Journal of Education and Health Promotion

Abstract Objective: Learning by lecture is a passive experience. Many innovative techniques have been
presented to stimulate students to assume a more active attitude toward learning. In this study,
simultaneous sketch drawing, as an interactive learning technique was applied to teach anatomy
to the medical students. Materials and Methods: We reconstructed a fun interactive model of
teaching anatomy as simultaneous anatomic sketching. To test the model’s instruction effectiveness,
we conducted a quasi‑ experimental study and then the students were asked to write their learning
experiences in their portfolio, also their view was evaluated by a questionnaire. Results: The results
of portfolio evaluation revealed that students believed that this method leads to deep learning and
understanding anatomical subjects better. Evaluation of the students’ views on this teaching approach
was showed that, more than 80% of the students were agreed or completely agreed with this statement
that leaning anatomy concepts are easier and the class is less boring with this method. More than
60% of the students were agreed or completely agreed to sketch anatomical figures with professor
simultaneously. They also found the sketching make anatomy more attractive and it reduced the time
for learning anatomy. These number of students were agree or completely agree that the method help
them learning anatomical concept in anatomy laboratory. More than 80% of the students found the
simultaneous sketching is a good method for learning anatomy overall. Conclusion: Sketch drawing,
as an interactive learning technique, is an attractive for students to learn anatomy.

Abstract Introduction: Media literacy is a 21st century approach to education. It provides a framework to
access, analyze, evaluate, and create messages in a variety of forms ‑ from print to video to the
Internet. Also, it builds an understanding of the role of media in society as well as essential skills
of inquiry and self‑expression necessary for citizens of a democracy. The purpose of this research
was to determine the rate of media literacy among Isfahan University of Medical Sciences’
students using Iranian Media Literacy Questionnaire (IMLQ). Materials and Methods: This
is a survey research in which the data were collected by a researcher‑made questionnaire.
Its validity and reliability were confirmed by Library and Information Sciences specialists and
Chronbach’s alpha (r = 0.89), respectively. Statistical population consisted of all students in
Isfahan University of Medical Sciences (7000 cases) and the samples were 364. Sampling
method was random stratified sampling. Data were analyzed by descriptive (frequency
distribution, mean) and inferential (T‑test, ANOVA, and one‑sample t‑test) statistics through
SPSS16 software. Results: The findings showed that the mean level of media literacy among
Isfahan University of Medical Sciences’ students was 3.20 ± 0.558 (higher than average).
The highest mean was skill in avoiding confusion and focus on activates such as watching
television, listening to radio, reading newspaper, and using internet; and the lowest mean was
skill in membership and subscription in useful society networks. The mean of evaluation of
media messages dimension was more than others. The lowest mean of dimensions was for
selective and purposeful use of media with 2.99 ± 0.761. Comparison between gender, married
status, educational degree, and college type and the rate of media literacy among Isfahan
University of Medical Sciences’ students showed no significant difference. Conclusion: The
results showed that the rate of media literacy among Isfahan University of Medical Sciences’
students was higher than average. But students didn’t have enough skill in membership and
subscription in useful society networks and Skill in tracking news about your favorite artists
and musicians. Generally, all students and education practitioners should pay special attention
to factors affecting in improving media literacy as a basic capability in using media.

Abstract Introduction: Osteoporosis is a multifactorial disease and one of the most important modifiable
factors in the development and maintenance of bone mass are nutrition nutritional status and its
relationship with Bone Mass Density (BMD) in postmenopausal women admitted in osteodensitometry
Center, Isfahan, Iran. Materials and Methods: Seventy‑two postmenopausal osteoporotic women
were studied. BMD of the lumbar spine and total hip were measured using dual‑energy X‑ray
absorptiometry. Demographic and dietary intakes were collected by interview and using a validated
food frequency questionnaires. T‑scores, Pearson correlation and one way analysis of variance
tests were conducted to analyze the data. Results: Mean of age and duration of menopause was
nearly 57.5 ± 7.2 and 10.6 ± 7.1 years, respectively. The mean t‑scores for BMD of spine and hip
were 0.877 ± 0.179 and 0.997 ± 0.21, respectively. The mean of calcium (Ca), phosphorous (P),
fluoride (F), Vitamin D, K and Zn were less than DRI and Na more than it (all P value less than
0.0001). BMD of hip was significantly correlated with dietary Ca, animal protein, Zn (P < 0.05), but
BMD of spine did not show any significant correlation with nutrients (P > 0.05). Conclusion: Most
of the postmenopausal osteoporotic women in this study had a considerable deficiency in terms of
micronutrients such as Ca, vitamin D and P, which can be deleterious for bone health.

Abstract Background: The physical activity in teaching faculties is an important aspect to maintain
good health. This not only prevents the various non - communicable diseases but also has
role in secondary prevention of diseases. It is also proven that the growing epidemic of
obesity mostly in children is linked to recent decline in physical activity levels both in home,
school and working places. Social class is thought to have a bearing on physical activity. On
basis of this, the survey was done to assess the physical activity levels in higher social class
population i.e. on teaching faculty of Melaka Manipal Medical College, Manipal, Karnataka,
India. Materials and Methods: Questionnaire study was implemented in 2010 as the design of
this research without any manual intervention. No experiment was conducted in the research.
Questions were specific and related to the physical activities in home and also in working
environment. Results: The study found that in medical college the lifestyle is restricted mostly
to sedentary and moderate work. Most of faculties were using bike and cars to reach there
working place and also we found the physical activities in the form of exercise and sports activity
were lacking. Discussion: In addition to the importance of a physical activity professional’s
potential influence on others as a model, engaging in a physically active lifestyle is very
important for personal reasons. Achieving and maintaining a health-enhancing level of physical
fitness is one of the basic standards for good teaching and maintaining good health. Physical
activity in professionals leads to both personal health benefits, and improve job satisfaction.
Conclusion: Infrastructure improvements such as sports activity in colleges among faculties,
combined with regular exercise provide additional physical activity that would help reduce
obesity and non-communicable diseases.

Abstract Background: Topics on environmental health are usually neglected by students and it is necessary
for them to learn this area with a public health perspective as environment plays a vital role in
multi‑factorial causation of diseases. Hence there is a need for alternative teaching/learning
methods to facilitate students in acquiring the required knowledge. Objectives: To increase the
student interest and enhance their participation in acquiring knowledge in public health perspective
of environmental health. Teaching Objectives/Learning Were: At the end of the session students
should know the importance of air as an environmental factor in disease causation in special
reference to public health hazards, the major sources of air pollution, major pollutants causing the
health hazards, the way to measure pollutants and control them. Materials and Methods: The
whole class of students was divided into two batches and one session was planned for each
batch. Each batch was divided into six small groups. The groups were given task of exploring
the internet on the different topics mentioned in the learning objectives. All the students were
asked to explore, compile information and collectively prepare a presentation and present their
findings based on their reviews. Students’ feedback was collected at the end of each session.
Results: Eighty five percent of them were clear about the learning objectives and interested about
internet learning. Most of them gave a positive opinion about the newer teaching learning method.
Conclusions: Internet assisted group study served as a valuable alternative, innovative, and
interesting tool to teach and learn the environmental health as revealed by students’ feedback.

Abstract Background: Students need emotional intelligence (EI) for their better academic excellence.
There are three important psychological dimensions of EI: Emotional sensitivity (ES), emotional
maturity (EM) and emotional competency (EC), which motivate students to recognize truthfully,
interpret honestly and handle tactfully the dynamics of their behavioral pattern. Objective: The
study was designed to assess ES in the students undergoing yoga therapy program in the
form of yoga instructor’s course (YIC) module. Materials and Methods: One hundred and
eighty four YIC students with 25.77 ± 4.85 years of mean age participated in this study of
21 days duration (a single group pre‑post design). The ES data was collected before (pre)
and after (post) YIC module using Emotional Quotient test developed by Dr Dalip Singh
and Dr N K Chadha. Statistical Analysis: Means, standard deviations, Kolmogorov‑Smirnov
test, and Wilcoxon signed rank test were used for analyzing the data with the help of SPSS
16. Results: The data analysis showed 3.63% significant increase (P < 0.01) in ES.
Conclusion: The present study suggests that YIC module can result in improvement of
ES among university students, thus paving the way for their academic success. Additional
well‑designed studies are needed before a strong recommendation can be made.

Abstract Introduction: The dental students, the same as other students, during their academic
courses are required to learn a wide range of scientific subjects. Obviously, choosing
the inappropriate method of study leads to confuse and disenchantment of students and
it causes wasting of their energy. The purpose of this study was to assess the existing
strengths and weaknesses of the skills and study habits in Dental Students of Shiraz
University of Medical Sciences in 2009‑10. Materials and Methods: In this cross‑sectional
study, all of the dental students (n = 274), who studied at the time of study at all levels in
the academic year of 2009‑10, were selected by the census. Data were collected by using
the Huston University questionnaire consisted of two parts of demographic questions
and 64 specific areas of study skills in eight domains of time management, concentration/
memory, study aids/note taking, test strategies, information processing, motivation,
self‑assessment/reading, and writing skills. Following the retranslation of the questionnaire,
the validity was confirmed by using the content validity method. The reliability was obtained
by using the Cronbach’s Alpha of 0.92. The data were analyzed with SPSS software
version 17 and using analytical statistic tests. Results: Students who have previously
participated in the study skills workshops had stronger skills in comparison with the
students who had not participated in these workshops. Time management skills (P = 0.04),
motivation (P = 0.0001) and information processing (P = 0.03) in students with professional
status were in a more favorable position and showed significant differences in terms of
educational levels. The study skills mean score of the students living in student housings
in comparison with the other students were significantly higher (P = 0.04). Marital status
showed no significant differences in reading skills. Conclusion and Recommendations:
The review of study skills in the undergraduate and post‑graduate dental students indicated
that the residents had higher reading skills.
By recognizing the existing strengths and
weaknesses and holding programs through
counseling centers can develop the study
skills in the students.

Abstract Introduction: Breast cancer is an international health problem in the world over.
Mammography screening behavior has critical role in early detection and decreasing of
its mortality. Educational programs play an important role in promoting breast cancer
screening behaviors and women health. Health belief models (HBM) is the most common
models that have been applied in Mammography screening behaviors. The aim of this
study was to determine the effect of breast cancer screening education using HBM on
knowledge and health beliefs in 40 years women and older. Materials and Methods: In this
Population‑based controlled trial, 290 women of 40 years and older were divided randomly
into experimental and control groups. Health beliefs determined using the Persian version
of Champion’s health belief model scale (CHBMS). Questionnaires were completed before
and 4 weeks after intervention. Four educational sessions were conducted each session
lasting 90 min by lecturing, group discussion, showing slide and educational film based
on HBM constructs. The obtained data were analyzed by SPSS (version 18) and statistical
test at the significant level of a = 0.05. Results: Mean scores of perceived susceptibility,
perceived severity, perceived benefits, barriers and self‑efficacy of mammography and
health motivation in the experimental group had significant differences in comparison
with the control group after educational intervention (P ≤ 0.001). Conclusion: The results
of this study have confirmed the efficiency of educational intervention based on HBM
in increasing of knowledge and health beliefs about breast cancer and mammography
screening behavior. Hence, implementing appropriate educational programs with focus
on benefits of Mammography in early detection of breast cancer and creating positive
motivation for health among women, can increase their practice of having mammography
screening.

Abstract Backgrounds: The present study was carried out in order to compare national and personal
identity and their subscales in internet addicts and nonaddicts. Materials and Methods: This study
was a descriptive-analytical research, and was carried out on 384 student internet users in
different universities in the city of Isfahan who were selected using quota sampling. Subjects
completed the questionnaires, then, subscales of personal and national identity questionnaires
in internet addict and nonaddict were analyzed via SPSS16 software. Results: Results indicated
a significant difference between the scores of national identity and personal identity as well as
all subscales in internet addicts and nonaddicts, except for national heritage and homeland
defence factors. In addition, there was a negative and significant relationship between addiction
to internet and personal and national identity, except for the fourth and fifth factors of national
identity (viewpoints of others considering the national group and homeland defence). Moreover,
after controlling for the sex variable, internet addiction had an effect on personal and national
identity. Conclusion: The findings of this research indicate that an excess of internet use and
overinvolvement in cyberspace and the addiction to them, could be associated with defects
in some aspects of national and personal identity.

Abstract Background: Breast cancer is the most common cause of death in women in the age range
of 35‑55 years. Each year, one or two cases of breast cancer per 1000 women are diagnosed
as new cases. Despite the serious prognosis and high rate of morbidity, mortality, and
pathogenicity, in the case of early diagnoses, the prognosis will be better. The aim of this
study was to investigate the age trends in breast cancer patients with different sizes of tumors
in Breast Cancer Research Center of Isfahan University of Medical Sciences in 2001‑2010.
Materials and Methods: The information in radiotherapy and oncology of Isfahan University of
Medical Sciences and Milad Hospital from 2001 to 2010 were coded and analyzed. Frequency
of patients’ age groups, tumor sizes and the year of cancer diagnosis were calculated.
Correlation test was used for data analysis in statistical analysis in social science (SPSS)
software version 18. Findings: Among the 3722 patients with breast cancer, the highest
relative frequency distribution, respectively was observed in the age of 40‑49 years (34.4%),
50‑59 years (26.6%), 30‑39 years (17.7%), 60‑69 years (13.2%), 20‑29 years (2.5%), 70 years
and older (5.2%) and less than 20 years. Relative frequency distribution of tumor sizes in a
variety of 5 cm (T2) was with the frequency of 59.8%, and then 26% at 5 cm (T3), 10.5% at
2 cm (T1), 3.1% at T4 and 0.6 at In‑situ, respectively. Conclusion: The investigation of age
trends showed that diagnosis rate of breast cancer increased from 2001 to 2004. It reached its
highest value in 2006 at the age range of 30‑39 years. Then, the trend has been downward, and
it has continued to decline until 2010, which
could be the result of the equipping screening
system and recording the malignant cases.
85.8% of the examined tumors in T2 and T3
group were visible and may be disturbing.
Comparing the frequency distribution of the
infected population showed that the highest
incidence of breast cancer diagnosis were in
the age range of 40‑49 years. It seems that as
long as the mass has not reached an obvious
palpable state, it has not been diagnosed.

Abstract Introduction: Health promotion behavior is one of the main criteria for determining health that
is recognized as the basic factor in catching numerous diseases. Observing such behaviors by
the elderly prevents affliction to various diseases and has potential effect in promoting health
and increasing the elderly quality of life. This research was done for the aim of determining
effective factors on health promotion behaviors and health status in the elderly of the Dena
province. Materials and Methods: One hundred twenty elderly of over 65 years of age
were selected randomly to do this descriptive‑analytical study (cross‑sectional type). The
questionnaire regarding health promoting lifestyle profile 2 (HPLP2) was used for measuring
the rate of health promotion behaviors. The data was collected by personal interviews and
face to face method for completing the relevant questionnaire and was analyzed by SPSS
software version 20 and also proper tests. Results: The average score of the elderly health
promotion behaviors in the Dena province (143.8) indicated the acceptable level of performing
health promoting behaviors in this group, such that 85% of the elderly had intermediate
health promoting behaviors and 15% had proper behaviors. Also, the results showed that the
average score of the physical activity and nutrition sub‑measuring conditions was lower than
the average score of other sub measures of prevention had the highest average. Moreover,
comparison of the correlation of health promotion behaviors with the sub‑measures showed
that apart from the healthy nutrition sub‑measure, all the other sub‑measures have significant
correlation with health promotion behaviors. Conclusion: From the findings of this study,
the authors recommend health providers to promote elderly health promotion behaviors in
all communities by identifying health promotion behaviors in other parts of the country, and
also designing suitable intervention programs based on effective factors on health promotion
behaviors of the elderly people.

Abstract Objective: Supporting a therapeutic approach and medication therapy management, the
pharmacy information system (PIS) acts as one of the pillars of hospital information system.
This ensures that medication therapy is being supported with an optimal level of safety and
quality similar to other treatments and services. Materials and Methods: The present study
is an applied, cross‑sectional study conducted on the PIS in use in selected hospitals. The
research population included all users of PIS. The research sample is the same as the research
population. The data collection instrument was the self‑designed checklist developed from the
guidelines of the American Society of Health System Pharmacists, Australia pharmaceutical
Society and Therapeutic guidelines of the Drug Commission of the German Medical Association.
The checklist validity was assessed by research supervisors and PIS users and pharmacists.
Findings: The findings of this study were revealed that regarding the degree of meeting the
standards given in the guidelines issued by the Society of Pharmacists, the highest rank in
observing input standards belonged to Social Services hospitals with a mean score of 32.75.
Although teaching hospitals gained the highest score both in process standards with a mean
score of 29.15 and output standards with a mean score of 43.95, the private hospitals had the
lowest mean score of 23.32, 17.78, 24.25 in input, process and output standards, respectively.
Conclusion: Based on the findings, it can be claimed that the studied hospitals had a minimal
compliance with the input, output and processing standards related to the PIS.

Abstract Objective: To estimate the incidence of hyperechoic, hypoechoic, isoechoic, prostatic cancer in
TRUS (transrectal ultrasound guided) guided prostatic specimens. Materials and Methods: Four
hundred and ninety three patients with raised serum prostatic specific antigen (PSA) and
abnormal DRE findings were subjected to TRUS‑Guided prostate biopsy. Lateralized sextant
biopsy plus prostatic cores from suspicious areas were obtained. Results: Out of 493 patients
who were enrolled in the study, 65 (13.18) patients showed hyperechoic lesions on TRUS and
211 (42.79) patients had hypoechoic lesions on TRUS. Conclusion: Our study has revealed
that hyperechoic lesions on transrectal ultrasonography have more chances of prostatic
cancer as reported in previous literature, so we suggest that we should take additional biopsy
of hyperechoic lesions and perhaps it should be part of the standard protocol in patients
suspected cancer prostate.

Abstract Background: Achieving a balanced and proper nutrition is one of the most important health
objectives in the early years of the child’s life. The aim of this study is to determine the level of
knowledge and attitude of the mothers covered by the urban health centers of Birjand about
nutritional behaviors. Materials and Methods: This descriptive‑analytical study was conducted
on the mothers with children less than five years referring the health centers of Birjand, in 1387.
A questionnaire was prepared for data collection. Data were analyzed using SPSS software,
Chi square, ANOVA, Tukey’s post hoc and Pearson correlation coefficient statistical tests with a
accuracy level of P < 0.05. Results: Two hundred ninety four patients were studied. A meaningful
difference was observed between the knowledge and attitude scores in terms of the mothers’
education stand (P = 0.002). Eighty three point seven percent, 65.6%, 82.7% and 64.6% of
mothers were aware about the importance of iron absorption, the onset of iron supplement drop,
the minerals and vitamins in the body, and the effects of vitamin A deficiency, respectively. The
mothers’ knowledge and attitude about the nutritional behavior was evaluated at the average and
good level, respectively. Conclusions: Considering the average level of the mothers’ knowledge
and attitude about children’s nutritional behaviors, the retraining of family physicians and health
centers staff about the importance of nutritional behaviors is recommended.

Abstract Introduction: Commitment to abstracting standards has a very significant role in information
retrieval. The present research aimed to evaluate the rate of Commitment to ISO 214
Standard among the Persian abstracts of approved research projects at School of Health
Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran.
Materials and Methods: This descriptive study used a researcher‑made checklist to collect data,
which was then analyzed through content analysis. The studied population consisted of 227
approved research projects in the School of Health Management and Medical Informatics, Isfahan
University of Medical Sciences during 2001‑2010. The validity of the checklist was measured by
face and content validity. Data was collected through direct observations. Statistical analyzes
including descriptive (frequency distribution and percent) and inferential statistics (Chi‑square
test) were performed in SPSS‑16. Results: The highest and lowest commitment rates to ISO 214
standard were in using third person pronouns (100%) and using active verbs (34/4%), respectively.
In addition, the highest commitment rates to ISO 214 standard (100%) related to mentioning third
person pronouns, starting the abstract with a sentence to explain the subject of the research,
abstract placement, and including keyword in 2009. On the other hand, during 2001‑2003, the
lowest commitment rate was observed in reporting research findings (16/7%). Moreover, various
educational groups differed significantly only in commitment to study goals, providing research
findings, and abstaining from using abbreviations, signs, and acronyms. Furthermore, educational
level of the corresponding author was significantly related with extracting the keywords from the
text. Other factors of ISO 214 standard did not have significant relations with the educational level
of the corresponding author. Conclusions: In
general, a desirable rate of commitment to ISO
214 standard was observed among the Persian
abstracts of approved research projects at the
School of Health Management and Medical
Informatics of Isfahan University of Medical
Sciences. However, commitment rates differed
between years. In addition, commitment to ISO
214 standard was not significantly related with
educational group and level.

Abstract Background: Due to the importance of health care organizations with significant
responsibility for prevention and care, assessment of job satisfaction among health care
staff is essential. Quality of health services will be decreased provided they are not satisfied.
Materials and Methods: This study was a cross‑sectional analysis of health care staff in
Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience,
they could enter the study. Data included a two‑part questionnaire with a standardized
questionnaire, demographic variables, and Smith job descriptive index, which is a questionnaire
with six domains. Reliability was obtained for each domain and its validity was reported 0.93.
Findings: The results showed an overall satisfaction score averages 43.55 ± 12.8 (from 100). Job
satisfaction score was not significantly different between the sexes. However, within the current
attitude toward job satisfaction, men scores was better than women (P = 0.001). Highest score
in job satisfaction was related to relationships with colleagues and lowest score was related to
the income, benefits, and job promotion.The more the years of work, the less the job satisfaction
was. The attitude toward the current job had a direct relationship with income (P = 0.01). There
was a significant inverse relationship between educational level and job satisfaction in domains
promotion, income, and benefits (P = 0.01). The staff with higher education levels was less
satisfied with income and job promotion qualification. Conclusion: Managers should focus on
job qualification to increase job satisfaction and improve the quality of work.

Abstract Introduction: University teachers are one of the main pillars of university and the quality of their
performance must continuously and systematically be evaluated. This evaluation can be carried
out in various ways. The aim of the present study was to survey and to compare the evaluation
of faculty members in the medical school in Birjand University of Medical Sciences by three
different sources: Student rating, self‑assessment, and evaluation by head of related department.
Materials and Methods: This descriptive analytical cross‑sectional study was conducted in the
academic year 2009‑2010. Sampling was drawn from all students studying basic science and
clinical training in the first and the second semesters. All heads of departments in basic science
and clinical training and their faculty members took part in this study. Means of data collection
were four different questionnaires designed in the education development center (EDC) and their
validity and reliability had been verified by the center. These questionnaires were based on student
rating, self‑assessment, and evaluation of faculty members by heads of clinical and basic sciences
academic departments. After the questionnaires were filled out, the obtained data was analyzed
by Statistical Package for the Social Sciences (SPSS) software (version 13), independent t‑test,
and Pearson’s correlation coefficient at the significant level of  = 0.05. Results: In the present
study, 2417 students completed the questionnaires regarding 63 faculty members, 87 faculty
members completed the self‑assessment form, and for 60 faculty members, 48 members in clinical
and 12 members in basic science, the questionnaires were completed by heads of respective
departments. Mean and standard deviation of student evaluation, self‑assessment, and teachers
evaluation by heads of departments were 3.23 ± 0.38, 3.51 ± 0.33, and 3.60 ± 0.32, respectively,
and the difference between student rating and
self‑assessment was significant (P = 0.02). In
comparing between managers scores with
students evaluation, no significant difference
was observed (P = 0.68). Comparison
between self‑assessment and teachers
scores by managers showed a significant
difference (P = 0.04). Mean scores of faculty
members in clinical training and in basic
science were 3.23 ± 0.73 and 3.31 ± 0.69
on the part of students, respectively; thus,
the difference was significant (P = 0.004).
Conclusion: Since, the present study wasinconsistent with similar previously carried out investigations, the observed difference among
the three procedures was statically significant; hence, it can be suggested that student’s scores
of teachers evaluation, previously used as the only one of evaluation source is not enough and
other sources such as assessment by the respective department heads, dean of faculty, and
self‑assessment must also be taken into consideration. This collection can definitely yield a more
favorable evaluation of faculty members and feedback can be more acceptable to them and it
will be more effective in improving their education.

Abstract Introduction: Studies showed that lack of interest in the field of study in the 1st year of residency
could create stress and then causing psychological problems like anxiety. The purpose of this study
was the evaluation of relationship between interest to the specialized field of study and the level of
medical residents’ anxiety in 2010. Materials and Methods: This study was a cross‑sectional study.
The statistical population of this study was the medical residents (1st‑4th year) from the Universities
of Medical Sciences of Isfahan, Gilan, Sanandaj and Kashan (370 residents). They were selected by
stratified sampling method proportional to size and were included in this study. Data was collected
by using the researcher‑made questionnaire of demographic characteristics, the questionnaire
about the field of study selection and Zung anxiety self‑assessment standard questionnaire. The
findings were analyzed by using the SPSS statistical software version 16, descriptive and analytical
tests (t‑test, one‑way ANOVA and Pearson). The significance level was considered as P ≤ 0.05.
Results: The results showed that more than 92% of the surveyed residents did not have anxiety
and were in the normal group. There was a significant correlation between the specialized field of
interest and anxiety scores of the residents (P < 0.05). In particular, the following cases had a direct
effect on interest rates and anxiety in residents: the amount of time for visiting and patient care, job
stress, time for personal affairs, the ability to predict the agenda and job security. Conclusions: The
relationship between various factors and anxiety level was corroborated that the residents’ interest
and success in studying was the result of their choices and management plans to eliminate barriers
for the selection of the field and the favorite city by the officials and planners.

Abstract Context:Studies on the World Health Organization Frame‑work Convention on Tobacco Control(FCTC)
are scarce in Iran and the Eastern Mediterranean region (EMR). Aim: This study was conducted in
2007‑2008 in Iran to design a practical evaluation model of the implementation of FCTC with the
potential to be adopted in the EMR. Given that, the findings of this evaluation can be useful in increasing
political and public support for enforcing the implementation of legislations, testing their feasibility, and
maintaining sustainability. The viewpoints of tobacco growers as part of stakeholders in this regardwould
have an influential role. Settings and Design:This study was a qualitative one to investigate the tobacco
growers viewpoints about thestrengths/weaknesses of FCTC implementation in Iran. Materials and
Methods: In this study, we conducted semi‑structured in‑depth individual interviews with 5 tobacco
growers. All interviews were carried out with their permissionwere recorded and were assured that
their interviews will be kept confidential. All questions were related to different FCTC articles, then
written transcripts were prepared and the basic concepts were extrapolated. Statistical Analysis:After
transcribing the recorded interviews, we extracted first level codes and main concepts from them.
Results: The findings suggested that although tobacco growers agreed with FCTC implementation,
however, subjects like the necessity to support tobacco growers and obtaining insurance from the
government, the necessity of the enforcement of national tobacco control law and planning to decrease
access to tobacco by policy makers were the most key points that tobacco growers pointed to them.
Conclusion: Our results showed that tobacco growers agreed with the implementation of FCTC but
they worried about their job and the expenses of their daily life. Therefore, it seems that policy makers
have to design a plan to support tobacco growers for changing tobacco with a safe cultivate.

Abstract Background: Majority of HIV/AIDS patients who are on Highly Active Anti Retroviral Therapy
(HAART), are not aware about drug adherence and its importance which is the most important
factor for drug adherence. Objectives: To study the level of drug adherence in patients accessing
antiretroviral therapy (ART) through the National program and factor influencing drug adherence.
Materials and Methods: In present study, we enrolled 102 newly diagnosed patients, among
them in 79 patients, ART was started. To study the drug adherence a pretested, semistructured
questionnaire was formed and patients were followed up for 6 months of the study. Pretest and
posttest counseling was done to all such patients. Results: A total of 28 patients missed the
dose in 1st follow-up, nine patients missed in 2nd follow-up, eight patients missed in 3rd follow-up.
Three patients lost follow-up in 2nd follow-up, three patients further lost follow-up in 3rd follow-up.
Running out of pills (40.0%), side effect (15.5%), and family problem (13.3%), poor transport
facility for taking drug (8.9%) and forgetfulness (11.1%) are five major causes related to miss
dose. In females patients, drug adherence (69%) was initially less than male patients (76%) but
latter on female patients (96.3%) had better adherence than males (95.2%). Conclusion: This
study suggest that drug adherence can be increased by proper counseling and close monitoring
of the patients which may have a great role in preventing the drug resistance and ART response.

Abstract Background: The advent of internet has triggered a growth in provision of more interactive
health promotion messages, which are likely to enhance the potential for behavior change
especially among children. We intended to find out the determinants and prevalence of use
of internet among school students of Puducherry. Materials and Methods: An exploratory
study was carried out among all the students belonging to the standards VI to IX (n = 421) in
three schools from urban areas and two schools from rural areas of Puducherry. A pretested,
self-administered questionnaire which sought information on sociodemographic details (age,
gender, standard of education, occupation of father, and type of school), use of internet, and
place of accessing internet, hours of use, and reasons for use was utilized. The statistical
significance between the categorical variables was done using chi-square test. All significance
tests were two-tailed and statistical significance was defined as a value of P < 0.05. Results:
Majority (72.2%) were boys. Less than one-third (23.8%) of the students used internet. The
use of internet was found to be significantly higher in mid-adolescents (Adjusted OR: 2.205);
among boys (Adjusted OR: 3.835) and students from urban areas (Adjusted OR: 4.694).
Conclusion: There is a geographical and gender divide observed among the school children
in the use of internet. Taking the steps to bridging the digital divide will help utilize internet as
a media for health promotion.

Abstract Introduction: One of the important criteria in the promotion of faculty members is in the scope of
their educational roles and duties. The purpose of this study was the assessment of reasonability
and attainability of educational criteria for scientific rank promotion from the perspective of
the faculty members of Medical Sciences Universities in Iran. Materials and Methods: This
descriptive study was conducted in 2011 in 13 Universities of Medical Sciences in Iran. Through
stratified sampling method, 350 faculty members were recruited. A questionnaire developed by
the researchers was used to investigate the reasonability and attainability of educational criteria
with scores from 1 to 5. The self-administered questionnaire was distributed and collected
at each university. The mean and standard deviation of reasonability and attainability scores
were calculated and reported by using the SPSS software version 16. Results: Faculty members
considered many criteria of educational activities reasonable and available (with a mean score
of more than 3). The highest reasonability and attainability have been obtained by the quantity
and quality of teaching with the mean scores (3.93 ± 1.15 and 3.82 ± 1.17) and (3.9 ± 1.22
and 4.13 ± 1.06) out of five, respectively. The mean and standard deviation of total scores of
reasonability of educational activities were 50.91 ± 14.22 and its attainability was 60.3 ± 13.72
from the total score of 90. Discussion and Conclusion: The faculty members of the Universities of
Medical Sciences in Iran considered the educational criteria of promotion moderately reasonable
and achievable. It is recommended to revise these criteria and adapt them according to the mission
and special conditions of medical universities. Furthermore, providing feedback of evaluations,
running educational researches, and implementing faculty development programs are suggested.

Abstract Introduction: Cognizance of any error-prone professional activities has a great impact on
the continuity of professional organizations in the competitive atmosphere, particularly in
health care industry where every second has critical value in patients’ life saving. Considering
invaluable functions of medical record department — as legal document and continuity
of health care — “failure mode and effects analysis (FMEA)” utilized to identify the ways
a process can fail, and how it can be made safer. Materials and Methods: The structured
approach involved assembling a team of experts, employing a trained facilitator, introducing
the rating scales and process during team orientation and collectively scoring failure modes.
The probability of the failure-effect combination was related to the frequency of occurrence,
potential severity, and likelihood of detection before causing any harm to the staff or patients.
Frequency, severity and detectability were each given a score from 1 to 10. Risk priority
numbers were calculated. Results: In total 56 failure modes were identified and in subsets
of Medical Record Department including admission unit dividing emergency, outpatient and
inpatient classes, statististic, health data organizing and data processing and Medical Coding
units. Although most failure modes were classified as a high risk group, limited resources
were, as an impediment to implement recommended actions at the same time. Conclusion:
Proactive risk assessment methods, such as FMEA enable health care administrators to
identify where and what safeguards are needed to protect against a bad outcome even
when an error does occur.

Abstract Context: One of the most important subjects in health economics and healthcare management
is the theory of induced demand. There are different views about the concept of induced
demand. Extensive texts have been presented on induced demand, however a compatible
concept has not necessarily been provided for this phenomenon and it has not been defined
explicitly. Aims: The main aim of this article is to understand the concept of induced demand
with the use of experts’ perceptions of Isfahan University of Medical Sciences. Settings and
Design: The research was done using a qualitative method. Semi-structured interview was
used for data generation. Participants in this study were people who had been informed in this
regard and had to be experienced and were known as experts. Purposive sampling was done
for data saturation. Materials and Methods: Seventeen people were interviewed and criteria
such as “reliability of information” and “stability” of the data were considered. The anonymity
of the interviewees was preserved. Statistical Analysis Used: The data are transcribed,
categorized and then the thematic analysis was used. Results: In this study, 21 sub-categories
and three main categories were derived. Three main subjects were included: Induced demand
definition, induced demand elements, and induced demand methods. Each of these issues
contained some sub-subjects. Conclusion: The result of this study provides a framework for
examining the concept of induced demand. The most notable findings include the definition
of induced demand, induced demand elements, and method of induced demand. In induced
demand definition, an important issue that is often overlooked is that inducing regarding to
the effectiveness of clinical services and medical values can lead to better or worse outcomes
for patients. These findings help the health policy makers study the phenomenon of induced
demand with clear-sighted approach.

Abstract One of the methods, especially those living in remote areas or have crashed and does not have
access to specialists is telemedicine. Telemedicine describes the use of medical information
exchanged from one site to another via electronic communications to improve patients’ health
status and care. Travel and wait times between the initial consultations with the patient’s own
general practitioner and referral to specialist can be reduced and specialists have successfully
provided remote triage and treatment consults of victims via the robot. The robot proved
to be a useful means to extend resources and provide expert consulting if specialists were
unable to physically be at the site. In fact, the telemedicine system is providing health care
services for individuals who are not available because of geographical and environmental
conditions. The aim of this study was to identify telemedicine applications in disaster, and
proposed use of this technology in areas where the shortage of specialists in remote areas
in disasters. This study was un-systematic (narrative) review. The literature was searched
for using of telemedicine in disaster and remote places with the help of libraries, conference
proceedings, data bank, and also search engines available at Google, Google scholar. In
our searches, we employed the following keywords and their combinations: telemedicine,
remote place, earthquake, disaster, war, and telecommunication in the searching areas of
title, keyword, abstract, and full text. In this study, more than 85 articles and reports were
collected and 26 of them were selected based on their relevancy. This literature review helps
define the concept of “components and usages of the Telemedicine in disaster” as the new
technology in the present age.