Journal of Education and Health Promotion

Abstract BACKGROUND: Sympathetic overactivity mediates abnormal cardiovascular outcome that is affected
by stress, lack of physical activity (PA), and familial hypertension (HTN). It can be assessed by blood
pressure‑based sympathetic function tests.
OBJECTIVE: We studied sympathetic function tests in young nonathletic males in relation to measures
of obesity, PA, and familial HTN.
METHODOLOGY: We recruited 100 males (mean age: 19 years) and measured body mass
index (BMI) and body composition parameters by tetrapolar bioelectrical impedance such as total body
fat, visceral fat, subcutaneous fat, and skeletal muscle mass. Using instrument cardiac autonomic
neuropathy system of Recorders and Medicare System Company, India, blood pressures (supine,
standing, and post hand grip) were recorded and studied quantitatively and qualitatively.
RESULTS: Physically active and inactive individuals (n = 50 each) had comparable age, BMI,
measures of obesity, and sympathetic function tests. However, individuals with familial HTN (n = 37)
showed significantly higher obesity measures and blood pressures (supine: systolic blood
pressure [SBP] – 133 vs. 115 and diastolic blood pressure [DBP] – 79 vs. 76; standing: SBP – 136 vs.
122 and DBP – 80 vs. 76; post hand grip: SBP – 136 vs. 125 and DBP – 86 vs. 81). Qualitatively,
postural hypotension was seen in only two individuals, while worst grading was in post hand grip
test significantly and more so in physically inactive group (30%, 28%, and 42% vs. 16%, 20%, and
64%) and individuals with positive familial HTN (32%, 38%, and 30% vs. 17%, 13%, and 70%).
CONCLUSION: Familial HTN, but not physical inactivity, affects sympathetic functioning in nonathletic
young male medical personnel. It asks for other lifestyle modifications for better cardiovascular health
as primary prevention.

Abstract BACKGROUND: Depression during pregnancy is one of the major concerns in mental health, hence
using interventional methods for the treatment or reducing the rate of depression is considered
a priority for maternal and fetal health. The present study aimed to examine the effectiveness of
problem‑solving training in reducing depression in pregnant women.
MATERIALS AND METHODS: This randomized clinical trial was conducted on seventy pregnant
women referring to Prenatal Care Clinics, Najmiyeh hospital in Tehran, Iran. The participants were
randomly allocated divided into experimental and control groups. The experimental group was given
routine prenatal care training at the clinic along with problem‑solving skills training based on the
Identify, Define, Explore, Act, Look back model in five sessions, but the control group only received
routine prenatal care training. Data were collected using the Beck’s Depression Inventory at the
beginning of the study and at the immediately and 1 month after two groups. Data were analyzed
using descriptive and analytical statistical tests.
RESULTS: In the experimental group, the mean depression score significantly reduced
from 16.06 ± 4.73 before intervention to 12.83 ± 4.10 and 13 ± 4.24 after intervention and at
follow‑up (P < 0.05). While in the control group, the mean depression from 15.34 ± 2.94 before
intervention to 14.80 ± 2.76 and 14.86 ± 2.924 after intervention and at follow‑up. It was not statistically
significant in the control group (P > 0.05).
CONCLUSIONS: Problem‑solving training can be used as an optional method of reducing depression
in pregnant women, and it is recommended that should be implemented by the health‑care team.

Abstract BACKGROUND: Academic motivation is highly important in nursing education. Providing high‑quality
nursing care requires students who have motivation to acquire information and skills. However, nursing
students lose their motivation gradually during their program. Thus, the present study is aimed at
elaborating on the strategies to improve academic motivation in nursing students.
MATERIALS AND METHODS: A qualitative study was conducted in Saveh University of Medical
Sciences. The data were collected through focus groups and individual semi‑structured interviews
with forty nursing students, professors, and lecturers of nursing and midwifery school. The participants
were selected through purposeful sampling method. This method is used for the selection of people
who have had experience with or are part of the culture or phenomenon of interest. Data analysis
was done as a continuous process through conventional qualitative content analysis.
RESULTS: The strategies to promote academic motivation of nursing students were categorized
into four main categories including strategies pertinent to professors (empowering and motivating
to improve the quality of teaching), strategies pertinent to students (creating positive attitude toward
nursing, empowering, and encouraging academic achievement), strategies pertinent to clinical
education (improvement of the quality of clinical training and optimization of the academic and
clinical relationships), and strategies pertinent to faculty (providing extracurricular activities, proper
curriculum programming, and educational and welfare facilities).
CONCLUSIONS: The strategies to improve academic motivation are available in different areas
including professors, students, faculty, and clinical education. In general, improving the quality of
education and creating positive attitude in nursing students increase their academic motivation.

Abstract Disasters and emergencies have been increasing all over the world. Todays, with technological
advancement, acquiring knowledge and its application in the realm of action is regarded as the only
effective way for prevent disasters or reducing its effects. The present study aimed to review the
importance of education and the effect of different methods of education on disaster risk reduction
and preparedness in vulnerable people. To this aim, some articles indexed in Database of PubMed,
Web of Science, Google Scholar, Scopus, Science Direct, and ProQuest were searched. The
search was limited to reviewed articles in English published between 1990 and 2017. In addition, the
selected articles were reviewed for relevant citations. The conducted studies were reviewed by two
researchers independently. The primary search generated 128 relevant references. After eliminating
the duplicates and articles which were not related to the review of the abstract, 41 references were
identified for inclusion. After reviewing more, 31 references, which failed to meet inclusion index,
were excluded from the study. Disaster education aims to provide knowledge among individuals
and groups to take actions to reduce their vulnerability to disasters. During the last decades, the
issue that trained people can be prepared for disasters and responding well has been extensively
investigated. Based on the results, disaster education is a functional, operational, and cost‑effective
tool for risk management. Based on some evidence, it is important for vulnerable people to learn
about disasters. There are different methods to educate vulnerable people, but no method is better
than others. Trained people can better protect themselves and others. In this regard, planning and
designing comprehensive educational programs are necessary for people to face disasters.

Abstract BACKGROUND: To respond to the growing expectations of the public and to meet the needs of the
society, health systems have always tried to improve their performance. This study investigated
the changes in the performance and quality of emergency department (ED) after implementation of
the health transformation plan (HTP) in Iran.
METHODS: This was a before–after study that was conducted in Tehran’s Lolagar General Hospital
in 2016. The data related to the performance indices and patients’ satisfaction indices were collected
in the two periods of 6 months before and 6 months after the implementation of the HTP. The data
were gathered by a checklist designed by the researchers.
RESULTS: Among performance indices, the maximum positive change was related to the failure in
cardiopulmonary resuscitation, which had a reduction of 18.27%. Discharge against medical advice
had a reduction of 1.11%, which is considered to be significant. Among the factors related to patients’
satisfaction, the maximum changes belonged to the out‑of‑pocket payment, access to medicines,
and giving information to the patients, which were 0.87%, 72%, and 61%, respectively.
CONCLUSIONS: HTP and its supporting packages have led to positive changes in the performance
of the ED of the hospital. Therefore, based on the results of this study, the continuation of this plan
is recommended.

Abstract INTRODUCTION: One of the major problems of higher education centers is the students’ academic
failure. Increased monitoring, counseling, or remediation may tax the resources of both the program
and the faculty. The present review study gathered evidence highlighted by the experimental studies
on the educational intervention with the purpose of improving preclinical medical performance.
MATERIALS AND METHODS: To achieve the intended studies, databases of PubMed, Web of
Knowledge (Thomson Reuters), Educational Resources and Information Center, and the Scopus were
searched. The inclusion criteria were being an interventional study and assessing the educational
intervention to preclinical academic performance. The study was carried out as a systematic literature
search published between January 1987 and January 2018. Based on valid tool through the best
evidence medical education review, after assessing the quality of the studies.
RESULTS: Ten studies were enrolled in the review for final evaluation. The Kirkpatrick Model was
employed to analyze and synthesize the included studies.
CONCLUSION: Reviewing the conducted studies showed that medical students had positive
responses and attitudes toward new teaching methods, self‑monitoring skills, and attention
to physiological needs. The results also indicated that new teaching strategies, attention to
self‑monitoring skills, and sleep hygiene in medical education could positively affect learning in two
domains of Bloom’s Taxonomy.

Abstract CONTEXT: India experienced pandemic phase of H1N1 in May 2009 to December 2010. The
postpandemic phase went on from January 2011 to December 2014. As per the WHO, all countries
should immunize their health‑care workers as a first priority to protect the essential health infrastructure.
AIMS: The aim of the study is to assess the level of awareness and acceptance of influenza vaccine
among physicians and also the perception of physicians regarding H1N1 infection. This study also
examined time of vaccine administration in relation with efficacy concerns based on literature.
SETTINGS AND DESIGN: A vaccination campaign was conducted for all health‑care workers of
Seth GSMC and KEM Hospital, Mumbai, in the month of July 2017 based on which a cross‑sectional
observational study was conducted among the physicians of the same institute.
METHODS: After ethical clearance, a prevalidated pretested survey based on a pilot survey of 20
physicians was distributed among physicians, which was based on the awareness and acceptance of
H1N1 vaccination among physicians and perception of H1N1 infection. Effective sample size was 272.
STATISTICAL ANALYSIS USED: Descriptive statistics and Chi‑square test were generated for
the survey responses. All the continuous variables were reported as mean, median, and range.
Categorical variables were reported as tables and pie charts. P < 0.05 was taken as significant. Data
analysis was done with SPSS version 21.
RESULTS: The overall vaccine compliance was 29.8%. This study has found that area of work,
deficiency in knowledge about adverse effect of vaccine, misconceptions regarding vaccine, and
concerns about efficacy and duration of vaccine are the important factors which lead to decreased
vaccine compliance. Furthermore, it is found during the study that timing of vaccination was not given
due importance as considering the epidemiological pattern.
CONCLUSIONS: More emphasis should be given to education sessions and counseling of physicians
regarding H1N1 vaccination and oseltamivir therapy. At administrative level, more focus should be
given on timing of vaccination and other logistics. Vaccine campaigns should be conducted ideally
1 month before expected rise in cases. Quadrivalent vaccine would be more appropriate over trivalent
based on epidemiology of infection in India.

Abstract BACKGROUND: Many women of childbearing age suffer from problems such as dysmenorrhea and irregular menstruation. OBJECTIVES: The objective of the study is to determine the relationship between the duration of menstrual bleeding and obesity‑related anthropometric indices in students. METHODS: This cross‑sectional study was carried out on 250 students in 2016. Data were collected by a questionnaire composed of: 1) demographic information, 2) information concerning menstrual cycle and 3) obesity‑related anthropometric parameters. Anthropometric parameters include height, weight, waist circumference, hip circumference, and arm circumference. Independent t‑test, Pearson correlation coefficient, and multiple linear regressions with backward strategy were used. RESULTS: The average age of students was 21/295 (±1/585) years. For most participants, the duration of menstrual bleeding was 3–7 days (87/2%, 218 people). None of the participants had menstrual bleeding <3 days, and the duration of bleeding was >7 days for 32 participants (12/800%). A significant relationship was observed between the intervals of menstruation and the waist‑to‑hip ratio (r = 0/136, P < 0/041). Based on multiple linear regression, hip circumference and waist‑to‑weight, hip‑to‑waist, arm‑to‑weight, hip‑to‑thigh, and arm‑to‑height ratios are predictors for menstrual duration. CONCLUSIONS: In this study, a significant association was found between the anthropometric indices and menstrual characteristics. These findings suggest the need for modifying anthropometric indicators to control menstrual cycle problems. 

Abstract INTRODUCTION: Developmental delay of children is a global health concern. One of the important
measures in the care of children and the assessment of children's health is the knowledge and ability
of mothers about the condition of their children's development. The purpose of this study was to
compare the outcome of lecture‑based method versus self‑learning package on the ability of mothers
to assess the development of their 12‑month‑old children seeking comprehensive health services
centers in Arak city, central province of Iran.
MATERIALS AND METHODS: The present study is a semi‑experimental study. The sample included
189 mothers of 12‑month‑old children. The data gathering tools were age and stages questionnaire
with confirmed validity and reliability. The participants in the study were divided into three group as
follows: lecture, self‑learning, and control group which were evaluated by pretest and posttest. Data
analysis was performed with SPSS version 21.
RESULTS: The results of this study indicate that both of interventional methods; lectures and
self‑learning; had a statistically significant effect on the ability of mothers to evaluate the development
of their children (P = 0.001). In the self‑learning group, the score of the participants increased from
53.35 ± 44.269 to 70.15 ± 47.290 and in the lecture group, the score of participants increased from
55.28 ± 41.268 to 16.14 ± 38.292 according to the posttests.
CONCLUSION: Due to the importance of self‑care and active role in the learning process, we suggest
the use of self‑learning package in practice.

Abstract BACKGROUND: Over the last decades, childhood obesity has become a worldwide epidemic health
problem. Identifying the barriers to a healthy lifestyle among children and adolescents is necessary for
further effective intervention to prevent overweight and obesity. This study aims to assess the barriers
to healthy lifestyle habits, including physical activity (PA), eating, and sleep among adolescents from
the perspective of their parents.
METHODS: In this cross‑sectional study, the parents of obese and overweight middle school students
were enrolled. Data were collected using a questionnaire about barriers of healthy nutrition and PA.
RESULTS: Overall, 172 parents completed the questionnaire. Lack of access to affordable facilities
for PA, lack of access to the appropriate place for PA, and lack of sufficient information on how to
do or increase PA were the main barriers to PA. The barrier factors for healthy eating were media
advertisement of unhealthy foods, lack of motivation to use healthy nutrition, and lack of adequate
information about healthy eating. Regarding poor sleep, lack of knowledge about the benefits of sleep,
prolonged watching television, and late sleep time of family members were reported as the main
barriers. These findings were not statistically different according to the family socioeconomic level.
CONCLUSION: Our findings propose that for improving healthy lifestyle in obese children and
adolescents, access to facilities, and appropriate places for PA should be provided at the community
level. Moreover, training parents and students about healthy lifestyle behaviors is necessary for
families of all socioeconomic levels.

Abstract INTRODUCTION: The cultural diversity of ethnic groups in Iranian academic contexts highlights the
importance of enhancing cultural awareness and minimizing cultural conflicts. Therefore, the present
study aimed to investigate the intercultural intelligence of the university personnel in interacting with
students.
MATERIALS AND METHODS: This cross‑sectional study was a correlational research conducted
on 136 employees in Sabzevar University of Medical Sciences, Iran. The participants were selected
by randomized clustered sampling. The data on intercultural intelligence were collected using Earley
and Ang’s Questionnaire and were analyzed in SPSS using descriptive and inferential statistics.
RESULTS: Mean score of intercultural intelligence in the education‑research staff, secretarial staff,
and student‑cultural staff was 41 ± 9, 35.6 ± 8.3, and 44.2 ± 7.7, respectively. ANOVA showed
a significant difference in the overall scores of intercultural intelligence across the three groups
(P = 0.001); the scores of subsections were also statistically different, the student‑cultural staff showing
higher intelligence scores than the other groups. Furthermore, the overall intercultural intelligence
scores varied significantly across the participants’ educational levels so that the score of the staff with
bachelor’s degree was 37.8 ± 8.7 and those with master’s degree was 45 ± 7.8 (P = 001), especially
in their metacognitive and cognitive subsection scores.
CONCLUSION: The scores of intercultural intelligence were moderate to low in the staff of different
working sections of the university. Moreover, the level of education shows impacts on intercultural
encounters in this academic setting. The results highlight the need to develop programs in order to
raise intercultural understanding in staff.

Abstract BACKGROUND: Childhood obesity remains a major health issue. The understanding of the
multifactorial nature of childhood obesity remains the cornerstone to eliminate the rising trends. This
study aimed to examine the association between parental and childhood weight status, in relation
to various socioeconomic (SE) factors.
METHODS: A cross‑sectional survey was conducted including 1190 children aged 10–12 years and
their parents, during school years 2014–2016. Primary schools from five Greek counties (including
Athens metropolitan area) were randomly selected. Parental and child data were collected through
self‑administered, anonymous questionnaires. Children’s weight status was based on gender‑ and
age‑specific tables derived from the International Obesity Task Force body mass index (BMI) cut offs.
General Linear Model (GLM), Univariate and multivariate analyses were applied. Multiple logistic
regressions was used to determine the association between children and parents’ weight status.
RESULTS: Childhood prevalence of overweight and obesity was 25.9% (21.8% overweight and 4.1%
obese), with prevalence being significantly higher in males (31.7% compared to 21.3%; P for gender
differences < 0.001). The percent of overweight and obese male (34.4% and 43.1%) and female
children (20.3% and 31.8%) significantly increased with paternal overweight and obesity status,
respectively. The same relationship was observed between male children and maternal overweight and
obesity status (43.4% and 65.7%). This was not evident among females (27% and 23.2%). Regression
analysis showed a significant positive association with parental BMI, a negative association with
both parental educational levels (low to high), living space, and parental age (P < 0.05, for all).
Children’s likelihood of being overweight or obese increased significantly with increasing parental
weight status (P < 0.001).
CONCLUSIONS: Parental weight status remained the most significant predictive factor for early
adolescence obesity among various SE factors. Health promotion strategies should consider parental
education as an effective childhood obesity preventive measure.

Abstract BACKGROUND: Marital satisfaction, conscientiousness, and self‑compassion are necessary
for successful and lasting marriages. Therefore, the purpose of this study was to investigate the
relationship between marital satisfaction, conscientiousness, and self‑compassion among married
employees of Shahid Mostafa Khomeini Hospital in the city of Ilam in 2017.
METHODOLOGY: This study is a descriptive research with a correlation design. The research
population included all 260 married employees of Mostafa Khomeini (I) Hospital in the city of Ilam,
among which 150 were selected using simple random sampling. Data were collected using three
questionnaires of conscientiousness, self‑compassions, and marital satisfaction. Data were analyzed
using Pearson correlation and multivariate regression.
RESULTS: The research results revealed a positive and significant relationship between
conscientiousness and marital satisfaction (P = 0.028 and r = 0.187) and a positive and significant
relationship between self‑compassion and marital satisfaction (P = 0.000 and r = 0.185). Both
conscientiousness and self‑compassion variables could predict 51% of the variance of marital
satisfaction among married employees.
CONCLUSIONS: Given the research results, it could be stated that people who have self‑compassion
and have a high level of conscientiousness make much effort for their improvement and resolving
their committed mistakes. For this reason, they have high motivation to maintain marital relationships.

Abstract INTRODUCTION: In developing countries, there is an increased risk of incidence of noncommunicable
diseases due to general and abdominal obesity. Therefore, this study aimed to assess socioeconomic
determinants of excess weight and central obesity among women in Tehran city based on information
motivation behavioral skills model (IMB).
MATERIALS AND METHODS: A cross‑sectional study was conducted among 260 women aged
between 20 and 49 years old using cluster sampling. A skilled interviewer completed socioeconomic
status (SES), food insecurity, and IMB questionnaires. Analysis of variance, Chi‑square tests, and
regression model were used for statistical analysis. The multiple logistic regression analysis was
used to identify independent predictors of the excess weight and central obesity using SPSS 21.
RESULTS: The mean and standard deviation of participants’ age was 34.7 (±7.59) years old. The
prevalence of overweight and obesity in adult women was estimated 35% and 21.2%, respectively.
The prevalence of abdominal obesity was 34.6%. Independent predictors of overweight/obesity in
women were age (odds ratio [OR] =1.09, 95% confidence interval [CI] =1.03–1.14), educational
level (OR = 2.35, 95% CI = 1.05–5.27), and total expenditure (OR = 3.14, 95% CI = 1.06–9.37).
Whereas, independent predictors for increased the likelihood of central obesity were age
(OR = 1.12, 95% CI = 1.06–1.18), marital status (OR = 6.44, 95% CI = 1.94–21.40), low education
(OR = 0.38, 95% CI = 0.16–0.91), number of rooms (OR = 1.19, 95% CI 1.03–3.45), and self‑regulation
score (OR = 0.94, 95% CI = 0.88–1.00).
CONCLUSIONS: The socioeconomic determinants, especially age, level of education, and
expenditure, as well as self‑regulation, play an important role in excess weight and central obesity
among women. Therefore, further research is needed to reach women in different SES groups with a
variety of interventions through concurrent triangulation of longitudinal studies and qualitative research.

Abstract BACKGROUND: Nurses are often faced with the variety of work‑related stress which could affect
their physical and mental health. Coping strategies play an important role in reducing stress and
consequently increasing the health and well‑being. This study was conducted to investigate the role
of stress and coping strategies to predict the general health of nursing staff.
SUBJECTS AND METHODS: An analytical cross‑sectional design was carried out on 318 nurses
working in governmental health centers of Guilan University of Medical Sciences, the North of Iran, in
2017. Data were collected through multistage cluster sampling using self‑report questionnaires and
demographic characteristics. The study instruments included Hospital Job Stress, Coping Strategies,
and General Health Questionnaires. For analysis of data, descriptive statistics and regression test
were applied using SPSS software version 19.
RESULTS: The results revealed that the highest mean score (47.71 ± 7.88) of different dimensions of
coping strategies was related to task‑oriented strategy. Furthermore, the results indicated that stress
and coping strategies together could explain around 2.5% of variance of general health (ΔR2 = 0.025).
However, based on the statistically significant level, the results revealed the coping strategies as the
predictor of general health (P = 0.002, beta = 0.094).
CONCLUSIONS: The results highlight the importance of considering coping strategies for predicting
general health in nurses. Regarding the inevitability of some stressors in the nursing profession and
the need to prevent stressful effects, workshops as an effective training method to reduce staff stress
should be on the agenda of managers.

Abstract CONTEXT: There is limited evidence on the influence of social media among medical students.
AIMS: To assess the pattern of social media usage among medical students in eastern part of India
and analyze self‑perceived impact on academic performance and interpersonal relations.
Methods: This cross‑sectional study was based on an online survey, taken by 650 medical students
at a tertiary medical center in Kolkata. The survey was created using an online tool, Google Forms.
It assessed social media usage patterns and students’ perspective on how it affects their academic
performance and interpersonal relations.
STATISTICAL ANALYSIS USED: Pearson’s correlation coefficient was used to quantify the
association between self‑rated academic performance and social and physical well‑being, with
different variables, assuming linear relationships. P <0.05 was considered statistically significant.
RESULTS: The usable responder rate was 55.23%, with majority being undergraduates (57.3%) in the
age group of 18–24years. The proportion who confirmed using social media was 88.58%(95% confidence
interval [CI]: 85.29%–91.87%), mainly for academic purposes (82.73%; 95% CI: 78.82%–86.64%). In
general, social media usage was more prevalent among medical students compared to paramedical
and nursing students (P = 0.009), although the extent of use for an academic purpose was comparable.
Nearly two‑thirds (60.87%) regarded social networking having a positive (improved) impact on academic
performance. However, the perceived impact on interpersonal relations was inconclusive (i.e., was
positive and negative in a nearly equal measure; 45% each).
CONCLUSIONS: Social media usage for academic purposes is high among medical and paramedical
students. Students benefit from social networking and are conscious of its positive as well as negative
influence on interpersonal relations.

Abstract BACKGROUND: Cooperative teaching methods have been used widely in medical education. The
aim of this study was to determine the effect of theater in the clinical stage on postpartum hemorrhage
management among midwifery student.
MATERIALS AND METHODS: This was an experimental study, performed in 2016 among midwifery
students in Isfahan University of Medical Sciences and selected through the random sampling method.
Satisfaction questionnaire and clinical practice checklist were completed by both groups before and
after the education. The collected data were analyzed using independent t‑test and paired test. The
significant level was considered statistically <0.05.
RESULTS: The findings of independent t‑test did not show any significant difference between
satisfaction and clinical practice scores of theater and control group before intervention while a
statistically significant difference was observed in after intervention between the scores of two groups
(P = 0.001). Paired t‑test showed a statistically significant difference in satisfaction and clinical practice
score in two groups after intervention theater and control group, respectively (P = 0.002, P = 0.002).
CONCLUSION: Theater method in postpartum hemorrhage can be increased satisfaction and
clinical practice levels in midwifery students. Hence, the conduction of this educational model is
recommended as an effective learning.

Abstract BACKGROUND: The study aimed to investigate the associations between life and health satisfaction
with health‑related quality of life (HRQoL), body mass index (BMI) and chronic disease among people
who are covered by health insurance schemes in Tehran city, Iran.
METHODS: A cross‑sectional study was conducted in Tehran city, Iran, from May to June 2016. A total
of 600 people were included in the study using a cluster sampling technique. The questionnaire that
used for data collection included demographic and socioeconomic variables, questions about health
variables such as chronic disease, weight, height, smoking status, and EQ‑5D‑3L questionnaire.
Two univariate and multivariate regression models performed to examine affecting factors on life
and health satisfaction.
RESULTS: The univariate regression showed that on average female have 0.22 and 0.69 score
lower than males with their life and health satisfaction, respectively. Explanatory variables of
gender, age, level of education, and employment status were not significantly associated with life
and health satisfaction in multiple regression models. However, marital status was correlated with
life satisfaction. Furthermore, HRQoL, BMI and chronic disease and smoking were associated with
dependent variables (P < 0.001).
CONCLUSIONS: The result showed that there was a strong association between BMI, HRQoL, chronic
disease, and life and health satisfaction among participants. Therefore, the Iranian policymakers
need to consider these factors on life and health satisfaction of adults and design health‑promoting
programs to improve health outcomes of them. Further studies should assess the associations
between BMI, HRQoL, chronic conditions, and life and health satisfaction among Iranian adults.

Abstract CONTEXT: There are numerous factors which affect the health status in different ways, including
financing mechanisms, health‑care expenditures, socioeconomic characteristics, and health‑care
resources. One of the most important factors which contribute to the health status of a population
is health‑care resource which includes number of beds or health‑care professionals for instance.
AIMS: The objectives of this study were as follows: to examine the regression of the life expectancy
and health‑care inputs and also to investigate the regression of death rate and health‑care inputs.
SETTINGS AND DESIGN: This study was a panel dataset analysis of OECD countries.
MATERIALS AND METHODS: A generalized method of moment (GMM) regression models with
country‑level health outcomes (death rate and life expectancy) as dependent variables were estimated.
A panel dataset with n = 26 (the number of countries) and T = 12 (the number of time periods) was
used. The GMM regression model was used to estimate the effect of health‑care resources on
health outcomes.
RESULTS: Findings showed that there are strong reverse correlations between immunization rate and
number of physicians with crude rate of death (−2.64 [P < 001] and −76.50 [P < 001], respectively).
There were also positive correlations between immunization rate and number of physicians with
life expectancy at birth (0.01 [P < 001] and 1.03 [P < 001], respectively). Moreover, there were
negative correlations between inpatient rate and beds with life expectancy (−0.00003 [P < 001]
and −0.12 [P < 001], respectively).
CONCLUSIONS: It is essential for policymakers to consider the optimal level of health resource to
achieve better health outcomes. Oversupply of hospital beds and specialist doctors could lead to
induced demand and put the patients at risk of unnecessary procedures.

Abstract BACKGROUND OF THE STUDY: A child’s social competence depends on a number of factors
including family atmosphere. Parental alcoholism effects the development of child directly or indirectly.
Children of alcoholics (COAs) may have lower social competence. Addressing this problem at the
earliest can significantly reduce the problems in future. The objective of the study is to compare the
social competence between COAs and non‑COA.
METHODS: A cross‑sectional comparative study design was used. The study was conducted
at a selected government high school located in Bengaluru urban. One hundred COA and
100 non‑COA were recruited for the study by using simple random sampling technique.
Children of Alcoholic Screening Test (modified) and Social Competence Scale were used in
the study.
RESULTS: Results show that there is statistically significant difference between COAs and non‑COAs
with regard to prosocial attitude, social competition, social leadership, social tolerance, social maturity,
social skills, and overall skills.
CONCLUSION: The study concludes that COAs have low level of social competence.