Exploring drivers of women's well-being in hospitals: mapping the landscape.

BACKGROUND AND PURPOSE: The workplace plays a key role in impacting the health and well-being of employees at various levels, including physical, psychological, and social aspects of health. This study aims to identify the drivers of a healthy environment that promotes the well-being of women employed in hospitals. MATERIALS & METHODS: This qualitative study used purposive sampling to recruit a total of 48 working women across a diverse range of participants with different job categories and socio-demographic statuses. These include clinical health (e.g., nurse, head nurse, practical nurse, supervisor, physicians); allied health (e.g., diagnostic services); public health (e.g., health promotion specialists); and administrative (e.g., hospital managers). Data was collected through semi-structured interviews and were analyzed using content analysis by creating codes, sub-themes, and themes. RESULTS: Content analysis resulted in 31 key codes, that generated 12 sub-themes and 4 key themes. These include Advancing women's health through collaborative leadership; a Psychologically safe environment for women; Thriving for positive social connections; and Advancing holistic health for women. DISCUSSION AND CONCLUSION: Hospital managers and leaders play a pivotal role in creating supportive workplaces for women. They can significantly assist in prioritizing their psychological and social health through personalized approaches tailored to women's needs, positioning them as co-designers of their health and well-being.

Psychosocial issues and sleep quality among seafarers: a mixed methods study.

BACKGROUND: Seafarers, especially those working for a prolonged period of time, are exposed to a high number of social, psychological and physical stressors including irregular working hours. AIM: This study aims to identify important aspects of Asian seafarers' psychosocial wellbeing and quality of sleep that could affect safety and health of the seafarers in long voyage tankers. METHODS: In this mixed method study, psychological health issues were investigated through semi-structured interviews with 17 Asian male seafarers. Participants were selected through purposive sampling. In the quantitative phase, 179 seafarers completed the Pittsburgh Sleep Quality Index (PSQI) on sleep quality. RESULTS: From the interviews, three categories consisting of six themes emerged, including sleep abnormalities, inevitable stressors, and lack of social communication. The majority of the seafarers believed that their quality of sleep was affected by their physical work environment and by issues raised by their families. As reasons for stress at sea, they mentioned the nature of the occupation and the psychosocial work environment. Most participants pointed out that lack of social communications had adverse effects on both their work lives on board and their private lives at home. In the quantitative phase, the response rate was 81.4%. Mean PSQI index was 5.9 (SD 2.6 and range from 2 to 14). Sleep impairment was higher in academic than non-academic individuals (p < 0.001). CONCLUSION: Sleep abnormalities and lack of social communication should be considered as modifiable risk factors for seafarers' psychosocial well-being at sea.

The components of workplace violence against nurses from the perspective of women working in a hospital in Tehran: a qualitative study.

BACKGROUND: Based on the World Health Organization (WHO), workplace violence can affect events where employees are abused, attacked or threatened in their workplace, and it also has some consequences such as safety, welfare, and health. Like other types of violence, workplace violence and aggression are an increasing phenomenon. Moreover, workplace violence not only disrupts interpersonal and organizational relationships, but it also impairs the persons self-esteem and affects their physical and mental health and well-being. Thus, this study aimed to explain the components of workplace violence against nurses from the perspective of women working in a hospital in Tehran, which was conducted through the qualitative method and content analysis. METHODS: In this study Purposive sampling included 21 female nurses who were working in different wards of the hospital. Also, female nurses were selected with maximum diversity in terms of work experience, age, and the wards they were working in. in this study the semi-structured interview was the main method of data collection. The interview transcriptions were extracted and then divided into meaningful units. For strengthening and confirming the results and accuracy of the research, the author used the data acceptability, credibility, accuracy, validity, believability, verifiability, reliability, and transferability. RESULTS: During the data analysis process of this study, the first 15 classes with the same characteristics were put together and then divided into 6 classes. Afterwards, based on the common features at a more abstract level, they were converted into 2 themes. Based on the findings, violence against women in the workplace occurs at two levels, that namely interpersonal violence and organizational coercion. CONCLUSION: Therefore, it is necessary for managers to commit to lay the groundwork for reducing violence in the hospital, as well as barriers to report these cases especially the hospital managers and officials should create awareness on workplace among the staff, patient and visitors and must ensure stringent actions to prevent it.

Explaining the reasons for not maintaining the health guidelines to prevent COVID-19 in high-risk jobs: a qualitative study in Iran.

BACKGROUND: Although the workers in many occupations are at the greatest risk of catching and spreading COVID-19 due to assembling and contacting people, the owners of these occupations do not follow COVID-19 health instructions. The purpose of this study is to explain the reasons for not maintaining health guidelines to prevent COVID-19 in high-risk jobs in Iran. METHODS: The present study was conducted with a qualitative approach among people with high-risk jobs in Tehran during March and April of 2020. Data were collected through semi-structured interviews with 31 people with high-risk occupations selected by purposeful sampling and snowballing. The data were analyzed using the conventional qualitative content analysis method and MAXQDA-18 software. Guba and Lincoln's criteria were also used to evaluate the quality of the research results. RESULTS: 4 main categories and 13 sub-categories were obtained, including individual factors (personality traits, lack of self-efficacy, little knowledge of the disease and how to observe health norms related to it, misconceptions about health), structural factors (difficulty of access to health supplies, lack of supportive environment, weak laws and supervision, the poor performance of officials and national media), economic factors (economic costs of living, lack of government economic support), Socio-cultural factors (learning, cultural beliefs, social customs, and rituals). CONCLUSION: COVID-19 prevention requires intervention at different levels. At the individual level: increasing people's awareness and understanding about how to prevent COVID-19 and strengthening self-efficacy in observing health norms, at the social level: highlighting positive patterns of observing health issues and training people about the consequences of social interactions during the outbreak of the virus, and at the macro level: strengthening regulatory rules and increasing people's access to hygienic products and support for the vulnerable must be taken into account.

The Impact of Educational Intervention Based on Theory of Planned Behavior for Promoting Physical Activity Among Middle-Aged Women Referring to Karaj (Iran) Health Centers.

BACKGROUND: Physical activity is the most critical determinant of physical health which reduces the health risks during life. This designed study aims to evaluate the effect of educational intervention based on the theory of planned behavior on promoting physical activity among middle-aged women attending the health centers in Karaj city during 2017-2018. METHODS: This research was a quasi-experimental controlled trial, and the study incorporated 140 Middle-Aged Women Referring to Karaj Health Centers assigned randomly to a control and intervention group (70 each group). Participants enrolling in the survey were asked to complete the International Physical Activity Questionnaire and also the theory of planned behavior measures at the baseline and the end of the study. The SPSS software were used, to analyze the data. The study applied Nonparametric Wilcoxon and Mann-Whitney tests and ANCOVA to interpret the results. RESULTS: The results revealed participants' age range between 30 to 50 years with the mean and standard deviation scores 40.07 (8.750) in training and 45.81 (8.513) at the control group. The intervention improved the theory of planned behavior measures and the physical activities of participants. The results showed a significant difference in the attitude score, the perceived behavioral control score, and the level of subjective norms between two training and non-training groups (P < 0.001). The followed-up physical activity score also showed an improvement in the IPAQ score of participants in the training group (p < 0.001). CONCLUSIONS: The results of this specific study support the effectiveness of the theory of planned behavior for promoting the physical activity of women.

Association of wrist circumference with cardio-metabolic risk factors: a systematic review and meta-analysis.

BACKGROUND AND AIMS: The association of Wrist Circumference (WrC) with cardio-metabolic risk factors is still contradictory. We aimed to systematically review the association of WrC with cardio-metabolic diseases among the general populations. METHODS: We systematically searched electronic databases such as PubMed/Medline, Web of Sciences, and Scopus without language restriction until March 2017. Observational studies that examined the association of WrC with any cardio-metabolic risk factors were included. Pooled association of WrC with metabolic syndrome (MetS) was estimated using a random-effect model, and heterogeneity among studies was assessed by I2 index and Q test. RESULTS: A total of 14 papers including cohort study (n = 9), cross-sectional study (n = 4), and case-control study (n = 1) met the criteria and included. The eligible papers have been examined the association of WrC with any cardiovascular disorders (n = 8), metabolic syndrome (n = 4), insulin resistance (IR) (n = 5), diabetes mellitus (n = 2), impaired glucose tolerance (n = 1), cardio-metabolic risk factors (n = 2) and obesity/overweight (n = 1). In the whole population (both adults and pediatric population), high WrC increased the risk of MetS by 33% (Pooled OR = 1.33; 95% CI 1.20, 1.48; I2 = 60.2%, p = 0.04), while the pooled OR in adult populations was 1.27 (95% CI 1.15-1.41; I2: 32.8%, p = 0.21). Qualitative synthesis showed that associations of WrC with other cardio-metabolic risk factors are conflicting. CONCLUSION: High WrC increased the risk of MetS and other cardio-metabolic risk factors. However, due to limited studies, particularly in children, results should be declared with great caution. Further cohort studies are needed to clarify whether WrC is a suitable anthropometric index to predict cardio-metabolic disorders in adult and children populations in different societies. LEVEL OF EVIDENCE: Level 1, systematic review and meta-analysis.

Association of screen time and physical activity with health-related quality of life in Iranian children and adolescents.

BACKGROUND: Health-related quality of life (HRQoL) is a multidimensional concept with significant effects and children and adolescence; while physical activity (PA) and screen time (ST) have been suggested as its probable predictors. Present study aims to investigate the association of PA, ST and their combination, with HRQoL in a nationally-representative sample of Iranian children and adolescents. METHODS: As for the estimated sample size, 25,000 students aged 6-18 years were selected via multi-stage cluster sampling from 30 provinces of Iran. Sociodemographic data was obtained by using the questionnaire of the World Health Organization-Global school based student health survey (GSHS). Persian Pediatric Quality of Life inventory (PedsQL) and Physical Activity Questionnaire for the pediatric age group (PAQ-A) were applied for evaluating HRQoL and PA, respectively. PA scores 1-1.9 and 2-5 were respectively considered as low and high PA. The average duration of time spent on watching TV and leisure time computer use were considered as ST behaviors. ST of less than 2 h was considered low. RESULTS: Out of 25,000 invited individuals, 23,043 students (mean age: 12.5) completed the study (response rate: 92.17%). In linear regression models, ST duration had significant inverse association with total QoL (ß: - 0.49, p < 0.05). PA showed positive significant associations with HRQoL total score (ß: 1.8, p < 0.05). Joint association of PA and ST revealed the strongest association of "high PA-low ST" category with total HRQoL (ß: 2.2, p < 0.05); while "high PA-high ST" showed better total HRQoL score (ß: 1.3) compared to "low PA-low ST" subgroup. CONCLUSION: Both PA and ST are significantly and independently associated with HRQoL in Iranian children and adolescents; while the adverse effect of prolonged ST could be diminished by a high PA.

Health-Related Quality of Life according to the Socioeconomic Status of Living Areas in Iranian Children and Adolescents: Weight Disorders Survey.

BACKGROUND: Health-related quality of life (HRQoL) has become a major concern in the field of children's health research. We assessed HRQoL among Iranian children and adolescents according to the socioeconomic status (SES) of their living region. METHODS: Via multistage cluster sampling from rural and urban school students aged 6 to 18 years, this nationwide study was conducted from 2011 to 2012. HRQoL was assessed using the adolescent core version of the Pediatric Quality of Life questionnaire. Through survey data analysis methods, the data were compared according to the SES of the living region, sex, and the living area. RESULTS: Overall, 23043 students participated in the survey (participation rate=92.2%). The mean age of the participants was 12.55±3.31 years. Boys accounted for 50.8% of the study population, and 73.4% were from urban areas. At national level, the mean of the HRQoL total score was 81.7 (95% CI: 81.3 to 82.1) with a mean of 83.5 (95% CI: 83.0 to 84.1) for the boys and 79.8 (95% CI: 79.1 to 80.5) for the girls. The highest and the lowest scores, respectively, belonged to social functioning (90.0 [95% CI: 89.7 to 90.3]) and emotional functioning (78.2 [95% CI: 77.7 to 78.7]). The highest total HRQoL score belonged to the second highest SES region of the country (mean=83.1; 95% CI: 82.5 to 83.7). The association between total HRQoL and the score of all the subscales and SES in the living area was statistically significant (P<0.001). CONCLUSION: The results of the present study showed that in the children and adolescents, SES was associated with HRQoL. Accordingly, HRQoL and the related SES differences should be considered one of the priorities in health research and health policy.

Determinants of life satisfaction in Iranian children and adolescents: the CASPIAN-IV study.

BACKGROUND: Life satisfaction (LS) in children and adolescents is important because of its effects on their school performance and the future adulthood life. In this multicentric study, we examined some determinants of LS in the pediatric age group. METHOD: This multicentric study was a part of the fourth national school-based surveillance program in Iran (2011-2012). It was conducted among 14,880 children and adolescents, aged 6-18 years, living in 30 provinces in Iran. We used the questionnaire of the World Health Organization on Global School-based Health Survey (WHO-GSHS), which was translated to Persian and validated in Iranian children and adolescents. LS was defined by a single question: 'Generally, which score between 0 (the worst) to 10 (the best) do you feel well describes your life at the moment?' The score of six and above was considered as satisfied. Multivariate logistic regression analysis was conducted to investigate the determinants of LS. RESULTS: In total, 13,486 students completed the study (response rate 90.6%). Overall, 86.7%, 78.19%, and 71.44 of students were satisfied with their life in elementary, middle, and high schools. Students in middle school (OR 0.83; 95% CI 0.73, 0.96) and high schools (OR 0.63; 95% CI 0.54, 0.72) were less satisfied with their life. Students with moderate (OR 1.36; 95% CI 1.20, 1.54) and good (OR 1.66; 95% CI 1.44, 1.91) socioeconomic status were more satisfied than those with low status. Those who consulted with one (OR 1.56; 95% CI 1.34, 1.81) or both (OR 2.22; 95% CI 1.89, 2.60) of their parents were more satisfied with their life. Students who felt being accepted by their peers were 1.34 (95% CI 1.18, 1.52) times more satisfied with their life. Other associated variables were weekly (OR 1.3; 95% CI 1.12, 1.572) or daily (OR 1.6; 95% CI 01.12, 1.57) fruit consumption, moderate (OR 1.14; 95% CI 1.01, 1.29) and high (OR 1.1; 95% CI 1.02, 1.347) physical activity, good self-rated health (OR 2.11; 95% CI 1.88, 2.37), and daily tooth brushing (OR 1.31; 95% CI 1.18, 1.46). Students with anxiety (OR 0.73; 95% CI 0.65, 0.82) and depression (OR 0.73; 95% CI 0.58, 0.74) were less satisfied with their life. CONCLUSION: Some demographic and lifestyle factors, including higher socioeconomic status, consultation with parents, healthy dietary, and physical activity habits, were associated with higher LS in children and adolescents. Then, interventions that focus on improving lifestyle factors and parents' support could increase LS among children and adolescents.

Prevalence of hepatitis C infection in Iranian hemodialysis patients: An updated systematic review and meta-analysis.

BACKGROUND: Hepatitis C virus (HCV) is a major cause of liver disease and a potential cause of substantial morbidity and mortality. This study aims to provide a comprehensive evidence on HCV Infection in Iranian hemodialysis (HD) patients we conducted a systematic review. MATERIALS AND METHODS: In this systematic review and meta-analysis, through a comprehensive search of literature until January of 2016, we estimated the pooled prevalence of hepatitis C infection in Iranian HD patients. Using Medical Subject Headings terms, Emtree, and related equal Persian key words for Iranian databases and also international databases of PubMed and NLM Gateway (for MEDLINE), and SCOPUS. Interest outcome of HCV infection prevalence was confirmed based on positive hepatitis B surface antigen of blood samples. Random effect meta-analysis was used to estimate pooled prevalence of HCV infection in Iranian HD patients, date and language, HD patients, in adult HD patients, Institute of Scientific Information, Iran-doc, irrespective of age, living in Iran. Searches run through main domestic databanks of Iran-Medex, renal transplantation, Scientific Information Database, the relevant literature-searched concentrating on HCV infection. RESULTS: Through searching steps, 305 publications were found from them following the excluding duplicates and overlapping studies 54 studies relevant to HCV prevalence in Iranian HD zcxw patients, with number of 23921 participants, remained in our analyses. The overall results of test of heterogeneity demonstrate sever heterogeneity between reported prevalence (I2 = 96.62%, Chi-square = 1566, P < 0.001). Due to sever heterogeneity results of random effect meta-analysis showed that the estimated pooled prevalence was 11% (95% confidence interval [CI] =10%-13%). The pooled prevalence base on polymerase-chain reaction, recombinant immunoblot assay, and enzyme-Linked Immunosorbant Antibody method were 11% (95% CI = 6%-15%), 9% (95% CI = 5-13) and 12% (95% CI = 10-14), respectively. In line with previous studies, the present finding shows the significant variation in the rate of HCV in dialysis units among the regions in Iran. CONCLUSION: Present paper is the comprehensive updated systematic review on HCV prevalence in the Iranian HD patients. Our findings provide the reliable evidence for promotion of policies and interventional programs.

Socioeconomic inequality in oral health behavior in Iranian children and adolescents by the Oaxaca-Blinder decomposition method: the CASPIAN- IV study.

BACKGROUND: The present study set to describe the socioeconomic inequality associated with oral hygiene behavior among Iranian pediatric population. METHODS: A representative sample of 13486 school students aged 6-18 years was selected through multistage random cluster sampling method from urban and rural areas of 30 provinces in Iran. Principle Component Analyses (PCA) correlated variables summarized as socioeconomic status (SES). Association of independent variables with tooth brushing was assessed through logistic regression analysis. Decomposition of the gap in tooth brushing between the first and fifth SES quintiles was assessed using the counterfactual decomposition technique. To assess the relation between tooth brushing and each socioeconomic category, Concentration Index (C) and the slope index of inequality (SII) were used, representing the linear regression coefficient. RESULTS: The participation rate was 90.6 % (50.7 % boys and 75.6 % urban inhabitants). The mean age of participants was 12.47 ± 3.36 years. The frequency of tooth brushing increased across SES quintiles, prevalence of tooth brushing between the first and fifth quintile, under 20 % difference, increased from 58.22 (95 % CI: 56.24,60.20) to 78.61 (95 % CI: 77.00,80.24). Only 3 % of the difference is explained by the factors considered in the study, and 17 % remained unknown. Residence area, family size, and smoking status made a significant contribution to the gap between the first and last SE groups. Residence area [ -2.01 (95 % CI: -3.46, -0.55)] was along the maximum levels of gaps between SE categories. CONCLUSIONS: The findings revealed a socio-economic inequality in oral health behavior in Iranian children and adolescents. Also, factors influencing oral health are addressed to develop and implement complementary public health actions.

Collaboration in research and the influential factors in Golestan University of Medical Sciences research projects (2005-2007): an academic sample from Iran.

BACKGROUND: Number of Iranian articles published in ISI journals has increased significantly in recent years.Despite the quantitative progress, studies performed in Iran represent low collaboration in research; therefore,we decided to evaluate collaboration in Golestan University of Medical Sciences (GOUMS) research projects. METHODS: In this cross-sectional study, all GOUMS research projects that had got grants from the universitybetween 2005-2007 were studied. Among 107 research projects included in our study, 102 projects were evaluatedand checklists were completed. The researcher's questionnaire was sent to the principle investigators (n=46) of the projects and eventually 40 questionnaires were collected. RESULTS: The review of 102 research proposals shows that 10 projects (9.8%) have been performed in collaborationwith other organizations. Scientific outputs in these projects have been more than projects which wereconfined to the university (98% compare to 68%; p= 0.04). The total cost of the projects under study was a littlemore than 300,000 US$. In just 12 projects (11.8%) a part of the cost had been provided by organizations outsidethe university. About 50% of researchers declared that they had chosen their research topic based on their"personal interest". Only 1 project was performed by the demand of nongovernmental organizations and 12 researchersreported no collaboration in their activities. CONCLUSION: This study shows that collaboration in GOUMS research projects is low. Moreover, collaborationswith governmental and nongovernmental organizations are trivial. The scientific outputs in collaborativeresearch projects are much more than other projects.

The menopausal age and associated factors in Gorgan, Iran.

BACKGROUND: Considering the physical, emotional and psychological complications of early or delayed menopause on women's life, it is necessary to determine associated factors of menopause age. This study designed to determine menopausal age and associated factors in women of Gorgan, i.e. the capital of Golestan province in the north-east of Iran. METHODS: In this cross-sectional study, 804 menopausal women in Gorgan were selected via two-stage sampling method in 2009. The study included only women who had undergone natural menopause and had their last menstrual bleeding at least one year before. Data were gathered through structured questionnaire that included individual characteristics, socioeconomic characteristics, menstrual and fertility characteristics and climacteric complaints. Socioeconomic status was defined using principal component analysis. Data were analyzed with T-student's and ANOVA tests using SPSS version 16 (SPSS Inc, Chicago, IL, USA) for Windows. RESULTS: The mean menopause age was 47.6±4.45 years with the median age of 48 years. The mean menopause age in women with first pregnancy before 30 years (47.58±4.47years), without pregnancy (46.26±4.90years) and without delivery (46.30±4.47 years) was significantly lower than others (p<0.01). The mean menopause age was lower in single women (46.6±2.80 years), with low income level (47.7±4.39 years) and smokers (47.6±4.45 years) compared to others; but these differences were not statistically significant (p>0.05). Socioeconomic status was not associated significantly with menopause age (p>0.05). CONCLUSION: This study illustrated that menstrual and fertility factors have influence on menopausal age while socioeconomic factors were not effective.

Analyzing the concept of sexual self-care in preschool children: A qualitative study.

BACKGROUND: Child sexual abuse is a global concern for families and societies. Therefore, child protection from sexual harassment is of particular importance. The present study aimed to investigate the concept of sexual self-care in children. MATERIALS AND METHODS: The present research is a qualitative study conducted with a content analysis approach. The study participants include 39 child sex education specialists, parents of children aged 4-7 years, adolescents who were sexually abused in childhood, and those with no experience of sexual abuse in childhood. The participants were selected through purposive sampling method. Different people's interpretations of the concept of sexual self-care in children were explored using semi-structured and face-to-face interviews, which continued until the saturation of concepts. Data were analyzed using the Graneheim and Lundman method. Guba and Lincoln's criteria were used to strengthen the validity and transferability of the data. RESULTS: Sexual self-care in children was identified from participants' viewpoints in the study. This self-care includes three main components and six subcomponents of (1) knowledge about privacy, risk situation, and trustworthy people, (2) attitude and perception of risk, and (3) behavioral skills in self-protection (i.e., post-injury reaction). CONCLUSION: Further injuries can be prevented by improving the level of awareness, forming the right attitude, and strengthening children's behavioral skills toward sexual self-care. Such issues, which are representatives of privacy, risk situations, and self-protection ability, can improve children's sexual self-care skills.

Patterns of better breast cancer care in countries with higher human development index and healthcare expenditure: Insights from GLOBOCAN 2020.

Background: The huge burden of breast cancer (BC) necessitates the profound and accurate knowledge of the most recent cancer epidemiology and quality of care provided. We aimed to evaluate BC epidemiology and quality of care and examine the effects of socioeconomic development and healthcare expenditure on disparities in BC care. Methods: The results from the GLOBOCAN 2020 study were utilized to extract data on female BC, including incidence and mortality numbers, crude rates, and age-standardized rates [age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs)]. The mortality-to-incidence ratio (MIR) was calculated for different locations and socioeconomic stratifications to examine disparities in BC care, with higher values reflecting poor quality of care and vice versa. In both descriptive and analytic approaches, the human development index (HDI) and the proportion of current healthcare expenditure (CHE) to gross domestic product (CHE/GDP%) were used to evaluate the values of MIR. Results: Globally, 2,261,419 (95% uncertainty interval (UI): 2,244,260-2,278,710) new cases of female BC were diagnosed in 2020, with a crude rate of 58.5/100,000 population, and caused 684,996 (675,493-694,633) deaths, with a crude rate of 17.7. The WHO region with the highest BC ASIR (69.7) was Europe, and the WHO region with the highest ASMR (19.1) was Africa. The very high HDI category had the highest BC ASIR (75.6), and low HDI areas had the highest ASMR (20.1). The overall calculated value of female BC MIR in 2020 was 0.30, with Africa having the highest value (0.48) and the low HDI category (0.53). A strong statistically significant inverse correlation was observed between the MIR and HDI values for countries/territories (Pearson's coefficient = -0.850, p-value < 0.001). A significant moderate inverse correlation was observed between the MIR and CHE/GDP values (Pearson's coefficient = -0.431, p-value < 0.001). Conclusions: This study highlighted that MIR of BC was higher in less developed areas and less wealthy countries. MIR as an indicator of the quality of care showed that locations with higher healthcare expenditure had better BC care. More focused interventions in developing regions and in those with limited resources are needed to alleviate the burden of BC and resolve disparities in BC care.

Investigation of factors related to healthy eating behavior based on the developed theory of planned behavior in adolescents.

BACKGROUND: Adolescence is a complicated and sensitive period, and proper nutrition in this period of life can influence the quality and quantity of growth and maturity. The aim of the present study is to determine the factors associated with healthy eating behavior based on the developed theory of planned behavior in adolescents. MATERIALS AND METHODS: This is a descriptive-correlational study in which 400 female students of the first grade of high school in Bandar Anzali participated. Among the junior high schools in this city, two schools were randomly selected and sampling was done using census method. Data collection tool was Healthy Eating Behavior questionnaire based on Theory of Planned Behavior, which includes three sections of demographic information, constructs of Theory of Planned Behavior, including attitude toward behavior, subjective norms, perceived behavioral control, and behavioral intention, and food behavior, and food habits questionnaire. The scale was evaluated and confirmed by content validity ratio, content validity index, and alpha coefficient. P value was considered significant at less than 5%. Data analysis was performed using SPSS software 24, through linear regression and Pearson's correlation. RESULTS: As shown by linear regression analysis, the developed theory of planned behavior is able to predict 26% of the variance of healthy eating behavior, and this predictive power is related to the constructs of behavioral intention, attitude, and habits. CONCLUSIONS: In the present study, adding the variable of habits to the theory of planned behavior showed that this variable is very effective in predicting healthy eating behavior in adolescents, just like the constructs of behavioral intention and attitude. Therefore, it is suggested to carry out educational interventions based on the developed theory of planned behavior with the focus of the mentioned structures.

Determining the characteristics of a mental supportive workplace according to female hospital staff in one of Tehran hospitals: A qualitative study.

BACKGROUND: Health-care workers are exposed to complex types of health and safety hazards. A high percentage of hospital staff in Iran are women, who in addition to heavy and stressful hospital work, also carry the burden of the family roles. It is in these circumstances that creating a supportive environment for women is of particular importance. Accordingly, this study is designed to determine the characteristics of a mental supporting work environment in the workplace from the perspective of female hospital staff. MATERIALS AND METHODS: This study was performed by a qualitative method and content analysis approach. Sampling was purposive and 26 women working in different wards of this hospital were included in the study. In this study, women with maximum diversity in terms of age, work experience, and employment ward were selected. The main method of data collection in this study was a semi-structured interview. Interview texts were extracted and divided into meaningful units. To validate and confirm the results plus accuracy of the research, the criterion of data validity or data credibility, admissibility, data accuracy, verifiability, reliability, and transferability were used. RESULTS: Through the data analysis, 58 primary concepts with the same features were classified into 10 subcategories. Then, based on common features at a more abstract level, they were converted into four main categories including job stressors, women's stress management, providing women's psychological-job satisfaction, and women's work-life balance. CONCLUSION: Creating supportive work environments for women, especially those operating in workplaces such as hospitals, which brings a lot of work pressure and workload for them, can be an important policy for organizations and hospital work environments.

Factors affecting the health literacy status of patients with type 2 diabetes through demographic variables: A cross-sectional study.

BACKGROUND: Health literacy (HL) is the ability of a person to acquire the process, understand the necessary health information, and make the health services needed for conscious health decisions. Besides, diabetes is the most common metabolic disorder that affects patients' quantity and quality of life. This study focused on determining the factors that affect the HL status of patients with type 2 diabetes (T2D) through the role of the demographic variables. MATERIALS AND METHODS: This descriptive-analytical research survey recruited a sample based on 280 patients with T2D at the Diabetes Research Center of Ayatollah Taleghani Hospital in Kermanshah in 2020. This study selected patients with T2D using a simple random sampling technique. The study applied the demographic information questionnaire and the Functional, Communicative, and Critical HL Scale to collect data from patients with T2D. This study used the SPSS version 23 on the received data sets to perform statistical analysis, including t-test, analysis of the variance, and multiple regression, to predict the factors affecting HL among diabetes patients. RESULTS: The study results showed that the mean age of the participating patients with T2D was 55.80 ± 13.04. The results indicated the mean score and standard deviation of total HL score in patients with T2D 2.70 ± 0.44. The findings specified a statistically significant relationship between HL, gender, education, occupation, income, and place of residence. Results indicated that ß-coefficients of the multiple regression analysis and the income variable (ß = 0.170), age (ß = 0.176), and employment variable (ß = 0.157). These are the most predictive of the HL of patients with T2D. CONCLUSION: The results of this study specified that the HL rate of individuals with diabetes type 2 is average. The potential communicative and critical HL influence is essential for communication and education for diabetes patients in the primary health-care system settings. The findings indicate that communicative and critical HL related to patients' management and functional HL looks passable in this study.

The child-to-family education program regarding self-medication: A theory-based interventional study.

BACKGROUND AND OBJECTIVE: Self-medication is considered one of the largest social, economic, and health problems in developing communities, including Iran. The present study aimed to determine the effectiveness of a child to family communication approach to self-medication based on the Health Belief Model [HBM]. MATERIAL AND METHODS: This study is a quasi-experimental study that was conducted on 124 students in the fourth grade and their mothers in the intervention and control groups in Isfahan city, Iran. Using multi-stage simple random sampling, two primary schools were selected from each group, and then one class was selected from each primary school. Students in the intervention group attended the educational sessions. Then, the students were required to transfer their education to their families. The impact of education on mothers was evaluated two months after the last session. Data were collected before and after the intervention with a researcher-created questionnaire based on the HBM and were analysed using the SPSS 17 software package, with chi-square, Mann-Whitney U, and Wilcoxon tests. RESULTS: Before training, there was not a significant difference in the mean scores of the HBM constructs in terms of the demographic characteristics between the two groups. After the educational intervention, the mean of knowledge and HBM constructs were increased significantly, and the mean of perceived barriers decreased significantly in the experimental group [P < 0.001]. CONCLUSION: According to the present study, the child-to-family education based on the HBM was effective. It is suggested that educational interventions based on the HBM be designed and implemented to decrease self-medication in Iranian families.

Significance of Knowledge in Children on Self-Protection of Sexual Abuse: A Systematic Review.

Background: Sexual child abuse is a form of anti-social behavior with the children that cause potential harm to the health, development and dignity of the child. Knowledge of children about these issues can help to protect themselves against sexual abuse. This study aimed to review systematically available documents about the importance of knowledge on self-protection of sexual abuse in children. Methods: In this systematic review, "sexual abuse", "self-protection" and "knowledge" were searched in Scopus, Google Scholar, Ovid, PubMed, and Science Direct as the search words, and after considering the inclusion criteria and excluding irrelevant articles, the relevant articles were included for data extraction. In the included studies, children were educated about sexual abuse, and questionnaires were designed to compare the impact of education and the level of knowledge in children before and after education. Results: Overall, 19 articles with overall 6582 children were found that were published from 1987-2020. The main awareness of children was from parents, educators and then the media. Age of the child, education level of family, good relationship between family members, adequate education by school teachers in the form of educational programs and even media play an important role in increasing knowledge of children about sexual abuse. Education to children, on average, led to 77.43% more awareness and as a results self-protection against sexual abuse and rape. Conclusion: Insufficient education or lack of knowledge about sexual abuse is a critical issue in children. Therefore, it is necessary to design educational programs to increase their knowledge about sexual abuse and strategies for self-protection in this age group.