fardin mehrabian

 Providing, maintaining and improving the health level of children under one year as a vulnerable group has a special place in healthcare services. The present study was conducted with the aim of investigating the frequency of mortality of children under one year of age in Guilan province.

 This study is descriptive-analytical cross-sectional type Recorded information related to the deaths of children under 1 year old in the program of the child death care system, including demographic characteristics (age, sex of the deceased, place of residence and city) and causes of death of children aged 1-12 months based on international classification and files. Hospital data were collected and measured according to ethical considerations.

In this study, 1002 children and infants who died in Guilan province were included in the study. The frequency of death of children under one month (81.4%) and one month to one year (18.6%) and also the frequency of death of boys under one year was higher than girls. The most common causes of death of children under one year of age were birth defects, heart and respiratory disorders, infectious diseases, cerebrovascular diseases and accidents, respectively.

 Due to the difference in the causes of death of children under one year old and babies in different years, new statistical protocols should be developed as well as strict monitoring processes to identify the factors that increase the death of babies and children in a short period of time.

Self-care is a fundamental aspect of health, encompassing conscious and purposeful actions by individuals for themselves, their children, and their families to maintain health.

This study aimed to determine the effect of an educational intervention based on the Health Belief Model (HBM) on self-care behaviors among health workers in comprehensive urban health service centers in Rudbar in 2019.

In this quasi-experimental study, 89 health workers from comprehensive urban health service centers in Rudbar city, Gilan, participated. The participants were randomly assigned into control and intervention groups. An educational intervention, consisting of five 60 - 75 minute sessions based on the HBM, was designed and implemented for the intervention group. Outcome data were collected before and three months after the educational intervention using a questionnaire that measured HBM constructs and health-promoting self-care behaviors. Data analysis was performed using the chi-square test and Mann-Whitney U test.

The age range of most participants (43%) was 30 - 39 years, and 86% of participants were female. Both experimental and control groups were comparable in demographic characteristics, HBM constructs, and health-promoting self-care behavior at pretest. The educational intervention based on the HBM improved the mean scores of the HBM constructs (except for perceived benefits) and dimensions of self-care behavior (P < 0.05 for all). The average score of self-care behavior in the intervention group increased from 128.4 before the intervention to 148.37 after the intervention.

According to the results, using the HBM, with its suitable methods and structure for engaging employees actively, was effective for designing educational interventions to promote self-care behaviors in health workers. Therefore, it can be used as a suitable framework for planning educational interventions to enhance self-care behaviors among health workers.

Childbirth is the most challenging physiological and psychological event in a woman’s life. Despite the recommendations of the Iranian Ministry of Health on having natural childbirth, no favorable statistics have been reported yet.

This study aims to determine the predictors of natural childbirth intention based on the extended theory of planned behavior (TPB) and social support in pregnant women referred to selected hospitals in Rasht, northern Iran.

This analytic cross-sectional study was conducted on 353 pregnant women aged 15-45 years referred to four hospitals in Rasht city in 2020 who were selected by systematic random sampling method proportional to the size of the study population. A researcher-made self-report questionnaire measuring the demographic information, the TPB constructs, social support, and natural childbirth intention was used. Data was analyzed using t-test, one-way ANOVA, Pearson correlation test, and multiple regression analysis. 

Most of the pregnant women had a high school diploma (43.6%) and were housekeepers (83.3%), living in the city (80.5%). Most of them were in the third trimester of pregnancy (37.7%) and had pregnancy for the first time (44.8%). Their mean age was 28.90±5.8, and 58.8% intended to give birth naturally. The mean score of the natural childbirth intention was 6.71±2.50. This intention had a direct correlation with all TPB constructs and social support (r=0.526-0.829; P=0.001). Based on results social support, and participation in childbirth education classes predicted 72% of changes in natural childbirth intention (R2 =0.72). Attitude alone was able to predict natural childbirth intention by 69% (β=0.12, 95% CI; 0.09%, 0.15%, P=0.001)

The power of the TPB constructs for predicting the natural childbirth intention in pregnant women in northern Iran is high. The attitude construct is the best predictor of natural childbirth intention. To increase the tendency to choose natural childbirth, educational interventions based on the TPB with an emphasis on attitudes can be useful. In addition, measures should be taken for the active participation of pregnant women in childbirth preparation classes.

The environment and activities related to nurses' work are factors that threaten their mental health and may result in anxiety.

The present study was conducted with the aim of determining the level of anxiety of nurses in the hospitals of the west of Guilan province and related factors.

In this cross-sectional analytical study, 388 nurses from West Guilan hospitals completed the Spielberger anxiety questionnaire. Data were analyzed using t-tests or non-parametric equivalent, and multivariate linear regression model.

The average age of the participants was 34.5±8.4 years. The mean score for state and trait anxiety were 45.4 ± 5.3 and 43.7 ± 3.9, respectively. In terms of state anxiety, more than half of the study's population (57%) had severe anxiety, while for trait anxiety, the majority of the sample (57.6%) had moderate anxiety. There was a significant relationship between walking and the reduction of anxiety levels.

The findings of this research highlight the importance of addressing nurses' anxiety in the health and treatment field. Given the impact of nurses' anxiety on job performance and the quality of patient care, it is crucial for planners to pay attention to this issue and develop necessary plans to improve the mental health of nurses.

Nurses are the first point of contact in hospitalsandplay a significant role in providing high-quality care. Missed nursing care has been shown to be associated with poorer patient outcomes, increased mortality, medication errors, falls, and hospitalacquired infections.

This study aimed to investigate missed nursing care and its causes and related factors in the north of Iran.

This cross-sectional study was conducted during the COVID-19 pandemic in Rasht, Iran, from January to March 2021. A total of 326 nurses from non-emergency wards of 7 medical centers were enrolled using a simple random sampling method. The data on demographic characteristics, occupational stress (using the expanded nursing stress scale [ENSS]), and missed nursing care and its causes (using the MISSCARE questionnaire) were collected. Data were analyzed by descriptive statistics and multiple logistic regression analyses.

Sixty-nine percent of nurses reported that at least 1 aspect of nursing care was missed occasionally, often, or frequently. Also, the median number of missed care items reported on each shift was 4 out of 25. Attending interdisciplinary care conferences (46%), interventions for basic care (45%), and psychological supports for patients (42%) were the most omitted items. The most stated reason was human resources (53%). Also, the occurrence of occasionally, often, or frequently missed care was significantly related to a higher level of nursing occupational stress (adjusted odds ratio [OR], 2.12; 95% CI, 1.28 - 3.52; P < 0.001) and rotating shift work compared to day shift work (adjusted OR, 4.54; 95% CI, 2.38-9.10; P = 0.003).

Nursing missed care is relatively prevalent in the north of Iran. Human resources, work shift schedules, and occupational stress play an important role in missed nursing care during the COVID-19 pandemic. It is necessary for policymakers and nursing managers to use strategies to optimize manpower and equipment, develop a standard work shift, and reduce stress in the workplace to improve the quality of patient care.

Mini stories are short, fictional narratives illustrating a particular concept or idea. This study aims to explore the effectiveness of mini-stories as a teaching technique based on teachers’ experiences who have used this approach in their classrooms.

A qualitative research approach was used to gather data from teachers using mini-stories as a teaching technique. A total of 8 professors from different scientific fields were selected for this study. Each participant was interviewed individually, and the interviews were recorded and transcribed for analysis. The data were analyzed using a thematic analysis approach.

Student-centered and teacher-centered are two categories extracted with ten Sub-categories extracted, including relevance to the lesson, attractiveness, brevity, informality, creativity, reflection, problem-solving, age appropriateness, effectiveness, and reflection.

The study’s findings reveal a two-fold teaching approach, encompassing teacher-centered and student-centered modes. Mini-stories represent a valuable teaching technique, captivate students, elucidate complex concepts, and stimulate critical thinking.

Oral and dental diseases, especially caries and periodontal diseases, are among the most common diseases in the world. This study aimed to determine the factors related to tooth brushing behavior in high school students based on the health belief model.

The present study is of a descriptive cross-sectional type. The sampling was done by random classification in two classes of girls' and boys' schools on 400 ninth-grade students from six cities east of Guilan Province, Iran, in 2022. The study instrument was a valid and reliable researcher-made questionnaire, including demographic characteristics, knowledge, constructs of the health belief model, and brushing behavior. Data were analyzed in SPSS software, version 23 using the chi-square test and Pearson linear correlation coefficient. The multivariate logistic regression model was used to estimate the adjusted relationship.

Direct and weak linear correlations were observed between the state of desirable brushing behavior with knowledge scores (r=0.15), self-efficacy constructs (r=0.25), and perceived benefits (r=0.22). Also, an inverse and significant correlation was observed between behavior and perceived barrier (r=-0.24). Based on logistic regression analysis with adjustment for age and socioeconomic status, the variables of knowledge (OR=1.11; 95%CI, 1.02%-1.21%), self-efficacy (OR=1.10; 95%CI, 1.05%-1.51%), and perceived barrier (OR=0.97; 95% CI, 0.95%-0.99%) had independent and significant relationships with desirable tooth brushing behavior.

Considering the low level of desirable tooth brushing behavior and the low average knowledge score, it is necessary to take appropriate interventions to provide, maintain, and improve students' oral health.

High-risk behaviors among different strata are one of the most severe health threats in recent years. This study aimed to investigate the frequency of high-risk behaviors among college students in Iran.

This study was a cross-sectional study with 144 new students in Tehran City, Iran, performed in 2018 using random sampling. The data collection tools included questions on demographic variables and Youth Risk Behavior Survey (YRBS) questionnaire. Students completed the questionnaire. The data were analyzed using SPSS 24 and descriptive tests.

In this study, all students were in their first year of university. The results showed that 66% of students were girls and 34% were boys. 6.9% and 9% of students did not wear helmets when riding motorcycles or sitting in the driver’s seat, respectively. Also, threatened and beaten once with a weapon such as a knife or a stick and physically assaulted or beaten once were seen in 9% and 3.6% of students, respectively.9.7% had taken money from their parents or others once without permission.

Based on the findings, many participants engage in high-risk behaviors that endanger their health; Therefore, designing and improving health programs and strategies is essential to reduce the risks and factors that cause high-risk behaviors. 

The MISSCARE survey is a useful instrument measuring the amount and type of missed nursing care and its important reasons, developed by Kalisch and Williams in 2009 and revised in 2019.

The present paper aimed to report the psychometric properties of part A (missed nursing care) and part B (reasons for missed nursing care) of the MISSCARE tool translated into Persian.

A Persian version of the MISSCARE tool were evaluated by a panel of experts, and the psychometric properties were determined with 326 nurses randomly selected from non-emergency wards of seven educational and medical centers in Rasht, North of Iran. Nurses completed the instruments from January to March 2021. Content validity was evaluated by calculating content validity index (CVI). Confirmatory factor analysis (CFA) was used to assess construct validity. Internal consistency (reliability) was measured using Cronbach's alpha coefficient.

CVI was measured 0.82 and 0.79 for parts A and B of the survey. The fit indices of CFA indicated the acceptable fit for the measurement model of part B (missed nursing care reasons). Also, factor loadings of items on three factors of labor, material and communication confirmed the structural validity of part B of the survey. Cronbach’s alpha coefficients for parts A and B were 0.991 and 0.994 in whole, and Cronbach's alpha coefficient for three factors of part B ranged from 0.831 to 0.936 confirmed their reliability.

The Persian version of the MISSCARE tool is valid and reliable for measuring missed nursing care and its reasons. It can be used by nursing authorities for evaluation purpose in Iranian hospitals.

Nurses are one of the most important elements of health care system that have been in a stressful situation during the Covid-19 pandemic. The aim of this study was to investigate the prevalence and sources of nurses' occupational stressand identify related factors during this period.

This cross-sectional study was performed on 392 nurses of Rasht educational and medical centers in January to March 2021 selected with stratified random method. Demographic and occupational stress data (by Expanded Nursing Stress Scale questionnaire) werecollected. Data analyses performed by descriptive statistics and multiple regression models with SPSS software version 26.

The mean age of nurses were 37.8±8.8 years old. Stress was mild in 62% of nurses, moderate in 20% and severe in 2%. Death and dying situation (1/78±0/74), uncertainty concerning treatments (1.71±0.72) and workload (1.69±0.68), expressed higher occupational stress. Working in the intensive care units or emergency ward, higher education, excessive hours of work and female gender were independently predictors of more occupational stress and these characteristics determined 15% of the variance of stress scores.

Stress related to the job during the Covid-19 pandemic is high, and stress in the workplace, especially in intensive care units and emergency ward, should be reduced and standard work shifts should be developed. Furthermore, training of stress management in situations of patients’ death and dying, high workload and uncertainty concerning treatment in pandemic conditions for at risk population of nurses should be done.

Today, addiction, especially injectable addiction, is the most important risk factor for viral diseases transmitted through blood, such as AIDS, hepatitis C and B.

The present study was conducted with the aim of determining the predictive factors of AIDS prevention behaviors based on the protection motivation theory (PMT) in drug addicts living in addiction treatment camps in city of Rasht, North of Iran.

This cross-sectional-descriptive study was conducted on 320 drug-dependent patients living in addiction treatment camps in Rasht city. The samples were selected by simple random sampling method. The required data was collected through a questionnaire and then analyzed using multivariate linear regression model.

There was a very weak significant correlation between the HIV prevention behaviors and constructs of PMT including perceived self-efficacy (r=0.20), knowledge (r=0.16), reward (r=0.15), perceived response cost (r=0.14), perceived response efficiency, and fear (r=0.11). The PMT model accounted for 7% of variation in HIV prevention behaviors. Though, the model explained 38% of variance of protection motivation.

The PMT model could not predict HIV prevention behaviors. There are many other factors such as low intention that may interfere for adopting the desired behaviors. So, it is suggested to explore a wider range of psychosocial factors in future research.

An accident is an unforeseen occurrence that happens in all organs, including medical centers, due to unsafe conditions and practices which cause damage and sometimes irreparable injuries. Establishing safety system in the medical center seek to prevent harm to both patients and health care professionals.

The aim of this study was to assess safety status in a medical center before and after implementing standard safety system.

 This case-study was carried out among the staff of a hospital in Guilan province, Iran in 2018-2019. The information was collected through observation and interview with staff and checking the observance of instructions and safety tips. Then, the possibility of needle stick injury was identified by calculating accident indices. human errors were assessed using risk assessment using Systematic human error reduction and prediction approach (SHERPA).

 A total of 9 departments of a selected hospital were studied and the accident and human errors were identified. The recurrence rate of the accident in 2019 compared to 2018 had a decreasing rate from 11.36 to 4.09 (safe_T_score=-3.14). Risk assessment using SHERPA method in the gynecology ward revealed 4 important types of errors in this department.

 There was considerable reduction in frequency and severity of needle stick injuries after establishment of safety system in the hospital. The SHERPA method, detailed the task errors and specific remedial measure to correct the task. The results of this study can be helpful for medical staff, managers, employers, and safety experts in identifying and preventing the causes of the accident.

The aim of this qualitative study was to explain the reasons for using smokeless tobacco based on the grounded theory approach.

We conducted a qualitative study using the grounded theory approach in 2020 - 2021. Participants were adult users of smokeless tobacco in Chabahar city, southeast Iran. The strategy for choosing participants was based on purposeful sampling and continued till theoretical saturation was achieved. Thirty adults who were smokeless tobacco users participated in the interviews voluntarily. We used techniques such as asking questions, constant comparisons, and writing memos to collect data, which were analyzed based on the grounded theory presented by Corbin and Strauss in 2008.

Two themes emerged from data analysis (the context of consumption and the need for effective supervision), each of which had several subcategories. The opportunity for consumption was the first main category of the contextual factors frequently mentioned by the participants, whose subcategories included consumption culture, individual and general beliefs, and consumption by family members. Insufficient supervision was the second main category, which included three subcategories, profitable market, insufficient supervision, and easy access.

In general, two main themes explain the tendency of adults to consume smokeless tobacco: The context of consumption and the need for effective supervision. Concepts such as the consumer’s culture, individual and public beliefs, family members and friends being users, profitable market, the need for effective supervision, and easy access were the key factors pushing people of different ages toward using smokeless tobacco in Chabahar city.

Spousal abuse in pregnancy leads to adverse consequences in mother and neonate and its prevalence is far higher than other dangerous complications during pregnancy. The aim of this study was to determine the prevalence of spousal abuse during pregnancy and its related factors in Guilan Province.

This cross-sectional and descriptive-analytical study included 1541 parous women referring to 160 selected health care delivery units for their babies' two-month vaccination in 2019. We used random multi-stage cluster sampling for sample collection. Data were collected using a valid and reliable self-administered questionnaire consisted of demographic variables and spouse abuse questionnaire during pregnancy. Using SPSS-26 software, data were analyzed by descriptive and analytical tests such as mean, chi-square and binary logistic regression. α <0.05 was considered significant.

The mean (SD) age of the women participating in the study was 29.2±5.6 years. The overall prevalence rate of spousal abuse in pregnancy was 71.3% and women had been abused by their spouses at least once during pregnancy with frequency of "sometimes" to "always". The prevalence rates of emotional (the most common), physical and sexual violence were 69.5%, 32.2% and 15.1% respectively. Husbands' substance abuse (Odd Ratio-OR= 2.38, 95% CI: 1.7, 3.34), couples' dissatisfaction of the gender of the fetus (OR= 1.91, 95% CI: 1.09, 3.35), lack of family support for mothers (OR = 1.63, 95% CI: 1.03, 2.57) and extended family (OR = 1.38, 95% CI: 1.03, 1.84) were found to be positively and significantly associated with spousal abuse during pregnancy.

Use of effective strategies in order to reduce the factors associated with spousal abuse can be effective in preventing and decreasing the rate of this social problem and its negative consequences.

spirituality is an important concept among human societies, and the relation of this concept to other human characteristics is important for health professionals.

The purpose of this study was to investigate the relationship between spiritual well-being (SWB) and happiness among the students of health sciences in Guilan University of Medical Sciences (GUMS).

This was a cross-sectional and descriptive-analytic study carried out among 322 students studying at school of health in GUMS, Iran. The Spiritual well-being scale and Oxford Happiness Questionnaire were used to measure SWB and happiness. Correlation coefficient and multivariate linear regression model were used to assess the association of SWB and happiness.

The mean and standard deviation of SWB and happiness were 55.82±4.71 and 60.88+-12.9, respectively. Spiritual health was significantly associated with age and marital status. There was strong correlation between cognitive dimension of spiritual health and welfare dimension (r=0.92, P=0.005) and positive mood dimension (r=0.90, P=0.007) of happiness. The adjusted model for age and marital status showed that satisfaction was significantly associated with SWB (β=0.66, P=0.02)

the finding revealed a lower than mean value of happiness and SWB among students of health sciences.  Satisfaction was the most important predictor of SWB.

Academic self-efficacy is an important prerequisite for academic achievement of students. This study aimed to determine the association between happiness and spiritual health with academic self-efficacy among students of Guilan University of Medical Sciences (GUMS), Iran.

Using quota sampling method, 250 students studying at different filed of medical sciences at GUMS were selected. The Oxford Happiness Questionnaire, Ellison and Paloutzin spiritual well-being scale, and Owen & Froman’s Academic Self-Efficacy Questionnaires were used to measure happiness, spiritual health, and self-efficacy, respectively. Data were analyzed using t-test, analysis of variance, and multivariate linear regression model in Stata version 14.

The mean score of happiness, spiritual health, and self-efficacy was 68.7 (SD = 13.2), 84.7 (SD = 17.3), and 96.7 (SD = 15.9), respectively. there was moderate significant correlation between happiness with spiritual health (r = 0.59, P-value = 0.001) and self-efficacy (r = 0.58,
P-value = 0.001). Spiritual health and self-efficacy had a weak correlation (r = 0.28, P-value = 0.001). Linear regression analysis showed that happiness was independently associated with self-efficacy. The mean score of self-efficacy increased by 0.75 per unit of increase in the happiness score
(P-value = 0.001).

This study revealed a moderate level of happiness and self-efficacy among students of Guilan University of Medical sciences. Happiness was the only significant predictor of self-efficacy.

Given the importance of adolescents’ health, especially girls and the inadequacy of dairy consumption around the world, we examined the psychological factors associated with dairy consumption behavior. Therefore, this study was conducted on high school girls.

The present descriptive-analytical study was carried out on 385 female high school students in Shaft City during 2019 using the census method. The survey questionnaire consisted of demographic information, knowledge structure, perceived self-efficacy, and dairy consumption behavior completed by students. To analyze the results,  Chi- Square tests, Spearman correlation coefficient, and multiple logistic regression were used via SPSS 21 software.

In total, 221 people (57.7%) consumed less than 2 units and 162 people (42.3) consumed more than 2 units of dairy products per day. The average scores of self-efficacy and knowledge constructs were 23.20 ± 6.6 (average) and 19.1± 3.05, respectively (at a good level). No significant correlation was found between perceived self-efficacy and dairy consumption behavior r = 0. 199 (p <0.05). Furthermore, no significant correlation was observed between knowledge and behavior (p> 0.05, r =- 0.25). The results of multiple logistic regression showed the predictive power of the perceived self-efficacy structure in dairy consumption behavior with an odds ratio of 1.052 (with a confidence interval of 95%: 1.089-1.016).

Perceived self-efficacy predicted the behavior of dairy consumption in the studied students. So, educational interventions in schools should focus more on promoting the perceptions and nutritional attitudes.

Service quality is a distinguishing and most powerful competitive factor. By improving the quality of service delivery, it is possible to increase productivity, reduce costs, and, as a result, increase patient satisfaction.

The present study aims to determine the level of patient satisfaction with the quality of health services provided by public hospitals based on the SERQUAL-KANO model.

This is an analytical study with cross-sectional design. The study population consists of all patients admitted to the emergency department, and male & female medical wards of public hospitals in Rasht, Iran. This, 250 patients were selected by a two-stage stratified sampling method. Data collection tools were two questionnaires of SERVQUAL and Kano with acceptable reliability (α=0.77 and 0.72). Kolmogorov-Smirnov and Wilcoxon tests were used to analyze data.

The majority of patients were male (53%) with a bachelor’s degree (32%) aged 40-59 years (38%). In all hospitals, according to the Wilcoxon test results, the highest and lowest mean quality scores were related to assurance and tangibility dimensions (P<0.05). The highest level of patient satisfaction was reported in Hospital no. 2 with a quality gap of +0.41, while the lowest level was related to Hospital no. 5 with a gap of -0.23. According to Importance-Performance Analysis matrix, tangibility was in the “Concentrate Here” quadrant; the dimensions of reliability and responsiveness were in the “Low Priority” quadrant; the dimension of assurance was in the “Possible Overkill” quadrant; and the dimension of empathy was in the “Keep Up the Good Work” quadrant. According to the Kano model, 13 attributes were classified as “Attractive”, 11 as “One-dimensional”, and only 1 property as “Reverse”; no attribute was classified as “Indifferent”.

It seems necessary to make more improvements in facilities and equipment, appearance of staff, communication tools, and cleanness of hospital environment to increase patient satisfaction in public hospitals.

Oral health is one of the key elements of quality of life and welfare. The aim of this study was to investigate the role of the Theory of Planned Behavior (TPB) as predictors of dental brushing behavior among Iranian adolescents.

This cross-sectional study was carried out on 791 students in Guilan province, Iran, during the year 2018. The participants were selected through the multi-stage random sampling method. The data collection tool was a self-administered questionnaire designed based on TPB. The validity and reliability of the scale were assessed and confirmed. The data were analyzed using linear and logistic regression models in SPSS software version 21.0.

Nearly half of the assessed students were girls (49.6%, n=392/791). In total, 363 students (45.9%) brushed their teeth once or more daily. The TPB constructs accounted for 28% of the variance of intention to teeth brushing. Multiple logistic regression showed that one-point increase in scores of attitude, perceived behavioral control (PBC), and subjective norms, led to 10%, 12%, and 3% increase in the odds of daily teeth brushing respectively. Moreover, one-point increase in behavioral intention increased the odds of daily teeth brushing 2.24 fold.

Based on the results, the level of oral health practice was unfavorable among most of Guilan high school students compared to similar studies in the world. It seems designing and implementing educational interventions based on TPB constructs especially variables of perceived behavioral control and attitude, could result in optimal activities regarding oral health care among students.

Musculoskeletal disorders are one of the most common and costly problems associated with work, caused by disruption or damage to one of the organs or tissues of the body. The aim of this study was to determine the prevalence of musculoskeletal disorders, cumulative disorder and its relationship with individual characteristics in Guilan University of Medical Sciences
This descriptive, analytical and cross sectional study was conducted in 1396. The society and the research environment were 336 employees of Guilan University of Medical Sciences. The Nordic Questionnaire (NMQ) was used to analyze the data using descriptive statistics and SPSS16 software.
41% of the study population had symptoms of musculoskeletal disorders in the neck region and 34.6% in the shoulder region And 65.4% of them had no symptoms of disturbances. There is a significant relationship between the prevalence of musculoskeletal disorders in the shoulder and elbows with computer work. Also, the prevalence of musculoskeletal disorders in the waist region was significantly correlated with BMI.
Since musculoskeletal disorders in the research community are high and due to the role of these disorders in reducing human resource productivity, managers should provide the ways for prevention and reduction of musculoskeletal disorders

The purpose of this study was to determine the prevalence of types of smokeless tobacco use between students in the city of Chabahar. A total of 105 students were selected from the schools of Chabahar city. The sample size was calculated using the G*Power software. For a questionnaire by the test-retest exam for knowledge and attitude structures, the reliability of the test (Pearson correlation coefficient’s) was 98% and 94%. The Cronbach alpha of these structures was about 74%. The CVR for these structures was 93% for knowledge and 88% for the structure of the attitude. Data was analyzed using the SPSS16 software. In this study, 14 students (13%) had a history of previous use and 48 students (45.7%) reported having had tobacco use at least once, 30 days before studying. The Pearson Correlation Test indicated a significant relationship between smokeless tobacco use with the family number (-0.224), mother's literacy (0.219), and father’s literacy (0.224). The number of smokeless tobacco users who had consumed at least once in the last month of the study were Pan 26 (24.8%), Gutkah 9 (8.6%), and Biti 5 (4.8%). The results of the study show that the prevalence of smokeless tobacco use in students around the city of Chabahar is high.

Although vaginal delivery is the safest type of childbirth, cesarean section (CS) without any medical indication is currently increasing in the world, especially in Iran. The purpose of this study was to determine the type of delivery and its related factors in women working in the departments of Guilan University of Medical Sciences. This cross-sectional study recruited 100 women employed in the departments of Guilan University of Medical Sciences in 2017. Data were collected using a questionnaire including demographic and reproductive details of all participants and the reason for choosing CS among women with previous CS. Fisher's exact test and Chi-square test were used to determine the factors related to delivery type. The prevalence of cesarean section in this study was 80%. Older age at pregnancy and higher education of the respondent and her husband was significantly associated with higher rate of CS. Spouse and relative suggestion for normal delivery was associated with lower rate of CS. The main reasons for CS were women’s fear of childbirth, labor pain, and physician’s recommendation. The rate of CS delivery is very high in working women. Since concern about pain and possible damage to the body was the most important reasons of choosing CS, providing training classes, better facilitation for normal delivery and adding a special course for girls in high school education is recommended to develop a positive attitude toward normal delivery in women.

High blood pressure is a major health threat and self-control has great importance in its management. Hence, a nutrition model is presented based on dietary approach to stop hypertension (DASH) diet. The present study aimed to investigate the effect of training on adherence to DASH diet on blood pressure among hypertensive patients in Rasht, North of Iran.
A total of 150 hypertensive patients visiting health care centers were randomly divided into education intervention and control groups. Food frequency questionnaire were completed before and 2.5 months after the intervention. Patients’ blood pressure was measured at the same time interval. The post-baseline DASH diet components and blood pressure between the two study groups were compared using analysis of covariance.
Participants’ mean age was 56.08 ± 6.1 years and 76% of them were female. At baseline, the daily intake of dairies, fruits, and nuts and beans were significantly lower than the recommended DASH values in both groups. In contrast of fat, tea and salty food, all post-baseline DASH diet components in the intervention group were significantly higher than the control group. The intervention group had a significantly lower systolic blood pressure compared to control group 2.5 months after of the intervention.
Our results indicated that training nutrition based on DASH diet can be considered as a useful strategy to control high blood pressure among hypertensive patients.

Turnover intention is influenced by several factors in the organization. The current study aimed at determining the correlation between perception of performance appraisal policies, and job satisfaction and turnover intention in the staff of Guilan University of Medical Sciences, Rasht, Iran.
The current descriptive-correlational study was conducted on the 693 personnel of Guilan University of Medical Sciences on the statistical population. Considering the total number of statistical population and according to the Morgan table 248, of which were selected by simple random sampling method. To collect data, the poon performance appraisal policies questionnaire and the turnover intention questionnaire developed by Longo and Mura, Jenkins and Thomlinson employee’s intention to turnover questionnaire and Minnesota job satisfaction questionnaire were used. Validity was assessed through content validity, convergent, and divergent validity. Data were analyzed with SPSS version 19 as well as SmartPLS 2 software.
There was a positive and significant correlation between performance appraisal policies and job satisfaction (β = 0.768), and negative relationship with turnover intention (β = -0.358); in addition, there was a negative and significant relationship between job satisfaction and intention to staff turnover (β = -0.436).
Employee’s perception of motivational policies of performance appraisal has a direct relationship with job satisfaction and inverse relationship with turnover intention. Also, more job satisfaction leads to a reduced employees turnover intention. Also, job satisfaction further leads to a decrease in the employee’s turnover intention. It is suggested that authorities pay more attention to the job promotion and job opportunities in order to increase job satisfaction in the personnel.