BACKGROUND AND AIM: Given the prevalence of novel coronavirus disease 2019 (COVID-19) and the lack of information on coronavirus and pregnancy, the purpose of this study was to evaluate the association of COVID-19 and perinatal outcomes in pregnant women. MATERIALS AND METHODS: In the present review article, the search process was conducted on English and Persian scientific databases of PubMed, Scopus, Google Scholar, Magiran, Irandoc, Iranmedx, and SID as well as the websites of international organizations of World Health Organization and Centers for Disease Control and Prevention using the main keywords of “Pregnancy,” “Perinatal outcomes,” “Coronavirus,” “COVID-19,” “MERS-CoV,” “MERS,” “SARS-CoV-2,” and “SARS-CoV-1” and their Persian-equivalent keywords from inception until March 16 2020. RESULTS: The findings of studies on mothers with COVID-19 were limited, and insufficient information is available on the adverse pregnancy outcomes in pregnant women with COVID-19. In cases of infection with other coronaviruses such as Middle East respiratory syndrome and severe acute respiratory syndrome during pregnancy, there have been reports on adverse pregnancy outcomes such as miscarriage, stillbirth, preterm labor, low birth weight, and congenital malformations following high fever in the first trimester. CONCLUSION: Pregnant women may be more susceptible to viral respiratory infections, including COVID-19, due to immunological and physiological changes. Therefore, pregnant women should take routine preventive measures, such as washing their hands frequently and avoiding contact with infected people, to prevent infection.

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Type-2 diabetes is a major, non-communicable disease with increasing prevalence at a global level. Type-2 diabetes results when the body does not make enough insulin or the body cannot use the insulin it produces. Type-2 diabetes is the leading cause of premature deaths. Improperly managed, it can lead to a number of health issues, including heart diseases, stroke, kidney disease, blindness, nerve damage, leg and foot amputations, and death. Type-2 diabetes or adult-onset diabetes is most common type of diabetes, usually begins when a person is in his or her mid-50s, but diabetes is not inevitable. Minor changes in your lifestyle can greatly reduce your chances of getting this disease. Therefore, in order to prevent this condition, action should be taken regarding the modifiable factors that influence its development-lifestyle and dietary habits. However, with proper testing, treatment and lifestyle changes, healthy eating as a strategy, promote walking, exercise, and other physical activities have beneficial effects on human health and prevention or treatment of diabetes, promoting adherence to this pattern is of considerable public health importance.

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Learning theories are the main guide for educational systems planning in the classroom and clinical training included in nursing. The teachers by knowing the general principles of these theories can use their knowledge more effectively according to various learning situations. In this study, Eric, Medline, and Cochrane databases were used for articles in English and for the Persian literature, Magiran, Iran doc, Iran medex, and Sid databases were used with the help of keywords including social cognitive learning, learning theory, behavioral theory, cognitive theory, constructive theory, and nursing education. The search period was considered from 1990 to 2012. Some related books were also studied about each method, its original vision, the founders, practical application of the training theory, especially training of nursing and its strengths and weaknesses. Behaviorists believe that learning is a change in an observable behavior and it happens when the communication occurs between the two events, a stimulus and a response. Among the applications of this approach is the influence on the learner's emotional reactions. Among the theories of this approach, Thorndike and Skinner works are subject to review and critique. Cognitive psychologists unlike the behaviorists believe that learning is an internal process objective and they focus on thinking, understanding, organizing, and consciousness. Fundamentalists believe that learners should be equipped with the skills of inquiry and problem solving in order to learn by the discovery and process of information. Among this group, we will pay attention to analyze Wertheimer, Brunner, Ausubel theories, Ganyeh information processing model, in addition to its applications in nursing education. Humanists in learning pay attention to the feelings and experiences. Carl Rogers support the retention of learning-centered approach and he is believed to a semantic continuum. At the other end of the continuum, experiential learning is located with the meaning and meaningful. It applies the minds and feelings of the person. From this group, the main focus will be on the works of Rogers and Novels. Finally, it could be concluded that the usage of any of these theoriesin its place would be desired and useful.

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Background: Most infectious diseases result from a lack of knowledge and poor personal hygiene. Hand hygiene, in particular, is one of the most common means by which pathogens are transmitted. The aim of this study was to determine college student's knowledge and awareness of personal hygiene in Kuwait. Materials and Methods: A multi-dimensional health assessment approach was followed using a self-administered questionnaire that was distributed among students of two colleges (the College of Nursing and the College of Health Sciences). Item analysis was conducted on 33 items of the questionnaire and measure five types of hygiene practices: hand hygiene, body hygiene, special hair application, oral care, and clothes hygiene. The data collected in the questionnaires and results were analyzed using statistical software SPSS version 23. Statistical analysis was performed using ANOVA and Student's t-test. Internal consistency, reliability was good, with an overall Cronbach's Alpha value of 0.749. Results: Most respondents were female with 64%, while 80% of the college students were in the age of <20-year-old. Twelve items were underhand hygiene practices, and four items under body hygiene. Nine items were under oral care; three, items were under hair application. Three were under clothes hygiene. Conclusions: This study showed that female students had a better knowledge and were more hygienic in hand hygiene, hair application, and body hygiene whereas, male students showed a better oral hygiene practice. Nevertheless, this study shows that the hygiene questionnaire is an acceptable and reliable measure of awareness and practice among college students.

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INTRODUCTION: Novel coronavirus is believed to be tiny enough (0.08–0.14 μm) to penetrate through face mask, thus protection offered by cloth mask may be too low. However, the use of cloth face mask in community has been recommended by the United States Centre for Disease Control and Prevention and regulatory bodies of other countries. There is paucity of literature on efficacy of cloth face mask in preventing SARS-CoV-2 infection transmission; thus, this review aims to update the available most recent evidences on efficacy of cloth face masks in prevention of viral infection transmission. METHODS: We searched MEDLINE, EMBASE, and Clinical Trials Register for identifying studies related to this review using free-text terms and MeSH terms. Both experimental and observational studies on efficacy of cloth masks which were published in English language have been included in this review except expert opinions, commentaries, editorials, and review articles. Twelve studies were eligible to be included in review for data extraction and qualitative synthesis was carried out from extracted data but quantitative analysis (meta-analysis) could not be performed because of serious heterogeneity between the studies. RESULTS: Cloth face masks show minimum efficacy in source control than the medical grade mask. The efficacy of cloth face masks filtration varies and depends on the type of material used, number of layers, and degree of moisture in mask and fitting of mask on face. CONCLUSION: Cloth face masks have limited efficacy in combating viral infection transmission. However, it may be used in closed, crowded indoor, and outdoor public spaces involving physical proximity to prevent spread of SARS-CoV-2 infection.

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OBJECTIVE: Self-efficacy is an individual's self-perception of one's ability to perform competently and to achieve a task or goal effectively. In the nursing field, self-efficacy can be useful in predicting performance, job satisfaction, or well-being. Therefore, due to the importance of this issue, this study aimed to determine the effect of educational workshop on nurses' self-efficacy along with follow-up in patient training. METHODS: The study employed a single group quasi-experimental study with a pretest/posttest design and was conducted in one educational hospital supervised by the Kerman University of Medical Sciences in 2016. Nurses' self-efficacy was analyzed through a researcher-made questionnaire prior and after the workshop and along with the follow-up period (n = 20). Data were analyzed using descriptive statistics including mean and standard deviation and analytic statistics such as Pearson correlation coefficient, independent t-test, paired t-test, and ANOVA with P ≤ 0.05. RESULTS: This study showed that 1 month after educational workshop, the score of self-efficacy dimensions increased (P < 0.05). Furthermore, results showed that after a 3-month follow-up period, self-efficacy score increased in comparison to preintervention self-efficacy score. Results showed that the total score means of self-efficacy before the workshop was 59.01 ± 14.91 while postworkshop, self-efficacy score means was 79.83 ± 11.90. CONCLUSION: The present research results presented that educational workshop may enhance self-efficacy among nurses. According to the obtained results, it is recommended that the Ministry of Health, Treatment and Medical Training, in cooperation with nursing institutions responsible for nursing and medical in-service education adopt necessary measures to enhance self-efficacy among employees in addition to improving patient training condition at medical processes through similar workshops or conducting related studies.

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Context: Lack of physical activity is a contributor to the obesity epidemic and is speculated to relate to reduced academic performance; however, this link has yet to be examined within the college population. Aims: The purpose of this study in a group of undergraduate students, was to determine if aerobic exercise activity was related to academic performance. Materials and Methods: The participants for this study included 740 students at multiple universities enrolled in nursing and kinesiology studies. The participants completed the Leisure and Physical Activity Questionnaire. Results: Pearson's χ² analysis revealed differences in grade point average with aerobic activity (χ² = 44.29 , P ≤ 0.001) as well as a trend toward differences in grade point average with weightlifting activity (χ² = 22.69, P = 0.61). Conclusions: Based on these findings it can be suggested that college students engage in greater aerobic exercise.

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Background: Breast cancer is a leading cause of deaths worldwide. In Pakistan, one in every nine women develops breast cancer some time in her life. This high incidence of breast cancer and the poor socioeconomic conditions of Pakistan make breast self-examination (BSE) the best tool for the prevention and early diagnosis of breast cancer. Therefore, the aim of the study was to assess the knowledge, attitude, and practice of BSE among female college students of Karachi, Pakistan. Methods: A cross-sectional study was conducted on 1000 students from June to December 2016. Data were collected using a pre-piloted questionnaire, and SPSS (version 20) was used for data analysis. Chi-square test was used to determine the significance of the difference in knowledge and attitude among participants who had performed BSE and those who had not. A P < 0.05 was considered statistically significant. Results: The overall response rate was 90.9%. Although 71.4% of the women knew what BSE was, only 33.1% had performed it. Majority of the participants considered that BSE is important in the early detection of breast cancer. With 59.7% of the population having an adequate amount of knowledge, 87.2% had a positive attitude toward BSE. A medical background was found to be a significant predictor for adequate knowledge and a positive attitude toward BSE. Conclusion: Despite a positive attitude found among the population toward BSE, its knowledge and practice were inadequate. Educational interventions are required in Pakistan to encourage young women to perform BSE regularly so that breast abnormalities can be detected early on and mortalities can be minimized.

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Background: Health literacy is a measure of an individual's ability to read, comprehend, and act on medical instructions. Limited health literacy can reduce the adults' ability to comprehend and use basic health-related materials, such as prescription, food labels, health education pamphlets, articles, appointment slips, and health insurance plans, which can affect their ability to take appropriate and timely health care action. Nowadays, low health literacy is considered a worldwide health threat. So, the purpose of this study was to assess health literacy level in older adults and to investigate the relationships between health literacy and health status, health care utilization, and health preventive behaviors. Materials and Methods: A cross-sectional survey of 354 older adults was conducted in Isfahan. The method of sampling was clustering. Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA). Data were collected using home interviewing. Health status was measured based on self-rated general health. Health care utilization was measured based on self-reported outpatient clinic visits, emergency room visits, and hospitalizations, and health preventive behaviors were measured based on self-reported preventive health services use. Results: Approximately 79.6% of adults were found to have inadequate health literacy. They tended to be older, had fewer years of schooling, lower household income, and were females. Inadequate health literacy was associated with poorer general health (P < 0.001). Health literacy level was negatively associated with outpatient visits (P = 0.003) and hospitalization (P = 0.01). No significant association was found between health literacy level and emergency room utilization. Self-reported lack of PSA (Prostate-Specific Antigen) test (P < 0.001) and fecal occult blood test (FOBT; P = 0.003) was higher among individuals with inadequate health literacy than those with adequate health literacy. No significant association was found between health literacy level and mammogram in the last 2 years. Conclusion: Low health literacy is more prevalent in older adults. It indicates the importance of health literacy issue in health promotion. So, with simple educational materials and effective interventions for low health literacy group, we can improve health promotion in the society and mitigate the adverse health effects of low health literacy.

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Background: Clinical learning environment is a complex social entity. This environment is effective on the learning process of nursing students in the clinical area. However, learning in clinical environment has several benefits, but it can be challenging, unpredictable, stressful, and constantly changing. In attention to clinical experiences and factors contributing to the learning of these experiences can waste a great deal of time and energy, impose heavy financial burden on educational systems, cause mental, familial and educational problems for students, and compromise the quality of patient care. Therefore, this study was carried out with the goal of determining the learning challenges of nursing students in clinical environments in Iran. Materials and Methods: In this qualitative study carried out in 2012-2013, 18 undergraduate nursing students were selected by using purposive sampling method from the Faculty of Nursing and Midwifery of Tehran and Shahid Beheshti Universities. Semi-structured interviews were used to collect data. The content analysis method was used to determine relevant themes. Results: Two themes were derived from the data analysis, which represented the students' clinical learning challenges. These two themes included insufficient qualification of nursing instructors and unsupportive learning environment. Conclusions: Identification of the students' clinical learning challenges and actions to remove or modify them will create more learning opportunities for the students, improve the achievement of educational goals, provide training to nursing students with the needed competencies to meet the complex demands of caring and for application of theories in practice, and improve the quality of healthcare services.

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Introduction: Primary dysmenorrhea without pelvic pathology is one of the most common complaints in women's medicine. Primary dysmenorrhea can affect the quality of life of women. Aerobic exercise is one of the ways to reduce the severity of primary dysmenorrhea. The present study aimed to determine the effect of 8 weeks of aerobic exercise on the severity of primary dysmenorrhea. Methods: This is a clinical trial study performed on 70 students with primary dysmenorrhea in dormitories of Mashhad University of Medical Sciences in 2015. Participants were randomly assigned to intervention and control groups. The instrument was a visual pain questionnaire completed by the two groups in the first 3 days of the menstrual cycle. The exercise protocol included aerobic exercise, which performed the intervention group for 8 weeks, three times a week, and each time for 30 min. Data were analyzed by Fisher and Chi-square tests. Results: The control and intervention groups were homogeneous in terms of demographic characteristics. Results showed that the severity of primary dysmenorrhea at the beginning of the study was not significantly correlated with the two groups. At the end of the 4 weeks after the intervention, the intervention group did not show any significant changes in the control group (P = 0.423) but At the end of 8 weeks after the study, the intervention group showed significant changes compared to the control group (P = 0.041). Conclusion: The results of this study showed that performing aerobic exercise can improve primary dysmenorrhea. Therefore, aerobic exercise can be used to treat primary dysmenorrhea.

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Background: Osteoporosis is a systemic skeletal disorder characterized by reduction of one mass, deterioration of bone structure, increasing bone fragility, and increasing fracture risk. Prevention of osteoporosis during childhood and adolescence is one of the most important issues in World Health Organization. The purpose of this study was to determine the effect of Health Belief Model based intervention on promoting nutritional behaviors about preventive osteoporosis among the second grade middle school girl students. Materials and Methods: This was an experimental intervention study, the research population being 130 students who were randomly divided into groups, experimental (66) and control (64). Before the educational program, Health Belief Model based standard questionnaire and Food Frequency Questionnaire (FFQ) questionnaire were filled up by both the groups. The standard questionnaire was completed three times (before, immediately, and 2 months after education) and FFQ questionnaire was completed two times (before and 2 months after education) by the students. After pre-test, four educational session classes in the experimental group were performed. Finally, data collected were analyzed by SPSS 18 computer software. Results: The result of this study showed a significant increase in the mean score of knowledge, perceived susceptibility, seriousness, benefits, barriers, as well as taking health action among girl students in the experimental group. Conclusion: The findings of the present study confirmed the practicability and effectiveness of the Health Belief Model based educational program in promoting nutritional behaviors about prevention of osteoporosis.

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Background: The main objective of creating a portal is to make information service available for users who need them for performance of duties and responsibilities regardless of the sources. This article is attempted to consider the parameters that can evaluate these sites since these criteria can be effective in designing and implementing such portals. On the other hand, portal sites in health systems of every country make it possible for leaders, policy makers, and directors to system education as a tool for new learning technologies. One of the main decisions each manager has to make is precise selection of appropriate portal sites. Materials and Methods: This is a descriptive and qualitative study. The research sample was 53 computer professional working in the area of computer programming and design. In the first part of the study a questionnaire was send to the participants and in the second part of the study based on their response to the questionnaire the participant was interviewed and the main themes of the studies were formulated. The validity and the reliability of the questionnaire were confirmed. Results: The study results were summarized in 10 themes and 50 sub-categories. The main themes included were portal requirements, security, management, and efficiency, user friendliness, built-in applications, portal flexibility, interoperability, and support systems. Conclusion: Portal sites in any education systems make it possible for health system leaders and policy makers to manage their organization information system efficiently and effectively. One of the major decisions each manager has to make is precise selection of an appropriate portal sites design and development. The themes and sub-categories of this study could help health system managers and policy makers and information technology professionals to make appropriate decisions regarding portal design and development.

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Background: Lifestyle choices and individuals' behaviors have the potential to influence health and improve the quality of life. Objectives: The purpose of this study was to develop and psychometrically test an instrument for measuring healthy lifestyle in Iranian adolescents. Materials and Methods: A comprehensive literature review related to health-promoting lifestyles was used to identify potential scale items. Data were collected from 797 school students. Construct validity was analyzed using exploratory factor analysis. Confirmatory factor analysis (CFA) was used to cross-validate. Results: Nine factors emerged that explained 59.8% of the variance in the 43 items. Cronbach's α coefficient Healthy Lifestyle Questionnaire was r=0.82. After the model was modified, the fit indices indicated that the data were an adequate-to-good fit to the proposed models. Conclusions: The current study provides some support to the internal and external validity of the healthy lifestyles questionnaire for Iranian adolescents.

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Background: Prevalence of work-related musculoskeletal disorders (WMSDs) is high among computer users. The study investigates the effect of three ergonomic interventions on the incidence of musculoskeletal disorders among the staff of Isfahan Province Gas Company, including training, sport, and installation of software. Materials and Methods: The study was performed in the summer of 2013 on 75 (52 men, 23 women) Isfahan Province Gas Company employees in three phases (phase 1 : e0 valuation of present situation, phase 2 : p0 erforming interventions, and phase 3 : r0 e-evaluation). Participants were divided into three groups (training, exercise, and software). The Nordic Musculoskeletal Questionnaire (NMQ) and rapid upper limb assessment (RULA) were used. Data collected were analyzed using SPSS software and McNemar test, t-test, and Chi-square test. Results: Based on the evaluations, there was a decrease in musculoskeletal symptoms among the trained group participants after they received the training. McNemar test showed that the lower rate of pain in low back, neck, knee, and wrist was significant (P < 0.05). The results obtained from the RULA method for evaluation of posture showed an average 25 points decrease in the right side of the body and 20 points decrease in the left side of the body in the group subjected to training. Based on t-test, the decrease was significant. Conclusion: The study demonstrated that majority of the participants accepted interventions, which indicates that most of the people were unsatisfied with the work settings and seeking improvement at the workplace. Overall, the findings show that training, chair adjustment, and arrangement in workplace could decrease musculoskeletal disorders.

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Background: Breastfeeding is the most natural and essential way for feeding newborn babies. This is an ideal approach for physical and emotional development of babies, as well as for the recovery of mothers. This study was aimed to determine the effect of breastfeeding education based on the health belief model (HBM) toward primiparous women. Materials and Methods: In a case-control group, quasi-experimental study, 88 subjects were allocated in control and experimental groups. Subjects who were assigned to the experimental group were provided a program consisting of group education based on HBM during their prenatal period. Instrument for data gathering was made by the researchers and standard questionnaire from Dennis and Faux for Breastfeeding Self-efficacy Scale (BSES). Baseline interviews were conducted before delivery and follow-up visits were conducted after 30 days and at the fourth month after delivery. Data were analyzed using SPSS (version 16) with c ² , independent sample t-tests, and paired t-test. Results: Mean age of pregnant women who participated in the study was 22 ± 3.29 years. After the program, the experimental group had significantly better scores in terms of self-efficacy, knowledge, and attitude scores statistically. In the fourth month, the mean of child weight in the experimental group was significantly higher than that of the control group (P=0.001) and exclusive breastfeeding was significantly higher than in the control group (P=0.007). Conclusion: Prenatal education in this study based on HBM was successful, and knowledge, attitude, self-efficacy, and related indicators improved. The necessity of producing standard education package and education of pregnant mothers, especially in their first pregnancy, by health professionals is perceived.

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Background: A student under optimal stress does bring out his or her best; however, extreme stress can result in mental health problems and deteriorates their academic performance. Students who esteem themselves low are most likely to engage in destructive and self-destructive behaviors. Moreover, excessive stress is harmful to academic performance and may lead to dropping out in student. Can Yoga be of benefit in students for improving their attention and self-esteem (SE)? Objective: To assess attention and SE in girls undergoing Integrated Yoga Module (IYM). Materials and Methods: Sixty low-income high school girls with 15.17 + 0.64 years of mean age participated in this single group pre-post study. The data was collected before and after 5 days of IYM. Statistical Analysis: Means, standard deviations, Kolmogorov-Smirnov test, and Wilcoxon signed rank test were used to analyze the data with the help of SPSS 16. Results: The data analysis showed 9.04% increase ( P = 0.001) in SE scores, whereas d2 test for attention revealed 10.12% increase ( P < 0.001) in total number of symbols processed scores and 44.73% decrease ( P < 0.001) in total number of errors. Conclusion: The present study suggests that of IYM can result in improvement of attention and SE among students and thereby enhancing their mental health and can help them in improving their academic achievement. Efforts aimed at reducing mental health problems among students may focus more on implementing effective and culturally acceptable interventions, such as Yoga, counseling, and social support. Additional well-designed studies are needed before a strong recommendation can be made.

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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 18–24 years. 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.

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Background: Effective cancer pain management requires accurate knowledge, attitudes, and assessment skills. The purpose of this study was to obtain information about the knowledge and attitudes of nurses concerning cancer pain management with the use Health Belief Model (HBM) as conceptual framework. Materials and Methods: The study was a descriptive survey and included 98 randomly selected nurses from Alzahra hospital, Isfahan, Iran. A self-administered questionnaire which was designed on the basis of HBM was used to collect the data. Knowledge, attitudes, and HBM constructs regarding cancer pain were the main research variables. The obtained data were analyzed by SPSS (version11.5) using descriptive statistics, independent t-test, and Pearson correlation at the significant level of α=0.05. Results: Ninety-eight nurses aged 38.7 ± 7.04 years were studied in this survey. From the 10 pain knowledge questions assessed, the mean number of correctly answered question was 61.2 (SD=16.5), with a range of 30-100. There was a direct correlation between knowledge and attitude of nurses with HBM constructs except for perceived barriers and perceived threat. Among the HBM constructs, the highest score was related to self-efficacy with mean score of 87.2 (SD=16.4). Conclusions: The findings support the concern of inadequate knowledge and attitudes in relation to cancer pain management. We believe that basic and continuing education programs may improve the knowledge level of nursing about pain management.

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Introduction: This study was aimed to compare the effect of nutrition educational program based on HBM with traditional education recommended weight gain among pregnant women in Gonabad. Target population was pregnant women who were resided in Gonabad and went to urban health care centers for prenatal cares. Materials and Methods: 110 pregnant women (case group: 54, control group: 56) were selected who had come to this centers in the first stage of prenatal care (6th -10th week of pregnancy) in 1388 and were consequently classified in case and control group. There is no significant difference for age, education, number of parity, history of abortion and job between case and control groups. Results: There was no significant differences in nutritional behavior mean score before intervention in case (74.42 ± 12.78) and control (77.14 ± 15.35) groups (P value = 0.82, independent t- test); but after education, intervention was significant in nutritional behavior between two groups (P value = 0.01, independent t - test); Discussion: after intervention, there also was significant difference in HBM structures mean score in case group compare with control group and the highest rise in score was related to perceived benefits (15.13 increment).

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Background: Colorectal cancer is one of the most important and most common cancers and the second leading cause of cancer deaths worldwide. Every year, nearly 1 million new cases of colorectal cancer are recognized around the world and nearly half of them lose their lives due to the disease. The statistics reveal shocking incidence and mortality from colorectal cancer, therefore secondary prevention of this cancer is important and research has shown that by early diagnosis 90% of patients can be treated. Among the colorectal cancer screening tests, fecal occult blood test (FOBT) takes the priority because of its convenience and also low cost. But due to various reasons, the participation of people in this screening test is low. The goal of this study is to assess the factors that affect participation of population at average risk in colorectal cancer screening programs, based on health belief model structures. Materials and Methods: A cross-sectional survey of 196 individuals, more than 50 years old, was conducted in Isfahan. Ninety-eight people of the target group were selected from laboratories while they came there for doing FOBT test; the method of sampling in this group was random sampling. The method of data collection in the other 98 ­individuals was by home interview and they were selected by cluster sampling. The questionnaire used was based on health belief model to assess the factors associated with performing FOBT. The data collected were analyzed using descriptive and inferential statistical methods. Results: The mean score of knowledge in the first group was 48/5 ± 11/7 and in the second group was 36/5 ± 19/3. Individuals in the first group were more likely to be married, had more years of schooling, and better financial status. There were significant relationships between knowledge (P<0.001), perceived susceptibility (P<0.001), perceived severity (P<0.001), perceived barriers (P<0.001), and self-efficacy (P<0.001) in the two groups. There was no significant association between the perceived benefits in the two groups. Those people who have had FOBT test in last year in each group reported better score of Health Belief Model model structures. Conclusion: According to this study, it seems that there is an urgent need to pay more attention to this disease and its prevention through screening. With a better ­understanding of factors affecting the test, it can be a useful step to reduce the rate of death and costs, and ­improve the community health outcomes.

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Background: Appropriate understanding of women that certain physical, mental, social and psychological changes occur during menopause helps them with greater readiness to cope with these changes. In all training programs to identify and analyze perceptions of the subjects is a key component. The purpose of this study was to investigate the knowledge and attitude of women toward the menopause phenomenon. Materials and Methods: This cross-sectional study was conducted on 400 healthy and non-menopaused women aged 40-45 years. The stratified sampling method was used and participation in this study was based on obtaining informed consent. The data collection instrument was a questionnaire consisting of three parts: demographic information, questions to assess knowledge and attitude investigation questions. Findings: The results showed that the average knowledge score of subjects was 63.57 ± 10.79, and their average attitude score was 61.21 ± 12.73. In this study, 8% of the subjects had poor knowledge, 68% had moderate knowledge and 38.5% had good knowledge. Meanwhile, 81.5% of the women had a positive attitude toward menopause. The correlation test showed that knowledge and attitude are meaningfully related to economic status and education level. But, the relationship between knowledge and attitudes of women under study was not significant. Conclusion: Identifying the quality of women's subjective perception of menopause has an essential role in the development of accurate and appropriate programs to promote women's health during menopausal years.

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Background: Growth and development in any country's national health system, without an efficient evaluation system, lacks the basic concepts and tools necessary for fulfilling the system's goals. The balanced scorecard (BSC) is a technique widely used to measure the performance of an organization. The basic core of the BSC is guided by the organization's vision and strategies, which are the bases for the formation of four perspectives of BSC. The goal of this research is the performance evaluation of Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences, based on Iran BSC model. Materials and Methods: This is a combination (quantitative-qualitative) research which was done at Al-Zahra Academic Medical Center in Isfahan University of Medical Sciences in 2011. The research populations were hospital managers at different levels. Sampling method was purposive sampling in which the key informed personnel participated in determining the performance indicators of hospital as the BSC team members in focused discussion groups. After determining the conceptual elements in focused discussion groups, the performance objectives (targets) and indicators of hospital were determined and sorted in perspectives by the group discussion participants. Following that, the performance indicators were calculated by the experts according to the predetermined objectives; then, the score of each indicator and the mean score of each perspective were calculated. Results: Research findings included development of the organizational mission, vision, values, objectives, and strategies. The strategies agreed upon by the participants in the focus discussion group included five strategies, which were customer satisfaction, continuous quality improvement, development of human resources, supporting innovation, expansion of services and improving the productivity. Research participants also agreed upon four perspectives for the Al-Zahra hospital BSC. In the patients and community perspective (customer), two objectives and three indicators were agreed upon, with a mean score of 75.9%. In the internal process perspective, 4 objectives and 14 indicators were agreed upon, with a mean score of 79.37%. In the learning and growth perspective, four objectives and eight indicators were agreed upon, with a mean score of 81.11%. Finally, in the financial perspective, two objectives and five indicators were agreed upon, with a mean score of 67.15%. Conclusion: One way to create demand for hospital services is performance evaluation by paying close attention to all BSC perspectives, especially the non-financial perspectives such as customers and internal processes perspectives. In this study, the BSC showed the differences in performance level of the organization in different perspectives, which would assist the hospital managers improve their performance indicators. The learning and growth perspective obtained the highest score, and the financial perspective obtained the least score. Since the learning and growth perspective acts as a base for all other perspectives and they depend on it, hospitals must continuously improve the service processes and the quality of services by educating staff and updating their policies and procedures. This can increase customer satisfaction and productivity and finally improve the BSC in financial perspective.

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Introduction: This study addresses the design and validation of the experiential curriculum model for medical education using a Feministic approach. Method: The present study was conducted on two non separable planes. On the first plan, the model was designed based on the Feministic approach using the theoretical study method and emphasizing the perspectives ascribed to Nell Noddings, Madeline Grumet and Janette Miller. Results: The levels of this model include Expected Curriculum, Imaginal Curriculum, Concealed curriculum, Interactive curriculum (Manifest Curriculum, Latent Curriculum, Look the parenting), Transferential Curriculum and Self Determination. On the second plane, to validate the combined model, a phenomenologically qualitative study was conducted. In this study, using goal-oriented sampling, undergraduate and graduate (Master's degree) students majoring in Dentistry, Nursing at Islamic Azad University Khorasgan Branch, Esfahan as well as those at at Esfahan University of Medical Sciences were selected. Deep interview was used to collect data. The findings were analyzed using Van Manen's six-stage model. To determine the reliability of the findings, reliability of reality reconstruction were used. Conclusion: The results obtained suggested that: Education is in need of some conceptual reconstruction. On this way, women's perceptions and experience of education and of the interior epistemological and curricular system which shape the discourse and performance of education must be addressed. Serving as a research model offering the various planes of the experiential curriculum and focusing more sharply on the dimensions of curriculum than the formal plane, the present study is recommended to the decision-makers of higher education curricular system.

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Introduction and Objective: Perception is the most important predictor of behavior and there is a strong relation and correlation between behavior and believes. Thus, to improve self-care behaviors of patients, it is required to fully understand their perceptions about behavior. This paper aimed to assess the prediction power of health promotion model of systolic blood pressure (SBP) as the result of self-care behavior in rural hypertensive. Methods: This cross-sectional study has been carried out through random multistage sampling on 671 rural patients under the coverage of health center of Ardebil city in 2013. Data were collected through reliable and valid questionnaire based on the health promotion model in eight sectors. For data analysis, Pearson correlation statistical tests, multivariate linear regression, ANOVA and independent t-test were used and for confirmatory factor analysis, SPSS 18 and AMOS 18 (SPSS Inc., Chicago, IL, USA) were used. Results: The results showed significant negative correlation between self-efficacy, perceived benefits, situational influences, affects related to behavior and commitment to action structures with SBP and showed a positive significant correlation between perceived barriers and SBP. Furthermore, age and body mass had direct significant relation with SBP. The age of patients showed inverse significant correlation with self-efficacy, perceived benefits, affects related to behavior, interpersonal influences and commitment and showed a direct significant correlation with perceived barriers, means that by increase of age, the perceived barriers also increased. The structures of health promotion model have in overall the prediction power of 71.4% of SBP changes. Conclusion: The diet perceptions of patients, the same as health promotion model, has good predictive power of SBP, especially the structures of perceived benefits and self-efficacy have inverse meaningful relation with systole blood pressure and predicted a higher percentage of this variable.

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