, Khorshid Sokhangooy, Maryam. The relationship between lower extremity strength and dynamic balance in patients with multiple sclerosis. Eighth International Conference on MS. 2011: 1-17.##Kurdi M, Anoosheh L, Khodadadh S, et al. The Effect of Selected Combined Training on Strength, Balance and Life Quality of Patients Multiple Sclerosis. Journal of Sport Medicine. 2011; 2(5): 46-59. [Persian]##Cattaneo D, Jonsdottir J, Zocchi M, et al. Effect of balance exercise on people with multiple sclerosis, a pilot study. 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