Cognitive appraisals of disability in persons with traumatic spinal cord injury: a scoping review.

STUDY DESIGN: Scoping review. OBJECTIVES: To describe the meaning of cognitive appraisals, their relation with outcome. measures, and adapted appraisal scales after Spinal Cord Injury (SCI) in the existing literature. METHODS: This review was performed according to the Arksey and O'Malley (2005) framework that consisted of five steps: setting the review question, searching the literature, selecting and classifying the studies, charting the data, and summarizing the results. Published articles from 1990 to 16 May 2020 related to cognitive appraisal, persons with traumatic SCI (TSCI), and persons older than 18 years were identified by searching by key terms in four databases (PubMed, Web of Science, Scopus, and Embase). RESULTS: The included studies (n = 26) were categorized into three categories. Categories focused on the meanings of cognitive appraisals following TSCI (i.e., appraisals being complex and context-related, or in general definition how persons with TSCI interpret their disability and how they evaluate the resources available to respond to it), the relationship between cognitive appraisals and physical/psychological/social/ outcomes, and appraisals of disability (including the use of appraisals as a predictor of subsequent positive or negative consequences). CONCLUSIONS: The results demonstrated that a cognitive appraisal of TSCI is critical to longer-term rehabilitation outcomes. A combination of physical and psychological-based interventions can help to modify negative or dysfunctional appraisals. Cognitive appraisal in TSCI seems to vary from person to person. To predict it and develop a rehabilitation plan, future research needs to focus on the relationship between cognitive appraisal and person-related factors, including demographic characteristics.

Development and validation of a short and easy-to-use instrument for measuring health literacy: the Health Literacy Instrument for Adults (HELIA).

BACKGROUND: Health literacy is the ability to access to, understand, evaluate and use of essential health information to make basic health decisions. This study aimed to develop and psychometrically evaluate an instrument for measuring health literacy among adults (the Health Literacy Instrument for Adults - HELIA). METHODS: In addition to a literature review, a panel of specialists from different disciplines was formed to generate an item pool. Then, a framework was defined to develop the initial questionnaire based on a definition of health literacy and the most important global public health issues. The initial questionnaire contained 66 items. Next, 15 experts in public health were approached to assess content validity. Consequently, 19 items were removed and a provisional version of the questionnaire with 47 items was provided. Finally, a random sample of adults completed the questionnaire and psychometric properties of the instrument were assessed. RESULTS: Overall, 323 adults aged 18 to 65 years old completed the questionnaire. When the exploratory factor analysis was performed, 33 items were loaded, which indicated a 5-factor solution for the questionnaire that jointly explained 52.9% of the variance observed. The factors were as follows: access to information (6 items), reading (4 items), understanding (7 items), appraisal (4 items), and decision making/behavioral intention (12 items). Confirmatory factory analysis also indicated a good fit to the data for the five-latent structure (χ2/df = 1.60, SRMR = 0.049; RMSEA = 0.043; CFI = 0.98; NFI = 0.95; NNFI = 0.98 and GFI = 0.87). Additional analysis for internal consistency showed satisfactory results with Cronbach's alpha coefficients ranging from 0.72 to 0.89. Intraclass correlation coefficient (test-retest analysis) also showed acceptable stability for the questionnaire (ICC = 0.84). The mean score for health literacy as measured by the HELIA was 76.3 (SD = 15.1) out of 100 for the study sample. CONCLUSION: The findings suggest that the Health Literacy Instrument for Adults (HELIA) is a valid and reliable instrument for measuring health literacy. It is a short and easy-to-use instrument that could be applied in different settings.

Understanding Female Students' Needs to Develop Health Promoting School Programme: An Exploratory Qualitative Analysis.

BACKGROUND: This study was carried out on Iranian female adolescents to understand health needs for the purpose of designing health promoting intervention in schools. METHODS: In this exploratory qualitative study, two focus group discussion (15 teachers) and 30 individual in-depth interviews were conducted among female adolescents in the eighth grade in Zahedan, Iran. Qualitative content analysis was used for data evaluation. RESULTS: The views of students and teachers demonstrated nine of needs including: informing students about the schools' health project aims, education and training all dimensions of health with an emphasis on mental health, use of experts in various fields for education from other organisations, employing capable and trusted counselors in schools, utilisation of a variety of teaching methods, activating reward systems for encouraging students' participation in group activities, teaching communication and the ability to establish good relationships with parents and strategies for resolving family conflict, teaching parents and students high-risk behaviours and strategies for handling them as well as reforming wrong attitudes and indigenous sub-culture. CONCLUSION: This study found the different needs of Iranian female students compared to other cultures about a health promoting school programme. Therefore, their contribution can provide an insight for formulating policies and intervention in schools.

Study of the pattern of mortality caused by Traffic Accidents (TAs) in The South of Iran.

OBJECTIVE: To investigate the pattern of mortality caused by road traffic accidents and its associated factors. METHODS: The retrospective cross-sectional study was conducted in the Fars province of Iran and comprised data of all people having died in road traffic accidents from March 21, 2011, to March 19, 2012. Using census method, all files related to deaths in road accidents were reviewed at the Legal Medicine Centre. Data was analysed using SPSS20. RESULTS: Of the 1668 people dead, 1291(77.4%) were male and 377(22.6 %) were female. The highest rate related to the age group 21-30 with 454(27%) killed. As for education level, the highest rate of mortality was 410(24.5%) for illiterate people and the least was 9(0.5%) for those having Masters degree or higher. In terms of time of year, the highest rate of mortality was 167(10%) between August 23and September 22, while the least was 82(5%) between July 23and August22. Head trauma was reported as the most important cause of death in 1191(71.4%) cases. CONCLUSIONS: Despite some minor differences, all provinces in Iran have the same patterns of death related to road traffic accidents.

Association between oral and general hygiene behaviours among Iranian adolescents.

PURPOSE: To assess the association between oral and general hygiene behaviours in 12-year-old Iranians and the impact of sociodemographic and educational factors on the association. MATERIALS AND METHODS: A representative random sample of 550 12-year-old Iranian adolescents from two deprived tribes answered a 41-item questionnaire on sociodemographic background, education and oral and general hygiene behaviours. The association between tooth cleaning frequency and other study outcome variables were tested using binary logistic regression. The sex differences in the study outcome variables were investigated using chi-square and Mann-Whitney tests. RESULTS: The frequency of tooth cleaning was significantly associated with a general hygiene behaviour: frequency of taking a bath (OR 0.5; 95% CI: 0.3, 0.7). This association remained significant when sociodemographic factors and educational factors were added to the model both separately (P < 0.001) and together (P < 0.001). Girls were significantly more likely than boys to clean their teeth once or more times a day (OR 2.4; 95% CI: 1.7, 3.4). CONCLUSION: Oral and a general hygiene behaviour were strongly associated. Oral, general and environmental hygiene programmes should use integrated approaches.

Effective education to decrease elective caesarean section.

OBJECTIVE: To examine the effect of education on deciding about natural delivery in women opting for elective caesarean section. METHODS: The quasi-experimental study was carried out between January and March 2012 and comprised a sample of 200 women in their third trimester of pregnancy attending women's clinics of Imam Ali Hospital, Zahedan, Iran, with the intention of having elective caesarean section. The subjects were voluntarily classified into three groups: one group received an educational package; the other had educational package along with group discussion, and the last one without any intervention was considered the control group. Post-test was conducted a month after intervention. Data were analysed using Kruskal Wallis, and logistic regression tests. RESULTS: Group A represented the controls and had 100 (50%) women; Group B with the educational package had 40 (20%), while there were 60 (30%) women in Group C who had exposure to the educational package as well as group discussion.There were significant changes in behaviour in Group B and C (p < 0.01) but no change among the controls in Group A. In Group C, 25 (42%) women decided to go for natural delivery, while 1 (2.5%) woman had a change of opinion in Group B. Four (4%) women in the control Group A had ultimately natural delivery, but they were all emergency cases. CONCLUSION: The two educational methods increased model construct scores, including awareness, attitude, perceived behaviour control, subjective norms and behavioural intention. Nevertheless, educational package in conjunction with group discussion was more effective in influencing the choice towards natural delivery.

Development and psychometric properties of appraisals of post traumatic spinal cord injury health scale in Iran.

STUDY DESIGN: Development and psychometrics study OBJECTIVE: To evaluate the reliability and validity of a new version of Appraisals of Post-Traumatic Spinal Cord Injury Health Scale (APTSCIHS) in the Persian language for persons with spinal cord injury (SCI). SETTING: The persons were selected from National Spinal Cord Injury Registry of Iran (NSCIR-IR) and Brain and Spinal Cord Injury Research center (BASIR). METHOD: This was a mixed sequential exploratory study that performed in two phases. In the qualitative phase, a systematic scoping review and 12 interviews with the participants were done. Finally, items were generated. In the quantitative phase, face, content, construct and convergent validity were assessed to evaluate validity. To evaluate construct validity, a cross-sectional study was conducted on 305 persons with TSCI along with internal consistency and stability assessments. All quantitative data analyses were conducted using SPSS 22 software. RESULTS: The content validity and reliability were indicated by Scale's Content Validity Ratio (S-CVR) = 0.73 and Scale's Content Validity Index (S-CVI) = 0.86, Cronbach's α = 0.9 and the Test re-test reliability using intra-class correlations were (ICC) = 0.97 to 0.98. Exploratory factor analysis determined eight factors which showed more than 52% of the variance. APTSCIHS had a significant and strong correlation with Appraisals of DisAbility Primary and Secondary Scale (ADAPSS) (r = 0.475, P < 0.001). CONCLUSION: Results showed the 36 items APTSCIHS tool had an acceptable validity and reliability in Iran, and it can help health care providers or even administrators improve the quality of the rehabilitation services and quality of life.

Baseline results of the first malaria indicator survey in Iran at household level.

BACKGROUND: Malaria is one of the leading causes of sickness and death in the developing world, causing more than a million deaths and around 250 million new cases annually worldwide. The aim of this comprehensive survey was to provide information on malaria indicators at household level in high-risk malaria areas in Iran. METHODS: In a cluster randomized cross-sectional survey data were collected from 5,456 households in both rural and urban areas of 20 malaria-affected districts of Iran. All the fieldwork was done by trained interviewers and a validated questionnaire. The questionnaire comprised baseline characteristics of the study population, the knowledge of people about different aspects of malaria (such as clinical symptoms, transmission and prevention) and their practice to prevent illness (such as using mosquito nets, spraying houses). The data were analysed and descriptive statistics (i.e. frequencies, percentages) were used to summarize the results. RESULTS: The results of this survey showed that 20% (95% CI: 17.36-22.24) of households owned at least one mosquito net, whether treated or untreated. Consequently, the use of mosquito nets was considerably low among both children under age five [5.90% (95% CI: 5.14-6.66)] and pregnant women [5.70% (95% CI: 3.07-8.33)]. Moreover, less than 10% of households reported that the interior walls of their dwelling had been sprayed in the previous year [8.70% (95% CI: 6.09-11.31)]. Data also suggest that 63.8% of the participants recognized fever as a sign of malaria, 56.4% reported that mosquito bites cause malaria and about 35% of participants mentioned that the use of mosquito nets could prevent malaria. CONCLUSION: Findings from this study indicate that low access to treated nets along with low understanding of the role of nets in malaria prevention are the main barriers to utilization of bed nets. Therefore, the use of insecticide-treated mosquito nets should be encouraged through health education on the importance of the use along with increasing access to it.

Baseline results of the first malaria indicator survey in Iran at the health facility level.

BACKGROUND: Malaria continues to be a global public health challenge, particularly in developing countries. Delivery of prompt and effective diagnosis and treatment of malaria cases, detection of malaria epidemics within one week of onset and control them in less than a month, regular disease monitoring and operational classification of malaria are among the major responsibilities of the national malaria programme. The study was conducted to determine these indicators at the different level of primary health care facilities in malaria-affected provinces of Iran METHODS: In this survey, data was collected from 223 health facilities including health centres, malaria posts, health houses and hospitals as well as the profile of all 5, 836 recorded malaria cases in these facilities during the year preceding the survey. Descriptive statistics (i.e. frequencies, percentages) were used to summarize the results and Chi square test was used to analyse data. RESULTS: All but one percent of uncomplicated cases took appropriate and correctly-dosed of anti-malarial drugs in accordance to the national treatment guideline. A larger proportion of patients [85.8%; 95% CI: 84.8 - 86.8] were also given complete treatment including anti-relapse course, in line with national guidelines. About one third [35.0%; 95% CI: 33.6 - 36.4] of uncomplicated malaria cases were treated more than 48 hours after first symptoms onset. Correspondingly, half of severe malaria cases took recommended anti-malarial drugs for severe or complicated disease more than 48 hours of onset of first symptoms. The latter cases had given regular anti-malarial drugs promptly.The majority of malaria epidemics [97%; 95% CI: 90.6 - 100] in study areas were detected within one week of onset, but only half of epidemics were controlled within four weeks of detection. Just half of target districts had at least one health facility/emergency site with adequate supply and equipment stocks. Nevertheless, only one-third of them [33% (95% CI: 0.00 - 67.8)] had updated inventory of malaria foci on quarterly basis. CONCLUSION: To sum up, malaria case management still constitutes a public health problem in Iran. Additionally, data suggest scarcity in management and evaluation of malaria foci, detection and control of malaria epidemics as well as assignment of emergency sites across different regions of the country. Consequently, massive and substantial investments need to be made at the Ministry of Health to coordinate national malaria control programmes towards achieving determined goals and targets.

'No to unnecessary caesarean sections': Evaluation of a mass-media campaign on women's knowledge, attitude and intention for mode of delivery.

INTRODUCTION: Improvement of women's knowledge and attitude toward vaginal birth is recognized as an important strategy to control caesarean sections (CS) on maternal request. This study aimed to evaluate the effectiveness of a mass-media campaign in improving knowledge, attitude and intention of women for vaginal birth. METHODS: This was a population-based study carried out in Tehran, Iran. A national 'No to unnecessary caesarean sections' campaign was launched in April 2016 and was televised for ten days. A random sample of pregnant women from all defined geographical areas of Tehran were recruited and assessed for knowledge about the benefits of vaginal birth and the risk of CS, attitude and intention toward mode of delivery at two points in time: before and after the campaign. A comparison was made to evaluate outcome measures among those who had seen the campaign and those who had not. RESULTS: In all, 37 public and private maternity care centers were selected randomly and 702 eligible pregnant women attending these centers were entered in the study. Pre- and post-intervention data for 466 women were available for analysis. Of these, 194 women indicated that they had seen the campaign and the remaining 272 women said that they had not. A comparison of the outcome measures between the two study groups showed that there were significant differences between those who had seen the campaign and those who had not. Those who had seen the campaign reported increased knowledge, had a more positive attitude and indicated increased behavioral intention toward vaginal birth. CONCLUSIONS: In general, the findings indicated that the mass-media campaign improved pregnant women's knowledge, attitude and intention towards vaginal birth. However, the long-term effects of such campaigns need further investigation.

Improving community health workers' knowledge and behaviour about proper content in malaria education.

OBJECTIVE: To enhance knowledge and behaviour of Community Health Workers (CHWs) regarding adequate educational content of malaria. METHODS: A quasi-experimental study was undertaken in 2003 in Sistan va Baluchestan province, Islamic Republic of Iran. Sixty-four CHWs were selected in both intervention and control groups. A questionnaire consisting of 17 open-ended questions was developed to assess CHWs' knowledge and behaviour about adequate content needed to be taught to the community. A multipurpose programme was held for the intervention group. Two follow-ups were carried out after three and six months. The data were analyzed using t-test, paired t-test, and ANOVA for repeated measurement. RESULTS: The knowledge and behaviour about proper content increased considerably after three months in both the groups. The knowledge increased in the intervention group significantly as compared to control group. CONCLUSION: The results showed these simple and inexpensive interventions effect to improve proper content in malaria education. The findings highlight the importance of considering the proper content in malaria education when planning CHWs education programmes.

Periconceptional care and offspring health at birth and long term, from the perspective of Avicenna.

Periconceptional care such as lifestyle plays an important impact role in offspring health. The aim of the present study was to clarify the perspective of Avicenna on periconceptional care. Avicenna (980-1037 A.D.) was one of the outstanding Persian physicians, who made great contributions to the field of medical sciences, in particular, obstetrics. In advance, Avicenna's book, Canon of Medicine, was considered to find his perspectives on periconceptional care. Then, his ideas and theories were compared to the current findings by searching the keywords in main indexing systems including PubMed/MEDLINE, Scopus and Institute for Scientific Information Web of Science as well as the search engine of Google Scholar. Current investigations show that gamete quality, pregnancy outcome, and offspring health at birth and long term depend on both parents' lifestyle in pre- and periconceptional period, as well as the intrauterine environment. Avicenna believed that seminal fluid, sperm, ovum, and developing conditions in utero were influenced by the stages of food digestion and the function of some organs. On the other hand, food digestion and function of the organs also depend on each parent's lifestyle and environmental factors. He mentioned 6 principles of healthy lifestyle: exercise, nutrition, sleep and awareness, excretion of body wastes and retention of necessary materials, psychic features, as well as air and climate. Thus, a multicomponent healthy lifestyle should be considered by parents of child-bearing age in an appropriate period before and in early pregnancy as well as elimination of any disorders in parents, to give birth to more healthy offspring.

Health literacy among Iranian adults: findings from a nationwide population-based survey in 2015.

BACKGROUND: Health literacy is one of the most important determinants of noncommunicable diseases prevention. Health literacy is associated with elevated risks for poorer access to care, adverse health outcomes, and increased hospitalization and health costs. AIMS: This study aimed to determine the level of health literacy among the general adult population in the Islamic Republic of Iran. METHODS: Using a cross-sectional study during 2014-2015 with a multistage cluster sampling approach, we administered a pilot-tested standardized questionnaire to assess different domains of health literacy (i.e., reading, comprehension, communication/decision-making and Interpretation/judgment skills, individual and social empowerment, health information access and health information use) among 8439 (3935 males) individuals aged 18-60 years. Data were collected through face-to-face interviews. Descriptive statistics and multivariable linear regression method using SPSS (20) were applied to identify the factors associated with health literacy among Iranian adults. RESULTS: The mean health literacy level was 10.2±3.8 (out of 20). Only 18% (95% confidence interval [CI]: 17.15-18.78) of the participants had adequate health literacy, while 45.7% (95% CI: 44.64-46.78) had inadequate, and the 36.3% (95% CI: 35.21-37.33) had moderate health literacy. In the adjusted linear regression model, education level (the smallest ß = 4.35, P < 0.001), age (ß = 0.01, P = 0.002), female sex (ß = 0.45, P < 0.001), residency in rural areas (ß = 0.26, P < 0.001) and having permanent job (ß = 1.03, P < 0.001) were significantly associated with more health literacy. CONCLUSION: Our findings highlighted that the Iranian adult population has an insufficient level of health literacy, which calls for comprehensive education planning to improve the levels, with special attention to certain subpopulations (e.g. illiterate populations) and domains (e.g. individual empowerment).

Knowledge, attitude and behaviour of mothers on neonatal jaundice.

OBJECTIVE: To determine knowledge, attitude, and behaviour of mothers about neonatal jaundice. METHODS: In this cross-sectional study, 400 cases who delivered at Ali-Ebne Abitaleb Hospital in Zahedan-Iran during April and May 2006 were interviewed to complete 21-point questionnaires. The first data was analyzed descriptively then analytically by chi2, Pearson correlation, and independent t-test using SPSS 11 software. RESULTS: The mean age of mothers was 26.8+/-6.5 years. The mean of knowledge score was 7.25+/-2.1 out of 13.5. Although knowledge of mothers about diagnostic methods was acceptable, it was not sufficient about causes, complications, harmful symptoms and prevention of the disease. The mean of attitude score was 18.5+/-3.7 out of 25. The mean of behaviour score was 6.8+/-2.3 out of 10.5. Knowledge had a significant association with history of neonatal jaundice (P=0.033), mother's age (P<0.001), and child's birth rank (P=0.001). There was also a significant association between mother's attitude and their educational level (P<0.001). Results showed a direct correlation between knowledge, attitude and behaviour (P<0.001). CONCLUSION: Increasing mothers' knowledge about jaundice of neonates can be the first step to enhance healthy behaviours; through education programmes during pregnancy.

Prevalence of health-risk behaviors among teen girls in Southeastern Iran.

BACKGROUND: Investigating female adolescents' health status is essential because of their two-fold role within the health of the community and the impending generations' health. OBJECTIVE: The present study aimed to determine the prevalence of health-risk behaviors among teen girls in Southeastern Iran. METHODS: This cross-sectional study was carried out on a sample of 457 tenth grade female adolescents in four public high schools in Zahedan in Southeastern Iran, in 2015. First, high schools were randomly selected; then, all students in Grade 10 were enrolled in the study through a census. Data were collected using a self-reported questionnaire of the health-risk behaviors with the content validity ratio (CVR) of 0.80, the content validity index (CVI) of 0.88 and Cronbach's α score of 0.71. The Results were analyzed using ANOVA test with SPSS-15. RESULTS: The highest prevalence rate of health-risk behaviors of students included: failing to drink natural fruit juice (53.1%), failing to wear a seat belt (43.0%), sitting in a car while the driver is sending message or emails (43.0%), failing to drink milk daily (36.0%), lack of minimum daily physical activity 37.0%, and watching TV more than 3 hours a day (35.0%). On average, the number of health-risk behaviors among under study students was 1.47. Additionally, the ANOVA showed a statistically significant difference in the average number of health-risk behaviors of adolescents in families with high economic status, those who never talked with their parents or those who had physical relations with the opposite sex (p<0.001). CONCLUSION: It is suggested that attention be paid to emphasizing the pattern of healthy eating, increasing physical activity, and reducing unsafe behaviors in adolescents; moreover, behavioral consultation should be given regarding relationships with the opposite sex. Furthermore, more attention must be paid to the familiar behavior patterns and the relationships in school health programs.

A study on school health policies and programs in the southeast of Iran: a regression analysis.

BACKGROUND: Investing in adolescent health is one of the most important interventions in the health system. Accordingly, health-promoting schools organize their policies, methods, infrastructures, and activities towards protecting and promoting the health and well-being of the students, teachers, directors, authorities and society as a whole. OBJECTIVE: To study the health policies of schools in the southeast of Iran. METHODS: This cross-sectional study was carried out on all governmental high schools (113 schools) which were enrolled by census sampling method in January 2017, in Zahedan, in the southeast of Iran. The study tool was a validated questionnaire about the "School Health Policies and Programs" that was completed by the principals or staff of the schools. Data were analyzed by SPSS version 15, using descriptive statistic and linear regression test. RESULTS: About one-third of the schools did not have a health educator. Some policies, including annual medical examinations, having a healthy breakfast at school, healthy food supply at lower prices in school buffets, and counseling the students with special conditions in schools were not implemented. The most inter-sectoral cooperation was among the health centers (47.8%). The mean score of health policy implementation in schools was 89.70±11.51. Linear regression analysis demonstrated a significant relationship between type of school (p<0.05) and number of students in schools as well as attendance of a health educator in schools (p<0.001) with health policies. CONCLUSIONS: Despite the implementation of the program in Iran in recent years, there are no clear and identical policies in the schools. Therefore, there is need to establish health policy committees in schools from among staff, teachers, parents, and students. In addition, success of the program requires inter-sectoral collaboration, supporting environmental health and improvement of parents' relationships with the school.

Seroprevalence of Crimean-Congo hemorrhagic fever in Sistan-va-Baluchestan province of Iran.

During the years 2000 to 2004, of 248 serologically confirmed cases of Crimean-Congo hemorrhagic fever (CCHF) that occurred in several parts of Iran, 169 were reported from Sistan-va-Baluchestan province. To assess the seroprevalence of CCHF virus infection within the Zahedan and Zabol districts of the Sistan-va-Baluchestan province in Iran, 300 subjects were sampled from the general population. In addition to blood sampling, a questionnaire was completed for every subject. All but just 3 of our 300 sampled subjects participated in blood sampling, and just 7 out of the 297 serum samples were found to be IgG ELISA positive. The point estimate of the seroprevalence was 0.024 (95% confidence interval: 0.003-0.044). A history of keeping livestock in houses (even for short periods) showed an association with seropositivity (P = 0.018). It seems that even occasional contact with livestock could be effective in transmission of the virus.

Spectrum of clinical disease in a series of hospitalized HIV-infected patients from southeast of Iran.

OBJECTIVE: To determine the pattern of opportunistic infections (OIs) and non-infectious opportunistic diseases in hospitalized HIV-infected patients in Zahedan, southeast of Iran. METHODS: We retrospectively reviewed the records of 52 HIV-infected patients (47 male, 5 female; age range, 21-54 years) who were admitted to Boo-Ali Hospital, Zahedan, Iran for evaluation and management of an HIV-related disorders from April 2000 to December 2005. RESULTS: Tuberculosis (TB) was the most common opportunistic infections (53.8%) followed by hepatitis C (11.5%), typhoid (9.6%), amebiasis (9.6%), candidal esophagitis (5.7%), acute bacterial pneumonia (3.8%), and cerebral toxoplasmosis (1.9 %). Most of the cases of TB were pulmonary (36.5%). Apart from other well-recognized OIs, 2 cases of HIV-associated lymphoma were encountered. Only 12 patients (23.07%) received antiretroviral therapy. Five patients (9.6%) died during hospital stay due to tuberculosis (4 cases) and typhoid (1 case). CONCLUSION: The findings show that opportunistic infections are common in HIV-infected patients in Zahedan, southeast of Iran. Tuberculosis remains the most common OIs and is the most common cause of death in these patients.

Development and psychometric properties of a self-regulation scale about leisure time physical activity in Iranian male adolescents.

BACKGROUND: Self-regulation is one of the current psychological concepts that have been known as a determinant of leisure time physical activity. Due to cultural and social diversity in different societies and age groups, application of specific questionnaires is essential to perform investigations about physical activities. The aim of this study is development and evaluation of psychometric properties of a self-regulation questionnaire about leisure time physical activity in Iranian male adolescents. MATERIALS AND METHODS: This cross-sectional study was conducted in 2013, and data of 603 male students from 12 high schools in Isfahan were collected. A comprehensive literature review and similar questionnaire review were conducted and 25 items were selected or developed to measure self-regulation. Comprehensibility of items was evaluated in a pilot study and an expert panel evaluated face and content validity. Exploratory factors analysis (EFA) was used for evaluation of construct validity and extraction of sub-constructs of self-regulation. Leisure time physical activity was assessed using International Physical Activity Questionnaire (IPAQ). RESULTS: The mean age of the participants was 16.3 years (SD =1.0) and the range was 15-19 years. Cronbach's α coefficient of the questionnaire in the pilot and main study was 0.84 and 0.90, respectively. EFA resulted in four sub-constructs including "enlistment of social support", "goal setting", "self-construction", and "self-monitoring", which explained 63.6% of the variance of self-regulation. CONCLUSIONS: Results of this investigation provide some support to the validity and reliability of the 16-item questionnaire of self-regulation abut leisure time physical activity in the target group.