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Prevalence of Anemia in Pregnant Women and Its Associated Socioeconomic Factors 2 1   2 Background: Anemia during pregnancy is an important public health problem, in developing countries. This community based study was conducted in Northeast India to study the prevalence of anemia along with the associated socioeconomic factors. Methods: The present one-year cross sectional study was carried out in the selected villages under Lahowal Block of Dibrugarh District and the relevant data was collected in a pre-designed and pre-tested proforma by house to house interviews. The sample size was calculated 310. Clinical examination was done and haemoglobin estimation was performed using Sahli’s acid hematin method. Data were analyzed in Microsoft Excel using percentage, range, t-test and ANOVA; wherever applicable. A significance level of 5% was taken with 95% confidence interval Results: Anemia was seen in 89.68% of the subjects. The highest mean hemoglobin (Hb) level was observed in the 1st trimester subjects (9.14 gm/dl), while the lowest mean Hb-level was observed in the 3rd trimester subjects (8.90 gm/dl). A significant difference was observed between the mean Hb-levels of the study subjects belonging to nuclear families and joint families, subjects belonging to different socio-economic status, different levels of education, different professions, those consuming tobacco and those not consuming tobacco, and those consuming betel nut and not consuming betel nut. Conclusion: There was a high prevalence of anemia in pregnancy which was related to the socioeconomic status, occupational status, level of education, type of family, and personal habits in these women.   1 7 2023/02/12 1401/11/23 2023/06/28 1402/4/7 Gobil Thapa Gobil Thapa Department of Community Medicine, Tinsukia Medical College, Tinsukia, India India gobilthapa0@gmail.com Swagata Dowerah Swagata Dowerah Department of Pathology, Tinsukia Medical College, Tinsukia, India India swagatadowerah@gmail.com Anemia Pregnancy Hemoglobin 1. World Health Organization. Iron defciency anaemia: assessment, prevention and control: a guide for programme managers; 2001.##2. World Health Organization. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia; 2008.##3. Tolentino K, Friedman JF. An update on anemia in less developed countries. The American journal of tropical medicine and hygiene. 2007; 77(1): 44-51.##4. Balarajan Y, Ramakrishnan U, Özaltin E, et al. Anaemia in low-income and middle-income countries. The lancet. 2011; 378(9809): 2123-35.##5. Crawley J. Reducing the burden of anemia in infants and young children in malaria-endemic countries of Africa: from evidence to action. The Intolerable Burden of Malaria II: What's New, What's Needed: Supplement to Volume 71 (2) of the American Journal of Tropical Medicine and Hygiene. 2004; 71(Suppl): 25-34.##6. Maskey M, Jha N, Poudel SI, et al. Anemia in pregnancy and its associated factors: A study from Eastern Nepal. Nepal journal of epidemiology. 2014; 4(4): 386-92.##7. Abay A, Yalew HW, Tariku A, et al. Determinants of prenatal anemia in Ethiopia. Archives of Public Health. 2017; 75: 1-0.##8. International Institute for Population Sciences (IIPS) and ICF.Assam: NFHS4 (2015-16). [Online]; 2015. Available at: URL: http://rchiips.org/NFHS/NFHS-4Reports/Assam.pdf..##9. Nternational Institute for Population Sciences (IIPS) and ICF. Assam:NFHS3 (2005 -06). [Online]; 2006. Available at: URL: http://rchiips.org/nfhs/pdf/Assam.pdf.##10. International Institute for Population Sciences (IIPS) and ICF.Assam: NFHS5 (2019-20). [Online]; 2020. Available at: URL: https://nhm.assam.gov.in/sites/default/files/swf_utility_folder/departments/nhm_lipl_in_oid_6/ menu/document/factsheet_as.pdf.##11. Saxena V, Srivastava VK, Idris MZ, et al. Nutritional status of rural pregnant women. Indian Journal of community medicine. 2000; 25(3): 104-7.##12. Suryanarayana R, Chandrappa M, Santhuram AN, et al. Prospective study on prevalence of anemia of pregnant women and its outcome: A community based study. Journal of family medicine and primary care. 2017; 6(4): 739.##13. Viveki RG, Halappanavar AB, Viveki PR, et al. Prevalence of anaemia and its epidemiological determinants in pregnant women. Al Ameen J Med Sci. 2012; 5(3): 216-3.##14. Toteja GS, Singh P, Dhillon BS, et al. Prevalence of anemia among pregnant women and adolescent girls in 16 districts of India. Food and Nutrition Bulletin. 2006; 27(4): 311-5.##15. Gautam VP, Bansal Y, Taneja OK, et al. Prevalence of anaemia amongst pregnant women and its socio-demographic associates in a rural area of Delhi. Indian Journal of Community Medicine. 2002; 27(4): 157.##16. Tiwari J, Linson CC. A Study on Prevalence of Anemia among Pregnant Women Attending Antenatal Clinic at Rural Health Centre (RHC) and Hospital, Jabalpur City, MP. Journal of Pharmaceutical Research International. 2021; 33(49B): 335-42.##17. Lokare PO, Karanjekar VD, Gattani PL, et al. A study of prevalence of anemia and sociodemographic factors associated with anemia among pregnant women in Aurangabad city, India. Annals of Nigerian Medicine. 2012; 6(1): 30.##18. Sahoo S, Panda B. A study of nutritional status of pregnant women of some villages in Balasore district, Orissa. Journal of Human Ecology. 2006; 20(3): 227-32.##19. Siddiqui MZ, Goli S, Reja T, et al. Prevalence of anemia and its determinants among pregnant, lactating, and nonpregnant nonlactating women in India. Sage Open. 2017; 7(3): 2158244017725555.##20. Sarala V, Gopalan U. A study on prevalence of anemia in pregnancy in South India. Int J Reprod Contracept Obstet Gynecol. 2020; 9(1).##21. Ahmad N, Kalakoti P, Bano R, et al. The prevalence of anemia and associated factors in pregnant women in a rural Indian community. AMJ. 2010; 3(5): 276-80.##22. KavithaK,SumayaaS, RavukumarS,et al. A study on nutritional status of pregnant women of rural area in Ramanathapuram district,Tamil Nadu. International Journal of current research. 2011; 3(11).##23. Gautam VP, Taneja DK, Sharma N, et al. Dietary aspects of pregnant women in rural areas of Northern India. Matern Child Nutr. 2008; 4(2): 86-94. doi:10.1111/j.1740-8709.2007.00131.x.## ##

Relationship between Risk Level, Risk Perception and Preventive Behaviors of Myocardial Infarction and Stroke in People Aged 30 to 60 Years of Jiroft City, South of Iran in 2022 2 2 Background: Among non-communicable diseases, myocardial infarction (MI) and stroke are the most common cause of death in the world. The current study aimed to investigate the relationship between risk level and preventive behaviors of heart in people aged 30 to 60 years of Jiroft city in 2022. Methods: This research was a cross-sectional study. The population under study is 383 middle-aged individuals (30-60 year) of Jiroft city with the combined sampling method. The data collection tools was reseacher made, included demographic questions, risk perception questionnaires, and preventive behavior questions for MI and stroke. Information was analyzed by SPSSv21 software and further analyzed with descriptive statistics tests, chi-square test, independent t-test, one-way ANOVA, and Pearson correlation test at level 0.05. Results: The participants' average age was 41.26 ± 8.32 years. The highest percentage (51.4%) of middle-aged individuals had a risk level between 10 and 20% for cardiovascular diseases. The study investigated a significant correlation (p < 0.01) between risk level, risk perception, and preventive behaviors for MI and stroke. Smoking and physical activity failed to reveal a significant correlation (p > 0.05), but other dimensions of preventive behaviors correlated positively and significantly with the total score of preventive behaviors (p < 0.01). Conclusion: According to study findings, risk perception plays a significant role in influencing preventive behaviors for MI and stroke. It is recommended to conduct educational interventions to enhance understanding of the actual risk of MI and stroke, particularly among individuals with a high-risk assessment level. This would encourage the adoption of preventive behaviors in this population. 8 17 2023/02/122023/12/5 1402/9/14 2023/06/282024/02/12 1402/11/23 Reza Faryabi Reza Faryabi Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran Iran behdasht2020@yahoo.com Aboubakr Jafarnezhad Aboubakr Jafarnezhad Department of Epidemiology, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Iran ajafarnejad0@gmail.com Salman Daneshi Salman Daneshi Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran Iran salmandaneshi008@gmail.com Risk Perception Preventive Behavior Myocardial infarction Stroke 1. Gaidai O, Cao Y, Loginov S. Global cardiovascular diseases death rate prediction. Current Problems in Cardiology. 2023: 101622.##2. Nowbar AN, Gitto M, Howard JP, et al. Mortality from ischemic heart disease: Analysis of data from the World Health Organization and coronary artery disease risk factors From NCD Risk Factor Collaboration. Circulation: cardiovascular quality and outcomes. 2019; 12(6): e005375.##3. Mensah GA, Roth GA, Fuster V. The global burden of cardiovascular diseases and risk factors: 2020 and beyond. Journal of the American College of Cardiology. 2019; 74(20): 2529-32.##4. Organization WH. Cardiovascular diseases: WHO; 2023. Available at: URL: https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1s.##5. Sarrafzadegan N, Mohammmadifard N. Cardiovascular disease in Iran in the last 40 years: prevalence, mortality, morbidity, challenges and strategies for cardiovascular prevention. Archives of Iranian medicine. 2019; 22(4): 204-10. [Persian]##6. Control CfD, Prevention. A public health action plan to prevent heart disease and stroke: US Department of Health and Human Services, Centers for Disease Control and prevention. 2003.##7. Albelbeisi AH, Albelbeisi A, El Bilbeisi AH, et al. Capacity of Palestinian primary health care system to prevent and control of non-communicable diseases in Gaza Strip, Palestine: A capacity assessment analysis based on adapted WHO-PEN tool. The International Journal of Health Planning and Management. 2020; 35(6): 1412-25.##8. Zhang XH, Lisheng L, Campbell NR, et al. Implementation of World Health Organization Package of Essential Noncommunicable Disease Interventions (WHO PEN) for primary health care in low-resource settings: a policy statement from the World Hypertension League. The Journal of Clinical Hypertension. 2016; 18(1): 5.##9. Pearson TA. Public policy approaches to the prevention of heart disease and stroke. Circulation. 2011; 124(23): 2560-71.##10. Sjöberg L, Moen BE, Rundmo T. Explaining risk perception. An evaluation of the psychometric paradigm in risk perception research. 2004; 10(2): 665-12.##11. Grima S, Hamarat B, Özen E, et al. The relationship between risk perception and risk definition and risk-addressing behaviour during the early COVID-19 stages. Journal of Risk and Financial Management. 2021 Jun 17; 14(6): 272.##12. Tunsi AY. An Exploration of the Factors that Influence the Adoption of Healthy Lifestyles Among Saudis Living with Cardiovascular Disease (CVD) (Doctoral dissertation, University of Edinburgh). 2019.##13. Ren H, Guo YF, Zhang ZX, et al. Perception of recurrent risk versus objective measured risk of ischemic stroke in first-ever stroke patients from a rural area in China: A cross-sectional study. Patient Education and Counseling. 2023; 107: 107586.##14. Gholizadeh L, Davidson P, Salamonson Y, et al. Theoretical considerations in reducing risk for cardiovascular disease: implications for nursing practice. Journal of Clinical Nursing. 2010; 19(15-16): 2137-45. [Persian]##15. World Health Organization. WHO package of essential noncommunicable (PEN) disease interventions for primary health care. WHO; 2020.##16. Faryabi R, Daneshi S, Davarani ER, et al. The assessment of risk factors and risk perception status of breast cancer in Northern Iran. BMC Women's Health. 2023; 23(1): 1-7. [Persian]##17. Jahani M, Barzegar M, Abbasi M, et al. Analysis of the Results of Cardiovascular Disease Risk Assessment Program. Journal of Babol University of Medical Sciences. 2021; 23(1): 236-43. [Persian]##18. Van der Aalst CM, Denissen SJ, Vonder M, et al. Screening for cardiovascular disease risk using traditional risk factor assessment or coronary artery calcium scoring: the ROBINSCA trial. European Heart Journal-Cardiovascular Imaging. 2020; 21(11): 1216-24.##19. Kharghani Z, Hoseinalizade MR, Ilati A, et al. Evaluating the average risk of cardiovascular disease in employees over 30 years of age in Shariati hospital in Mashhad in 2018. medical journal of mashhad university of medical sciences. 2019; 61(6): 1294-301. [Persian]##20. Guo Z, Yuan Y, Fu Y, et al. Cardiovascular disease risk perception among community adults in South China: a latent profile analysis. Frontiers in Public Health. 2023; 11: 1073121.##21. Dearborn JL, McCullough LD. Perception of risk and knowledge of risk factors in women at high risk for stroke. Stroke. 2009; 40(4): 1181-6.##22. Barnhart JM, Wright ND, Freeman K, et al. Risk perception and its association with cardiac risk and health behaviors among urban minority adults: the Bronx Coronary Risk Perception study. American journal of health promotion. 2009; 23(5): 339-42.##23. Everett B, Salamonson Y, Rolley JX, et al. Underestimation of risk perception in patients at risk of heart disease. European Journal of Cardiovascular Nursing. 2016; 15(3): e2-9.##24. Meischke H, Sellers DE, Sellers DE, et al. Factors that influence personal perceptions of the risk of an acute myocardial infarction. Behavioral Medicine. 2000; 26(1): 4-13.##25. Abed MA, Khalil AA, Moser DK. Awareness of modifiable acute myocardial infarction risk factors has little impact on risk perception for heart attack among vulnerable patients. Heart & Lung. 2015; 44(3): 183-8.##26. Dearborn JL, McCullough LD. Perception of risk and knowledge of risk factors in women at high risk for stroke. Stroke. 2009; 40(4): 1181-6.##27. Wu Z, Li ZR, Dai YQ, et al. Relationship between risk perception and lifestyle in ischemic stroke patients with H-type hypertension. Annals of Palliative Medicine. 2020; 9(6): 3731-41.##28. Dearborn JL, McCullough LD. Perception of risk and knowledge of risk factors in women at high risk for stroke. Stroke. 2009; 40(4): 1181-6.##29. Thakkar J, Heeley EL, Chalmers J, et al. Inaccurate risk perceptions contribute to treatment gaps in secondary prevention of cardiovascular disease. Internal Medicine Journal. 2016; 46(3): 339-46.## ##

Legal Principles and Strategies to Encourage Citizens to Get Vaccinated against COVID-19 Virus 2 2 Background: Following the outbreak of COVID-19 pandemic, in some countries, mandatory vaccination programs were put to practice. However, there were widespread opposition against vaccination, which is investigated in this research. Methods: This was a descriptive-analytical research and data collection was conducted by referring to documents, books and articles in library. Results: With the emergence of corona virus in the world and the need to end this dangerous pandemic, various countries, including Iran's legal system, decided to implement "compulsory vaccination" mechanisms. The findings of this study indicated that the government from the perspective of various schools (even the school of individual originality) was not only allowed to legislate rules to make vaccination obligatory, but also it was expected to enact appropriate laws to create public safety. Conclusion: According to the principles of Islamic jurisprudence and law, including the priority of collective interests over the individual, the rule of no harm, and the authority of the Supreme Leader, the government is not only authorized but also obliged to enact laws for making vaccination obligatory. 18 21 2023/02/122023/12/52023/09/30 1402/7/8 2023/06/282024/02/122023/12/24 1402/10/3 Seyed Mostafa Mirmohamadi Meybodi Seyed Mostafa Mirmohamadi Meybodi Department of Law, Faculty of Theology, Meybod University, Meybod, Iran Iran mirmohamadi@meybod.ac.ir Nasrollah Jafari Nasrollah Jafari Department of Law, Faculty of Theology, Meybod University, Meybod, Iran Iran nasrjafari@meybod.ac.ir COVID-19 Right to Health Vaccination Quarantine Patient Rights 1. Imam Khomeini R. Tahrir al-Waseela. Imam Khomeini Publishing House. 2013; 1(548)##2. Aslani S, Seyed Mousavi MS, Hajipour Kondroud A. The Position of the Right to Health in the Constitution of the World Health Organization (WHO) and the Challenges of this Organization in Guaranteeing Health Rights. Medical Law Journal. 2023; 17(58): 105-23.##3. Azarnoosh M, Kafi AH. Legal Review of the Possibility of Forcing People to Inject Vaccines (Corona Virus) in Iran's Legal System. Medical Law Journal. 2023; 17(58): 79-90.##4. Aminzadeh E. Legal aspects of responsibility of WHO and the governments regarding the right to health during the pervasive diseases and economic sanctions. Medical Law Journal. 2021; 15(56): 725-40.##5. Makarem Shirazi N. Ta'zir and its scope, Qom - Iran, Imam Ali Ibn Abi Talib School (PBUH). 2004; 161##6. Mohebian GR, Mousavi SE, Mirzaei J. Jurisprudential Foundations of the Government's Civil Responsibility in Compensating for Damages Caused by the Corona Vaccine. Medical Law Journal. 2023; 17(58): 719-35.## ##

Breastfeeding Practices among Urban Mothers of Central Kerala, India: A Cross-Sectional Study 2 2 Background: The practice of breastfeeding is vital in child nutrition and morbidity. The authors aimed to determine breastfeeding practices and factors related to Exclusive Breastfeeding (EBF) among mothers with children aged six months to 2 years in an urban area of Thrissur district, Kerala, India. Methods: This was a community-based and cross-sectional study conducted on 339 mothers using cluster sampling in 2016 for one year in the urban area of Thrissur district, Kerala. Details regarding sociodemographic factors, obstetric history, child-related data and breastfeeding practices were collected from mothers using a pretested and semi-structured questionnaire. Analyses were done using SPSS16 and Epi Info 7. Results: The mean age of study population was 27.21 ± 4.27. 223 mothers (65.78 %, 95% CI = 60.43-70.77) initiated breastfeeding within 1 hour, and prelacteal feeding was observed in 25 cases (7.37%, 95% CI = 4.92-10.83). 99.71% practiced feeding on demand, and 30.97% (95% CI = 26.15- 36.24) of children were exclusively breastfed up to 6 months with mean duration of 3.95± 1.79 months. The mean age at which complementary feeding started was 4.83 ± 1.32 months. Cultural beliefs, mothers' employment, and problems during breastfeeding were significant predictors of EBF for up to 6months. Conclusion: Despite high educational status and good antenatal care among the study population, breastfeeding practices were not carried out at the recommended level. Breastfeeding was initiated within 1 hour of delivery by 2/3rd ,and  1/3rd of the children were exclusively breastfed up to 6 months. Cultural beliefs and mothers' employment were factors associated with EBF.   22 31 2023/02/122023/12/52023/09/302023/04/10 1402/1/21 2023/06/282024/02/122023/12/242023/08/5 1402/5/14 Fathimathusalma Othayoth Fathimathusalma Othayoth Department of Community Medicine, Government Medical College, Kozhikode, Kerala, India India fathimathusalmao@gmail.com Prabhakumari Chellamma Prabhakumari Chellamma Department of Community Medicine, Travancore Medical College, Kollam, Kerala, India India drcprabhakumari@gmail.com Sajna Mathumkunnath Vijayan Sajna Mathumkunnath Vijayan Department of Community Medicine, Government Medical College, Idukki, Kerala, India India mvsajna@yahoo.com Jackson Kulampallil Sebastian Jackson Kulampallil Sebastian Department of General Surgery, Government Medical College, Wayanad, Kerala, India India mailmejackson@gmail.com Rini Raveendran Rini Raveendran Department of Community Medicine, Government Medical College, Thrissur, Kerala, India India rinisujay@gmail.com Breastfeeding Practices Exclusive Breastfeeding Breastfed Prelacteal Feeding Central Kerala. 1. World Health Organization. Fact Sheets- Infant and Young child feeding. WHO; 2021. Available at: URL: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding. Accessed May 04, 2023.##2. World Health Organization. Indicators for assessing Breast feeding practices. Geneva: WHO; 1991.##3. The World Health Organization. Exclusive breastfeeding for six months best for everywhere. WHO; 2011.##4. Victora CG, Smith PG, Vaughan JP, et al. Evidence for protection against infant deaths from infectious diseases in Brazil Lancet. 1987; 2: 319-22##5. World Health Organization and the United Nations Children’s Fund (UNICEF). Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: implementing the revised Baby-friendly Hospital Initiative; 2018. Available at: URL: http://apps.who.int/iris. Accessed May 04, 2023.##6. Roy MP, Mohan U, Singh SK, et al. Determinants of prelacteal feeding in rural northern India. International journal of preventive medicine. 2014; 5(5): 658.##7. Chaturvedi M, Nandan D, Gupta S. Rapid assessment of infant-feeding practices in Agra district. Indian Journal of Community Medicine. 2007; 32(3): 227.##8. Bhattacharjya H, Das S, Mog C, et al. Breast feeding: Practices and determinants in rural area of west Tripura district of India. National Journal of Community Medicine. 2013; 4(04): 628-31.##9. International institute for population sciences. National Family Health Survey (NFHS-3), 2005-06: India. Vol. I. Mumbai: International Institute for Population Sciences. IIPS O; 2007.##10. Betran AP, De Onis M, Lauer JA, et al. Ecological study of effect of breast feeding on infant mortality in Latin America. Bmj. 2001; 323(7308): 303.##11. World Health Organization. Indicators for assessing infant and young child feeding practices- part 1: Definitions. Conclusions of a consensus meeting held 6-8 November 2007 in Washington D.C. Geneva: WHO; 2008.##12. Varshney AM, Kumar D, Patel M, et al. Determinants Of Breast-Feeding Practices in Urban Slums of a Taluka Headquarter of District Anand, Gujarat. National Journal of Community Medicine. 2012; 3(03): 534-7.## 13. Patel A, Badhoniya N, Khadse S, et al. Infant and young child feeding indicators and determinants of poor feeding practices in India: secondary data analysis of National Family Health Survey 2005-06. Food Nutr Bull. 2010; 31(2): 314-33## 14. Jones G, Steketee RW, Black RE, et al. How many child deaths can we prevent this year?. The lancet. 2003; 362(9377): 65-71.##15. Office of the Registrar General & Census Commissioner, India 2011. Census of India 2011. India: New Delhi; 2011. Available at: URL: https://censusindia.gov.in/2011- common/censusdataonline.html##16. International institute for population sciences (IIPS) and ICF. National Family Health Survey (NFHS- 5), 2019- 2021: India: Volume 1. Mumbai: IIPS and ICF; 2021. ##17. Office of the Registrar General & Census Commissioner, India. Census. India: New Delhi; 2011. Available at: URL: http://www.census2011.co.in/census/state/kerala/html. ## 18. Kumar BR, Dudala SR, Rao AR. Kuppuswamy’s socio-economic status scale–a revision of economic parameter for 2012. Int J Res Dev Health. 2013; 1(1): 2-4.## 19. International Institute for Population Sciences. The Concurrent Evaluation of National Rural Health Mission. Kerala: Mumbai; IIPS; 2009. ##20. Dongre AR, Deshmukh PR, Rawool AP, et al. Where and How Breastfeeding Promotion Initiatives Should Focus Its Attention? A Study from Rural Wardha. Indian J Community Med. 2010; 35(2): 226-9 ##21. Sagar MV, Mane V, Praveenkumar N, et al. A Community Based Study on Infant and Young Child Feeding Practices in Bhadravati Taluk, Shivamogga. Indian Journal of Public Health Research & Development. 2015; 6(3).##22. Satija M, Sharma S, Chaudhary A, et al. Infant and young child feeding practices in a rural area of North India. Asian journal of medical sciences. 2015; 6(6): 60-5.##23. International institute for population sciences. District Level Household and Facility survey (DLHS-4), 2012- 2013. Kerala: Mumbai; IIPS; 2013##24. Dukuzumuremyi JP, Acheampong K, Abesig J, et al. Knowledge, attitude, and practice of exclusive breastfeeding among mothers in East Africa: a systematic review. International breastfeeding journal. 2020; 15: 1-7.https://doi.org/10.1186/s13006-020-00313-9##25. Aarti P, AK R, KA N. Prevalence of exclusive breast feeding and its correlates in an urban slum in Western India. International e-Journal of Science, Medicine and Education. 2009: 14-8.##26. Subbiah N, Jeganathan A. Socio-cultural beliefs influencing breastfeeding practices among primi postnatal mothers residing in urban slum area of Delhi. Health Popul Perspect Issues. 2012; 35(2): 61-73.##27. Madhu K, Chowdary S, Masthi R. Breast feeding practices and newborn care in rural areas: a descriptive cross-sectional study. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2009; 34(3): 243.##28. Yadavannavar MC, Patil SS. Socio cultural factors affecting breast feeding practices and decisions in rural women. International Journal of Plant, Animal and Environmental Sciences. 2011; 1(2): 46-50.##29. Vyas S, Sharma P, Kandpal SD, et al. A community based study on breastfeeding practices in a rural area of Uttarakhand. National Journal of Community Medicine. 2012; 3(02): 283-7.##30. Banapurmath C R, Nagaraj M C, Banapurmath S, et al. Breastfeeding Practices in Villages of Central Karnataka. Indian Pediatr. 1996; 33(6): 477-9. ##31. Rahman M, Begum N, Rahman MM, et al. Breast Feeding Practices among Rural Women in a selected area of Bangladesh. Northern International Medical College Journal. 2014; 5(2): 345-8.##32. Randhawa A, Chaudhary N, Gill BS, et al. A population-based cross-sectional study to determine the practices of breastfeeding among the lactating mothers of Patiala city. Journal of family medicine and primary care. 2019; 8(10): 3207.##33. Nishimura H, Krupp K, Gowda S, et al. Determinants of exclusive breastfeeding in rural South India. International breastfeeding journal. 2018; 13(1): 1-7. https://doi.org/10.1186/s13006-018-0178-5.##34. Aldalili AY, El. Mahalli AA. Factors associated with cessation of exclusive breastfeeding. Journal of Multidisciplinary Healthcare. 2021: 239-46. https://doi.org/10.2147/JMDH.S277819.##35. Joseph N, Naik VA, Mahantshetti NS, et al. Factors associated with morbidities among infants in three sub centre areas of belgaum district of south India: A longitudinal study. Indian J Community Med. 2013; 38(3): 168-74.##36. Mihrshahi S, Oddy WH, Peat JK, et al. Association between infant feeding patterns and diarrhoeal and respiratory illness: a cohort study in Chittagong, Bangladesh. International breastfeeding journal. 2008; 3: 1-0.##37. Jennifer HG, Muthukumar K. A cross-sectional descriptive study was to estimate the prevalence of the early initiation of and exclusive breast feeding in the rural health training centre of a medical college in Tamilnadu, South India. Journal of clinical and diagnostic research: JCDR. 2012; 6(9): 1514.## ##

A Protocol for Patient Education Based on Andragogy: A Convergent Parallel Mixed Methods Study 2 2 Background: Patients' education is a key factor in patients' care. The purpose of this study is to design a protocol for a convergent parallel mixed methods study to explore the experiences of patients about their received educations based on andragogy model. Methods: This convergent parallel mixed method study includes two parallel quantitative and qualitative phases. During the quantitative phase, a cross-sectional survey will be conducted on 350 adult patients who had the history of hospitalization and received patient education from selected hospitals of Tehran, Iran. Sampling method will be random, and data collection tool will be a researcher-made questionnaire based on the principles of andragogy. The questionnaire’s validity and reliability are also measured, and data will be analyzed using SPSS 16. The qualitative phase will be conducted on adult patients who will be recruited purposively with maximum variation from the selected hospitals. Data will be gathered through semi-structured interviews and analyzed by directed content analysis. With regard to mixed method and using aligning convergence method, the results of the two sets of data will be compared or merged to see if the findings confirm or disconfirm each other. In this parallel section, the similarities between quantitative and qualitative results for assessing patient education are discussed and adapted to suit each other based on andragogy. Conclusions: The findings of this study will provide information regarding defects in patient education, suggesting that the principles of andragogy will develop patient education programs.   32 39 2023/02/122023/12/52023/09/302023/04/102023/12/19 1402/9/28 2023/06/282024/02/122023/12/242023/08/52024/04/15 1403/1/27 Mohtasham Ghaffari Mohtasham Ghaffari Department of Health Education and Promotion, School of Health & safety, Shahid Beheshti University of Medical Sciences. Tehran, Iran Iran mohtasham.gh@yahoo.com Sakineh Rakhshanderou Sakineh Rakhshanderou Department of Health Education and Promotion, School of Health & safety, Shahid Beheshti University of Medical Sciences. Tehran, Iran Iran s_rakhshandero@yahoo.com Reza Negarandeh Reza Negarandeh Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran Iran negarandeh@gmail.com Negin Niksadat Negin Niksadat 1. Department of Public Health, Faculty of health, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran 2. Department of Health Education and Promotion, School of Health & safety, Shahid Beheshti University of Medical Sciences. Tehran, Iran Iran Neginniksadat@yahoo.com Ali Ramzankhan Ali Ramzankhan Department of Health Education and Promotion, School of Health & safety, Shahid Beheshti University of Medical Sciences. Tehran, Iran Iran ali_ramezankhan@yahoo.com Ali Vasheghani Farahani Ali Vasheghani Farahani Cardiac primary prevention research center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran Iran Vasheghan@tums.ac.ir Patient Education Mixed Methods Research Qualitative Research Andragogy model 1. Day D. Postpartum patient teaching success: implications from nursing and patient perspectives [PhD Thesis in Education]: Walden University; 2014.##2. Juillière Y, Suty-Selton C, Riant E, et al. Prescription of cardiovascular drugs in the French ODIN cohort of heart failure patients according to age and type of chronic heart failure. Archives of Cardiovascular Diseases. 2014; 107)1(: 21-32.##3. De Melo Ghisi GL, Grace SL, Thomas S, et al. Behavior determinants among cardiac rehabilitation patients receiving educational interventions: An application of the health action process approach. Patient education and counseling. 2015; 98(5): 612-21.##4. Imani A, Imani E. Needs assessment of self-care training in patients with coronary artery disease in Bandar Abbas. Preventive Care in Nursing & Midwifery Journal. 2013; 3(1): 30-37. [Persian]##5. Norouzi H, Tohidi S, Moonaghi HK, et al. The Comporison of the Effects of the Lecture and Self-Learning Module on Nurses, Teaching-Competency to Cardiac Patient Education Cardiac Patient Education. J Mazandaran U Med Sci. 2014; 23(1): 197-202. [Persian]##6. Deyirmenjian M, Karam N, Salameh P. Preoperative patient education for open-heart patients: a source of anxiety? Patient Education and Counseling. 2006; 62(1): 111-117. ##7.Tahery N, Razavi Zadegan M, Kaiali M, et al. Importance of Patient education according Abadan nursing students’ opinions. Modern Care Journal. 2011; 8(2): 100-106. [Persian]##8. Boyde M, Grenfell K, Brown R, et al. What have our patients learnt after being hospitalised for an acute myocardial infarction? Australian Critical Care. 2015; 28: 134-139.##9. Holton EF, Wilson LS, Bates RA. Toward development of a generalized instrument to measure andragogy. Human Resource Development Quarterly. 2009; 20(2): 169-93.##10. Knowles MS, Holton EF, Swanson RA. The Adult Learner: The definitive classic in adult education and human resource development Burlington: MA: Elsevier; 2011.##11. Kennedy MBB, Parish AL. Educational theory and cognitive science: Practical principles to improve patient education. Nursing Clinics. 2021; 56(3): 401-12.##12. Hazavehei SMM, Sahabadi S, Hashemi SZ. The role of health education in reducing cardiovascular diseases risk factors: A systematic review. Knowledge and Health. 2014; 9(1): 30-42. [Persian]##13. Creswell JW, Plano Clark VL. Designing and conducting mixed methods research,choosing a mixed methods design, 2nd ed,3rd , SAGE publication;2011.##14. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005; (15): 1277-1288.##15. Templeton HR, Coates VE. Development of an education package for men with prostate cancer on hormonal manipulation therapy. Clinical Effectiveness in Nursing. 2003; 7(1): 33-42.##16. Van Wyk K, Backwell A, Townson A. A narrative literature review to direct spinal cord injury patient education programming. Topics in spinal cord injury rehabilitation. 2015; 21(1): 49-60.##17. Hopstock LA. Motivation and adult learning: A survey among hospital personnel attending a CPR course. Resuscitation. 2008; 76(3): 425-30.##18. Hill CA. Acute heart failure: too sick for discharge teaching? Critical care nursing quarterly. 2009; 32(2): 106-11.##19. Teasdale S, Bainbridge M, editors. Improving information management in family practice: testing an adult learning model. Proceedings of the AMIA Annual Fall Symposium; 1997: American Medical Informatics Association.##20. Niksadat N, Rakhshanderou S, Negarandeh R, Ramezankhani A, Farahani AV, Ghaffari M. Concordance of the cardiovascular patient education with the principles of Andragogy model. Archives of Public Health. 2022; 80(1): 1-10.##21. Kennedy MBB, Parish AL. Educational Theory and Cognitive Science: Practical Principles to Improve Patient Education. Nursing Clinics. 2021; 56(3): 401-12.##22. Mann KS. Education and health promotion for new patients with cancer: A quality improvement model. Clinical journal of oncology nursing. 2011; 15(1): 55.##23. Cullen MW, Geske JB, Anavekar NS, McAdams JA, Beliveau ME, Ommen SR, et al., editors. Reinvigorating continuing medical education: meeting the challenges of the digital age. Mayo Clinic Proceedings; 2019: Elsevier.##24. Sanchez LM, Cooknell LE. The Power of 3: Using adult learning principles to facilitate patient education. Nursing. 2017; 47(2): 17-9.## ##

Changes in Quality of Life among Patients with Chronic Low Back Pain in the Iranian Traditional Medicine Clinics 2 1   2 Background: Chronic low back pain (CLBP) is regarded as one of the most frequent and costly conditions which can affect patients’ quality of life. The current study aims to investigate changes in quality of life among patients with CLBP. Methods: Prospective observational study was performed from December 2021 to February 2022 in Baharan, Sina and Asadabadi traditional medicine clinics, Tabriz, Iran. Patients were recruited using a convenience sampling method, who were aged 20 years or older and had low back pain symptoms for 12 weeks or more.  Data were collected at baseline, one month and two month follow-up by interviewing the patients. The study tool was Short Form Health Survey (SF-12) questionnaire. Results: Out of 210 participants, 62.4% (131) were female. The change in mean score of life quality at the baseline, one- month and two-month follow-up was 23.76, 35.08 and 40.11, respectively (P = 0.0001).There were significant changes in all eight dimensions of life quality (P = 0.0001).  Additionally, younger Patients (50 ≥) had 1.35 scores of life quality higher than older patients (P = 0.021). Retired, self-employed, housewife and unemployed patients had 6.41, 4.68, 4.18 and 5.38 scores of quality of life lower than office workers, subsequently (P = 0.001). Furthermore, illiterate patients, patients with primary and high school educations had 5.76, 2.61 and 1.33 scores of quality of life less than patients with university degree (p < 0.05). Conclusion: ITM treatment method could contain several effects on the dimensions of quality of life among patients with CLBP. More detailed investigation is required to achieve greater accuracy.   40 49 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/4 1402/10/14 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/20 1403/2/1 Maryam Baradaran_Binazir Maryam Baradaran_Binazir Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran Iran maryam_baradaran@hotmail.com Fatemeh Ranjbar-Oskoui Fatemeh Ranjbar-Oskoui Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran Iran Seyyed Mohammadbagher Fazljou Seyyed Mohammadbagher Fazljou Department of Persian Medicine, Faculty of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Iran Delara Laghousi Delara Laghousi Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran Iran low back pain medicine traditional quality of life 1. Agnus Tom A, Rajkumar E, John R, et al. Determinants of quality of life in individuals with chronic low back pain: a systematic review. Health Psychology and Behavioral Medicine. 2022; 10(1): 124-44##2. Liang YD, Li Y, Zhao J, et al. Study of acupuncture for low back pain in recent 20 years: a bibliometric analysis via CiteSpace. Journal of pain research. 2017; 10: 951.##3. Noormohammadpour P, Mansournia MA, Koohpayehzadeh J, et al. Prevalence of chronic neck pain, low back pain, and knee pain and their related factors in community-dwelling adults in Iran. The Clinical journal of pain. 2017; 33(2): 181-7.##4. Suman A, Schaafsma FG, Bamarni J,et al. A multimedia campaign to improve back beliefs in patients with non-specific low back pain: a process evaluation. BMC Musculoskeletal Disorders. 2017; 18(1): 1-3.##5. Wong JJ, Côté P, Sutton DA, et al. Clinical practice guidelines for the noninvasive management of low back pain: A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. European journal of pain. 2017; 21(2): 201-16.##6. Tsang VH, Lo PH, Lam FT, et al. Perception and use of complementary and alternative medicine for low back pain. Journal of Orthopaedic Surgery. 2017; 25(3): 2309499017739480.##7. Sung WS, Jeon SR, Hong YJ, et al. Efficacy, safety, and cost-effectiveness analysis of adjuvant herbal medicine treatment, Palmijihwang-hwan, for chronic low back pain: a study protocol for randomized, controlled, assessor-blinded, multicenter clinical trial. Trials. 2019; 20(1): 1-1.##8. Chan E, Tan M, Xin J, et al. Interactions between traditional Chinese medicines and Western. Curr Opin Drug Discov Devel. 2010; 13(1): 50-65.##9. Nejat N, Rahbarian A, Mehrabi F, et al. Complementary and alternative medicine application in cancer patients in Iran. Journal of Cancer Research and Clinical Oncology. 2023; 149(6): 2271-7.##10. Ghaedi F, Dehghan M, Salari M, et al. Complementary and alternative medicines: usage and its determinant factors among outpatients in Southeast of Iran. Journal of evidence-based complementary & alternative medicine. 2017; 22(2): 210-5.##11. Malek VG, Parvari S, Abbassian A. Low back pain treatments in traditional iranian medicine. J Pharm Res Int. 2019; 27: 1-9.##12. Husky MM, Ferdous Farin F, Compagnone P, et al. Chronic back pain and its association with quality of life in a large French population survey. Health and quality of life outcomes. 2018; 16(1): 1-9##13. Namiranian P, Karimi M, Razavi SZE, et al. Comparison of an Iranian Traditional Massage (Fateh Method) with Physiotherapy and Acupuncture for Patients with Chronic Low Back Pain: a Randomized Controlled Trial. J Acupunct Meridian Stud. 2022; 15(3): 163-173.##14. Sanei M, Roozafzai F, Abousaidi SR, et al. Persian manual therapy method for chronic low-back pain with lumbar radiculopathy; a randomized controlled trial. Journal of Bodywork and Movement Therapies. 2020; 24(3): 123-30.##15. Allegri M, Montella S, Salici F, et al. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Research. 2016; 5. ##16. Tavafian SS, Jamshidi A, Mohammad K, et al. Low back pain education and short term quality of life: a randomized trial. BMC musculoskeletal disorders. 2007; 8(1): 1-6.##17. Montazeri A, Vahdaninia M, Mousavi SJ, et al. The Iranian version of 12-item Short Form Health Survey (SF-12): factor structure, internal consistency and construct validity. BMC public health. 2009; 9(1): 1-0.##18. Pan Z, Yang S, Ren X, et al. GEE can prominently reduce uncertainties from input data and parameters of the remote sensing-driven distributed hydrological model. Science of the Total Environment. 2023; 870: 161852.##19. Leem J, Kim H, Jo HG, et al. Efficacy and safety of thread embedding acupuncture combined with conventional acupuncture for chronic low back pain: A study protocol for a randomized, controlled, assessor-blinded, multicenter clinical trial. Medicine. 2018; 97(21): e10790.##20. Lee HJ, Choi BI, Jun S, et al. Efficacy and safety of thread embedding acupuncture for chronic low back pain: a randomized controlled pilot trial. Trials. 2018; 19(1): 1-0.##21. Farhadi K, Schwebel DC, Saeb M, et al. The effectiveness of wet-cupping for nonspecific low back pain in Iran: a randomized controlled trial. Complementary therapies in medicine. 2009; 17(1): 9-15.##22. Hohmann CD, Stange R, Steckhan N, et al. The Effectiveness of Leech Therapy in Chronic Low Back Pain: A Randomized Controlled Trial. Deutsches Ärzteblatt International. 2018; 115(47): 785.##23. Parapia LA. History of bloodletting by phlebotomy. British journal of haematology. 2008; 143(4): 490-5.##24. Farhadi K, Schwebel DC, Saeb M, et al. The effectiveness of wet-cupping for nonspecific low back pain in Iran: a randomized controlled trial. Complementary therapies in medicine. 2009; 17(1): 9-15.##25. Michalsen A, Klotz S, Ldtke R, et al. Effectiveness of leech therapy in osteoarthritis of the knee: a randomized, controlled trial. Annals of internal medicine. 2003; 139(9): 724-30.##26. Solhi H, Salehi B, Alimoradian A, et al. Beneficial Effects of Rosmarinus Officinalis for Treatment of Opium Withdrawal Syndrome during Addiction Treatment Programs: A Clinical Trial. Addiction & Health. 2013; 5(3-4): 90-4.##27. Tavafian SS, Jamshidi A, Mohammad K, et al. Low back pain education and short term quality of life: a randomized trial. BMC musculoskeletal disorders. 2007; 8(1): 1-6.##28. Horng YS, Hwang YH, Wu HC, et al. Predicting health-related quality of life in patients with low back pain. Spine (Phila Pa 1976). 2005; 30(5): 551-5. doi: 10.1097/01.brs.0000154623.20778.f0. PMID: 15738789.##29. Wettstein M, Eich W, Bieber C, et al. Pain intensity, disability, and quality of life in patients with chronic low Back pain: does age matter?. Pain Medicine. 2019; 20(3): 464-75.##30. Westerhof GJ, Keyes CLM. Mental illness and mental health: The two continua model across the life-span. J Adult Dev 2010; 17(2): 110–9.##31. Alemanno F, Houdayer E, Emedoli D, et al. Efficacy of virtual reality to reduce chronic low back pain: Proof-of-concept of a non-pharmacological approach on pain, quality of life, neuropsychological and functional outcome. PloS one. 2019; 14(5): e0216858.## ##

Exploring the Determinants of Diabetes’ Self-Care Practices among the Diabetics Living in Urban Field Practice Area of Medical College in Hyderabad 2 2 Background: Diabetes is a chronic disease, and among the adults, type II diabetes is more common. In 2021, approximately 537 million adults between 20 to79 suffered from diabetes. Diabetics who follow self-care practices can manage their blood glucose levels better, which in turn prevents the secondary complications. Methods: This was a community-based and cross-sectional study performed in the urban field practice (UHC) area of a tertiary care medical college conducted on 110 type II diabetics. The ‘summary of diabetes self-care activities’ questionnaire was used for data collection. Results: Mean age was 53 +/- 7.6, 70% of whom were females and 45.4% were lower-middle Socio-Economic Status. 33% of the participants had uncontrolled diabetes. The majority of study subjects (68.2%) suffered from hypertension as a co-morbidity, followed by heart disease (10.9%), thyroid disease (10%), and hypercholestrolism (1.8%). 62.7% of the subjects showed treatment adherence for > 4 days/week. Diabetics who had the disease for more than 5 years and followed a proper diet and adhered to treatment (> 4 d/week), showed a better control of glucose levels. Conclusion: The findings of this study can be used to strengthen NPCDCS program to bridge the knowledge gap regarding self-care among patients and caregivers.   50 55 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/8 1402/9/17 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/12 1402/11/23 Jayasuriya Jayabalan Jayasuriya Jayabalan Department of community medicine, Osmania medical college, Hyderabad, India India jayasuriyajayabalan@gmail.com Misha Gorantla Misha Gorantla Department of community medicine, Osmania medical college, Hyderabad, India India misha.gorantla@gmail.com B Kiranmai B Kiranmai Department of community medicine, Osmania medical college, Hyderabad, India India andasukiranmai@gmail.com Type II Diabetes Self-Care Practices Diabetic Foot Care 1. International Diabetes Federation, diabetes facts and figures, dec 2021. Available at: URL: https://www.idf.org/ aboutdiabetes/what-is-diabetes/facts-figures.html. Accessed May, 2023.##2. World Health Organisation- Diabetes, Key facts, 5 April 2023. Available at: URL: https://www.who.int/news-room/fact-sheets/detail/diabetes. Accessed May 31, 2023.##3. Rajasekharan D, Kulkarni V, Unnikrishnan B, et al. Self-care activities among patients with diabetes attending a tertiary care hospital in Mangalore Karnataka, India. Annals of medical and health sciences research. 2015; 5(1): 59-64.##4. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA. 2002: 288: 1775–9. doi: 10.1001/jama.288.14.1775##5. American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010; 33(supplement 1): S11–S61##6. 4. Sigal RJ, Kenny GP, Wasserman DH, et al. Physical activity/exercise and type 2 diabetes. Diabetes Care. 2004; 27(10): 2518–2539##7. Tomky D, Tomky D, Cypress M, et aL. Aade position statement. The Diabetes Educator. 2008; 34(3): 445-9.##8. Mohandas A, Bhasin SK, Upadhyay M, et al. Diabetes self-care activities among adults 20 years and above residing in a resettlement colony in East Delhi. Indian journal of public health. 2018; 62(2): 104-10.##9. American Diabetes Association. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care. 2002; 25(1): 202–212. ##10. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes care. 2000; 23(7): 943-50.##11. Chandrika K, Das BN, Syed S, et al. Diabetes Self-Care Activities: A Community-Based Survey in an Urban Slum in Hyderabad, India. Indian J Community Med. 2020; 45(3): 307-310.##12. Chittooru CS, Ananda KG, Panati D, et al. Self-care practices and its determinants among diabetic population in rural Andhra Pradesh, India: A cross-sectional study. Clinical Epidemiology and Global Health. 2022; 16: 101102.##13. Viswanathan V, Thomas N, Tandon N, et al. Profile of diabetic foot complications and its associated complications—a multicentric study from India. Journal of Association of Physicians of India. 2005; 53: 933–936.##14. Karthik RC, Radhakrishnan A, Vikram A, et al. Self-care practices among type II diabetics in rural area of Kancheepuram district, Tamil Nadu. Journal of family medicine and primary care. 2020; 9(6): 2912-8.##15. Pati S, Schellevis FG. Prevalence and pattern of co morbidity among type2 diabetics attending urban primary healthcare centers at Bhubaneswar (India). PLoS One. 2017; 12(8): e0181661. ##16. Raithatha SJ, Shankar SU, Dinesh K. Self-care practices among diabetic patients in Anand district of Gujarat. International Scholarly Research Notices. 2014.##doi: 10.1155/2014/743791##17. Dasappa H, Prasad S, Sirisha M, et al. Prevalence of self-care practices and assessment of their sociodemographic risk factors among diabetes in the urban slums of Bengaluru. J Family Med Prim Care. 2017; 6(2): 218-221.## ##

Cross cultural adaptation, reliability and validity of the Persian version of COVID-19 Preventive Measures questionnaire at the radiation therapy center in Yazd, Iran 2 2 Background: Due to the crowds of people in radiation therapy centers and the importance of not interrupting the treatment process, preventive measures to deal with COVID-19 is one of the most important measures; therefore, this study aimed to evaluate the intercultural compatibility, reliability and validity of COVID-19 prevention measures in a radiation therapy center. Methods: This analytical cross-sectional study was performed with 20 personnel at the radiation therapy center of Yazd, Iran, using a census method in September 2021. A 29 items COVID-19 prevention scale was used as measurement tool. First, cultural adaptation was performed and then face validity was determined by calculating the Impact Score. Content validity was assessed by calculating the content validity ratio (CVR) and content validity index (CVI) and reliability was determined using the Test-Retest method and Kuder–Richardson (KR20) alpha coefficient and calculating intra-class correlation coefficient (ICC). All analyses were performed in SPSS software version 24 with a significance level of 5%.   Results: 30% (6 people) were male and 70% (40 people) had   less than 15 years of work experience. Four items of the questionnaire were removed based on the minimum Lawshe's CVR values, as their CVR was less than 0.62. Finally, the Kuder Richardson coefficient, Scale-level CVI, and ICC were 0.827, 0.98, and 0.52, respectively. Conclusion:  The validity and reliability of the questionnaire were confirmed; therefore, this Persian version of 25-item scale is proposed as a suitable and effective tool for COVID-19 prevention measures in Persian language countries. 56 68 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/4 1402/9/13 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/15 1402/12/25 Farzan Madadizadeh Farzan Madadizadeh Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran F.Madadizadeh@ssu.ac.ir Sepideh Abdollahi-Dehkordi Sepideh Abdollahi-Dehkordi Departments of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Iran Abdollahimph@Gmail.Com Nima Hamzian Nima Hamzian Departments of Medical Physics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Iran Hamzian.Nima@Gmail.Com korosh saber korosh saber Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Iran korosh.iut@gmail.com COVID-19 Radiotherapy Validity and Reliability 1. Coronavirus N. Situation Report–11. Available at: UPL: https://www. who. int/docs/default-source/coronaviruse/situation-reports/20200131-sitrep-11-ncov. pdf? sfvrsn= de7c0f7_4. Accessed Feb 1, 2020.##2. Liu J, Zheng X, Tong Q, et al. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS‐CoV, MERS‐CoV, and 2019‐nCoV. Journal of medical virology. 2020; 92(5): 491-4.##3. O'Connor RC, Wetherall K, Cleare S, et al. Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study. The British Journal of Psychiatry. 2021; 218(6): 326-33.##4. Dai M, Liu D, Liu M, et al. Patients with cancer appear more vulnerable to SARS-CoV-2: a multicenter study during the COVID-19 outbreak. Cancer discovery. 2020; 10(6): 783-91.##5. Bansal N, Ghafur A. COVID-19 in oncology settings. Cancer Research, Statistics, and Treatment. 2020; 3(5): 13.##6. Xia Y, Jin R, Zhao J, et al. Risk of COVID-19 for cancer patients. Lancet Oncol. 2020; 21(4).##7. Tison GH, Avram R, Kuhar P, et al. Worldwide effect of COVID-19 on physical activity: a descriptive study. Annals of internal medicine. 2020; 173(9): 767-70.##8. Reed SC, Bell JF, Miglioretti DL, et al. Fear of cancer recurrence and associations with mental health status and individual characteristics among cancer survivors: Findings from a nationally representative sample. Journal of psychosocial oncology. 2020; 38(2): 125-42.##9. Borras JM, Lievens Y, Dunscombe P, et al. The optimal utilization proportion of external beam radiotherapy in European countries: an ESTRO-HERO analysis. Radiotherapy and Oncology. 2015; 116(1): 38-44.##10. Wang Y, Duan Z, Ma Z, et al. Epidemiology of mental health problems among patients with cancer during COVID-19 pandemic. Translational psychiatry. 2020; 10(1): 1-10.##11. Hamzian N, Shabani M, Saber K, et al. Evaluation of Safety Measures and Related Factors in Yazd Radiation Therapy Center in the Face of Covid-19 in 2020. Journal of Shahid Sadoughi University of Medical Sciences; 2023. [Persian]##12. Ornell F, Schuch JB, Sordi AO, et al. “Pandemic fear” and COVID-19: mental health burden and strategies. SciELO Brasil. 2020; 232-5.##13. Simcock R, Thomas TV, Estes C, et al. COVID-19: Global radiation oncology’s targeted response for pandemic preparedness. Clinical and translational radiation oncology. 2020; 22: 55-68.##14. Montesi G, Di Biase S, Chierchini S, et al. Radiotherapy during COVID-19 pandemic. How to create a No fly zone: a Northern Italy experience. La radiologia medica. 2020; 125(6): 600-3.##15. Tamari K, Nagata Y, Nishiki S, et al. Nationwide survey of COVID-19 prevention measures in Japanese radiotherapy departments via online questionnaire for radiation oncologists. Radiotherapy and Oncology. 2020; 149: 219-21.##16. Ghanbari-Firoozabadi M, Mirzaei M, Nasab MV, et al. Cross-cultural adaptation and psychometric validation of the Persian version of the Cardiac Rehabilitation Barriers Scale (CRBS-P). BMJ open. 2020; 10(6): e034552. [Persian]##17. Abdollahipour F, Alizade ZM, Akbarfahimi M, et al. Study of face and content validity of the Persian version of behavior rating inventory of executive function, preschool version. 2016. [Persian]##18. Yusoff MSB. ABC of content validation and content validity index calculation. Resource. 2019; 11(2): 49-54.##19. Lawshe CH. A quantitative approach to content validity. Personnel psychology. 1975; 28(4): 563-75.##20. Polit DF, Beck CT. The content validity index: are you sure you know what's being reported? Critique and recommendations. Research in nursing & health. 2006; 29(5): 489-97.##21. Cortina JM. What is coefficient alpha? An examination of theory and applications. Journal of applied psychology. 1993; 78(1): 98.##22. Ritter NL. Understanding a widely misunderstood statistic: Cronbach's. Online Submission. 2010.##23. Saber K, Hamzian N, Madadizadeh F. COVID-19 Anxiety and Related Factors in Cancer Patients Undergoing External Radiation Therapy. Asian Pacific Journal of Cancer Care. 2022 Aug 12; 7(3): 451-8. [Persian]##24. Pezzulla D, Macchia G, Taccari F, et al. Radiotherapy in Southern Italy at the time of COVID-19: options for radiation oncology units. BMJ Specialist Journals; 2020.##25. Han JW, Park J, Lee H. Effect of exposure to COVID‐19 infodemic on infection‐preventive intentions among Korean adults. Nursing Open. 2021.##26. Srivastava A, Srivastava S, Upadhyay R, et al. Stressor combat strategies and motivating factors among health care service providers during COVID-19 pandemic. Cureus. 2021; 13(4).##27. Mohebbi Z, Ershadpoor R, Ostovari M, et al. Radiation Protection Capability of Operating Room Personnel: Development and Psychometric Properties of a Questionnaire. Journal of Biomedical Physics & Engineering. 2021; 11(5): 603. [Persian]##28. Alavi SS, Dabbagh ST, Abbasi M, et al. Medical radiation workers’ knowledge, attitude, and practice to protect themselves against ionizing radiation in Tehran Province, Iran. Journal of education and health promotion. 2017; 6. [Persian]##29. Saadati M, Rezapour R, Khasraghi JS. Safety Status of Imaging Ward in Public and Private Hospitals. Depiction of Health. 2021; 12(2): 105-12. [Persian]## ##

Modeling the Structural Relationships of Attachment Styles with Readiness for Addiction with the Mediation Cognitive Regulation of Emotion in Addicts Who Are Quitting 2 1   2 Background: This research aimed to model the structural relationships of attachment styles with for addiction readiness with mediating variable cognitive regulation of emotion in quitting drug addicts. Methods: This is an analytical-cross-sectional study. The sample included 300 rehabilitated addicts (18 to 55 years old) were selected from 4 addiction treatment centers in Amol city in 1401 using stratified random sampling. The tools used in this research were the questionnaire on attachment styles, readiness for addiction,cognitive regulation of emotions. Data analysis was perfprmed based on structural equation modeling in Amos 22 software. Results: The findings manifested that attachment styles affect addiction readiness with the mediating variable being cognitive regulation of emotions in recovering addicts (P = 0.006, P = 0.0001). Attachment styles were directly related to the cognitive regulation of emotions in recovering addicts (P = 0.0001). Cognitive regulation of excitement had a direct association with readiness for addiction in drug addicts who are quitting (P = 0.0001). Conclusion:The results can beapplied in the interventions and trainings of addiction treatment clinics with regard to the predictive power of variables. 69 76 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/11 1402/9/20 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/2 1403/1/14 Mahnaz Elahinezhad Mahnaz Elahinezhad Department of Psychology, Faculty of Psychology and Social Sciences, Roudhen Branch, Islamic Azad University, Roudhen, Iran Iran mahnazelahinejad@yahoo.com Rahim Davari Rahim Davari Department of Psychology, Faculty of Psychology and Social Sciences, Roudhen Branch, Islamic Azad University, Roudhen, Iran Iran rahimdavari@yahoo.com Attachment styles Addiction Emotional Regulation 1. Eslami-Jahromi M, Keshvardoost S, Ershad-Sarabi R, et al. Information Needs of Addicted Individuals: A Qualitative Case Study. Addict Health. 2021; 13(3): 138-47. [Persian]##2. Narod SA. Which Genes for Hereditary Breast Cancer? N Engl J Med. 2021; 384(5): 471-473.##3. Hu C, Hart SN, Gnanaolivu R, et al. A Population-Based Study of Genes Previously Implicated in Breast Cancer. N Engl J Med. 2021; 384(5): 440-451.##4. Foulkes WD. The ten genes for breast (and ovarian) cancer susceptibility. Nat Rev Clin Oncol. 2021; 18(5): 259-260.##5. Arts-de Jong M, De Bock GH, Van Asperen CJ, et al. Germline BRCA1/2 mutation testing is indicated in every patient with epithelial ovarian cancer: A systematic review. Eur J Cancer. 2016; 61: 137-4.##6. Speight B, Tischkowitz M. When to Consider Risk-Reducing Mastectomy in BRCA1/BRCA2 Mutation Carriers with Advanced Stage Ovarian Cancer: a Case Study Illustrating the Genetic Counseling Challenges. J Genet Couns. 2017; 26(6): 1173-1178.##7. Shi H, You Z, Guo Y. (Mutation of breast cancer susceptibility gene in ovarian cancer and its clinical significance). Zhonghua Fu Chan Ke Za Zhi. 1998; 33(11): 676-8.##8. Konstantinopoulos PA, Norquist B, Lacchetti C, et al. Germline and Somatic Tumor Testing in Epithelial Ovarian Cancer: ASCO Guideline. J Clin Oncol. 2020; 38(11): 1222-1245.##9. Basharat M, Noorbakhsh S, Rostami R, et al. The moderating role of self-regulation in the relationship between attachment styles and severity of substance use disorders. Journal of Clinical Psychology. 2019; 4(3): 21-32. [Persian]##10. Arghabaei M, Solimanian A A, Mohammadipoor M, et al. The role of attachment style in substance use tendency: Investigating the mediating role of sense of coherence. etiadpajohi. 2019; 13(53): 97-118.##11. Tabibnia G, Creswell JD, Kraynak TE, et al. Common prefrontal regions activate during self-control of craving, emotion, and motor impulses in smokers. Clinical Psychological Science. 2014; 2(5): 611-9. 10.1177/2167702614522037.##12. Perez-Dandieu B, Lenoir H, Othily E, et al. The impact of eye movement desensitization and reprocessing and schema therapy on addiction severity among a sample of French women suffering from PTSD and SUD. Drug and Alcohol Dependence. 2015; 100(146): e68-9.##13. Steiner H, Van Waes V. Addiction-related gene regulation: Risks of exposure to cognitive enhancers vs. other psychostimulants. Progress in neurobiology. 2013; 100: 60-80.##14. Weed NC, Butcher JN, McKenna T, Ben-Porath YS. New measures for assessing alcohol and drug abuse with the MMPI-2: The APS and AAS. Journal of personality assessment. 1992; 58(2): 389-404.##15. Wu L, Winkler MH, Wieser MJ, et al. Emotion regulation in heavy smokers: experiential, expressive and physiological consequences of cognitive reappraisal. Frontiers in psychology. 2015; 6: 155544.## ##

Survival Analysis of Ovarian Cancer Patients in Yazd City, Central part of Iran, 1999-2018 2 2 Background: Ovarian Cancer (OC) as a common gynecologic cancer according to mortality rate has the seventh rank among women in the world. This study aimed to identify risk factors associated with OC survival in Yazd, Iran. Methods: In this observational retrospective cohort study, the medical records of 150 patients who were definitively diagnosed with OC from 1999 to 2018 were investigated. The Kaplan–Meier estimator and the Cox proportional hazard model with hazard ratio and the log-rank test were used for data analysis. All statistical analyses were done in R 4.0.5, package survival. Results: 60.77% (91 people) of patients were under 60 years old. 32.7% (49 people) were in stage III of the disease. 62% (93 people) did not have ascites, 67.3% (101 people) had disease-free survival more than 65 months. 45 (30%) of 150 patients were dead. Median survival time was 96 months (95% CI∶57.20 to 134.79), one, three, five-, and ten-year survival rates were 83,73,55 and 33 months; respectively. Log-rank test results showed there was a significant difference between age, stage, ascites, disease-free survival, and Treatment method, CA125 after and before treatment (p < 0.05). Cox proportional hazard model result showed ascites (HRadj = 3.89, 95% CI: 1.35 to 11.15, P = 0.01) and DFS (HRadj = 23.52, 95 % CI: 4.21to128.33, p = < 0.001) as significant covariates. Conclusion: The results of our study showed that disease-free survival and ascites are the main risk factors for OC and paying attention to them will be effective in increasing patient survival. 77 86 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/19 1402/9/28 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/8 1403/1/20 Maryam Arabi Maryam Arabi Center for Healthcare Data Modeling, Departments of biostatistics and Epidemiology, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran maryamarabi273@gmail.com Farzan Madadizadeh Farzan Madadizadeh Center for Healthcare Data Modeling, Departments of biostatistics and Epidemiology, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran madadizadehfarzan@gmail.com Mohammadreza Mortazavizadeh Mohammadreza Mortazavizadeh Assistant Professor,Aliebn Abitaleb School Of Medicince, Islamic Azad University,Yazd,Iran Iran Mortazavizadeh@iauyazd.ac.ir Hossien Fallahzadeh Hossien Fallahzadeh Center for Healthcare Data Modeling, Departments of biostatistics and Epidemiology, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran hofaab@yahoo.com Ovarian cancer survival cox proportional hazard Iran 1. Momenimovahed Z, Tiznobaik A, Taheri S, et al. Ovarian cancer in the world: epidemiology and risk factors. International journal of women's health. 2019; 11: 287. [Persian]##2. La Vecchia C. Ovarian cancer: epidemiology and risk factors. European journal of cancer prevention. 2017; 26(1): 55-62.##3. Kujawa KA, Lisowska KM. Ovarian cancer--from biology to clinic. Postepy higieny i medycyny doswiadczalnej (Online). 2015; 69: 1275-90.##4. Chuffa LGA, Lupi Júnior LA, Seiva FbR, et al. Quantitative proteomic profiling reveals that diverse metabolic pathways are influenced by melatonin in an in vivo model of ovarian carcinoma. Journal of proteome research. 2016; 15(10): 3872-82.##5. Dinca AL, Birla RD, Dinca VG, et al. Prognostic factors in advanced ovarian cancer–a clinical trial. Chirurgia (Bucur). 2020; 115(1): 50-62.##6. Högberg T, Bergfeldt K, Borgfeldt C, et al. Hopp om förbättring av överlevnad i ovarialcancer. Läkartidningen. 2015; 112.##7. Wu S-G, Wang J, Sun J-Y, et al. The real-world impact of survival by period of diagnosis in epithelial ovarian cancer between 1990 and 2014. Frontiers in oncology. 2019; 9: 639.##8. Nagle C, Dixon S, Jensen A, et al. Obesity and survival among women with ovarian cancer: results from the Ovarian Cancer Association Consortium. British journal of cancer. 2015; 113(5): 817-26.##9. Sharifian A, Pourhoseingholi MA, Norouzinia M, et al. Ovarian cancer in Iranian women, a trend analysis of mortality and incidence. Asian Pacific Journal of Cancer Prevention. 2015; 15(24): 10787-90.##10. Najafi Z, Rivaz M, Shokrollahi P, et al. Survival rate of women with ovarian cancer in Fars Province, Iran. Hormozgan Medical Journal. 2013; 16(6): 459-65.##11. Sienko J, Gaj P, Czajkowski K, et al. Peroxiredoxin-5 is a negative survival predictor in ovarian cancer. Ginekologia polska. 2019; 90(1): 1-6.##12. Torre LA, Trabert B, DeSantis CE, et al. Ovarian cancer statistics, 2018. CA: a cancer journal for clinicians. 2018; 68(4): 284-96.##13. Ahmed N, Stenvers K. Getting to know ovarian cancer ascites: opportunities for targeted therapy-based translational research. Frontiers in oncology. 2013; 3: 256.##14. Eisenkop SM, Friedman RL, Wang H-J. Complete cytoreductive surgery is feasible and maximizes survival in patients with advanced epithelial ovarian cancer: a prospective study. Gynecologic oncology. 1998; 69(2): 103-8.##15. Kurta ML, Edwards RP, Moysich KB, et al. Prognosis and conditional disease-free survival among patients with ovarian cancer. Journal of clinical oncology. 2014; 32(36): 4102.##16. Gupta A, Sedhom R, Beg MS. Ascites, or Fluid in the Belly, in Patients With Cancer. JAMA oncology. 2020; 6(2): 308-.##17. Smolle E, Taucher V, Haybaeck J. Malignant ascites in ovarian cancer and the role of targeted therapeutics. Anticancer research. 2014; 34(4): 1553-61.##18. Loggie BW, Perini M, Fleming RA, et al. Treatment and prevention of malignant ascites associated with disseminated intraperitoneal malignancies by aggressive combined-modality therapy. The American surgeon. 1997; 63(2): 137-43.##19. Sebastian M. Review of catumaxomab in the treatment of malignant ascites. Cancer management and research. 2010; 2: 283.##20. Barni S, Cabiddu M, Ghilardi M, et al. A novel perspective for an orphan problem: old and new drugs for the medical management of malignant ascites. Critical reviews in oncology/hematology. 2011; 79(2): 144-53.##21. Cohen M, Petignat P. The bright side of ascites in ovarian cancer. Taylor & Francis; 2014.##22. Oldak S, Ioannou S, Kamath P, et al. Polypharmacy in patients with ovarian Cancer. The oncologist. 2019; 24(9): 1201.##23. Wang L, Li X. Identification of an energy metabolism‑related gene signature in ovarian cancer prognosis. Oncology reports. 2020; 43(6): 1755-70.##24. Hsieh S-F, Lau H-Y, Wu H-H, et al. Prognostic factors of early stage epithelial ovarian carcinoma. International journal of environmental research and public health. 2019; 16(4): 637.##25. Chen Y, Bi F, An Y, et al. Identification of pathological grade and prognosis‐associated lncRNA for ovarian cancer. Journal of cellular biochemistry. 2019; 120(9): 14444-54.##26. Zheng Q-Q, Wang P, Hui R, et al. Prognostic analysis of ovarian cancer patients using the Cox regression model. Ai zheng= Aizheng= Chinese journal of cancer. 2009; 28(2): 170-2.##27. Zhang X-y, Zhou L-l, Jiao Y, et al. Adenylate kinase 7 is a prognostic indicator of overall survival in ovarian cancer. Medicine. 2021; 100(1).##28. Urpilainen E, Marttila M, Hautakoski A, et al. Prognosis of ovarian cancer in women with type 2 diabetes using metformin and other forms of antidiabetic medication or statins: a retrospective cohort study. BMC cancer. 2018; 18(1): 1-9.##29. Dixon-Suen SC, Webb PM, Wilson LF, et al. The Association between hysterectomy and ovarian cancer risk: a population-based record-linkage study. JNCI: Journal of the National Cancer Institute. 2019; 111(10): 1097-103.##30. Lund B, Williamson P. Prognostic factors for overall survival in patients with advanced ovarian carcinoma. Annals of Oncology. 1991; 2(4): 281-7.## ##

Institutionalization of Sports for All in Iranian Families 2 2 Background: The institutionalization of sports in families plays a significant role in promoting the health of the society. This study is aimed to extract effective background factors in institutionalizing sports in Iranian families.   Methods: The present research follows interpretive paradigm, inductive logic and qualitative approach. Besides meta-synthesis approach and interviews were conducted. The research population of the present study included 166 national and international articles presented over the last twelve- year period. After screening the articles, 15 studies were finally selected which met the necessary criteria and were analyzed using content analysis technique. In the next step, an interview was conducted with 23 experts in “public sports” in a targeted manner using the snowball and theoretical saturation techniques, and finally, the codes of the first and second stages were combined. Results: Meta-synthesis results led to the identification of 36 indices, the overlap of the codes was compared, the results showed the reliability of 0.92 After the interview was conducted, 41 indices were identified. The comparison of the results in two time periods showed the reliability of 0.89. Finally, by latent content analysis, summarizing, overlapping and merging the codes of the previous two steps, 47 influential indices affecting the institutionalization of sports in Iranian families were extracted. Conclusion: Based on the results of our research it can be concluded that by recognizing, planning and creating mechanisms for the operationalization of the discovered factors, the process of institutionalizing physical activity in Iranian families will be facilitated.   87 100 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/10 1402/10/20 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/19 1403/1/31 Abolfazl Kargar Sharif Abad Abolfazl Kargar Sharif Abad Department of Sport Management, Sport Science Faculty, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran Iran aboalfazlkargar57@gmail.com Rasoul Nazari Rasoul Nazari Department of Sport Management, Sport Science Faculty, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran Iran r.nazari@khuisf.ac.ir Mehdi Salimi Mehdi Salimi Department of Sport Management, Faculty of Physical Education and Sports Sciences, Isfahan of University, Isfahan, Iran Iran m.salimi@spr.ui.ac.ir Institutionalization public sports family 1. Rezaei, S. (2022). Effects of the Covid-19 on the level of sports activities in Iran. Strategic Studies on Youth and Sports, 22(59), 395-412. doi:10.22034/ssys.2022.1782.2266##2. UK, G. (2019). Physical activity: applying All our Health. Published October, 16.‌##Available at: URL: https://www.gov.uk/government/publications/physical-activity-applying-all-our-health/physical-activity-applying-all-our-health#introduction .Accessed March 12, 2022.##3. Walker, A. R., Walker, B. F., & Adam, F. (2003). Nutrition, diet, physical activity, smoking, and longevity: from primitive hunter-gatherer to present passive consumer—how far can we go?. Nutrition, 19(2), 169-173.‌##4. Karstoft, K., Safdar, A., & Little, J. P. (2018). optimizing Exercise for the Prevention and treatment of type 2 diabetes. Frontiers in Endocrinology, 9, 328841.‌##5. Mohammadi Khas, S. S., Bombay Chi, Sh., Ebrahimi Atari, A., and Shah Tahmasabi, B. (2023). The key role of exercise and physical activity in patients with chronic back pain during the covid-91 epidemic, a review study- The first international conference of sports science and physical education students, Tehran.##6. Mohammadi Mirzaei, R., Mohammadi, M., & Mohammadi Mirzaei, M. (2023). The Effectiveness of Web-based Physical Activity on Physical Literacy and General Health of Primary School Students During the Corona Epidemic. Community Health Journal, 17(2), 27-38.‌##7. Iskandernejad, M., Alizadeh, R., Malai Zangi, F. (2020). "The role of predicting the level of physical activity on the level of anxiety of the medical staff during the peak of Corona." Studies in Sport Psychology, 32(9), 189-200.##8. Chalip, L., Green, B. C., Hill, B. (2003). The effect of destination advertising and sport event media (advertising and telecast) were compared ... [11] pointed that sport events play two roles, attracting participants and spectators ... (2003); 2005;Ryan 2008).##9. Askarian, Fariba, and Jafari, Afshar. Economic study of sports expenses of Iranian households in 1377 and 1380. Research in Sports Sciences. (1387); 6(18), 75-86. SID. ttps://sid.ir/paper/68120/fa##10. Qolinia, Mohammad Javad. Creating context and programA plan for everyone to do sports, special research The development of the country, the joint plan of the management organization and Country planning and physical education organization(1383).##11. Asefi, A., & Ghanbarpor Nosrati, A. (2018). “The effective factors model in institutionalization of sport for all in Iran”.Research in Sport Management & MotorBehavior, 8(16), 29-46. [Persian]##12. Shirouei A, Kashkar S, Esmaili R, Asadi . H.Study the sociological institutionalisation of pablic sport in the country and provide favourable model (with the approach of Grounded Theory). Quarterly Journal of Sport Development and Management. (2018); 6(11): 31-47. (In Persian)##13. Satija, A., Khandpur, N., Satija, S., Mathur Gaiha, S., Prabhakaran, D., Reddy, K. S., & Venkat Narayan, K. M. Physical activity among adolescents in India: a qualitative study of barriers and enablers. Health education & behavior. (2018); 45(6), 926-934.‌##14. Benar N, Dastoom S, Goharrostami H.R, Mohaddes F. Designing a model of sport participation development (Case study of Guilan province). Journal of Human Resource Management in Sport. 2018; 5(2): 217-34. (In Persian)##15. Kuvaja-Köllner, V., Kankaanpää, E., Laine, J. et al. Municipal resources to promote adult physical activity - a multilevel follow-up study. (2022); BMC Public Health 22, 1213 https://doi.org/10.1186/s12889-022-13617-8##16. Xiaoyue Chen a , Astrid Kemperman, Harry Timmermans. Socio-demographics, neighborhood characteristics, time use, and leisure-time physical activity engagement patterns over the life courseSSM - Population HealthVolume 19, September 2022, 101244##17. Shaholi Koh Shouri, Askari, Ahmid Reza, Nazari, Naqsh, & Amir Reza. Scenarios for the development of student sports in Iran. Research in sports management and movement behavior. (2021); 11(21), 184-209. (In Persian)##18. Kargar sharifabad A, Nazari R, Salimi M. Explaining the Health-Related Factors Affecting the Institutionalization of Sports in Iranian Families. Tolooebehdasht. (2022); 21(1), 43-56.##19. Sadeghi, H. R., Nazari, R., & Rahimi seroshbaderani, G. The Role of tendency toward spirituality and moral ideology among Athletes. Strategic Sociological Studies in Sport. (2022); 2(1), -. doi: 10.30486/ 4s. 2022.1950422.1012##20. Fernanda Maria Oliveira da Silva, Giana Zarbato Longo, Anice Milbratz de Camargo, Giovanna Medeiros Rataichesck Fiates, Milene Cristine Pessoa, Neighborhood factors associated with leisure-time physical activity in a Brazilian city. Health Promotion International, Volume 37, Issue 6, December 2022, daac158, https://doi.org/ 10.1093/heapro/daac158##21. Zimmer, L. Qualitative meta-synthesis: a question of dialoguing with texts. Journal of Advanced Nursing. (2006); 53(3), 311–318.##22. Sandelowski, M., & Barroso, J. Handbook for synthesizing qualitative research. springer publishing company. New York: Springer Publishing Company. (2006). ##23. Minavand, M. G., Bagheri, S., & Qasemi, H. Methods for institutionalization of public sports by national media (IRIB); A case study of sports TV channel. Communication Research. (2015); 22(81), 9-34.##24. Darogh Arefi, Nahid, Bigleri, Nasreen, and Bahrul Uloom, Hassan. (2015). Investigating the relationship between talent management and emotional intelligence and organizational commitment of employees of sports and youth departments in Fars province. Human resource management in sports, 4(1), 47-59. SID. https://sid.ir/paper/267370/fa##25. Mehrali Hemmati Nezhad, Dr Esmaeel Sharifiyan, Dr Mohammad Mahdi Rahmati, Mohsen Manocheri Nezhad, (2016). Exploration of the Background Factors of Family, Peers, School, and Media in the Internalization of Sports Culture in Children and Adolescents: A Qualitative Study, Journal of Qualitative Research in Health Sciences, 5(1), 83-95. magiran.com/p1576575##26. Casey, M. M., Eime, R. M., Payne, W. R., & Harvey, J. T. Using a socioecological approach to examine participation in sport and physical activity among rural adolescent girls. Qualitative Health Research. (2009); 19(7), 881–893##27. Gunathevan Elumalai and Saryono(2015). sports culture one student one sport policy in malaysia, Jurnal Pendidikan Jasmani Indonesia,Volume 11, Nomor 1, April##28. Jovanmard, Kamal, & Sanat Khah, Alireza. (1401). Qualitative explanation of the contexts and conditions of participation of female students in public sports (case study of Payamnoor University, Kerman). Women in Development and Politics, 20(3), 365-388. doi: 10.22059/jwdp.2022.335488.1008125##29. Ghafouri, Farzad, Memarzadeh, Mohammad Saeed, & Alavi, Salman. (2018). Determining the contribution and role of executive bodies in the development of public sports. Scientific quarterly of applied research in sports management, 8(1), 11-32. doi: 10.30473/arsm.2019.5843##30. Taherzadeh, Javad; Nazari, Rasul and Hemti Jamshid (2019). Presentation of a paradigmatic model for the development of public sports in Islamic Azad University, Sports Management Studies, Volume 12, Number 61, August and September 2019, pp. 85-108##31. Shahryari N, Tabesh S, Nazari R, Zolfagharzadeh M.M. A Meta-analysis of the effects of social-health development on the institutionalization of sport for all. Nurse and Physician within Warhttps. (2020); //www.sid.ir/paper/382712/fa, 7(25): 8-41. (In Persian)##32. Heather M Sedibe, Kathleen Kahn Kerstin Edin, Tabitha Gitau.2014. 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Ebrahimi, Abdul Hossein; Mahdipour, Abdurrahman and Azmasha, Tahereh (2014) The effect of neighborhood indicators and access to sports venues on the level of sports participation", case study: the eight regions of Ahvaz city, studies of organizational management in sports, second period, number 5, Novat Bahar, 31-39##36. Wafai Moghadam, Ali, Farzan, Farzam, Razavi, Mohammad Hossein, and Afshari, Mustafa. (2017). Analysis of the development factors of public sports based on the foundational data theory. Sports Management Studies (Research in Sports Sciences), 10(52), 43-72. SID. https://sid.ir/paper/234531/fa##37. Hanlon, C., Morris, T., & Nabbs, S. (2014). Program providers’ perspective: Recruitment and retention strategies for women in physical activity programs. Sport Management Review, 17(2), 133–144. https://doi.org/ 10.1016/ j.smr.2013.04.001##38. Kinsman, J., Norris, S. A., Kahn, K., Twine, R., Riggle, K., Edin, K., & Micklesfield, L. K. 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Recognizing and Describing the Factors Affecting the Design of the Innovation Ecosystem Model in the Field of Health with an Emphasis on the Role of E-Government 2 2 Background: Development of innovation issues in countries has led to the formation of new concepts in this field. Some of these concepts include innovation systems ranging from national, sectoral, etc., innovation networks, commercialization, and innovation ecosystems. Therefore, the purpose of this study is to design recognition and description of the factors affecting the design of the ecosystem model of innovation in the field of health with an emphasis on the role of e-government. Methods: The type of qualitative study is a type of theory. A semi-structured interview was used to gather information. And the analysis of Strauss and Corbyn's method and the paradoxical model were used. The samples were selected through targeted sampling. And finally, 7 senior and middle managers of government and non-governmental hospitals in Yazd province entered the study. Results: The model designed in this study includes the effective dimensions and components, obstacles and strategies, causal conditions, contextual, intermediary and constituent elements that are the pivotal phenomenon, Shows the consequences and strategies. identifiers and Ecosystem Factors Innovation 37 Concepts, 4 Main categories Enabling policies and regulations, Access to data and infrastructure، funding and validation opportunities and ease of acceptance and dissemination of innovations (from interviews and research literature) were formulated in the form of a conceptual model Conclusion: The process of study was explained in the form of the story line of the electronic government data theory. Finally, the innovation ecosystem model in the field of biotechnology was designed and analyzed. Finally, this model can be used to design an innovation ecosystem in the field of health. 101 108 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/13 1402/11/24 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/11 1403/2/22 Zahra Mirjalili Zahra Mirjalili Department of Public Administration, Kerman Branch, Islamic Azad University, Kerman, Iran Iran Fateme.mirjalili1400@gmail.com Abbas Babaeinejad Abbas Babaeinejad Department of Public Administration, Kerman Branch, Islamic Azad University, Kerman, Iran Iran a.babaei@iauk.ac.ir Saeed Sayadi Saeed Sayadi Department of Public Administration, Kerman Branch, Islamic Azad University, Kerman, Iran Iran sayadi@iauk.ac.ir Hamid Reza Mollaei Hamid Reza Mollaei Department of Public Administration, Kerman Branch, Islamic Azad University, Kerman, Iran Iran Hrmollaei@ut.ac.ir Ecosystem innovation technology electronics health hospital 1. Durst S, Poutanen P. Success factors of innovation ecosystems-Initial insights from. The Role of Objects in the Constitution of Collaborative Spaces: 27.##2. Hajikhani A. Emergence and dissemination of ecosystem concept in innovation studies: A systematic literature review study; 2017. [Persian]##3. Carlsson B, Jacobsson S, Holmén M, Rickne A. Innovation systems: analytical and methodological issues. Research policy. 2002; 31(2): 233-45.##4. Bramwell A, Hepburn N, Wolfe DA. Growing innovation ecosystems: University-industry knowledge transfer and regional economic development in Canada. Final Report to the Social Sciences and Humanities Research Council of Canada. 2012; 62.##5. Autio E, Thomas L. Innovation ecosystems. The Oxford handbook of innovation management; 2014.##6. Adner R. Ecosystem as structure: An actionable construct for strategy. Journal of management. 2017; 43(1): 39-58.##7. Mercan B, Goktas D. Components of innovation ecosystems: A cross-country study. International research journal of finance and economics. 2011; 76(16): 102-12.##8. Esmailipour Masouleh E, Afshari-Mofrad M, Bashiri M. Innovation Ecosystem in Iran’s Automotive Industry; What it has, What it Lacks. Journal of Improvement Management. 2022; 15(4): 105-27. [Persian]##9. Asgharzadeh S, Safari A. Investigating the position of electronic government in the era of virtual communication. Management and accounting studies. 2023; 9(1): 113-22. [Persian]##10. Dabbagafrouz R, Zendeh AB, Pasebani M. Designing a Strategic Model of Innovation Ecosystem by Using Grounded Theory in the Field of Biotechnology. Depiction of Health. 2021; 12(2): 113-26. [Persian]##11. Arena C, Catuogno S, Saggese S, Sarto F. The adoption of e-Health in public hospitals. Unfolding the gender dimension of TMT and line managers. Public Management Review. 2021; 23(10): 1553-79.##12. Soumitra D, Lanvin B, Wunsch-Vincent S, editors. Global innovation index 2020: who will finance innovation?. WIPO; 2020.##13. Dabbagafrouz R, Zendeh AB, Pasebani M. Designing a Strategic Model of Innovation Ecosystem by Using Grounded Theory in the Field of Biotechnology. Depiction of Health. 2021; 12(2): 113-26. [Persian]##14. Asadifard R, Nozari M. A Development Pattern for University-Based Innovation Ecosystems: The Case Study of Sharif Innovation District. Journal Strategi c Studies of Public Policy. 2023; 12(45): 140-65. [Persian]##15. Ahmadi A, Shirani M, Khaledifar A, Hashemzadeh M, Solati K, Kheiri S, Sadeghi M, Mohammadian-Hafshejani A, Shahraki HR, Asgharzadeh A, Salehifard AZ. Non-communicable diseases in the southwest of Iran: profile and baseline data from the Shahrekord PERSIAN Cohort Study. BMC Public Health. 2021; 21: 1-4. [Persian]##16. Song Y, Sahut JM, Zhang Z, Tian Y, Hikkerova L. The effects of government subsidies on the sustainable innovation of university-industry collaboration. Technological Forecasting and Social Change. 2022; 174: 121233.##17. Smorodinskaya N, Russell M, Katukov D, Still K. Innovation ecosystems vs. innovation systems in terms of collaboration and co-creation of value; 2017.##18. Almpanopoulou A, Ritala P, Blomqvist K. Innovation ecosystem emergence barriers: Institutional perspective; 2019.## ##

Predictors of the Intention to Perform Preventive Behaviors Against the Occurrence of Breast Cancer 2 2 Background: Breast cancer is the most common cancer in women. The purpose of study was to determine the predictors of the intention to perform preventive behaviors against the occurrence of breast cancer (BC) based on the protection motivation theory (PMT). Methods: This research was a cross-sectional study that was conducted on 400 women aged 18 to 70 living in Babol city with a multi-stage sampling method. The data collection tool was a researcher-made questionnaire containing demographic information, questions on BC risk factors based on the constructs of PMT. data was entered into SPSS V20 and analyzed with chi-square, independent t-test, ANOVA, Pearson correlation-test and linear regression at a significance level of 0.05. Results: More than of the participants were single. 66% of participants had no risk factors, 12.5% had one risk factor, 7.5% had three risk factors, and 1.5% had more than four risk factors. The strongest predictors of the intention to perform preventive behaviors against BC were perceived severity (β = 0.280), number of risk factors (β = 0.206), death of a relative due to BC (β = 0.147), and self-efficacy (β = 0.141). Among PMT constructs, perceived severity and self-efficacy constructs were the strongest predictors of preventive behaviors against BC. Conclusion: The PMT plays an important predictive role in the intention to perform cancer prevention behaviors. In this context, it is necessary to design and implement training programs based on these constructs of this model, especially the perceived intensity, self-efficacy and response efficiency. 109 118 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/29 1402/10/8 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/23 1403/2/4 Reza Faryabi Reza Faryabi School of Public Health, Jiroft University of Medical Sciences, Jiroft, Iran Iran ajafarnejad0@gmail.com Aboubakr Jafarnezhad Aboubakr Jafarnezhad Department of Epidemiology, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Iran behdasht2020@yahoo.com Salman Daneshi Salman Daneshi School of Public Health, Jiroft University of Medical Sciences, Jiroft, Iran Iran salmandaneshi008@gmail.com Motivation-behavioral skills intentions preventive health care breast cancer 1. Hajian-Tilaki K, Nikpour M. Accuracy of self-perceived risk perception of breast cancer ‎development in Iranian women. BMC Women's Health. 2021;21(1):1-8‎‌.‌##2.Estebsari F, Kandi ZR, Latifi M, Nasab AF, Vasli P, Mostafaie D. Protection motivation theory and prevention of breast cancer: a systematic review. Clinical Breast Cancer. 2023 Mar 14.3. ##3.Isfahani P, Hossieni Zare SM, Shamsaii M. The Prevalence of depression in Iranian women with breast cancer: A meta-Analysis. Internal Medicine Today. 2020;26(2):170-81.##‌4. Sun Y-S, Zhao Z, Yang Z-N, Xu F, Lu H-J, Zhu Z-Y, et al. Risk factors and preventions of breast ‎cancer. Int J Biol Sci. 2017;13(11):1387‎‌.‌##‌‌5. Marzbani B, Taymoori P, Nouri B. Assessment of risk factors for breast cancer among women ‎under 50 years old. sjsph 2017 ;15(1): 15-60‎‌.‌##‌6. Zahedi R, Rezapour M, Molavi Vardanjani H, Baneshi MR, Haghdoost AA, Malekpour Afshar R, et ‎al. Breast Cancer Risk Perception and Screening Behaviors of Iranian Women. Women’s Health. Bull. ‎‎2021;8(2):63-71‎‌.‌##‌7. Wang X, Yang Y, An Y, Fang G. The mechanism of anticancer action and potential clinical use of kaempferol in the treatment of breast cancer. Biomedicine & Pharmacotherapy. 2019;117:109086.##‌8. Kissal A, Kartal B. Effects of health belief model-based education on health beliefs and breast self-examination in nursing students. Asia-Pacific journal of oncology nursing. 2019;6(4):403-10.##‌9. Ghaffari M, Esfahani SN, Rakhshanderou S, Koukamari PH. Evaluation of health belief model-based intervention on breast cancer screening behaviors among health volunteers. Journal of Cancer Education. 2019;34(5):904-12.##‌10. Momenimovahed Z, Salehiniya H. Epidemiological characteristics of and risk factors for breast ‎cancer in the world. Breast Cancer: Targets and Therapy. 2019;11:151‎‌-164.##‌11. Rezabeigi-davarani E, Khanjani N, Falahi M, Daneshi S, Iranpour A. Breast self-examination and its ‎effective factors based on the theory of planned behavior among women in Kerman, Iran. J Educ ‎Community Health. 2016;3(3):1-8‎‌.‌##‌12. Sopik V. International variation in breast cancer incidence and mortality in young women. Breast Cancer Research and Treatment. 2021;186:497-507.##‌13. Wu Z, Liu Y, Li X, Song B, Ni C, Lin F. Factors associated with breast cancer screening participation among women in mainland China: a systematic review. BMJ open. 2019;9(8):e028705.##14. Ginsburg O, Yip CH, Brooks A, Cabanes A, Caleffi M, Dunstan Yataco JA, Gyawali B, McCormack V, McLaughlin de Anderson M, Mehrotra R, Mohar A. Breast cancer early detection: A phased approach to implementation. Cancer. 2020;126:2379-93.##‌15. Mohaghegh P, Farahani M, Moslemi A, Ahmadi F, Nazari J. Participation Rate, Family Histories, ‎Symptoms, and Incidence of Breast Cancer in the Screening Program for Breast Cancer in the Population ‎Covered by Arak Health Centers. IJBD. 2021;14(2):41-9‎‌.##‌16. Coughlin SS. Social determinants of breast cancer risk, stage, and survival. Breast cancer research and treatment. 2019;177:537-48.##‌17. Kim J, Yang K, Min J, White B. Hope, fear, and consumer behavioral change amid COVID‐19: Application of protection motivation theory. International Journal of Consumer Studies. 2022;46(2):558-74.##‌18. Wilkinson L, Gathani T. Understanding breast cancer as a global health concern. The British Journal of Radiology. 2022;95(1130):20211033.##19.Tang JS, Feng JY. Residents’ Disaster Preparedness after the Meinong Taiwan Earthquake: A Test of Protection Motivation Theory. Int J Environ Res Public Health. 2018;15(7).. ##20.Bubeck P, Wouter Botzen W, Laudan J, Aerts JC, Thieken AH. Insights into flood‐coping appraisals of protection motivation theory: Empirical evidence from Germany and France. Risk analysis. 2018;38(6):1239-57. ##21.Faryabi R, Sharifabad MA, Sardooei ZA, Daneshi S, Hushmandi K, Raei M. Safety behavior predictors related to the food safety of greenhouse products among the greenhouse owners based on protection motivation theory. The Open Public Health Journal. 2021;14(1). ##22.Morowatisharifabad MA, Faryabi R, Sardooei ZA, Fallahzadeh H, Zare Sakhvidi MJ. Predictors of Safety Behavior Among Jiroft-City Greenhouse Spray Workers Based on Protection Motivation Theory in 2016. Iranian Red Crescent Medical Journal. 2017 Aug 1;19(8).##23.Allo T, Edewor P, Imhonopi D. Assessment of perceived risks of breast cancer and breast cancer ‎screening among women in five selected local governments in Ogun State, Nigeria. SAGE Open. ‎2019;9 (2):2158244019841924‎‌##24. Zhang M, Wei W, Li Q, Chen X, Zhang M, Zuo D, Liu Q. Determinants of intention to participate in breast cancer screening among urban Chinese women: an application of the protection motivation theory. International journal of environmental research and public health. 2021 Oct 21;18(21):11093.##25. Helmes AW. Application of the protection motivation theory to genetic testing for breast cancer risk. Preventive medicine. 2002 Nov 1;35(5):453-6.##26. Osei E, Osei Afriyie S, Oppong S, Ampofo E, Amu H. Perceived Breast Cancer Risk among Female Undergraduate Students in Ghana: A Cross-Sectional Study. Journal of Oncology. 2021;2021.##27. Gao Y, Yu J, Wang H, Liu B, Zhang S. Predicting Breast Cancer Screening Behaviors Using Protective Motivation Theory: A Structural Equation Modeling Approach. Clinical and Experimental Obstetrics & Gynecology. 2023 Aug 14;50(8):168.##28. Hodgkins S, Orbell S. Can protection motivation theory predict behaviour? A longitudinal test exploring the role of previous behaviour. Psychology and Health. 1998 Apr 1;13(2):237-50.##29. Neuberger L, Silk KJ, Yun D, Bowman ND, Anderson J. Concern as motivation for protection: An investigation of mothers' concern about daughters' breast cancer risk. Journal of health communication. 2011 Nov 1;16(10):1055-71.##30. Nazari M, Ghazaani FM, Kaveh MH, Karimi M, Ghahremani L. Investigating the predictors of breast cancer screening behaviors (breast self-examination, clinical examination or examination by physician/midwife and mammography) based on protection motivation theory (PMT) in women. Journal of preventive medicine and hygiene. 2021 Sep;62(3):E736##31. Semagn BE, Bisetegn TA, Wolde M. Application of protection motivation theory to identify factors associated with breast self-examination behavior among female students at the University of Gondar: Structural equation modeling approach.##32. Bashirian S, Barati M, Mohammadi Y, Moaddabshoar L, Dogonchi M. An application of the protection motivation theory to predict breast self-examination behavior among female healthcare workers. European journal of breast health. 2019 Apr;15(2):90.## ##

Occupational Morbidities and Health-Seeking Behavior among Automobile Mechanics in the Western Region of Nigeria 2 2 Background: Automobile mechanic work is associated with illnesses and injuries. These occupational diseases can result in sickness absence, economic loss, disability, or death of these workers. This study assessed self-reported health problems and health-seeking behavior of automobile mechanics in Surulere, Lagos State. Methods: A cross-sectional study was used in this study carried out in December 2014. A systematic sampling method was employed to select 120 respondents from various workshops within their Local Government Area and were interviewed using a structured questionnaire. Data entry and analysis were done using epi-info3.5.1 Results: About 27.5% of the respondents reported at least one work-related illness or injury. Five percent of the respondents had musculoskeletal disease. About 11.5% of the respondents reported having cuts and crushing injuries. Most (86.7%) of these workers do not have health workers available around their workplaces. Slightly less than half (48.3%) visit health facilities between 6 to 15 minutes of estimated walking distance. Most (70%) respondents visit health facilities when ill or injured; 33.3% patronize traditional healers/ herbs/ prayer houses (spiritualists); 25% patronize patent medicine vendors and practice self-medication. The level of education of the workers was inversely significantly associated with the occurrence of occupational injury or illness. Conclusion: High work-related morbidities were managed by a few available health workers who were majoring in the patent medicine vendor category. The importance of level of education in the control of workplace injuries and illnesses was demonstrated by this study. 119 128 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/19 1402/12/29 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/8 1403/4/18 Ebenezer Adeiza Ozomata Ebenezer Adeiza Ozomata Department of Community Health, College of Medicine, University of Lagos, Lagos, Nigeria Nigeria ebenezer.ozomata@yahoo.com Automobile mechanic health-seeking behavior occupational morbidities 1. Sambo MN, Idris SH, Shamang A. Determinants of occupational health hazards among roadside automobile mechanics in Zaria, North Western Nigeria. Borno Medical Journal. 2012; 9(1): 5-9.##2. Smith SM. Occupational injuries, illnesses, and fatalities to automotive service technicians and mechanics, 2003 to 2005. Compensation and Working Conditions. 2007: 1-5.##3. Latunji OO, Akinyemi OO. Factors influencing health-seeking behaviour among civil servants in Ibadan, Nigeria. Annals of Ibadan postgraduate medicine. 2018; 16(1): 52-60.##4. Azuogu BN, Eze NC, Azuogu VC, et al. Appraisal of healthcare-seeking behavior and prevalence of workplace injury among artisans in automobile site in Abakaliki, Southeast Nigeria. Nigerian Medical Journal. 2018; 59(5): 45-9. DOI: 10.4103/nmj.NMJ_110_18. PMID: 31293287; PMCID: PMC6593898.##5. Kakkar R, Kandpal SD, Negi KS, et al. To study health seeking behavior of population catered by rural health training centre, Rajeev Nagar. Indian J Prev Soc Med. 2013; 44(3-4): 137-41.##7. Gerald EI, Ogwuche CH. Educational level, sex and church affiliation on health seeking behaviour among parishioners in Makurdi metropolis of Benue state. Journal of Educational policy and entrepreneurial research. 2014; 1(2): 311-6.##8. Chattopadhyay O. Pulmonary function in automobile repair workers. Indian Journal of Community Medicine. 2007; 32(1): 40-2.##9. Vyas H, Das S, Mehta S. Occupational injuries in automobile repair workers. Industrial health. 2011; 49(5): 642-51. DOI:10.2486/indhealth.MS1294.##10. Oche OM, Nneka OC, Abiola OR, et al. Determinants of occupational health hazards among roadside automobile mechanics in Sokoto Metropolis, Nigeria. Annals of African medicine. 2020; 19(2): 80-8.##11. Nwambuonwo OJ, Mughele ES. Using geographic information system to select suitable landfill sites for megacities (Case Study of Lagos, Nigeria). Computing, Information Systems & Development Informatics. 2012; 3(4): 48-56.##12. Atubi AO. A monthly analysis of road traffic accident in selected local government areas of Lagos State, Nigeria. Mediterranean Journal os Social Sciences. 2012; 3.##13. Surulere MO, Campbell PC. Comparative study of road traffic accidents caused by motorcycles before and after the Lagos state new traffic laws. Yenagoa Medical Journal. 2020; 2: 28-37.##14. Arinola OG, Akiibinu MO. The levels of antioxidants and some trace metals in Nigerians that are occupationally exposed to chemicals. Indian Journal of Occupational and Environmental Medicine. 2006; 10(2): 65-8.##15. Philip M, Alex RG, Sunny SS, et al. A study on morbidity among automobile service and repair workers in an urban area of South India. Indian journal of occupational and environmental medicine. 2014; 18(1): 9-12. DOI:10.4103/0019-5.##16. Awoyemi AO. Awareness about occupational hazards among roadsides automechanics in Ilorin, Nigeria. Journal of Community Medicinine & Primary Health Care. 2002; 14: 27-33.##17. Budhathoki SS, Singh SB, Sagtani RA, Niraula SR, Pokharel PK. Awareness of occupational hazards and use of safety measures among welders: a cross-sectional study from eastern Nepal. BMJ open. 2014; 4(6): e004646.##18. Ajayi IA, Adeoye AO, Bekibele CO, et al. Awareness and utilization of protective eye device among welders in a southwestern Nigeria community. Annals of African medicine. 2011; 10(4). DOI:10.4103/1596-3519.87047.##19. Paudyal P, Simkhada P, Bruce J. Infection control knowledge, attitude, and practice among Nepalese health care workers. American Journal of Infection Control. 2008; 36(8): 595-7. DOI: 10.1016/j.ajic.2007.10.026.##20. Sabitu K, Iliyasu Z, Dauda MM. Awareness of occupational hazards and use of safety measures amongst welders in northern Nigeria. Annals of African medicine. 2009; 8(1): 46-51.##21. Kumar SG, Dharanipriya A, Kar SS. Awareness of occupational injuries and utilization of safety measures among welders in coastal South India. Int J Occup Environ Med. 2013; 4(4): 172-177.##22. Selvi Thangaraj ST, Nimra Shireen NS. Occupational health hazards among automobile mechanics working in an urban area of Bangalore-a cross sectional study. Int J Med Sci Public Health. 2016; 6(1): 18-22##23. Girish N, Ramachandra K, Arun G M, et al. Prevalence of musculoskeletal disorders among cashew factory workers. Archives of environmental & occupational health. 2012; 67(1): 37-42. DOI:10.1080/19338244.2011.573020.## ##

Factors Influencing Access to Sexual and Reproductive Health Information among Adolescents Aged 12-19 Years in Mukono Municipality Schools: A Cross-Sectional Study 2 2 Background: Adolescent sexual and reproductive health is one of the essential health care services that promote a adolescent’s health. Complications of unwanted pregnancies lead to school dropouts’, disability and mortality.  However, many adolescents 12-19 years face barriers to reproductive health information about their health and rights. And are unable to access services needed to protect their health. This study aimed to assess factors influencing access to Sexual and Reproductive Health Information among adolescents aged 12-19 years in Mukono municipality schools, Uganda. Methods: Analytical cross-sectional survey and simple random sampling were used to select 384 participants between July and December 2022 in Mukono municipality. A Self-administered structured was used to collect data. Data was analyzed using descriptive statistics, chi-square test, and a modified Poisson regression model. Results: Findings showed the mean age of participants was 16.1 (S.D + 2) years. The proportion of access to information was 80.27%. Significant factors strongly associated with access to sexual and reproductive health information were being Moslem (OR: 0.284 (0.089-0.912)], going to hospital [OR: 2.350 (1.143-4.828)], distance 3-5 Kms from home to nearest health facility [OR: 0.41 (0.176-0.912)].   Conclusion: Two of every ten participants had access to Sexual Reproductive Health and Rights information. Significant determinants were radio media and print newspapers. Stakeholders should advocate for adolescents’ increased access to healthcare information to avert the upsurge in related diseases. Policy makers should review and monitor new guidelines for Adolescent and School health inclusive of sexuality and reproductive health. Thus, improve health equity for all. 129 139 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/29 1403/1/10 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/12 1403/3/23 Josephine Namyalo Josephine Namyalo Department of Maternal and Child Health, Faculty of Public Health, Nursing and Midwifery, Uganda Christian University, Mukono, Uganda Uganda njozena@gmail.com Dissan Sentumbwe Dissan Sentumbwe Department of Maternal and Child Health, Faculty of Public Health, Nursing and Midwifery, Uganda Christian University, Mukono, Uganda Uganda disansentbwa@gmail.com Annet Patience Nakalega Annet Patience Nakalega Department of Public Health, Faculty of Health Sciences, Victoria University, Kampala, Uganda Uganda APnakalegye@gmail.com Jacqueline Kobusingye Jacqueline Kobusingye Department of Public health, Faculty of Public Health, Nursing and Midwifery, Uganda Christian University, Mukono, Uganda Uganda jkobusinge2015@gmail.com Emmanuel Otieno Emmanuel Otieno 1. Department of Health Economics, School of Public Health, Gudie University Project, Kampala, Uganda 2. Department of Medical Services, Uganda Peoples Defense Forces, Kampala, Uganda Uganda otienomdc@gmail.com Unwanted pregnancies adolescents girls schools UNICEF. Investing in a safe, healthy, and productive transition from childhood to adulthood is critical. Adolescents overview; 2019. Available at: URL: https://data.unicef.org/topic/adolescents/overview/##2. Shinde S, Noor RA, Mwanyika Sando M, et al. Adolescent health and well-being in sub-Saharan Africa: Strengthening knowledge base and research capacity through a collaborative multi-country school-based study. Maternal & Child Nutrition. 2023: e13411.##3. Hegde A, Chandran S, Pattnaik JI. Understanding adolescent sexuality: A developmental perspective. Journal of psychosexual health. 2022; 4(4): 237-42. DOI:10.1177/26318318221107598 ##4. Ntulume CK. Access to and utilisation of adolescent sexual and reproductive health services among secondary school students in Mityana district. Uganda. J. Biomed. Res. Stud. 2018; 1: 102.##5. Phillips-Howard PA, Caruso B, Torondel B, et al. Menstrual hygiene management among adolescent schoolgirls in low-and middle-income countries: research priorities. Global health action. 2016; 9(1): 33032. DOI: 10.3402/gha.v9.33032##6. Smith AL. Meaning and Purpose in Adolescent Education: How Educators Can Help Adolescents Develop Purpose and Use It To Maximize Meaningfulness in Their Lives; 2018##7. Ssebadduka B, Nanyingi M. Determinants of adolescent and youth sexual and reproductive health service utilization in hard-to-reach communities of Amudat District, Uganda. African Journal of Health Sciences. 2021; 34(4): 512-25.##8. Moore EV, Hirsch JS, Spindler E, et al. Debating sex and sovereignty: Uganda’s new national sexuality education policy. Sexuality Research and Social Policy. 2022; 19(2): 678-88. DOI:10.1007/s13178-021-00584-##9. Ravindran TS, Govender V. Sexual and reproductive health services in universal health coverage: a review of recent evidence from low-and middle-income countries. Sexual and reproductive health matters. 2020; 28(2): 1779632. DOI: 10.1080/26410397.2020.1779632 ##10. Gulliford M, Figueroa-Munoz J, Morgan M, et al. What does' access to health care'mean?. Journal of health services research & policy. 2002; 7(3): 186-8. Available at: URL: http://www.jstor.org/stable/26749764. ##11. Appleford G, RamaRao S, Bellows B. The inclusion of sexual and reproductive health services within universal health care through intentional design. Sexual and Reproductive Health Matters. 2020; 28(2): 1799589. DOI: 10.1080/26410397.2020.1799589. ##12. Nalwanga R, Nuwamanya E, Nuwasiima A, et al. Utilization of a mobile phone application to increase access to sexual and reproductive health information, goods, and services among university students in Uganda. Reproductive Health. 2021; 18(1): 95. DOI: 10.1186/s12978-020-01037-z.##13. Mambo SB, Sikakulya FK, Ssebuufu R, et al. Challenges in access and utilization of sexual and reproductive health services among youth during the COVID-19 pandemic lockdown in Uganda: an online cross-sectional survey. Frontiers in Reproductive Health. 2022; 3: 705609. DOI:10.3389/frph.2021.705609. ##14. Bukuluki P, Kisaakye P, Mwenyango H, et al. Adolescent sexual behavior in a refugee setting in Uganda. Reproductive Health. 2021; 18(1): 131. DOI:10.1186/s12978-021-01181-0. ##15. UNFPA Uganda. Data overwiew- Sexual and reproductive health; 2023. Available at: URL: https://www.unfpa.org/data/UG ##16. Uganda Demographic and Health survey (UDHS) Key findings; 2022. Available at: URL: https://www.ubos.org/wp- content/uploads/publications/12 _2023UDHS_2022 _Key_Findings_ Presentation _B.pdf ##17. Tumwakire E, Ashaba S, Mubangizi V, et al. Sexual and reproductive health knowledge and practices among youth with and without mental illness in Uganda: a comparative study. Tropical Medicine and Health. 2022; 50(1): 51. DOI:10.1186/s41182-022-00444-1, ##18. Amanu A, Birhanu Z, Godesso A. Sexual and reproductive health literacy among young people in Sub-Saharan Africa: evidence synthesis and implications. Global Health Action. 2023; 16(1): 2279841. DOI:10.1080/ 16549716.2023.227984 ##19. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in nursing & health. 2007; 30(4): 459-67. DOI:10.1002/nur.20199##20. Starrs AM, Ezeh AC, Barker G, et al. Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher–Lancet Commission. The lancet. 2018; 391(10140): 2642-92.##21. Biddlecom A, Awusabo-Asare K, Bankole A. Role of parents in adolescent sexual activity and contraceptive use in four African countries. International perspectives on sexual and reproductive health. 2009: 72-81.##22. Adan FI, Githae MN, Githae CA. Factors influencing access to reproductive health information services among young aged 15-24 in Garissa Municipality, Kenya. Int J Contemp Res Rev. 2018; 9(08): 20537-74##23. Ninsiima LR, Chiumia IK, Ndejjo R. Factor’s influencing access to and utilization of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review. Reproductive health. 2021; 18: 1-7. DOI:10.1186/s12978-021-01183-y, ##24. Janighorban M, Boroumandfar Z, Pourkazemi R, et al. Barriers to vulnerable adolescent girls’ access to sexual and reproductive health. BMC public health. 2022; 22(1): 2212. DOI:10.1186/s12889-022-146874 ##25. UNHCR Uganda. Livelihood and Economic Inclusion Strategic Directions 2023 – 2028. Available at: URL: https://data.unhcr.org/en/ documents/details/102633 ##26. WHO. SDG Target 3.1: Reduce the global maternal mortality ratio to less than 70 per 100,000 live births 2024. Available at: URL: https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/sdgtarget3-1-reduce-maternal-mortality##27. Heath K, Levi J, Hill A. The Joint United Nations Programme on HIV/AIDS 95–95–95 targets: worldwide clinical and cost benefits of generic manufacture. Aids. 2021; 35(Supplement 2): S197-203. DOI: 10.1097/ QAD.0000000000002983##28. Abdurahman C, Oljira L, Hailu S, et al. Sexual and reproductive health services utilization and associated factors among adolescents attending secondary schools. Reproductive Health. 2022; 19(1): 161. DOI:10.1186/ s12978-022-01468-w##29. Ndayishimiye P, Uwase R, Kubwimana I, et al. Availability, accessibility, and quality of adolescent Sexual and Reproductive Health (SRH) services in urban health facilities of Rwanda: a survey among social and healthcare providers. BMC Health Services Research. 2020; 20: 1. DOI:10.1186/s12913-020-05556-0.## ##

Epidemiology of Human Monkeypox about the 2022 Outbreak: A Narrative Review 2 2 Abstract:  Human Monkeypox is a zoonotic disease caused by 2 distinct clades of human monkeypox virus (MPXV). MPXV infections can cause several clinical symptoms including fever, skin rash, back pain, and lymphadenopathy in humans. Even though MPXV infections are generally self-limiting, death is possible and fatality due to MPXV infections in humans is 3-6 percent. While the disease is endemic to Africa, its potential to cause outbreaks in other continents has been observed. The natural reservoir of MPXV in Africa and the full host range of the virus are not known, but rodents are suggested to be the reservoirs. The transmission of MPXV occurs via close contact and the prevention strategies include avoiding close contact and post-exposure prophylactic vaccination of people at risk with smallpox vaccines. In this study, the most recent information about the epidemiology of MPXV about the latest research on the 2022 outbreak of MPXV has been reviewed.   140 148 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/17 1402/2/27 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/10 1402/6/19 Aliasghar Fakhri-Demeshghieh Aliasghar Fakhri-Demeshghieh Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran Iran aliasghar.fakhri@ut.ac.ir Hesameddin Akbarein Hesameddin Akbarein Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran Iran akbarein@ut.ac.ir Parsa Almasi Parsa Almasi Department of Internal Medicine, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran Iran parsa.almasi@ut.ac.ir Monkeypox Monkeypoxvirus epidemiology zoonoses ## ##

Evaluating Vaccination Delay in Infants during COVID-19 Outbreak in Yazd 2 2 Background: One of the potential consequences of COVID-19 is the interruption of childhood vaccination. The aim of this study is to investigate the frequency of vaccination delay in children during the COVID-19 outbreak in Yazd, Iran. Methods: In this cross-sectional study in 2020, 667 children living in Yazd were enrolled through multi-stage sampling method. Date of birth, vaccination dates of 2-, 4-, and 6- months of age, gender, family size, birth order and municipal area were extracted from the Integrated System Information Block (SIB) system. Data were analyzed using SPSS software version 22. Results: among 667 infants, 322 (48.3%) were girls and 345 (51.7%) were boys. In total, 53.5% of children had delay in vaccination at 2-month of age, 54%, at 4-month, and 45% at 6-month regarding vaccination appointment. Moreover, the dangerous delay was 3% in vaccination rounds for 2-month-olds, 5.4% for 4-month-olds, and 1.7% for 6-month-olds. At all the three appointments, there was a statistically significant difference between both the family size (P-value: 0.025, 0.017 and 0.004, respectively) and birth order (P-value: 0.015, 0.007 and 0.013, respectively) regarding vaccination delay. Conclusion: Despite the high frequency of one or more than one day delay for 2-, 4-, and 6-month-old infants regarding vaccination appointments, dangerous delay in the mentioned times was relatively infrequent. Meanwhile, family size and birth order were two influential factors respecting vaccination delay in children. It is essential to raise awareness among families, particularly those with larger size and higher number of children about the importance of timely vaccination.   150 157 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/8 1402/10/18 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/1 1402/12/11 Elham Nakhaei Elham Nakhaei School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran nakhae.e76@gmail.com Saeed Hosseini Saeed Hosseini Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Iran saeed.hosseini2014@gmail.com Mohsen Mirzaei Mohsen Mirzaei Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran drmmirzaei@yahoo.com Mahmood Vakili Mahmood Vakili Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran vakilim52@yahoo.com Narjes Hazar Narjes Hazar Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran narjeshazar@yahoo.com routine vaccination dangerous delay COVID-19 Yazd 1. Chandir S, Siddiqi DA, Mehmood M, et al. Impact of COVID-19 pandemic response on uptake of routine immunizations in Sindh, Pakistan: an analysis of provincial electronic immunization registry data. Vaccine. 2020; 38(45): 7146-55.##2. Feehan J, Apostolopoulos V. Is COVID-19 the worst pandemic?. Maturitas. 2021; 149: 56.##3. Wang Y, Dong C, Hu Y, et al. Temporal changes of CT findings in 90 patients with COVID-19 pneumonia: a longitudinal study. Radiology. 2020; 296(2): E55-E64.##4. Phelan AL, Katz R, Gostin LO. The novel coronavirus originating in Wuhan, China: challenges for global health governance. Jama. 2020; 323(8): 709-10.##5. Liao X, Wang B, Kang Y. Novel coronavirus infection during the 2019–2020 epidemic: preparing intensive care units—the experience in Sichuan Province, China. Intensive care medicine. 2020; 46: 357-60.##6. World Health Organization. COVID-19 weekly epidemiological update, edition 159. Available at: URL: https://www.who.int/publications/m/item/covid-19-epidemiological-update---29-september-2023. Accessed September 29, 2023.##7. Hosseini S, Bahrevar V, Rahmanian V, et al. Fear of COVID 19 Pandemic: A case study in Iran. Pakistan Journal of Medical and Health Sciences. 2020; 14(2): 484-7. [Persian]##8. Kabwama SN, Wanyenze RK, Kiwanuka SN, et al. Interventions for maintenance of essential health service delivery during the COVID-19 response in Uganda, between March 2020 and April 2021. International Journal of Environmental Research and Public Health. 2022; 19(19): 12522.##9. Shet A, Carr K, Danovaro-Holliday MC, et al. Impact of the SARS-CoV-2 pandemic on routine immunisation services: evidence of disruption and recovery from 170 countries and territories. The Lancet Global Health. 2022; 10(2): e186-e94.##10. Altuntaş SB, Elitok GK. Routine Pediatric Vaccination During Pandemic: Attitudes of Parents. Turkish Archives of Pediatrics. 2022; 57(3): 342.##11. Rawat M, Sehrawat A. Effect of COVID-19 on Routine Pediatric Vaccination. Asian Journal of Pediatric Research. 2020; 4(4): 14-6.##12. Saso A, Skirrow H, Kampmann B. Impact of COVID-19 on immunization services for maternal and infant vaccines: results of a survey conducted by imprint—the immunising pregnant women and infants network. Vaccines. 2020; 8(3): 556.##13. Alsuhaibani M, Alaqeel A. Impact of the COVID-19 pandemic on routine childhood immunization in Saudi Arabia. Vaccines. 2020; 8(4): 581.##14. Gras P, Bailly A-C, Lagree M, et al. What timing of vaccination is potentially dangerous for children younger than 2 years? Human Vaccines & Immunotherapeutics. 2016; 12(8): 2046-52.##15. Kiely M, Boulianne N, Talbot D, et al. Impact of vaccine delays at the 2, 4, 6 and 12 month visits on incomplete vaccination status by 24 months of age in Quebec, Canada. BMC public health. 2018; 18(1): 1-15.##16. Almoosa Z, Alhamoud HH, Alkhalaf AB, et al. Impact of Coronavirus Disease 2019 (COVID-19) pandemic on routine pediatric vaccination in Eastern Region, Saudi Arabia. Med Sci. 2020; 24(106): 4672-81.##17. Din M, Asghar M, Ali M. Delays in polio vaccination programs due to COVID-19 in Pakistan: a major threat to Pakistan's long war against polio virus. Public health. 2020; 189: 1.##18. Bramer CA. Decline in child vaccination coverage during the COVID-19 pandemic—Michigan Care Improvement Registry, May 2016–May 2020. MMWR. Morbidity and mortality weekly report. 2020; 69.##19. Ogundele OA, Omotoso AA, Fagbemi AT. COVID-19 outbreak: a potential threat to routine vaccination programme activities in Nigeria. Human Vaccines & Immunotherapeutics. 2021; 17(3): 661-3.##20. Ali I. Impact of COVID-19 on vaccination programs: adverse or positive? Human vaccines & immunotherapeutics. 2020; 16(11): 2594-600. [Persian]##21. Rahman SU, Haq FU, Imran M, et al. Impact of the COVID-19 lockdown on routine vaccination in Pakistan: a hospital-based study. Human vaccines & immunotherapeutics. 2021; 17(12): 4934-40. [Persian]##22. Russo R, Bozzola E, Palma P, et al. Pediatric routine vaccinations in the COVID 19 lockdown period: the survey of the Italian Pediatric Society. Italian Journal of Pediatrics. 2021; 47(1): 1-4.##23. Silveira MF, Tonial CT, Maranhão AGK, et al. Missed childhood immunizations during the COVID-19 pandemic in Brazil: analyses of routine statistics and of a national household survey. Vaccine. 2021; 39(25): 3404-9.##24. Wale Tegegne A, Kassie Gidafie A, Girma Mamo D, et al. Immunization Status and Challenges During COVID-19 and Associated Factors Among Children Aged 10–23 Months in South Region, Ethiopia 2020. Pediatric Health, Medicine and Therapeutics. 2021: 101-9.##25. Dong A, Meaney C, Sandhu G, et al. Routine childhood vaccination rates in an academic family health team before and during the first wave of the COVID-19 pandemic: a pre–post analysis of a retrospective chart review. Canadian Medical Association Open Access Journal. 2022; 10(1): E43-E9.##26. Hull BP, McIntyre PB. Timeliness of childhood immunisation in Australia. Vaccine. 2006; 24(20): 4403-8.##27. Odutola A, Afolabi MO, Ogundare EO, et al. Risk factors for delay in age-appropriate vaccinations among Gambian children. BMC health services research. 2015; 15: 1-9.##28. Choudhary TS, Reddy NS, Apte A, et al. Delayed vaccination and its predictors among children under 2 years in India: Insights from the national family health survey–4. Vaccine. 2019; 37(17): 2331-9.##29. Rejali M, Mohammadbeigi A, Mokhtari M, et al. Timing and delay in children vaccination; evaluation of expanded program of immunization in outskirt of Iranian cities. Journal of research in health sciences. 2015; 15(1): 54-8. [Persian]## ##

Identifying the Components of Organizational Culture in Hospital Environments: A Qualitative Study 2 2 Background: Weak organizational culture is one of the main factors of inefficiency in hospitals. Identifying the type of organizational culture of hospitals is an important step in increasing productivity. Therefore, this study was conducted with the aim of identifying the components of organizational culture. Methods: This qualitative study was conducted in Shahid Sadoughi Hospital in Yazd in 1400. The statistical population included the nurses of Shahid Sadoughi Hospital in Yazd. The sampling method used in this study was purposive and snowball sampling. To collect data, semi-structured interviews were used. The content analysis method was used to analyze the texts using MAXQDA version 10 software. Results: In this study, 13 experts were interviewed. The results of the data analysis showed that the 11 main components of organizational culture at Yazd University of Medical Sciences are rational, ideological, agreement and participation, hierarchical, constructive, passive, work and open culture, club, stronghold, flexible, Learner, and value orientation. Conclusion: The identified components of organizational culture can help healthcare managers and policymakers to improve service quality, job satisfaction, and organizational commitment of employees, improve organizational performance, and increase patient satisfaction. 158 171 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/11 1402/8/20 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/26 1403/1/7 Masoud Saffari Masoud Saffari 1. Management of organization development and administrative transformation, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran saffari.msd@gmail.com Elham Roshanian Elham Roshanian 2. Department of Business Administration, Faculty of Economics, Management and Accounting, Yazd University, Yazd, Iran Iran e_roshanian1988@yahoo.com Mohadeseh Karimizadeh Mohadeseh Karimizadeh 1. Management of organization development and administrative transformation, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran m.karimi6998@yahoo.com Alireza Rajabipoor Alireza Rajabipoor 1. Management of organization development and administrative transformation, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran alireza.rajabipoor@gmail.com Sajjad Bahariniya Sajjad Bahariniya 3. Department of Healthcare Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Iran sajjadbahari98@gmail.com Organizational culture hospital nurses employee performance and productivity 1. Mahdi F, Mojtaba Zadeh M, Kamali N. Designing and validating a scale for measuring the organizational culture of the country's universities. Bimonthly of Education Strategies in Medical Sciences. 2022; 15(1): 1-9. [Persian]##2. Chatman JA, O’Reilly CA. Paradigm lost: Reinvigorating the study of organizational culture. Research in Organizational Behavior. 2016; 36: 199-224.##3. Paais M, Pattiruhu JR. Effect of motivation, leadership, and organizational culture on satisfaction and employee performance. The Journal of Asian Finance, Economics and Business. 2020; 7(8): 577-88.##4. Lam L, Nguyen P, Le N, et al. The relation among organizational culture, knowledge management, and innovation capability: Its implication for open innovation. Journal of Open Innovation: Technology, Market, and Complexity. 2021; 7(1): 66.##5. Juliati F. The influence of organizational culture, work ethos and work discipline on employee performance. AKADEMIK: Jurnal Mahasiswa Ekonomi & Bisnis. 2021; 1(1): 34-9.##6. Pavlidou CT, Efstathiades A. The effects of internal marketing strategies on the organizational culture of secondary public schools. Evaluation and Program Planning. 2021; 84: 101894.##7. Bashokoh M, Beigi FA. The Effect of Staff Cultural Intelligence on Hospital Organizational Culture. 2021. [Persian]##8. Mannion R, Davies H. Understanding organisational culture for healthcare quality improvement. Bmj. 2018; 363.##9. Mosadeghrad AM, Parsaeian M, Hedayati SP. Organizational culture of hospitals affiliated to Tehran University of Medical Sciences. Journal of the Iranian Institute for Health Sciences Research. 2023; 22(4). [Persian]##10. Mosadeghrad AM, Ashrafi E. The impact of quality management on patient satisfaction in a hospital: brief report. Tehran University of Medical Sciences Journal. 2017; 75(3): 228-34. [Persian]##11. Mosadeghrad AM. Strategic collaborative quality management and employee job satisfaction. International journal of health policy and management. 2014; 2(4): 167. [Persian]##12. Mosadeghrad AM. Quality of working life: an antecedent to employee turnover intention. International journal of health policy and management. 2013; 1(1): 43. [Persian]##13. Ojogiwa OT, Qwabe BR. Leveraging on the management of organisational cultural change for an improved change outcome in the Nigerian public health sector. African Journal of Governance and Development. 2021; 10(1): 61-79.##14. Lee D. Impact of organizational culture and capabilities on employee commitment to ethical behavior in the healthcare sector. Service Business. 2020; 14(1): 47-72.##15. Glisson C, Williams NJ, Hemmelgarn A, et al. Increasing clinicians' EBT exploration and preparation behavior in youth mental health services by changing organizational culture with ARC. Behaviour research and therapy. 2016; 76: 40-6.##16. Lee E, Jang I. Nurses’ fatigue, job stress, organizational culture, and turnover intention: A culture–work–health model. Western journal of nursing research. 2020; 42(2): 108-16.##17. Yoo JY, Kim JH, Kim JS, et al. Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS one. 2019; 14(12): e0226742.##18. Mosadeghrad AM, Parsaeian M, Hedayati P. Organizational culture of hospitals affiliated to Tehran University of Medical Sciences. Payesh (Health Monitor) Journal. 2023; 22(4): 375-85. [Persian]##19. Yasavoli AR, Salajeghe S, Shekari GA, et al. The Relationship between Organizational Culture and Productivity Effects in Hospitals of Mashhad University of Medical Sciences. North Khorasan University of Medical Sciences. 2019; 10(4): 40-4.##20. Bahmani A, Biglarkhani A, Fallahinia GH, et al. The Relationship Between Organizational Culture and Knowledge Management in Educational-Therapeutic Hospitals(Case study Hamadan Educational-Therapeutic Hospitals in 2017). Avicenna Journal of Nursing and Midwifery Care. 2018; 26(3): 203-10. [Persian]##21. Tashakkori A, Teddlie C. Handbook of mixed methods in social & behavioral research: Sage Publications, Inc; 2003.##22. Guba EG, Lincoln YS. Competing paradigms in qualitative research. Handbook of qualitative research. 1994; 2(163-194): 105.##23. Ruona WE. Analyzing qualitative data. Research in organizations: Foundations and methods of inquiry. 2005; 223(263): 233-63.##24. Belotto MJ. Data analysis methods for qualitative research: Managing the challenges of coding, interrater reliability, and thematic analysis. The Qualitative Report. 2018; 23(11): 2622-33.##25. Berry JC, Davis JT, Bartman T, et al. Improved safety culture and teamwork climate are associated with decreases in patient harm and hospital mortality across a hospital system. Journal of patient safety. 2020; 16(2): 130-6.##26. Rafferty A-M, Ball J, Aiken LH. Are teamwork and professional autonomy compatible, and do they result in improved hospital care? BMJ Quality & Safety. 2001; 10(suppl 2): ii32-ii7.##27. Zincirkiran M, Emhan A, Yasar MF. Analysis of teamwork, organizational commitment and organizational performance: A study of health sector in Turkey. Asian Journal of Business and Management. 2015; 3(2).##28. Hassan Mohamed S, Ahmed Abd Allah Mohamed N, Hussein Yassein Hussein N. Perspective of Teamwork Effectiveness and Its Relation with Job Attraction and Organizational Commitment among Staff Nurses. Egyptian Journal of Health Care. 2022; 13(1): 996-1008. [Persian]##29. Körner M, Wirtz MA, Bengel J, et al. Relationship of organizational culture, teamwork and job satisfaction in interprofessional teams. BMC health services research. 2015; 15: 1-12.##30. Adeoye AO, Hope O. Organizational culture, employee retention and employee loyalty: Empirical evidence from Nigeria. Academic Journal of Economic Studies. 2020; 6(3): 139-45.##31. Park J-K, Ahn J, Han S-L, et al. Exploring internal benefits of medical tourism facilitators’ satisfaction: customer orientation, job satisfaction, and work performance. Journal of Healthcare Management. 2020; 65(2): 90-105.##32. Aburayya A, Marzouqi A, Alawadhi D, et al. An empirical investigation of the effect of employees’ customer orientation on customer loyalty through the mediating role of customer satisfaction and service quality. Management Science Letters. 2020; 10(10): 2147-58.##33. Rohim A, Budhiasa IGS. Organizational culture as moderator in the relationship between organizational reward on knowledge sharing and employee performance. Journal of Management Development. 2019; 38(7): 538-60.##34. Pardede J. The Effects Acceptance and Aommitment Therapy and Health Education Adherence to Symptoms, Ability to Accept and Commit to Treatment and Compliance in Hallucinations Clients Mental Hospital of Medan, North Sumatra. J Psychol Psychiatry Stud. 2019; 1: 30-5.##35. Hollander H. Construction flexibility and adaptability inside hospitals: Queensland University of Technology; 2020.##36. Apostu SA, Vasile V, Veres C. Externalities of lean implementation in medical laboratories. Process optimization vs. adaptation and flexibility for the future. International Journal of Environmental Research and Public Health. 2021; 18(23): 12309.##37. Anning-Dorson T. Organizational culture and leadership as antecedents to organizational flexibility: implications for SME competitiveness. Journal of Entrepreneurship in Emerging Economies. 2021; 13(5): 1309-25.##38. Ani KJ, Onu C, Anikelechi IG. Contributions of interpersonal conflict management on performance of government hospitals in Nigeria. Independent Journal of Management & Production. 2021; 12(7): 1785-807.##39. Umrani WA, Afsar B, Khan M, et al. Addressing the issue of job performance among hospital physicians in Pakistan: The role of job security, organizational support, and job satisfaction. Journal of Applied Biobehavioral Research. 2019; 24(3): e12169.##40. Saadeh IM, Suifan TS. Job stress and organizational commitment in hospitals: The mediating role of perceived organizational support. International Journal of Organizational Analysis. 2020; 28(1): 226-42.##41. 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The Prevalence of Smartphone Addiction and Its Associated Risk Factors among School Students of a Metropolitan City: A Cross-Sectional Study 2 2 Background: Smartphone is a term used to distinguish cell phones with advanced features from basic feature phones. Smartphone addiction is a phenomenon that pertains to uncontrollability of smartphone use. The increasing use of smartphones and easy availability of smartphones to school children after Covid-19 Pandemic were the reasons for conducting this study. Aims - To estimate the prevalence of smartphone addiction among school children and its associated risk factors Methods: This was a cross-sectional study conducted on English middle-school students of Mumbai, involving students from secondary section i.e.,6th to 10thgrade. Data were collected by interview using a pre-structured questionnaire, and all the students were asked to fill out smartphone addiction questionnaire i.e. Smartphone Application Based Addiction Scale (SABA). Then, data were entered into Microsoft EXCEL and analysed using SPSS. Results: The mean age of 275 participants, was 13.1, and the prevalence of smartphone addiction in the present study was 45.5%. Addiction was significantly associated with age (P value 0.000), gender (P value 0.004), self-owned phone (P value 0.03), duration of time spent on phone on weekdays(P value 0.000) and weekends (P value 0.000), having social media accounts(P value 0.000),and the time spent on social media (P value 0.042). On applying logistic regression, female gender and the time spent on social media were the major risk factors. Conclusions: The risk factors associated with addiction are age, female gender; owning a smartphone, increased time spent on phones on weekdays and weekends, having social media accounts and excessive time spent on social media applications. 172 179 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/11 1403/3/22 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/1 1403/7/10 Smita Chavhan Smita Chavhan Department of Community Medicine, Cooper Hospital Mumbai, Mumbai, India India drsmita1409@gmail.com Kamran Qureshi Kamran Qureshi Department of Community Medicine, Cooper Hospital Mumbai, Mumbai, India India qureshikamran41090@gmail.com Saniya Qureshi Saniya Qureshi Department of Community Medicine, Cooper Hospital Mumbai, Mumbai, India India saniqureshi33@gmail.com Deepika Bishnoi Deepika Bishnoi Department of Community Medicine, Cooper Hospital Mumbai, Mumbai, India India deepika.r.bishnoi@gmail.com Students social media cell phones 1. Sager I. Before IPhone and Android came Simon, the first smartphone. Bloomberg Businessweek. 2012; 29(1): 14-26. ##2. “Ericsson GS88 Preview”. Eri-no-moto; 2006. Available at: URL: http://www.pws.prserv.net/Eri_no_moto/ GS88_ Preview.htm2011-12-15.##3. Sarwar M, Soomro TR. Impact of smartphone’s on society. European journal of scientific research. 2013; 98(2): 216-26.##4. Kraut R, Patterson M, Lundmark V, Kiesler S, Mukophadhyay T, Scherlis W. Internet paradox: A social technology that reduces social involvement and psychological well-being?. American psychologist. 1998; 53(9): 1017.##5. Turner A. How Many Smartphones Are in the World?. 2020. Available at: URL: https://www. bankmycell. com/blog/how-many-phones-are-in-the-world. Accessed May 21, 2021.##6. Taylor P. Number of smartphone subscriptions worldwide from 2016 to 2021, with forecasts from 2022 to 2027##7. Newzoo. Top Countries/Markets by Smartphone Penetration & Users [Internet]. Newzoo. 2022. Available at: URL: https://newzoo.com/insights/rankings/top-countries-by-smartphone-penetration-and-users##8. Young KS. Internet addiction: Evaluation and treatment. Bmj. 1999; 319 (Suppl S4).##9. Griffiths M. Gambling on the Internet: A brief note. J. Gambl. Stud. 1996; 12: 4-71.##10. Griffiths MA. ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance use. 2005; 10(4): 191-7.##11. Chang J. Smartphone Addiction Statistics You Must See: 2022 Usage and Data Analysis. Finances Online. 90; 6. Available at: URL: https://financesonline.com/smartphone-addiction-statistics/##12. Davey S, Davey A. Assessment of smartphone addiction in Indian adolescents: A mixed method study by systematic-review and meta-analysis approach. International journal of preventive medicine. 2014; 5(12): 1500. ##13. Jamir L, Duggal M, Nehra R, Singh P, Grover S. Epidemiology of technology addiction among school students in rural India. Asian journal of psychiatry. 2019; 40: 30-8.##14. Csibi S, Griffiths MD, Cook B, Demetrovics Z, Szabo A. The psychometric properties of the smartphone application-based addiction scale (SABAS). International journal of mental health and addiction. 2018; 16(2): 393-403.##15. Zhong Y, Ma H, Liang YF, Liao CJ, Zhang CC, Jiang WJ. Prevalence of smartphone addiction among Asian medical students: A meta-analysis of multinational observational studies. International Journal of Social Psychiatry. 2022; 68(6): 1171-83.##16. Pradeep BS, Shenoy AB, Shahane S, Srividya RN, Arelingaiah M, D’Souza R, Garady L, Jyoti MK, Rache S, et al. Age, gender, peers, life skills and quality of life influence risk of cell phone addiction among college teachers in Karnataka, India: a state level epidemiological analysis. BMC Public Health. 2022; 22(1): 180.##17. Nayak JK. Relationship among smartphone usage, addiction, academic performance and the moderating role of gender: A study of higher education students in India. Computers & Education. 2018; 123: 164-73.##18. Priya N, Maheswari PU. Influence of different parental mediation strategies on adolescents’ hedonistic smartphone use: Parent–adolescent reports. Mobile Media & Communication. 2024: 20501579241260649.##19. Lee H, Ahn H, Choi S, Choi W. The SAMS: Smartphone addiction management system and verification. Journal of medical systems. 2014; 38: 1-0.##20. Haug S, Castro RP, Kwon M, et al. Smartphone use and smartphone addiction among young people in Switzerland. Journal of behavioral addictions. 2015; 4(4): 299-307.##21. Abbasi GA, Jagaveeran M, Goh YN, et al. The impact of type of content use on smartphone addiction and academic performance: Physical activity as moderator. Technology in Society. 2021; 64: 101521.##22. Jain P, Gedam SR, Patil PS. Study of smartphone addiction: prevalence, pattern of use, and personality dimensions among medical students from rural region of central India. Open Journal of Psychiatry & Allied Sciences. 2019; 10(2): 132-8.##23. Mathew P, Raman K. Prevalence of problematic internet use and internet usage pattern among adolescents. Indian Journal of Psychiatric Nursing. 2020; 17(1): 39-50.##24. Singh A, Ali A, Choudhury M, et al. Online gaming and its association with emotional and behavioral problems among adolescents–A study from Northeast India. Archives of Mental Health. 2020; 21(2): 71-6.## ##

Prevalence of Internet Use among Adolescents of 15 to 18 Years of Age in A Village under RHTC of A Medical College: Cross-Sectional Study 2 2 Background: The environment in which today’s adolescents are growing has changed drastically and affected their access to internet as well. The study was conducted with the aim of estimating the prevalence of internet use and pattern of internet use among adolescents of a village area. Methods: About 114 adolescents of a village in Western Maharashtra belonging to age group 15-18 years participated in the study. They were selected based on the inclusion criteria of age group and willingness to participate in the study via universal sampling method and were interviewed with the help of semi-structured questionnaire, which included questions regarding socio-demography, internet use and its interrelationship with other variables. Chi-square test was used as a test of statistical significance to study the association between the predictor variable and the outcome with (p<0.05) as a level of significance. Results: The prevalence of internet use was 99.12%. Where 74% of adolescents used internet for an average of 1-2 hours in a day and 26% used internet for an about 2-4 hours in a day. Taking p < 0.05 as a level of significance we found gender was significantly associated with duration of internet use (p = 0.01) and Purpose of internet use (p = 0.004). Conclusion: Almost all adolescents have access to internet and are more inclined towards its use for non-educational purpose which can be detrimental for their educational progress and long-term career goals. Hence, monitoring of internet use by adolescents has to be done by guardians/teachers. Further studies should be conducted on cause-effect relationship to study the either way of association.   180 188 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/24 1403/1/5 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/9 1403/3/20 Bhagwan Morale Bhagwan Morale Department of Community medicine B.J GMC & SGH, Maharashtra University of Health Sciences, Pune, India India moralebhagwan2@gmail.com Jagannath Dixit Jagannath Dixit Department of Community medicine B.J GMC & SGH, Maharashtra University of Health Sciences, Pune, India India drjvdixit@gmail.com Varsharani Kendre Varsharani Kendre Department of Community medicine B.J GMC & SGH, Maharashtra University of Health Sciences, Pune, India India mundevarsharani@gmail.com Muralidhar Tambe Muralidhar Tambe Department of Community medicine B.J GMC & SGH, Maharashtra University of Health Sciences, Pune, India India muralidhartambe@gmail.com Vinay Kumar Vinay Kumar Department of Community medicine B.J GMC & SGH, Maharashtra University of Health Sciences, Pune, India India vinaykr663@gmail.com Adolescents Behaviour addictive Internet use Mental health 1. Vadher SB, Panchal BN, Vala AU, et al. Predictors of problematic Internet use in school going adolescents of Bhavnagar, India. Int J Soc Psychiatry. 2019; 65(2): 151-157. DOI: 10.1177/0020764019827985. ##2. Mathew P, Krishnan R Dr. Impact of problematic internet use on the self-esteem of adolescents in the selected school, Kerala, India. Arch Psychiatr Nurs. 2020; 34(3): 122-128. DOI: 10.1016/j.apnu.2020.02.008. ##3. Tenzin K, Dorji T, Gurung MS, et al. Prevalence of Internet Addiction and Associated Psychological Co-morbidities among College Students in Bhutan. JNMA J Nepal Med Assoc. 2018; 56(210): 558-564. ##4. A Profile of Adolescents and Youth in India. 30 June, 2014. Available at: URL: https://india.unfpa.org/sites/ default/files/pubpdf/AProfileofAdolescentsandYouthinIndia_0.pdf. Accessed April 4, 2023.##5. Internet in India 2022. Published in April 2023. Available at: URL: https://www.iamai.in/sites/default/files/research/ Internet%20in%20India%202022_Print%20version.pdf . Accessed April 14, 2023.##6. Ko CH, Yen JY, Liu SC, et al. The associations between aggressive behaviors and internet addiction and online activities in adolescents. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine. 2009; 44(6): 598-605. DOI: 10.1016/j.jadohealth.2008.11.01.##7. Joseph J, Varghese A, Vijay VR, et al. Problematic internet use among school going adolescents in India: A systematic review and meta analysis. Indian J Community Med. 2022; 47: 321-7.##8. Cha SS, Seo BK. Smartphone use and smartphone addiction in middle school students in Korea: Prevalence, social networking service, and game use. Health Psychol Open. 2018; 5(1): 2055102918755046. DOI: 10.1177/2055102918755046. ##9. Jeong YJ, Suh B, Gweon G. Is smartphone addiction different from Internet addiction? Comparison of addiction-risk factors among adolescents. Behav. Inf. Technol. 2019; 39: 1-16. DOI:10.1080/0144929X.2019.1604805.##10. Ran G, Li J, Zhang Q, et al. The association between social anxiety and mobile phone addiction: A three-level meta-analysis. Comput. Hum. Behav. 2022; 130: 107198.##11. Zhang Q, Ran G, Ren J. Parental Psychological Control and Addiction Behaviors in Smartphone and Internet: The Mediating Role of Shyness among Adolescents. Int J Environ Res Public Health. 2022; 19(24): 16702.##12. Gedam SR, Shivji IA, Goyal A, et al. Comparison of internet addiction, pattern and psychopathology between medical and dental students. Asian Journal of Psychiatry. 2016; 22: 105-110. DOI: 10.1016/j.ajp.2016.06.007.##13. Schmid UK, Kumpel AS, Rieger D. How social media users perceive different forms of online hate speech: A qualitative multi-method study. New Media & Society. 2022: 0(0). DOI:10.1177/14614448221091185##14. Jhala J, Sharma R. Prevalence and Nature of Internet Use among Adolescents in Vadodara (Gujarat). Int J of Ind Psy. 2017; 2348-5396. DOI:10.25215/0402.164.##15. Prabhakaran MC, Patel VR, Ganjiwale DJ, et al. Factors associated with internet addiction among school-going adolescents in Vadodara. J Family Med Prim Care. 2016; 5(4): 765-769. DOI: 10.4103/2249-4863.201149. ##16. Chen JJ, Bai J. Internet Use and Academic Achievement among Chinese Adolescents: Examining the Mediating Role of Future Orientation in a Rural-Urban Dual System. Psychol Res Behav Manag. 2022; 15: 2439-2448. DOI: 10.2147/PRBM.S343199. ##17. Durkee T, Kaess M, Carli V, et al. Prevalence of pathological internet use among adolescents in Europe: demographic and social factors. Addiction. 2012; 107(12): 2210-2222. DOI:10.1111/j.1360-0443.2012.03946.x##18. Hong FY, Huang DH, Lin HY, et al. Analysis of the psychological traits, Facebook usage, and Facebook addiction model of Taiwanese university students. Telematics and Informatics. 2014; 31: 597-606.##19. Kirschner P, Karpinski AC. Facebook (R) and academic performance. Computers in Human Behavior. 2010; 26: 1237-1245. DOI:10.1016/j.chb.2010.03.024.##20. Krishnamurthy S, Chetlapalli SK. Internet addiction: Prevalence and risk factors: A cross-sectional study among college students in Bengaluru, the Silicon Valley of India. Indian J Public Health. 2015; 59(2): 115-21. DOI: 10.4103/0019-557X.157531.##21. Raju Srijampana VG, Endreddy AR, Prabhath K, et al. Prevalence and patterns of internet addiction among medical students. Med J DY Patil Univ. 2014; 7: 709-713. Available at: URL: https://journals.lww.com/mjdy/ pages/default.aspx/ text.asp?2014/7/6/709/144851##22. Dhawan V, Kang T, Sharma S. Internet addiction among adolescents in India: a study of gender differences. Multilogic in Science. 2021; 10: 1457-1463.##23. Parel JT, Thomas L. Level of internet addiction among nursing students: A cross sectional survey. Asian Journal of Nursing Education and Research. 2017; 7(4): 466–470.##24. McKinsey Global Institute (2019). Digital India: Technology to transform a connected nation. Available at: URL: https://www.mckinsey.com/~/media/McKinsey/Business%20Functions/McKinsey%20Digital/Our%20Insights/Digital%20India%20Technology%20to%20transform%20a%20connected%20nation/Digital-India-technology-totransform-a-connected-nation-Executive-Summary.ashx. Accessed September 16, 2023.##25. Throuvala MA, Griffiths MD, Rennoldson M, et al. Policy Recommendations for Preventing Problematic Internet Use in Schools: A Qualitative Study of Parental Perspectives. Int J Environ Res Public Health. 2021; 18(9): 4522. DOI: 10.3390/ijerph18094522.## ##

Understanding Factors Responsible for Delay and Non-Compliance in COVID-19 Vaccination at a Tertiary Care Hospital in Mumbai, India 2 2 Background: Despite extensive first-dose coverage, delays in second doses and late first doses prompted a study on vaccine hesitancy and non-compliance. Methods: In 2022, a cross-sectional survey was conducted at a Mumbai vaccination center, involving 504 individuals who had received either the first or second dose of the COVID-19 vaccine. The study, conducted from February to April 2022, included interviews using a pre-validated schedule to assess vaccine acceptance, refusal, socio-demographics, and reasons for hesitancy. Data analysis was performed using IBM SPSS Statistics software 23.0 to understand factors influencing vaccine delay and non-compliance. Result: The study interviewed 504 participants at a Mumbai vaccination center. Most were male (63.9%), aged 18-44 (80%), and skilled workers (22.6%). Of those surveyed, 64 had received only the first vaccine dose. The delay in receiving the second dose was 37.4% for BBV152 and 41% for ChAdOx1 nCoV-19. The primary reason for delay was lack of time (50.6%), followed by fear of the vaccine (14.8%). Reasons for getting vaccinated later included resolving constraints (40.5%) and compulsion (25.8%). Vaccine choice reasons varied significantly (p < 0.0005), but delay proportions were similar across vaccines (p = 0.531). Conclusion: Even after many efforts by the government, large numbers of people have not taken vaccine on time. One of the reasons, as seen in the study is a busy work schedule which has hindered timely vaccination in individuals. Making vaccine available at work place may address this issue to some extent, besides ownership of the program by the public.   189 198 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/20 1403/4/30 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/11 1403/7/20 Roshni C Miranda Roshni C Miranda HBT Medical College & Dr RN Cooper Hospital, Mumbai, India India drroshnicdsouza@gmail.com Girijaprasad Patil Girijaprasad Patil HBT Medical College & Dr RN Cooper Hospital, Mumbai, India India patilgirijaprasad@gmail.com Priyanka D Chate Priyanka D Chate HBT Medical College & Dr RN Cooper Hospital, Mumbai, India India priyankadchate@gmail.com COVID-19 Vaccination hesitancy Hospital 1. World Health Organisation. WHO Coronavirus (COVID-19) Dashboard. [Online]. Available at: URL:https://covid19.who.int/. Accessed Feb 21, 2023.##2. Rutten LJ, Zhu X, Leppin AL, et al. Evidence-based strategies for clinical organizations to address COVID-19 vaccine hesitancy. InMayo clinic proceedings. 2021; 96(3): 699-707.##3. Edwards B, Biddle N, Gray M, et al. COVID-19 vaccine hesitancy and resistance: Correlates in a nationally representative longitudinal survey of the Australian population. PloS one. 2021; 16(3): e0248892.##4. Hou Z, Tong Y, Du F, et al. Assessing COVID-19 vaccine hesitancy, confidence, and public engagement: a global social listening study. J Med Internet Res. 2021; 23(6): e27632. DOI: 10.2196/27632.##5. Soares P, Rocha JV, Moniz M, et al. Factors associated with COVID-19 vaccine hesitancy. Vaccines (Basel). 2021; 9(3): 300. DOI: 10.3390/vaccines9030300.##6. Ministry of Health and Family Welfare, Government of India. Co-WIN. [Online]. Available from: URL:https://www.cowin.gov.in/. Accessed Feb 21, 2023.##7. Chakraborty C, Sharma AR, Bhattacharya M, et al. The current second wave and COVID-19 vaccination status in India. Brain, behavior, and immunity. 2021; 96: 1-4. DOI: 10.1016/j.bbi.2021.05.018.##8. Piltch-Loeb R, Harriman NW, Healey J, et al. COVID-19 vaccine concerns about safety, effectiveness, and policies in the United States, Canada, Sweden, and Italy among unvaccinated individuals. Vaccines (Basel). 2021; 9(10): 1138. DOI: 10.3390/vaccines9101138. ##9. Cerda AA, García LY. Hesitation and refusal factors in individuals' decision-making processes regarding a coronavirus disease 2019 vaccination. Front Public Health 2021; 9: 626852. DOI: 10.3389/fpubh.2021.626852.##10. Chandani S, Jani D, Sahu PK, et al. COVID-19 vaccination hesitancy in India: State of the nation and priorities for research. Brain Behav Immun Health. 2021; 18: 100375. DOI: 10.1016/j.bbih.2021.100375.##11. Umakanthan S, Patil S, Subramaniam N, et al. COVID-19 vaccine hesitancy and resistance in India explored through a population-based longitudinal survey. Vaccines (Basel). 2021; 9(10): 1064. DOI: 10.3390/vaccines9101064.##12. El-Elimat T, AbuAlSamen MM, Almomani BA, et al. Acceptance and attitudes toward COVID-19 vaccines: A cross-sectional study from Jordan. PLoS One. 2021; 16(4): e0250555. DOI: 10.1371/journal.pone.0250555.##13. Lazarus JV, Wyka K, White TM, et al. A survey of COVID-19 vaccine acceptance across 23 countries in 2022. Nat Med. 2023; 29: 366–375. DOI: 10.1038/s41591-022-02185-4.##14. Lazarus JV, Wyka K, White TM, et al. Revisiting COVID-19 vaccine hesitancy around the world using data from 23 countries in 2021. Nat Commun. 2022; 13: 3801. DOI:10.1038/s41467-022-31441-x.##15. Freeman D, Loe SH, Yu L, et al. Effects of different types of written vaccination information on COVID-19 vaccine hesitancy in the UK (OCEANS-III): a single-blind, parallel-group, randomised controlled trial. Lancet Public Health. 2021; 6: e416–27. https://doi.org/10.1016/S2468-2667(21)00096-7.##16. Leigh JP, Moss SJ, White TM, et al. Factors affecting COVID-19 vaccine hesitancy among healthcare providers in 23 countries. Vaccine. 2022; 40(31): 4081-9.##17. Inam A, Mushtaq A, Zaman S, et al. Vaccine hesitancy and post-vaccination adherence to safety measures: A mixed-method study. Frontiers in Public Health. 2023; 11: 1072740.##18. Hill PL, Burrow AL, Strecher VJ. Sense of purpose in life predicts greater willingness for COVID-19 vaccination. Social Science & Medicine. 2021; 284: 114193.##19. Tolia V, Renin Singh R, Deshpande S, et al. Understanding factors to COVID-19 vaccine adoption in Gujarat, India. International Journal of Environmental Research and Public Health. 2022; 19(5): 2707.##20. Jain J, Saurabh S, Kumar P, et al. COVID-19 vaccine hesitancy among medical students in India. Epidemiology & Infection. 2021; 149: e132.##21. Romate J, Rajkumar E, Greeshma R. Using the integrative model of behavioural prediction to understand COVID-19 vaccine hesitancy behaviour. Scientific Reports. 2022; 12(1): 9344.## ##

The Role of Fathers' Involvement in Parenting and Adolescent Social Harms: A Narrative Review 2 1   2 Background: In today's society, the issue of fatherhood and involvement in the upbringing of children has been emphasized. The study aimed to investigate the impact of fathers' involvement in parenting on the social victimization of adolescents. Methods: The present research utilized a narrative review methodology, with technical terms being explained at the beginning. Relevant sources were identified by conducting searches on reputable academic databases, including ISI Web of Knowledge, PubMed, Google Scholar, ProQuest, Ovid, Elsevier, SID, and Magiran, covering the period from 2000 to 2023. The search keywords encompassed various related themes, such as fatherhood, absent fathers, childrearing, adolescents, father involvement, engagement, social problems, and Boolean operators (AND, OR, NOT). Compilation procedures were conducted according to the SANRA checklist. In the initial search, 162 articles were obtained. After removing duplicates and evaluating their titles and abstracts, 9 articles were selected for the review. Results: Based on the findings of this literature review, paternal involvement in child-rearing is shown to positively affect the intellectual, moral, and social development of adolescents. Conversely, the absence of a father figure has been linked to negative outcomes such as drug addiction, decreased academic performance in both school and university, anti-social attitudes, separation anxiety, aggression, feelings of insecurity, and negative thoughts in teenagers. Conclusion: The involvement of fathers in upbringing of their children fosters critical thinking and reinforces children's empowerment in making pivotal decisions, while simultaneously acting as a safeguard against social risks. 199 212 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/25 1402/12/6 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/19 1403/3/30 Maryam Mohammadi Maryam Mohammadi 1. Research Center for Nursing and Midwifery Care, Non-communicable Diseases Institute, Department of Midwifery, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2. 3. Department of Midwifery and Reproductive Health, School of Nursing and Midwifery Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Iran Maryammohammadi0224@yahoo.com Fateme Moshirenia Fateme Moshirenia Research Center for Nursing and Midwifery Care, Non-communicable Diseases Institute, Department of Midwifery , School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Iran F.moshirenia@gmail.com Moradali Zareipour Moradali Zareipour Department of Public Health, Khoy University of Medical Sciences, Khoy, Iran Iran z.morad@yahoo.com Shahnaz Kohan Shahnaz Kohan Department of Midwifery and Reproductive Health, School of Nursing and MidwiferyReproductive Sciences and Sexual Health Research CenterIsfahan University of Medical Sciences Iran kohan@nm.mui.ac.ir Zahra Boroumandfar Zahra Boroumandfar Department of Midwifery and Reproductive Health, School of Nursing and MidwiferyReproductive Sciences and Sexual Health Research CenterIsfahan University of Medical Sciences Iran boroumandfar@nm.mui.ac.ir Fatherhood Parenting Social harms 1. Kohan S, Simbar M, Taleghani F. Exploring women's empowerment experiences in family planning in socio-cultural context of Isfahan city: A qualitative study; 2012. [Persian]##2. Sourinejad H, Reisi Dehkordi Z, Kohan S, et al. Comparison of parenting style and mental health in single-child and multiple-children mothers in Isfahan, Iran. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2020; 5(4): 62-71. [Persian]##3. Verniers C, Bonnot V, Assilaméhou-Kunz Y. Intensive mothering and the perpetuation of gender inequality: Evidence from a mixed methods research. Acta psychologica. 2022; 227: 103614.##4. Jessee V, Adamsons K. Father involvement and father–child relationship quality: An intergenerational perspective. Parenting. 2018; 18(1): 28-44.##5. Esping-Andersen G. Families in the 21st Century: SNS förlag Stockholm; 2016.##6. Sarkadi A, Kristiansson R, Oberklaid F, et al. Fathers' involvement and children's developmental outcomes: A systematic review of longitudinal studies. Acta paediatrica. 2008; 97(2): 153-8.##7. Diniz E, Brandao T, Monteiro L, et al. Father involvement during early childhood: A systematic review of the literature. Journal of Family Theory & Review. 2021; 13(1): 77-99.##8. Yogman MW, Eppel AM. The role of fathers in child and family health. Engaged fatherhood for men, families and gender equality: Healthcare, social policy, and work perspectives. 2022: 15-30.##9. Yaffe Y. Systematic review of the differences between mothers and fathers in parenting styles and practices. Current psychology. 2023; 42(19): 16011-24.##10. Canning V, Tombs S. From social harm to zemiology: A critical introduction: Routledge; 2021.##11. Nasiri Asl S, Nemat Firouzjaian J. Analyzing the experience of high-risk behavior among teenagers, emphasizing the conflict between children and parents. Sociological studies. 2023; 61(16): 19-27. [Persian]##12. Bagheri Z, Boroumandfar Z, Shirazi M. Self-care needs in the domains of knowledge, attitude and performance of adolescent girls with regard to drug addiction and risky sexual behaviors in Iran. Iranian journal of nursing and midwifery research. 2021; 26(5): 411-6. [Persian]##13. Janighorban M, Boroumandfar Z, Pourkazemi R, et al. Barriers to vulnerable adolescent girls’ access to sexual and reproductive health. BMC public health. 2022;22(1):2212. [Persian]##14. Madih A, Rahmat MR, Arzhang A. Favorable Social and Moral Consequences of Organized Crime Management in Society. International Journal of Ethics and Society. 2023; 5(2): 9-17.##15. Thompson MJ. An ontological account of social pathology. Pathology diagnosis and social research: New applications and explorations. 2021: 113-40.##16. Mezmur H, Assefa N, Alemayehu T. Teenage pregnancy and its associated factors in eastern Ethiopia: a community-based study. International Journal of Women's Health. 2021: 267-78.##17. Anand P, Kahn LB. The effect of a peer’s teen pregnancy on sexual behavior. Journal of Health Economics. 2024; 96: 102888.##18. Chikovore ES, Sooryamoorthy R. Perspectives on Sexual Behaviour. Family Influence on Adolescent Sexual Behaviour in South Africa. 2024: 65-105.##19. Fagan J. The myth of low-income Black fathers’ absence from the lives of adolescents. Journal of Family Issues. 2024; 45(1): 144-62.##20. Lei M-K, Beach SR. Testing Whether Protective Parenting is a Causal Mediator of Intervention Effects on Decreased Delinquency Using a Randomized Prevention Trial. Justice Quarterly. 2024: 1-22.##21. Dopke C, Romm KF, Berg CJ. Parental openness and communication regarding cannabis and alcohol use with their children. The American journal on addictions. 2024; 33(1): 15-25.##22. Hare MM, Trucco EM, Hawes SW, et al. Pathways to substance use: Examining conduct problems and parenting behaviors from preschool to adolescence. Development and Psychopathology. 2024; 36(1): 454-66.##23. Bozzini AB, Bauer A, Maruyama J, et al. Factors associated with risk behaviors in adolescence: a systematic review. Brazilian Journal of Psychiatry. 2020; 43: 210-21. ##24. Qureshi MS, Khattak AZ, Alay A. The Effect of Father's Absence on Depression Levels in Male Children. Journal of Behavioural Sciences. 2021; 31(1): 124. [Persian]##25. Langergaard MJ, Ernst A, Brix N, et al. Prenatal Exposure to Parental Lifestyle Factors, Diseases, and Use of Medications and Male Pubertal Development: a Review of Epidemiological Studies Published 2017–2022. Current Epidemiology Reports. 2023; 10(1): 61-83.##26. Panula V, Junttila N, Aromaa M, et al. Parental psychosocial well-being as a predictor of the social competence of a child. Journal of child and family studies. 2020; 29(11): 3004-19.##27. Criss MM, Cui L, Wood EE, et al. Associations between emotion regulation and adolescent adjustment difficulties: Moderating effects of parents and peers. Journal of Child and Family Studies. 2021; 30(8): 1979-89.##28. Temmen CD, Crockett LJ. The importance of father involvement for adolescent internalizing and externalizing symptoms. Psychology of Men & Masculinities. 2021; 22(3): 564.##29. Fitzgerald HE, von Klitzing K, Cabrera N, et al. Handbook of fathers and child development: Springer; 2020.##30. Mao M, Zang L, Zhang H. The effects of parental absence on children development: evidence from left-behind children in China. International journal of environmental research and public health. 2020; 17(18): 6770.##31. Mays CJ, Krueger LE. Does locus of control influence parentification and anxiety in father–daughter relationships? Journal of Family Issues. 2021; 42(12): 2881-95.##32. Li X. How do Chinese fathers express love? Viewing paternal warmth through the eyes of Chinese fathers, mothers, and their children. Psychology of Men & Masculinities. 2021; 22(3): 500.##33. Wilder S. Effects of parental involvement on academic achievement: a meta-synthesis. Mapping the field: Routledge; 2023; 137-57.##34. Bateson K, Darwin Z, Galdas P, et al. Engaging fathers: acknowledging the barriers. Journal of Health Visiting. 2017; 5(3): 126-32.##35. Lee SJ, Yelick A, Brisebois K, et al. Low-income fathers’ barriers to participation in family and parenting programs. Journal of Family Strengths. 2011; 11(1): 12.##36. Cabrera N, Peters HE. Public policies and father involvement. Fatherhood: Routledge; 2014; 295-314.##37. Jukes LM, Di Folco S, Kearney L, Sawrikar V. Barriers and facilitators to engaging mothers and fathers in family-based interventions: a qualitative systematic review. Child Psychiatry & Human Development. 2022:1-15.##38. Ellis BJ, Bates JE, Dodge KA, et al. Does father absence place daughters at special risk for early sexual activity and teenage pregnancy? Child development. 2003; 74(3): 801-21.##39. Castetter C. The developmental effects on the daughter of an absent father throughout her lifespan; 2020.##40. Qureshi MS, Shah AA, Qureshi MI. Development and Validation of Shah & Qureshi Father’s Involvement Inventory (S&QFII). Journal of Development and Social Sciences. 2022; 3(3): 258-69. [Persian]##41. Rabbani M, Javadian SR, Askari-Nodoushan A. Consequences of father’s long work hours on the intergenerational relationship quality: A qualitative study. Journal of Social Continuity and Change (JSCC). 2022; 1(1): 57-75.##42. Nord CW, West J. Fathers' and Mothers' Involvement in Their Children's Schools by Family Type and Resident Status. National Household Education Survey. Statistical Analysis Report: ERIC; 2001.##43. Bano J, Jabeen Z, Qutoshi SB. Perceptions of teachers about the role of parents in developing reading habits of children to improve their academic performance in schools. Journal of Education and Educational Development. 2018; 5(1).##44. Qureshi MS, Ahmad A. Effects of father absence on children's academic performance. Journal of Educational, Health and Community Psychology. 2014; 3(1): 1-6. [Persian]##45. Mosley J, Thomson E. Fathering behavior and child outcomes: The role of race and poverty; 1995.##46. Lui M, Lau GK, Tam VC, et al. Parents’ impact on children’s school performance: Marital satisfaction, parental involvement, and mental health. Journal of Child and Family Studies. 2020; 29: 1548-60.##47. Malonda E, Llorca A, Mesurado B, et al. Parents or peers? Predictors of prosocial behavior and aggression: A longitudinal study. Frontiers in psychology. 2019;10:2379.##48. Flouri E, Buchanan A. The role of father involvement in children's later mental health. Journal of adolescence. 2003; 26(1): 63-78.##49. Chung G, Phillips J, Jensen TM, et al. Parental involvement and adolescents’ academic achievement: Latent profiles of mother and father warmth as a moderating influence. Family process. 2020; 59(2): 772-88.##50. McLanahan S, Tach L, Schneider D. The causal effects of father absence. Annual review of sociology. 2013; 39: 399-427.##51. King V, Sobolewski JM. Nonresident fathers’ contributions to adolescent well‐being. Journal of Marriage and Family. 2006; 68(3): 537-57.##52. Flouri E. Fathering and child outcomes: John Wiley & Sons; 2005.##53. East L, Jackson D, O'Brien L. Father absence and adolescent development: a review of the literature. Journal of Child Health Care. 2006; 10(4): 283-95.##54. Rollè L, Gullotta G, Trombetta T, et al. Father involvement and cognitive development in early and middle childhood: A systematic review. Frontiers in psychology. 2019; 10: 2405.##55. Zhao X, Zhang A, Liu W, et al. Childhood separation from parents with cognitive and psychopathological outcomes in adolescence. Developmental Science. 2023; 26(3): e13324.##56. Fatemi D, Rahimi A, Saadati MMA. The Survey of Family’s Role in Delinquency of Teenagers (Case Study: Zanjan City’s Teenagers). Strategic Research on Social Problems in Iran. . 2016; 5(3): 35-50.##57. Zimmerman MA, Salem DA, Notaro PC. Make room for daddy II: The positive effects of fathers' role in adolescent development. Resilience across contexts: Psychology Press; 2012; 233-53.##58. Ogundele MO. Behavioural and emotional disorders in childhood: A brief overview for paediatricians. World journal of clinical pediatrics. 2018; 7(1): 9.##59. Esmaeilpour K, Jamil L. Relationship between perceived parenting practices and maternal paternal trait anxiety with young adults' anxiety. Journal of Instruction and Evaluation. 2014; 7(25): 75-85.## ##

Designing the Spiritual Care Training Courses for Healthcare Staff 2 2 Background: Admission to a hospital increases individuals' vulnerability and consequent requirements for religion and/or spirituality. Religion and spirituality are two relevant but inequivalent concepts. Religion consists of a set of beliefs, rituals, and affairs that usually characterize a community's faith in a sacred power. The purpose of this research is to design the title and objectives of the spiritual care course for service providers. Methods: This research was a mixed exploratory study (qualitative and quantitative) with text analysis and descriptive-analytical methods. First, the review of similar texts and sources published between 2012 and 2023, and after classifying and analyzing them, the final components and titles of spiritual care courses, including 32 components, are available to experts and experts for valid review and evaluation. The statistical community at this stage includes all medics, nurses, clergy, managers, and carers in the field of spiritual health in the country, and 13 people were selected by purposive sampling to reach the Theoretical saturation stage. By examining and revising the components by experts and specialists, the final components and titles of spiritual care courses were designed as 8 goals and 4 titles. To validate the components extracted from Lavshe's method (to convert qualitative to quantitative judgment) two quantitative validity indices (CVI) and validity ratio (CVR) were used. Results: The minimum and maximum acceptable values ​​were 0.80 in the CVR index and 0.77 in the CVI index. The research findings showed that out of 8 objectives, 7 goals, and 4 titles, all the proposed titles are approved and valid. Conclusion: Based on the findings, it can be concluded that the designed titles and goals of spiritual care can be used as a guide for developing spiritual care training courses in medical centers and hospitals. 213 220 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/252024/07/19 1403/4/29 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/192024/10/22 1403/8/1 Mohammad Hassan Lotfi Mohammad Hassan Lotfi 1. Department of Biostatistics & Epidemiology, Health Faculty, ShahidSadoughi University of Medical Sciences, Yazd, Iran, Islamic Republic Of Iran 2. Spiritual Health Research Center, Department of Health Research, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mhlotfi56359@gmail.com Masoumeh Dashtabadi Masoumeh Dashtabadi 1. Department of Counseling, Yazd Branch, Islamic Azad University, Yazd, Iran 2. Spiritual Health Research Center, Department of Health Research, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran ma.dashtabadi67@gmail.com Esmail Emami Esmail Emami Department of Islamic Revolution, University of Islamic Sciences, Qom, Iran Iran Hasan Zare Khormizi Hasan Zare Khormizi Spiritual Health Research Center, Department of Health Research, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mh.zare48@gmail.com Spiritual care Healthcare staff Courses 1. Abbasi M, Khalajinia Z, Abbasinia M, et al. Explaining the experiences of nurses about barriers of religious care in hospitalized patients: a qualitative study. Health Spiritual Med Ethics. 2018; 5(4): 36-45. [Persian]##2. Dezorzi LW, Raymundo MM, Goldim JR, et al. Spirituality in the continuing education of healthcare professionals: An approach to palliative care. Palliative & Supportive Care. 2019; 17(6): 662-7.##3. Puchalski CM, Vitillo R, Hull SK, et al. Improving the spiritual dimension of whole person care: reaching national and international consensus. Journal of palliative medicine. 2014; 17(6): 642-56.##4. Liefbroer AI, Ganzevoort RR, Olsman E. Addressing the spiritual domain in a plural society: What is the best mode of integrating spiritual care into healthcare?. Mental Health, Religion & Culture. 2019; 22(3): 244-60.##5. Sulmasy DP. A biopsychosocial-spiritual model for the care of patients at the end of life. The gerontologist. 2002; 42(suppl_3): 24-33.##6. Merath K, Palmer Kelly E, Hyer JM, et al. Patient perceptions about the role of religion and spirituality during cancer care. Journal of religion and health. 2020; 59: 1933-45.##7. Balboni MJ, Sullivan A, Amobi A, et al. Why is spiritual care infrequent at the end of life? Spiritual care perceptions among patients, nurses, and physicians and the role of training. Journal of clinical oncology. 2013; 31(4): 461-7.##8. Palmer Kelly E, Hyer M, Payne N, et al. Does spiritual and religious orientation impact the clinical practice of healthcare providers?. Journal of interprofessional care. 2020; 34(4): 520-7.##9. Bar-Sela G, Schultz MJ, Elshamy K, et al. Training for awareness of one's own spirituality: A key factor in overcoming barriers to the provision of spiritual care to advanced cancer patients by doctors and nurses. Palliative & supportive care. 2019; 17(3): 345-52.##10. Ripamonti CI, Giuntoli F, Gonella S, et al. Spiritual care in cancer patients: a need or an option?. Current opinion in oncology. 2018; 30(4): 212-8.##11. Rykkje L, Søvik MB, Ross L, et al. Educational interventions and strategies for spiritual care in nursing and healthcare students and staff: A scoping review. Journal of clinical nursing. 2022; 31(11-12): 1440-64.##12. Bar-Sela G, Schultz MJ, Elshamy K, et al. Training for awareness of one's own spirituality: A key factor in overcoming barriers to the provision of spiritual care to advanced cancer patients by doctors and nurses. Palliative & supportive care. 2019; 17(3): 345-52.##13. Viftrup DT, Laursen K, Hvidt NC. Developing an educational course in spiritual care: an action research study at two Danish hospices. Religions. 2021; 12(10): 827.##14. Jones KF, Paal P, Symons X, et al. The content, teaching methods and effectiveness of spiritual care training for healthcare professionals: A mixed-methods systematic review. Journal of Pain and Symptom Management. 2021; 62(3): e261-78.##15. Damari B, Hajebi A, Bolhari J, et al. Developing a training course for spiritual counselors in health care: Evidence from Iran. Indian journal of palliative care. 2018; 24(2): 145.##16. Huang X, Wei F, Hu L, et al. Epidemiology and clinical characteristics of COVID-19. Archives of Iranian medicine. 2020; 23(4): 268-71.##17. Bolhari J, Mohsenikabir M. Compiling and evaluating educational package of spiritual skills for university students. Iranian Journal of Psychiatry and Clinical Psychology. 2019; 25(2): 210-21. [Persian]##18. Asadzandi M, Abolghasemi H, Javadi M, et al. A Comparative assessment of the spiritual health behaviors of the Iranian Muslim in the COVID-19 pandemic with religious evidence. Journal of Military Medicine. 2020; 22(8): 864-72. [Persian]##19. Sadeghi M. Human cloning, divine religious authorities point of views and Islamic jurisprudence. Comp Law Res. 2004; 8(3): 35-60. [Persian]##20. Dashtabadi M, Fallah MH, Sederposhan N, et al. Designing A Spiritual Care Training Course for Clergymen. Health, Spirituality & Medical Ethics Journal. 2023; 10(4). [Persian]## ##

Health System Efficiency in Iran and Its Influencing Factors 2 2 Background: Given the importance of public health, evaluating the performance of the health system and striving to address its shortcomings is a concern for policymakers and health officials. The aim of this study is to examine the health system efficiency in Iran and investigate the impact of economic variables on the health system efficiency. Methods: In this study, the Stochastic Frontier Analysis (SFA) method was used to evaluate the health system efficiency in Iran, using data from Iranian provinces in 2016. The Stata software was used to evaluate the health system efficiency and investigate the impact of economic variables on the health system efficiency. Results: According to findings, the highest level of efficiency belonged to Alborz and Mazandaran provinces, while the lowest level of efficiency belonged to Sistan and Baluchestan and Ilam provinces. Regression estimates using the Tobit method indicated that the coverage of social insurance and the private sector share of healthcare costs have a positive effect on efficiency, while per capita production has a negative effect on the health system efficiency. Also, the coefficients obtained for GDP per capita, the population covered by insurance and the share of the private sector were -0.00049, 0.00602, and 0.00640, respectively. Conclusion: The average health system efficiency in the provinces varies significantly, suggesting that there is a considerable gap from optimal efficiency. It is recommended to expand the coverage of social insurance, which includes healthcare insurance, in order to improve the health system efficiency, so that more people can benefit from its services. The second suggestion is to pay more attention to the private sector in the health sector.   221 227 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/252024/07/192024/06/20 1403/3/31 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/192024/10/222024/10/8 1403/7/17 Habib Ansari Samani Habib Ansari Samani Department of Economics - Faculty of Economics, Management and Accounting - Yazd University - Yazd - Iran Iran Ha.ansarisa@gmail.com Malek Khabbazi Khanaghah Malek Khabbazi Khanaghah Department of Economics - Faculty of Economics, Management and Accounting - Yazd University - Yazd - Iran Iran m.khabbazi.kh@gmail.com Health System Efficiency Stochastic Frontier Analysis Tobit Iran 1. Bahadori MK, Abolghasemi K, Teymourzadeh E. Performance evaluation and ranking of selective wards in a military hospital using DEA and promethee method. Journal of military medicine. 2017; 18(4): 325-34. [Persian]##2. Gómez-Gallego JC, Gómez-Gallego M, García-García JF, et al, editors. Evaluation of the efficiency of European health systems using fuzzy data envelopment analysis. Healthcare; 2021: MDPI.##3. Lupu D, Tiganasu R. COVID-19 and the efficiency of health systems in Europe. Health Economics Review. 2022; 12(1): 14.##4. Oliaeimanesh A, Takian A, Mouhamadi E. Assessing the health system efficiency in the Islamic Republic of Iran. 1, editor. tehran: sharif publisher; 2021. [Persian]##5. Cylus J, Smith PC. Comparative measures of health system efficiency. Health system performance comparison: an agenda for policy, information and research. 2013: 281-312.##6. Kang J, Peng R, Feng J, et al. Health systems efficiency in China and ASEAN, 2015–2020: a DEA-Tobit and SFA analysis application. BMJ open. 2023; 13(9): e075030.##7. Gong G, Chen Y, Gao H, et al. Has the efficiency of China’s healthcare system improved after healthcare reform? A network data envelopment analysis and tobit regression approach. International journal of environmental research and public health. 2019; 16(23): 4847.##8. Khan C, Nasrulddin V. Privatization, corporatization, and public-private partnership in the Kingdom of Saudi Arabia. Health services insights. 2022; 15: 11786329221104240. [Persian]##9. Ismaili F, Mehr Al-Hosni M, Gudarzi R. Determining the efficiency of the direct treatment department of the treatment management units of the Social Security Organization of Iran using the stochastic frontier analysis (SFA) method during the years 2007-2014. Journal of Hospital. 2020; 5(2): 155-64. [Persian]##10. Sedighi H, Nosrati F, Baskha B. Evaluating the health system efficiency in Iran compared to the countries that are members of the Economic Cooperation and Development Organization using the non-parametric method of data coverage analysis. Journal of management strategies in the health system. 2020; 5(2): 155-64. [Persian]##11. Godarzi H, Haghighat Fard E, Vali L. Estimating the efficiency of Kerman province hospitals using the stochastic frontier analysis method 1386-1390. Journal of health-oriented research. 2015; 1(2): 105-14.##12. Aghlmand S, Feizollahzadeh S, Fathi B, et al. The stochastic frontier analysis technique in measuring the technical and economic efficiency of hospital diagnostic laboratories: a case study in Iran. Cost Effectiveness and Resource Allocation. 2022; 20(1): 65. [Persian]##13. Fried H. The Measurement of Productive Efficiency and Productivity Growth: Oxford University Press; 2008.##14. Zhong K, Chen L, Cheng S, et al. The efficiency of primary health care institutions in the counties of Hunan Province, China: data from 2009 to 2017. International journal of environmental research and public health. 2020; 17(5): 1781.##15. Cheng J, Kuang X, Zeng L. The impact of human resources for health on the health outcomes of Chinese people. BMC Health Services Research. 2022; 22(1): 1213.##16. Asiabar AS, Sharifi T, Rezapour A, et al. Technical efficiency and its affecting factors in Tehran’s public hospitals: DEA approach and Tobit regression. Medical Journal of the Islamic Republic of Iran. 2020; 34: 176. [Persian]##17. Gautier L, Ridde V. Health financing policies in Sub-Saharan Africa: government ownership or donors’ influence? A scoping review of policymaking processes. Global health research and policy. 2017; 2: 1-17.##18. Arhin K, Oteng-Abayie EF, Novignon J. Effects of healthcare financing policy tools on health system efficiency: Evidence from sub-Saharan Africa. Heliyon. 2023; 9(10).##19. Medarević A, Vuković D. Efficiency and productivity of public hospitals in Serbia using DEA-malmquist model and tobit regression model, 2015–2019. International journal of environmental research and public health. 2021; 18(23): 12475.##20. Yang Q, Xu Q, Lu Y, et al. The impact of public health insurance on household credit availability in rural China: Evidence from NRCMS. International Journal of Environmental Research and Public Health. 2020; 17(18): 6595.## ##

Determinants of Hypertensive Disorders in Pregnant Women Attended at Parirenyatwa Group of Hospitals in Zimbabwe from January - December 2022 2 2 Background: Globally 2.73% of pregnant women suffer from hypertension. Currently, there is still a gap of knowledge in Zimbabwe on hypertensive disorders of pregnancy hence the present study. Methods: An analytical cross-sectional study was conducted. The structured checklist was used to extract data. HBP was measured two times on the right arm using an electronic device (OMRON HEM-7261) with an average of two readings. Patient records were used to collect secondary data from prenatal care visits and laboratory tests. We used simple random sampling methods to screen prenatal care records for pregnant women. All pregnant women at Parirenyatwa Group of Hospitals in 2022 were eligible and constituted our study population. The sample size was determined statistically by power analysis using epidemiological information, this yielded a sample of 240. The Prevalence of HBP in pregnancy and risk factors were determined by Fisher exact test using Graph Pad (Prism version6.0), P < 0.05 was set as statistically significant. Results: 240 pregnant women were enrolled given a prevalence of HBP of   25%. Most pregnant women having HBP are 36 to 40 years old and located in urban areas (92%, n = 55). Gestational age 33 % (n = 5), Gravida 3-4 (33%, n = 13) Parity 3-4 (74%, n = 25), and Multiple Pregnancy (25%, n = 5) were the most associated with HBP. Pre-existing hypertension was the most common comorbidity 92%.Family history of HBP (OR = 4.62, 95%, CI = 1.4-15.1), p = 0.016) and age being < 30 years OR= 0.26, 95%, CI = 0.14-0.49), p = 0.0001) were associated with HBP. Conclusions: The prevalence of HBP in pregnancy was higher (25%) than the worldwide prevalence of 2.7% and risk factors are mainly age and family history of HBP. 228 236 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/252024/07/192024/06/202024/08/21 1403/5/31 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/192024/10/222024/10/82024/10/18 1403/7/27 Loice Nhamo Loice Nhamo Department of Biomedical and Laboratory Sciences, College of Health Agriculture and Natural Sciences, Africa University, Mutare, Zimbabwe Africa nhamol@africau.edu Mahamane Salissou Maibouge Tanko Mahamane Salissou Maibouge Tanko Department of Biomedical and Laboratory Sciences, College of Health Agriculture and Natural Sciences, Africa University, Mutare, Zimbabwe Africa salissoum@africau.edu Sundika Makengo Olivier Sundika Makengo Olivier Department of Biomedical and Laboratory Sciences, College of Health Agriculture and Natural Sciences, Africa University, Mutare, Zimbabwe Africa sundikam@africau.edu Prevalence High blood pressure Determinants Pregnancy Prevalence high blood pressure Risk factors 1. Kobashi G. Genetic and environmental factors associated with the development of hypertension in pregnancy. Journal of epidemiology. 2006; 16(1): 1-8.##2. Program NHBPE. Report of the national high blood pressure education program working group on high blood pressure in pregnancy. American journal of obstetrics and gynecology. 2000; 183(1): s1-s22.##3. Tranquilli A, Dekker G, Magee L, et al. The classification, diagnosis, and management of the hypertensive disorders of pregnancy: a revised statement from the ISSHP. Elsevier. 2014; 97-104.##4. Wang L, Ye W, Xiong W, et al. Effects of blood pressure level management on maternal and perinatal outcomes in pregnant women with mild to moderate gestational hypertension. Ginekologia Polska. 2020; 91(3): 137-43.##5. Abalos E, Cuesta C, Carroli G, et al. Pre‐eclampsia, eclampsia, and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry S survey on M maternal and N newborn H health. BJOG: An International Journal of Obstetrics & Gynaecology. 2014; 121: 14-24.##6. Stuart JJ, Tanz LJ, Missmer SA, et al. Hypertensive disorders of pregnancy and maternal cardiovascular disease risk factor development: an observational cohort study. Annals of internal medicine. 2018; 169(4): 224-32.##7. Noubiap JJ, Bigna JJ, Nyaga UF, et al. The burden of hypertensive disorders of pregnancy in Africa: a systematic review and meta‐analysis. The Journal of Clinical Hypertension. 2019; 21(4): 479-88.##8. Benschop L, Duvekot JJ, van Lennep JER. Future risk of cardiovascular disease risk factors and events in women after a hypertensive disorder of pregnancy. Heart. 2019; 105(16): 1273-8.##9. Tachiweyika E, Gombe N, Shambira G, et al. Determinants of perinatal mortality in Marondera district, Mashonaland East Province of Zimbabwe, 2009: a case-control study. The Pan African Medical Journal. 2011; 8.##10. Muti M, Tshimanga M, Notion GT, et al. Prevalence of pregnancy-induced hypertension and pregnancy outcomes among women seeking maternity services in Harare, Zimbabwe. BMC cardiovascular disorders. 2015; 15: 1-8.##11. Gemechu KS, Assefa N, Mengistie B. Prevalence of hypertensive disorders of pregnancy and pregnancy outcomes in Sub-Saharan Africa: A systematic review and meta-analysis. Womens Health (Lond). 2020; 16: 1745506520973105.##12. Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. The Lancet Global Health. 2014; 2(6): e323-e33.##13. Noubiap JJ, Bigna JJ, Nyaga UF, et al. The burden of hypertensive disorders of pregnancy in Africa: A systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2019; 21(4): 479-88.##14. Raj K, Paul A, Bansal K, et al. Incidence of gestational hypertension among pregnant women in the rural population of District Amritsar-A community-based study. EXECUTIVE EDITOR. 2018; 9(8): 42.##15. Ye C, Ruan Y, Zou L, et al. The 2011 Survey on Hypertensive Disorders of Pregnancy (HDP) in China: Prevalence, Risk Factors, Complications, Pregnancy and Perinatal Outcomes. PLoS ONE. 2014; 9(6).##16. Berhe AK, Kassa GM, Fekadu GA, et al. Prevalence of hypertensive disorders of pregnancy in Ethiopia: a systemic review and meta-analysis. BMC Pregnancy Childbirth. 2018; 18(1): 34.##17. Umesawa M, Kobashi G. Epidemiology of hypertensive disorders in pregnancy: prevalence, risk factors, predictors and prognosis. Hypertens Res. 2017; 40(3): 213-20.##18. Lisonkova S, Joseph KS. Incidence of preeclampsia: risk factors and outcomes associated with early- versus late-onset disease. Am J Obstet Gynecol. 2013; 209(6): 544.e1-.e12.##19. Sengodan SS, Sreeprathi N. Prevalence of hypertensive disorders of pregnancy and its maternal outcome in a tertiary care hospital, Salem, Tamil Nadu, India. International Journal of reproduction, contraception, Obstetrics and Gynecology. 2020; 9(1): 236-40.##20. Larson E, Rabkin M, Mbaruku GM, et al. Missed opportunities to improve the health of postpartum women: high rates of untreated hypertension in rural Tanzania. Maternal and child health journal. 2017; 21: 407-13.##21. Olié V, Moutengou E, Grave C, et al. Prevalence of hypertensive disorders during pregnancy in France (2010-2018): The Nationwide CONCEPTION Study. J Clin Hypertens (Greenwich). 2021; 23(7): 1344-53.## ##

A Review of the Breastfeeding Importance from the Perspective of the Holy Quran and Medical Literature 2 2 Background: Mother's breast milk is the sole and best food for a neonate. It is one of the blessings of Almighty God that is physiologically given to the child through the mother’s breast. Breastfeeding is one of the issues receiving special attention in the Holy Quran. Nowadays, this issue has been explored and investigated in scientific and medical literature. In the present review, the importance of breastfeeding was examined from the reported medical scientific studies and articles and compared with the verses of the Holy Quran and authentic Islamic traditions. Methods: This scoping review was developed by PubMed, Web of Science, and Google Scholar using predetermined keywords. Authentic narrations related to breastfeeding in Arabic and articles published in English during 2014-2024 on its importance in neonatal health were selected by the present researchers. After applying inclusion criteria, the papers related to this topic were screened by experts for suitability. Results: This review included one verse of the Holy Quran, 3 valid authentic Islamic traditions, and 6 scientific medical literature highlighting the importance of mothers’ breastfeeding. Thematic analysis indicated the health and safety of mothers during breastfeeding. Breastfeeding duration and breastfeeding time are important points in the Holy Quran and traditions emphasized by researchers. Conclusion: The present study revealed that the results of scientific medical literature, like the Holy Quran, emphasizes the importance of breastfeeding. There are special instructions for breastfeeding in the Holy Quran. Today, the guidelines of the Quran in this field of study are emphasized in scientific research articles. 237 242 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/252024/07/192024/06/202024/08/212024/08/2 1403/5/12 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/192024/10/222024/10/82024/10/182024/12/21 1403/10/1 Mohammad Reza Yavari Mohammad Reza Yavari Department of Islamic Sciences, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mhsalmani4306@gmail.comm Mohammad Javad Salmani Mohammad Javad Salmani Department of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran Iran mgsalmani80@yahoo.com Kazem Barzegar Kazem Barzegar Department of English Language, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran kbarprof@ssu.ac.ir Mohammad Hossein Salmani Mohammad Hossein Salmani Food Safety and Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mhsn06@yahoo.com Holy Quran Breastfeeding Medical literature Scientific Mothers 1. Shamir R. The benefits of breast feeding. Protein in neonatal and infant nutrition: recent updates. 2016; 86: 67-76.##2. Mehrpisheh S, Memarian A, Ameri M, et al. The importance of breastfeeding based on Islamic rules and Qur’an. Hospital Practices and Research. 2020; 5(2): 37-41.##3. Bayyenat S, Hashemi SA, Purbafrani A, Saeidi M, Khodaee GH. The importance of breastfeeding in Holy Quran. International Journal of Pediatrics. 2014; 2(4): 339-47.##4. Alimoradi F, Javadi M, Barikani A, et al. An overview of importance of breastfeeding. Journal of Comprehensive Pediatrics. 2014; 5(2).##5. Pereira PC. Milk nutritional composition and its role in human health. Nutrition. 2014; 30(6): 619-27.##6. Ciampo LA, Ciampo IR. Breastfeeding and the Benefits of Lactation for Women’s Health. Revista Brasileira de Ginecologia e Obstetrícia. 2018; 40(06): 354-9.##7. Firoozabadi MD, Ali MS. Breastfeeding from Quran to medical science. Int J Curr Res Acad Rev. 2015; 3(7): 134-7.##8. Nuri M. Mustadrak Al-wasa'il: Mu'assisa Al al-Bayt li Ihya' al-Turath. 1988; 15: 156-157.##9. Brahm P, Valdes V. Benefits of breastfeeding and risks associated with not breastfeeding. Rev Chil Pediatr. 2017; 88(1): 15-21.##10. Quran Holy. Al-baqarah (233). Avalible at: URL: https://quran.com/en/al-baqarah/233##11. Nuri MH. Musdrak Al-vasa'il: Mu'assisa Al al-Bayt li Ihya' al-Turath. 1988; 21(15).##12. Al-Amili, A.-H., Wasa"ll Al-Shia, 1988. 21.##13. Cheng YJ, Yeung CY. Recent advance in infant nutrition: Human milk oligosaccharides. Pediatrics & Neonatology. 2021; 62(4): 347-53.##14. Hassiotou F, Geddes DT. Immune cell-mediated protection of the mammary gland and the infant during breastfeeding. Adv Nutr. 2015 15;6(3):267-75. doi: 10.3945/an.114.007377.##15. Power ML, Schulkin J. Milk: the biology of lactation. JHU Press; 2016.##16. Mirghafourvand M, Kamalifard M, Ranjbar F, et al. Relationship of breastfeeding self-efficacy with quality of life in Iranian breastfeeding mothers. The Journal of Maternal-Fetal & Neonatal Medicine. 2018; 31(20): 2721-8.##17. Meek JY, Noble L. Breastfeeding and the use of human milk. Pediatrics. 2022; 150(1): e2022057988.##18. Quigley MA, Carson C, Sacker A, et al. Exclusive breastfeeding duration and infant infection. European journal of clinical nutrition. 2016; 70(12): 1420-7.## ##

Prevalence of Primary Dysmenorrhea and Its Associated Risk Factors among Adolescent Girls in Selected Schools of Lusaka District, Zambia 2 2 Background: Dysmenorrhea is a common gynecological issue among young females. However, no studies in Zambia have examined the prevalence and associated factors of primary dysmenorrhea among adolescent girls. This study aimed to determine the prevalence and associated factors of primary dysmenorrhea among adolescents in selected schools in the Lusaka District. Methods: A cross-sectional study was conducted in eight randomly selected schools in Lusaka, including 400 post-menarche girls aged 10–19 years. Participants were selected via random sampling, and data were collected using a researcher-designed questionnaire informed by literature. The tool included closed-ended and Likert scale questions, piloted for reliability (Cronbach's alpha: 0.8–0.9). Analysis was performed using STATA version 14.2, with variables having p < 0.05 in multivariate logistic regression considered statistically significant. Results: All 400 participants responded (response rate: 100%). The prevalence of primary dysmenorrhea was 78% (312/400; 95% CI: 73.6%–82.0%). Major risk factors included a positive family history (p < 0.001) and symptoms like breast tenderness (p = 0.008), diarrhea (p < 0.001), headache (p = 0.002), and nausea (p = 0.015). Menstrual cycles lasting 31–35 days (p = 0.034) and moderate menstrual flow (p = 0.011) were also significant. Conclusion: Primary dysmenorrhea is highly prevalent among adolescents in Lusaka. Determinants included family history, long cycles, moderate flow intensity, and menstrual discomfort. 243 255 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/252024/07/192024/06/202024/08/212024/08/22024/05/15 1403/2/26 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/192024/10/222024/10/82024/10/182024/12/212024/09/11 1403/6/21 Nachizya Edith Namukanga Nachizya Edith Namukanga 1. Department of Epidemiology & Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia- 2. School of Health and Applied Sciences, UNICAF University, Lusaka, Zambia Zambia nachizyanamukanga@gmail.com Joseph Mumba Zulu Joseph Mumba Zulu Department of Community Health, Health Promotion and Policy, School of Public Health, University of Zambia, Lusaka, Zambia Zambia josephmumbazulu@gmail.com Margarate N Munakampe Margarate N Munakampe Department of Community Health, Health Promotion and Policy, School of Public Health, University of Zambia, Lusaka, Zambia Zambia margaratemuna@yahoo.com Dennis M Ngosa Dennis M Ngosa 1. Department of Epidemiology & Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia 2. Analysis Unit, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia Zambia dennisngosam@gmail.com Samson Shumba Samson Shumba Department of Epidemiology & Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia Zambia samsonshumba1@gmail.com Choolwe Jacobs Choolwe Jacobs Department of Epidemiology & Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia Zambia choolwe2003@yahoo.com Prevalence Dysmenorrhea Adolescent Risk Factors Menstruation Karout S, Soubra L, Rahme D, et al. Prevalence, risk factors, and management practices of primary dysmenorrhea among young females. BMC Womens Health. 2021; 21(1): 392.##2. Midilli TS, Yasar E, Baysal E. Dysmenorrhea characteristics of female students of health school and affecting factors and their knowledge and use of complementary and alternative medicine methods. Holistic Nursing Practice. 2015; 29(4): 194-204.##3. Omidvar S, Bakouei F, Amiri FN, et al. Primary dysmenorrhea and menstrual symptoms in Indian female students: prevalence, impact and management. Global journal of health science. 2015; 8(8): 135.##4. Smith RP, and Kaunitz AM. Patient education: Painful menstrual periods (dysmenorrhea) beyond the basics. Waltham, MA: UpToDate, Inc.; 2020. Available at: URL: https://myvirtualphysician.com/wp-content/uploads/2020/05/Patient-education_-Painful-menstrual-periods-dysmenorrhea-Beyond-the-Basics-UpToDate.pdf ##5. Maitri Shah MS, Anuradha Monga AM, Sangita Patel SP, et al. A study of prevalence of primary dysmenorrhea in young students-a cross-sectional study. 2013: 30-34.##6. Deligeoroglou E, Tsimaris P. Menstrual disturbances in puberty. Best Pract Res Clin Obstet Gynaecol. 2010; 24(2): 157-71.##7. Ju H, Jones M, Mishra G. The prevalence and risk factors of dysmenorrhea. Epidemiologic reviews. 2014; 36(1): 104-13.##8. Abdel-Salam DM, Alnuman RW, Alrwuaili RM, et al. Epidemiological aspects of dysmenorrhea among female students at Jouf University, Saudi Arabia. Middle East Fertility Society Journal. 2018; 23(4): 435-9.##9. Akiyama S, Tanaka E, Cristeau O, et al. Evaluation of the treatment patterns and economic burden of dysmenorrhea in Japanese women, using a claims database. ClinicoEconomics and Outcomes Research. 2017: 295-306.##10. Ghafouri M, Teymourzadeh A, Nakhostin-Ansari A, et al. Prevalence and predictors of low back pain among the Iranian population: Results from the Persian cohort study. Ann Med Surg (Lond). 2022; 74: 103243.##11. Marjoribanks J, Ayeleke RO, Farquhar C, et al. Nonsteroidal anti‐inflammatory drugs for dysmenorrhoea. Cochrane database of systematic reviews. 1996; 2015(7).##12. Gebeyehu MB, Mekuria AB, Tefera YG, et al. Prevalence, impact, and management practice of dysmenorrhea among University of Gondar students, northwestern Ethiopia: A cross‐sectional study. International journal of reproductive medicine. 2017; 2017(1): 3208276.##13. Azagew AW, Kassie DG, Walle TA. Prevalence of primary dysmenorrhea, its intensity, impact and associated factors among female students’ at Gondar town preparatory school, Northwest Ethiopia. BMC women's health. 2020; 20: 1-7.##14. Muluneh AA, Nigussie TS, Gebreslasie KZ, et al. Prevalence and associated factors of dysmenorrhea among secondary and preparatory school students in Debremarkos town, North-West Ethiopia. BMC Women's Health. 2018; 18: 1-8.##15. MK AN. Comparative study on Dysmenorrhoea Initial management system by Indian student and Zambians student in ITM University. Journal of Medical Care Research and Review. 2018; 1(2): 29-33.##16. Ministry of Health and Social Services (Zamibia), ICF. Zamibia Demographic and Health Survey 2018, Maryland, USA: Ministry of Health and Social Services and ICF International; 2018. Available at: URL: https://www.dhsprogram.com/pubs/pdf/FR361/FR361.pdf ##17. Lghoul S, Loukid M, Hilali MK. Prevalence and predictors of dysmenorrhea among a population of adolescent’s schoolgirls (Morocco). Saudi Journal of Biological Sciences. 2020; 27(7): 1737-42.##18. Amu EO, Bamidele JO. Prevalence of menstrual disorders among adolescent girls in Osogbo, South Western Nigeria. Int J Adolesc Med Health. 2014; 26(1): 101-6. ##19. Nyirenda T, Nyagumbo E, Murewanhema G, et al. Prevalence of dysmenorrhea and associated risk factors among university students in Zimbabwe. Womens Health (Lond). 2023; 19: 17455057231189549. ##20. Osayande AS, Mehulic S. Diagnosis and initial management of dysmenorrhea. American family physician. 2014; 89(5): 341-6.##21. Hikma N, Faizah Z, Amalia RB. Literature review irregular menstrual cycle based on bmi and body fat percentage. Indonesian Midwifery and Health Sciences Journal. 2021; 5(3):242-50.##22. Kotagasti T. Prevalence of different menstrual irregularities in women with abnormal uterine bleeding (AUB)-an observational study. International Journal of Current Research and Review. 2015; 7(10): 66.##23. Itani R, Soubra L, Karout S, et al. Primary dysmenorrhea: pathophysiology, diagnosis, and treatment updates. Korean journal of family medicine. 2022; 43(2): 101.##24. Mrugacz G, Grygoruk C, Sieczyński P, et al. Etiopatogeneza zespołu bolesnegomiesiączkowania [Etiopathogenesis of dysmenorrhea]. Med Wieku Rozwoj. 2013; 17(1): 85-9##25. Sharlini P, Sukandar H, Fadil R. Familial Predisposition of Primary Dysmenorrhea among Senior High School Girl Students. Althea Medical Journal. 2015; 2(4): 579-83.##26. Parveen N, Majeed R, Rajar UD. Familial predisposition of dysmenorrhea among the medical students. Pak j med sci. 2009; 25(5): 857-60.##27. Septiyani T, Simamora S. Riwayat Keluarga, Aktivitas Fisik dan Pola Makan terhadap Kejadian Dismenorea Primer pada Wanita. Journal of Agri-food, Nutrition and Public Health. 2021; 2(2): 88-96.##28. Ylikorkala O, Dawood MY. New concepts in dysmenorrhea. American Journal of Obstetrics and Gynecology. 1978; 130(7): 833-47.## ##

Depression and Anxiety as Potential Risk Factors for Tuberculosis 2 2 No Abstract   256 258 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/252024/07/192024/06/202024/08/212024/08/22024/05/152024/12/1 1403/9/11 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/192024/10/222024/10/82024/10/182024/12/212024/09/112024/12/15 1403/9/25 Ehsan Allah Kalteh Ehsan Allah Kalteh 1. Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2. Management and Social Development Research Center, Golestan University of Medical Sciences, Golestan, Iran Iran kalteh270@yahoo.com Masoud Mirzaei Masoud Mirzaei Non-Communicable Disease Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran masoud_mirzaei@hotmail.com Ayuob Shokoufamanesh Ayuob Shokoufamanesh Department of Public Health, Torbat jam University of Medical Sciences, Torbat jam, Iran Iran ayub.shokoufa@gmail.com Hossein Akhondi Hossein Akhondi Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran 7041hosseinakhondi@gmail.com Shahin Izadi Shahin Izadi Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran shahin.izadi.65@gmail.com Tuberculosis Depression Anxiety Iran Risk factors 1. Price C, Nguyen AD. Latent Tuberculosis. StatPearls [Internet]: StatPearls Publishing; 2024.##2. Dheda K, Barry CE, Maartens G. Tuberculosis. The Lancet. 2016; 387(10024): 1211-26.##3. EVALUATION IFHMA. Global Burden of Disease Compare; 2019. Available at: URL: https://vizhub. healthdata.org/gbd-compare/##4. Organization WH. Global Tuberculosis Report; 2023. Available at: URL: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023.##5. Education MoHaM. Tuberculosis Situation in Iran; 2022-2023. Available at: URL: https://tb.behdasht.gov. ir/TB_Situation_in_Iran.aspx.##6. Urdahl K. Understanding the immune response to M. tuberculosis. Nat Educ. 2015; 8(3): 6.##7. Marais BJ, Lönnroth K, Lawn SD, et al. Tuberculosis comorbidity with communicable and non-communicable diseases: integrating health services and control efforts. The Lancet infectious diseases. 2013; 13(5): 436-48.##8. Lyon SM, Rossman MD. Pulmonary tuberculosis. Microbiology spectrum. 2017; 5(1): 10. ##9. Jeong YJ, Lee KS. Pulmonary tuberculosis: up-to-date imaging and management. American Journal of Roentgenology. 2008; 191(3): 834-44.##10. Fatemeh Moharreri FR, Seyed Alireza Sajadi, Soheil sarjamei. The comparison of anxiety and depression among patients with bronchial asthma, chronic obstructive pulmonary disease, and lung tuberculosis. Fundamentals of Mental Health. 2013; 15(2(58)): 82-90.##11. Goyal S, Srivastava K, Kodange C, et al. Immunological changes in depression. Industrial psychiatry journal. 2017; 26(2): 201-6.##12. Oh K, Choi H, Kim E, et al. Depression and risk of tuberculosis: a nationwide population-based cohort study. The International Journal of Tuberculosis and Lung Disease. 2017; 21(7): 804-9.##13. Cheng K-C, Liao K-F, Lin C-L, et al. Increased risk of pulmonary tuberculosis in patients with depression: a cohort study in Taiwan. Frontiers in Psychiatry. 2017; 8: 300970.##14. World Health Organization. Global health estimates: Leading causes of DALYs. WHO; 2019 Available at: URL: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/global-health-estimates-leading-causes-of-dalys.## ##

Comparing the Effectiveness of Reality Therapy and Solution-Oriented Therapy on Academic Procrastination and Academic Hope of Female Secondary High School Students in Bandar Abbas City 2 2 Background: One of the most important effective factors in the discussion of motivation and academic progress can be found in the concepts of procrastination and academic hope. Therefore, the present study was conducted to compare the effectiveness of reality therapy and solution-oriented therapy on academic procrastination and academic hope of secondary school girls in Bandar Abbas City. Methods: The research was semi-experimental with a pre-test-post-test design with a control group. The statistical population of the study was made up of all the female students of the second level of secondary education Bandar Abbas in the academic year of 2023-2024. Using the random sampling method, 45 people were selected and randomly assigned to two experimental groups and a control group. The research tools were Rothbloom and Solomon's (1984) academic procrastination questionnaires and Campbell and Cowen's (2001) academic hope questionnaires. The data were analyzed using covariance analysis.  Results: The results showed that there is a significant difference in academic procrastination (P < 0.01& F = 514/91)  and academic hope (P < 0.01& F = 184/61) between the subjects of the experimental and control groups in the post-exam and follow-up stages in favor of the two experimental groups; Also, the results of the Bonferroni test showed that the difference between reality therapy and solution-oriented variables in procrastination and academic hope is significant in favor of reality therapy. Conclusion: Both approaches, especially reality therapy, can be used to improve students' procrastination and academic hope and ultimately increase their academic progress.   259 266 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/252024/07/192024/06/202024/08/212024/08/22024/05/152024/12/12024/10/21 1403/7/30 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/192024/10/222024/10/82024/10/182024/12/212024/09/112024/12/152024/12/28 1403/10/8 Maryam Abolfathi Maryam Abolfathi Clinical Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran Iran mn395576@gmail.com Ashraf Beirami Ashraf Beirami Department of Nursing, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran Iran drashrafbeirami@iau.ir Moosa Javdan Moosa Javdan Department of Counseling and Psychology, Faculty of Humanities, University of Hormozgan, Bandar Abbas, Iran Iran 8011363@gmail.com Reality therapy solution-oriented therapy students 1. Habibi M. The effectiveness of mindfulness-based stress reduction program training on procrastination and motivation to progress in female students. 2019; 8(11): 57-66. [Persian]##2. Namono R, Musenze IA, Mayende TS. Activating creative behaviour of academic knowledge workers in selected public universities in Uganda: The role of hope. New Ideas in Psychology. 2022; 65: 100930.##3. Hoseinnezhad SZ, Elyasi F, Shahhosseini Z. A rapid review on domestic violence as a silent consequence in corona time: A double pandemic. European Journal of Environment and Public Health. 2020; 5(1): em0062.##4. Hershberger MA, Jones MH. The influence of social relationships and school engagement on academic achievement in maltreated adolescents. Journal of adolescence. 2018; 67: 98-108.##5. Gustavson DE, Miyake A. Academic procrastination and goal accomplishment: A combined experimental and individual differences investigation. Learning and individual differences. 2017; 54: 160-72.##6. Nowruzpoor E, Vakili P, Rezakhani SD. The effectiveness of Reality therapy on Self-efficacy and Identity Styles of Female Students. Journal of Pediatric Perspectives. 2021; 9(8): 14212-14223. doi: 10.22038/ijp.2020.50939.4044 ##7. Hershberger MA, Jones MH. The influence of social relationships and school engagement on academic achievement in maltreated adolescents. Journal of adolescence. 2018; 67: 98-108.##8. Sadoughi M, Hesampour F. The mediating role of happiness in the relation between hope and academic self-efficacy with academic buoyancy among students. Rooyesh-e-Ravanshenasi Journal (RRJ). 2019; 8(9): 21-30. [Persian]##9. Yilmaz MB. The Relation between Academic Procrastination of University Students and Their Assignment and Exam Performances: The Situation in Distance and Face-to-Face Learning Environments. Journal of Education and Training Studies. 2017; 5(9): 146-57.##10. Klassen RM, Krawchuk LL, Rajani S. Academic procrastination of undergraduates: Low self-efficacy to self-regulate predicts higher levels of procrastination. Contemporary educational psychology. 2008; 33(4): 915-31.##11. Sayadi Ghasbeh M, Moghtader L. The effectiveness of mindfulness training on students' progress motivation and academic procrastination. Education and Evaluation. 2021; 14(54): 113-35. [Persian]##12. Dougherty D, Sharkey J. Reconnecting Youth: Promoting emotional competence and social support to improve academic achievement. Children and Youth Services Review. 2017; 74: 28-34.##13. Borzabadi Farahani N, Emamipur S, Sepahmansour M. Effectiveness of Social-Emotional Learning Training on Academic procrastination and Communication Skills in Female Students. Educational researches. 2020; 15(62): 33-56. [Persian]##14. Abron E, Azizi Ziabari LS, Khajevand Khosheli A. Effectiveness of Online Reality Therapy on Exam Anxiety and Academic Procrastination of Male High School Students: A Quasi-experimental Study. 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Assessing the effectiveness of solution-focused brief therapy for couples raising a child with autism: A pilot clinical outcome study. Journal of Couple & Relationship Therapy. 2019; 18(3): 257-79.##27. Smith S, Macduff C. A thematic analysis of the experience of UK mental health nurses who have trained in solution focused brief therapy. Journal of psychiatric and mental health nursing. 2017; 24(2-3): 105-13.##28. Salguero-Pazos MR, Reyes-de-Cózar S. Interventions to reduce academic procrastination: A systematic review. International Journal of Educational Research. 2023; 121: 102228.##29. Motaharinasab Z, Mohsenzadeh F, Zahrakar K. The Effect of Reality-Therapy on the Negligence and Self-Regulation of School Students. The Culture Strategy Quarterly. 2021; 13(52): 203-221. [Persian]## ##

An In-Depth Regression Analysis on Anthropometric Indices Influencing Subjective Weight Perception 2 2 Background: Subjective weight perception significantly impacts overall health and is influenced by various factors. This study aims to develop predictive models using anthropometric indices to estimate subjective weight perception in women. Methods: This descriptive cross-sectional study involved a random sample of 287 women, aged 18-45, with a body mass index (BMI), ranging from 18.5 to 40.0 kg/m2 who were referred to a nutrition clinic in Ardabil city between May and September 2023.  Weight, BMI, waist-to-hip ratio (WHR), waist circumference (WC), waist-to-height ratio (WHtR), body adipocyte index (BAI), abdominal volume index (AVI), and conicity index (CI) were measured using standardized procedures. Subjective weight was assessed using a subscale of the Multidimensional Body Self-Relation Questionnaire. Regression analysis was employed to develop prediction models. Results: The predictive equation for subjective weight was 2.548 + (-0.303 × weight in kg) + (0.089 × BMI in kg/m2) + (27.773 × WHR) + (1.032 × WC in cm) + (-109.256 × WHR) + (0.540 × BAI in %) + (-0.260 × AVI in m2) + (-39.423 × CI in m3/2kg− 1/2). The model accounted for 78.50% of the variance and significantly predicted subjective weight perception (F (8, 279) = 104.604, and p < 0.001). Weight, WHR, WC, WHtR, BAI, and CI significantly contributed to the model (p < 0.05). Conclusion: The findings underscore the importance of considering multiple anthropometric indices to understand individual differences in subjective weight perception. This understanding will be essential for developing more effective approaches to overall health. 267 275 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/252024/07/192024/06/202024/08/212024/08/22024/05/152024/12/12024/10/212024/08/17 1403/5/27 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/192024/10/222024/10/82024/10/182024/12/212024/09/112024/12/152024/12/282024/12/22 1403/10/2 Fatemeh Ghannadiasl Fatemeh Ghannadiasl Department of Food Sciences and Technology, University of Mohaghegh Ardabili, Ardabil, Iran Iran ghannadiasl@uma.ac.ir Anthropometry regression analysis weight perception women 1. Gao Q, Li R, Chen Z, et al. Weight self-perception and weight loss attempts in Chinese cardiovascular patients and non-cardiovascular patients: evidence from a population-based study. BMC Public Health. 2023; 23(1): 707.##2. Niswah I, Rah JH, Roshita A. The association of body image perception with dietary and physical activity behaviors among adolescents in Indonesia. Food and Nutrition Bulletin. 2021; 42(1_suppl): S109-21.##3. Silva SU, Alves MD, Vasconcelos FD, et al. Association between body weight misperception and dietary patterns in Brazilian adolescents: Cross-sectional study using ERICA data. PLoS One. 2021; 16(9): e0257603.##4. Jamani NA, MFamMed AH, MFamMed KH, et al. Agreement between body weight perception and body weight status among late adolescents in Kuantan, Malaysia. Medical Journal of Malaysia. 2020; 75(2): 159.##5. Uchôa FN, Uchôa NM, Daniele TM, et al. Influence of the mass media and body dissatisfaction on the risk in adolescents of developing eating disorders. International Journal of Environmental Research and Public Health. 2019; 16(9): 1508.##6. Pool AC, Coffman DL, Sarwer DB, et al. Associations between weight misperception, contextual factors, and weight loss behaviors in young adult men with overweight/obesity. Obesity Science & Practice. 2020; 6(1): 39-46.##7. Park B, Cho HN, Choi E, et al. Self-perceptions of body weight status according to age-groups among Korean women: A nationwide population-based survey. PloS one. 2019; 14(1): e0210486.##8. Alyousefi NA, Alqarni FD, Alqarni BS, et al. Association of weight misperception with weight loss attitudes, behaviors and psychological distress in Saudi adult population. Biomedical Research. 2017; 28(6).##9. Wilson OW, Jones H, Mama SK, et al. Female college student weight perception discordance. Journal of American College Health. 2021; 69(1): 23-9.##10. Garrusi B, Baneshi MR. Body dissatisfaction among Iranian youth and adults. Cadernos de saude publica. 2017; 33: e00024516.##11. Wang Y, Liu H, Wu F, et al. The association between BMI and body weight perception among children and adolescents in Jilin City, China. PloS one. 2018; 13(3): e0194237.##12. Chen G, He J, Zhang B, et al. Body weight and body dissatisfaction among Chinese adolescents: Mediating and moderating roles of weight-related teasing. Current Psychology. 2019: 1-9.##13. Pop CL. Association between body mass index and self-body image perception. Iranian Journal of Public Health. 2017; 46(12): 1744.##14. Quaye L, Owiredu WK, Amidu N, et al. Comparative abilities of body mass index, waist circumference, abdominal volume index, body adiposity index, and conicity index as predictive screening tools for metabolic syndrome among apparently healthy Ghanaian adults. Journal of Obesity. 2019; 2019.##15. Ghannadiasl F. Novel anthropometric predictors of subjective weight among women. Women & Health. 2021; 61(9): 889-95. [Persian]##16. Green SB. How many subjects does it take to do a regression analysis? Multivariate Behavioral Research. 1991; 26(3): 499-510.##17. Cash TF. Multidimensional body-self relations questionnaire: MBSRQ user’s manual. Norfolk, VA: Old Dominion University; 2000.##18. Rahati A. Evolutionary study of body image and its relationship with self-esteem based on a comparison between adolescent, middle age, and old people. Tehran: Shahed University. 2004; 34. [Persian]##19. Liu BP, Jia CX, Li SX. The association of weight control attempts with suicidality: The role of objective weight status and weight perception among adolescents of United States. Journal of Affective Disorders. 2023; 325: 369-77.##20. Lee KH, Bong SH, Kang DH, et al. Association between weight misperception and some mental health-related characteristics in Korean adolescents. Neuropsychiatric Disease and Treatment. 2020: 3053-62.##21. Hwang IC, Lee KS, Park DK, et al. Association with self-perception for obesity and mental health among Korean adolescents. Journal of the Korean Academy of Child & Adolescent Psychiatry. 2011; 22(2): 112-9.##22. Haynes A, Kersbergen I, Sutin A, et al. Does perceived overweight increase the risk of depressive symptoms and suicidality beyond objective weight status? A systematic review and meta-analysis. Clinical Psychology Review. 2019; 73: 101753.##23. Pearl RL. Weight bias and stigma: public health implications and structural solutions. Social Issues and Policy Review. 2018; 12(1): 146-82.##24. Pearl RL, Puhl RM, Lessard LM, et al. Prevalence and correlates of weight bias internalization in weight management: a multinational study. SSM-population Health. 2021; 13: 100755.##25. Gaylis JB, Levy SS, Hong MY. Relationships between body weight perceptions, body mass index, physical activity, and food choices in Southern California male and female adolescents. International Journal of Adolescence and Youth. 2020; 25(1): 264-75.##26. Paterna A, Alcaraz-Ibáñez M, Fuller-Tyszkiewicz M, et al. Internalization of body shape ideals and body dissatisfaction: A systematic review and meta-analysis. International Journal of Eating Disorders. 2021; 54(9): 1575-600.##27. Ghannadiasl F, Hoseini N. The Relationship between Body Image Dissatisfaction and New Anthropometric Indices in Women Referred to the Nutrition Clinic in Northwest of Iran, Ardabil City, 2019. J Community Health Research 2021; 10(3): 243-250. [Persian]##28. Khalesi M, Nasiri E, Samadi A. Prevalence of body weight misperception among female university students and its relationship with anthropometric indices: A concept for overweight and obesity management. Journal of Sabzevar University of Medical Sciences. 2024; 30(6): 732-41. [Persian]##29. Paulin A, Manikpurage HD, Després JP, et al. Sex‐specific impact of body weight on atherosclerotic cardiovascular disease incidence in individuals with and without ideal cardiovascular health. Journal of the American Heart Association. 2023; 12 (13): e028502.##30. Tuffa TA, Gebreyesus SH, Endris BS, et al. Unhealthy weight control behaviors among Ethiopian female adolescents. International Journal of Eating Disorders. 2020; 53(4): 525-32.##31. Jeong E. Factors associated with the adoption of extreme weight control behavior by non-obese adolescents: a secondary analysis. BMC Pediatrics. 2023; 23(1): 464.##32. Lee K. Self-perceived weight and self-rated health have distinct relationships according to body mass index in Korean teenagers. Nutrition Research. 2022; 107: 179-86.##33. Hock K, Vanderlee L, White CM, et al. Body weight perceptions among youth from 6 countries and associations with social media use: Findings from the international food policy study. Journal of the Academy of Nutrition and Dietetics; 2024.##34. Wu Y, Li D, Vermund SH. Advantages and Limitations of the Body Mass Index (BMI) to Assess Adult Obesity. International Journal of Environmental Research and Public Health. 2024; 21(6): 757.##35. Linder J, McLaren L, Siou GL, et al. The epidemiology of weight perception: perceived versus self-reported actual weight status among Albertan adults. Canadian Journal of Public Health. 2010; 101: 56-60.##36. Cai J, Lin C, Lai S, et al. Waist-to-height ratio, an optimal anthropometric indicator for metabolic dysfunction associated fatty liver disease in the Western Chinese male population. Lipids in health and disease. 2021; 20: 1-2.##37. Ramírez-Manent JI, López-González ÁA, Tomás-Gil P, et al. Relationship between abdominal volume index and body adiposity index and scales of insulin resistance and metabolic syndrome. Diagnostics. 2023; 13(21): 3356.##38. Hudzik B, Nowak J, Szkodzinski J, et al. Discordance between body-mass index and body adiposity index in the classification of weight status of elderly patients with stable coronary artery disease. Journal of Clinical Medicine. 2021; 10(5): 943.## ##

Investigating the Relationship between Dysmenorrhea and Menstrual Disorders with the Type and Severity of Blood Pressure Disorders in Pregnancy in Bandar Abbas Hospitals in 2024 2 2 Background: The current study aims to investigate the relationship between dysmenorrhea and menstrual disorders with the type and severity of blood pressure disorders in pregnancy in Bandar Abbas hospitals in 2024. Methods: This research is a cross-sectional study of the descriptive-analytic type. 404 pregnant women in the third trimester of pregnancy who were hospitalized in Bandar Abbas hospitals due to high blood pressure were included in this study. After receiving the consent form, the demographic-social and medical information form was recorded by a researcher from patients' files. The blood pressure of pregnant women was measured during hospitalization. The dysmenorrhea multidimensional scoring system questionnaire and checklist on other menstrual cycle disorders such as menorrhagia and menstrual irregularity were completed by the participants. After collecting the data, SPSS version 26 software was used to analyze the data. Results: According to the results of the present study, it has been shown that the average age of the patients was 30.43 ± 5.82. There is a significant positive correlation between primary dysmenorrhea and gestational hypertension, preeclampsia, eclampsia, and superimposed (p < 0.05). There is a significant positive correlation between secondary dysmenorrhea and gestational hypertension, preeclampsia, and superimposed (p < 0.05). There is a significant positive correlation between menstrual disorders and gestational hypertension, preeclampsia, eclampsia, and superimposed (p < 0.05). There is a significant positive correlation between hypermenorrhea and gestational hypertension and superimposed (p < 0.05).         Conclusion: The results of the study showed that there is a significant relationship between menstrual disorders and hypertension in pregnancy.   276 284 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/252024/07/192024/06/202024/08/212024/08/22024/05/152024/12/12024/10/212024/08/172024/10/25 1403/8/4 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/192024/10/222024/10/82024/10/182024/12/212024/09/112024/12/152024/12/282024/12/222024/12/29 1403/10/9 Ashraf Beirami Ashraf Beirami Department of Nursing, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran Iran Maryam Naji Abhary Maryam Naji Abhary Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Iran Aboubakr Jafarnezhad Aboubakr Jafarnezhad Department of Epidemiology, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Iran Seydeh Zeynab Hoseinnezhad Seydeh Zeynab Hoseinnezhad Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran Iran zeynabhoseinnezhad@gmail.com Hypertension menstrual irregularity Menorrhagia dysmenorrhea 1. LeFevre ML, US Preventive Services Task Force*. Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: US Preventive Services Task Force recommendation statement. Annals of internal medicine. 2014; 161(11): 819-26.##2. Heshmat F, Beirami A, Hoseinnezhad SZ, et al. The relationship between menstrual disorders and blood pressure disorders in pregnancy: a systematic review of observational studies. The Iranian Journal of Obstetrics, Gynecology and Infertility, 2024; 27(3): 76-87. [Pesian]##3. Rumbold AR, Crowther CA, Haslam RR, et al. Vitamins C and E and the risks of preeclampsia and perinatal complications. New England Journal of Medicine. 2006; 354(17): 1796-806.##4. Villar J, Purwar M, Merialdi M, et al. World Health Organisation multicentre randomised trial of supplementation with vitamins C and E among pregnant women at high risk for pre‐eclampsia in populations of low nutritional status from developing countries. BJOG: An International Journal of Obstetrics & Gynaecology. 2009; 116(6): 780-8.##5. Abalos E, Cuesta C, Grosso AL, et al. Global and regional estimates of preeclampsia and eclampsia: a systematic review. European journal of obstetrics & gynecology and reproductive biology. 2013; 170(1): 1-7.##6. Ananth CV, Keyes KM, Wapner RJ. Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis. Bmj. 2013; 347.##7. Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best practice & research Clinical obstetrics & gynaecology. 2011; 25(4): 391-403.##8. Wolde Z, Segni H, Woldie M. Hypertensive disorders of pregnancy in Jimma University specialized hospital. Ethiopian journal of health sciences. 2011; 21(3).##9. Lo JO, Mission JF, Caughey AB. Hypertensive disease of pregnancy and maternal mortality. Current Opinion in Obstetrics and Gynecology. 2013; 25(2): 124-32.##10. Rath W, Fischer T. The diagnosis and treatment of hypertensive disorders of pregnancy: new findings for antenatal and inpatient care. Deutsches Ärzteblatt International. 2009; 106(45): 733.##11. Best LG, Lunday L, Webster E, et al. Pre-eclampsia and risk of subsequent hypertension: in an American Indian population. Hypertension in pregnancy. 2017; 36(2): 131-7.##12. Black MH, Zhou H, Sacks DA, et al. Hypertensive disorders first identified in pregnancy increase risk for incident prehypertension and hypertension in the year after delivery. Journal of hypertension. 2016; 34(4): 728-35.##13. McCoy S, Baldwin K. Pharmacotherapeutic options for the treatment of preeclampsia. American Journal of Health-System Pharmacy. 2009; 66(4): 337-44.##14. Fenakel K, fenakel G, Lurie S, et al. Nifedipine in the treatment of severe preeclampsia. Obstetrics & Gynecology. 1991; 77(3): 331-7.##15. Zibaeenezhad MJ, Ghodsi M, Arab P, et al. The prevalence of hypertensive disorders of pregnancy in Shiraz, Southern Iran. 2010; 169-172. [Pesian]##16. Schiff E, Peleg E, Goldenberg M, et al. The use of aspirin to prevent ppregnancy-induced hypertension and lower the ratio of thromboxane A2 to prostcyclin in relatively high risk pregnancies. New England Journal of Medicine. 1989; 321(6): 351-6.##17. Fruscalzo A, Bertozzi S, Londero AP, et al. Menstrual abnormalities and predisposition to pregnancy-related hypertensive disorders: a retrospective study. Gynecological Endocrinology. 2010; 26(6): 445-50.##18. Nakayama M, Ono M, Iizuka T, et al. Hypertensive disorders of pregnancy are associated with dysmenorrhea in early adulthood: A cohort study. Journal of Obstetrics and Gynaecology Research. 2020; 46(11): 2292-7.##19. Chung HF, Ferreira I, Mishra GD. The association between menstrual symptoms and hypertension among young women: A prospective longitudinal study. Maturitas. 2021; 143: 17-24.##20. Bonnesen B, Oddgeirsdóttir HL, Naver KV, et al. Women with minor menstrual irregularities have increased risk of preeclampsia and low birthweight in spontaneous pregnancies. Acta obstetricia et gynecologica Scandinavica. 2016; 95(1): 88-92.##21. Xu H, Li PH, Barrow TM, et al. Obesity as an effect modifier of the association between menstrual abnormalities and hypertension in young adult women: results from Project ELEFANT. PLoS One. 2018; 13(11): e0207929.##22. Yeh CH, Muo CH, Sung FC, et al. Risk of ischemic heart disease associated with primary dysmenorrhea: a population-based retrospective cohort study. Journal of Personalized Medicine. 2022; 12(10): 1610.##23. Carrarelli P, Funghi L, Bruni S, et al. Naproxen sodium decreases prostaglandins secretion from cultured human endometrial stromal cells modulating metabolizing enzymes mRNA expression. Gynecological Endocrinology. 2016; 32(4): 319-22.##24. Hellman KM, Yu PY, Oladosu FA, et al. The effects of platelet-activating factor on uterine contractility, perfusion, hypoxia, and pain in mice. Reproductive Sciences. 2018; 25(3): 384-94.##25. Boomsma CM, Fauser BC, Macklon NS. Pregnancy complications in women with polycystic ovary syndrome. InSeminars in reproductive medicine 2008; 26(1): 072-084.##26. ロッテルダム. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction. 2004 Jan 1;19(1):41-7.##27. Hu S, Leonard A, Seifalian A, et al. Vascular dysfunction during pregnancy in women with polycystic ovary syndrome. Human reproduction. 2007; 22(6): 1532-9.##28. Charkoudian N, Hart EC, Barnes JN, et al. Autonomic control of body temperature and blood pressure: influences of female sex hormones. Clinical Autonomic Research. 2017; 27: 149-55.##29. Schisterman EF, Gaskins AJ, Mumford SL, et al. 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Determining the Role of Psychological Hardiness and Resilience in Predicting Psychological Differentiation in Secondary School Girls of Bandar Abbas City 2 1 .   2 Background: Considering the importance of mental abilities in continuing education in students, the present study was conducted to determine the role of psychological toughness and resilience in predicting the psychological differentiation of female students of the second level of high school in Bandar Abbas city. Methods: The current research method was a correlational description. The statistical population of the research was made up of all female students of second-secondary education in Bandar Abbas city in the academic year of 2024. Several 380 people were selected as a sample by cluster random sampling method. The research tools were Skorn and Friedlander's self-differentiation questionnaires, Kubasa's psychological toughness, and Connor and Davidson's resilience scale. Data were analyzed using Pearson's correlation test and multivariate regression. Results: The results showed that psychological toughness (R = 0.23 & P < 0.01) and all its components and resilience (R = 0.26 & P < 0.01) and all its components have a positive and significant relationship with psychological differentiation in students. Also, the results of the regression analysis showed that psychological toughness (β = 0.26 & P < 0.01) and resilience (β = 0.30 & P < 0.01) can positively and meaningfully predict differentiation in students.  Conclusion: using the results of this research and considering the identification of factors affecting differentiation, it is suggested to pay special attention to the field of increasing the characteristics of psychological toughness and resilience of students. This article has been updated due to an error in the names of the authors: https://jhr.ssu.ac.ir/article-1-1153-en.html   285 293 2023/02/122023/12/52023/09/302023/04/102023/12/192024/01/42023/12/82023/12/42023/12/112023/12/192024/01/102024/02/132023/12/292024/03/192024/03/292023/05/172024/01/82023/11/112024/06/112024/03/242024/07/202024/02/252024/07/192024/06/202024/08/212024/08/22024/05/152024/12/12024/10/212024/08/172024/10/252024/10/21 1403/7/30 2023/06/282024/02/122023/12/242023/08/52024/04/152024/04/202024/02/122024/03/152024/04/22024/04/82024/04/192024/05/112024/04/232024/07/82024/06/122023/09/102024/03/12024/03/262024/10/12024/06/92024/10/112024/06/192024/10/222024/10/82024/10/182024/12/212024/09/112024/12/152024/12/282024/12/222024/12/292024/12/29 1403/10/9 Azita Khanjani Azita Khanjani Clinical Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran Iran Ashraf Beirami Ashraf Beirami Department of Nursing, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran Iran drashrafbeirami@iau.ir Moosa Javdan Moosa Javdan Department of Counseling and Psychology, Faculty of Humanities, University of Hormozgan, Bandar Abbas, Iran Iran Self-differentiation students resilience psychological 1. 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