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Abstract Background The objective of this investigation is to evaluate the consistency of intra-rater and inter-rater assessments utilizing ultrasound elastography to examine the muscle stiffness of the popliteus and gastrocnemius (medial and lateral heads) in patients with knee osteoarthritis accompanied by myofascial trigger points. Methods Thirty individuals with knee osteoarthritis accompanied by myofascial trigger points were assessed. Two examiners independently measured the muscle stiffness levels of the popliteus and gastrocnemius (medial and lateral heads) three times using ultrasound elastography in the first session. The second session was conducted one week later. Results In the initial test session, the mean shear modulus values for the popliteus and gastrocnemius (medial and lateral heads) muscles were measured as follows for tester 1 (12.75, 13.72, 14.13 kPa) and tester 2 (11.66, 12.81, 13.17 kPa). During the retest session, the previously measured variables by tester 1 and tester 2 yielded the following values: (12.61, 13.43, 14.26 kPa) and (11.62, 12.87, 13.30 kPa) respectively." Good to excellent intra-rater reliability (ICC = 0.912—0.986) and inter-rater reliability (ICC = 0.766—0.956) were reported for the shear moduli of the popliteus, medial and lateral gastrocnemius muscles. Conclusions The assessment of muscle stiffness in the popliteus and gastrocnemius (medial and lateral heads) using ultrasound elastography is a reliable method in patients with knee osteoarthritis accompanied by myofascial trigger points.

Abstract Background It has been estimated that 60,000 Iranians have been infected with HIV/AIDS and only 36% of them are aware of their status. This study aimed to design, implement and evaluate a social marketing campaign to promote HIV testing in Boyer-Ahmad County, Kohgiluyeh, and Boyer-Ahmad Province, southwest of Iran. Materials and methods This study was a quasi-experimental pretest-posttest without a control group, developed based on a social marketing assessment and response tool. To design the intervention formative research was conducted, comprised of four focus group discussion sessions with 42 participants of the target community along with seven in-depth semi-structured personal interviews with health care providers involved in the HIV/AIDS Program. Data analysis was done manually using content analysis and the main content was formulated for the campaign. Afterward, the slogan and messages of the campaign were developed. The campaign’s materials including banners, posters, pamphlets, referral forms, and short messages were designed, pretested, and revised. Ultimately, the campaign was conducted for one month in October 2019. To determine the effectiveness of the campaign, the rate of referrals to the Center for Behavioral Health Counseling Services (CBHCS), for three months before and after the campaign, was compared. Results Qualitative findings identified that the majority of the interviewees mentioned that the main reasons for the low rate of referrals to get tested for HIV were lack of awareness and information about HIV/AIDS and its diagnosis as well as the free and confidential tests available from the CBHCS. Moreover, the stigma associated with HIV/AIDS was another important reason for low referrals for testing. The rate of referrals for HIV testing in the three months leading up to the campaign was 18, 32, and 23 people, and three months after the campaign was 64, 81, and 44 individuals; respectively. The results of the multivariate analysis demonstrated that the campaign had increased the rates of referrals for HIV testing through its significant influence on females, and individuals with academic degrees. Conclusion It can be concluded that the social marketing campaign was successful in persuading people to get tested for HIV.

Background: Skin cancer is one of the most preventable diseases. The purpose of this study is to describe a social marketing-based intervention design protocol to promote sun-protective behaviors among adolescent boys living in urban areas in Yasuj, south west of Iran.Methods: This study will be conducted based on six specific steps including a qualitative study, a systematic review, development of appropriate tools, a cross-sectional study, intervention designing, and a feasibility study. The main objective of the qualitative study is to elicit the views and opinions of adolescent boys, their parents, and teachers about sun-protective behaviors. In the second step, factors affecting sun-protective behaviors will be reviewed systematically. Based on the findings of the first and second steps, an appropriate model/theory of behavior change will be selected, and a standardized questionnaire will then be developed. In the fourth step, a cross-sectional survey will be conducted using the developed questionnaire to assess current sun-protective behavior practices.Results: Findings of the first to fourth stages will provide a comprehensive picture of the issue and the affecting factors. During the fifth step, the structure and the content of the intervention package, as well as educational and promotional materials, will be developed and pre-tested. Finally, in the sixth step, a feasibility study will be conducted.Conclusion: This study will provide practical information on the achieving of content and construct of a community-based social marketing intervention. This protocol reports on how to achieve audience-oriented insights for designing a tailored intervention aimed at promoting sun-protective behaviors among adolescent boys using social marketing.

Background and Objective: Increasing the level of health awareness of food preparation and distribution staff can have a direct impact on improving the level of public health in the community. Education can change people's knowledge, attitudes, and practices. Health education courses that provide integrated education as well as to other education systems, include educational inputs, processes, and outputs. The objective of this research is to evaluate these elements of the educational system of health education courses in Shiraz. Materials and Methods: The current study evaluated the educational input, process, and output of 7 current health education institutions in Shiraz. Factors that influence the input of educational courses were evaluated using an inspection checklist of health education courses, the educational process was measured employing a satisfaction survey, and the educational output was assessed through a checklist of inspection of Article 13 of the Regulations. The health performance of 160 guild health certified units and 160 uncertified education units was analyzed as a criterion for effectiveness. Data were analyzed using the IBM SPSS21 software. Data related to the assessment of the input and educational process were analyzed using the Spearman correlation coefficient. Mann-Whitney and Kruskal-Wallis non-parametric statistical tests were also used for cross-group comparisons of output evaluation data. Results: The findings of the educational input evaluation showed a strong correlation and a significant relationship between the overall evaluation score of the educational courses and the "observation" (0.96) "educational course principal" (0.94). Also, in the process evaluation, the "educational environment" and "general educational programs" with correlation coefficients of 0.99 and 0.84 had the most correlation with the overall process evaluation score. In all the health fields studied, there was a significant difference (p = 0.001) between the average score obtained for educational courses with and without certificates. There was a significant difference (p

Abstract Background Iran has a low incidence but higher rate of death from cervical cancer (CC). The country is in the process of implementing an organized screening program including HPV testing and cytology. Studies show high dropout in continued testing among eligible women. This qualitative study aimed to explore women’s awareness regarding CC and CC testing and the role of knowledge, perceived risk, and cues to action in this process. Method Through a qualitative study based on the Framework Method, we recruited 81 women aged 25–65 who participated in 15 focus group discussions (FGDs) and two in-depth interviews in Tehran. The interviewees were selected purposefully during January to May 2015 from households belonging to different socioeconomic classes until data saturation. The data were acquired through 11 open-ended questions and 32 related probe questions. All interviews were transcribed and independently analyzed by two researchers (Kappa and agreement testing respectively: 0.77, 97.11%). Results The coded texts were categorized under three themes and 13 subthemes. The three thematic areas referred to knowledge, cues to action, and perceived risks regarding CC and screening. The results showed that women had limited and unspecified knowledge about CC and screening, compounded by misconceptions regarding infection and cancer prevention measures. Social and cultural barriers hindered proper communication between health system/providers and clients and within communities on subjects related to CC and screening. The perceived risk of getting CC was low because of overestimating the role of hereditary factors for CC, difficulty in differentiating between cancer and sexually transmitted infections (STI), and the absence of visible symptoms. Conclusion The results indicate a strong need to invest more efforts to improve health education and communication in the current national health program to promote awareness of the need to screen for CC through, for example, establishing correct knowledge and risk perceptions among women. In addition, this intervention should address women’s social environment in order to prevent misconceptions being communicated to women.

Background and Aim: Health literacy refers to abilities of individuals, communities and groups to obtain, understand, and use the basic necessary information and services to improve, maintain and promote health. This study aimed to determine the status of ear and hearing- related health literacy in adolescents and young adults. Materials and Methods: Given the lack of specific tools for measuring the ear and hearing- related health literacy, an appropriate tool was developed. The validity of the tool was confirmed by a survey of experts and calculating the content validity rate and index. Internal correlation of questionnaire was confirmed using Cronbachchr('39')s alpha; and the reliability of questionnaire was approved by a test-retest method. After the tool finalization, the ear and hearing- related health literacy was measured in 4890 Iranian young adults and adolescents. Results: In the selected sample, 45.9% were male and 54.1% were female, and the mean and standard deviation of participantschr('39') age were 17± 3. The mean score of ear and hearing- related health literacy was 30.81 ± 3.75. The ear and hearing- related health literacy was adequate in 2.8% of samples and inadequate in 97.2%. There were significant statistical differences in the status of ear and hearing- related health literacy in people with different age, gender, number of study years, occupation, marital status, and income. Conclusion: There were low general levels of ear and hearing- related health literacy as well as skills of searching, understanding, evaluating and using health information and services in Iranian adolescents and young adults.

Purpose: This study aimed to compare the effectiveness of physiotherapy with uphill walking versus physiotherapy alone on the disability of patients with knee osteoarthritis. Methods: This study was a randomized clinical trial carried out on 30 patients (5 males and 25 females) with moderate knee osteoarthritis aged between 40 and 65 years. They were assigned to the intervention and control groups. Both groups received 10-session routine physiotherapy, and the intervention group received an 8-degree treadmill walking at a speed of 1.1m/s for 30 minutes in each session. The participants’ disability was measured before, immediately after, and 20 days after the 10-session treatment by the Persian version of Knee injury and Osteoarthritis Outcome Score (KOOS). The data were analyzed through the repeated measures analysis of variance in SPSS V. 22. The significant level was set at 0.05. Results: Statistical analysis showed significant improvements in the activity of daily living (P≤0.01) and quality of life (P

Objective (s): Lack of attention to nutrition and having non-healthy nutritional habits, is one of the influencing factors for non-communicable diseases. In recent years, nutritional literacy, as a abilities to access, understand, appraise, and apply necessary information to make decision related to healthy nutrition, is considered to be a very important health-related issue. This study aimed to investigate the effect of an educational intervention on nutritional literacy of elementary school teachers in Yasuj, Iran. Methods: In this quasi-experimental study, 110 teachers of the elementary schools in Yasuj, who were randomly selected in two areas of the city (intervention and control group) were included in the study. Nutritional literacy was measured by using a validated tool for Iranian society, and after analyzing the data, the educational content and structure were developed to improve the nutritional literacy. Intervention consisted of two training sessions, sending two SMS and providing educational pamphlets. Data were analyzed before and three months after the intervention by using Spss16 software. Results: There was a significant difference in terms of nutritional literacy, reading comprehension, food units (P

Introduction. In Iran, the rate of cesarean section is three times more than the acceptable rate considered by the World Health Organization. This study aimed at reducing the selection of cesarean section by primigravida through an intervention based on social marketing in Boyer-Ahmad County, Iran, 2015. Methods. In this field trial, 39 of primigravida women were identified and selected as a target group. Formative research (a quantitative survey and a qualitative study) was done to achieve the social marketing mix. The tailored intervention was developed based on the findings of formative research. The intervention was implemented for one month for pregnant women who had cesarean section intention. Their intention for the cesarean section was studied again one month after the implementation of the intervention. The effectiveness of the intervention was evaluated by the proportion test. Results. The average age of the women was 25.82. All of the women 38.5 percent had a diploma degree and lower than and 61.5 percent had a university degree. Before the intervention, 39 women intended to do Cesarean. The intention of 30 pregnant women was changed significantly one month after the intervention. Conclusion. The study showed the effectiveness of an intervention based on consumer-oriented social marketing theory and could be used to reduce Cesarean intention. More studies about related factors of vaginal delivery selection especially from behavioral intention up to behavior are suggested.

Objectives: WHO has recommended that the average salt intake must be

Introduction: Nutritional literacy is skills and the degree capacity of privates to obtain, process and understand nutrition information to make good decisions about nutrition. The use of this information and nutritional services leads to health promotion. This study examined the status of nutritional literacy in elementary school teachers in Yasuj and its related factors. Methods: In this Cross-Sectional study, a questionnaire of 35 items belonging to Turkey was used. After translation-retranslation and determine its validity for assessing nutritional literacy, it is used in 110 persons of elementary school teachers in Yasuj. The samples were selected by multistage stratified sampling and questionnaire was completed for them. The data were analyzed by using descriptive and analytical statistics. Findings: The average age of participants was 39.48±3.2. The results showed that the mean score of nutrition literacy for participants was 27.14± 3.2. 22.7 percent of teachers had limited or poor nutrition literacy. Teachers with less work experience and bachelor's and higher degree had more nutritional literacy scores. The least number of correct answers was related skills of food centers determination, computing skills and reading of food labels. Conclusions: Overall, according to the level of nutritional literacy in different parts of the group of teachers, it should be considered the designing of interventions to improve nutrition literacy. Because of its uniqueness in Iran, this questionnaire can be used as needs assessment tool in nutritional interventions in Iranian society.

Background and aim: In social marketing, at the center of the program is consumer perception. The objective of this study was to explore the viewpoints of Iranian women for tailoring interventions so as to increase physical activity. Methods: The social marketing model served as the framework of the study. Qualitative data were collected via six semi-structured focus group discussions (FGDs), in 2014 in Iran. Participants were 51 women, 20 to 60 years old, selected by purposive sampling, with a maximum diversity. Qualitative content analysis of the data was conducted by researchers. Results: After data analysis and extracting initial codes, they were all categorized in four predefined categories of social marketing model (product, price, place and promotion) and related sub-categories. Most of the participants were inactive. Price was addressed by women as the dominant category of this study. The majority of participants emphasized the benefits of prevention of chronic diseases, fitness, staying young, and improving family relations. Most women preferred to do physical activity in a secure and enclosed female environment. And the majority of participants considered radio, television, face to face training, texting, and advertising billboards as promotional strategies. Conclusion: This study provides a unique insight into consumers’ values and motivations that affect consumers’ decisions to adopt physical activity, in Iran. It could also help researchers to design and implement intervention programs to increase physical activity.

Abstract Background Despite recommendations, many middle-age adults neglect to check their blood cholesterol levels. Short message service (SMS, also known as texting) has been seldom studied for preventive education. We estimated how SMS can be a cost-effective method in encouraging people to check their blood cholesterol levels. Methods In a field trial, 3600 cell phone users (age > 30) were randomly assigned to the intervention (N: 1200) and the control groups (N: 2400). An SMS was sent to the intervention group for five rounds every two weeks, which targeted the cognitive and affective learning and finally advised the blood cholesterol level to be checked, if not checked during the past twelve months. Two weeks after the last round, both groups were asked for the time/level of their latest blood cholesterol, family history of early cardiac death and having a family member with coronary heart disease (CHD), and to report their attitude about whether annual blood sampling is worth the cost and time to prevent CHD. Moreover, the intervention group was asked if they remembered the SMS content. The cost-effectiveness was evaluated by estimating the “number needed to treat” (NNT) and calculating the cost of sending SMS to that number of people. Results In the intervention group, 629 individuals (72.0%) recalled the SMS content. The factors associated with cholesterol screening during the past two years were older age, diabetes, family history of coronary disease, higher education, female gender and being non-smoker. In both groups, women were significantly more aware of their blood cholesterol level (68.7% vs. 53.6%). The relative frequency of respondents who believed it was not worth checking their cholesterol annually was significantly lower in the intervention group (P

Background & aim: The effectiveness of the Transtheoretical model for changing nutritional behavior has been questioned by some studies. The purpose of this study was to investigate the relationship between self-efficacy and decisional equilibrium and transfer among the stages of behavior change of a calorie balance intake among obese women inYasuj, Iran. Methods : The data of the present descriptive analytical study were baseline data of 447 obese or overweight who were selected using the random cluster method. Based on the Transtheoretical model, individuals pass stages of change, which are precontemplation, contemplation, preparedness, action and maintenance. Two other main constructs which affect the stages of behavior change are self-efficacy and decisional balance. Demographic and anthropometric variables and stages of change, self-efficacy, decisional equilibrium pros and cons related to calorie balance intake were measured using valid and reliable questionnaires. Results: The participants average age was 33.49 years. Neither demographic nor anthropometric variables changes were significant among the stages of behavior change except literacy level before high school ( P=.047,OR=.502, %95 CI=.255 ~ .990). A significant change was observed in self-efficacy ( F(4.425)= 27.09, P= .000),decisional equilibrium (F(4.394), P= .004), and pros (F(4.430)=5.33, P=000), while no significant change was observed among cons (F(4.400)=1.83, P=.123). Conclusion: The findings confirmed the specific model of self-efficacy, decisional equilibrium and pros which predict that the obese women transfer between the five stages of calorie balance intake.

Background and Aims: Audience analysis has important role in designing behavior change interventions. In this study, we aimed to measure attitudes and behaviors related to usage of personal protective equipment (PPE) to design an intervention for persuading employees to use PPE in their work settings. Methods: In this cross-sectional analytical study, an attitude and self- reported behaviors questionnaire and an observational checklist were used to measure the attitudes and behaviors related to usage of PPE in all 44 employees. Then, the collected data were analyzed. Results: Labors have relatively desired attitudes toward using PPE. Most labors reported that they always or usually had used PPE while working. During observation, we explore that PPE usage was not good at all and some PPE like safety helmets, masks and safety clothes were used less by them. Conclusion: Regardless of having desired attitude and self-reported behaviors, people might have risky behaviors. So, we must notice to virtual behaviors and their causes to have a successful program. Identifying and analyzing audience is necessary to design an effective behavior change intervention.

Objective(s): To assess attitudes, self-reported and observational behaviors among taxi drivers, a large group of professional drivers, in Tehran, the capital of Iran. Methods: In this cross-sectional study, we selected two municipality district of Tehran which had the highest rate of traffic accidents among taxicabs. By using a questionnaire, we asked them about their attitudes and reports of their behaviors during driving and a checklist was used for observing their risky driving behaviors. Then, data were analysed in a descriptive fashion. Results: We found that taxi drivers in Tehran had had desired attitudes toward not driving risky and had reported their driving behavior well and non- risky.There was a significant direct relationship between their attitudes and driving history. However, we found a reverse significant relationship between self-reported behaviors and literacy level. Risky driving behavior wrer different based on the time of observation. Using cell phone, tailgaiting and not moving between lines were three most common observed risky driving behaviors among taxi drivers. Conclusion: Taxi drivers, as professional drivers have not desired behaviors regardless of their positive attitudes and self reports. Thus, we should design and implement the interventios based on their driving history, literacy level, common behaviors and even the time of driving.

Objective(s): Road traffic crashes are the second highest cause of mortality in Iran and risky driving behaviors among Iranian drivers are evident. In this study, the views of taxi drivers about risky driving behaviors were extracted in order to recommend the effective interventions for modifying these behaviors. Methods: This was a qualitative study carried out in Tehran, Iran. Forty-Two taxi drivers were invited to participate in four focus group discussions. Discutions on risky driving behaviors were tape recorded and were analyzed using a thematic approach. Results: Data analysis showed five main themes: the role of taxi drivers in current driving situation in Tehran, driverschr('39') reasons for committing risky driving behaviors, actions for modifying risky driving behaviors, suitable places for implementing the recommended interventions and the best channels for communicating and persuading taxi drivers. The participants believed that developing and communicating well-developed persuasive messages for increasing their concentration during driving and reminding the message content by taxi driverschr('39') opinion leaders can affect their driving behaviors. Conclusion: According to findings, a consumer-oriented planning model such as social marketing was recommended to modify the risky driving behaviors among taxi drivers in Tehran.

Background: Health care providers have important role in identification and management of domestic violence against women. The purpose of this study was to explore views and ideas of the women health worker about the screening and management programs related to domestic violence against women, their benefits and barriers and introducing the appropriate interventions for removing the barriers. Materials and methods: This qualitative study was held through six focus group discussions and three in-depth interviews by the participation of fifty-six women who had provided reproductive health care of South Tehran, Rey and Eslamshahr Health Networks. The health care providers' views about domestic violence screening and management were extracted, categorized and analyzed. Results: The majority of health care providers were aware of the importance of identifying and management of domestic violence cases in health care facilities. Respondents felt that they have responsibility to screen for domestic violence. Major barriers to domestic violence screening and management included perceived lack of time and place, insufficient knowledge and skills related to domestic violence screening and management, insufficient personnel and referral services. Conclusion: : Improvement of identifying and management of domestic violence in health care settings by removing the barriers to screening and improvement of referral and supportive services, can lead to decreasing in domestic violence against women cases.

Background: The aim of continuous medical education is to improve physicians performance Unfortunately most of the efforts which have been done in recent years for achieving this goal have been ineffective Using ineffective educational methods and techniques are probably the major cause of this deficiency Consumerbased models such as social marketing model can be used efficiently in the field of medical education Social marketing is “the use of commercial marketing concepts and tools in programs designed to influence individuals behavior to improve their well being and that of the society” In this paper the main concepts and principles of social marketing model have been explained Consumer analysis market analysis and channel analysis are the main concepts of social marketing that can be used in the field of continuous medical education Conclusion: Although planning educational programs based on the mentioned principles seems to impose more expenses it increases the probability of success and can affect physicians behavior more than other applied programs

Introduction: Many training programs have been conducted, aiming to encourage women to perform breast self-examination for early detection of breast cancer. This study aimed to review studies performed on efficacy of educational interventions to correct women’s behavior in breast self-examination. Method: Through systematic search of MEDLINE and ISI Web of Science databanks to retrieve titles and abstracts of articles containing results of educational interventions associated with women’s breast self-examination, the articles that focused on determining efficacy of educational interventions were selected. Eventually, results obtained from reviewing full text of 19 selected articles were analyzed. Results: The majority of educational programs were designed for training skills, and most trainers were healthcare staff, and in some cases, educators were made up of peers and families of breast cancer patients. A huge diversity was observed in studies in terms of demographics, such as age, race, education, and occupation, and in some cases, first degree relatives of breast cancer patients were educated as the most important at-risk group. Conclusion: Teaching breast self-examination, with regard to knowledge, attitude, and behavior, plays an essential role in increasing cases of early detection and treatment of breast cancer. More effective education is provided by nurses and other medical staff compared to doctors. Attention to finding a suitable location for education, including healthcare centers and workplace, attributes to success.

Background and objectives: Acetamiprid, a widely used neonicotinoid pesticide in agriculture, acts as a stimulant on nicotinic acetylcholine receptors, potentially causing neurotoxicity. Quercetin, a neuroprotective flavonoid found in fruits and vegetables, shows promise in mitigating neurological disorders. This study investigated quercetin's protective potential against acetamiprid-induced memory impairment. Methods: Male rats were divided into four groups: control, acetamiprid (40 mg/kg), quercetin (20 mg/kg), and a combination of acetamiprid and quercetin, administered orally for 28 days. Cognitive performance was assessed using the Morris water maze test; oxidative stress markers in the hippocampus were evaluated, along with histological analysis. Results: Rats exposed to 40 mg/kg acetamiprid exhibited significant memory impairment. Notably, co-treatment with quercetin reversed this effect. Acetamiprid induced oxidative stress, as indicated by increased lipid peroxidation, reduced thiol content, and decreased catalase (CAT) enzyme activity. Simultaneous quercetin and acetamiprid administration effectively mitigated these oxidative stress markers. Histological analysis demonstrated quercetin's ability to prevent acetamiprid-induced hippocampal neuronal damage. Conclusion: Quercetin shows promise in ameliorating acetamiprid-induced memory deficits and neuronal damage, making it a potentially valuable nutraceutical, especially for individuals exposed to pesticides like agricultural workers.

Dear Editor, Communicating correctly and effectively with clients is considered one of the most important and essential skills for health professionals. However, they mainly use jargon in the process of communicating with clients, and sometimes there is a lot of information that is beyond the ability of their clients. Thus, paying attention to health literacy as one of the most important strategies to improve the quality of patient-physician communication in both providers and recipients of health services. However, the main and major focus of health literacy research has been patients, and the other side of the problem, that is, health professionals and their communication skills, has received less attention; While the lack of familiarity with the concept of health literacy and lack of attention to its principles by health professionals during every encounter with clients and in general, the process of communicating with clients, can be challenging and ultimately might lead to a communication failure.

In this study, construction and demolition waste (CDW) materials, including waste clay bricks, concrete, and glass, were used as aggregates of chip seal layers to enhance the reflectivity and reduce the temperature of asphalt pavements as an urban heat island (UHI) mitigation policy. UHI is an urban area that has a higher temperature in comparison to its suburbs. As considerable parts of cities are covered with asphalt pavements, their heat absorption and heat release can directly affect the UHI. Four types of chip seal layers, containing CDW aggregates were prepared in this study. The reflectivity and cooling effects of asphalt pavement coated with the developed chip seals were then evaluated with laboratory, field experiments, and computational fluid dynamics (CFD) simulation. Regarding the laboratory methods, UV-Visible-NIR spectrometer reflectance, a trident thermal properties measurement, and solar simulation cooling effect were used. Besides, the albedo and cooling effects of the developed chip seals were evaluated with a pyranometer and thermocouples through a field experiment. The indoor reflectance test showed yellow and red brick chip seals reflected almost 136 % higher than the aged asphalt pavement, followed by concrete chip seals with 80 % higher solar reflectance. Besides, the surface temperatures of yellow brick, red brick, and concrete chip seals were 23 %, 18 %, and 15 % cooler than the hot mix asphalt (HMA) specimens. More importantly, clay brick chip seals had the lowest nighttime heat release, followed by the concrete chip seal. The field test indicated that the albedo of yellow brick was 2 and 6 times higher than the aged and new HMA, causing 17 % and 27 % lower surface temperatures. The numerical models also revealed that using the yellow brick and concrete chip seals decreased the surrounding air temperature at least by 18 % and 14 % respectively. Overall, the numerical modeling, laboratory, and field tests showed similar results, indicating the benefits of using clay bricks and concrete aggregates for chip seal development, which can mitigate the UHI effectively.

Abstract Background COVID-19 is a universal challenge and novel disease is one of the core public health concerns. This study aimed to determine the factors that affected COVID-19 prevention behaviors (CPB) based on constructs of Social Cognition Theory (SCT). Methods This cross-sectional study was conducted on 426 participants referred to health centers of Arak from October 2021 to February 2022, and they were selected through a multi-stage random sampling method. Data were collected via a self-administered questionnaire which includes socio-demographic data (6 items), COVID-19 prevention behaviors (12 items), and SCT constructs related to COVID-19 (32 items). SPSS Ver-16 statistical software was used to analyze the data with one-way ANOVA, independent samples t-test, and multiple linear regressions. The significance level of α = 0.05 was considered for all tests. Results The mean age was 37.8 years (SD = 12.2) and ranged from 17 to 81. According to the results, 51.2% had higher education and 52.6% of the participants were female. The mean (SD) of COVID-19 preventive behaviors was 43 (SD = 7.8) out of 60. There was statistical association between CPB and three constructs of SCT. Multiple regression showed that the outcomes expectations (β = 0.11, p

Background: Waste separation education is very important for students because of the important role of this group in attracting parental involvement. Therefore, this study was conducted to investigate the effect of educational intervention based on the theory of planned behavior on the promotion of waste separation at source behavior among the primary school students in Khorramabad City, Iran. Methods: This randomized controlled interventional study was conducted during the academic year of 2020-2021 among the primary school students in the city of Khorramabad. Eight schools were selected in a multi-stage method and the sample size was estimated at a total of 200 people, taking into account at least 100 samples in each group (test and control). Then, the educational intervention was performed based on the results of needs assessment for the experimental group during one month and in the form of three sessions of 60-minute training. The data were collected 2 months after the intervention and were analyzed using SPSS software by using independent t-test, paired t-test, and chi-square test. Findings: Before the educational intervention, except for the score of awareness variable, all variables were not significantly different between the two groups; however, after the intervention, the two groups had significant differences regarding all of the studies variables (P < 0.050). The performance of the intervention group before training was 2.34 ± 0.73, which increased significantly to 3.11 ± 0.45 after training (P < 0.001). Conclusion: Educational intervention based on the theory of planned behavior by promoting attitudes and evaluating the behavioral consequences of students in the field of waste separation behavior at source eventually improved the behavior of students; it is suggested that this educational method be implemented in other schools as well.

Objective(s): Injuries among children are one of the problems of childhood worldwide. The present study aimed to assess the factors related to the belief and performance of mothers in preventing injuries among children under five years of age using the health belief model (HBM). Methods: This was a descriptive study that conducted on 201 mothers with children under 5 years of age who were randomly selected from health centers in Arak, Iran in 2022-2023. Data was collected through a four-part questionnaire consisting of demographic information, items on knowledge, questions related to constructs of the HBM, and a questionnaire on previous injury records. Data were analyzed by using t-test, ANOVA, chi-square, Pearson correlation and linear regression. Results: The mean age of the mothers was 33.84±7.24 years and it was 48.23±16.48 months for children. The mean knowledge score of mothers was 40.06±14.74 (out of 100 marks). Also, the mean score for perceived benefits (80.08±12.24) and perceived barrier (64.41±17.13) had the highest and lowest scores respectively (out of 100 scores). There was a significant relationship between education and perceived sensitivity score (p=0.002) and perceived severity (p=0.012). Child's age, susceptibility, and perceived benefits predicted a total of 38% (R2=0.38) of mothers' preventive behavior. Conclusion: The health behavior of mothers in preventing childhood injuries was significantly influenced by the mother's understanding of the child's vulnerability and the benefits of taking timely and effective action to reduce possible risks.

In this article we describe a design process of a manipulator that is designed for complete servicing of a date palm. The feasibility of using this manipulator and determining the optimum position of its cameras as well as the number of cameras to be mounted on the equipment were also investigated. The manipulator was equipped with several cameras for monitoring the operations utilizing a ground-based operator. The operator monitors the manipulator and the end-effector on the display and navigates it using a joystick. In order to build the manipulator, a systematic deign method was utilized. Total length of the manipulator was 100 cm. Four electric motors provide the dynamic force of the manipulator to transport the end effectors to the desired positions for conducting horticultural operations. To investigate the performance of the manipulator, 9 different camera setups and 4 different manipulator distances from the target, were analyzed at 5 replication levels, through a statistical factorial experiment design (4х9). The experiments results showed that the remotely controlled manipulator is efficient in conducting horticultural operations. On the other hand, different camera setups showed significantly different results. The tests also indicated that to obtain the shortest reaching time, three cameras must be installed on the manipulator. The average time for reaching the target from a 100-cm distance was calculated 20.8 seconds.

Abstract Background Adherence to prescribed treatment in chronic diseases, as occurs in multiple sclerosis (MS), is a critical factor for a successful therapeutic response. This study aimed to investigate the effect of educational program based on Theory of Planned Behavior (TPB) on treatment adherence in patients with multiple sclerosis (MS) receiving injectable immunomodulatory drugs. Methods The present study is an educational randomized controlled trial research that was conducted on 100 patients with MS who had gone to MS clinic in Tehran city (Iran). The samples were randomly assigned to the intervention (N = 50) and control groups (N = 50). Data collection instrument was a researcher-made questionnaire based on TPB. Then, educational program was performed for the intervention group through four educational sessions. After three months, data collection was repeated for the two groups and data were analyzed. Results The knowledge and performance of the intervention group on treatment adherence drugs increased from 56.25 ± 20.3 to 78.31 ± 15.57 and 56.22 ± 5.76 to 71.62 ± 12.01 after the education respectively (p