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Background: The World Health Organization has identified leishmaniosis as one of the eight major tropical parasitic diseases in the world. Every year, from 0.7 million to 1.3 million new cases of cutaneous leishmaniasis (CL) are registered in the world. Cutaneous leishmaniasis is still a great health problem in Iran. Of the total annual cases of leishmaniasis in Iran, about 80% are related to rural cutaneous leishmaniasis, 5% to visceral leishmaniasis and the rest are related to urban cutaneous leishmaniasis. this study aimed to investigate the epidemiological factors in patients with cutaneous leishmaniasis. Methods: A total of 2119 patients afflicted with cutaneous leishmaniosis due to skin lesions were examined. The data were analyzed after entering the data into SPSS software, vol 26. Tables and graphs were used for displaying the qualitative variables; central indicators and dispersion were used for indicating quantitative variables, and chi-square test was used for analyzing the data. The level of P ≤ 0.05 was considered as the level of significance. Results: The mean age of 2119 patients was 28.32 ± 20.38 years. Furthermore, 65.2% of male patients and 34.8% of female ones were infected with the disease. As for the nationality of the patients, 81.8% of them were Iranians and 18.1% of them were Afghans, and 88.9% of them had a history of traveling to other areas. More than 51% of the cases occurred in the young age group, the age group of 21 to 30 years had the highest incidence (18.4%), and the incidence trend of the disease did not decrease. There was a statistically significant relationship between patients’ nationality and travel history, gender, and occupation (P = 0.0001). There was no statistically significant relationship between the incidence season and travel history (P = 0.221). Conclusions: Due to the patients’ travel to endemic areas, providing them with training on effective methods for preventing mosquito bites may have had a great impact on reducing the incidences of cutaneous leishmaniosis in travelers.

Background: There are scarce Iranian and worldwide research articles on designing the questionnaires of the factors influencing violence prevention. This indicates the need to design a specific questionnaire on factors affecting violence prevention and examine its psychometric properties before using it. Objectives: The present study aimed to design and evaluate psychometric properties (the reliability and validity) of factors affecting violence prevention questionnaire in female students. Methods: The current psychometric research was conducted in Rudsar, Iran during 2017 - 2018. In the first part (designing the questionnaire), data were collected from 50 participants by purposive sampling and using Waltz methodology. In the second part (evaluating psychometric properties of the questionnaire). The validity of the questionnaire was assessed using face, content, and structural validities. Reliability was evaluated using Cronbach’s alpha and intra-class correlation coefficient, and SPSS 20 software was used for data analysis. Results: The initial version of the questionnaire was designed with 212 items. After confirming the validity and reliability, the second version of the questionnaire was extracted with 56 items with an impact score of > 1.5 for all 56 items, the mean CVI = 0.94, and the mean CVR = 0.88. Concerning construct validity, 48 items were extracted with a predictive power of 38.16 based on exploratory factor analysis. The Internal Consistency of Reliability (α = 0.88; ICC = 0.92) was also confirmed. Conclusions: In general, the questionnaire represented acceptable reliability and validity for use in the student population. Therefore, the present questionnaire can predict the risk of violence against female adolescents.

Background: Family and parents’ supervision and performance affect the proper socialization process of adolescents and their behavioral development. Therefore, this qualitative study was conducted to examine the family factors affecting violence in adolescents. Materials and Methods: This qualitative study was conducted using the conventional qualitative content analysis method in 2017 in Roodsar. Data saturation was obtained with 50 individuals using 4 questions. The data were collected using in-depth interviews with purposive sampling among female primary and secondary school students as the main participants of the study and their teachers and family as contributors. All interviews were recorded and then typed. Data analysis was done continuously and simultaneously by collecting data using Lundman and Graneheimm constant comparative method. Results: Data analysis was conducted using the conventional qualitative analysis method resulted in the extraction of 357 primary codes, 21 sub-sub-categories, 4 sub-categories, and one main category. At the end of this stage, the family factors affecting the violence of adolescents in the whole family provided insecurity to the adolescents, and an insecure family was defined according to the findings as follows: "a broken family with incorrect parenting practices and open borders that provide an insecure environment for the student and lead to violent behavior in adolescent". Conclusions: According to the results of this study family factors are related to adolescent violence. Regarding the independence of adolescents at this age and the role of other socializing formal and informal institutions that affect adolescent behavior, the strong and influential role of the family on adolescent behavior is quite obvious.

Background: Sedentary occupations frequently expose employees to prolonged periods with poor posture, which has been considered as the cause of musculoskeletal disorder. Objectives: The study set out to identify the related factors of a taking healthy sitting posture in office workers. Methods: This qualitative study aimed to use the theoretical domains framework (TDF) to investigate perceived determinants to taking a proper sitting posture in office workers. Semi-structured interviews with 25 office workers according to purposive sampling was conducted with a convenience sample of university office workers in Iran. Recorded interviews were transcribed into MAXQDA version 10. Directed content analysis and framework analysis were used for drawing the 12 domains of the TDF. Results: Explored themes were mapped onto the TDF domains, including skills, knowledge, behavioral regulation, goals, environmental context and resources, social influences, beliefs about capability, intentions, emotion, beliefs about consequences, memory, and attention and reinforcement. Conclusions: This study is a theoretical starting point in making structured interventions to change improper sitting posture among office workers. Also, the identified factors provide organizational managers with a wide list of factors by which they can encourage their employees to use proper postures in the workplace, leading to a significant reduction in job absenteeism and insurance fees associated with health problems. In addition, this study enriches the literature by providing additional empirical evidence for the TDF theory.

Background: Breast cancer is one of the most common cancers among Iranian women. The early diagnosis of this disease can decrease the mortality rate and promote patient survival. Objectives: This study aimed at identifying the barriers to early detection of breast cancer in Iranian women. Methods: In this qualitative study, which was extracted from a large research project, an exploratory sequential mixed-methods design was used, and conventional content analysis was carried out. Twenty-one participants were selected by purposeful sampling (ten health professionals and 11 female patients with breast cancer). Data were collected through in-depth, semi-structured interviews from July 2018 to June 2019. Results: The content analysis revealed three major themes related to delay in presentation: individual barriers (limited/lack of knowledge, other life preferences, negative reactions to the disease, and belief in fate), environmental barriers (insufficient social support, inaccurate information sources, and alternative therapy recommendations), and organizational barriers (poor quality of health services, inadequate access to health services, and role of media in informing people). Conclusions: Various perceived barriers, at different levels, play influential roles in the patients’ early detection. Therefore, collaboration between public health professionals, healthcare providers, and policymakers seems necessary for reducing delays in presentation among women.

Background: Brucellosis is a major problem in many parts of the world, including Iran, where livestock are an important source of income and employment. Methods: This cross-sectional (descriptive-correlational) study enrolled individuals diagnosed with brucellosis from 2012 to 2016 and their information was available in the health center of Kermanshah province. Data were analyzed in SPSS software (version 21). Results: From all the patients with brucellosis (2714), 55.3% were male and 44.7% were female. Most of them were living in Kermanshah province, their mean age was 35.05 ± 17.35 years and the most common age group was 21 - 30 years. The most common route of transmission was consumption of contaminated dairy products (99.1%) and contact with livestock (99.71%). Musculoskeletal and back pain were the most commonly observed clinical signs (89.8%). There was a statistically significant difference between years of incidence and livestock vaccination history (P < 0.001). The highest number of patients wright test was in titer 1:160 (33.1%) and 2 ME test 1:80 (36.8%). Regarding the use of medication for treatment, most patients were prescribed combination of rifampin and co-trimoxazole (12.97%). Conclusions: Timely diagnosis, livestock vaccination, training and refraining from unpasteurized dairy products can be effective in preventing outbreaks of brucellosis.

Background: The rate of cigarette smoking has increased among students. Smoking prevention behavior has significant relationship with health literacy. Moreover, health literacy has potential effects on the constructs of the Health Belief Model (HBM). Objectives: This study aimed to determine the predictors of health literacy based on HBM constructs for smoking prevention among university students. Methods: This descriptive-analytical study was conducted in 2016 on 337 dormitory students recruited through one-stage cluster sampling from ShahidBeheshti University of Medical Sciences, Tehran, Iran. Data were collected using the Health Literacy for Iranian Adults scale as well as a researcher-made questionnaire on students’ perceptions about smoking prevention developed based on HBM constructs. Chi-square test, Pearson correlation test, and multiple linear regression analysiswere used. SPSS software (v. 16.0) was used to analyze the data. Results: Health literacy had significant relationships with cigarette smoking and all HBM constructs (P < 0.05). Multiple linear regression analysis revealed that the perceived susceptibility, perceived benefits, and self-efficacy constructs of HBM significantly predicted 32.9% of the total variance of health literacy(P < 0.05). Conclusions: Health literacy is significantly related with cigarette smoking. Moreover, the significant predictors of health literacy based on HBM constructs for smoking prevention are perceived susceptibility, perceived benefits, and self-efficacy. Therefore, educational programs based on these HBM constructs can be used as an appropriate framework for developing strategies to promote health literacy and prevent cigarette smoking.

Background Smoking causes premature and preventable death of millions of educated people. Objectives Given the role model for medical students in the future of the country, the current study aimed at determining the smoking prevalence and its related factors among dormitory students of Shahid Beheshti University of Medical Sciences in Tehran, Iran. Methods The current cross sectional study was conducted with descriptive-analytical approach on 355 dormitory students selected by single-stage random cluster sampling method. Data were collected using a researcher-made questionnaire including demographic and background information and smoking features. Then, data were analyzed with SPSS version. 21, using descriptive statistics and Chi-square test. Results The current study findings indicated that 23.8% (n = 81) of the subjects were current smokers; smoking had a significant relationship with gender variables, history of probation, close friends that smoked, and employment (P < 0.05). Conclusions In comparison to other studies, the smoking prevalence was relatively high. Therefore, the necessity of proper education about the harms and health effects of smoking are felt more than ever.

Objective: This systematic review and meta-analysis was conducted to assess the level of health literacy (HL) in the Iranian population. Data Sources: Persian and English-language articles were identified through Embase, MEDLINE, CINAHL, PsycINFO, SID, Web of Science, and hand-searching (search dates for articles on health literacy, 1990 to February 2016). Study Selection: Two reviewers independently selected studies that directly measured health literacy levels. Data Extraction: Abstracted article information were categorized into evidence tables by one reviewer; information accuracy was checked by a second reviewer. Two reviewers independently evaluated the study quality by using predefined inclusion criteria, and jointly the overall strength of evidence evaluated by the research team. Results: Twenty-eight relevant good-or fair-quality studies amongst 102 articles were identified, and 44 publications were assessed in full text. The researchers excluded 16 studies: Nine were reports with inadequate results and seven had low quality. Results of meta-analysis showed that better level of HL existed among 66 adults (62.47 to 69.53), 61.62 patients (53.40 to 69.84), 58.88 female (51.68 to 66.07), and 40.98 elderly (17.71 to 64.26). Conclusions: Health Literacy of the Iranian population was inadequate and borderline. Therefore, the need to increase awareness and intervention to reduce poor HL in the Iranian population is crucial.

Context: One of the serious global problems is the irrational prescribing of medicines that can be regarded as harmful or wasteful. Inappropriate use and overuse of medicines, waste resources and therefore lead to health and economic consequences in patients. The goal of this systematic review was to identify factors associated with irrational prescriptions of medicine. Evidence Acquisition: We searched the Cochrane database of systematic reviews (via Cochrane library), PubMed, Medline, Scopus, Science Direct, BMC, Scholar Google, and SID from 1980 up to October of 2016. Results: Of the 594 papers, 26 papers were finally included. The combined results of the 26 papers indicated 24 factors for unnecessary prescriptions of medicine. Factors related to the patient were expectations, demand to prescribe, and poor medical knowledge. Factors related to the physician were inaccurate diagnosis, inadequate awareness and knowledge, low experience, information asymmetry, poor medical education, and the physician’s attitude. Factors related to the institutional and political issues were fee-for-service, out-of-pocket payment, financial incentives, insurance reimbursements, insurance coverage, medicine subside, medicine advertisement, ineffective monitoring programs, regulation on prescription, prescription supervision, clinical guidance, and medicines near-expiry dates or expired. Conclusions: It can be concluded that the irrational/unnecessary prescription of medicine was influenced by many different factors, such as patient, physician, and institution. Thus to prevent irrational/unnecessary prescription, one needs to consider all the involved factors.

BACKGROUND: Adolescence is a risky period with high tendency towards drug abuse. Addressing the problem of drug abuse among students is essential. OBJECTIVES: This study was carried out in 2013 with the purpose of investigating the prevalence of substance abuse among dormitory students of Shahid Beheshti University of Medical Sciences. PATIENTS AND METHODS: In this descriptive analytical study, which was carried out in 2013, a total of 604 students living at dormitories of Shahid Beheshti University of Medical Sciences were selected by random sampling method. A questionnaire designed by the researcher was used to collect the data. Data were analyzed using descriptive statistics and chi-square test. RESULTS: The prevalence of substance abuse among the students was 15.4%. With respect to the types of the drug used by students, the highest frequencies belonged to smoking 4.47% and hookah with 42.9%. Forty-eight percent of the students, who used drugs, started it for the first time when they were 18 years old or younger. About 58% of students used drugs for the first time in dormitories and parks. Students' meetings and parties with friends were frequent occasions for substance abuse (47.5%). CONCLUSIONS: Students are considered one of the most vulnerable groups of society. The students living in dormitories are more vulnerable to drug abuse due to the lack of parental supervision and the impact of peer pressure. Therefore, localization of acceptance at Universities in order to prevent cultural mixing of students and education programs for teaching life skills to students efficiently reduce their substance abuse. Language: en