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Corrigendum to "Determining the Role of Psychological Hardiness and Resilience in Predicting Psychological Differentiation in Secondary School Girls of Bandar Abbas City" [JCHR 2024; 13(1): 285-293] 2 2 The mistake in Article 7 is that the order of the authors is  "Azita Khanjani 1, Ashraf Beirami 2*, Moosa Javdan 3", while the correct order is "Azita Khanjani 1 , Ashraf Beirami 2 *, Moosa Javdan 3, Aboubakr Jafarnezhad4". On behalf of the author, the publisher wishes to apologize for this error. The online version of the article was updated on May 12, 2025, and the previous version can be found at: https://jhr.ssu.ac.ir/article-1-1102-en.html 0 0 2024/10/21 1403/7/30 2024/12/29 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 Aboubakr Jafarnezhad Aboubakr Jafarnezhad Department of Epidemiology, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Iran Self-differentiation students resilience psychological ## ##

Corrigendum to "Determining the Validity and Reliability of the Innovation Ecosystem with Emphasis on the Role of E-government in Hospitals in Yazd Province in 2023" [JCHR 2025; 14(1): 57-67] 2 2 The mistake in Article 7 is that the order of the authors is " Zahra Mirjalili1, Saeed Sayadi2, Hamidreza Melai2, Abbas Babai Nejad *2 ", while the correct order is " Zahra Mirjalili 1 , Abbas Babai Nejad 2 *, Saeed Sayadi 2 , Hamidreza Mollaei 2 ". On behalf of the author, the publisher wishes to apologize for this error. The online version of the article was updated on March 20, 2025, and the previous version can be found at: https://jhr.ssu.ac.ir/article-1-1104-en.html 0 0 2024/10/212024/10/22 1403/8/1 2024/12/292025/02/8 1403/11/20 Zahra Mirjalili Zahra Mirjalili Department of Public Administration, Kerman Branch, Islamic Azad University, Kerman, Iran Iran Zahra.Mirjalili@gmail.com Abbas Babai Nejad Abbas Babai Nejad Department of Management, Kerman Branch, Islamic Azad University, Kerman, Iran Iran a.babaei@iauk.ac.ir Saeed Sayadi Saeed Sayadi Department of Management, Kerman Branch, Islamic Azad University, Kerman, Iran Iran Saeed.Sayadi@fgmai.com Hamidreza Mollaei Hamidreza Mollaei Department of Management, Kerman Branch, Islamic Azad University, Kerman, Iran Iran Hamidreza.Melai@gmail.com ## ##

A Prospective Study on Implementation of Long Term Follow-up of Cured Tuberculosis Patients and Barriers Faced by Health Care Workers at Ahmedabad City, Gujarat: A Mixed Method Approach 2 2 Background: Tuberculosis (TB) remains a major public health challenge in India. Efforts outlined in the National Strategic Plan (2017-2025) are committed to achieve targets towards eliminating TB. Early identification of recurrence among cured TB cases is a crucial strategy towards this goal.  However, there are limited data on the implementation of long-term follow-up for cured cases. Methods: A prospective mixed-method study was conducted to evaluate the implementation of long-term follow-up strategy among 180 cured TB patients. Quantitative assessment involved tracking follow-up visits at 6, 12, 18, and 24 months post-treatment success. Moreover, Focus Group Discussions (FGDs) with 46 TB Health Visitors (TB HVs) were conducted to identify barriers to the implementation of long-term follow-up strategies for cured TB cases. Results: Quantitative analysis revealed a decline in follow-up visits over time, and only 16.89% of patients were followed up by TB HVs during fourth visit at 24 months post-treatment. Recurrent TB was identified in 22 cases, 13.7% of which were not followed up by health workers. Qualitative analysis highlighted patient-related factors like loss to follow-up due to migration and denial of sputum testing. Health workers cited workload issues and inadequate financial incentives as barriers to implementation. Conclusion: The study underscores challenges in implementing long-term follow-up strategies for cured TB patients in India. Addressing barriers such as loss to follow-up and workload issues among health workers is crucial for improving recurrence detection and management. Efforts to enhance program effectiveness must prioritize overcoming these barriers to achieve the goal of TB elimination by 2025.   1 8 2024/10/212024/10/222024/09/18 1403/6/28 2024/12/292025/02/82025/01/18 1403/10/29 Tejas Shah Tejas Shah Department of Health, Ahmedabad Municipal Corporation, Ahmedabad, Gujarat, India India southzonehealth.amc@gmail.com Venu Shah Venu Shah Department of Community Medicine, Gujarat Cancer Society Medical College, Ahmedabad, Gujarat, India India drvenushah@gmail.com Viral Dave Viral Dave Department of Community Medicine, Gujarat Cancer Society Medical College, Ahmedabad, Gujarat, India India dr.vdave@gmail.com Evaluation Follow-up Recurrence Tuberculosis Health worker Mixed method research 1. World Health Organization. Tuberculosis. Available at: URL: https://www.who.int/health-topics/tuberculosis#tab=tab_1. Accessed April 10, 2024.##2. Central Tuberculosis Division, National Strategic Plan for Tuberculosis Elimination 2017-2025. Available at: URL: https://tbcindia.gov.in/WriteReadData/NSP%20Draft%2020.02.2017%201.pdf. Accessed April 10, 2024.##3. Bhardwaj AK. Tuberculosis control programme from NTCP to RNTCP to NTEP. Indian J Comm Health. 2020; 32(3): 469-470.##4. World Health Organization. Global Tuberculosis Report 2022. Available at: URL: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022. Accessed April 10, 2024.##5. TB Free India starts with stopping TB before it spreads. Available at: URL: https://www.cdc.gov/globalhivtb/who-we-are/success-stories/success-story-pages/tb-free-india.html. Accessed April 10, 2024.##6. National Tuberculosis Elimination Pogramme. Long Term Post-treatment follow-up of TB patients. Available at: https://ntep.in/node/611/CP-long-term-post-treatment-follow-tb-patients. Accessed April 10, 2024.##7. Millet JP, Shaw E, Orcau A, et al. Barcelona Tuberculosis Recurrence Working Group. Tuberculosis recurrence after completion treatment in a European city: reinfection or relapse?. PLoS One. 2013; 8(6): e64898. ##8. Mathur N, Chatla C, Syed S, et al. Prospective 1-year follow-up study of all cured, new sputum smear positive tuberculosis patients under the Revised National Tuberculosis Control Program in Hyderabad, Telangana State, Lung India. 2019; 36(6): 519-524.##9. Anaam MS, Alrasheedy AA. Recurrence Rate of Pulmonary Tuberculosis in Patients Treated with the Standard 6-Month Regimen: Findings and Implications from a Prospective Observational Multicenter Study. Trop Med Infect Dis. 2023; 8(2): 110. ##10. Kim L, Moonan PK, Yelk Woodruff RS, et al. Epidemiology of recurrent tuberculosis in the United States, 1993-2010. Int J Tuberc Lung Dis. 2013; 17: 357–60.##11. Azhar GS. DOTS for TB relapse in India: A systematic review. Lung India. 2012 Apr;29(2):147-53. ##12. TB unit officer directory. Ahmedabad Municipal Corporation. Available at: URL: https://reports.nikshay.in/Reports/TBUDirectory. Accessed September 15, 2020##13. Youn HM, Shin MK, Jeong D, et al. Risk factors associated with tuberculosis recurrence in South Korea determined using a nationwide cohort study. PLoS One. 2022; 17(6): e0268290. ##14. Verma SK, Kant S, Kumar S, et al. A five-year follow-up study of revised national tuberculosis control programme of India at Lucknow Indian J Chest Dis Allied Sci. 2008; 50: 195–7.## ##

Examination of Healthcare Demand Procrastination Behaviors from a Societal Perspective 2 2 Background: Health is one of the most fundamental rights of individuals from birth and is guaranteed by national and international texts. This study aims to evaluate individuals' healthcare demand procrastination behaviors from a societal perspective. Methods: This descriptive cross-sectional study was conducted in the province of Kocaeli, located in the Marmara region of Türkiye. The population of the study consisted of literate individuals aged 18-65 residing in Kocaeli. The sample included 438 individuals who volunteered to participate in the study. Data were collected using a sociodemographic information form and the Healthcare Demand Procrastination Scale (HDPS) through face-to-face interviews employing the convenience sampling method. Descriptive statistics and SPSS 27 software were used for data analysis. Results: Women were found to have statistically significantly higher total scores on the HDPS compared to men (p = 0.016; p < 0.05). Married individuals had significantly lower total scores for procrastination behaviors than single individuals (p = 0.015; p < 0.05). Participants with low income and no social security exhibited more healthcare demand procrastination behaviors (p = 0.015; p = 0.042; p < 0.05). A weak but significant negative relationship was found between age and procrastination behavior (r = -0.133; p = 0.005; p < 0.01). Conclusion: To achieve a healthy society, it would be beneficial to implement policy regulations aimed at protecting disadvantaged groups who cannot seek healthcare services when needed due to various reasons.   9 20 2024/10/212024/10/222024/09/182024/10/15 1403/7/24 2024/12/292025/02/82025/01/182025/01/20 1403/11/1 Yasemin Aslan Yasemin Aslan Department of Health Management, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Balıkesir, Turkey Turkey yaseminaslan@bandirma.edu.tr Yasemin Özdil Yasemin Özdil Department of Health Management, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Balıkesir, Turkey Turkey yaseminorakci10@gmail.com Health services needs and demand Health services Procrastination 1. United Nations (UN). United Nations Sustainable Development Goals (UNDP); 2015. Available at: URL: https://www.un.org/sustainabledevelopment/sustainable-development-goals/##2. Türkiye Cumhuriyeti Anayasası; (1982). Available at: URL: https://www.mevzuat.gov.tr/mevzuatmetin/1.5.2709.pdf##3. Demirci HF. SAĞLIK SİGORTASI SAHİPLİĞİ VE SAĞLIK HİZMETLERİ TALEBİ. Selçuk Sağlık Dergisi. 2020; 1(1): 37-45.##4. Fuchs VR. Essays in the economics of health and medical care. NBER Books; 1972.##5. Yaprak ZÖ, Ecevit E. Sağlık hizmetleri talebi ve fayda maksimizasyonu modeli. Cukurova Medical Journal. 2019; 44(4): 1484-94.##6. Akyürek A, Orhaner E. Özel hastanelere talebi etkileyen faktörler. Sağlık Akademisyenleri Dergisi. 2017; 4(4): 237-48. ##7. Wellay T, Gebreslassie M, Mesele M, et al. Demand for health care service and associated factors among patients in the community of Tsegedie District, Northern Ethiopia. BMC health services research. 2018; 18: 1-9.##8. Erdem R, Pirinçci E. Sağlık Hizmetleirnde Kullanım ve Kullanımı Etileyen Faktörler. O.M.U. Medical Journal. 2003; 20(1): 39-46. ##9. Sirois FM. “I’ll look after my health, later”: A replication and extension of the procrastination–health model with community-dwelling adults. Personality and individual differences. 2007; 43(1): 15-26.##10. Sirois FM, Stride CB, Pychyl TA. Procrastination and health: A longitudinal test of the roles of stress and health behaviours. British Journal of Health Psychology. 2023; 28(3): 860-75.##11. Turkish Statistical Institute (TÜİK) Address-based population registration system results; 2024. Available at: URL: https://data.tuik.gov.tr/Bulten/Index?p=49685 ##12. Kline RB. Principles and practices of structural equation modeling (4th ed). New York City: The Guilford Press; 2016.##13. P. Pai Y, T. Chary S. Dimensions of hospital service quality: A critical review: Perspective of patients from global studies. International journal of health care quality assurance. 2013; 26(4): 308-40.##14. Soyler S, Uyar S, Kirac R, Yilmaz G, Ciftci F. Development of healthcare demand procrastination scale: a reliability and validity study. J Basic Clin Health Sci. 2022; 6(2): 283-91.##15. Evans JD. Straightforward statistics for the behavioral sciences. Thomson Brooks/Cole Publishing Co; 1996.##16. Habibov N. What determines healthcare utilization and related out-of-pocket expenditures in Tajikistan? Lessons from a national survey. International Journal of Public Health. 2009; 54: 260-6.##17. Mutlu A, Işık AK. Introduction to Health Economics (Third edition). Bursa: Ekin Publishing Publishing; 2012.##18. Sinai I, Anyanti J, Khan M, Daroda R, Oguntunde O. Demand for women’s health services in northern Nigeria: a review of the literature. African Journal of Reproductive Health. 2017; 21(2): 96-108.##19. Azad AD, Charles AG, Ding Q, Trickey AW, Wren SM. The gender gap and healthcare: associations between gender roles and factors affecting healthcare access in Central Malawi, June–August 2017. Archives of Public Health. 2020; 78: 1-1.##20. Brown PH, Theoharides C. Health‐seeking behavior and hospital choice in China's New Cooperative Medical System. Health Economics. 2009; 18(S2): S47-64.##21. Habtom GK, Ruys P. The choice of a health care provider in Eritrea. Health policy. 2007; 80(1): 202-17.##22. Dall TM, Chakrabarti R, Storm MV, Elwell EC, Rayburn WF. Estimated demand for women's health services by 2020. Journal of women's health. 2013; 22(7): 643-8.##23. Şenol V. Utilization of the health services in the center of Kayseri and its relationship wıth perceived health status. [PhD Thesis]. Erciyes University Institute of Health Sciences, Department of Public Health; 2006.##24. Girma F, Jira C, Girma B. Health services utilization and associated factors in jimma zone, South west ethiopia. Ethiopian journal of health sciences; 2011.##25. Qian D, Pong RW, Yin A, Nagarajan KV, Meng Q. Determinants of health care demand in poor, rural China: the case of Gansu Province. Health policy and planning. 2009; 24(5): 324-34.##26. Abu-Mourad T, Alegakis A, Shashaa S, Koutis A, Lionis C, Philalithis A. Individual determinants of primary healthcare utilisation in Gaza Strip, Palestine. Journal of Epidemiology & Community Health. 2008; 62(8): 701-7.##27. Devaux M. Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries. The European Journal of Health Economics. 2015; 16: 21-33.##28. Lépine A, Le Nestour A. Health Care Utilisation in Rural Senegal: the facts before the Extension of Health Insurance to Farmers. International Labour Office, Geneva; 2011.##29. Qian D, Pong RW, Yin A, Nagarajan KV, Meng Q. Determinants of health care demand in poor, rural China: the case of Gansu Province. Health policy and planning. 2009; 24(5): 324-34.##30. Ntembe A. User charges and health care provider choice in Cameroon. International Review of Business Research Papers. 2009; 5(6): 33-49.##31. Kermani MS, Ghaderi H, Yousefi A. Demand for medical care in the urban areas of Iran: an empirical investigation. Health Economics. 2008; 17(7): 849-62.##32. Doğan E. Gelir Düzeyi ve Sağlık Hizmet Talebi İlişkisi: Mikro Veriler ile Türkiye Örneği. MANAS Sosyal Araştırmalar Dergisi. 2020; 9(4): 2376-92.##33. Yaylalı M, Kaynak S, Karaca Z. Health services demand: A study in Erzurum. Ege Academic Review. 2012; 12(4): 563-73.##34. Çelik Y. Health Economics, 2nd Edition, Ankara: Siyasal Kitabevi; 2011.##35. Greene W. Functional forms for the negative binomial model for count data. Economics Letters. 2008; 99(3): 585-90.##36. Halasa Y, Nandakumar AK. Factors determining choice of health care provider in Jordan. EMHJ-Eastern Mediterranean Health Journal. 2009; 15(4): 959-968.##37. Wang Z, Li X, Chen M, Si L. Social health insurance, healthcare utilization, and costs in middle-aged and elderly community-dwelling adults in China. International journal for equity in health. 2018; 17: 1-3.##38. 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Conceptual Gap between Education and Literacy in Health Sciences Studies 2 2 This article explores the distinction between education and literacy, emphasizing their close yet separate meanings. Education typically refers to formal schooling and academic qualifications, while literacy now includes a wider range of skills beyond basic reading and writing, such as digital, financial, and health literacy. Education is achieved through structured learning environments and results in certifications, whereas literacy involves the application of knowledge to effect significant changes in one’s life. Effective learning brings about stable changes in behavior, unlike temporary shifts due to external factors. The article argues that true literacy depends on various societal factors, including supportive families, well-equipped schools, and community resources. Despite this, many individuals receive degrees without attaining comprehensive literacy. In epidemiological research, addressing bias and confounding variables is crucial. Bias, such as misclassification bias, can skew results by misrepresenting data. Confounding occurs when an external variable influences both exposure and outcome, potentially distorting the observed relationships. Residual confounding may persist despite adjustments, highlighting the need for accurate indicators. The article questions the validity of using educational level as a proxy for literacy, suggesting it may not fully capture literacy’s complexity and introduce residual confounding.   21 24 2024/10/212024/10/222024/09/182024/10/152024/12/1 1403/9/11 2024/12/292025/02/82025/01/182025/01/202025/01/27 1403/11/8 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 Mohammad Hassan Lotfi Mohammad Hassan Lotfi Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mhlotfi56359@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 Education literacy health literacy bias confounding factors educational status 1. Brown I, Lockyer L, Caputi P. Multiliteracies and assessment practice. InMultiliteracies in motion; Routledge. 2009; 203-218.##2. Tafazoli D, Parra ME, Abril CA. Computer literacy: Sine qua non for digital age of language learning & teaching. Theory and Practice in Language Studies. 2017; 7(9): 716-22.##3. Chen D. Confronting complexity: A new meaning to world literacy. InThirteenth Labor; CRC Press. 2020; 87-100.##4. Gontijo CM. Literacy in UNESCO’s Fundamental Education Program. Educação e Pesquisa. 2024; 50: e265044.##5. Saif AA. Modern Educational Psychology Psychology of Learning and Instruction.Tehran: Dowran; 2019; 30-35##6. Moosavi-Movahedi AA. Literacy Is a Fact, Not Just a Degree. Science Cultivation 2021; 11 (2): 114## 7. Dorak MT. Bias and confounding. Ders notu. Erişim adresi: http://www. dorak. info/epi/bc. html Erişim tarihi. 2012; 11.##8. Celentano DD, Szklo M, Farag Y. Gordis Epidemiology E-Book: Gordis Epidemiology E-Book. Elsevier Health Sciences; 2023.##9. Szklo M, Nieto FJ. Epidemiology: beyond the basics. Jones & Bartlett Publishers; 2014.##10. Kahlert J, Gribsholt SB, Gammelager H, et al. Control of confounding in the analysis phase–an overview for clinicians. Clinical epidemiology. 2017: 195-204.##11. Celentano DD, Szklo M, Farag Y. Gordis Epidemiology E-Book: Gordis Epidemiology E-Book. Elsevier Health Sciences; 2023.##12. Rothman KJ, Greenland S, Lash TL. Modern epidemiology. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008.## ##

COVID-19 Related Challenges in Virtual Dental Education: Dental Students Experience 2 2 Background: Dental students have experienced changes in their learning format due to the SARS-CoV-2 pandemic. This study aimed to evaluate their perspectives on E-learning during this time. Methods: A cross-sectional study utilizing a validated and reliable questionnaire and an online self-report was conducted with dental students in 2022 in Yazd. The study included 120 dental students from the last three years of their program. Socio-demographic and academic data were collected, and certain questions explored students' perspectives on E-learning and its impact on dental education during the COVID-19 pandemic. Responses were rated using a four-point Likert-like scale. Data analysis was performed using SPSS (v. 24) with paired T-tests, one-way ANOVA, Tukey tests, and Pearson correlation (P < 0.05). Results: There was an insignificant difference between the two genders across all dimensions. Overall, 39 students (32.5%) believed that online courses are more appealing than in-person classes, whereas 72 students (60%) found dental professional courses with a laboratory format more engaging than online courses. A significant difference in the fear of COVID-19 was noted among 5thyear students compared to 4thyear and 6thyear students (P-value = 0.0001). Endodontics (39.2%) and prosthodontics (30.8%) were the two fields that were most negatively affected. Conclusions: The results of this study indicated that online activity could serve as a beneficial substitute for dental students during the quarantine. Overall, students expressed positive views about the impact of E-learning during the COVID-19 pandemic. Additionally, a significant correlation was found between the fear of COVID-19 infection and the positive experiences associated with online activity.   25 35 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/26 1403/9/6 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/3 1403/12/13 Fatemeh Owlia Fatemeh Owlia Department of Oral and Maxillofacial Medicine, School of Dentistry, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran f.owlia@ssu.ac.ir Roqayeh Hakimian Roqayeh Hakimian Library and Information Center, School of Dentistry, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran hakimianr@yahoo.com Coronavirus disease COVID-19 dental education perception 1. Farrokhi F, Mohebbi SZ, Farrokhi F, et al. Impact of COVID-19 on dental education- a scoping review. BMC Med Educ. 2021; 21(1): 587. [Persian]##2. Owlia F, Kargar M-J, Kazemipoor M. Investigating the pre- and post-COVID-19 vaccination infection status of Iranian dental students: a cross-sectional study. The Egyptian Journal of Bronchology. 2025; 19(1): 5. [Persian]##3. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020; 91(1): 157-160.##4. El Keshky MES, Basyouni SS, Al Sabban AM. Getting Through COVID-19: The Pandemic’s Impact on the Psychology of Sustainability, Quality of Life, and the Global Economy – A Systematic Review. Frontiers in Psychology. 2020; 11.##5. Hajimaghsoodi S, Paydar E, Owlia F. Determination of objective taste perception among Iranian medical sciences students during COVID-19 pandemic in Yazd, Eastern Iran: a case-control pilot study. BMC Infectious Diseases. 2024; 24(1): 997. [Persian]##6. Misra M, Joshi H, Sarwal R, et al. Exit strategies from lockdowns due to COVID-19: a scoping review. BMC Public Health. 2022; 22(1): 488.##7. Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020; 395(10242): 1973-1987.##8. Karimian Z, Farrokhi MR, Moghadami M, et al. Medical education and COVID-19 pandemic: a crisis management model towards an evolutionary pathway. Educ Inf Technol (Dordr). 2021: 1-22. [Persian]##9. Iurcov R, Pop LM, Iorga M. Impact of COVID-19 Pandemic on Academic Activity and Health Status among Romanian Medical Dentistry Students; A Cross-Sectional Study. Int J Environ Res Public Health. 2021; 18(11).##10. Oyedotun TD. Sudden change of pedagogy in education driven by COVID-19: Perspectives and evaluation from a developing country. Research in Globalization. 2020; 2: 100029.##11. Razmara F, Khayamzadeh M, Shabankare G. Dental practice in the era of COVID-19: A review of literature. J Family Med Prim Care. 2021; 10(1): 41-47. [Persian]##12. Zheng M, Bender D, Lyon C. Online learning during COVID-19 produced equivalent or better student course performance as compared with pre-pandemic: empirical evidence from a school-wide comparative study. BMC Medical Education. 2021; 21(1): 495.##13. Amir LR, Tanti I, Maharani DA, et al. Student perspective of classroom and distance learning during COVID-19 pandemic in the undergraduate dental study program Universitas Indonesia. BMC Medical Education. 2020; 20(1): 392.##14. Soltanimehr E, Bahrampour E, Imani MM, et al. Effect of virtual versus traditional education on theoretical knowledge and reporting skills of dental students in radiographic interpretation of bony lesions of the jaw. BMC Medical Education. 2019; 19(1): 233. [Persian]##15. Borhani F, Vatanparast M, Zadeh AA, et al. Virtual education effect on cognitive learning and attitude of nursing students towards it. Iran J Nurs Midwifery Res. 2011; 16(4): 321-4. [Persian]##16. Padhi KS, Balmuchu G, Acharya PS, et al. The Perspectives of Educators and Learners on E-Learning: A Cross-Sectional Descriptive Study in a Medical School. Adv Med Educ Pract. 2021; 12: 1059-1066.##17. Hattar S, AlHadidi A, Sawair FA, et al. Impact of COVID-19 pandemic on dental education: online experience and practice expectations among dental students at the University of Jordan. BMC Med Educ. 2021; 21(1): 151.##18. Cheng HC, Lu SL, Yen YC, et al. Dental education changed by COVID-19: Student's perceptions and attitudes. BMC Med Educ. 2021; 21(1): 364.##19. Romeo M, Yepes-Baldó M, Soria MÁ, et al. Impact of the COVID-19 Pandemic on Higher Education: Characterizing the Psychosocial Context of the Positive and Negative Affective States Using Classification and Regression Trees. Frontiers in Psychology. 2021; 12.##20. Gonzalez T, de la Rubia MA, Hincz KP, et al. Influence of COVID-19 confinement on students' performance in higher education. PLoS One. 2020; 15(10): e0239490.##21. Schlenz MA, Schmidt A, Wöstmann B, et al. Students’ and lecturers’ perspective on the implementation of online learning in dental education due to SARS-CoV-2 (COVID-19): a cross-sectional study. BMC Medical Education. 2020; 20(1): 354.##22. Regmi K, Jones L. A systematic review of the factors – enablers and barriers – affecting e-learning in health sciences education. BMC Medical Education. 2020; 20(1): 91.##23. Huynh R. The Role of E-Learning in Medical Education. Acad Med. 2017; 92(4): 430.##24. Ruiz JG, Mintzer MJ, Leipzig RM. The impact of E-learning in medical education. Acad Med. 2006; 81(3): 207-12.##25. Chang TY, Hong G, Paganelli C, et al. Innovation of dental education during COVID-19 pandemic. J Dent Sci. 2021; 16(1): 15-20.##26. Chang T-Y, Hsu M-L, Kwon J-S, et al. Effect of online learning for dental education in asia during the pandemic of COVID-19. Journal of Dental Sciences. 2021; 16(4): 1095-1101.##27. Kelekar AK, Lucia VC, Afonso NM, et al. COVID-19 vaccine acceptance and hesitancy among dental and medical students. J Am Dent Assoc. 2021; 152(8): 596-603.##28. Conway DI, Culshaw S, Edwards M, et al. SARS-CoV-2 Positivity in Asymptomatic-Screened Dental Patients. J Dent Res. 2021; 100(6): 583-590.##29. Pelikan ER, Lüftenegger M, Holzer J, et al. Learning during COVID-19: the role of self-regulated learning, motivation, and procrastination for perceived competence. Zeitschrift für Erziehungswissenschaft. 2021; 24(2): 393-418.##30. Ghanbari N, Nowroozi S. The practice of online assessment in an EFL context amidst COVID-19 pandemic: views from teachers. Language Testing in Asia. 2021; 11(1): 27. [Persian]##31. Rapanta C, Botturi L, Goodyear P, et al. Online University Teaching During and After the Covid-19 Crisis: Refocusing Teacher Presence and Learning Activity. Postdigital Science and Education. 2020; 2(3): 923-945.## ##

Spatial and Temporal Modeling of Cutaneous Leishmaniasis in Yazd Province, Iran: Based on the Geographic Information System (GIS) 2 2 Background: Cutaneous Leishmaniasis (CL) remains a significant health concern in Iran, particularly in specific areas of Yazd province in central Iran. This investigation was conducted with the aim of presenting the spatial and temporal modeling of CL in Yazd province. Methods: This was an ecological study, using data from the health department of Yazd province. The data for the cases of CL during 2004-2013 were extracted and merged into Arc Geographic Information System (GIS) 9.3 software. Cochran-Armitage test, Choropleth Map, Hot-Spot Analysis, and High/Low Clustering analysis were used to determine time trend, distribution of disease, hot-spots, and possible abnormal clustering, respectively. Results: The results indicated a decreasing trend of incidence of CL from 199 to 29.2 cases (per 100,000 populations) during 2004-2013. The findings of the choropleth map showed that cities of Khatam and Abarkuh had a high incidence of CL. The results of the analysis of hot spots showed that during 2004-2008, cities of Yazd and Saduq were classified as cold spots of disease and the difference with neighboring cities was statistically significant (p = 0.031). No hot spots were obtained. In the cluster analysis, no results were obtained to separate high or low level. Conclusion: Maps of spatial distribution of CL were generated to facilitate the decision-making capacity at provincial health department. These results showed that in regions of Yazd province neighboring Fars, Isfahan and Kerman provinces, there was a high risk of disease. Hence, in these areas, preventive strategies can be focused and pursued more purposefully.   36 45 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/3 1403/7/12 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/2 1403/11/14 Hadis Barati Hadis Barati Guilan Road Trauma Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran Iran hbarati7@gmail.com Mohammad Barati Mohammad Barati Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran Iran mbaratim@gmail.com Reza Pakzad Reza Pakzad Department of Epidemiology, School of Health, Ilam University of Medical sciences, Ilam, Iran Iran rezapakzad2010@yahoo.com Fardin Mehrabian Fardin Mehrabian Research Center of Health and Environment, Department of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran Iran mehrabian@gums.ac.ir Esmaeil Fattahi Esmaeil Fattahi Department of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran Iran Esmaeil.fattahi1@gmail.com Mohammad Hassan Lotfi Mohammad Hassan Lotfi Social Determinants of Health Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences,Yazd, Iran Iran mhlotfi56359@gmail.com Leishmaniasis spatio-temporal analysis geographic information systems disease hotspot 1. Desjeux P. Leishmaniasis: current situation and new perspectives. Comparative immunology, microbiology and infectious diseases. 2004; 27(5): 305-18.##2. Imran M, Khan SA, Abida, Alshrari AS, et al. Small molecules as kinetoplastid specific proteasome inhibitors for leishmaniasis: A patent review from 1998 to 2021. Expert Opinion on Therapeutic Patents. 2022; 32(5): 591-604.##3. Thumbi SM, Jung'a JO, Mosi RO, et al. Spatial distribution of African animal trypanosomiasis in Suba and Teso districts in Western Kenya. BMC research notes. 2010; 3(1): 1.##4. Yang G-J, Vounatsou P, Xiao-Nong Z, et al. A review of geographic information system and remote sensing with applications to the epidemiology and control of schistosomiasis in China. Acta tropica. 2005; 96(2): 117-29.##5. Barati M, Keshavarz-valian H, Habibi-nokhandan M, et al. Spatial outline of malaria transmission in Iran. Asian Pacific Journal of Tropical Medicine. 2012; 5(10): 789-95. [Persian]##6.Sunyoto T, Verdonck K, El Safi S, et al. Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa-A systematic review. PLoS neglected tropical diseases. 2018; 12(10): e0006914.##7. Reithinger R, Dujardin J-C, Louzir H, et al. Cutaneous leishmaniasis. The Lancet infectious diseases. 2007; 7(9): 581-96.##8.World Health Organization. Leishmaniasis status of endemicity of cutaneous leishmaniasis: 2023. WHO; 2023. Available at: URL: https://apps.who.int/neglected_diseases/ntddata/leishmaniasis/leishmaniasis.html. Accessed February 23, 2023.##9. Barati H, Ayubi E, Iranpour S, et al. Time Series Analysis of Cutaneous Leishmaniasis in Sabzevar Northeastern Iran Using Segmented Regression Model. International Journal of Epidemiologic Research. 2020; 7(3): 101-6. [Persian]##10. Karimi A, Hanafi-Bojd AA, Yaghoobi-Ershadi MR, et al. Spatial and temporal distributions of phlebotomine sand flies (Diptera: Psychodidae), vectors of leishmaniasis, in Iran. Acta tropica. 2014; 132: 131-9. [Persian]##11. Holakouie-Naieni K, Mostafavi E, Boloorani AD, et al. Spatial modeling of cutaneous leishmaniasis in Iran from 1983 to 2013. Acta Tropica. 2017; 166: 67-73. [Persian]##12. Gage KL, Burkot TR, Eisen RJ, et al. Climate and vectorborne diseases. American journal of preventive medicine. 2008; 35(5): 436-50.##13. Schröder W. GIS, geostatistics, metadata banking, and tree-based models for data analysis and mapping in environmental monitoring and epidemiology. International Journal of Medical Microbiology. 2006; 296: 23-36.##14. Mollalo A, Khodabandehloo E. Zoonotic cutaneous leishmaniasis in northeastern Iran: a GIS-based spatio-temporal multi-criteria decision-making approach. Epidemiology and infection. 2016; 144(10): 2217-29.##15. Pakzad R, Dabbagh-Moghaddam A, Mohebali M, Safiri S, Barati M. Spatio-temporal analysis of cutaneous leishmaniasis using geographic information system among Iranian Army Units and its comparison with the general population of Iran during 2005–2014. Journal of parasitic diseases. 2017; 41: 1114-22. [Persian]##16. Salahi-Moghaddam A, Khoshdel A, Hanafi-Bojd A-A, et al. Mapping and review of leishmaniasis, its vectors and main reservoirs in Iran. Journal of Kerman University of Medical Sciences. 2014; 21(1): 83-104. [Persian]##17. Salahi-Moghaddam A, Mohebali M, Moshfae A, et al. Ecological study and risk mapping of visceral leishmaniasis in an endemic area of Iran based on a geographical information systems approach. Geospatial health. 2010; 5(1): 71-7. [Persian]##18. Salehi-Moghadam A, Barati M, Mpoghadam AD, et al. Temporal changes and mapping Leishmaniasis in military units of IRI Army. Bimonthly Journal of Hormozgan University of Medical Sciences. 2015; 18(1): 91-8. [Persian]##19. Babaie E, Alesheikh AA, Tabasi M. Spatial modeling of zoonotic cutaneous leishmaniasis with regard to potential environmental factors using ANFIS and PCA-ANFIS methods. Acta Tropica. 2022; 228: 106296. [Persian]##20. Karmaoui A, Ben Salem A, Sereno D, et al. Geographic distribution of Meriones shawi,Psammomys obesus, and Phlebotomus papatasi the main reservoirs and principal vector of zoonotic cutaneous leishmaniasis in the Middle East and North Africa. Parasite Epidemiology and Control. 2022; 17: e00247.##21. Sharifi I, Khosravi A, Aflatoonian MR, et al. Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan. Frontiers in Public Health. 2023; 11: 1091709. [Persian]##22. Aflatoonian M, Sharifi I, Aflatoonian B, et al. Fifty years of struggle to control cutaneous leishmaniasis in the highest endemic county in Iran: A longitudinal observation inferred with interrupted time series model. PLoS Neglected Tropical Diseases. 2022; 16(4): e0010271.##23. Karimi T, Sharifi I, Aflatoonian MR, et al. A long-lasting emerging epidemic of anthroponotic cutaneous leishmaniasis in southeastern Iran: population movement and peri-urban settlements as a major risk factor. Parasites & Vectors. 2021; 14(1): 1-14. [Persian]##24. Barati H, Lotfi M, Mozafari G, et al. Study of Epidemiological Aspects of Cutaneous Leishmaniasis in Yazd province During 2004 - 2013. Journal of Community health Research. 2016; 5(2): 131-9. [Persian]##25. Nam J-m. A simple approximation for calculating sample sizes for detecting linear trend in proportions. Biometrics. 1987: 701-5.##26. Asgari A. Analysis of Spatial Statistics in ArcGIS. organization of tehranMunicipality Information and Communication Technology; 2011. [Persian]##27. Gonzalez U, Pinart M, Reveiz L, et al. Interventions for Old World cutaneous leishmaniasis. The Cochrane database of systematic reviews. 2008; (4): Cd005067.##28. Yaghoobi-Ershadi MR, Jafari R, Hanafi-Bojd AA. A new epidemic focus of zoonotic cutaneous leishmaniasis in central Iran. Annals of Saudi medicine. 2004; 24(2): 98-101. [Persian]##29. World Health Organization. Manual for case management of cutaneous leishmaniasis in the WHO Eastern Mediterranean Region, 2014. WHO; 2014. Available at: URL: https://www.who.int/publications/i/item/9789290219453. Accessed March 5, 2014.##30. Amin TT, Al-Mohammed HI, Kaliyadan F, et al. Cutaneous leishmaniasis in Al Hassa, Saudi Arabia: Epidemiological trends from 2000 to 2010. Asian Pacific Journal of Tropical Medicine. 2013; 6(8): 667-72.##31. Barati H, Barati M, Lotfi MH. Epidemiological Study of Cutaneous Leishmaniasis in Khatam, Yazd Province, 2004-2013. Paramedical Sciences and Military Health. 2015; 10(2): 1-5. [Persian]##32. Fendri AH, Beldjoudi W, Ahraou S, et al. Leishmaniasis in Constantine (Algeria): review of five years (2006-2010) at the University Hospital. Bulletin de la Societe de pathologie exotique. 2012; 105(1): 46-8.##33. 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Comparing the Effectiveness of Behavioral Activation and Metacognitive Therapy on Depression, Cognitive Emotion Regulation, and Assertiveness Strategies in Women Victims of Domestic Violence 2 2 Background: Domestic violence is a social and behavioral problem affecting almost half of females. This study aimed to compare the effectiveness of behavioral activation and metacognitive therapy on depression, emotion regulation strategies, and assertiveness in women victims of domestic violence. Methods: The quasi-experimental design of the study was pretest-posttest with a control group. The statistical population included all female victims of domestic violence who referred to family counseling clinics under the supervision of Shiraz Welfare in 2019. This study was conducted on 45 people, who were selected using random sampling method and assigned to experimental and control groups. The measurement tools included the Beck Depression Inventory, Assertiveness Inventory, Cognitive Emotion Regulation Questionnaire, and Domestic Violence Against Women Questionnaire. The data were analyzed using multivariate analysis of covariance (MANOVA) and Kolmogorov-Smirnov test to check the normality of data distribution and the Levene test was applied to test the homogeneity hypothesis of group variances. Results: The mean age of participants was 36.58 ± 11.31 in behavioral activation group and was 35.17 ± 7.54 in metacognitive therapy group, and their marriage duration was 6.23 ± 2.89. The results demonstrated that behavioral activation therapy improved components of self-blame, blame others, repetition and positive concentration, assertiveness and depression, and metacognitive therapy components of self-blame, acceptance, cognitive emotion regulation strategies, positive focus, assertiveness, and improved depression (P < 0.05). However, there was no significant difference between the effectiveness of behavioral activation and metacognitive therapy (P < 0.05). Conclusion: Behavioral and metacognitive activation therapies can be used to improve mental health and teach coping skills to women victims of domestic violence, educational and therapeutic planning.   46 56 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/16 1403/8/26 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/15 1403/11/27 Zahra Simi Zahra Simi Department of Family Counseling, Faculty of Psychology, Allameh Tabatabai University, Tehran, Iran Iran z.simin00@yahoo.com Hakime Kamkar Hakime Kamkar Department of Criminal Law and Criminology, Azad University, North Tehran Branch, Tehran, Iran Iran hakamkar.iau.ac@gmail.com Mitra Amiri Mitra Amiri Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Chamran Ahvaz University, Ahvaz Iran amiri_m651@yahoo.com Roghayeh Mazarei Roghayeh Mazarei Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Roudhen Azad University, Roudhen, Iran Iran roghayeh.mazarei@yahoo.com Behnaz Moohamadi Behnaz Moohamadi Department of Clinical Psychology, Faculty of Psychology, Azad Bushehr University, Bushehr, Iran Iran Bmoohamadi.1371@yahoo.com Emotion regulation depression assertiveness domestic violence 1.Taşkale N, Soygüt G. Risk Factors for Women’s Intimate Partner Violence Victimization: An Examination from the Perspective of the Schema Therapy Model. J Fam Viol. 2017; 32: 3–12.##2. Schechter S, Ganley AL. Domestic violence: A national curriculum for family preservation practitioners. Family Violence Prevention Fund; 1995.##3. Dokkedahl S, Ko N, Murphy S, et al. The psychological subtype of intimate partner violence and its effect on mental health: Protocol for a systematic review and meta-analysis. Syst Rev. 2019; 8: 198.##4. World Health Organization. Violence Against Women Prevalence Estimates. 2018. Available at: URL: https://cdn.who.int/ media/docs/default-source/documents/violence-prevention/vaw_report_web_09032021_oleksandr.pdf?sfvrsn=a82ef89c_5& download=true Accessed March 20, 2021.##5. Bigizadeh S, Sharifi N, Javadpour S, et al. Attitude toward violence and its relationship with self-esteem and self-efficacy among Iranian women. Journal of Psychosocial Nursing and Mental Health Services. 2021; 59(4): 31-37. [Persian]##6. Lagdon S, Armour C, Stringer M. Adult experience of mental health outcomes as a result of intimate partner violence victimization: A systematic review. Eur. J. Psychotraumatol. 2014; 5: 1–12.##7. Pereira ME, Azeredo A, Moreira D, et al. Personality characteristics of victims of intimate partner violence: A systematic review. Aggression and violent behavior. 2020; 52: 101423.##8. Malik M, Munir N, Ghani U, et al. Domestic violence and its relationship with depression, anxiety and quality of life: A hidden dilemma of Pakistani women. Pak J Med Sci. 2021; 37(1): 191–194.##9. Dutton MA, Goodman LA. Coercion in intimate partner violence: toward a new conceptualization. Sex Roles. 2005; 5212(11): 743–756.##10. Kocherhina I. Types of emotional self-regulation of women who have suffered from psychological abuse in the family. J Educ Cult Soc. 2018; 9(2): 81-92.##11. Gross JJ. The emerging field of emotion regulation: An integrative review. Rev Gen Psychol. 1998; 2: 271–299.##12. Fruzzetti AE, Worrall JM. Accurate expression and validating responses: A transactional model for understanding individual and relationship distress. Support processes in intimate relationships. 2010; 11: 121-50.##13. Muñoz-Rivas M, Bellot A, Montorio I, et al. Profiles of Emotion Regulation and Post-Traumatic Stress Severity among Female Victims of Intimate Partner Violence. Int J Environ Res Public Health. 2021; 18(13): 6865.##14. Alberti RE, Emmons ML. A guide to assertive living: Your perfect right; 1982.##15. Astuti AD, Alizamar A, Afdal A. Assertive behaviour difference among domestic violence victims. Journal of Educational and Learning Studies. 2019; 2(1): 83-87.##16. Kanter JW, Santiago-Rivera AL, Rusch LC, et al. Initial outcomes of a culturally adapted behavioral activation for Latinas diagnosed with depression at a community clinic. Behavior modification. 2010; 34(2): 120-44.##18. Leahy RL, Holland SJ, McGinn LK. Treatment plans and interventions for depression and anxiety disorders. Guilford press; 2011.##19. Soleymani M. Comparative study of behavioral activation therapy and group cognitive therapy in reducing the symptoms of anxiety and depression sympt. [Doctorate Thesis]. Iran. Tehran University of Social Welfare and Rehabilitation Sciencess; 2012. [Persian]##20. Wells A, Carter KE. Maladaptive thought control strategies in generalized anxiety disorder, major depressive disorder, and nonpatient groups and relationships with trait anxiety. International Journal of Cognitive Therapy. 2009; 2(3): 224-34.##21. Solem S, Kennair LEO, Hagen R, et al. Metacognitive Therapy for Depression: A 3-Year Follow-Up Study Assessing Recovery, Relapse, Work Force Participation, and Quality of Life. Front Psychol. 2019; 10: 2908.##22. Ataei N. The effectiveness of behavioral activation therapy on depression, cognitive strategies of emotion regulation and assertiveness in female students of Yasouj University. [POSTER] at: Proceedings First National Scientific Conference on Psychology and Educational Sciences; 2019 Jun 25; Shirvan: Khorasan Shomali; 2019: 17. [Persian]##23. Ekers D, Webster L, Van Straten A, et al. Behavioural activation for depression; an update of meta-analysis of effectiveness and sub group analysis. PloS one. 2014; 9(6): e100100##24. Takatoshi H, Yuko O, Yuko Y, et al. Feasibility and preliminary effectiveness of behavioral activation for cancer patients with depression. BMJ. 2022; 1-23. ##25. Parhon H, Moradi A, Hatami M, et al. Comparison of short-term behavioral activation therapy and metacognitive therapy on reducing the severity of symptoms and increasing the quality of life of patients with major depression. Quarterly Journal of Mental Health Research. 2012; 6(4): 52-36.##26. Stein AT, Carl E, Cuijpers P, et al. Looking beyond depression: a meta-analysis of the effect of behavioral activation on depression, anxiety, and activation. Psychol Med. 2021; 51(9): 1491-1504.##27. Tull MT, Berghoff CR, Bardeen JR, et al. An Initial Open Trial of a Brief Behavioral Activation Treatment for Depression and Medication Adherence in HIV-Infected Patients. Behav. Modif. 2018; 42(2): 196–209. ##28. Moshier SJ, Otto MW. Behavioral activation treatment for major depression: A randomized trial of the efficacy of augmentation with cognitive control training. J Affect Disord. 2017; 1(210): 265-268.##29. Hagen R, Hjemdal O, Solem S, et al. Metacognitive therapy for depression in adults: a waiting list randomized controlled trial with six months follow-up. Frontiers in Psychology. 2017; 8: 31.##30. Winter L, Gottschalk J, Nielsen J, et al. A comparison of metacognitive therapy in current versus persistent depressive disorder–a pilot outpatient study. Frontiers in psychology. 2019; 10: 1714.##31. Bahadori MH, Jahanbakhsh M, Mohammad Hosseinpour F, et al. Effect of meta-cognitive therapy on self assertiveness skill in patients with social phobia disorder. 2014; 16(5): 22-26. [Persian]##32. Habibi R, Atlasroody A, Matinpour B. Effectiveness of Behavioral Activation Group Therapy on Emotional Regulation Difficulties and Ego Strength in People with Major Depressive Disorder. JTBCP. 2020; 14(54): 67-76. [Persian]##33. Tol WA, Murray SM, Lund C, et al. Can mental health treatments help prevent or reduce intimate partner violence in low-and middle-income countries? A systematic review. BMC Women's Health. 2019; 19: 1-5.##34. Garnefski N, Kraaij V, Spinhoven P. Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual differences. 2001; 30(8): 1311-27.##35. Hashemloo S, Sobhi A. Comparison of Defense Styles, Attributional Styles and Cognitive Emotion Regulation in Women Memorizing and Non-Memorizing the Quran in Zanjan. Journal of Health Promotion Management. 2021; 10(6): 101-110. [Persian]##36. Samani S, Sadeghi L. Psychometric properties of the cognitive emotion regulation questionnaire. Psychological Models and Methods. 2010; 1(1): 51-62. [Persian]##37. Marnat GG. Psychological Evaluation Guidelines for clinical psychologists, counselors and psychiatrists. Translation by Mohammad Hassan Pasha Sharifi and Mohammad Reza Nikkhou. Tehran: Growth Publication; 2005. [Persian]##38. Lee E-H, Lee S-H, -Taeg Hwang S, et al. Reliability and Validity of the Beck Depression Inventory-II among Korean Adolescents. Psychiatry Investig. 2017; 14(1):30-36. ##39. Fata L. Bireshk B. Atefvahid MK. Dobson KA. Semantic Structures/Schemas and Cognitive Processing of Emotional Information: A Comparison of Two Conceptual Frameworks. Iranian Journal of Psychiatry and Clinical Psychology. 2005; 11: 312-326.##40. Mazloum Hamedani SS, Amupour M. The Relationship Between Parents’ Perfectionism with Self-esteem and Optimism of Their Children Among Female high School Students in Rasht City. Educational Development of Judishapur. 2017; 8(Supplement): 118-22. [Persian]##41. Naghashzadeh E, Khalatbari J, Hosseini Almadani SA, et al. The Effectiveness of Life Skills Training Based on Jay McGraw's Approach to Self-Expression Emotion Regulation in Adolescent. medical journal of mashhad university of medical sciences. 2020; 62(5.1): 456-64. [Persian]##42. Mohseni Tabrizi AR, Kaldi AR, Javadianzadeh M. The study of domestic violence in marrid women addmitted to yazd legal medicine organization and welfare organization. Tolooebehdasht. 2013; 11(3): 11-24. [Persian]##43. Dimidjian S, Martell CR, Addis ME, et al. Behavioral activation for depression. 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Determining the Validity and Reliability of the Innovation Ecosystem with Emphasis on the Role of E-government in Hospitals in Yazd Province in 2023 2 2 Background: Today's changes in health systems and the importance of health can be a basis for self-care, increasing the quality of services, patient satisfaction, achieving optimal levels of health in people, and finally using innovation to improve the quality of health services. Electronic measures in the health sector also include many benefits such as improving the quality of health services, reducing costs, and increasing efficiency. Therefore, this study aimed to design an ecosystem model of innovation with an emphasis on the role of e-government in Yazd hospitals. Methods: This was a qualitative-quantitative study conducted in Yazd in 2023. In the qualitative phase, 7 people and in the quantitative phase, 70 senior and middle managers of government and non-government hospitals were selected and interviewed through convenience sampling. In this study, SMSRT-PLS 3.2.4 software was used to measure the reliability and validity of the questionnaire, considering the number of available samples (70 people) and the insensitivity to the normality of the data. Cronbach's alpha coefficient and composite reliability coefficient (CR) were used to examine reliability, and convergent validity was used to examine validity. Results: Most of the participants were female (81/43%), between the ages of 36-54 (34/29%), and had a master's degree (30%). After using factor analysis, the questionnaire was designed into 4 dimensions: 1- Activation of policies and regulations, 2- Access to data and infrastructure, 3- Funding and validation opportunities, 4- Ease of adoption and dissemination of innovations The results showed that the reliability of these dimensions was 89% , 91%, 76% and 88%, respectively. Also, the validity results of Wager showed that its value for the studied dimensions was 51%, 71%, 63% and 79%, respectively. Conclusion: According to the accepted validity and reliability, this questionnaire can be a valid, reliable and easy-to-use tool to improve the field of technology. Although the questionnaire is in Persian, it can be used in other languages as a basis to check the validity and reliability through the scientific process. This article has been updated due to an error in the names of the authors: https://jhr.ssu.ac.ir/article-1-1151-en.html   57 67 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/22 1403/8/1 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/8 1403/11/20 Zahra Mirjalili Zahra Mirjalili Department of Public Administration, Kerman Branch, Islamic Azad University, Kerman, Iran Iran Zahra.Mirjalili@gmail.com Saeed Sayadi Saeed Sayadi Department of Public Administration, Kerman Branch, Islamic Azad University, Kerman, Iran Iran Saeed.Sayadi@fgmai.com Hamidreza Melai Hamidreza Melai Department of Public Administration, Kerman Branch, Islamic Azad University, Kerman, Iran Iran Hamidreza.Melai@gmail.com Abbas Babai Nejad Abbas Babai Nejad Department of Public Administration, Kerman Branch, Islamic Azad University, Kerman, Iran Iran management7204020@yahoo.com Health hospital innovation designing 1. Smorodinskaya N, Russell M, Katukov D,et al. Innovation ecosystems vs. innovation systems in terms of collaboration and co-creation of value; 2017.##2. Tsujimoto M, Kajikawa Y, Tomita J, et al. Designing the coherent ecosystem: Review of the ecosystem concept in strategic management. In 2015 Portland International Conference on Management of Engineering and Technology (PICMET). IEEE. 2015; 53-63.##3. Scaringella L, Radziwon A. Innovation, entrepreneurial, knowledge, and business ecosystems: Old wine in new bottles? Technological Forecasting and Social Change. 2018; 136: 59-87.##4. Yang Z, Chen H, Du L, et al. How does alliance-based government-university-industry foster cleantech innovation in a green innovation ecosystem? Journal of Cleaner Production. 2021; 283: 124559.##5. Reynolds EB, Uygun Y. Strengthening advanced manufacturing innovation ecosystems: The case of Massachusetts. Technological Forecasting and Social Change. 2018; 136: 178-91.##6. Nylund PA, Brem A, Agarwal N. Innovation ecosystems for meeting sustainable development goals: The evolving roles of multinational enterprises. Journal of Cleaner Production. 2021; 281: 125329.##7. Ahmadi A, Shirani M, Khaledifar A, et al. Non-communicable diseases in the southwest of Iran: profile and baseline data from the Shahrekord PERSIAN Cohort Study. BMC Public Health. 2021; 21(1): 1-14.##8. Pilinkienė V, Mačiulis P. Comparison of different ecosystem analogies: The main economic determinants and levels of impact. Procedia-social and behavioral sciences. 2014; 156: 365-70.##9. Groves P, Kayyali B, Knott D, et al. The'big data'revolution in healthcare: Accelerating value and innovation; 2016.##10. Roberts JP, Fisher TR, Trowbridge MJ, et al. A design thinking framework for healthcare management and innovation. Healthcare: Elsevier; 2016.##11. Castro MC, Massuda A, Almeida G, et al. Brazil's unified health system: the first 30 years and prospects for the future. The lancet. 2019; 394(10195): 345-56.##12. 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Glue-sniffing among the Street Children in Bangladesh: The Intersection of Hunger and Addiction 2 2 This study explores the complex phenomenon of glue-sniffing among the street children in Bangladesh, focusing on the complex interplay between hunger and addiction. Street children, often marginalized and forgotten, face numerous challenges including lack of shelter and limited access to education. In the midst of these hardships, many turn to glue-sniffing as a means of escape from hunger and harsh realities of their life. This paper explores the socio-economic factors that drive street children towards glue-sniffing. It examines how poverty and food insecurity push these children into the streets, where they are exposed to the lure of cheap and accessible inhalants. Moreover, the study explores the physiological effects of glue-sniffing on these vulnerable individuals. The findings of this study underscore the urgent need for holistic interventions that address both the immediate needs of street children, such as food and shelter, as well as the underlying factors driving their substance abuse. Ultimately, this paper will contribute to a deeper understanding of the complex dynamics at play within the lives of street children in Bangladesh. 68 70 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/17 1403/8/27 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/14 1403/12/24 Kallol Debnath Kallol Debnath Department of Pharmacy, Faculty of Life Sciences, University of Development Alternative, Dhaka, Bangladesh Bangladesh kalloldebnath@pharmacy.uoda.edu.bd Habiba Akter Nahida Habiba Akter Nahida Department of Pharmacy, Faculty of Life Sciences, University of Development Alternative, Dhaka, Bangladesh Bangladesh habibaakternahida90@gmail.com Shila Debnath Shila Debnath Department of English, Faculty of Arts, University of Development Alternative, Dhaka, Bangladesh Bangladesh hellowwshila@gmail.com Beton Chakma Beton Chakma Department of Pharmacy, Faculty of Life Sciences, University of Development Alternative, Dhaka, Bangladesh Bangladesh beton.ku07@gmail.com Chandon Chakma Chandon Chakma Department of Pharmacy, Faculty of Life Sciences, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh Bangladesh chandonchakma6@gmail.com Street children glue-sniffing hunger drug addiction crime bangladesh 1. Khan I. Glue-sniffing. World health 1986; Jun: 23. WHO; 1986. Available at: URL: https://iris. who.int/handle/ 10665/53591. Accessed April 02, 2024.##2. Report. Glue-sniffing Dandy alarmingly spreading among street children. Bangladesh Sangbad Sangstha (2022, Jan 31). Available at: URL: https://www.bssnews.net/news/41671. Accessed April 02, 2024.##3. Report. A qualitative study on Children living in Street situations in Bangladesh 2024. UNICEF Bangladesh (2024). Available at: URL: https://www.unicef.org/bangladesh/en/reports/children-living-street-situations-bangladesh-2024. Accessed April 03, 2024.##4. Survey Findings Report. Survey on Street children 2022. Bangladesh Bureau of Statistics and UNICEF (2023, March). Available at: URL: https://bbs.gov.bd/site/page/b588b454-0f88-4679-bf20-90e06dc1d10b. Accessed April 06, 2024.##5. Rahman M. BD's 48.5pc street children live in Dhaka Division. Daily Observer (2023, April 11). Available at: URL: https://www.observerbd.com/news.php?id=415236. Accessed April 05, 2024.##6. Suhrawardy F. Dhaka’s glue-sniffing street kids becoming threat to peers. Dhaka Tribune (2023, Dec 30). Available at: URL: https:// www.dhakatribune.com/bangladesh/335293/dhaka%E2%80%99s-glue-sniffing-street-kids-becoming- threat. Accessed April 07, 2024.##7. Documents. Volatile solvents abuse: A global overview. World Health Organization. (‎1999)‎. Available at: URL: https://iris.who.int/handle/10665/65899. Accessed April 06, 2024.##8. Nandy D. and Khan M. J. Childhood lost in dandy addiction. The Daily Star (2023, Sep 4). Available at: URL: https://www.thedailystar.net/news/bangladesh/news/childhood-lost-dandy-addiction-3410576. Accessed April 04, 2024.##9. Annual Drug Report - Bangladesh, 2011. Available at: URL: https://dnc.portal.gov.bd/sites/default/ files/files/ dnc. portal.gov.bd/annual_reports/9b979acf_e4bd_4870_a1cd_79bc6663cb76/annual_drug_report_2011.pdf. Accessed April 09, 2024.##10. Alam R. Building pathways to a secure and bright future for street children. Dhaka Tribune (2023, Jul 05). Available at: URL: https://www.dhakatribune.com/opinion/op-ed/314879/building-pathways-to-a-secure-and-bright-future. Accessed April 09, 2024.## ##

The Effect of Hemoglobin and Body Mass Index on the Outcomes of COVID-19: A Prospective Cohort Study 2 2 Background: Previous studies indicated the risk factors for COVID-19. Malnutrition is one of the main causes of immune system failure. This study aims to investigate the effect of nutritional status on the outcomes of COVID-19 in participants of Yazd Health Study (YaHS). Methods: 279 people who had taken a blood test before contracting COVID-19 were included in this study in 2022. Data of PO2 level, rate of hospitalization, "supplementation with oxygen" rate, BUN, and creatinine were extracted. Malnutrition status was evaluated using hemoglobin levels and body mass index (BMI). The authors applied analysis of variance (ANOVA) and independent sample t-test to show differences between levels of BMI and hemoglobin. All statistical analyses were conducted using IBM SPSS version 22.0 software. Results: The results showed a significant difference between hemoglobin levels and different BMI levels (P = 0.03). However, there was no significant relationship between different BMI levels and BUN (P = 0.34), creatinine (P = 0.42), BUN/Cr (P = 0.14), PO2 (P = 0.34), supplementation with oxygen (P = 0.26), and hospitalization rates (P = 0.97). The results according to the normal and abnormal hemoglobin levels were not significant. Conclusion: According to the criteria used in this study to assess nutritional status (BMI and hemoglobin levels), there was no significant relationship between nutritional status (different levels of BMI and hemoglobin) and COVID-19 outcomes, including hospitalization rate, “supplementation with oxygen” rate, and low PO2 levels. Further studies in different countries using other nutritional status assessment tools are needed to confirm these findings.   71 78 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/15 1403/10/26 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/8 1404/1/19 Shirin Hasanizadeh Shirin Hasanizadeh 1. Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 2. Student Research Committee, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran Iran Shirin_hasanizadeh@yahoo.com Hadis Varaee Hadis Varaee 1. School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2. Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran hadis.varaee@gmail.com Fatemeh Mirjalili Fatemeh Mirjalili 1. Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2. Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran f.mirjalili98nut@gmail.com Azadeh Najarzadeh Azadeh Najarzadeh Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran azadehnajarzadeh@gmail.com Masoud Mirzaei Masoud Mirzaei Yazd Cardiovascular Research Centre, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran masoud_mirzaei@hotmail.com Malnutrition COVID-19 hemoglobins nutritional sciences nutritional status 1. O'Neill LAJ, Netea MG. BCG-induced trained immunity: can it offer protection against COVID-19? Nat Rev Immunol. 2020; 20(6): 335-7.##2. Zheng Z, Peng F, Xu B, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 2020; 81(2): e16-e25.##3. Cattaruzza MS, Zagà V, Gallus S, et al. Tobacco smoking and COVID-19 pandemic: old and new issues. A summary of the evidence from the scientific literature. Acta Biomed. 2020; 91(2): 106-12.##4. Mehra MR, Desai SS, Kuy S, et al. Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. N Engl J Med. 2020; 382(25): e102.##5. Lighter J, Phillips M, Hochman S, et al. Obesity in Patients Younger Than 60 Years Is a Risk Factor for COVID-19 Hospital Admission. Clin Infect Dis. 2020; 71(15): 896-7.##6. Cai Q, Chen F, Wang T, et al. Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China. Diabetes Care. 2020; 43(7): 1392-8.##7. Marques-Vidal P, Bochud M, Bastardot F, et al. Association between inflammatory and obesity markers in a Swiss population-based sample (CoLaus Study). Obes Facts. 2012; 5(5): 734-44.##8. Bokov P, Delclaux C. [The impact of obesity on respiratory function]. Rev Mal Respir. 2019; 36(9): 1057-63.##9. Petrakis D, Margină D, Tsarouhas K, et al. Obesity ‑ a risk factor for increased COVID‑19 prevalence, severity and lethality (Review). Mol Med Rep. 2020; 22(1): 9-19.##10. Kruglikov IL, Scherer PE. The Role of Adipocytes and Adipocyte-Like Cells in the Severity of COVID-19 Infections. Obesity (Silver Spring). 2020; 28(7): 1187-90.##11. Engin AB, Engin ED, Engin A. Two important controversial risk factors in SARS-CoV-2 infection: Obesity and smoking. Environ Toxicol Pharmacol. 2020; 78: 103411.##12. Ryan PM, Caplice NM. Is Adipose Tissue a Reservoir for Viral Spread, Immune Activation, and Cytokine Amplification in Coronavirus Disease 2019? Obesity (Silver Spring). 2020; 28(7): 1191-4.##13. Katona P, Katona-Apte J. The interaction between nutrition and infection. Clin Infect Dis. 2008; 46(10): 1582-8.##14. Imoberdorf R, Rühlin M, Beerli A, et al. Mangelernährung im Alter. Swiss Medical Forum ‒ Schweizerisches Medizin-Forum. 2014; 14.##15. Correia M, Perman MI, Waitzberg DL. Hospital malnutrition in Latin America: A systematic review. Clin Nutr. 2017; 36(4): 958-67.##16. Gomes F, Schuetz P, Bounoure L, et al. ESPEN guidelines on nutritional support for polymorbid internal medicine patients. Clin Nutr. 2018; 37(1): 336-53.##17. Bernard V, Noel J. Do inventory disclosures predict sales and earnings? Journal of Accounting, Auditing & Finance. 1991; 6(2): 145-81.##18. Leiva Badosam E, Badia Tahull M, Virgili Casas N, et al. Cribado de la desnutrición hospitalaria en la admisión: la desnutrición aumenta la mortalidad y la duración de la estancia hospitalaria. Nutrición Hospitalaria. 2017; 34(4): 907-13.##19. Khalatbari-Soltani S, Marques-Vidal P. Impact of nutritional risk screening in hospitalized patients on management, outcome and costs: A retrospective study. Clin Nutr. 2016; 35(6): 1340-6. [Persian]##20. Khalatbari-Soltani S, Marques-Vidal P. Adherence to hospital nutritional status monitoring and reporting guidelines. PLoS One. 2018; 13(9): e0204000. [Persian]##21. Khalatbari-Soltani S, de Mestral C, Waeber G, et al. Large regional disparities in prevalence, management and reimbursement of hospital undernutrition. Eur J Clin Nutr. 2019; 73(1): 121-31. [Persian]##22. Khalatbari-Soltani S, Waeber G, Marques-Vidal P. Diagnostic accuracy of undernutrition codes in hospital administrative discharge database: improvements needed. Nutrition. 2018; 55-56: 111-5. [Persian]##23. Leij-Halfwerk S, Verwijs MH, van Houdt S, et al. Prevalence of protein-energy malnutrition risk in European older adults in community, residential and hospital settings, according to 22 malnutrition screening tools validated for use in adults ≥65 years: A systematic review and meta-analysis. Maturitas. 2019; 126: 80-9.##24. Dent E, Hoogendijk EO, Visvanathan R, et al. Malnutrition Screening and Assessment in Hospitalised Older People: a Review. J Nutr Health Aging. 2019; 23(5): 431-41.##25. Power L, Mullally D, Gibney ER, et al. A review of the validity of malnutrition screening tools used in older adults in community and healthcare settings - A MaNuEL study. Clin Nutr ESPEN. 2018; 24: 1-13.##26. Yeo HJ, Byun KS, Han J, et al. Prognostic significance of malnutrition for long-term mortality in community-acquired pneumonia: a propensity score matched analysis. Korean J Intern Med. 2019; 34(4): 841-9.##27. Falcone M, Russo A, Gentiloni Silverj F, et al. Predictors of mortality in nursing-home residents with pneumonia: a multicentre study. Clin Microbiol Infect. 2018; 24(1): 72-7.##28. Briguglio M, Pregliasco FE, Lombardi G, et al. The Malnutritional Status of the Host as a Virulence Factor for New Coronavirus SARS-CoV-2. Front Med (Lausanne). 2020; 7: 146.##29. Barazzoni R, Bischoff SC, Breda J, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr. 2020; 39(6): 1631-8.##30. Hejazi N, Mazloom Z, Zand F, et al. Nutritional assessment in critically ill patients. Iranian journal of medical sciences. 2016; 41(3): 171. [Persian]##31. Ahmed T, Haboubi N. Assessment and management of nutrition in older people and its importance to health. Clinical interventions in aging. 2010: 207-16. [Persian]##32. Shamlan G, Albreiki M, Almasoudi HO, et al. Nutritional status of elderly patients previously ill with COVID-19: Assessment with nutritional risk screening 2002 (NRS-2002) and mini nutritional assessment (MNA-sf). Journal of Infection and Public Health. 2024; 17(2): 372-7.##33. Barazzoni R, Bischoff SC, Breda J, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Elsevier; 2020; 1631-8.##34. Mojtahedi SS, Zarrinfar H, Bakhshaee M. Hematological Indices in COVID-19 Patients with Rhinosinusitis Mucormycosis. Iran J Otorhinolaryngol. 2024; 36(2): 399-405. [Persian]##35. Kurtz A, Grant K, Marano R, et al. Long-term effects of malnutrition on severity of COVID-19. Scientific Reports. 2021; 11(1): 14974.##36. Barazzoni R, Bischoff SC, Krznaric Z, et al. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Elsevier; 2020.##37. Phillips T, Mughrabi A, Garcia LJ, et al. 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Study of Prosodic Skills of Persian-Speaking Adults with Autism Spectrum Disorder Based on the Persian Version of Montreal Protocol for the Evaluation of Communication (P.M.E.C.) 2 2 Background: Research indicates that individuals with autism spectrum disorder (ASD) often struggle with prosodic skills, which include the rhythm, stress, and intonation of speech. While most studies focus on children, some findings suggest these challenges persist into adulthood. Methods: This comparative cross-sectional study used a quantitative approach to assess prosodic impairments in Persian-speaking adults with ASD. Thirteen Persian-speaking men with autism, aged 25 to 44 (mean = 32.84, SD = 4.17), participated. Their educational backgrounds ranged from third grade to 20 years of formal education. A control group of 26 healthy Persian-speaking men matched in age and education was also included. Prosodic skills were evaluated using five subtests from the Persian version of the Montreal Protocol for the Evaluation of Communication (P.M.E.C.): linguistic prosody comprehension, linguistic prosody repetition, emotional prosody comprehension, emotional prosody repetition, and emotional prosody production. Data were analyzed using descriptive statistics, independent samples t-tests, and the Kolmogorov-Smirnov test. Results: Participants with ASD performed significantly worse than the control group across all five subtests. Significant differences were found in linguistic prosody comprehension (p = 0.002), linguistic prosody repetition (p = 0.0001), emotional prosody comprehension (p = 0.004), emotional prosody repetition (p = 0.015), and emotional prosody production (p = 0.0001). These results highlight substantial deficits in both linguistic and emotional prosody among adults with ASD. Conclusion: This study emphasizes the need for targeted assessment and intervention strategies for prosodic impairments in adults with autism. The findings have practical implications for clinical, educational, and research settings. 79 86 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/10 1403/12/20 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/15 1404/1/26 Shahed Zandiehrad Shahed Zandiehrad Department of Linguistics, Science and Research Branch, Islamic Azad University, Tehran, Iran Iran Iran.szandiehrad@googlemail.com Shahla Raghibdoust Shahla Raghibdoust Department of General Linguistics, Allameh Tabataba'i University, Tehran, Iran Iran sraghibdoust@atu.ac.ir Mohammad Taghi Joghataei Mohammad Taghi Joghataei Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Iran joghataei.mt@iums.ac.ir Arsalan Golfam Arsalan Golfam Department of Linguistics, Tarbiat Modares University, Tehran, Iran Iran golfamarsalan@gmail.com Autism Spectrum Disorder P.M.E.C. Protocol Prosodic Skills Prosodic Impairments 1. Roehr B. American Psychiatric Association explains DSM-5. Bmj. 2013; 346.##2. Kanner L. Autistic disturbances of affective contact. Nervous child. 1943; 2(3): 217-50.##3. Asperger H. Die„Autistischen psychopathen” im kindesalter. Archiv für psychiatrie und nervenkrankheiten. 1944; 117(1): 76-136.##4. Liu J, Yao L, Zhang W, et al. Gray matter abnormalities in pediatric autism spectrum disorder: a meta-analysis with signed differential mapping. European child & adolescent psychiatry. 2017; 26: 933-45.##5. Tager‐Flusberg H, Paul R, Lord C. Language and communication in autism. Handbook of autism and pervasive developmental disorders. 2005; 1: 335-64.##6. Grosvenor LP, Croen LA, Lynch FL, et al. Autism diagnosis among US children and adults, 2011-2022. JAMA Network Open. 2024; 7(10): e2442218-.##7. Zufferey S. Lexical pragmatics and theory of mind. Lexical Pragmatics and Theory of Mind. 2010: 1-208.##8. Cohen H. Re Millard S. Encyclopedia of Language and Linguistics (ELL2), (2nded.). UK: Elsevier. 2003; 617-620. ##9. Eigsti IM. Peabody picture vocabulary test. In Encyclopedia of Autism Spectrum Disorders 2021 Mar 14 (pp. 3357-3360). Cham: Springer International Publishing.##10. Sepulveda EM, Resa PL, García NP. Language evaluation in developmental language disorder: celf 4 vs Celf 5. International Linguistics Research. 2021; 4(2): p46-.##11. Joanette Y, Ska B, Côté H, et al. Montreal Protocol for the Evaluation of Communication. Sydney: ASSBI Resources; 2015.##12. Joanette Y, Ska B, & Côté H. Protocole Montréal d’Évaluation de la Communication, Isbergues: Ortho Edition; 2004.##13. Raghibdoost S, Modarres-Tehrani Y, Torabi MH, et al. Montreal Protocol: Persian version of the Montreal Communication Skills Assessment Protocol (PMAC). Tehran: Siyahrood; 2023.##14. Karami M. Comparison of linguistic features in children with autism and typically developing children [Master's thesis]. Kerman: Shahid Bahonar University; 2011.##15. Ruhparvar R, Karami M. Comparison of semantic and pragmatic features of speech in children with autism and typically developing children. Allameh Tabataba'i University Proceedings. 2012; 280: 337-344.##16. Fallahi MH, Mahdizadeh M, Vahab M. Investigation and comparison of various aspects of language ability in children aged 5 to 8 years with autism and typically developing children [Internet]. 2015. Available at: URL: https://civilica.com/doc/970804##17. Torabi MH. Assessment of language skills in Persian-speaking patients with right hemisphere brain damage based on the Montreal Communication Skills Assessment Protocol (MAC) [Doctoral dissertation]. Tehran: Institute for Humanities and Cultural Studies; 2019.##18. Arianpour M. Assessment and comparison of communication skills in Persian-speaking adult patients with right and left hemisphere brain damage based on the Montreal Communication Skills Assessment Protocol (MAC) [Doctoral dissertation]. Tehran: Allameh Tabataba’i University; 2021.##19. Asghari SZ, Farashi S, Bashirian S, et al. Distinctive prosodic features of people with autism spectrum disorder: a systematic review and meta-analysis study. Scientific reports. 2021; 11(1): 23093.##20. Zandiehrad S, Raghibdoust S, Joghataei MT, et al. Study of Pragmatic Skills of Persian-speaking Adults with Autism Spectrum Disorder Based on the Persian Version of Montreal Protocol for the Evaluation of Communication (P.M.E.C.). Med J Islam Repub Iran. 2024; 38: 45.##21. Zandiehrad S, Raghibdoust S, Joghataei M T, et al. Study of lexical-semantic skills of Persian-speaking adults with autism spectrum disorder based on the Persian version of Montreal Protocol for the evaluation of communication. Advances in Cognitive Sciences 2024; 26(3): 102-116##22. Hermelin B, O'CONNOR N. Remembering of words by psychotic and subnormal children. British journal of psychology. 1967; 58(3‐4): 213-8.##23. Ramondo N, Milech D. The nature and specificity of the language coding deficit in autistic children. British Journal of Psychology. 1984; 75(1): 95-103.##24. Paul R, Fischer ML, Cohen DJ. Brief report: Sentence comprehension strategies in children with autism and specific language disorders. Journal of autism and developmental disorders. 1988; 18: 669-79.##25. Howlin P. Outcome in high-functioning adults with autism with and without early language delays: implications for the differentiation between autism and Asperger syndrome. J Autism Dev Disord. 2003; 33(1): 3-13.##26. Preissler MA, Carey S. The role of inferences about referential intent in word learning: Evidence from autism. Cognition. 2005; 97(1): B13-23.##27. Tek S, Jaffery G, Fein D, et al. Do children with autism spectrum disorders show a shape bias in word learning? Autism Research. 2008; 1(4): 208-22.##28. Ahtam B, Braeutigam S, & Bailey A. Semantic processing in autism spectrum disorders is associated with the timing of language acquisition: a magnetoencephalographic study. Frontiers in Human Neuroscience. 2020; 14: 267.##29. Ahmadi S, Brütting M, & Bailey R. (2022). Prosodic Features in Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Journal of Autism and Developmental Disorders. 2022; 52(6): 2345–2361.##30. Knutsen S. The Effects of Gender and Autism Spectrum Disorder on Prosody. University of Pennsylvania Working Papers in Linguistics. 2024: 87-96.##31. Holbrook S, Israelsen M. Speech prosody interventions for persons with autism spectrum disorders: A systematic review. American Journal of Speech-Language Pathology. 2020; 29(4): 2189-205.##32. Lyakso E, Frolova O, Grigorev A. A comparison of acoustic features of speech of typically developing children and children with autism spectrum disorders. InSpeech and Computer: 18th International Conference, SPECOM 2016, Budapest, Hungary, August 23-27, 2016, Proceedings 18 2016 (pp. 43-50). Springer International Publishing.##33. Krueger J, Maiese M. Mental institutions, habits of mind, and an extended approach to autism. Thaumàzein| Rivista di Filosofia. 2018; 6: 10-41.##34. Wolk L, Brennan C. Phonological investigation of speech sound errors in children with autism spectrum disorders. Speech, Language and Hearing. 2013; 16(4): 239-46.##35. DePape AM, Chen A, Hall GB, et al. Use of prosody and information structure in high functioning adults with autism in relation to language ability. Frontiers in psychology. 2012; 3: 72.##36. Grice M, Wehrle S, Krüger M, et al. Linguistic prosody in autism spectrum disorder—An overview. Language and Linguistics Compass. 2023; 17(5): e12498.##37. Bellinghausen C, Schröder B, Rauh R, et al. Processing of prosodic cues of uncertainty in autistic and non-autistic adults: a study based on articulatory speech synthesis. Frontiers in Psychiatry. 2024; 15: 1347913.##38. Putnam OC, Erickson KA. The Role of Prosody in Reading Comprehension for Individuals on the Autism Spectrum. Perspectives of the ASHA Special Interest Groups. 2024; 9(2): 297-307.## ##

Association between Serum Liver Enzymes and Hypertension: Findings from Shahedieh Yazd Cohort Study, Iran 2 2 Background: Hypertension, known as a silent killer, leads to various complications and may influence serum liver enzymes, potentially resulting in liver diseases. This study aims to investigate the relationship between hypertension and serum liver enzymes in Yazd, Iran. Methods: This cross-sectional study analyzed data from the first phase of Shahedieh Yazd Cohort Study (2015–2016), including 9,550 individuals aged 35–70. Statistical analyses were performed using Chi-square tests and multivariable logistic regression in STATA 17, with a significance level of P < 0.05. Result: Among 9,550 participants (mean age 49.68 ± 9.54, 50.02% male), hypertension prevalence was 7.53%. Hypertensive individuals showed significant differences in age, sex, education, smoking, diabetes, cardiac diseases, and cholesterol levels compared to normotensive individuals. However, no significant associations were found with fatty liver history, alcohol consumption, low-density lipoprotein (LDL), high-density lipoprotein (HDL), serum glutamic-oxaloacetic transaminase (SGOT, also known as aspartate aminotransferase [AST]), or serum glutamic-pyruvic transaminase (SGPT, also known as alanine aminotransferase [ALT]) levels. Liver enzymes, including AST, ALT, gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP), were significantly associated with hypertension, particularly in younger age groups. GGT was related to hypertension in individuals aged 30–39 and ≥50, while ALP showed an association only in those aged ≥ 60 (P < 0.05). Conclusion: A significant association between liver enzymes (ALT, AST, GGT) and hypertension was observed, especially in younger individuals. These findings suggest liver enzymes as potential hypertension indicators, emphasizing the need for early screening. Public health policies should incorporate liver function tests alongside hypertension management, particularly for younger populations.   87 96 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/5 1403/9/15 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/3 1403/12/13 Kousar Zardosht Kousar Zardosht Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran k.zardosht@gmail.com Zahra Mandegari Zahra Mandegari Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mandegar.zahra@yahoo.com Sara Jambarsang Sara Jambarsang Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran s.jambarsang@gmail.com Moslem Taheri Soodejani Moslem Taheri Soodejani Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran moslem.taheri2009@yahoo.com Seyyed Mohammad Tabatabaei Seyyed Mohammad Tabatabaei Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Iran moh.taba@gmail.com Hossein Akhondi Hossein Akhondi Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran 7041hosseinakhondi@gmail.com Hypertension Blood pressure Risk factors Liver enzymes Age factors Cross-sectional studies 1. Fard MT, Najafi F, Rezaeian S, et al. Association between serum liver enzymes and hypertension using propensity score matching analysis: evidence from a large kurdish prospective cohort study. BMC cardiovascular disorders. 2022; 22(1): 476. [Persian]##2. Oliveros E, Patel H, Kyung S, et al. Hypertension in older adults: Assessment, management, and challenges. Clinical cardiology. 2020; 43(2): 99-107.##3. Princewel F, Cumber SN, Kimbi JA, et al. Prevalence and risk factors associated with hypertension among adults in a rural setting: the case of Ombe, Cameroon. Pan Afr Med J. 2019; 34: 147.##4. Rahman S, Islam S, Haque T, et al. Association between serum liver enzymes and hypertension: A cross-sectional study in Bangladeshi adults. BMC Cardiovascular Disorders. 2020; 20(1).##5. Ali N, Mohanto NC, Nurunnabi SM, et al. Prevalence and risk factors of general and abdominal obesity and hypertension in rural and urban residents in Bangladesh: a cross-sectional study. BMC Public Health. 2022; 22(1): 1707.##6. Khalili P, Abdollahpoor S, Ayoobi F, et al. Evaluation of Relationship between Serum Liver Enzymes and Hypertension: A Cross-Sectional Study Based on Data from Rafsanjan Cohort Study. International Journal of Hypertension. 2022; 2022. [Persian]##7. López-Suárez A, Guerrero JMR, Elvira-González J, et al. Nonalcoholic fatty liver disease is associated with blood pressure in hypertensive and nonhypertensive individuals from the general population with normal levels of alanine aminotransferase. European journal of gastroenterology & hepatology. 2011; 23(11): 1011-7.##8. Bonnet F, Gastaldelli A, Natali A, et al. Gamma-glutamyltransferase, fatty liver index and hepatic insulin resistance are associated with incident hypertension in two longitudinal studies. Journal of hypertension. 2017; 35(3): 493-500.##9. Xie J-h, Liu Q, Yang Y, et al. Correlation of liver enzymes with diabetes and pre-diabetes in middle-aged rural population in China. Journal of Huazhong University of Science and Technology [Medical Sciences]. 2016; 36: 53-8.##10. Katzke V, Johnson T, Sookthai D, et al. Circulating liver enzymes and risks of chronic diseases and mortality in the prospective EPIC-Heidelberg case-cohort study. BMJ open. 2020; 10(3): e033532.##11. Corti A, Belcastro E, Dominici S, et al. The dark side of gamma-glutamyltransferase (GGT): Pathogenic effects of an ‘antioxidant’enzyme. Free Radical Biology and Medicine. 2020; 160: 807-19.##12. Raya-Cano E, Molina-Luque R, Vaquero-Abellán M, et al. Metabolic syndrome and transaminases: systematic review and meta-analysis. Diabetology & Metabolic Syndrome. 2023; 15(1): 220.##13. Lleo A. A change of paradigm in PBC: Pursuing normal alkaline phosphatase. Ebiomedicine. 2022; 82.##14. Huang C-W, Wu T-H, Hsu H-Y, et al. Reappraisal of the role of alkaline phosphatase in hepatocellular carcinoma. Journal of Personalized Medicine. 2022; 12(4): 518.##15. Moghaddasifar I, Lankarani K, Moosazadeh M, et al. Prevalence of non-alcoholic fatty liver disease and its related factors in Iran. International journal of organ transplantation medicine. 2016; 7(3): 149. [Persian]##16. Chegeni M, Nili S, Darabi M, et al. Prevalence of non-alcoholic fatty liver and its related factors in Iran: Systematic review and meta-analysis. Journal of Education and Health Promotion. 2023; 12(1): 356.##17. Khalili P, Abdollahpoor S, Ayoobi F, et al. Evaluation of Relationship between Serum Liver Enzymes and Hypertension: A Cross‐Sectional Study Based on Data from Rafsanjan Cohort Study. International Journal of Hypertension. 2022; 2022(1): 5062622. [Persian]##18. Kohsari M, Moradinazar M, Rahimi Z, et al. Liver enzymes and their association with some Cardiometabolic diseases: evidence from a large Kurdish cohort. BioMed Research International. 2021; 2021(1): 5584452. [Persian]##19. Mirzaei M, Mirzaei M, Mirzaei M, et al. Changes in the prevalence of measures associated with hypertension among Iranian adults according to classification by ACC/AHA guideline 2017. BMC Cardiovascular Disorders. 2020; 20(1): 372. [Persian]##20. Mahdavi M, Parsaeian M, Farzadfar F, et al. Inequality in prevalence, awareness, treatment, and control of hypertension in Iran: the analysis of national households’ data. BMC Public Health. 2022; 22(1): 2349. [Persian]##21. Yano Y, Reis JP, Colangelo LA, et al. Association of blood pressure classification in young adults using the 2017 American College of Cardiology/American Heart Association blood pressure guideline with cardiovascular events later in life. Jama. 2018; 320(17): 1774-82.##22. Lala V, Zubair M, Minter D. Liver Function Tests [Updated 2023 July 30]. StatPearls. 2024.##23. Marzban A, Nadjarzadeh A, Abbasi-Shavazi M, et al. Prevalence of Overweight, Obesity, and Its Related Factors in Adult Population of Yazd. Journal of Nutrition and Food Security. 2020; 5(3): 192-200. [Persian]##24. Samiee RF, Ziaee A, Qambarian A, et al. Association between risk factors of cardiovascular diseases and obesity among Tehranian women: Tehran Lipid and Glucose Study (TLGS); 2012.##25. Onat A, Can G, Örnek E, et al. Serum γ‐glutamyltransferase: independent predictor of risk of diabetes, hypertension, metabolic syndrome, and coronary disease. Obesity. 2012; 20(4): 842-8.##26. Gaeini Z, Bahadoran Z, Mirmiran P, et al. The Association Between Liver Function Tests and Some Metabolic Outcomes: Tehran Lipid and Glucose Study. 2020; 20(5): e98535.##27. Jia J, Yang Y, Liu F, et al. The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults. BMC Cardiovascular Disorders. 2021; 21(1): 1-12.##28. Chang Y, Ryu S, Sung E, et al. Higher concentrations of alanine aminotransferase within the reference interval predict nonalcoholic fatty liver disease. Clinical chemistry. 2007; 53(4): 686-92.##29. Zhu L, Fang Z, Jin Y, et al. Association between serum alanine and aspartate aminotransferase and blood pressure: a cross-sectional study of Chinese freshmen. BMC Cardiovascular Disorders. 2021; 21(1): 472.##30. Sakboonyarat B, Poovieng J, Lertsakulbunlue S, et al. Association between raised blood pressure and elevated serum liver enzymes among active-duty Royal Thai Army personnel in Thailand. BMC Cardiovascular Disorders. 2023; 23(1): 1-11.##1. Fard MT, Najafi F, Rezaeian S, et al. Association between serum liver enzymes and hypertension using propensity score matching analysis: evidence from a large kurdish prospective cohort study. BMC cardiovascular disorders. 2022; 22(1): 476. [Persian]##2. Oliveros E, Patel H, Kyung S, et al. Hypertension in older adults: Assessment, management, and challenges. Clinical cardiology. 2020; 43(2): 99-107.##3. Princewel F, Cumber SN, Kimbi JA, et al. Prevalence and risk factors associated with hypertension among adults in a rural setting: the case of Ombe, Cameroon. Pan Afr Med J. 2019; 34: 147.##4. Rahman S, Islam S, Haque T, et al. Association between serum liver enzymes and hypertension: A cross-sectional study in Bangladeshi adults. BMC Cardiovascular Disorders. 2020; 20(1).##5. Ali N, Mohanto NC, Nurunnabi SM, et al. Prevalence and risk factors of general and abdominal obesity and hypertension in rural and urban residents in Bangladesh: a cross-sectional study. BMC Public Health. 2022; 22(1): 1707.##6. Khalili P, Abdollahpoor S, Ayoobi F, et al. Evaluation of Relationship between Serum Liver Enzymes and Hypertension: A Cross-Sectional Study Based on Data from Rafsanjan Cohort Study. International Journal of Hypertension. 2022; 2022. [Persian]##7. López-Suárez A, Guerrero JMR, Elvira-González J, et al. Nonalcoholic fatty liver disease is associated with blood pressure in hypertensive and nonhypertensive individuals from the general population with normal levels of alanine aminotransferase. European journal of gastroenterology & hepatology. 2011; 23(11): 1011-7.##8. Bonnet F, Gastaldelli A, Natali A, et al. Gamma-glutamyltransferase, fatty liver index and hepatic insulin resistance are associated with incident hypertension in two longitudinal studies. Journal of hypertension. 2017; 35(3): 493-500.##9. Xie J-h, Liu Q, Yang Y, et al. Correlation of liver enzymes with diabetes and pre-diabetes in middle-aged rural population in China. Journal of Huazhong University of Science and Technology [Medical Sciences]. 2016; 36: 53-8.##10. Katzke V, Johnson T, Sookthai D, et al. Circulating liver enzymes and risks of chronic diseases and mortality in the prospective EPIC-Heidelberg case-cohort study. BMJ open. 2020; 10(3): e033532.##11. Corti A, Belcastro E, Dominici S, et al. The dark side of gamma-glutamyltransferase (GGT): Pathogenic effects of an ‘antioxidant’enzyme. Free Radical Biology and Medicine. 2020; 160: 807-19.##12. Raya-Cano E, Molina-Luque R, Vaquero-Abellán M, et al. Metabolic syndrome and transaminases: systematic review and meta-analysis. Diabetology & Metabolic Syndrome. 2023; 15(1): 220.##13. Lleo A. A change of paradigm in PBC: Pursuing normal alkaline phosphatase. Ebiomedicine. 2022; 82.##14. Huang C-W, Wu T-H, Hsu H-Y, et al. Reappraisal of the role of alkaline phosphatase in hepatocellular carcinoma. Journal of Personalized Medicine. 2022; 12(4): 518.##15. Moghaddasifar I, Lankarani K, Moosazadeh M, et al. Prevalence of non-alcoholic fatty liver disease and its related factors in Iran. International journal of organ transplantation medicine. 2016; 7(3): 149. [Persian]##16. Chegeni M, Nili S, Darabi M, et al. Prevalence of non-alcoholic fatty liver and its related factors in Iran: Systematic review and meta-analysis. Journal of Education and Health Promotion. 2023; 12(1): 356.##17. Khalili P, Abdollahpoor S, Ayoobi F, et al. Evaluation of Relationship between Serum Liver Enzymes and Hypertension: A Cross‐Sectional Study Based on Data from Rafsanjan Cohort Study. International Journal of Hypertension. 2022; 2022(1): 5062622. [Persian]##18. Kohsari M, Moradinazar M, Rahimi Z, et al. Liver enzymes and their association with some Cardiometabolic diseases: evidence from a large Kurdish cohort. BioMed Research International. 2021; 2021(1): 5584452. [Persian]##19. Mirzaei M, Mirzaei M, Mirzaei M, et al. Changes in the prevalence of measures associated with hypertension among Iranian adults according to classification by ACC/AHA guideline 2017. BMC Cardiovascular Disorders. 2020; 20(1): 372. [Persian]##20. Mahdavi M, Parsaeian M, Farzadfar F, et al. Inequality in prevalence, awareness, treatment, and control of hypertension in Iran: the analysis of national households’ data. BMC Public Health. 2022; 22(1): 2349. [Persian]##21. Yano Y, Reis JP, Colangelo LA, et al. Association of blood pressure classification in young adults using the 2017 American College of Cardiology/American Heart Association blood pressure guideline with cardiovascular events later in life. Jama. 2018; 320(17): 1774-82.##22. Lala V, Zubair M, Minter D. Liver Function Tests [Updated 2023 July 30]. StatPearls. 2024.##23. Marzban A, Nadjarzadeh A, Abbasi-Shavazi M, et al. Prevalence of Overweight, Obesity, and Its Related Factors in Adult Population of Yazd. Journal of Nutrition and Food Security. 2020; 5(3): 192-200. [Persian]##24. Samiee RF, Ziaee A, Qambarian A, et al. Association between risk factors of cardiovascular diseases and obesity among Tehranian women: Tehran Lipid and Glucose Study (TLGS); 2012.##25. Onat A, Can G, Örnek E, et al. Serum γ‐glutamyltransferase: independent predictor of risk of diabetes, hypertension, metabolic syndrome, and coronary disease. Obesity. 2012; 20(4): 842-8.##26. Gaeini Z, Bahadoran Z, Mirmiran P, et al. The Association Between Liver Function Tests and Some Metabolic Outcomes: Tehran Lipid and Glucose Study. 2020; 20(5): e98535.##27. Jia J, Yang Y, Liu F, et al. The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults. BMC Cardiovascular Disorders. 2021; 21(1): 1-12.##28. Chang Y, Ryu S, Sung E, et al. Higher concentrations of alanine aminotransferase within the reference interval predict nonalcoholic fatty liver disease. Clinical chemistry. 2007; 53(4): 686-92.##29. Zhu L, Fang Z, Jin Y, et al. Association between serum alanine and aspartate aminotransferase and blood pressure: a cross-sectional study of Chinese freshmen. BMC Cardiovascular Disorders. 2021; 21(1): 472.##30. Sakboonyarat B, Poovieng J, Lertsakulbunlue S, et al. Association between raised blood pressure and elevated serum liver enzymes among active-duty Royal Thai Army personnel in Thailand. BMC Cardiovascular Disorders. 2023; 23(1): 1-11.## ##

Tutorial on Methods to Adjust for Confounding Variable in Medical Research 2 2 Background: Confounders can distort the actual connection between exposure and outcome, resulting in skewed results. In research, it is essential to account for confounding variables to preserve the validity of causal inferences.  Methods: In this narrative review study, all statistical methods for adjusting confounding variable such as standardization, propensity score, stratification, restriction, statistical model for control, matching, randomization were reviewed.  Results: The five most important methods were reviewed. Conclusion: Adequate adjustment improves the internal validity of findings and elucidates the relationships among variables, underscoring the importance of a comprehensive analysis of confounding for trustworthy research results. 97 103 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/12 1403/8/22 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/30 1404/2/10 Muhammad Ajmal Dina Muhammad Ajmal Dina Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran ajmaljhl@gmail.com Farzan Madidadizadeh Farzan Madidadizadeh Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran statlearningeasy@gmail.com Anam Arshed Anam Arshed Rahbar Medical and Dental College, Lahore Pakistan Pakistan anamarshed574@gmail.com Confounding variable Adjustment Statistical methods Matching stratification 1. 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Diarrhoeal disease and subsequent risk of death in infants and children residing in low-income and middle-income countries: analysis of the GEMS case-control study and 12-month GEMS-1A follow-on study. The Lancet Global Health. 2020;8(2):e204-e14.##40. Scriven M. A summative evaluation of RCT methodology: & an alternative approach to causal research. Journal of multidisciplinary evaluation. 2008;5(9):11-24.##41. Seeger JD, Davis KJ, Iannacone MR, Zhou W, Dreyer N, Winterstein AG, et al. Methods for external control groups for single arm trials or long‐term uncontrolled extensions to randomized clinical trials. Pharmacoepidemiology and Drug Safety. 2020;29(11):1382-92.##42. Gill DP, Blunt W, Boa Sorte Silva N, Stiller-Moldovan C, Zou G, Petrella R. The Health e Steps™ lifestyle prescription program to improve physical activity and modifiable risk factors for chronic disease: A pragmatic randomized controlled trial. BMC Public Health. 2019;19:1-15.##43. Sanderson E, Glymour MM, Holmes MV, Kang H, Morrison J, Munafò MR, et al. Mendelian randomization. Nature reviews Methods primers. 2022;2(1):6.##44. Lakens D. Sample size justification. Collabra: psychology. 2022;8(1):33267.##45. Berger VW, Bour LJ, Carter K, Chipman JJ, Everett CC, Heussen N, et al. A roadmap to using randomization in clinical trials. BMC Medical Research Methodology. 2021;21:1-24.## ##

Dimensionality and Reliability of the Adult Responses to Children's Symptoms Questionnaire in Iranian Children with Chronic Diseases 2 2 Background: The purpose of this research is to determine the dimensionality and reliability assessment of the questionnaire of Adult Responses to Symptoms (ARCS) of Iranian children suffering from chronic diseases. When adults respond appropriately to the physical symptoms of sick children, they can manage chronic diseases more effectively and prevent the worsening of symptoms associated with psychological factors. Methods: In this psychometric and validation study, 290 parents of children aged 4 to 16 with chronic diseases were selected through consecutive sampling. They were recruited from a children's educational and therapeutic center in Rasht city (north of Iran) and participated by answering the ARCS questionnaire between December 2021 and June 2022. Confirmatory factor analysis (CFA) was used to determine the construct validity. Pearson correlation coefficient and intraclass correlation coefficient (ICC) were employed to assess the test-retest reliability over a 4-week interval. Results: In the CFA, the factor loadings of all the items were above 0.3, and the fit indices of the modified Iranian model (PCFI = 0.69, PNFI = 0.62, CMIN/DF = 2.80, RMSEA = 0.07, IFI = 0.90, CFI = 0.90 and GFI = 0.92) were obtained, which shows the confirmation of the three-factor model of the ARCS questionnaire (i.e. protective, encouraging and minimizing dimensions). The test-retest reliability of the ARCS questionnaire scores for the dimensions of protective, encouraging/monitoring and minimizing responses were equal to 0.85, 0.94 and 0.87 (p = 0.001). Furthermore, ICC for the dimensions of protective, encouraging/monitoring and minimizing responses was obtained as 0.90, 0.97, and 0.93, respectively. The Cronbach's alpha coefficients were also calculated for the three above-mentioned subscales as 0.83, 0.70, and 0.60, respectively. Conclusions: The ARCS questionnaire has desirable reliability coefficients and construct validity. It can be used for clinical monitoring, educating families of children with chronic illnesses, and evaluating improvements in treatment outcomes.   104 113 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/31 1403/10/11 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/26 1404/2/6 Yasaman Larijani Yasaman Larijani Department of Psychology, University of Guilan, Rasht, Iran Iran ylarijani@gmail.com Sajjad Rezaei Sajjad Rezaei Department of Psychology, University of Guilan, Rasht, Iran Iran Rezaei_psy@hotmail.com Azra Zebardast Azra Zebardast Department of Psychology, University of Guilan, Rasht, Iran Iran zebardast@guilan.ac.ir Shoreh Maleknejad Shoreh Maleknejad Department of Pediatric Gastroenterology, Guilan University of Medical Sciences, Rasht, Iran Iran maleknejadshohreh@yahoo.com Bahram Darbandi Bahram Darbandi Department of Pediatric Hematology and Oncology, Guilan University of Medical Sciences, Rasht, Iran Iran darbandi45@gmail.com Dimensionality Reliability Validity Chronic diseases Parents Children 1. Bernell S, Howard SW. Use your words carefully: what is a chronic disease? Frontiers in public health. 2016; 4: 159. ##2. Consolini DM. Children with chronic health conditions [Internet]. Pennsylvania: MSD Manual: 2020 [updated Sep 2022: cited Sep 2022]. Available at: URL:https://www.msdmanuals.com/professional/pediatrics/caring-for-sick-children-and-their-families/children-with-chronic-health-conditions##3. Valero-Moreno S, Lacomba-Trejo L, Casaña-Granell S, et al. Psychometric properties of the questionnaire on threat perception of chronic illnesses in pediatric patients. Rev Lat Am Enfermagem. 2020; 28: e3242##4. Craig KD, MacKenzie NE. What is pain: Are cognitive and social features core components? Paediatr Neonatal Pain. 2021; 3(3): 106-118.##5. Harrison LE, Timmers I, Heathcote LC, et al. Parent Responses to Their Child's Pain: Systematic Review and Meta-Analysis of Measures. J Pediatr Psychol. 2020; 45(3): 281-298. ##6. Donnelly TJ, Palermo TM, Newton-John TR. Parent cognitive, behavioural, and affective factors and their relation to child pain and functioning in pediatric chronic pain: a systematic review and meta-analysis. Pain. 2020; 161(7): 1401-19. ##7. Smith J, Cheater F, Bekker H. Parents' experiences of living with a child with a long‐term condition: a rapid structured review of the literature. Health Expect. 2015; 18(4): 452-74.##8. Fussner LM, Schild C, Lewandowski Holley A, et al. Parent chronic pain and mental health symptoms impact responses to children’s pain. Can J Pain. 2018; 2(1): 258-65. ##9. Dougherty BL, Zelikovsky N, Miller KS, et al. Longitudinal impact of parental catastrophizing on child functional disability in pediatric amplified pain. Journal of pediatric psychology. 2021; 46(4): 474-84. ##10. Shneider CE, Cohen LL, Shih SW, et al. The influence of child pain catastrophizing and parent behavior on health-related quality of life in pediatric sickle cell disease. Pediatr Blood Cancer. 2023; 70(8): e30372. ##11. Aggarwal Dutta R, Salamon KS. Risk and Resilience Factors Impacting Treatment Compliance and Functional Impairment among Adolescents Participating in an Outpatient Interdisciplinary Pediatric Chronic Pain Management Program. Children. 2020; 7(11): 247. ##12. Fussner LM, Schild C, Lewandowski Holley A, et al. Parent chronic pain and mental health symptoms impact responses to children’s pain. Can J Pain. 2018; 2(1): 258-65. ##13. Walker LS, Claar RL, Garber J. Social consequences of children's pain: when do they encourage symptom maintenance? J Pediatr Psychol. 2002; 27(8): 689-98. ##14. Van Slyke DA, & Walker LS. Mothers' responses to children's pain. The Clinical Journal of Pain. 2006; 22(4): 387-391. ##15. Walde P, Völlm BA. The TRAPD approach as a method for questionnaire translation. Front Psychiatry. 2023; 14: 1199989.##16. Tanaka JS. " How big is big enough?": Sample size and goodness of fit in structural equation models with latent variables. Child Dev. 1987: 134-46. ##17. Kline R. Data preparation and psychometrics review. Principles and practice of structural equation; 2013 ##18. Weston R, Gore Jr PA. A brief guide to structural equation modeling. Couns. Psychol. 2006; 34(5): 719-51. ##19. Meyers LS, Gamst G, Guarino AJ. Applied multivariate research: Design and interpretation. Sage; 2016##20. Munro BH. Statistical methods for health care research. lippincott williams & wilkins; 2005.##21. Van Griethuijsen RA, van Eijck MW, Haste H, et al. Global patterns in students’ views of science and interest in science. Research in science education. 2015; 45: 581-603.##22. Walker LS, Levy RL, Whitehead WE. Validation of a measure of protective parent responses to children's pain. Clin. J. Pain. 2006; 22(8): 712-6.##23. Claar RL, Guite JW, Kaczynski KJ, et al. Factor structure of the Adult Responses to Children's Symptoms: validation in children and adolescents with diverse chronic pain conditions. Clin J Pain. 2010; 26(5): 410-7.##24. Nikfarid L, Eezadi H, Shakoori M. Coping Behaviors of Mothers of Chronically Ill Children. Iran J Nurs 2012; 24(74): 53-62. [persian]## ##

Examining the Relationship between Health Literacy with Public Health in Employees of Highway and Road Transportation Department of Razavi Khorasan Province in 2023 2 2 Background: Promoting the health of society members, especially the workforce, is a top priority for any society. Hence, this study was conducted with the aim of determining the relationship between health literacy with public health in employees of Highway and Road Transportation Department of Razavi Khorasan province in 2023. Methods: This cross-sectional study was conducted on 121 employees of Highway and Road Transportation Department of Razavi Khorasan province in Iran in 2023. Data collection tools included demographic information questionnaire of employees, health literacy questionnaire, and public health questionnaire. The data were analyzed using SPSS26.00 with a significance level of 0.05. Result: The mean (SD) health literacy of participants was 111.2 (22.01). The study found that 55.4% of people had medium health literacy, and there was a statistically significant relationship between health literacy and public health (p < 0.05). Additionally, there was a statistically significant relationship between education level and health literacy (p < 0.05). Conclusion: The results of the study showed that health literacy is related to public health, so, to improve the public health of employees, their health literacy should be improved, and it is necessary to design interventions to improve the health literacy of employees. 114 122 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/27 1403/10/7 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/28 1404/2/8 Nooshin Afsharian Nooshin Afsharian Department of Advanced Information Systems, Islamic Azad University, Department of Science and Research, Tehran, Iran Iran afshariyan_n@yahoo.com Hadi Tehrani Hadi Tehrani 1.Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran 2. Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Iran tehranih@mums.ac.ir Nooshin Peyman Nooshin Peyman 1.Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran 2. Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Iran peymann@mums.ac.ir Mahdi Gholian aval Mahdi Gholian aval 1.Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran 2. Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Iran gholianm@mums.ac.ir Elham Charoghchian Khorasani Elham Charoghchian Khorasani 1.Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran 2. Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Iran echaroghchian@yahoo.com Employees Public Health Health Literacy 1. World Health Organization. Health promotion glossary of terms 2021. InHealth promotion glossary of terms 2021. WHO; 2021.##2. Rakhshanderou S, Safari-Moradabadi A, Bahrambeygi F, et al. Designing health literacy measurement tools: a critical review of common paths and probable mistakes. Journal of Health Literacy. 2023; 8(3): 90-102.##3. Nutbeam D, Lloyd JE. Understanding and responding to health literacy as a social determinant of health. Annual review of public health. 2021; 42(2021): 159-73.##4. Khorasani EC, Peyman N, Esmaily H. Effect of education based on the theory of self-efficacy and health literacy strategies on exclusive breastfeeding: A randomized clinical trial. Koomesh. 2019; 21(4): 633-8.##5. Wu S, Wang R, Zhao Y, et al. The relationship between self-rated health and objective health status: a population-based study. BMC public health. 2013; 13: 1-9.##6. Charoghchian Khorasani E, Jafari A, Mahdiadeh M, et al. Designing a model of health literacy organization in health care centers in Iran. Journal of Health Literacy. 2023; 7(4): 44-59.##7. Charoghchian Khorasani E, Tavakoly Sany SB, Mahdizadeh M, et al. Attributes of organizational health literacy in health care centers in Iran: a qualitative content analysis study. International Journal of Environmental Research and Public Health. 2022; 19(4): 2310.##8. Li Y, Lv X, Liang J, et al. The development and progress of health literacy in China. Frontiers in public health. 2022; 10: 1034907.##9. Callahan D. The WHO definition of'health'. Hastings Center Studies. 1973: 77-87.##10. Zonderman AB, Ejiogu N, Norbeck J, et al. The influence of health disparities on targeting cancer prevention efforts. American journal of preventive medicine. 2014; 46(3): S87-97.##11. Tehrani H, Mahdizadeh M, Peyman N, et al. Exploration factors on smoking among female adolescents based on the viewpoints of Iranian adolescent girls. BMC Women's Health. 2022; 22(1): 1-8.##12. Peyman N, Samiee-roudi K. Investigating the status of health literacy among health providers of rural area. Journal of Health literacy. 2016; 1(1): 46-52.##13. Afshari M, Khazaei S, Bahrami M, et al. Investigating adult health literacy in Tuyserkan city. Journal of Education And Community Health. 2014; 1(2): 48-55.##14. Tavousi M, Ebadi M, Fattahi E, et al. Health literacy measures: A systematic review of the literature. Payesh (Health Monitor). 2015; 14(4): 485-96.##15. Moodi M, Doosti H, Moodi M, et al. Health literacy in the population covered by family physicians in Askarieh rural health center-2016. J Health Sci Technol. 2017; 2: 80-5.##16. Goldberg DP, Gater R, Sartorius N, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological medicine. 1997; 27(1): 191-7.##17. Taghavi MR. Reliability and validity of mental health questionnaire (G.H.Q). General Psychology Journal. 2000; 5: 398-381.##18. Arbabi H, Mansouri A, Nooshirvani S, et al. The relationship between health literacy and general health in patients with type II diabetes referring to diabetes clinic of Zabol in 2016. Journal of Diabetes Nursing. 2017; 5(1): 29-39.##19. Reisi M, Mostafavi F, Hasanzade A, et al. The relationship between health literacy, health status and healthy behaviors among elderly in Isfahan, Iran. Journal of health system research. 2011; 7(4): 0-.##20. Bakhshalipour V, Khodaparast S, Kalashi M. The effect of Socio-Economic Variables on the Relationship between Health Literacy and General Health and the Quality of Life in Inactive Staff of Baqerul Uloom Marine Science Training Center. Journal of Marine Medicine. 2023; 5(1): 22-30.##21. Ghanbari A, Rahmatpour P, Khalili M, et al. The Association between Health Literacy and Health Status among the Staff of Guilan University of Medical Sciences, IranThe Association between Health Literacy and Health Status among the Staff of Guilan University of Medical Sciences, Iran. Journal of Health System Research. 2016; 12(3): 381-7.##22. Khorasani EC, Sany SB, Orooji A, et al. Health literacy in Iranian women: a systematic review and meta-analysis. Iranian journal of public health. 2020; 49(5): 860.##23. Stormacq C, Van den Broucke S, Wosinski J. Does health literacy mediate the relationship between socioeconomic status and health disparities? Integrative review. Health promotion international. 2019; 34(5): e1-7.##24. Kavivani A. Health literacy level and its related factors among college students of Hamadan university of medical sciences, Hamadan, Iran. Health. 2017; 4(2): 11-7.##25. Khoshravesh S, Moeini B, Rezapur-Shahkolai F, et al. Health literacy of employees of hamadan university of medical sciences and related demographic factors. Journal of Education and Community Health. 2018; 5(1): 19-26.##26. Mahdifar M, Tavakoly Sany SB, Ghavami V, et al. Health literacy and body image concern among Healthcare Employees in Binaloud, Iran. Journal of Health Literacy. 2021; 6(1): 31-40.##27. Raeisi Yekta N, Bozorgi Z, Charoghchian Khorasani E, et al. The Level of Anxiety in Those Participating in Premarital Counseling Classes and Its Relationship With Health Literacy. Journal of Research and Health. 2021; 11(4): 267-74.##28. Tosun Guleroglu Fu. The effect of women's health literacy status on their attitudes and behaviors towards the Pap Smear Test: a series in Turkey. Journal of Health Literacy. 2023; 8(2): 63-73.##29. Changizi M, Mohamadian H, Cheraghian B, et al. Health literacy predicts readiness to behavior change in the Iranian adult population. Journal of Health Literacy. 2023; 7(4): 84-92.##30. Charoghchian Khorasani E, Tavakoly Sany SB, Abdollahi M, et al. Maternal health literacy and its association with spiritual health in women. Journal of Health Literacy. 2022; 7(1): 67-74.## ##

Assessment of the State of Knowledge of Chemical Safety and GHS Labelling System in Zahedan Industries (Iran) 2 2 Background: The present study aims to evaluate the level of awareness of workers with the Globally Harmonized System (GHS) among workers exposed to chemicals. Methods: The current study was cross-sectional which was conducted on 80 industrial workers in Zahedan (Iran). Therefore, the Multiple-Choice Question (MCQ) questionnaire according to the GHS international system was used to evaluate general knowledge and the labelling status of chemical substances by designing integrated visual and theoretical questions. Descriptive statistics, and correlation coefficients were also used in data analysis. Results: The highest awareness of workers was related to explosive (100%) and flammable (96.3%) pictograms. About 72.5% of the participants claimed to have encountered unlabeled chemical packages in their work experience. 86.3% of the workers considered the label on the package "useful to prevent accidents"; about 32% reported that they had never seen "health hazard" pictogram; and about 98.8%, received the necessary training about the dangers of chemicals. Also, the results showed that there was no significant correlation between the age and work history of the participants and their level of awareness (P>0.05), but a statistically significant correlation was observed between education and gender and the level of awareness (P<0.05). Conclusions: Analysis of the current state of chemical safety labeling showed that pictograms such as GHS "health hazard" are not familiar to workers. Despite the high level of education, workers could analyse English labels at an average level. Moreover, increasing work records did not have much effect on improving people's awareness. 123 133 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/30 1403/9/10 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/27 1404/1/7 Maryam Hormozi Maryam Hormozi Department of Occupational Health, School of Health, Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran Iran hormozym@yahoo.com Fereydoon Laal Fereydoon Laal Department of Occupational Health and safety Engineering, School of Health, Social determinants of health research center, Birjand University of Medical Sciences, Birjand, Iran Iran fereydoonlaal@gmail.com Anahita Hejazi Anahita Hejazi Department of Occupational Health Engineering and Safety at Work, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran Iran anahitahejazi1378@gmail.com Fatemeh Dalakeh Fatemeh Dalakeh Social determinants of health research center, Birjand University of Medical Sciences, Birjand, Iran Iran f.dalakeh73@gmail.com Maryam Ashouri Maryam Ashouri Department of Occupational Health and Safety Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran Maryam.Ashouri2018@gmail.com GHS system Labelling Awareness Chemical safety 1. Ghaedsharaf Z, Jabbari M. Identifying hazards and presenting HSE risk management program using Bow-Tie and SOWT-ANP methods at the urea unit of Shiraz petrochemical complex. Health and Safety at Work. 2020; 10(1): 46-57. [Persian]##2. Mahmoudi D, Nazari S, Derakhshani M, et al. The occupational health student's awareness towards the globally harmonized system for the chemical safety signs. Safety promotion and injury prevention (Tehran). 2018; 5(4): 219-26. [Persian]##3. Wang B, Wu C, Reniers G, et al. The future of hazardous chemical safety in China: Opportunities, problems, challenges and tasks. Science of the total environment. 2018; 643: 1-11.##4. Fayazi A, Pouyakian M, Jafari MJ, et al. A survey among three Iranian occupational groups: general knowledge of chemical safety and familiarity with GHS and outdated labeling systems. ACS Chemical Health & Safety. 2020; 27(1): 43-51. [Persian]##5. Draman SFS, Daik R, Abdullah ML, editors. Globally harmonized system: A study on understanding and attitude towards chemical labeling amongst students of secondary school. 2010 International Conference on Science and Social Research (CSSR 2010); 2010: IEEE.##6. Wogalter MS, Mayhorn CB, Laughery Sr KR. Warnings and hazard communications. Handbook of human factors and ergonomics. 2021: 644-67.##7. Jafarvand M, Heydari P, Varmazyar S. The effect of training intervention on student's awareness toward warning signs of Global Harmonized System (GHS). Journal of Health & Safety at Work. 2019; 9(1). [Persian]##8. Walters AU, Lawrence W, Jalsa NK. Chemical laboratory safety awareness, attitudes and practices of tertiary students. Safety science. 2017; 96: 161-71.##9. Kalteh HO, Mortazavi SB, Mohammadi E, et al. The relationship between safety culture and safety climate and safety performance: a systematic review. International journal of occupational safety and ergonomics; 2019. [Persian]##10. Chemicals LO. Globally harmonized system of classification and labelling of chemicals (GHS); 2001.##11. Silk JC. Development of a globally harmonized system for hazard communication. International journal of hygiene and environmental health. 2003; 206(4-5): 447-52.##12. Winder C, Azzi R, Wagner D. The development of the globally harmonized system (GHS) of classification and labelling of hazardous chemicals. Journal of hazardous materials. 2005; 125(1-3): 29-44.##13. Fayazi A, Pouyakian M, Jafari MJ, et al. Development and validation of two awareness and current status assessment questionnaires for the hazardous chemically-exposed staffs though Globally Harmonized System of Classification and Labeling of Chemicals (GHS). Journal of Health & Safety at Work. 2019; 9(1). [Persian]##14. Ruokolainen J, Hyttinen M, Sorvari J, et al. Exposure of cleaning workers to chemical agents and physical conditions in swimming pools and spas. Air Quality, Atmosphere & Health. 2022: 1-20.##15. Zhao L, Qian Y, Hu Q-M, et al. An analysis of hazardous chemical accidents in China between 2006 and 2017. Sustainability. 2018; 10(8): 2935.##16. Bakand S. The review of Globally harmonized system of classification and labeling of chemicals (GHS)(Editorial). Iran Occupational Health Journal. 2011; 8(1): 0-.##17. Peterson PJ, bin Mokhtar M, Chang C, et al. Indicators as a tool for the evaluation of effective national implementation of the Globally Harmonized System of Classification and Labelling of Chemicals (GHS). Journal of environmental management. 2010; 91(5): 1202-8.##18. Mehrifar Y, Ramezanifar S, Khazaei P, et al. Safety culture and perception of warning signs of chemical hazards among hospital cleaning workers: a cross-sectional study. BMC public health. 2023; 23(1): 817. [Persian]##19. Jahangiri M, Omidvary F, Maghsoudi A. A Comparison study of perception towards Chemical Hazard Warning Signs in Old and Globally Harmonized System (GHS) among chemical workers in Shiraz, Iran. Iran Occupational Health. 2018; 15(5): 1-9. [Persian]##20. Abu-Siniyeh A, Al-Shehri SS. Safety in medical laboratories: perception and practice of university students and laboratory workers. Applied biosafety. 2021; 26(S1): S-34-S-42.##21. Mehrifar Y, Eskandarnia A, Pirami H, et al. Assessment of awareness and comprehension of chemical hazard symbols among chemistry students. Journal of Occupational Health and Epidemiology. 2016; 5(1): 20-5. [Persian]##22. Davoodi R, Shabestari MM, Takbiri A, et al. Patient safety culture based on medical staff attitudes in Khorasan Razavi hospitals, Northeastern Iran. Iranian journal of public health. 2013; 42(11): 1292. [Persian]##23. Finster DC, Jackson P. Comprehensive undergraduate safety instruction. Journal of Chemical Education. 2020; 98(1): 39-44.##24. Boelhouwer E, Davis J, Franco-Watkins A, et al. Comprehension of hazard communication: effects of pictograms on safety data sheets and labels. Journal of safety research. 2013; 46: 145-55.##25. 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Tutorial on Comorbidity Indices in Medical Research 2 1   2 Background: Comorbidity indices, such as Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Measure (ECM), are essential tools for assessing the influence of comorbid health conditions on patient outcomes. This study aims to review comorbidity indices by assigning weighted scores to a spectrum of comorbidities; these instruments play a critical role in predicting mortality rates and evaluating healthcare resource utilization. Methods: In this narrative review study, we reviewed all comorbidity indices and important points were mentioned. Results: CCIand ECIhave proven to be highly effective tools for predicting mortality and healthcare outcomes across a wide range of patient populations. This review examines four comorbidity indices: CCI, ECI, Acute Myeloid Leukemia (AML), and the Chronic Disease Index (CDI). Conclusion: Among four types, CCI and ECM were the most applied, and the researcher should know different types of comorbidity indices to use in research.   134 139 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/13 1403/10/24 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/30 1404/2/10 Muhammad Ajmal Dina Muhammad Ajmal Dina Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran ajmaljhl@gmail.com Farzan Madidadizadeh Farzan Madidadizadeh Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran statlearningeasy@gmail.com Anam Arshed Anam Arshed Rahbar Medical and Dental College, Lahore Pakistan Pakistan anamarshed574@gmail.com CCI (Comorbidity by Charlson Index) ECI (Elixhauser comorbidity index AML (Acute myeloid leukemia) CDI (Chronic disease index) Indices Research 1. Trüeb RM, Trüeb RM. Patient expectation management. The Difficult Hair Loss Patient: Guide to Successful Management of Alopecia and Related Conditions. 2015: 31-48.##2. Svicher A. PAINMIG: Cohort Study for the Evaluation of Mental Pain in Migraine Patients; 2020.##3. Zulman DM, Asch SM, Martins SB, et al. Quality of care for patients with multiple chronic conditions: the role of comorbidity interrelatedness. Journal of general internal medicine. 2014; 29: 529-37.##4. Nanayakkara N, Curtis AJ, Heritier S, et al. Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses. Diabetologia. 2021; 64: 275-87.##5. Ssentongo P, Ssentongo AE, Heilbrunn ES, et al. Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. PloS one. 2020; 15(8): e0238215.##6. Austin SR, Wong Y-N, Uzzo RG, et al. Why summary comorbidity measures such as the Charlson comorbidity index and Elixhauser score work. Medical care. 2015; 53(9): e65-e72.##7. Sinvani L, Kuriakose R, Tariq S, et al. Using Charlson comorbidity index to predict short-term clinical outcomes in hospitalized older adults. The Journal for Healthcare Quality (JHQ). 2019; 41(3): 146-53.##8. Drosdowsky A, Gough K. The Charlson Comorbidity Index: problems with use in epidemiological research. Journal of clinical epidemiology. 2022; 148: 174-7.##9. Charlson ME, Carrozzino D, Guidi J, et al. Charlson comorbidity index: a critical review of clinimetric properties. Psychotherapy and psychosomatics. 2022; 91(1): 8-35.##10. Asai N, Ohashi W, Sakanashi D, et al. Combination of Sequential Organ Failure Assessment (SOFA) score and Charlson Comorbidity Index (CCI) could predict the severity and prognosis of candidemia more accurately than the Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) score. BMC infectious diseases. 2021; 21: 1-11.##11. Grady PA, Gough LL. Self-management: a comprehensive approach to management of chronic conditions. American journal of public health. 2014; 104(8): e25-e31.##12. Fernando DT, Berecki-Gisolf J, Newstead S, et al. Effect of comorbidity on injury outcomes: a review of existing indices. Annals of epidemiology. 2019; 36: 5-14.##13. Zhang X-M, Wu X-J, Cao J, et al. Effect of the age-adjusted Charlson comorbidity index on all-cause mortality and readmission in older surgical patients: a national multicenter, prospective cohort study. Frontiers in Medicine. 2022; 9: 896451.##14. Whitney DG, Kamdar NS. Development of a new comorbidity index for adults with cerebral palsy and comparative assessment with common comorbidity indices. Developmental Medicine & Child Neurology. 2021; 63(3): 313-9.##15. Kirby JJ, Shaikh S, Bryant DP, et al. A simplified comorbidity evaluation predicting clinical outcomes among patients with coronavirus disease 2019. Journal of Clinical Medicine Research. 2021; 13(4): 237.##16. Oterino-Moreira I, Lorenzo-Martínez S, López-Delgado Á, et al. Comparison of three comorbidity measures for predicting in-hospital death through a clinical administrative nacional database. International journal of environmental research and public health. 2022; 19(18): 11262.##17. Cai M, Liu E, Zhang R, et al. Comparing the performance of Charlson and Elixhauser comorbidity indices to predict in-hospital mortality among a Chinese population. Clinical Epidemiology. 2020: 307-16.##18. Epstein RH, Dexter F. Development and validation of a structured query language implementation of the Elixhauser comorbidity index. Journal of the American Medical Informatics Association. 2017; 24(4): 845-50.##19. Soroa G, Gorostiaga A, Aritzeta A, et al. A shortened Spanish version of the Emotional Creativity Inventory (the ECI-S). Creativity Research Journal. 2015; 27(2): 232-9.##20. Schneeweiss S, Seeger JD, Maclure M, et al. Performance of comorbidity scores to control for confounding in epidemiologic studies using claims data. American journal of epidemiology. 2001; 154(9): 854-64.##21. Pot GK, Richards M, Prynne CJ, et al. Development of the Eating Choices Index (ECI): a four-item index to measure healthiness of diet. Public health nutrition. 2014; 17(12): 2660-6.##22. Huang Y-J, Chen J-S, Luo S-F, et al. Comparison of indexes to measure comorbidity burden and predict all-cause mortality in rheumatoid arthritis. Journal of Clinical Medicine. 2021; 10(22): 5460.##23. Döhner H, Estey EH, Amadori S, et al. Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood, The Journal of the American Society of Hematology. 2010; 115(3): 453-74.##24. Roman E, Smith A, Appleton S, et al. Myeloid malignancies in the real-world: Occurrence, progression and survival in the UK’s population-based Haematological Malignancy Research Network 2004–15. Cancer epidemiology. 2016; 42: 186-98.##25. Delie A. Impact of new treatment guidelines pertaining to the indication for allogeneic stem cell transplantation in acute myeloid leukemia at the: Ghent University; 2018.##26. Porter CC, Druley TE, Erez A, et al. Recommendations for surveillance for children with leukemia-predisposing conditions. Clinical Cancer Research. 2017; 23(11): e14-e22.##27. Airlangga G. Comparative Analysis of Machine Learning Models for Chronic Disease Indicator Classification Using US Chronic Disease Indicators Dataset. MALCOM: Indonesian Journal of Machine Learning and Computer Science. 2024; 4(3): 1034-42.##28. Betancourt M, Roberts K, Bennett T-L, et al. Monitoring chronic diseases in Canada: the chronic disease indicator framework. Chronic Diseases & Injuries in Canada. 2014; 34.##29. 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Enhancing Self-Care and General Health in Women with Breast Cancer: The Impact of Quality-of-Life Therapy 2 2 Background: Breast cancer, one of the most prevalent cancers among women, not only affects physical health but also significantly impacts psychological well-being and self-care practices. This study aimed to evaluate the impact of Quality-of-Life Therapy (QoLT) on self-care and mental health in women with breast cancer. Methods: A quasi-experimental design with pre-test, post-test, and two-month follow-up was employed, involving a control group. The study population included breast cancer patients admitted to Shohadaye Kargar Hospital in Yazd from September 2023 to February 2024. Participants were selected based on inclusion criteria such as female gender, age 30–60, breast cancer diagnosis, and undergoing hormone therapy, while exclusion criteria included smoking, severe illness, or psychiatric treatment. Thirty-one patients were purposively sampled and randomly assigned to an intervention group (N = 15) receiving 10 QoLT sessions over two months, or a control group (N = 16) receiving routine care only. Data were collected using the General Health Questionnaire (GHQ-28), Individualized Self-Care Scale (ICS), and a demographic form, and analyzed using SPSS-21 and repeated measures ANOVA. Results: Findings showed that QoLT significantly improved self-care (F = 11.06, effect size = 61%) and mental health (F = 255.2, effect size = 80%) (p < 0.001). These effects persisted at the two-month follow-up. Conclusion: The results demonstrated the effective impact of QoLT on self-care behavior and improvement in mental health among breast cancer patients. It is therefore recommended that QoLT be used as an adjunctive treatment alongside routine care for breast cancer patients.   140 150 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/17 1403/10/28 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/8 1404/1/19 Nahid Khalilnejad Nahid Khalilnejad Department of Health Psychology, UAE Branch, Islamic Azad University, Dubai, United Arab Emirates United Arab Emirates N.khalilnejad@yahoo.com Parviz Asgari Parviz Asgari Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran Iran Askary47@yahoo.com Hamzeh Ahmadian Hamzeh Ahmadian Department of Psychology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran Iran Ahmadian@iausdj.ac.ir Heyder Eslami Shahrbabaki Heyder Eslami Shahrbabaki Department of Psychology, Anar Branch, Islamic Azad University, Anar, Iran Iran Hy.eslami@gmail.com Quality of Life Self-Care Mental Health Breast Cancer 1. Giaquinto AN, Sung H, Miller KD,et al. Breast cancer statistics. CA: a cancer journal for clinicians. 2022; 72(6): 524-541.##2. Mussallem D. Lifestyle for breast cancer risk reduction. Menopause. 2022; 29(8): 979-981.##3. Arnold M, Morgan E, Rumgay H, et al. Current and future burden of breast cancer: Global statistics for 2020 and 2040. The Breast. 2022; 66: 15-23.##4. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics. CA: a cancer journal for clinicians. 2024; 74(1): 1-6.##5. Seyedkanani E, Hosseinzadeh M, Mirghafourvand M, et al. Breast cancer screening patterns and associated factors in Iranian women over 40 years. Scientific Reports. 2024; 14(1): 1-9. [Persian]##6. Shamshirian A, Heydari K, Shams Z, et al. Breast cancer risk factors in Iran: a systematic review & meta-analysis. Hormone molecular biology clinical investigation. 2020; 41(4): 20-31. [Persian]##7. Akbari ME, Akbari A, Khayamzadeh M, et al. Ten-year survival of breast cancer in Iran: a national study (Retrospective cohort study). Breast Care. 2023; 18(1): 12-21. [Persian]##8. Budisavljevic A, Dedic Plavetic N, Klaric K, et al. The Impact of Newly Diagnosed Early Breast Cancer on Psychological Resilience, Distress Levels, and the Perception of Health. International Journal of Environmental Research Public Health. 2024; 21(6): 677-683.##9. Seiler A, Jenewein J. Resilience in cancer patients. Frontiers in psychiatry. 2019; 10(677): 1-11.##10. Penberthy JK, Stewart AL, Centeno CF, et al. Psychological Aspects of Breast Cancer. Psychiatric Clinics. 2023; 46(3): 551-570.##11. World Health Organization. Noncommunicable diseases and mental health in small island developing states. WHO; 2023.##12. Sharma M, Branscum P. Foundations of mental health promotion: Jones & Bartlett Publishers; 2020.##13. Gueldner BA, Feuerborn LL, Merrell KW. Social and emotional learning in the classroom: Promoting mental health and academic success: Guilford Publications; 2020.##14. Galderisi S, Heinz A, Kastrup M, et al. A proposed new definition of mental health. Psychiatria Hungarica. 2017; 51(3): 407-411.##15. Parhoon H, Moradi A, Hasanabadi H, et al. Effectiveness of cognitive rehabilitation on Executive Function and Self care Behavior in patients with Brest Cancer. Journal of Research in Behavioural Sciences. 2019; 16(3): 365-378. [Persian]##16. Wang Z, Yin G, Jia R. Impacts of self-care education on adverse events and mental health related quality of life in breast cancer patients under chemotherapy. Complementary therapies in Medicine. 2019; 43: 165-169.##17. Zhang X, Zhang D, Yu P, et al. Effects of Continuous Care Combined with Evidence‐Based Nursing on Mental Status and Quality of Life and Self‐Care Ability in Patients with Liver from Breast Cancer: A Single‐Center Randomized Controlled Study. Computational Mathematical Methods in Medicine. 2022; 2022(1): 36-46.##18. Puig Llobet M, Sánchez Ortega MA, Lluch‐Canut MT, et al. Positive mental health and self‐care in patients with chronic physical health problems: Implications for evidence‐based practice. Worldviews on Evidence‐Based Nursing. 2020; 17(4): 293-300.##19. Weiderpass E. Lifestyle and cancer risk. Journal of preventive medicine public health. 2010; 43(6): 459-471.##20. Yanardağ CH, Çürük GN, Karayurt Ö. Effects of selfcare and selected factors on the quality of life in women with breast cancer-related lymphedema. Supportive Care in Cancer. 2023; 31(1): 22-28.##21. Tommasi C, Balsano R, Corianò M, et al. Long-term effects of breast cancer therapy and care: calm after the storm? Journal of clinical medicine. 2022; 11(23): 39-45.##22. Villalona S, Castillo BS, Chavez Perez C, et al. Interventions to mitigate financial toxicity in adult patients with cancer in the United States: a scoping review. Current Oncology. 2024; 31(2): 918-932.##23. Veenhoven R. Quality of life (QOL), an overview. Encyclopedia of quality of life well-being research. 2024; 1(2): 5668-5671.##24. Boelhouwer J, Noll H-H. Objective quality of life.Encyclopedia of quality of life and well-being research: Springer; 2024; 4783-4785.##25. Jones P, Drummond P. Construction and evaluation of a mindfulness-based quality of life and well-being program (MQW) in a randomized trial. Current Psychology. 2023; 42(17): 782-803.##26. Moudjahid A, Abdarrazak B. Psychology of quality of life and its relation to psychology. International Journal of Inspiration Resilience Economy. 2019; 3(2): 58-63.##27. Carroll AJ, Christon LM, Rodrigue JR, et al. Implementation, feasibility, and acceptability of quality of life therapy to improve positive emotions among patients with implantable cardioverter defibrillators. Journal of behavioral medicine. 2020; 43: 968-78.##28. Hoseini F, Abedi MR, Gorgi Y. Effectiveness of Quality-of-Life Therapy on the Quality of Parent-Adolescent Interaction and Adolescent Adjustment. Journal of Applied Psychological Research. 2024; 15(1): 73-89. [Persian]##29. Golant M, Altman T, Martin C. Managing cancer side effects to improve quality of life: a cancer psychoeducation program. Cancer nursing. 2003; 26(1): 37-44.##30. Casla S, Hojman P, Cubedo R, et al. Integrative exercise and lifestyle intervention increases leisure-time activity in breast cancer patients. Integrative Cancer Therapies. 2014; 13(6): 493-501.##31. D’egidio V, Sestili C, Mancino M, et al. Counseling interventions delivered in women with breast cancer to improve health-related quality of life: a systematic review. Quality of Life Research. 2017; 26: 2573-2592.##32. Naghibi SH, Saeedi Z, Khazaei F. The Effectiveness of Group training Based on Improving Quality of Life on Hope and Happiness of People with Cancer; a three Months follow up. Journal of Counseling Research. 2018; 17(65): 4-29. [Persian]##33. Jafari F. The effectiveness of quality of life therapy in self-compassion and future time perspective in menopausal women. Positive Psychology Research. 2017; 3(2): 37-50. [Persian]##34. Sorbi MH, Sadeghi K, Rahmanian M, et al. Positive psychotherapy effect on life expectancy and general health of type 2 diabetic patients: A randomized controlled trial. Iranian Journal of Diabetes Obesity. 2018; 10(1): 31-36. [Persian]##35. Shayan Z, Pourmovahed Z, Najafipour F, et al. Factor structure of the General Health Questionnaire-28 (GHQ-28) from infertile women attending the Yazd Research and Clinical Center for Infertility. International journal of reproductive biomedicine. 2015; 13(12): 801-810. [Persian]##36. Suhonen R, Leino‐Kilpi H, Välimäki M. Development and psychometric properties of the Individualized Care Scale. Journal of evaluation in clinical practice. 2005; 11(1): 7-20.##37. Bahrami MA, Jambarsang S, Ranjbar M, et al. Validation of persian version of suhanen et al.'s individualized care scale. Quarterly journal of management strategies in health system. 2023; 8(2): 106-115. [Persian]##38. Frisch MB. Quality of life therapy. The Wiley handbook of positive clinical psychology. 2016: 409-425.##39. Maeda T, Kurihara H, Morishima I, et al. The effect of psychological intervention on personality change, coping, and psychological distress of Japanese primary breast cancer patients. Cancer nursing. 2008; 31(4): 27-35.##40. Ghanbari H, Jani HT, Nejat H. Comparison of the effectiveness of Acceptance and Commitment-Based Therapy (ACT) and Quality of Life therapy (QOLT) on self-destructive behaviors and emotional cognitive regulation in substance abusers. Journal of Fundamentals of Mental Health. 2020; 22(1): 47-55. [Persian]##41. Marchioro G, Azzarello G, Checchin F, et al. The impact of a psychological intervention on quality of life in non-metastatic breast cancer. European Journal of Cancer. 1996; 32(9): 1612-1615.##42. Saeidi Z, Asgharnejad AA. The Effectiveness of Positivism Group Psychotherapy Based on Frisch's Theory in Promoting Happiness and Life Satisfaction of Breast Cancer Patients. American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS). 2018; 48(1): 53-63. [Persian]##43. Nikbakhsh N, Moudi S, Alvarzandi S, et al. Citalopram and group psychotherapy in breast cancer patients: A randomized clinical trial. Medical Journal of the Islamic Republic of Iran. 2018; 32: 68. [Persian]##44. Fauser D, Rimalis-Vogt E, Mattes J, et al. Psychological interventions during breast cancer rehabilitation: a randomized controlled trial comparing structured short-term psychotherapy versus non-specific group discussion. BMC cancer. 2023; 23(1): 11-33.## ##

Bio-Medical Waste Management among Health Care Providers and Support Staff in a Secondary Level Hospital: A Cross-Sectional Study 2 2 Background: According to WHO, for every 100 hospitalized patients at least 7 in developed and 10 in developing countries acquire healthcare associated infection. Important factors that put the patients at the risk of infections are inadequate environmental hygiene, waste disposal, and poor knowledge, and application of basic infection control measures. To assess the knowledge, attitude and practice regarding biomedical waste management (BMWM) among health care providers (HCP) and support staffs in a secondary level Hospital with the goal of identifying gaps and informing strategies for improved compliance and waste management practices. Methods: A cross-sectional study was done in government hospital, Mayiladuthurai, Nagapattinam district, during September 2018 to November 2018. Among the 32 districts in Tamilnadu, Nagapattinam district was randomly selected and Mayiladuthurai government hospital was randomly selected among 9 secondary level care hospitals. All the categories of staff in the hospital like doctors, pharmacists, staff nurses, lab and x ray technicians, sanitary workers who handle the biomedical waste in the study area were included in the study. After getting informed consent, data was collected using pre-tested semi structured questionnaire. Data entry was made in the Microsoft Excel software and analysis was done with SPSS version 21 software package.   Results: Out of 109 participants, 24.8% were males and 75.2% were females. Age group of the participants ranges from 20-60 with the mean age of 35.34 and standard deviation of 7.51. Majority of them belong to 31-40 age group (44%). In this study, based on the work experience 72.5% participants belong to 0-8 -years' experience group, 22.9% participants belong to 9- 16years experience and about 4.6% belongs to 17-24 years of experience group. It was observed that those having adequate knowledge and good attitude about BMW management were found to have less adequate practices which also varies among different categories of health workers (p < 0.001). Conclusions: The results of the present study showed that knowledge, attitude and practices of participants were not adequate among different categories of health care providers. Safe and effective management of waste is not only a legal necessity but also a social responsibility. The government should take the responsibility to train effectively the healthcare providers working in secondary healthcare settings. Compulsory continuous intensive training programs should be conducted at regular time interval for all the paramedical personnel with special importance to the newcomers, and they should have access to BMWM guidelines in their department/healthcare delivery section. The authors recommend similar studies in different settings and further research to provide accurate data for future decision-making.   151 160 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/15 1403/11/27 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/17 1404/3/27 Vijaykumar M Vijaykumar M Department of Community Medicine, Govt.ESI medical College, Coimbatore, India India drvijaym12@gmail.com Rathnakumar M Rathnakumar M Health Officer, Mayiladuthurai, Nagapattinam, India India geethar3333@gmail.com Biomedical waste management knowledge healthcare workers paramedical nurses lab technicians 1. Sharma AK. Bio Medical Waste (Management and Handling) Rules. Bhopal: Suvidha Law House. 1998: 50-70.##2. World Health Organization. Healthcare waste [Internet]. WHO; 2019. Available at: URL: https://www.who.int/news-room/fact-sheets/detail/health-care-waste. Accessed October 24, 2024.##3. Prashanth VK, Jadhav HC, Dodamani AS, et al. Assessment of Knowledge, Attitude, and Practices regarding Awareness of Biomedical Waste Management among Health Care Personnel: A Cross-sectional Survey. Journal of Oral Health & Community Dentistry. 2017; 11(1).##4. Pandey A, Ahuja S, Madan M, et al. Bio-medical waste managment in a tertiary care hospital: an overview. Journal of clinical and diagnostic research: JCDR. 2016; 10(11): DC01.##5. Somaiah PT, Shivaraj BM. A study on bio-medical waste management using Kayakalp Tool at District Hospital in Southern India. National Journal of Community Medicine. 2016; 7(07): 614-7.##6. Sarker MA, Harun-Or-Rashid M, Hirosawa T, et al. Evaluation of knowledge, practices, and possible barriers among healthcare providers regarding medical waste management in Dhaka, Bangladesh. Medical science monitor: international medical journal of experimental and clinical research. 2014; 20: 2590.##7. Goyal S, Dileep CL, Mathur A, et al. Knowledge, attitude and practices regarding biomedical wastes among health care professionals in Sri Ganganagar city: A cross-sectional study. DHR International Journal of Medical Sciences. 2015; 6(2): 162-71.##8. Joshi SC, Diwan V, Tamhankar AJ, et al. Staff perception on biomedical or health care waste management: A qualitative study in a rural tertiary care hospital in India. PloS one. 2015; 10(5): e0128383.##9. Deress T, Hassen F, Adane K, et al. Assessment of knowledge, attitude, and practice about biomedical waste management and associated factors among the healthcare professionals at Debre Markos town healthcare facilities, Northwest Ethiopia. Journal of environmental and public health. 2018; 2018(1): 7672981.##10. Sood AG, Sood A. Dental perspective on biomedical waste and mercury management: a knowledge, attitude, and practice survey. Indian Journal of Dental Research. 2011; 22(3): 371-5.##11. Kumar R, Gupta AK, Aggarwal AK, et al. A descriptive study on evaluation of bio-medical waste management in a tertiary care public hospital of North India. Journal of Environmental Health Science and Engineering. 2014; 12: 1-7.##12. Kapoor D, Nirola A, Kapoor V, et al. Knowledge and awareness regarding biomedical waste management in dental teaching institutions in India-A systematic review. Journal of clinical and experimental dentistry. 2014; 6(4): e419.##13. Pullishery F, Panchmal GS, Siddique S, et al. Awareness, knowledge and practices on bio-medical waste management among health care professionals in Mangalore-A cross sectional study. Int Arch Integr Med. 2016; 3(1): 29-35.##14. Dudi M, Sharma R, Sharma S, et al. Assessment of the knowledge, attitude and practices regarding biomedical waste management amongst paramedical staff in a tertiary level health care facility. Int J Med Sci Public Health. 2016; 5(4): 615-9.## ##

The Critical Role of Systematic Reviews in Identifying Common Risk Factors for Gastrointestinal Cancers 2 2 No Abstract 161 163 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/18 1403/10/29 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/27 1403/12/9 Hossein Akhondi Hossein Akhondi Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Iran 7041hosseinakhondi@gmail.com Mohammad Hassan lotfi Mohammad Hassan lotfi Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Iran mhlotfi56359@gmail.com Gastrointestinal (GI) Cancers Systematic reviews Common Risk Factors Public health policies 1. Arnold M, Abnet CC, Neale RE, et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology. 2020; 159(1): 335-49. e15.##2. Xi Y, Xu P. Global colorectal cancer burden in 2020 and projections to 2040. Translational oncology. 2021; 14(10): 101174.##3. Sekiguchi M, Oda I, Matsuda T, et al. Epidemiological trends and future perspectives of gastric cancer in Eastern Asia. Digestion. 2022; 103(1): 22-8.##4. Abbas M, Alqahtani M, Alshahrani MY, et al. Aggressive and drug-resistant pancreatic cancer: challenges and novel treatment approaches. Discovery Medicine. 2022; 34(173): 158-64.##5. Gupta B, Kumar N. Worldwide incidence, mortality and time trends for cancer of the oesophagus. European journal of cancer prevention. 2017; 26(2): 107-18.##6. Jardim SR, de Souza LMP, de Souza HSP. The rise of gastrointestinal cancers as a global phenomenon: unhealthy behavior or progress? International journal of environmental research and public health. 2023; 20(4): 3640.##7. Pritchett N, Spangler EC, Gray GM, et al. Exposure to outdoor particulate matter air pollution and risk of gastrointestinal cancers in adults: a systematic review and meta-analysis of epidemiologic evidence. Environmental health perspectives. 2022; 130(3): 036001.##8. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Annals of internal medicine. 2009; 151(4): W-65-W-94.##9. Masood S, Kothari A, Regan S. The use of research in public health policy: a systematic review. Evidence & Policy. 2020; 16(1): 7-43.##10. Jushua J, Hussein MR, Utterman S, Thomas M. Unpacking Social Determinants of Cancer Disparities: A Systematic Review and Strategic Framework for Equitable Prevention and Control. medRxiv. 2024: 2024-07.##11. Shams AZ, Haug U. Strategies for prevention of gastrointestinal cancers in developing countries: a systematic review. Journal of global health. 2017; 7(2).##12. Chang SM, Carey TS, Kato EU, et al. Identifying research needs for improving health care. Annals of internal medicine. 2012; 157(6): 439-45.## ##

Navigating Daily Life- Prevalence of Activities of Daily Living (ADL) among the Elderly in Urban Bengaluru - A Community-Based Cross-Sectional Study 2 2 Background: The global elderly population is growing rapidly, and India is home to the world's second-largest elderly population. Understanding the activities of daily living (ADL) among the elderly is essential for providing effective healthcare and support. This study aimed to assess the prevalence of dependency with respect to ADL and its association with socio-demographic and comorbidities variables among elderly individuals residing in three wards of urban Bengaluru. Methods: This community-based cross-sectional study was conducted between January and March 2023. A total of 132 elderly were selected using simple random sampling. Data were collected through semi-structured interviews. Data analysis was performed using EpiData 3.1 software, with the chi-square test and binary logistic regression used to study associations. Results: The study found that 43% of the elderly population experienced activity limitations in ADL where 75(57%) showed full function, 47(36%) showed moderate impairment, and 10 (7%) showed severe functional impairment. Activity limitations were more prevalent among females, those over 80 years of age, illiterate individuals, homemakers, and those with hypertension and economic dependency. The adjusted odds ratio analysis showed a significant association between activity limitations and those aged above 80. Conclusion: The study highlights the need for targeted healthcare interventions, regular health check-ups, and literacy programs for elderly population, particularly elderly feamles and those over 80 years of age. Policies should focus on addressing the determinants of activity limitations to improve the functional status and overall quality of life for the elderly.   164 175 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/13 1403/9/23 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/17 1404/1/28 Sreenath Menon P.K Sreenath Menon P.K Department of Community Medicine, ESIC Medical College and PGIMSR, Karnataka, India India sreenathpk30@gmail.com Deepthi R Deepthi R Department of Community Medicine, ESIC Medical College and PGIMSR, Karnataka, India India drdeepthikiran@gmail.com Sangeetha M.D Sangeetha M.D Department of Community Medicine, ESIC Medical College and PGIMSR, Karnataka, India India sangeethamd33@gmail.com Activities of Daily Living (ADL) Elderly Bengaluru Community-Based Independence Proportion 1 World Health Organisation (WHO). Report of the World Health Organization. Active ageing: a policy framework. Aging Male. WHO: 2002; 5(1): 1–37. Available at: URL: https://apps.who.int/iris/handle/10665/67215.##2 United Nations Department of Economic and Social Affairs. World Population Ageing 2019: Highlights. New York: United Nations; 2019. Available at: URL: https://digitallibrary.un.org/record/3846855/files/WorldPopulationAgeing2019-Highlights.pdf.##3 United Nations Fund for Population Activities (UNFPA). India Ageing Report 2023. Caring for Our Elders [Internet]. India: UNFPA; 2023. Available from: https://india.unfpa.org/sites/default/files/pub-pdf/20230926_india_ageing_report_2023_web_version_.pdf. Accessed January 08, 2024.##4 Pinquart M, Sörensen S. Influences of socioeconomic status, social support, and health on subjective well-being in later life: a meta-analysis. Psychol Aging. 2001; 16(2): 187-224. Available at: URL: https://pubmed.ncbi.nlm.nih.gov/10879576/.##5 Figueiredo Neto JA, Reis LM, Veras MR, et al. Impact of cardiovascular interventions on the quality of life in the elderly. Braz J Cardiovasc Surg. 2015; 30(6): 626–630. Available at: URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4762554/.##6 National Research Council. Preparing for an Aging World: The Case for Cross-National Research. National Academies Press (US); 2001.##7 Meunier D, Stamatakis EA, Tyler LK. Age-related functional reorganization, structural changes, and preserved cognition. Neurobiol Aging. 2014; 35(1): 42–54.##8 India demographic profile. Available at: URL: https://www.indexmundi.com/in dia/demographics_profile. Html; 2018. Accessed July 4, 2020.##9 Usha P, Kishore S, Singh M, et al. Assessment of Activities of Daily Living (ADL) in elderly population. Indian J Community Health (Internet). 2020; 32(2): 447–9. Available at: URL: http://dx.doi.org/10.47203/ijch.2020.v32i02.026.##10 Peter RM, Logaraj M, Ramraj B. Association of comorbidities with Activity of Daily Living (ADL) in a community-based sample of older adults in Tamil Nadu, India. Clin Epidemiol Glob Health (Internet). 2022; 15(101068): 101068. Available at: URL: http://dx.doi.org/10.1016/j.cegh.2022.101068.##11 Rnt KD, Md CG. Activities of daily living ratings of elderly people using Katz ‘ADL index and the GBS-M scale. Scand J Caring Sci. 1995; 9(1): 35–40.##12 Shelkey M, Wallace M. Katz index of independence in activities of daily living (ADL). Int J Older People Nurs. 2012; 2(3): 204–212. Available at: URL: https://pubmed.ncbi.nlm.nih.gov/11081028/.##13 Arik G, Varan HD, Yavuz BB, et al. Validation of Katz index of independence in activities of daily living in Turkish older adults. Arch Gerontol Geriatr. 2015; 61(3): 344–350. Available at: URL: https://pubmed.ncbi.nlm.nih.gov/26328478/.##14 Katz index of independence in activities of daily living activities (Internet). Alz.org. Available at: URL: https://www.alz.org/careplanning/downloads/katz-adl.pdf. Accessed Aug 6, 2023.##15 Katz S, Downs TD, Cash HR, et al. Progress in development of the index of ADL. Gerontol. 1970; 10(1_Part_1): 20–30.##16 Chauhan S, Kumar S, Bharti R, et al. Prevalence and determinants of activity of daily living and instrumental activity of daily living among elderly in India. BMC Geriatr (Internet). 2022; 22(1): 64. Available at: URL: https://pubmed.ncbi.nlm.nih.gov/35045809/. Accessed Aug 6, 2023.##17 Gupta S, Yadav R, Malhotra AK. Assessment of physical disability using Barthel index among elderly of rural areas of district Jhansi (U.P), India. J Family Med Prim Care. 2016; 5(4): 853-857. doi: 10.4103/2249-4863.201178##18 Abbasian M, Ghalichi F, Ahmadi B, et al. Status of Daily Living Activities among Older People in Maku. Elderly Health Journal. 2016; 2(2): 73-7.##19 Keshari P, Shankar H. Prevalence and spectrum of functional disability of urban elderly subjects: A community-based study from Central India. J Family Community Med. 2017; 24(2): 86-90. doi: 10.4103/jfcm.JFCM_80_16.##20 Patel R, Chauhan S, Chaurasiya D, et al. Role and impact of social capital on health of older adult in India. Indian J Soc Res. 2019; 60(2): 279–305.##21 Gupta S, Yadav R, Malhotra AK. Assessment of physical disability using Barthel index among elderly of rural areas of district Jhansi (UP), India. J Fam Med Prim Care. 2016; 5(4): 853.##22 Veerapu N, Praveenkumar BA, Subramaniyan P, et al. Functional dependence among elderly people in a rural community of Andhra Pradesh, South India. Int J Community Med Public Health. 2016; 3(7): 1835–40.##23 Nagarkar A, Kashikar Y. Predictors of functional disability with focus on activities of daily living: a community based follow-up study in older adults in India. Arch Gerontol Geriatr. 2017; 69: 151–5.##24 Beydoun MA, Popkin BM. The impact of socio-economic factors on functional status decline among community-dwelling older adults in China. Soc Sci Med. 2005; 60(9): 2045-57.##25 Fuller-Thomson E, Yu B, Nuru-Jeter A, et al. Basic ADL disability and functional limitation rates among older Americans from 2000–2005: the end of the decline? J Gerontol Ser A Biomed Sci Med Sci. 2009; 64(12): 1333-6.##26 Burman J, Sembiah S, Dasgupta A, et al. Assessment of poor functional status and its predictors among the elderly in a rural area of West Bengal. J Mid Life Health. 2019; 10(3): 123.##27 Vlassoff C. Gender differences in determinants and consequences of health and illness. J Health Popul Nutr. 2007; 25(1): 47.##28 Patel R, Chauhan S. Gender differential in health care utilisation in India. Clin Epidemiol Glob Health. 2020; 8(2): 526-30.##29 Lawton MP, Brody EM. Instrumental activities of daily living scale (IADL). Gerontologist. 1969; 9: 179-86.##30 Srivastava S, Chauhan S, Patel R. Socio-economic inequalities in the prevalence of poor self-rated health among older adults in India from 2004 to 2014: a decomposition analysis. Ageing Int. 2020: 1-18.##31 Ran L, Jiang X, Li B, et al. Association among activities of daily living, instrumental activities of daily living and health-related quality of life in elderly Yi ethnic minority. BMC Geriatr. 2017; 17(1): 74.##32 Tomioka K, Kurumatani N, Hosoi H. Age and gender differences in the association between social participation and instrumental activities of daily living among community-dwelling elderly. BMC Geriatr. 2017; 17(1): 99.##33 Wisniowska-Szurlej A, Wilmowska-Pietruszynska A. An assessment of factors related to disability in ADL and IADL in elderly inhabitants of rural areas of South-Eastern Poland. Ann Agric Environ Med. 2018; 25(3): 504–11.##34 Hu P, Adler NE, Goldman N, et al. Relationship between subjective social status and measures of health in older Taiwanese persons. J Am Geriatr Soc. 2005; 53(3): 483-8.##35 Vaish K, Patra S, Chhabra P. Functional disability among elderly: a community-based cross-sectional study. J Fam Med Prim Care. 2020; 9(1): 253.##36 Lestari SK, Ng N, Kowal P, et al. Diversity in the factors associated with ADL-related disability among older people in six middle-income countries: a cross-country comparison. Int J Environ Res Public Health. 2019; 16(8): 1341.##37 Molanorouzi K, Khoo S, Morris T. Validating the physical activity and leisure motivation scale (PALMS). BMC Public Health. 2014; 14(1): 1–12.##38 Balzi D, Lauretani F, Barchielli A, et al. Risk factors for disability in older persons over 3-year follow-up. Age Ageing. 2010; 39(1): 92–8.## ##

Identifying the Components of Prehospital Emergency Preparedness in Radiological and Nuclear Incidents: A Protocol Study 2 2 Background: Prehospital emergency preparedness in radiological and nuclear incidents is significant to the health system's first responders. This study aims to conduct a scoping literature review to identify and explain the components affecting prehospital emergency preparedness in radiological and nuclear incidents. Methods: This study is a scoping review protocol. A search will be conducted in PubMed, Scopus, Web of Science, ProQuest, and Google Scholar databases using main keywords, including nuclear, radiation, radiological, and Prehospital Emergency Care, preparedness, and relevant MeSH terms defined in the PubMed database from 1970 to 2024. Articles related to prehospital emergency preparedness and nuclear and radiation incidents are the inclusion criteria for the study. The documents used will include a variety of original, systematic, and scoping review articles. The basis for defining search strategies will be the guide for each database. Database management, removing duplicate and irrelevant articles, and extracting appropriate articles will be done using EndNote software version X7. Two team members will perform all screening and selection steps based on the inclusion and exclusion Criteria. The PRISMA 2020 flowchart will be used to show the article selection process. Results: The results of this study will identify the effective components for prehospital emergency preparedness in radiological and nuclear incidents, categorized into subcategories and codes. Conclusion: Knowing the effective components of prehospital emergency preparedness will improve the response. In this way, various groups, including decision-makers, researchers, and executive areas, including the Ministry of Health and Medical Education and the Non-Active Defense Organization, can take a more effective step in managing the risk of emergencies and disasters.   176 181 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/25 1404/2/5 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/1 1404/5/10 Somayeh Yadollahifar Somayeh Yadollahifar Department of Health in Disaster and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran yadollahifar@yahoo.com Mohsen Aminizadeh Mohsen Aminizadeh Department of Medical Emergencies, Sirjan School of Medical Sciences, Sirjan, Iran Iran ems.mohsenamini@gmail.com Khadijeh Nasiriani Khadijeh Nasiriani Spiritual Health Research Center, Research Center for Nursing and Midwifery Care, Non-communicable Diseases Research Institute, hahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran nasiriani@gmail.com Abas Ali Dehghani Tafti Abas Ali Dehghani Tafti Department of Health in Disaster and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran aadtafti@yahoo.com Reyhaneh Sefidkar Reyhaneh Sefidkar Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran reyhanesefidkar@gmail.com Samaneh Mirzaei Samaneh Mirzaei Department of Health in Disaster and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran s.mirzaei2113@gmail.com Emergency medical service radiological radiation radioactive hazard release nuclear reactor disaster planning 1. Yahya NY, Rahmat RB, Termizi MS, et al. Preparedness towards Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) threats among healthcare personnel in Pasir Gudang, Johor, Malaysia. International Journal of Disaster Risk Reduction. 2022; 82: 103235.##2. Nadworny D, Davis K, Miers C, et al. Boston strong—one hospital’s response to the 2013 Boston Marathon bombings. Journal of Emergency Nursing. 2014; 40(5): 418-27.##3. Mackie BR, Weber S, Mitchell ML, et al. Chemical, biological, radiological, or nuclear response in queensland emergency services: A multisite study. Health security. 2022; 20(3): 222-9.##4. Blumenthal DJ, Bader JL, Christensen D, et al. A sustainable training strategy for improving health care following a catastrophic radiological or nuclear incident. Prehospital and disaster medicine. 2014; 29(1): 80-6.##5. Nyaku MK, Wolkin AF, McFadden J, et al. Assessing radiation emergency preparedness planning by using Community Assessment for Public Health Emergency Response (CASPER) methodology. Prehospital and disaster medicine. 2014; 29(3): 262-9.##6. Arian rad S. Review of Chernobil powerhouse disaster. Available at: URL: http: // feyzih. blogfa. com/ Category/ 13. [Persian]##7. De Cauwer H, Barten DG, Tin D, et al. 50 years of terrorism against the nuclear industry: a review of 91 incidents in the Global Terrorism Database. Prehospital and disaster medicine. 2023; 38(2): 199-206.##8. Linet MS, Slovis TL, Miller DL, et al. Cancer risks associated with external radiation from diagnostic imaging procedures. CA: a cancer journal for clinicians. 2012; 62(2): 75-100.##9. Fazel R, Krumholz HM, Wang Y, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. New England Journal of Medicine. 2009; 361(9): 849-57. .##10. Barten DG, Klokman VW, Cleef S, et al. When disasters strike the emergency department: a case series and narrative review. International journal of emergency medicine. 2021; 14: 1-9.##11. Dallas CE, Klein KR, Lehman T, et al. Readiness for radiological and nuclear events among emergency medical personnel. Frontiers in public health. 2017; 5: 202.##12. Rebmann T, Charney RL, Loux TM, et al. Firefighters' and emergency medical service personnel's knowledge and training on radiation exposures and safety: results from a survey. Health security. 2019; 17(5): 393-402.##13. Ghanbari V, Sadat Seyedbagher M, Khankeh HR, et al. Effect of disaster preparedness on nursing staff preparedness in response with natural disasters. Iranian Nursing Juornal. 2011; 24(73).##14. United Nations International Strategy for Disaster Reduction (UNISDR). Hyogo Framework for Action Progress Reports. Geneva: UNISDR; 2010. Available at: URL: http://www. preventionweb.net/ english/hyogo/progress/?pid:181&pil:1. Accessed Feb 25, 2010.##15. Framework S. Sendai Framework for Disaster Risk Reduction 2015–2030. Australian Journal of Emergency Management. 2015; 30.3. Available at: URL: https://knowledge.aidr.org.au/resources/ajem-jul-2015-sendai-framework-for-disaster-risk-reduction-2015-2030/##16. Plan and Budget Organization. Law on the Sixth Five-Year Economic, Cultural and Social Development Plan for 1396-1400 - Sixth Five-Year Development Plan (2016-2021). Available at: URL: http://www.mporg.ir/FileSystem/View/File.aspx?FileId=ccd382df-13d3-459f-a691-008611f18a80. [Persian]##17. Nazari S, Sharififar ST, Ahmadi Marzaleh M, et al. Structure of Prehospital Rapid Response Teams to Chemical, Biological, Radiation and Nuclear Accidents in Iran, A Qualitative Study. Payavard Salamat. 2023; 17(1): 86-96.##18. Ciottone Gregory R. Ciottone's Disaster Medicine. Elsevier Health Sciences; 2015. Available at: URL: https://shop.elsevier.com/books/ciottones-disaster-medicine/ciottone/978-0-323-80932-0 ##19. International Atomic Energy Agency. Medical management of radiation injuries. Safety Reports Series No. 101, IAEA, Vienna; 2020. Available at: URL: https://www.iaea.org/publications/12370/medicalmanagement- of-radiation-injuries. Accessed December 15, 2022.##20. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. International journal of surgery. 2010; 8(5): 336-41.##21. Shamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ (Clinical research ed). 2015; 349: g7647.## ##

A Study on Prevalence and Pattern of Tobacco Usage among Adults in Manikeshwari, Kalaburagi, Karnataka, India: A Cross-Sectional Study 2 2 Background: Tobacco use in India is a significant public health challenge, contributing to high morbidity and mortality. Despite strict regulations, widespread cultural acceptance and accessibility continue to drive its prevalence across diverse population groups. The objective is to estimate prevalence of tobacco, its usage patterns, and their socio-demographic associations among adults in Manikeshwari, Kalaburagi.” Methods: A cross-sectional study was conducted for 2 months among adults residing in Manikeshwari using a pre-tested questionnaire administered through face-to-face interviews. The sample size of 350 was calculated based on a 33.5% prevalence in Kalaburagi, with participants selected through cluster sampling. Data from 310 participants were analyzed for completeness using Jamovi software. Results:  Among 310 participants, 41.9% had used tobacco at least once, with 29.7% currently using it. Most smokers (54.9%) commenced between 20 and 30, whereas 23.6% started earlier. 47.6% of users had been consuming tobacco for less than 10 years. Smokeless tobacco was utilized by 63% of the participants. With addiction as the main hurdle (48.9%), only 13.9% of current users are willing to quit. Smoking was found to be associated with gender (p-value: <0.001), religion (p-value: 0.02), marital status(p-value:<0.03), education(p-value:<0.001), and occupation(p-value:<0.001). Conclusion: The study shows high tobacco use, mainly smokeless forms, starting in early adulthood, influenced by demographic and socio-cultural factors. Targeted interventions and stricter enforcement of sales bans and no-tobacco zone regulations are recommended. 182 191 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/17 1403/11/29 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/16 1404/4/25 Sangita S Sangita S Department of Community Medicine, Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka, India India sangitasivarman@gmail.com Kuldeep Jagannath Dabade Kuldeep Jagannath Dabade Department of Community Medicine, Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka, India India dr.kuldeepdabade@gmail.com Meenakshi.M Dhadave Meenakshi.M Dhadave Department of Community Medicine, Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka, India India msdmrmc@gmail.com Ajaykumar G Ajaykumar G Gulbarga Institute of Medical Sciences, Kalaburagi, Karnataka, India India g_kumarajay@hotmail.com Tobacco prevalence pattern Kalaburagi 1. Gupta A, Grover S, Sakrawal K, et al. Prevalence, Patterns, and Predictors of Tobacco Consumption among Adolescents: An Observational Study from a Rural area of Rajasthan. Indian Journal of Community Medicine. 2023; 48(5): 748-54.##2. Pahari S, Barman D, Talukdar R. Tobacco usage in India: A meta‐analysis of evidence drawn from regional studies between 2010 and 2022. Tropical Medicine & International Health. 2023; 28(9): 699-709.##3. Chawla A. The worrying patterns of tobacco consumption in India. Centre for Economic Data and Analysis (CEDA), Ashoka University; 2022. Available at: URL: ceda.ashoka.edu.in##4. Shah S, Dave B, Shah R, et al. Socioeconomic and cultural impact of tobacco in India. Journal of family medicine and primary care. 2018; 7(6): 1173-6.##5. Hosseinpoor AR, Parker LA, Tursan d'Espaignet E, et al. Social determinants of smoking in low-and middle-income countries: results from the World Health Survey. PloS one. 2011; 6(5): e20331.##6. Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA. 2014; 311(2): 183-92.##7. Kulkarni RR, Kumar Y, Patil S. Prevalence of geriatric tobacco use in an urban slum of Belagavi, Karnataka. International Journal of Advanced Community Medicine 2019; 2(1): 01-04.##8. Mini GK, Sarma PS, Thankappan KR. Pattern of tobacco use and its correlates among older adults in India. Asian Pacific Journal of Cancer Prevention. 2014; 15(15): 6195-8.##9. National Family Health Survey (NFHS-5) 2019-21. Available at: URL: https://dhsprogram.com/pubs/pdf/FR375/FR375.pdf. Accessed 11 June, 2024. ##10. Patil AP, Khona PP, Patil M. Prevalence of tobacco consumption in an urban area Belgaum, Karnataka, India. Int J Community Med Public Health. 2016; 3(11): 3059-62.##11. Mini GK, Sarma PS, Thankappan KR. Pattern of tobacco use and its correlates among older adults in India. Asian Pacific Journal of Cancer Prevention. 2014; 15(15): 6195-8.##12. World Health Organization. Global Report on Trends in Prevalence of Tobacco Smoking. Geneva: World Health Organization; 2015. Available at: URL: https://www.who.int/tobacco/global_report/en/##13. Maheshwari V, Sodhi B, Sharma R, et al. Determinants of tobacco use patterns and predictors of quit among older women in India: Findings from the study on global aging and adult health. Pneumon. 2024; 37(1): 1.##14. Rani M, Bonu S, Jha P, et al. Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey. Tobacco control. 2003; 12(4).##15. Sukumar GM, Banandur P, Dagar V, et al. Prevalence and factors associated with tobacco use among beneficiaries attending the youth mental health promotion clinics (Yuvaspandana Kendra) in India: A case-record analysis. Tobacco Prevention & Cessation. 2022; 8.##16. Viswanathan A, Doddamani A, Praharaj SK, et al. Substance Use Among People Seeking Health Care Services in Primary Health Care Settings in Coastal Karnataka. Indian Journal of Psychological Medicine. 2024; 46(6). ##17. Nichter M, Nichter M, Carkoglu A. The Tobacco Etiology Research Network. Reconsidering stress and smoking: a qualitative study among college students. Tob Control. 2007; 16(3): 211-214.##18. Sreedevi A, Majumdar A, Olando Y, et al. Experiences and Beliefs on Tobacco Use, Cessation in India: A Qualitative Study. Global Heart. 2023; 18(1).##19. Gupta R, Pednekar MS, Kumar R, et al. Tobacco cessation in India–Current status, challenges, barriers and solutions. Indian Journal of Tuberculosis. 2021; 68: S80-5.##20. Chockalingam K, Vedhachalam C, Rangasamy S, et al. Prevalence of tobacco use in urban, semi urban and rural areas in and around Chennai City, India. PLoS One. 2013; 8(10): e76005.##21. Ahammed B, Maniruzzaman M, Kundu S, et al. 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Psychological Factors, Sleep Quality, and Injury Prevalence among Iranian Taekwondo Athletes (November–December 2023): A Cross-Sectional Study 2 2 Background: This study investigated the prevalence of injuries among Taekwondo athletes, with specific emphasis on psychological attributes, namely competitive anger and aggression, as well as sleep quality. Although these factors are recognized contributors to sports-related injury risk, their association with Taekwondo-specific injuries remains insufficiently explored. The research aimed to identify injury patterns and evaluate the relationships between these psychological constructs, sleep quality, and injury incidence to guide targeted prevention and management approaches. Methods: A cross-sectional survey was administered in Tehran between November and December 2023 to 201 Iranian Taekwondo practitioners. Participants completed a validated Farsi-language online questionnaire capturing demographic information, training characteristics, scores on the 12‑item Competitive Aggressiveness and Anger Scale (CAAS), the 19‑item Pittsburgh Sleep Quality Index (PSQI), and self-reported musculoskeletal injuries over the preceding six months. Data analyses employed descriptive statistics and multivariable logistic regression to determine independent predictors of injury. Results: Among respondents, 118 athletes (58.7%) reported at least one injury, most commonly involving the ankle (20.6%) and foot/toe (17.6%). Adjusted regression analyses revealed that each one‑point increase in CAAS score was associated with greater injury risk (OR = 1.23; 95% CI 1.11–1.36; p < 0.001), as was each one‑point increase in PSQI score (OR = 1.12; 95% CI 1.05–1.38; p = 0.006). Training more than three sessions per week (OR = 4.01; 95% CI 1.93–8.33; p < 0.001) and session durations exceeding 60 minutes (OR = 2.27; 95% CI 1.07–4.84; p = 0.032) were also independent predictors. Conclusion: The findings underscore the need to systematically assess competitive aggressiveness, anger, sleep quality, and training load when formulating injury prevention and management strategies for Taekwondo athletes.   192 204 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/172025/03/11 1403/12/21 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/162025/07/26 1404/5/4 Ali Asghar Maleki Ali Asghar Maleki Department of Sport Injuries and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran Iran ali.asghar.maleki@ut.ac.ir Roqayeh Mohammadi Roqayeh Mohammadi Department of Sport Injuries and Biomechanics, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran Iran Roqayeh.mohammadi@ut.ac.ir Hassan Gharayagh Zandi Hassan Gharayagh Zandi Department of Behavioral and Cognitive Science, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran Iran ghzandi110@ut.ac.ir Athletic injuries Aggression Anger Sleep quality Risk factors 1. 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Architecture and Urban Design for Social Health: A Two-Decade Global Systematic Review 2 2 Background: Social health is a crucial yet underexplored dimension of human well-being, particularly in architecture and environmental design. While the links between design and physical or mental health have been widely studied, the social dimension remains insufficiently addressed. This review examines how architectural and urban design influence social health outcomes globally from 2002 to 2024. Methods: This systematic review followed the PRISMA protocol. Peer-reviewed articles were retrieved from Scopus, Web of Science, PubMed, and Google Scholar using Boolean keywords (e.g., “design*” AND “social health”). After screening 16,402 initial records, 44 studies from 14 countries and 31 journals met the inclusion criteria. Eligible studies empirically assessed environmental design factors in relation to social health indicators in real-world settings. Results: Key design features positively linked to social health include access to green and blue spaces, walkability, aesthetics, public safety, mixed land use, spatial layout, and third places. Common social outcomes were enhanced interaction, cohesion, trust, and sense of belonging. The majority of studies focused on outdoor spaces, with fewer addressing interior environments. Conclusion: The built environment significantly shapes social well-being. However, notable research gaps persist, especially in non-Western and indoor contexts. Future studies should apply mixed methods, include diverse cultural settings, and develop standardized frameworks to evaluate the social impacts of design.   205 221 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/172025/03/112025/05/13 1404/2/23 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/162025/07/262025/08/18 1404/5/27 Mahdiye Barkhordari Firouzabadi Mahdiye Barkhordari Firouzabadi 1. Department of Architecture, Institute of Society and Media, ISF.c., Islamic Azad University, Isfahan, Iran 2. Architecture and Urban Research Center, ISF.c., Islamic Azad University, Isfahan, Iran Iran mahdiyebarkhordari@yahoo.com Sanaz Rahravi Poodeh Sanaz Rahravi Poodeh 1. Architecture and Urban Research Center, ISF.c., Islamic Azad University, Isfahan, Iran 2. Department of Architecture, Institute of Society and Media, ISF.c., Islamic Azad University, Isfahan, Iran Iran s_rahravi@iau.ir Seyedeh Marzieh Tabaeian Seyedeh Marzieh Tabaeian 1. Architecture and Urban Research Center, ISF.c., Islamic Azad University, Isfahan, Iran 2. Department of Architecture, Institute of Society and Media, ISF.c., Islamic Azad University, Isfahan, Iran Iran marzieh.tabaeian1@gmail.com Seyed Alireza Afshani Seyed Alireza Afshani Department of Sociology, Social Sciences Faculty, Yazd University, Yazd, Iran Iran afshanialireza@yazd.ac.ir Environmental design social health architecture urban planning social well-being systematic review . World Health Organization. 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Designing a liveable compact city: Physical forms of city and social life in urban neighbourhoods. Built environment. 2010; 36(1): 63-80.##36. Abdollahi S, Waygood EO, Aliyas Z, et al. An overview of how the built environment relates to children’s health. Current environmental health reports. 2023; 10(3): 264-77.##37. Alidoust S, Holden G, Bosman C. Urban environment and social health of the elderly: A critical discussion on physical, social and policy environments. Athens journal of health. 2014; 1(3): 169-80.##38. Bhuyan MR, Yuen B. Older adults’ views of the connections between neighbourhood built environment and health in Singapore. Journal of Population Ageing. 2022; 15(1): 279-99.##39. Kemperman A, Timmermans H. Green spaces in the direct living environment and social contacts of the aging population. Landscape and urban planning. 2014; 129: 44-54.##40. Rahnama MR, Shaddel L. Assessment of Spatial Relationship between Social Health in Women of Mashhad and Urban Green Spaces: What Factors Affect Their Presence in Urban Green spaces?. Human Geography Research. 2022; 54(1): 45-65. [Persian].##41. Colenberg S, Appel-Meulenbroek R, Romero Herrera N, et al. Conceptualizing social well-being in activity-based offices. Journal of Managerial Psychology. 2021; 36(4):327-43.##42. Arbuthnott KD. Nature exposure and social health: Prosocial behavior, social cohesion, and effect pathways. Journal of Environmental Psychology. 2023; 90: 102109.##43. Bris P, Bendito F. Impact of Japanese post-disaster temporary housing areas’(THAs) design on mental and social health. International journal of environmental research and public health. 2019; 16(23): 4757.##44. Dreyer BC, Coulombe S, Whitney S, et al. Beyond exposure to outdoor nature: exploration of the benefits of a green building’s indoor environment on wellbeing. Frontiers in psychology. 2018; 9: 1583.##45. Huang W, Lin G. The relationship between urban green space and social health of individuals: A scoping review. Urban forestry & urban greening. 2023; 85: 127969.##46. Irvine KN, Warber SL. Greening healthcare: Practicing as if the natural environment really mattered. Alternative Therapies in Health and Medicine. 2002; 8(5): 76.##47. Lee Y, Hwang J, Lim S, et al. Identifying characteristics of design guidelines for elderly care environments from the holistic health perspective. Indoor and built environment. 2013; 22(1):242-59.##48. Li H, Luo W, Hou Y, et al. Factors affecting perceived health benefits and use behaviors in urban green spaces during the COVID-19 pandemic in Southern China megacities. Frontiers in public health. 2021; 9: 759444.##49. Liu W, Zheng S, Hu X, et al. Effects of spatial scale on the built environments of community life circles providing health functions and services. Building and Environment. 2022; 223: 109492.##50. Ma L, Shi W, Wu L. Mediating roles of perceptions and visiting behavior in the relationship between urban greenspace accessibility and personal health: Evidence from Lanzhou, China. Applied Geography. 2023; 159: 103085.##51. Rafi Far j, Shukri S. Sustainable architecture and social health (research case: Chaharsed Dazat neighborhood in Tehran). Sociological studies. 2014; 21(2): 31-42 [Persian].##52. Rahimi Fard F, Zamani B. Comparative comparison of the role of physical-environmental factors on the level of social health in two traditional and new neighborhoods (case study: Dardasht and Molla Sadrai neighborhoods of Isfahan). Urban Studies Quarterly. 2019; 8(29): 99-110 [Persian].##53. Rice L, Drane M. Indicators of healthy architecture—a systematic literature review. Journal of urban health. 2020; 97(6): 899-911.##54. Stuckey HL, Nobel J. The connection between art, healing, and public health: A review of current literature. American journal of public health. 2010; 100(2): 254-63.##55. Warner E, Sutton E, Andrews F. Cohousing as a model for social health: A scoping review. Cities & Health. 2024; 8(1): 107-19.##56. Zutter C, Stoltz A. Community gardens and urban agriculture: Healthy environment/healthy citizens. International journal of mental health nursing. 2023; 32(6): 1452-61.## ##

Prehospital Emergency Preparedness in Radiological and Nuclear Incidents: Letter to the Editor 2 1   2 No Abstract   222 224 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/172025/03/112025/05/132025/09/16 1404/6/25 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/162025/07/262025/08/182025/09/30 1404/7/8 Somayeh Yadollahifar Somayeh Yadollahifar Department of Health in Disaster and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran yadollahifar@yahoo.com Mohsen Aminizadeh Mohsen Aminizadeh Department of Medical Emergencies, Sirjan School of Medical Sciences, Sirjan, Iran Iran mohsen.aminizadeh@gmail.com Samaneh Mirzaei Samaneh Mirzaei Department of Health in Disaster and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran s.mirzaei2113@gmail.com Emergency medical service Radiation accident nuclear accidents CBRN events 1. Blumenthal DJ, Bader JL, Christensen D, et al. A sustainable training strategy for improving health care following a catastrophic radiological or nuclear incident. Prehospital and disaster medicine. 2014; 29(1): 80-6.##2. Wilson MH, Habig K, Wright C, et al. Pre-hospital emergency medicine. The Lancet. 2015; 386(10012): 2526-34.##3. Maegele M. Prehospital care for multiple trauma patients in Germany. Chinese Journal of Traumatology. 2015; 18(03): 125-34.##4. Nazari S, Sharififar ST, Ahmadi Marzaleh M, et al. Structure of Pre-Hospital Rapid Response Teams to Chemical, Biological, Radiation and Nuclear Accidents in Iran, A Qualitative Study. Payavard Salamat. 2023; 17(1): 86-96. [Persian] ##5. Yusof MA, Ali HM. Radiological emergency: Malaysian preparedness and response. Radiation protection dosimetry. 2011; 146(1-3): 41-8. [Persian]##6. Liu Y, Lei C, Qin B, et al. Medical preparedness for radiation emergency for the Olympic Games, Beijing 2008. Health physics. 2010; 98(6): 784-7. ##7. Liutsko L, Montero M, Trueba C, et al. Stakeholder participation in nuclear and radiological emergency preparedness and recovery in Spain: benefits and challenges of working together. Journal of Radiological Protection. 2020; 40(1): N1.##8. Geysmans R, Zeleznik N, Abelshausen B, et al. Broadening and strengthening stakeholder engagement in emergency preparedness, response and recovery. Radioprotection. 2020; 55(2): S219-25.##9. Stenke L, Von Schreeb J, Simonsson M, Johansson J, Postgård P, Sigurdsson S, Ljungquist Å, Lagergren Lindberg M. Lessons Learnt from the Fukushima Accident—A Swedish Medical Preparedness Perspective. Radiation Protection Dosimetry. 2016; 171(1): 134-8.##10. Yadollahifar S, Aminizadeh M, Nasiriani K, et al. Identifying the components of prehospital emergency preparedness in radiological and nuclear incidents: a scoping review. BMC Emergency Medicine. 2025; 25(1): 100. [Persian]## ##

The Importance of Healthcare Sector Preparedness against Terrorist Incidents with Chemical Weapons of Mass Destruction: Recommendations 2 1   2 No Abstract 225 227 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/172025/03/112025/05/132025/09/162025/07/13 1404/4/22 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/162025/07/262025/08/182025/09/302025/09/7 1404/6/16 Zoha Dorri Zoha Dorri Department of Health in Disaster and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran Zoha.dori@gmail.com Samaneh Mirzaei Samaneh Mirzaei Department of Health in Disaster and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran Iran s.mirzaei2113@gmail.com Leila Mohammadinia Leila Mohammadinia 1. Emergency ;Trauma Care Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2.Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran Dr.mohammadinial@gmail.com Preparedness Terrorist incidents Chemical weapons of mass destruction 1. Okoro OI, Oluka NL. Weapons of mass destruction and modern terrorism: implications for global security. Asian Social Science. 2019; 15(3): 1-13.##2. Dudley JP. New challenges for public health care: Biological and chemical weapons awareness, surveillance, and response. Biological research for nursing. 2003; 4(4): 244-50.##3. Cavalcante SFdA, Simas AB, Barcellos MC, et al. Acetylcholinesterase: The “hub” for neurodegenerative diseases and chemical weapons convention. Biomolecules. 2020; 10(3): 414.##4. Seyedin H, Moradimajd P, Bagheri H, et al. Providing a chemical events and threatâ s preparedness model for hospitals in the country: A qualitative study. Journal of military medicine. 2022; 23(3): 220-7. [Persian]##5. Amiresmaili M, Talebian A, Miraki S. Pre-hospital emergency response to terrorist attacks: A scoping review. Hong Kong Journal of Emergency Medicine. 2022; 29(1): 56-62. [Persian]##6. Marzaleh MA, Rezaee R, Rezaianzadeh A, et al. Emergency department preparedness of hospitals for radiation, nuclear accidents, and nuclear terrorism: a qualitative study in Iran. Iranian Red Crescent Medical Journal. 2019; 21(5). [Persian]##7. Miraki S, Molavi-Taleghani Y, Amiresmaeili M, et al. Design and validation of a preparedness evaluation tool of pre-hospital emergency medical services for terrorist attacks: a mixed method study. BMC emergency medicine. 2022; 22(1): 154. [Persian]##8. Farhat H, Alinier G, Chaabna K, et al. Preparedness and emergency response strategies for chemical, biological, radiological and nuclear emergencies in disaster management: a qualitative systematic review. Journal of Contingencies and Crisis Management. 2024; 32(3): e12592.##9. Mehri S, Habibi Soola A, Mohammadi M-A, et al. Exploring managers’ experiences of hospital disaster preparedness: A qualitative study. J Qual Res Health Sci. 2022; 11(3): 156-63. [Persian]##10. Qzih ES, Ahmad MM. Hospital-based preparedness measures for CBRNE disasters: A systematic review. Environmental Health Insights. 2024; 18: 11786302241288859.##11. Aminizadeh M, Farrokhi M, Ebadi A, et al. Hospital preparedness challenges in biological disasters: A qualitative study. Disaster Medicine and Public Health Preparedness. 2022; 16(3): 956-60. [Persian]##12. Baikmohammadi S, Amirheidari B, Dehesh T, et al. A qualitative study on barriers and strategies to hospital preparedness against chemical, biological, radiological, and nuclear incidents. Journal of Education and Health Promotion. 2024; 13(1): 3. [Persian]##13. Balachandar KG. Management of chemical terrorism and chemical disasters. International Journal of Disaster Management. 2021; 4(3): 51-64.##14. Miraki S, Sabet HR, Farahmandnia H. Design and Validation of Prehospital Emergency Preparedness Evaluation Tool for Terrorist Attacks in Iran: A Study Protocol. Health Management & Information Science. 2023; 10(3): 139-47. [Persian]##15. Zibasokhan S, Teymouri F, Sharififar S, et al. Factors Influencing the Integrated Management of Chemical Terrorist Incidents. Iranian Journal of War and Public Health. 2024; 16(4): 309-17. v##16. Mohammadi S, Aminisaman J, Karimpour H, et al. Assessing of preparedness for disasters and crisis in centers of trauma and accidents of Kermanshah university of medical sciences in 2016; 2017. [Persian]##17. Keshvari M, Shirdel A, Taheri Mirghaedi M, et al. Challenges in the optimal management of human resources in hospitals: A qualitative study. Journal of Qualitative Research in Health Sciences. 2018; 7(4): 349-60. [Persian]##18. Phattharapornjaroen P, Carlström E, Atiksawedparit P, et al. The impact of the three-level collaboration exercise on collaboration and leadership during scenario-based hospital evacuation exercises using flexible surge capacity concept: a mixed method cross-sectional study. BMC Health Services Research. 2023; 23(1): 862.##19. Farhat H, Laughton J, Gangaram P, et al. Hazardous material and chemical, biological, radiological, and nuclear incident readiness among prehospital care professionals in the State of Qatar. Global Security: Health, Science and Policy. 2022; 7(1): 24-36.## ##

Knowledge, Attitude, and Practice of Students from Kurdistan University of Medical Sciences regarding Fire Safety in 2023: A Cross-Sectional Study 2 2 Background: Fire is a significant disaster that poses a threat to people's lives, properties, and overall well-being. The level of awareness within a community plays a crucial role in effective handling of fire incidents. This research aims to assess knowledge, attitude, and practice of students at Kurdistan University of Medical Sciences concerning fire safety. Methods: This was a cross-sectional descriptive study conducted in 2023 among the students studying medical sciences in Kurdistan. The sample size consisted of 250 participants, and data were collected using a researcher-made questionnaire consisting of four parts: demographic information, knowledge, attitude, and practice. Data analysis was performed using SPSS24, employing descriptive statistics, independent t-tests, and ANOVA. Results: The mean and standard deviation of knowledge, attitude, and performance scores were 23.28 ± 4.31, 21.53 ± 8.36, and 23.04 ± 4.94, respectively, and the average scores of knowledge, attitude, and performance were reported in 24.56%, 32.59%, and 41.05% of the participants. The results indicated a statistically significant relationship between the average knowledge score and gender and educational level (p < 0.05). The primary sourceof information about fire for students was the Internet, followed by professors and academic units’ views. Conclusion: The findings of this study reveal an average level of knowledge, attitude, and performance among students regarding fire safety, and the obtained scores are considered inadequate for educated and young individuals in the country. It is recommended to develop suitable educational programs that encompass both theoretical knowledge and practical exercises (maneuvers) to enhance awareness, foster the right attitude, and improve practice. These educational programs should be conducted regularly to minimize forgetfulness in this context. 228 234 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/172025/03/112025/05/132025/09/162025/07/132025/07/11 1404/4/20 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/162025/07/262025/08/182025/09/302025/09/72025/12/19 1404/9/28 Ameneh Marzban Ameneh Marzban Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Iran amenemarzban@yahoo.com Soheil Golzarhamid Soheil Golzarhamid Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Iran golzarsoheil9@gmail.com Boshra Ebrahimy Boshra Ebrahimy Department of Emergency Medical Sciences, School of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran Iran BOSHAR541@yahoo.com Golnaz Azami Golnaz Azami Department of Emergency Medical Sciences, School of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran Iran AZAMI5412@yahoo.com Payam Emami Payam Emami Department of Emergency Medical Sciences, School of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran Iran payamemami115@gmail.com Knowledge Attitude Practice Student Fire safety 1. Dargahi A, Bagheri S, Poursadeghiyan M, et al. Knowledge and attitudes of students in Khalkhal medical sciences faculty on health actions in emergencies. Health in Emergencies and Disasters Quarterly. 2017; 3(1): 51-6. [Persian]##2. Arghami S, Javadi N, Jafari Z. Survey of Students' Knowledge on methods of Fire Control. Iran Occupational Health. 2015; 12(4): 56-64. [Persian]##3. Rezaei F, Mohebbi-Dehnavi Z. Evaluation of the readiness of hospitals affiliated to Isfahan University of Medical Sciences in unexpected events in 2017. Journal of education and health promotion. 2019; 8. [Persian]##4. Abdollahi T, Entezari A, Vali Esfahani M, et al. Investigating the Knowledge of Operating Room Personnel on Combustion Sources and Its Prevention Methods in the Operating Rooms of Shahid Sadoughi University of Medical Sciences, Yazd, 2017: A Short Report. Journal of Rafsanjan University of Medical Sciences. 2019; 18(5): 497-504. [Persian]##5. Fallahi A. Reducing the vulnerability of shahid beheshti university dormitories to the risks of fire and earthquake. Soffeh. 2014; 24(4): 77-100. [Persian]##6. Sahebi A, Jahangiri K, Alibabaei A, et al. Factors affecting emergency evacuation of Iranian hospitals in fire: a qualitative study. Journal of education and health promotion. 2021; 10. [Persian]##7. Delshad V, Borhani F, Khankeh HR, et al. Early warning system and disaster preparedness in motahari hospital. Journal of Research Development in Nursing and Midwifery. 2015; 12(2): 51-8. [Persian]##8. Amasi AS. Assessment of Awareness, Knowledge and Attitude on Impacts of Fire Outbreak to Standard Seven Pupils at Morogoro Municipal and Mvomero District, Tanzania: The Open University of Tanzania; 2021.##9. Mihanpor H. Examining the level of knowledge, attitude and performance of Shiraz urban train personnel about fire and its extinguishing methods in 2015. Safe Society Summit and the first Mashhad Safe Society Regional Summit; 2017. [Persian]##10. Jalali H, Asl EB, Mehr AM, et al. Prevention and control of operating room fires: Knowledge of staff employed by selected hospitals of Isfahan University of Medical Sciences. Asian Journal of Nursing Education and Research. 2016; 6(3): 342-6. [Persian]##11. Musigapong P, Phanprasit W. Knowledge, attitudes and practices relating to fire prevention among students in the elementary schools of Muang Nakhon Ratchasima, Thailand. Journal of Educational and Social Research. 2013; 3(7): 288.##12. Yeturu SK, Annapurani R, Janakiram C, et al. Assessment of Knowledge and Attitudes of Fire Safety-An Institution Based Study. Journal of Pharmaceutical Sciences and Research. 2016; 8(11): 1281.##13. Davoodiantalab A, Zadeh F, Moshkani M, et al. Evaluation of awareness concerning fire prevention and control methods among personnel of operating room in a hospital. J Health Saf Work. 2012; 1: 69-78. [Persian]##14. Morrongiello BA, Schwebel DC, Bell M, et al. An evaluation of The Great Escape: can an interactive computer game improve young children's fire safety knowledge and behaviors? Health psychology. 2012; 31(4): 496.##15. Karemaker M, Ten Hoor GA, Hagen RR, et al. Elderly about home fire safety: A qualitative study into home fire safety knowledge and behaviour. Fire safety journal. 2021; 124: 103391.##16. Rahim NA, Taib M, Mydin MO, editors. Investigation of fire safety awareness and management in mall. MATEC Web of Conferences; 2014: EDP Sciences [Persian]##17. DeChamplain A, Rosendale E, McCabe I, et al editors. Blaze: A serious game for improving household fire safety awareness. 2012 IEEE International Games Innovation Conference; 2012: IEEE.##18. Kim S-S, Kong H-S. The effect of safety education satisfaction of apartment residents and application of fire protection plan on fire safety awareness. Fire Science and Engineering. 2020; 34(1): 103-14.##19. Baek E-S, Baek G-J, Shin H, et al. A study on the awareness of fire safety and evacuation guide system. Fire Science and Engineering. 2010; 24(6): 45-53.##20. Hong Y-H. Awareness on middle and high school teachers for fire safety education. Journal of the Korea Academia-Industrial cooperation society. 2019; 20(8): 586-93.## ##

Quality Assessment of Services Provided by Comprehensive Health Centers in Birjand (East of Iran) Based on SERVQUAL Model 2 2 Background: Health centers play an important role in improving the health of society in the structure of the health system in Iran. This study was conducted to evaluate the quality of health services based on SERVQUAL Model (Service Quality Model) in Birjand Comprehensive Health Centers based on the perspective of the clients in 2021. Methods: In this cross-sectional (descriptive-analytical) study, 257 health service users referring to Birjand Comprehensive Health Centers participated. The sampling method was a quota from 8 Comprehensive Health Centers in Brijand. Demographic characteristics and SERVQUAL questionnaire were completed by the participants. Furthermore, data were analyzed using Mann-Whitney U, Wilcoxon, and Kruskal-Wallis tests at a significant level of 0.05 in SPPS (16) software. Results: The average scores of health service users’ perceptions and expectations were 5.80 ± 0.56 and 6.14 ± 0.37, respectively. The average score of the gap between perceptions and expectations was also -0.34 ± 0.64. There was a significant difference between the average score of perceptions and expectation of service quality. Conclusion: Due to the gap between perceptions and expectations of service quality, it seems that the health system policymakers should plan a program in order to improve the quality of services based on the factors affecting the quality of services. 235 241 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/172025/03/112025/05/132025/09/162025/07/132025/07/112024/10/13 1403/7/22 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/162025/07/262025/08/182025/09/302025/09/72025/12/192025/11/5 1404/8/14 Zahra Yoosefi Zahra Yoosefi Department of Pediatric, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran Iran z.yoosefi.2015@gmail.com Dorsa Abbasi Dorsa Abbasi Student Research Committee, Birjand University of Medical Sciences (BUMS), Birjand, Iran Iran dorsa.abbasi.82@gmail.com Mohammad Hassan Zangouei Dovvom Mohammad Hassan Zangouei Dovvom Department of Educational Sciences, Farhangian University, Tehran, Iran Iran h.zangoei2@gmail.com Bita Bijari Bita Bijari Cardiovascular Diseases Research Center, Department of Community Medicine, Birjand University of Medical Sciences (BUMS), Birjand, Iran bita.bijari@yahoo.com SERVQUAL Model Health Centers Quality ## ##

The Future Biostatistics and Epidemiology in the Age of Artificial Intelligence 2 2 No Abstract 242 243 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/172025/03/112025/05/132025/09/162025/07/132025/07/112024/10/132025/10/6 1404/7/14 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/162025/07/262025/08/182025/09/302025/09/72025/12/192025/11/52025/11/17 1404/8/26 Maedeh Arshadi Maedeh Arshadi Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran maedeharshadi@gmail.com Farzan Madadizadeh Farzan Madadizadeh Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Iran madadizadehfarzan@gmail.com Artificial intelligence (AI) Biostatistics Epidemiology ## ##

Community Health Nursing and Artificial Intelligence: Empowering Data-Driven Interventions and Personalized Care 2 2 No Abstract 244 245 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/172025/03/112025/05/132025/09/162025/07/132025/07/112024/10/132025/10/62023/08/29 1402/6/7 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/162025/07/262025/08/182025/09/302025/09/72025/12/192025/11/52025/11/172022/12/19 1401/9/28 Mahsa Boozari Pour Mahsa Boozari Pour Department of Medical Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran emami.payam@sbmu.ac.ir Mina Moafi Mina Moafi Department of Community Health, Tehran University of Medical Sciences, Tehran, Iran Iran mina.moafi.nurse@gmail.com Payam Emami Payam Emami Department of Emergency Medical Sciences, Faculty of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran Iran emami.payam@sbmu.ac.ir Community Health Nursing Artificial Intelligence 1. Hosseinnejad A, Rassouli M, Jahani S, et al. Community Health Nursing in Iran: A Review of Challenges and Solutions (An Integrative Review). Frontiers in Public Health. 2022; 10: 899211. [Persian]##2. Kuo C-P, Hsieh P-L, Chen H-M, et al, editors. Community health nursing competency and psychological and organizational empowerment of public health nurses: A cross-sectional survey. Healthcare; 2021: MDPI.##3. Davenport T, Kalakota R. The potential for artificial intelligence in healthcare. Future Healthcare Journal. 2019; 6(2): 94.##4. Robert N. How artificial intelligence is changing nursing. Nursing management. 2019; 50(9): 30.##5. Javaid M, Haleem A, Singh RP, et al. Significance of machine learning in healthcare: Features, pillars, and applications. International Journal of Intelligent Networks. 2022; 3: 58-73.## ##

Prevalence and Causes of Smoking Tendency in High School Students in Yazd, Iran 2 2 Background: Tendency to smoke is one of the most important social problems and harms. The aim of this study was to determine the prevalence and causes of smoking in high school students in Yazd province and to study some of the factors affecting it. Methods: This was descriptive-analytical cross-sectional study with a statistical population of 455 high school students in Yazd who were selected by cluster-random sampling. Research data were collected using a researcher-made questionnaire. Results: In this study, 34.7% of students had a history of smoking, and the age of the first experience of smoking was 15-20. 20.7% smoked cigarettes through others, and 14% smoked their first cigarette. 13.8% believed that the reason for smoking their first cigarette was imitation of others, and 8.8% believed in becoming more mature and beautiful. 15.8% of the students were currently smoking, of whom 9.7% was for hoby and occasionally, and 12.7% was through friends. 23.7% of students had a history of alcohol consumption. The most sources of information about smoking were family, cyberspace, and friends, respectively. 55.6% of students found smoking cessation difficult, and 89.2% of students believed that smoking was harmful. 62.4% did not believe that smoking was a risk factor for coronary heart disease, and 37.6% did not believe that smoking was a risk factor for coronary heart disease. Conclusion: Due to the relatively high frequency of smoking (about one sixth) among high school students, educational programs should be done since adolescence, and because family, cyberspace, and friends were the most important source of information about smoking, so appropriate education can be very effective. 246 254 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/172025/03/112025/05/132025/09/162025/07/132025/07/112024/10/132025/10/62023/08/292025/08/10 1404/5/19 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/162025/07/262025/08/182025/09/302025/09/72025/12/192025/11/52025/11/172022/12/192025/12/11 1404/9/20 Mohtasham Ghafari Mohtasham Ghafari Department of Health Education & Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran mohtashamghaffari@yahoo.com Sakineh Rakhshanderou Sakineh Rakhshanderou Department of Health Education & Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran s_rakhshanderou@yahoo.com Salime Zare Abdollahe Salime Zare Abdollahe Department of MPH, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran salimezare2319@gmail.com Smoking - Students - Prevalence - Causes of tendency ## ##

Application of Time-Series SIR Models in Analyzing the COVID-19 Pandemic in Iran: A Case Study of Data from February 2020 to December 2023 2 2 Background: The COVID-19 pandemic underscored the critical need for advanced modeling approaches to elucidate transmission dynamics and inform public health strategy. This study employed a Time-Series Susceptible-Infected-Recovered (TSIR) model to quantitatively analyze the pandemic trajectory in Iran and estimate the time-varying basic reproduction number (R₀) from February 2020 to December 2023. Methods: In an analytical cross-sectional study, comprehensive national COVID-19 data were obtained from the Iranian Ministry of Health and validated international repositories. The TSIR framework was implemented using R software (v4.0.0) to estimate transmission parameters (β, γ) and reconstruct epidemic dynamics. Vaccination impact was assessed through comparative analysis of compartmental populations pre- and post-vaccination deployment. Results: Analysis of 1,373 surveillance days revealed 7,625,160 confirmed cases with 146,741 fatalities (CFR: 2%). The TSIR model demonstrated superior tracking of seven distinct epidemic waves, with R₀ estimates declining to 0.2 during 2022-2023. Statistical analysis confirmed significant compartmental shifts post-vaccination (p<0.001), indicating substantial intervention impact. Moreover, model validation showed robust performance across multiple epidemic phases. Conclusion: The TSIR model provides a validated framework for epidemic monitoring and evaluation of public health interventions in Iran. The sub-critical R₀ values observed during the study's conclusion reflect successful containment through combined vaccination and control measures. Therefore, integration of time-series epidemiological modeling into national surveillance systems is recommended for enhanced preparedness against future infectious disease threats.   255 263 2024/10/212024/10/222024/09/182024/10/152024/12/12024/11/262024/10/32024/11/162024/10/222024/11/172025/01/152025/03/102024/12/52024/11/122024/12/312024/12/272024/11/302025/01/132025/01/172025/02/152025/01/182024/12/132025/04/252025/02/172025/03/112025/05/132025/09/162025/07/132025/07/112024/10/132025/10/62023/08/292025/08/102025/11/9 1404/8/18 2024/12/292025/02/82025/01/182025/01/202025/01/272025/03/32025/02/22025/02/152025/02/82025/03/142025/04/82025/04/152025/03/32025/04/302025/04/262025/04/282025/03/272025/04/302025/04/82025/06/172025/02/272025/04/172025/08/12025/07/162025/07/262025/08/182025/09/302025/09/72025/12/192025/11/52025/11/172022/12/192025/12/112025/11/12 1404/8/21 Masoumeh Miri Masoumeh Miri Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran masoumehmiri93@gmail.com محمدحسن لطفی Mohammadhasan Lotfi Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mhlotfi56359@gmail.com Hosein Falahzadeh Hosein Falahzadeh Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran fallahzadeh.ho@gmail.com Farzan Madadizadeh Farzan Madadizadeh 1.Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran 2.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 COVID-19 Basic Reproduction Number Time Series Analysis SIR Model Iran Vaccination Coverage Epidemiological Modeling ## ##