Journal of Education and Health Promotion

Abstract

Abstract Background and Objectives: To determine the prevalence of impaired fasting glucose in
adolescents in Birjand city in eastern Iran. Materials and Methods: This cross‑sectional study
was done on 2653 students aged 11–18 years selected through multi‑stage stratified and
random sampling. Fasting blood glucose (FBS) of these students was measured applying
the enzymatic process. The obtained data were analyzed by means of SPSS software (V: 15)
and statistical tests T and X2. Results: The mean age of individual was 14.5 ± 2 years. Mean
FBS of the whole population was 89.8 ± 9.8 mg/dl, but it was significantly higher among
boys than girls (P < 0.001). Out of the whole subjects (92.4%), 1,328 (95.1%) of the girls and
1,122 (89.3%) of the boys, FBS was less than 100 mg/dl among whom 64.4% had FBS above
86 mg/dl. In 200 subjects (7.5%) of whole population, FBS was 100–125 mg/dl; with that of
the boys was 2.3 times than the girls revealing a prediabetes condition: OR = 2.3(CI: 1.7‑3.2).
Among the students, 3 (0.1%) had an FBS > 126 mg/dl. Mean blood glucose was significant
regarding age and sex. Conclusions: High prevalence of high FBS (within normal range)
among adolescents is warning and requires special attention of health officials. Screening of
children and adolescents in order to identify those at risk and plan for intervening is urgent to
prevent type‑2 diabetes epidemic and following cardiovascular complications in the Society.

Abstract Introduction: Cardiovascular disease is the major cause of mortality in developed countries and has
an increasing trend in developing countries. There are some evidences that calcium supplementation
may decrease blood pressure and consequently cardiovascular disease, but they are not conclusive
and there is no agreement in this respect. The aim of the present study was to assess the effect
of supplementary calcium on systolic and diastolic blood pressure in healthy adult women aged
18–30 years. Materials and Methods: Seventy‑five normotensive volunteers were randomly divided
into two groups, the treatment group received 1000 mg/day calcium (four doses of 625 mg calcium
carbonate) for 1 month and the control group received placebo (dextrose). Systolic and diastolic
blood pressure was determined before and after intervention in supine position after 10 min of rest.
Results: The mean daily calcium intake from food was 773.9 mg in treatment and 721 mg in control
group (no significant difference) but in both the groups dietary calcium intake was less than the
recommended dietary allowance: After calcium supplementation, the mean change of systolic blood
pressure was not significant in the two groups, but diastolic blood pressure reduced in treatment
group and increased in control group (−4.9 vs 2.6 mmHg) (P < 0.05). Conclusions: These results
suggest that, calcium supplementation does not have any effect on systolic blood pressure of our
volunteers but can decrease diastolic blood pressure significantly and therefore it seems that calcium
supplementation may be useful for people with increased diastolic blood pressure, especially for
those who receive less calcium than recommended dietary allowance.

Abstract Background: Considering the increasing importance of emotional intelligence (EI) in different
aspects of life, such as academic achievement, the present survey is aimed to predict academic
performance of medical students in the comprehensive examination of the basic sciences, according
to the indices of emotional intelligence and educational status. Materials and Methods: The present
survey is a descriptive, analytical, and cross‑sectional study performed on the medical students
of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was
performed randomly after which selecting the students was done, taking into consideration the
limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of
2005, who had attended the comprehensive basic sciences examination in 2008, entered the
study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in
Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters,
and the grade of the comprehensive basic sciences examination. The data were analyzed through
stepwise regression coefficient by SPSS software version 15. Results: The results indicated
that the indicators of independence from an emotional intelligence test and average scores of
the first and third academic semesters were significant in predicting the students’ academic
performance in the comprehensive basic sciences examination. Conclusion: According to the
obtained results, the average scores of students, especially in the earlier semesters, as well as
the indicators of independence and the self‑esteem rate of students can influence their success
in the comprehensive basic sciences examination.

Abstract Background: Prevalence of work‑related musculoskeletal disorders (WMSDs) is high among
computer users. The study investigates the effect of three ergonomic interventions on the
incidence of musculoskeletal disorders among the staff of Isfahan Province Gas Company,
including training, sport, and installation of software. Materials and Methods: The study was
performed in the summer of 2013 on 75 (52 men, 23 women) Isfahan Province Gas Company
employees in three phases (phase 1: Evaluation of present situation, phase 2: Performing
interventions, and phase 3: Re‑evaluation). Participants were divided into three groups (training,
exercise, and software). The Nordic Musculoskeletal Questionnaire (NMQ) and rapid upper
limb assessment (RULA) were used. Data collected were analyzed using SPSS software and
McNemar test, t‑test, and Chi‑square test. Results: Based on the evaluations, there was a
decrease in musculoskeletal symptoms among the trained group participants after they received
the training. McNemar test showed that the lower rate of pain in low back, neck, knee, and
wrist was significant (P < 0.05). The results obtained from the RULA method for evaluation
of posture showed an average 25 points decrease in the right side of the body and 20 points
decrease in the left side of the body in the group subjected to training. Based on t‑test, the
decrease was significant. Conclusion: The study demonstrated that majority of the participants
accepted interventions, which indicates that most of the people were unsatisfied with the work
settings and seeking improvement at the workplace. Overall, the findings show that training,
chair adjustment, and arrangement in workplace could decrease musculoskeletal disorders.

Abstract Background: The worldwide concern for safety has created the need for new and effective
methods to improve safety in the workplace. This study was designed to determine the
effect of educational intervention based on Health Action Model on the safe behavior among
workers in Isfahan Steel Company. Materials and Methods: This study was designed as a
quasi‑experimental research with experimental and control groups with pre‑ and post‑ intervention
measurements. The experimental group received intervention based on the Health Action Model.
The control group did not receive any intervention except that they participated in the current
safety courses of the company. The sample size was 270 workers who were randomly selected
and divided into two groups: Experimental (n = 135) and control (n = 135). Data were collected
using a questionnaire and a checklist after and before the intervention and were analyzed. Based
on the distribution of variables, parametric (t‑test, paired t‑test) or nonparametric (Chi‑square,
Wilcoxon) tests were utilized to analyze data. P value less than 0.05 was considered significant.
Results: The results indicated that before intervention, the experimental and control groups
were similar in model structures. After intervention, the mean scores of knowledge, attitude, and
behaviors in relation to safety in the experimental group increased statistically significantly and
the observed difference in the control group was not significant. The results also indicated that
unsafe behaviors in the experimental group decreased following the educational intervention.
This difference also was not statistically significant in the control group. Conclusion: The results
showed that application of Health Action Model has an acceptable and positive influence on
promoting safe behaviors, knowledge, normative system, and facilitating factors among workers
in Isfahan Steel Company. It is, therefore, recommended that Health Action Model based
intervention be used for other and similar industries.

Abstract Context: Most of the studies show that emotional intelligence (EI) is an important factor for
effective leadership and team performance in organizations. Aims: This research paper aims
to provide an exploratory analysis of EI in the hospitals managers located in Tehran, and
examine its relation to their performance. Settings and Design: The present research was an
analytical and cross‑sectional study. Setting of the study was hospitals located in Tehran, Iran.
Subjects and Methods: We conducted a cross‑sectional study from a matched sample of
120 managers and 360 subordinates in hospitals located in Tehran. Cyberia shrink EI measure
was used for assessing the EI of the participants. Moreover, a management performance
Questionnaire is specifically developed for the present study. The total of 480 questionnaires
analyzed throughout Kolmogorov–Smirnov, Mann–Whitney, and Kruskal–Wallis tests in SPSS.
Results: The findings suggested a poor EI among hospital managers. As for EI subscales,
social skills and self‑motivation were in the highest and lowest levels respectively. Moreover,
the results indicated that EI increases with experience. The results also showed there is
no significant relationship between the components of EI and the performance of hospital
managers. Conclusions: Present research indicated that higher levels of EI did not necessarily
lead to better performance in hospital managers.

Abstract Introduction: This study aimed at determining the causal relationship of metacognitive beliefs
as a mediator between one of early maladaptive schemas including (emotional deprivation,
abandonment, mistrust/abuse, social isolation/alienation and defectiveness/shame) and
borderline and antisocial personality patterns. Materials and Methods: The study type has
been relational and seeking causal modeling of path analysis has been used. The population
used in this study included outpatients in counseling, psychological and psychiatric centers
in 2012–2013. We randomly distributed 350 questionnaires in five centers out of three parts in
Isfahan, and finally 230 valid questionnaires were evaluated and analyzed. Data collection tool
has been Millon Clinical Multiaxial Inventory‑III’s (MCMI‑III’s) personality questionnaire, Yang’s
schema questionnaire (75 items), Metacognition Questionnaire‑30 (30 items). Reliability of the
Yang’s Schema Questionnaire in this study was calculated by Cronbach’s alpha (α =96%),
and that of metacognition was calculated the same way (α =87%). Data analysis has been
done using MCMI‑III’s software for Millon’s personality questionnaire, and SPSS‑16 and
AMOS‑18 software. We used path analysis method for testing each model in statistical data
analysis. Result: The results of this study suggest a possible causal relationship between the
number of one of the early maladaptive schemas and the patterns of anti‑social and borderline
personalities through some metacognitive beliefs. Conclusion: This study showed that
cognitive beliefs can be activators of the early schema and continuation’s coping behaviors
in personality patterns.

Abstract Introduction: Nausea is the worst and most prevalent chemotherapy‑induced complication
experienced by 70–80% of patients despite mediation therapy. Reduction of nausea is one of
the most important roles of oncologist nurses. Today, complementary therapies in addition
to classic medicine, because of their lower costs, receive much attention. Nonetheless, their
safety and effectiveness are not yet proven. The purpose of this research was to investigate the
effect of therapeutic touch plan as a complementary therapy on acute nausea in women with
breast cancer in 2012–2013 in Isfahan, Iran. Materials and Methods: A quasi‑experimental,
single‑blind, randomized control trial with three groups (control, placebo and intervention) was
performed at the Isfahan Seyedolshohada (AS) Teaching Hospital, Isfahan, in 2012–2013. The
intervention was therapeutic touch plan on women with breast cancer, with the three groups
receiving the same medicine regimen. Information was recorded by a checklist after infusion of
chemotherapy drugs. Data analysis was performed by SPSS, ANOVA and Kruskal–Wallis tests.
Results: The ANOVA test showed that the therapeutic touch plan was significantly effective in
reducing the duration of nausea compared with the control and placebo groups (P < 0.001).
The Kruskal–Wallis test showed that the frequency of occurrence of nausea was also reduced
in the intervention and placebo groups compared with the control group (P < 0.001). The
therapeutic touch plan was significantly effective in delaying the onset of nausea compared
with the control and placebo groups (P < 0.001). Conclusion: This research showed that the
therapeutic touch plan is effective in reducing acute chemotherapy‑induced nausea; thus,
education and implementation of the therapeutic touch plan is proposed for clinical nurses.

Abstract Background: On account of the prevalence of psychoactive substances and drug abuse
and its diversity of forms and methods of use, along with the reduction in the age of
drug abuse, a continuing medical educationof physicians with these issues is necessary.
Although it is legally forbidden, most physicians have no close contact to these drugs,
and this is not effective for training, prevention and treatment of drug addiction. In this
regard, offering an educational tool is needed, if in close contact to these drugs. The ‘Nejat
Briefcase’ is a tool designed for the purpose of training and familiarization of psychoactive
substances and drugs. The aim of this study is to investigate the points of view of the
participants in the continuing medical education program, ‘Introduction to types of
psychoactive substances and drugs’ and about the Nejat Briefcase, in the Isfahan University
of Medical Sciences (IUMS). Materials and Methods: In this descriptive, cross‑sectional
study, all the general physicians (108 people) who participated in the continuing medical
education program, ‘Introducing types of psychoactive substances and drugs,’ in the
Isfahan University of Medical Sciences (IUMS), in 2012 – 2013, were considered. In this
program, in order to introduce various types of psychoactive substances and drugs to
the physicians, as well as acquaint them with their forms, methods of use, and prices,
the new educational tool (Nejat Briefcase), containing various types of psychoactive
substances and drugs and the related educational packages, such as, booklets and
brochures, was used. A researcher‑made, valid and reliable questionnaire was distributed
at the end of program to gather the participants’ points of view about the educational
program. Data was analyzed by the SPSS and t‑test and descriptive statistical tests.
Results and Discussion: The response rate to the questionnaire was 83%. Forty‑four
people (41%) were women and 64 (59%) were men. The mean total score of the participants’
points of view was 4/58 ± 0/45 (out of 5), which indicated the positive points of view of the
participants. Ninety‑seven people (90%) were satisfied with the program. Conclusions: On
account of the participants’ positive points of view on the Nejat Briefcase and their consent
to it, using varied and attractive educational tools for psychoactive substances and drug
training and producing tools similar to the
Nejat Briefcase are proposed.

Abstract Introduction: Major thalassemia is a hereditary, chronic blood disease caused by the synthesis
deficiency of one or more polypeptide chains of globin during childhood. This leads to the rise of
blood pressure and family tensions. Therefore, the coping strategies of the family could seriously
affect and facilitate the thalassemic child’s healthy growth. The present research sought to investigate
the mental health and coping strategies of families with major thalassemic children in Bandar Abbas
in 2013. Materials and Methods: This study is of a descriptive‑analytical and cross‑sectional
type. Research population consisted of 140 parents of major thalassemic children who visited
Shahid Mohammadi Hospital of Bandar Abbas. The instruments used were the 12‑item General
Health Questionnaire of Goldberg and Williams along with the coping strategies questionnaire.
Nonprobabilistic, convenient sampling method was used. To analyze the data, Spearman’s
correlation coefficient, Chi‑square and descriptive statistical tests were used. The significance
level was set at P < 0.05. Results: Data analysis showed that parents’ mental health (32 ± 4.25)
along with their coping strategy scores (45 ± 7.50) was about the average. The most prevalent
coping strategies among the parents were represented as: “I trust in God in order to get my problems
solved” (87%), “to get mentally and spiritually relieved, I would visit mosques and holy shrines” (53%),
and “to overcome problems, I make harder attempts” (50.7%). A significant correlation was found
between the parents’ coping strategies and general health (P < 0.001). A significant correlation
was also observed between mother’s educational level (P = 0.044), age (P = 0.022) and general
health. Discussion and Conclusion: According to the results of this research, it is categorical for
the ministry of health and medical education and those in charge to pay special and adequate
attention to the social, spiritual, and mental health of these children and their families.

Abstract Introduction: with due attention to the importance of learning disabilities and necessity
of presenting interventions for improvement of these disorders in order to prevent future
problems, this study used meta‑analysis of the research model on the impact of psychological
and educational interventions to improve academic performance of students with learning
disabilities. Methods: with the use of meta‑analysis method by integrating the results of various
researches, this study specifies the effect of psychological and educational interventions. In
this order, 57 studies, which their methodology was accepted, were selected and meta‑analysis
was performed on them. The research instrument was a meta‑analysis checklist. Results: The
effect size for the effectiveness of psychological‑educational interventions on improving the
academic performance of students with mathematics disorder (0.57), impaired writing (0.50)
and dyslexia (0.55) were reported. Conclusions: The result of meta‑analysis showed that
according to Cohen’s table, the effect size is above average, and it can be said that educational
and psychological interventions improve the academic performance of students with learning
disabilities.

Abstract Background: Students tend to internalize and perpetuate the patterns of behavior and
the values surrounding them. Review of literature showed that there are several student
learning sources through the hidden curriculum, but they have not been identified in nursing
yet. Hence, the purpose of this study is explanation of learning resources in the hidden
curriculum in the view of baccalaureate nursing students. Materials and Methods: This
qualitative study was carried out in 2012 with the participation of 32 baccalaureate
nursing students in Nursing and Midwifery College of Ahvaz Jundishapur University of
Medical Sciences, Ahvaz, Iran by purposeful sampling strategies. Data were collected
by semi‑structured interviews and continued to the level of data saturation and themes’
emergence. Data analysis was performed through inductive content analysis method.
Result: “Instructor as the unique learning element,” “various learning resources in the
clinical setting,” and “instructive nature of the education environment” were extracted as
the main themes, each of which incorporated some categories. Conclusion: Baccalaureate
undergraduate nursing students learnt the hidden curriculum by the resources such as
instructors, resources existing in the clinical setting, and the university campus. Therefore,
more research is recommended for the identification of other resources. In order to promote
positive messages and reduce the negative messages of the hidden curricula running at
academic and clinical settings, nursing educators and nurses need to learn more about
this issue in the nursing profession.

Abstract Background: The Iranian victims of sulfur mustard attack are now more than 20 years post‑exposure
and form a valuable cohort for studying the chronic effects of an exposure to sulfur mustard.
Articles on sulfur mustard exposure in Iran–Iraq war were reviewed using three known international
databases such as Scopus, Medline, and ISI. The objectives of the study were measurement of
the author‑wise distribution, year‑wise distribution, subject area wise, and assessment of highly
cited articles. Materials and Methods: We searched three known international databases,
Scopus, Medline, and the international statistical institute (ISI), for articles related to mustard gas
exposure in Iran–Iraq war, published between 1988 and 2012. The results were analyzed using
scientometric methods. Results: During the 24 years under examination, about 90 papers were
published in the field of mustard gas in Iran–Iraq war. Original article was the most used document
type forming 51.4% of all the publications. The number of articles devoted to mustard gas and
Iran–Iraq war research increased more than 10‑fold, from 1 in 1988 to 11 in 2011. Most of the
published articles (45.7%) included clinical and paraclinical investigations of sulfur mustard in
Iranian victims. The most highly productive author was Ghanei who occupied the first rank in the
number of publications with 20 papers. The affiliation of most of the researchers was Baqiyatallah
Medical Sciences University (research center of chemical injuries and dermatology department)
in Iran. Conclusion: This article has highlighted the quantitative share of Iran in articles on sulfur
mustard and lays the groundwork for further research on various aspects of related problems.

Abstract Introduction: Traumatic events such as breast cancer along with negative effects on patients
also have positive effects. These cases have been studied less in Iran. Therefore, this study
was conducted with the aim of explanation of positive changes after breast cancer by using a
qualitative approach. Materials and Methods: This qualitative study was conducted in 2012 in
one of the specialized centers for cancer affiliated to Isfahan University of Medical Sciences.
In this study, it was interviewed with 19 women with breast cancer about positive changes
after cancer by using individual, open and deep methods. The interviews were analyzed
with conventional content analysis method. Results: The titles of the three major categories
were included as behavioral changes to maintain and promote health (acquisition of health
information and adopting promoting health behaviors), spiritual development (attention to the
God and sense of meaning in life, revising the values and priorities, strengthening moral and
behavioral traits) and personal growth and flourish (feeling empowerment, confidence and
efforts to achieve the goals and desires). These three categories have led to emerge themes
in this study as the “Awakening after cancer.” Conclusions: The results of this study indicated
positive changes after breast cancer. Considering such changes while providing care and
consulting to patients with breast cancer in addition to facilitate and accelerate positive changes
will be prompted to provide care and proper and influential consulting to promote patient health.

Abstract Introduction: Medical errors in hospitals kill more people every year than AIDS, breast cancer and
auto accidents combined. Widespread consensus exists that health care organizations can reduce
patient injuries by improving the environment for safety from implementing different alternatives
from technical and managerial improvements to considering medical record data. Considering
the preventability of medical errors, the Agency for Healthcare Quality and Research (AHRQ)
developed patient safety indicators (PSIs). This study analyzes the PSIs calculated in Alzahra
Hospital of Isfahan. Materials and Methods: This study was conducted retrospectively using the
inpatient medical record data of hospitalized patients in a six month period, from October 2010
to March 2011. An experienced team in the fields of medical record, health management and
health information technology was involved in data reviewing. Based on a prior consultation and
reviewing, some PSIs were selected. Indicators were calculated considering AHRQ guidelines.
Excel software and hospital information system software were used. Results: Across all studied
medical records of patients, out of 25,164 discharges, below measures were calculated.
‑8 Foreign Body cases (PSI 5) (0.31 per 1000).
‑30 Postoperative Hemorrhage or Hematoma cases (PS I9) (2.2 per 1000).
‑5 Accidental Puncture or Laceration cases (PSI 15) (0.3 per1000).
‑8 Complications of Anesthesia cases (PSI 1) (2.2 per 1000).
‑96 Selected Infections Due to Medical Care cases (PSI 7) (3.8 per1000).
‑17 cases of Postoperative Wound Dehiscence (PSI 14) (3.7per1000).
‑1 Birth Trauma – Injury to Neonate case, and (PSI 17) (1.7 per 1000).
‑18 Obstetric Trauma – Cesarean Delivery cases (PSI 20) (40 per 1000) were flagged by
studied PSIs developed by AHRQ.
Conclusion: Comparing with the reported rates by other studies and AHRQ study in 2006, all
of calculated indicators have inadequate condition; i.e. these are far from empirical estimated
rates. The hospital administrators should be more sensitive to this issue and perform some
improvement programs.

Abstract Background: Undoubtedly, proper nutrition has important role in safeguarding the individual
from many diseases, especially chronic ones, and increasing ones physical and intellectual
efficiency. Considering the importance of nutrition education to school‑age kids, this research
was done with the purpose of determining the effect of nutrition education on the knowledge,
attitude, and performance of female students at primary school about junk food consumption.
Materials and Methods: This is an experimental intervention study in Shahr‑e‑kord city about
the reduction of junk foods consumption in 2011. Seventy‑two primary girl students were
randomly divided into 2 groups, experimental (36) and controls (36). Before of the educational
program, self‑administrative questionnaire and FFQ (Food Frequency Questionnaire)
questionnaire were filled out for both the groups. The self‑administrative questionnaire was
completed 3 times (before, immediately, and 2 months after education), and FFQ questionnaire
was completed 2 times (before and 2 months after education) by students. After pre‑test,
4 educational session classes in experimental group were performed. Finally, data were collected
and analyzed by SPSS16 computer software. Results: Demographic variables of the studied
population in 2 groups were similar. Before intervention, there were no significant differences
regarding the knowledge, attitude, and performance in 2 groups (P > 0/05). After intervention,
there were significant differences in the levels of knowledge, attitude, and performance between
experimental and control groups (P < 0.001). Conclusion: According to the results, intervention
has positive impact on pattern of nutrition, and it can be concluded that intervention is effective
on increasing or improving the knowledge, attitude, and performance of the students.

Abstract Background: Clinical learning environment is a complex social entity. This environment is
effective on the learning process of nursing students in the clinical area. However, learning
in clinical environment has several benefits, but it can be challenging, unpredictable,
stressful, and constantly changing. In attention to clinical experiences and factors
contributing to the learning of these experiences can waste a great deal of time and
energy, impose heavy financial burden on educational systems, cause mental, familial and
educational problems for students, and compromise the quality of patient care. Therefore,
this study was carried out with the goal of determining the learning challenges of nursing
students in clinical environments in Iran. Materials and Methods: In this qualitative study
carried out in 2012–2013, 18 undergraduate nursing students were selected by using
purposive sampling method from the Faculty of Nursing and Midwifery of Tehran and
Shahid Beheshti Universities. Semi‑structured interviews were used to collect data. The
content analysis method was used to determine relevant themes. Results: Two themes
were derived from the data analysis, which represented the students’ clinical learning
challenges. These two themes included insufficient qualification of nursing instructors
and unsupportive learning environment. Conclusions: Identification of the students’
clinical learning challenges and actions to remove or modify them will create more
learning opportunities for the students, improve the achievement of educational goals,
provide training to nursing students with the needed competencies to meet the complex
demands of caring and for application of theories in practice, and improve the quality
of healthcare services.

Abstract Background: Lifestyle affects people’s health and life length, however, no sufficient studies
have been done on the effect of lifestyle on middle‑ageing, as the transitional period from
adulthood to old‑ageing, this study has been conducted to study the effect of educational
intervention on health promoting lifestyle of middle‑aged women in Lenjan city of Isfahan
Province, Iran. Methods: This quasi‑experimental study was conducted on 88 middle‑aged
women were selected through randomized sampling from two health centers in Lenjan, and
then were categorized into experimental and control groups. To collect data, a researcher‑made
demographic and life style questionnaire was used. The educational intervention was performed
in five sessions. Data were collected from both groups in two stages: Before the intervention
and 3 months after the education. Data were analyzed with using SPSS‑20 and P < 0.05 were
considered statistically significant. Results: The results showed that educational program had a
positive significant effect on increasing the mean scores in the intervention group, considering
the physical activity, mental health, and interpersonal relationship, P < 0.001. However, regarding
the nutrition, the mean increase was not significant (P = 0.113). Conclusion: According to the
findings, it is evident that educational intervention is beneficial for various aspects of middle‑aged
women’s lifestyle. Therefore, applying a healthy lifestyle seems essential for having a healthy
aging period, and educational intervention can be effective.

Abstract Introduction: Disease mapping includes a set of statistical techniques that provides maps based on estimates of diseases rates. Bayesian ones are the most important models in this field. They consider prior information on changes in the disease rates in overall map and spatial pattern of the disease. These include a broad range of models with their own formulation, characteristics, strengths, and weaknesses. In the present study, we explain and compare three important and widely-used Bayesian models in the study of evaluating relative risk of suicide in Ilam province. Materials and Methods: In this applied-ecological research, suicide incidence in Ilam province in 2008 and 2009 was analyzed by use of Gamma-Poisson, Log-normal, and BYM Bayesian models. Models were fitted to data using WinBUGS software. Results: Fitting the three models showed that Darehshahr and Shirvan-Chrdavol had the highest and the lowest relative risk of suicide, respectively (relative risks based on Gamma-Poisson, Log-normal, and BYM models were 2.243, 2.275, and 2.279 for Dareshahr and 0.321, 0.321, and 0.319 for Shirvan-Chrdavol, respectively). Conclusion: Despite some differences in estimates, the ranks of relative risks in counties in all three models are the same. The counties based on the relative risks of suicide from the most to the least are: Darehshahr, Ilam, Dehloran, Eyvan, Abdanan, Mehran, Malekshahi, and Shirvan-Chrdavol.  

Abstract Background: Understanding of the medical society’s from the types of information resources for quick
and easy access to information is an imperative task in medical researches and management of the
treatment. The present study was aimed to determine the level of awareness of the physicians in using
various electronic information resources and the factors affecting it. Materials and Methods: This study
was a descriptive survey. The data collection tool was a researcher‑made questionnaire. The study
population included all the physicians and specialty physicians of the teaching hospitals affiliated
to Isfahan University of Medical Sciences and numbered 350. The sample size based on Morgan’s
formula was set at 180. The content validity of the tool was confirmed by the library and information
professionals and the reliability was 95%. Descriptive statistics were used including the SPSS
software version 19. Results: On reviewing the need of the physicians to obtain the information
on several occasions, the need for information in conducting the researches was reported by the
maximum number of physicians (91.9%) and the usage of information resources, especially the
electronic resources, formed 65.4% as the highest rate with regard to meeting the information
needs of the physicians. Among the electronic information databases, the maximum awareness
was related to Medline with 86.5%. Among the various electronic information resources, the highest
awareness (43.3%) was related to the E‑journals. The highest usage (36%) was also from the same
source. The studied physicians considered the most effective deterrent in the use of electronic
information resources as being too busy and lack of time. Conclusion: Despite the importance
of electronic information resources for the physician’s community, there was no comprehensive
knowledge of these resources. This can lead to less usage of these resources. Therefore, careful
planning is necessary in the hospital libraries in order to introduce the facilities and full capabilities
of the mentioned resources and methods of information retrieval.