Journal of Education and Health Promotion

Abstract Background: Today, much attention has been paid to the patient role as the central factor in the
management of their own health. It is focused on the issue that the patient has a more critical role
compared with the health-care provider in controlling the patient own health. defines health literacy
as the degree to which individuals have the capacity to obtain, process, and understand basic health
information and services needed to make appropriate health decisions. Objective: The objective of
this study was to determine health literacy, health status, healthcare utilization and the relationship
between them in 18 - 64 years old people in Isfahan. Structure and Design: This study was a
descriptive analytical survey, which was conducted on 300 subjects of 18-64 years old in Isfahan
with Multi-stage sampling method proportional to selected sample size. Materials and Methods:
For collecting the data, questionnaire adapted from CHAP (Consumer Assessment of Healthcare
Providers and Systems) health literacy questionnaire was used. Health status was measured based
on an assessment of the physical and mental health over the past 6 months by 5° Likert scale. Data
analysis was performed by using SPSS 18, descriptive statistics, Chi-square test and multivariate
analysis of variance. Results: There was no significant correlation between health literacy, health
status and healthcare utilization. Utilization was less in the urban area No. 6 of the city. In the
bachelor’s degree group, the health status was lower than the other groups in these cases: Older
ages, married, women, large family size, undergraduates, and urban area No. 14. Conclusions:
Due to the average prevalence of health literacy in 18-64 years old individuals in Isfahan and lowhealthcare utilization, the followings are recommended: Necessity of more attention to the issue
of health literacy, improving the physician-patient relationship and community awareness, whether
through health promotion programs or media for the optimum use of available resources.

Abstract Introduction: Obesity is a growing problem in all countries which leads to various physical,
psychological, and social problems. The present study aimed to assess depression
in children and adolescents aged 10-18-year old compared with the control group.
Materials and Methods: In a case-control study, from among the 10- to 18-year-old students
of the five education districts of Isfahan, 100 people (50 girls and 50 boys) were selected as
obese children with the Body Mass Index (BMI) of greater than 95th percentile for their age
and gender and 100 others (50 girls and 50 boys) as the control group with the BMI of 5th to
85th percentile. The case and control groups were matched for age, gender, and socio-economic
status. After calculating BMI based on weight (kg)/height2 (meter), subjects were interviewed
based on DSM IV criteria to diagnose clinical depression. The severity of children’s depression
was measured using standardized questionnaire. Results: The mean age of the case group
was 12.2 ± 1.86-years old and that of the control group 13.06 ± 2.25. They were, respectively,
diagnosed with depression of 7% and 6%. The mean depression score of the case group
was 11.7 ± 5.3 and that of the control group was 10.6 ± 6.03 with no statistical significance.
Discussion: Given our findings, the Jolly fat hypothesis applies to the case group. It seems
that health policy-makers need to make intervention plans to change behavior; attitude, skill,
and knowledge (BASK) of the public toward obesity and its long-term side-effects.

Abstract Background: Studies indicate that the initial transition period between preclinical and clinical
phases are the most stressful. The students have experienced the difficulty in performing clinical
procedures due to the vast difference in the clinical and preclinical setup. It is better to identify the
particular skill found poorly correlated, enabling educators to address the concerns. We sought
the opinion and suggestion from the beneficiary student on fixed prosthodontics steps difficult to
practice in clinical setup at the initial stage, their suggestion to overcome these shortcomings was
also sought. Aims: To determine the fixed prosthodontics skills difficult to perform in a transition
period due to poor correlation between preclinical and clinical training from our focus group study
on the student’s perception, and their suggestion regarding alternative methods to improve the
preclinical training. Materials and Methods: Focus groups in the study were the students involved
in clinical practice of fixed partial denture procedure. A well-constructed Questionnaire, designed
to evaluate the difficult clinical steps in a transitional period and suggestion to improve the existing
preclinical training was distributed to all focus group students. The response to the questionnaire
was based on the five-point Likert scale. Statistical Analysis Used: Medians, frequencies were
used to assess their perception on preclinical training and suggestion. Results: A total of 97
students participated in the study, 88% response received during the survey. The clinical steps
student felt difficult during a transition period from preclinical to clinical phase were positional
variations of teeth (52.6%-63.9%), fluid control (48.5-67.1%), shade selection procedure (29.9%-
50.5%), subgingival cervical finish line preparation (38.1-51.5%), and gingival retraction procedure.
The students felt that the inclusion of problem-based learning, preclinical patient exposure, and
better simulation will alleviate the stress during the transition period. Conclusions: This study
highlighted the tooth preparation steps found difficult to practice in a transition period between
preclinical and clinical phases. This study also
obtained suggestions from the students for
innovative upgradation of the course curricula.

Abstract Psychological problems as state anxiety (SA) in the work environment has negative effect on
the employees life especially shift work nurses, i.e. negative effect on mental and physical
health (sleep quality, eye fatigue and comfort thermal).The purpose of this study was
determination of effects of state anxiety and thermal comfort on sleep quality and eye fatigue
in shift work nurses. Methods: This cross-sectional research conducted on 82 shift-work
personnel of 18 nursing workstations of Isfahan hospitals in 2012. To measure the SA, sleep
quality, visual fatigue and thermal comfort, Spielberger state-trait anxiety inventory, Pittsburg
sleep quality index, eye fatigue questionnaire and thermal comfort questionnaire were used
respectively. The data were analyzed with descriptive statistics, student test and correlation
analysis. Results: Correlation between SA and sleep quality was −0.664(P < 0001), Pearson
correlation between SA and thermal comfort was −0.276(P = 0.016) and between SA and eye
fatigue was 0.57 (P < 0001). Conclusion: Based on these results, it can be concluded that
improvement of thermal conditions and reduce state anxiety level can be reduce eye fatigue
and increase the sleep quality in shift work nurses.

Abstract Background: A number of diagnostic scales or questionnaires have been developed in recent
years, to assess mobile phone dependency. A valid and reliable assessment instrument for
correspondence of Iranian culture is essential. The aim of our study is to validate the Iranian
version of the Cell Phone Dependency Questionnaire (CPDQ). Materials and Methods: In this
cross-sectional study, data were collected from 784 students, who were studying in four main
Isfahan Universities. The participants completed the demographic questionnaire, CPDQ,
anonymously. To analyze the data we used concurrent validity, factor analysis, internal
consistency, split-half, and test–retest. Results: We extracted three factors including Salience,
Overusing of the cell phone, compulsive use of SMS. Cronbach’s alpha of the CPDQ was.
88 (Cronbach’s alpha of the factors were 0.85, 0.70, and 0.76,, respectively). Conclusion: The
CPDQ proved to be a reliable questionnaire to assess the extent of problems caused by the
‘misuse’ of the cell phone in Iranian society.

Abstract Background: The present study aimed to investigate the effect of stress management
training through cognitive-behavioral techniques on stress, social adaptability and depression
in women with depression disorders. Materials and Methods: In this study, 40 patients
diagnosed with depression who had referred to psychiatry and consultation clinics of Isfahan
were randomly selected and assigned to intervention and control groups (20 patients in each
group). The intervention group received eight 90-min sessions of stress training through
cognitive–behavioral techniques. Data collection tools included Cooper’s stress questionnaire,
Bell’s social adaptability questionnaire and Hamilton’s depression scale questionnaire.
The participants completed the questionnaires before the intervention and 1 month after
the same. Data analysis was performed using covariance analysis. Results: Based on the
results, considering variables of stress, social adaptability and depression, the equal variance
hypothesis was confirmed. The relationship between pre- and post-test scores on stress,
social adaptability and depression was statistically significant (P < 0.001). The modified mean
difference was F = 12.45, P < 0.001 on stress; F = 6.88, P < 0.01 on social adaptability;
and F = 5.36, P < 0.02 on depression, all of which were significant. Conclusion: Stress
management training through cognitive behavioral techniques can play a main role in
depression reduction and development of social adaptability through modifying inappropriate
social information-processing patterns.

Abstract Background: Breast cancer is the most prevalent type of cancer among Iranian females;
it is noteworthy that the condition of this type of cancer among Iranian women does not
significantly differ from what has been reported from other countries. Considering the
importance of this issue, identification of the backgrounds factors and risk factors of the
breast cancer risk are highly needed. Therefore, the present study is aimed to compare
the risk factors of resident patients of Isfahan province, Iran, with accredited risk factors by
other countries and also identify the importance of each factor in the incidence of cancer.
Materials and Methods: The present work is a case-control study, which was conducted
in 2011. In order to conduct the study, 216 women who had been clinically identified with
breast cancer were selected from Seiedo-Shohada Hospital, Isfahan, Iran, as the case group.
Moreover, 41 healthy women who were the relatives of the selected patients (i.e., sisters and
aunts) were selected as the control group. The data and information of the patients from
1999 to 2010 were collected from either assessing the database system of the center for breast
cancer research or interviewing the patients through phone. To analyze the data, multiple
logistic regression method was applied. Results: The range of age among selected individuals
in this study was from 20-75 years old. The determinant factors for odds of breast cancer
included in the applied multiple logistic regression model were the use of oral contraceptive
pills (OCPs) (odds ratio [OR] =0.18, 95% confidence interval [CI] = 0.04-0.75) as the protective
factor, hormone replacement therapy (OR = 10.2, 95% CI = 1.18-88.89) and menopause at
old age (OR = 1.26, 95% CI = 1.11-2.12) as the risk factors. Furthermore, there was not seen
any significant relationship between age, vocation, and marital status with odds of breast
cancer in multiple model. Conclusion: Based
on the results, use of OCPs as protective
factor, hormone replacement therapy, and
menopause at old age are identified as the
risk factors in developing breast cancer
among women. Influencing and modifiable
factors should be considered very important
in society based interventions and preventive
interventions planning.

Abstract Background: Although psychological factors are now recognized as playing a significant
and independent role in the development of coronary heart disease (CHD) and its
complications, many of these factors are correlated with each other. The present study is
aimed at examining the association between alexithymia and anxiety depression, stress,
quality of life, and social support in CHD patients. Materials and Methods: In this research
398 patients with coronary heart disease (166 females and 232 males) from the city of
Isfahan were selected using random sampling. The tools used included depression, anxiety,
and stress scale (DASS-21), Health-related to Quality Of Life (HRQOL-26), Multiple Scale
Perceived Social Support (MSPSS-12), and the Toronto Alexithymia Scale (TAS-20). The data
were analyzed using structural equation modeling by using the Statistical Package for Social
Science (SPSS21) (IBM Corp: Armonk, New York.U.S.) and Asset Management Operating
System (AMOS21) SPSS, an IBM Company: Chicago, U.S. Software. Results: Results of
the structural equation model showed an acceptable goodness of fit, for the explanation
alexithymia that was significantly associated with lower HRQOL and social support and
increasing anxiety, depression, and stress. Conclusions: Alexithymia may increase anxiety,
depression, and stress and can be a predisposing factor to poorer HRQOL and social
support.

Abstract Background: Appropriate family planning counseling for informed choice, the right and
responsible use of contraceptive methods is very important. Various barriers such as social
barriers can have the effect on family planning counseling. In addition, investigation of those
barriers from the perspective of managers, staff and clients, who are major members in
health care system, has great importance. The present study was conducted with the goal
of comparing managers’, employees’, and clients’ viewpoints about social barriers in family
planning counseling in health care centers in Isfahan in 2012. Materials and Methods: This is a
cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects
including 59 managers, 110 employees, and 126 clients in medical health care centers
in Isfahan in 2012. Managers and employees were selected by census sampling and the
clients were recruited through convenient random sampling. The data collection tool was a
researcher made questionnaire, which was designed in two sections of fertility and personal
characteristics and viewpoint measurement. Descriptive and inferential statistical test were
used to analyze the data. Results: The obtained results showed significant difference between
mean scores of viewpoints in three groups of managers, employees, and clients concerning
social barriers in family planning counseling (P = 0.001). In addition, most of the managers
and employees reported social barriers as the barriers in process of family planning in a large
level and clients reported it in moderate level. Conclusion: The results express the necessity
of health services managers’ planning to modify or delete social barriers, especially the agreed
barriers from the viewpoint of managers and employees that effect on family planning counseling
and quality of service provided by them.

Abstract Background: Health literacy is an individual’s need in each Society. Health literacy is a
set of skills in reading, listening, analysis, decision making and the ability to apply these
skills to health situations. The purpose of this study was to assess health literacy level
in Inpatients of educational Hospitals of Isfahan University of Medical Sciences in 2012.
Materials and Methods: A navigational and analytical- applied survey of 384 Inpatients was
conducted in educational hospitals of Isfahan University of Medical Sciences. Health literacy
was measured by the Test of Functional Health Literacy in Adults (TOFHLA). Reliability of
Questionnaire was obtained through Cronbach’s alpha and it was 0/89 and its validity was
confirmed by experts. The data were collected in clinical inquiry and were analyzed using
SPSS (as Descriptive was Frequency distribution, mean, standard deviation and as analytical
was Independent T-test, ANOVA and Pearson correlation test and Spearman correlation test).
Findings: Results showed that the average of Health literacy scores in Inpatients was 35/31
in Numeracy test and 31/94 in Reading Comprehension test. The mean total score of health
literacy was 29/63. Thus, the Most of these Inpatients were found to have inadequate health
literacy. No significant association was found between health literacy level and gender, income,
Occupation and residence. Health literacy was associated with age, marriage status and
education. Conclusion: The results showed that most of Inpatients in of educational Hospitals of
Isfahan University of Medical Sciences were marginal and inadequate health literacy. Therefore,
they need to more help and details to understand and use health information.

Abstract Background and Objective: Depression is one of the most common and specific problems
during pregnancy and after it. Maternal postpartum depression compromises mother’s health
and affects social relationship, and has negative effect on infant development. The aim of
this study was to investigate the prevalence of postpartum depression and its related factors
in Isfahanian mothers. Materials and Methods: This is a cross - sectional study. The study
populations were 133 women who at the last 8-4 weeks of labor referred to Isfahan health
centers. Demographic information and obstetric and Beck Depression Inventory were applied.
Three categories emerged according to the degree of scale: Mild, moderate, and severe
depression. Statistical analysis was used with the Pearson correlation and linear regression
in SPSS version 18. Results: A total of 73 mothers had mild depression (10-19) and 56 had
moderate depressions (20-29). Among the factors related to depression such as maternal
education, financial status, unwanted pregnancy, premenstrual syndrome, and maternal
occupational history, there was a significant correlation with postpartum depression (P > 0.05).
Variables in the regression analysis include maternal education, financial status, unwanted
pregnancy, history of premenstrual syndrome, maternal occupation, type of delivery, history
of miscarriage, and having a satisfaction with baby gender. And, a total of 27.7% variance
explains the postpartum depression. Among these factors, the predictive variables of maternal
education, type of delivery, financial condition, unwanted pregnancy, premenstrual syndrome,
and maternal occupational history were significant in the meantime; the prediction of unplanned
pregnancy was more than other variables (ß = 0.24). Conclusions: With attention to factors
associated with postpartum depression, the healthcare planner will help to better manage the
problem. The results of this study will help to better understand the factors influencing mothers
in the labor process, and mothers in the labor
process, experiences minimum mental health
disorders.

Abstract Background: The goal of treating chronic diseases, including hematologic malignancies, is
to increase patients’ life span and to improve their capabilities as much as possible; so that
patients could maintain an appropriate level of quality of life (QoL) and continue their lives. Most
studies performed to evaluate the treatment of various diseases were mostly focused on the
increase of life expectancy regardless of the QoL and treatment issues. Furthermore, fatigue
is one of the most common and distressing side effects of cancer and treatments related to it,
which can affect a patient’s QoL, and be followed by many problems. This study was designed
and implemented with the aim to determine the factors affecting the QoL and fatigue in patients
with leukemia undergoing chemotherapy. Materials and Methods: This was a cross-sectional
correlation descriptive-analytical study. One hundred and fifteen patients with leukemia referred
to Sayyed-Al-Shohada Hospital were enrolled in the study through convenient sampling method.
To collect data, a three-part questionnaire was used: The first part was related to demographic
characteristics and disease-related data and the second part was the fatigue check list and
the third part was the Short-Form 36 Health Survey (SF-36) related to QoL. The data were
analyzed after collection and coding through Software SPSS version 18 and descriptive and
analytical statistics (analysis of variance test, independent t test, Pearson’s and Spearman’s
correlation coefficient) with 95% confidence interval. Results: The results showed that there was
a significant correlation between QoL in Physical Component Summary with gender (P = 0.03),
educational level (P = 0.09), and marital status (P = 0.004), Also there was a significant correlation
between QoL in Mental Component Summary with educational level (P = 0.01) and economic
status (P = 0.02). Findings showed that there was a significant correlation between fatigue
and marital status (P = 0.005). But statistically there was no significant correlation between
demographic variables such as age, educational level, and employment status with patients’
fatigue. Spearman correlation coefficient showed that there was a significant correlation between
fatigues with pain (P = 0.005). Also findings revealed the statistically significant correlation
between fatigues with economic status (P = 0.003). Conclusion: According to the present
results, it seems that some demographic
factors affect QoL and significant relationship
exists between them. Fatigue in patients
with leukemia dramatically affects their QoL.
Therefore, it is important for medical staff to
pay attention to demographics and fatigue
in leukemic patients in order to improve their
QoL and help them to organize their activities
to promote health and QoL.

Abstract Background: Neonatal conjunctivitis leads to several ocular consequences in the affected
neonates such as blindness. Currently available therapeutic options include NaNO3,
Gentamicin, Neomycin and so on, in which each of them has their own limitations. Regarding
the immunologic content of colostrum and its safety and easy accessibility, we aimed to
evaluate its preventive effects against neonatal conjunctivitis. Materials and Methods: In
this clinical trial, conducted from November 2011 to July 2012, 300 preterm neonates, with
culture negative eye swab, were enrolled and randomly assigned into three groups. The
intervention group received two drops of colostrum. Control group received no treatment and
other neonates were treated with topical Erythromycin ointment (0.5%). All neonates were
followed for occurrence of clinical conjunctivitis for 28 days. Data analysis were performed by
Chi-square test. Results: Our data demonstrate the beneficial preventive effects of Colostrum
against neonatal conjunctivitis (P = 0.036). Conclusion: Colostrum is suggested as an
alternative prophylactic option for antibiotics against neonatal conjunctivitis. As colostrum is
easily accessible without cost, potential hazards and side effects, public education about its
topical favorable effects is worthwhile.

Abstract Introduction: Rabies is a fatal zoonotic viral disease that is spread to people through animal bites.
Around 35,000-50,000 individuals worldwide die of rabies each year, of which more than 99%
of deaths occur in the developing countries. Since legislative actions does not appear to have
been effective in reducing the incidence and severity of the bites in some developed countries, it
seems public education is key to reducing animal bites. For effective education, understanding
factors affecting the preventive and protective behaviors based on appropriate health behavior
change models is important. So, the study tried to examine the relationship between Health
Belief Model (HBM) constructs and rabies preventive measures. Materials and Methods: In the
cross-sectional study, a HBM-based researcher-designed questionnaire was completed by
204 participants who were selected via cluster sampling design from urban families of the
Abadeh, Iran. The psychometric properties of the questionnaire were established. Descriptive
statistics, independent sample t-test, bivariate correlations, and stepwise multiple regression
analysis were applied to analyze data using SPSS 19. The level of significance was set a priori
at 0.05. Results: The scale mean for the total knowledge of the participants about rabies was
14.12 ± 6.04 out of 29. Participants’ preventive behaviors were significantly correlated with their
total knowledge, perceived susceptibility, perceived severity, perceived benefits and cues to
action, which 19% of the variation in these behaviors were explained by perceived benefits and
cues to action. Protective activities of participants who kept animals in their house had statistically
significant correlation with their total knowledge score and cues to action. 32.1% of the variation
in these activities was explained by cues to action. Discussion: Findings indicate that participants
had not enough knowledge about routes of infecting by rabies and how to prevent it. The most
powerful predictors for preventive behaviors and protective activities were perceived benefits
and cues to action, respectively, which indicate the importance of the availability of accurate
information about efficacy of these behaviors, from sources that are easily accessible, such
as healthcare providers and veterinary professionals. Conclusion: Educational programs are
needed for increasing public knowledge in
this area. And more studies should be done
to determine predictive factors of rabies
preventive measures based on other health
behavior change models.

Abstract Introduction: Nowadays, modern laboratories are faced with a huge volume of information.
One of the goals of the Laboratory Information Management System (LIMS) is to assist
in the management of the information generated in the laboratory. This study intends to
evaluate the LIMS based on the standards of the American National Standard Institute (ANSI).
Materials and Methods: This research is a descriptive–analytical study, which had been
conducted in 2011, on the LIMSs in use, in the teaching and private hospitals in Isfahan. The
data collecting instrument was a checklist, which was made by evaluating three groups of
information components namely: ‘System capabilities’, ‘work list functions,’ and ‘reporting’
based on LIS8-A. Data were analyzed using the SPSS 20. Data were analyzed using (relative)
frequency, percentage. To compare the data the following statistical tests were used: Leven test,
t-test, and Analysis of Variance (ANOVA). Results: The results of the study indicated that the
LIMS had a low conformity (30%) with LIS8-A (P = 0.001), with no difference between teaching
and private hospitals (P = 0.806). The ANOVA revealed that in terms of conformity with the
LIS8-A standard, there was a significant difference between the systems produced by different
vendors (P = 0.023). According to the results, a Kowsar system with more than %57 conformity in
the three groups of information components had a better conformity to the standard, compared
to the other systems. Conclusions: This study indicated that none of the LIMSs had a good
conformity to the standard. It seems that system providers did not pay sufficient attention to
many of the information components required by the standards when designing and developing
their systems. It was suggested that standards from certified organizations and institutions be
followed in the design and development process of health information systems.

Abstract Background and Aim: The objective of this study was to determine the prevalence of signs
and symptoms of temporomandibular joint dysfunction (TMJD) in the Iran/Iraq war veterans
suffering from post-traumatic stress disorder. Materials and Methods: A total of 120 subjects
in the age range of 27 to 55 years were included; it included case group (30 war veterans
with PTSD) and three control groups (30 patients with PTSD who had not participated in the
War, 30 healthy war veterans, and 30 healthy subjects who had not participated in the War).
All subjects underwent a clinical TMJ examination that involved the clinical assessment of the
TMJ signs and symptoms. Results: The groups of veterans had high prevalence of TMJD
signs and symptoms vs. other groups; history of Trauma to joint was significantly higher in
subjects who had participated in the war compare with subjects who had not participated in
the war (P = 0.0006). Furthermore, pain in palpation of masseter, temporal, pterygoideus,
digastric, and sternocleidomastoid muscles in the groups of veterans was significantly greater
than other groups (P < 0.0001). Clicking noise during mouth chewing was significantly different
between groups (P = 0.01). And, there was significant difference in the frequencies of maximum
opening of the mouth between groups (P = 0.001). Conclusion: The results of this study
showed that subjects’ war veterans with PTSD have significantly poorer TMJ functional status
than the control subjects.

Abstract Background: Health volunteers can have a great effect by training the population about prevention
of cardiovascular disease (CVD) and lifestyle modification. This study evaluated the health volunteers’
knowledge following the “Isfahan Healthy Heart Program (IHHP)” that was performed between 2000
and 2006. Materials and Methods: In this study, 491 females were selected among health volunteers
in the Isfahan and Najafabad districts as intervention areas and Arak as a reference area through
2000-2001 until 2006. They participated in training courses on CVD, its complications, methods
of prevention of risk factors control as well healthy lifestyle promotion. The health volunteers’ level
of knowledge was assessed before and after training. Results: Before intervention, there was no
significant difference between the scores of health volunteers in the intervention and the control
regions in terms of knowledge about recognizing the symptoms, complications and prevention
of CVD and relevant risk factors and healthy lifestyle. However, their knowledge scores increased
significantly in the fields of CVD (β = 0.13, P = 0.04), hypertension (β = 0.18, P = 0.009), healthy
nutrition (β = 0.19, P = 0.007), appropriate physical activity (β = 0.17, P = 0.01) and dealing with
stress (β = 0.16, P = 0.02) after trainings. Conclusion: The 6 year interventional program of IHHP
showed that training health volunteers on prevention of CVD, their risk factors and modification of
lifestyle continued to be effective even in a long time.

Abstract Background and Objectives: Researchers believe that there are social exchanges
between the employers and employees, because the employees would be interested in
their organization and trust it based on how the organization values them and their welfare,
comfort, and security. This belief is known as perceived organizational support that makes
employees consider themselves as a part of their organization and have a commitment to it.
The literature review is very limited in both variables in Iran and thus few studies also report
the perceived organizational support and job involvement at the lower levels in our country.
This research aimed at studying the levels of perceived organizational support and job
involvement, relationship between this two, and the demographic factors relationship with both
of them. Materials and Methods: This research was a descriptive analytical study conducted in
2012. The population included 123 emergency nurses in General Hospitals of Qom. Data were
collected through Perceived Organizational Support and Job Involvement Questionnaires and
analyzed using SPSS software, descriptive statistics and Spearman correlation and Chi-square
test. Results: Both mean scores for perceived organizational support and job involvement
were in average level, 146/12 and 35/38, respectively. There was a significant relationship
between perceived organizational support and age, education, tenure, organizational position,
and job shift. There was also a significant relationship between job involvement and age
and education and finally between perceived organizational support and job involvement
(P = 0/029). Discussion: The high correlation between perceived organizational support
and job involvement indicates that the improvement of perceived organizational support are
necessary through motivating the employees, showing interest in them, paying attention to
them, respecting them, and providing development opportunity in the organization. These
should be always considered by managers
to improve job involvement

Abstract Introduction: The present study aims to provide a model for explaining the mental health of
war veterans based on the variables of spiritual well-being, social support, and self-efficacy,
with the mediating role of life satisfaction. Materials and Methods: The research method was
descriptive a correlational. The study samples included 210 veterans, who had records in the
Veterans Foundation in Tehran’s number one district, Sarallah and Imam Khomeini shelters
and Essaar Sports Center in Tehran. They were selected randomly and were asked to respond
to questionnaires on mental health, spiritual well-being, life satisfaction, social support, and
self-efficacy. The data was analyzed by LISREL software version 8.5, using the path analysis.
Results: The results showed that the designed model fitted the data (AGFI = 1.00, RMSEA = 0.00
and NFI = 1.00). In the fitted model, life satisfaction and spiritual well-being directly, and social
support indirectly, had a significant relationship with the mediator variable of life satisfaction
of the war veterans’ mental health. Conclusions: Veterans with better social support, life
satisfaction, and spiritual well-being have better mental health.

Abstract Context: A disease registry is a database that includes information about people diagnosed
with specific types of diseases. The registry collects information that can be used for capturing,
managing, and organizing specific information for patients. Aims: The aim of this study was
to identify and compare the National Renal Disease Registry (NRDR) in selected countries
including the United States, United Kingdom, and Iran. Settings and Design: Retrieval of
data of the NRDR performed through scholars responsible in related agencies, including
the Ministry of Health and Medical Education, and Renal Disease charity, and data registries
in the United States, United Kingdom, and Iran. Materials and Methods: This research
was an applied and descriptive, comparative study. The study population consisted of
the National Renal Disease Registry of the selected countries including the United States,
United Kingdom, and Iran, from which data were collected using forms that were designed
according to the study objectives. Sources of data were researchers, scholars responsible
in related agencies, including the Ministry of Health and Medical Education, and Renal
Disease charity, data registries, articles, books, journals, databases, websites, and related
documents. Data were gathered through phone, e-mail, study, observation, and interview.
Statistical Analysis Used: The researchers collected data for each country based on
the study objectives and then put them in comparative tables. Data were analyzed by
descriptive, comparative, and theoretical methods. Results: There is no NRDR in Iran to
report the short- and long-term results of renal disease. Most of the renal transplant teams
report their own results as single-center
experiences. America and Britain have
pre-eminent national registry of renal
disease, compared to other countries.
Conclusions: The Iranian Society of
Nephrology should be actively involved to
create a National Renal Registry in Iran. The
registry should have representatives from
the universities, government, armed forces,
and private sectors. Researchers proposed
to design the Iran National Renal Registry
according to the UK Renal Disease Registry
model because of its prominent healthcare
system.

Abstract Background and Objective: To establish a balance between work (physical exercise) and human
beings, the aerobic capacity (VO2 max) could be used as a measure. Additionally, the subjective
and physiological assessment could be applied as one of the methods for assessing physical
exercise. The most commonly used tools for the assessment of fatigue during physical exercise
include the Borg scale Rating of perceived Exertion (RPE) in relation to subjective symptoms
and heart rate (HR) in relation to physiological symptoms. The study is aimed to investigate
the relationship between the aerobic capacity and the RPE based on the measurement of
heat rate (HR) of workers from the Metal Industries of Isfahan. Materials and Methods: The
subjects were 200 male workers from metal components manufacturers in Isfahan selected
by using random sampling based on statistic method. The subjects were examined by using
ergometer in accordance with A strand 6 minutes cycle test protocol. Furthermore, the subjects
were asked to rate their status based on the Borg rating scale at the end of each minute.
Additionally, their heat rates were monitored and recorded automatically at the end of each
minutes. Results: Statistical analysis showed that there was a significant relationship between
the RPE and the aerobic capacity (VO2 max) (r = –0.904, P < 0.05). The results illustrated
that there was a stronger correlation between HR and VO2 max (r = 0.991, P < 0.001). The
regression analysis of the quadratic equation also indicated that there was also a significant
relationship between the VO2 max and HR. Conclusions: The results indicated that there was a
strong relationship between the RPE and VO2 max, as well as a greater correlation between HR
and VO2 max. Therefore, the HR could be used as a Prediction measure to estimate VO2 max.

Abstract Context: People capacity maturity model (PCMM) is one of the models which focus on
improving organizational human capabilities. Aims: The aim of this model’s application is to
increase people ability to attract, develop, motivate, organize and retain the talents needed
to organizational continuous improvement. Settings and Design: In this study, we used the
PCMM for investigation of organizational maturity level in medical record departments of
governmental hospitals and determination strengths and weaknesses of their staff capabilities.
Materials and Methods: This is an applied research and cross sectional study in which
data were collected by questionnaires to investigation of PCMM model needs in medical
record staff of governmental hospitals at Isfahan, Iran. We used the questionnaire which has
been extracted from PCMM model and approved its reliability with Cronbach’s Alpha 0.96.
Statistical Analysis Used: Data collected by the questionnaire was analyzed based on the
research objectives using SPSS software and in accordance with research questions descriptive
statistics were used. Results: Our findings showed that the mean score of medical record
practitioners, skill and capability in governmental hospitals was 35 (62.5%) from maximum
56 (100%). There is no significant relevance between organizational maturity and medical
record practitioners, attributes. Conclusions: Applying PCMM model is caused increasing staff
and manager attention in identifying the weaknesses in the current activities and practices, so
it will result in improvement and developing processes.

Abstract Introduction: Hepatitis B infection is an important health problem all over the world, and
according to the studies, Iran is a country with intermediate prevalence, so vaccination is a
cost-benefit approach. In this study, evidence about the efficacy of hepatitis B vaccine was
collected by systematic review methods and its amount was estimated by a meta-analysis.
Materials and Methods: In this study, documents and literature search were performed
using valid key words in Information Sciences Institute, PubMed, Scientific Information
Data base, and Iranmedex databases from 1997 to 2010 in different regions of Iran. All
cross-sectional studies about the efficacy of hepatitis B vaccine in Iran which fulfilled
the inclusion criteria entered the study. Antibody titer (Anti-hemoglobins > 10 IU/L) was
considered as the desired efficacy. In order to present the results, prevalence and Forest
plot were used and for evaluation of the inconsistency meta-regression model and I2
 index
were used. We used R.15.3.2 software for analysis. Results: Totally 64 studies (52 studies
in general population and 12 studies among specific populations) including 12,575 subjects
with age range from 8 months to 55 years entered the meta-analysis. The efficacy was
86.3% (confidence interval [CI]: 83.9-88.7%) in the general population and 59.62% (CI:
47.9-71.29%) in specific patient populations. Also the efficacy was significantly related to the
year of publication, age and gender (P < 0.05). Conclusion: Prevention is an important issue
in general health. Hepatitis B vaccination is one of the methods used to prevent hepatitis
B infection. According to this study, the efficacy of hepatitis B vaccination was more than
80% in general population, so injection of full course of hepatitis B vaccinationis enough
and booster dose is not required.

Abstract Background: Numerous researches conducted on about the quality of perception of media
messages shows that the people are not passive receivers but they have the ability of
understanding, interpreting and accepting or rejecting messages. In order to make clear the
relationship of information and communication technologies with social changes and to gain
a broader vision from this scope, sociological theories about information and communication
technologies’ usage, especially appropriation approach can be very useful. So, keeping in
mind the important role of Databases in the qualitative expansion of education, research,
diagnosis, remedy and medical services presentation, this research was carried out with
the aim of status determination of databases appropriation in the academic staffs of Iranian
Universities of Medical Sciences according to the social appropriation approach in 2012.
Materials and Methods: This is an applicative research of an analytical‑descriptive type,
which was carried out by measurement approach. The statistical society of this research
was composed of the academic staffs of the Iranian Universities of Medical Sciences in
2012 and finally 390 academic staffs were selected according to the Cochran’s formula
were selected. The research tool are searcher’s made questionnaire, which was composed
of nine separate parts. Its validity was accepted by the specialists and its reliability was
calculated and found to be 0.961 by Cronbakh’s alpha. Results: Database appropriation
score in the academic staffs of Iranian Universities of Medical Sciences with 65.020% was
in a good status and data bases dis appropriation score with 71.484 was in a high status.
Conclusion: According to the findings of this research, Librarians and politicians in this
scope‑with determination of the academic staff’s positive and negative points in usage
and appropriation would be capable of
accurately diagnozing and analyzing the
chances and challenges of the academic
staffs members in using databases and
would also be capable of achieving solutions
and appropriate catalyzers of prolific usage
and appropriation of databases.

Abstract In recent years, medical guidelines for communicating bad news to patients have been
published. Training for this task was included in the curricula of undergraduate medical
courses, specialization, and continuing medical education. The objective of this review is
to evaluate the existing evidence in the literature on the effectiveness of such training. Only
seven controlled trials were found, four of which were randomized, and these four indicate
an improvement in the trainees. These findings suggest that training undergraduate and
postgraduate doctors in skills for communicating bad news may be beneficial but there are
important limitations to reach a definitive conclusion. These limitations are discussed in this
article.