jila sadighi

The pre-marriage education program started in Iran in 1993. The present study had several main goals, and this article deals with the results of two objectives, including the assessment of pre-marriage education centers and assessment of the instructors' satisfaction with the program.

The study was cross-sectional. Ninety-six centers were selected by simple random sampling, and instructors of selected centers included in the study by census method. Data were analyzed using SPSS-18 software.

The mean of overall satisfaction score of instructors with the "pre-marriage education program" was 20.56 (SD=3.753). The instructors were satisfied or very satisfied, including 88.4% with the content of textbooks, 70.1% with the regular holding of retraining courses, 96.2% with the cooperation with the center, 98.2% with the behavior of colleagues, and 98% with the center authorities management for holding classes. The instructors were dissatisfied or very dissatisfied, including 60.6% with the paid amount for instruction and 51% with the timely payment. There was no significant relationship between the overall satisfaction with age, gender, marital status, education, and duration of the instruction experience. A significant relationship was between overall satisfaction with the level of education (p=0.012), employment relationship with the center (p=0.014), and the type of class (p<0.001). Thus, instructors with master education were the most, and instructors with bachelor education were the least satisfied with the program. Official instructors had the least, and contract instructors had the most satisfaction. The instructors of the "reproductive and sexual health course" were the least, and the instructors of the "ethics and laws course" were the most satisfied with the program. The results of the evaluation of centers showed that more than 80% of the centers were in good condition in terms of lighting, heating system, and the appropriate seat numbers for participants in each class. About 70-80% of centers were in favorable condition in terms of the appropriate number of classes, adequate ventilation, the fitness of educational facilities with needs, and adequate physical space for classes. Only 50-70% of the centers were in good condition in terms of cooling system, and access to the necessary infrastructure for online classes.

The promotion of the pre-marriage education program requires the development of the necessary infrastructure and the improvement of the welfare conditions of the instructors. We hope that the results of the present study can help the policy-makers of the health system to improve the monitoring of program.

Dear Editor, In “before-after" intervention studies with qualitative outcome(s), we should not use the same formula when the outcome(s) are quantitative since the appropriate variance in this formula are not used and thus the sample size will not have adequate confidence and power.  A formula for such studies is proposed to overcome problems highlighted above.

Objective (s):

 COVID-19 vaccination is considering to be the ideal solution for the COVID-19 control. This study aimed to investigate the factors affected the COVID-19 vaccination in Iran.

This cross-sectional study included a sample of Iranian men and women over 18 years of age who agreed to participate in the study. A cluster sampling method was used, and the data was collected in 2021 through a self-designed questionnaire via telephone survey. Logistic regression was performed to investigate the influencing factors on vaccination.

Among 2649 participants from 31 provinces of Iran, about 88% had a history of injecting at least one dose of vaccine. The odds ratio of corona vaccine injection was similar among women and men. Age and marital status showed no significant effect on this ratio. The odds ratio of corona vaccine injection in people living in cities was about 40% less than people living in rural areas. Furthermore, the odds ratio of COVID-19 vaccination increased by about 11 times for each unit increase in positive attitude toward vaccination.

The findings indicated that overall those who were employed, students, and people with lower income and living in rural areas were more likely to be vaccinated. It seems that distribution and availability of vaccines by government was acceptable for quick and adequate coverage of vaccination in Iran.

The "pre-marriage education program" is one of the strategies to strengthen the family foundation in Iran. The present study was carried out with the support of the Iran Ministry of Health and Medical Education to evaluate this program. This paper presents the results obtained on knowledge and satisfaction of couples.

This was an interventional study on a sample of couples participating in a pre-marriage education program. The intervention was offered via in-person and virtual (online and offline) aproaches. Ninety-six centers of pre-marriage education through country were selected by simple random sampling. A convince sample of 15 couples (15 men and 15 women) was thought for each center. Data was collected by two questionnaires and analyzed using the SPSS-18 software.

A total of 2868 people were entered into the study. Pre-marriage education led to an increase in knowledge. The mean score of knowledge changed from 8.78 (SD = 1.693) to 9.34 (SD = 1.639) (P<0.001). The results showed that education has led to a statistically significant increase in the knowledge score of people who participated in in-person and online classes, while offline classes had no effect on increasing the knowledge of couples. Education increased knowledge of employed and unemployed people at all educational levels. Education also increased knowledge in most age groups, but it had no effect on the age group of 46-55 years. Most participants (87.1%) had "high and very high satisfaction" with timing, and overall satisfaction by 90.3% reported as high and very high. About 60% of people reported that the duration of the classes was appropriate. Overall satisfaction of women were more than men. Younger age groups had higher overall satisfaction than other age groups. The satisfaction of the unemployed was more than employed couples. People with higher education had the highest overall satisfaction with the program.

The results showed that the "pre-marriage education program" in achieving short-term goals was successful. Evaluating the effect of the program on long-term goals (such as the effect on marriage outcomes) requires a different study design.

Dear Editor, Sample size calculation is one of the most important steps in developing a plan for research projects/dissertations. The sample size affects the power of the study and also has economic implications for a research project. If the sample size would be less than the required level, the tests used to analyze the research data will not have adequate power. Also, if the sample size would be too many, it will cause a waste of resources. In this regard, it is suggested that researchers report the "correlation coefficient between the data before and after the intervention" in addition to the mean and standard deviation in a pre-and post-intervention study with a quantitative dependent variable so that other researchers can refer to it and calculate the sample size of their study correctly.

With progress in medical care, the rate of premature birth has increased and the mortality rate of very low birth weight (VLBW) babies has decreased. However, there is an increased incidence of disabilities in survivors, including neurodevelopmental delay, particularly in infants born very prematurely. This study aimed to assess the neurodevelopment in such children.

This was a cross-sectional study on non-randomized sample of children aged 3 to 5 years with weight less than 1500 grams or the mother's pregnancy lasted in less than 32 weeks in 2018 and born in one of the hospitals in Tehran, Iran. and alive at the study commence. They were evaluated by the Ages and Stages Questionnaires (ASQ) in 5 developmental fields. Data was collected by completing a general questionnaire, the ASQ, and using the hospital records.  The data were analyzed by SPSS-22 software, and statistical tests included descriptive and analytical tests such as chi-square and t-test.

Out of the total number of births, the data for 220 VLBW children were eligible for analysis. Of these, 12 children (5.7%) had at least one developmental disorder in the five investigated fields including:  4.2% of the children had neurological developmental delayed in communication, 2.4% in gross motor, 2.4% in fine motor, 2.8% in problem solving, and 2.8% in the personal-social aspects. There was no significant relationship between gender, length of pregnancy, and parents' education level with children's developmental disorders. There was a significant difference between the rehabilitation status of VLBW children and developmental delay (P<0.001).

The findings suggest that the VLBW children are at higher risk for neurodevelopmental and behavioral disorders. It is recommended that such children undergo physical, neurological, and developmental evaluations at different ages.

Introduction:

Chemotherapy-induced oral mucositis (COM) is a prominent complication of chemotherapy (CT). Non-thermal CO2 laser therapy (NTCLT) has been demonstrated as an innovative and safe photobiomodulative approach in some kinds of painful oral lesions. The purpose of this study was to evaluate the palliative effects of one session of NTCLT on COM lesions.

Methods:

Patients with painful COM (WHO grade: ≥ 2) were included in this before-after clinical trial based on the eligibility criteria. The oral lesions were irradiated with a CO2 laser (power: 1 W, scanning the lesions with the rapid circular motion of the defocused handpiece) through a thick layer (3-4 mm) of a transparent gel containing a high-water content. The severity of pain in the lesions was self-assessed using a 0-to-10 visual analogue scale (VAS) for 7 consecutive days. The evaluating physician visited the patients on the 3rd and 7th days in search of any kind of complications.

Results: 

Seventeen adult patients with 35 patches of OM due to chemotherapy of solid tumors completed the trial. Immediately after NTCLT, the mean for non-contact VAS pain scores of the lesions significantly declined from 4.91 ± 2.356 to 0.29 ± 0.622 (P < 0.001) and the mean for contact VAS pain scores from 7.77 ± 1.57 to 1.31 ± 1.18 (P < 0.001). The mean VAS pain scores of the lesions showed statistically significant differences between the follow-up periods compared to the baseline (P < 0.001). The process was completely pain-free and required no anesthesia. After NTCLT, no kind of thermal adverse effects such as irritation, destruction, aggravation and even erythema were observed.

Conclusion:

Based on the results of this before-after clinical trial, NTCLT has the potential to be considered as a non-invasive and safe palliative option for the pain management of patchy OM due to chemotherapy of solid tumors.

 The World Health Organization has recognized public reluctance to vaccinate against Covid-19 as one of the ten biggest threats to global health in 2019. Vaccination hesitancy is likely to be a key obstacle to global production of a Covid-19 vaccine. In order to develop universal access to the corona vaccination program, this study was conducted with the aim of measuring the attitude of Iranian adults regarding the corona vaccine and the factors affecting it in the autumn  of 1400.

This was a cross-sectional study and was conducted among Iranian men and women over 18 years of age who consented to participate in the study using cluster sampling method and through telephone calls. The data was collected by a 13-item valid and reliable questionnaire and were analyzed using the SPSS-22 software.

In all 2649 Iranians were studied (50.2% men and 49.8% women). The mean attitude score towards the corona vaccine injection was 64.1 out of 100 (SD = 11.0). The results of the multivariate logistic regression analysis showed that the positive attitude of adults regarding the corona vaccine was significantly associated with male gender (OR= 1.31, 95% CI: 1.009-1.71), and marital status (OR for married = 1.35, 95% CI: 1.054-1.75). The results showed no significant association between positive attitude and other variables such as, history of corona vaccine injection, history of corona disease, and also the death history of participants' family members due to corona.

The findings suggest to increase positive attitudes towards corona virus females and those who are single, divorced and widowed should be targeted.

Acceptance of COVID-19 vaccination could be influenced by attitude towards the vaccine. The aim of this study was to develop and evaluate the validity and reliability of adult attitudes towards COVID-19 vaccination.

First, an item pool was generated by reviewing existing resources. Then content and face validity was examined. In the next stage, the structural validity (exploratory and confirmatory factor analysis) of the questionnaire was examined in two distinct samples among 505 Iranian adults. Finally, the attitude was assessed among two samples. The internal consistency of the instrument was estimated by calculating Cronbach's alpha.

The initial questionnaire consisted of 38 items that after examining the content and face validity, a number of items was removed and corrections were applied to the remaining items. The results of exploratory factor analysis showed a three factor solution (emphasis on the need for corona vaccine, no need for corona vaccine and emphasis on the side effects of corona vaccine) including 13 items that jointly explained about 52% of variance observed. Similarly, the results obtained from confirmatory factor analysis indicate a good fit for the data. The fit indexes were as follows: (X2/df =2.15, GFI=0.91, CFI=0.95, NFI=0.91, NNFI=0.94, SRMR=0.068, RMSEA=0.076). The reliability of the questionnaire as assessed by the Cronbach’s alpha was 0.853 for the scale and ranged from 0.68-0.74 for its dimensions. Finally, the mean attitude score of the participants was 64.1 out of 100 points.

Considering the validity and reliability of the attitude assessment questionnaire regarding the COVID-19 vaccination in adults, this questionnaire could be used for measuring attitude towards COVID-19 vaccination.

Evidences from various studies through the world reports experiences similar to hallucinations in people without a specific disease. This perception is called extrasensory perception, pseudo hallucination and paranormal cognition in scientific-research texts. The incidence and prevalence of extrasensory perception in different societies and the lack of information in educational programs of health service providers, indicate the necessity of appropriate criteria for diagnosing extrasensory perception from hallucinations and other sensory perception disorders. Differences in the causes and management of these situations increase the necessity of the issue.

Review and qualitative study methods were used in different steps of the study. In the review study, relevant information was collected from scientific sources in the field of psychiatry and psychology and in the field of Islamic philosophy and mysticism. During a series of expert panels and based on documents from review study, different states of perception were identified and a "perceptual diagnostic algorithm and its spectrum without sensory stimulus" were designed.

Perceptual diagnostic algorithm is a tool to distinguish a person with experience of extrasensory perception from people with sensory perception disorders as well as normal sensory perception.Hallucination, extrasensory perception and revelation are categorized as perceptual experiences without the presence of sensory stimuli. These situations Based on these characteristics: awareness of the presence or absence of sensory stimuli, physical and mental health of the experiencer, awareness of the message of perceptual experience forms the spectrum of perception without sensory stimuli.

The use of "perceptual diagnostic algorithm" and its spectrum without sensory stimulus" by physicians, psychiatrists, psychologists, and counselors can meet the need to diagnose various sensory-related conditions in health system.

Birth of an infant with very low birth weight (VLBW) (weight less than 1500 grams) is a major cause of deaths and complications in infancy and childhood. Despite recent progressions in medical care and treatment for VLBW children, the mortality rate is high in this group of children. The present study was performed to better identify the survival rate of these children and the problems that affect the survival of this group of infants in the short and long term.

The study population was all infants weighing less than 1500 grams or infants who borne at less than 32 weeks of pregnancy. Infants whom birth occurred from the beginning to the end of 2018 in hospitals in Tehran were included. Information about these children was provided by the Family and Population Health Office of the Ministry of Health and Medical Education. Sampling was non-random and all information about the infants under study was recorded in a questionnaire. All data from the study were entered into SPSS-22 software and the results were presented using descriptive and analytical statistics. Survival analysis was performed by Kaplan-Meier test and the effect of variables on survival was evaluated using multivariate Cox model.

A total of 338 children were studied. Based on the results of cox regression models, the probability of one-month survival of children was about 68% and the probability of one-year survival was about 60%. Of the 10 variables affecting the survival of VLBW infants and children under study, 6 variables of maternal education, number of pregnancies, parent and infant insurance, gestational age, birth weight and maternal vaccination before pregnancy were significantly related with the death of infant (P ≤0.05).

The findings suggest one of the effective strategies for improving VLBW infant survival rate is encouraging women to continue their education, vaccinating mother before pregnancy, insuring family members and preventing multiple pregnancies.

The aim of this study was to investigate the fertility indicators in Iran. 

This was a cross-sectional study and included Iranian women of reproductive-age. The data were collected using a questionnaire and analyzed using SPSS18.

In all 10547 women included in the study. The mean live birth was 1.96 and it was increased as age of both women and husbands were increased; and it was decreased as age at marriage, age at birth of the first child, and education were increased. Live birth was more in low-income women and in rural areas. The frequency of stillbirth was 4.8% and increased as age of both women and husbands were increased. The stillbirth decreased as age at marriage, the age at birth of the first child, and education were increased. There was no relationship between stillbirth and women’s occupation, occupation of husbands, and religion. The stillbirth was more in low-income women and in rural areas. The frequency of abortion was 18.2% and increased with age of women, age of husbands, and age at birth of the first child. Abortion decreased with increased age at marriage and education. Abortion was more common in low-income women. Abortion had no relationship with women’s occupation, religion, and urban/rural residency. The frequency of the cesarean section was 42.1%. Cesarean increased with increased age of women and husbands, age at marriage, age at birth of the first child, and education. Delivery by cesarean had no relationship with occupation of husbands. The cesarean decreased with decreased income and was higher in urban areas.

Investigating the trend of fertility indicators can play important role in identifying problems, planning for required services, and optimal allocation of resources. The findings from this study will complement the information that is needed by policy-makers.

The extent to which a person’s health‑related behavior corresponds with medical instructions (adherence) is an important modifier of health system effectiveness. This study was designed to determine the patients’ adherence to Iranian traditional medicine in a group of patients with chronic disease.

Convenience sampling was used to enroll 320 patients with chronic diseases from January 2014 to January 2015 in clinics of traditional medicine affiliated with medical universities in Tehran. Morisky Medication Adherence Scale (MMAS) was used to measure the adherence. After describing the variables and the frequency of adherence, logistic regression analysis was used to determine the influencing factors.

Mean age was 40.8 (standard deviation [SD] =13) years. The mean of the duration of disease was 54.6 (SD = 56.1) months and mean of the duration of referring to the clinics 6.5 (SD = 6.9) months. Total score of MMAS was zero in 33 (10.3%) of patients (high adherence), one or two in 128 (40%) of patients (moderate adherence), and more than two in 159 (49.7%) of patients (low adherence). Forgetfulness, bad taste, not availability, and the high cost of the drugs were the most commonly reported causes of non‑adherence. Adherence was associated with age(odds ratio[OR] =1.05, 95% confidence interval [95% CI] 1–1.1), marriage (OR = 10.8, 95% CI 2.05–57.6), number of prescribed drugs (OR = 0.05, 95% CI 0.02–0.14), and duration of disease (OR = 1.01, 95% CI 1–1.02).

Considering the low adherence in users of medications of Iranian traditional medicine, health care practitioners need to be trained in adherence and the influencing factors and also to use some interventions to increase the adherence.

More than two decades have passed since the establishment of research ethics committees in Iran. With many years of experience of research ethics committees, Iran Ministry of Health and Medical Education revised previous regulations and developed “Regulation on the Establishment, Leveling, and Duties of the Biomedical Research Ethics Committees”. Following publish and notification of “Regulation on the Establishment, Leveling, and Duties of the Biomedical Research Ethics Committees” in 2014, research ethics committees formed in national, academic, and organizational levels. In this regard, due to cooperation of the Iran Ministry of Health and Medical Education with the Iran Ministry of Science, Research and Technology, “the single article of the Act for Prevention and Combating Fraud in Scientific Publications” was approved in the Parliament of Iran in 2017; its executive bylaw was notified for implementation by the Cabinet of Ministers in 2019 and accordingly research ethics committees found a legal status in Iran. For promotion and update of the mentioned regulation and adaption to the Act, the secretariat of the national ethics committee proposed revised version of the regulation after obtaining opinions of stakeholders and several expert meetings. Then the new regulation entitled “Regulation on the Establishment, Procedures, and Duties of the Research Ethics Committees” was approved by the Iran National Committee for Ethics in Biomedical Research and the High Council of Medical Ethics of Iran in 2021. Structure of the committees in the new regulation includes “the National Committee for Ethics in Biomedical Research”, “Regional Research Ethics Committee”, “Institutional Research Ethics Committee”, “Biomedical Research Ethics Committee”, and “Specialized Committee”. This article introduces this new regulation.

 Many information sources including mass media provide health information in order to increase awareness and promote people's health. The aim of this study was to examine people’s trust in mass media and virtual social networks health information. This cross-sectional study was conducted among a random sample of adults aged 18 to 65 years living in Tehran, Iran. The data were collected using a questionnaire and descriptive statistics were applied to analyze the data. A total of 1174 adults (581 women and 615 men) with a mean age of 37.2 ± 13.02 years and mean education years of 12.5 ± 3.8 years were studied. The highest trust in health information was reported for television (65%) followed by radio (56%). This for social media was 30%. The results obtained from multiple logistic regression analysis indicated that there were no association between trust and demographic variables. However, association between trust and the amount of mass media or social networks use was observed. A unit, increase in the use of mass media and social networks health information increased the odds for trust about 2 to 3.4 times. The study results showed that people’s trust on television and radio for seeking health information was relatively high. This implies that those who provide health for television v and radio have significant responsibility to convey correct information to the public.

Many information sources, including mass media, are trying to play an important role in health-promoting of people in society through increasing their health information. The aim of the present study was to investigate the rate of use of health information, presented in mass media and virtual social networks among citizens of Tehran. This cross-sectional descriptive study was carried out on 1196 citizens of Tehran aged 18-65 years old in 2016. The subjects were selected using a multi-stage cluster sampling method. Data were collected by a researcher-made questionnaire after assessment of its validity and reliability. Data were analyzed by SPSS 19 software, using appropriate descriptive statistical methods. 1,196 citizens of Tehran (581 women and 615 men) were studied in this research with a mean age of 37.2±13.2 years old. The highest use of media health information was about television (about 81%), internet (about 64%) and the print media (about 58%). The use of health information in virtual social networks was about 56%. The use of health information of mass media and virtual social networks in the age group of 24 to 35 years old, married, the group with 13 years of education and workers were more than other groups.  The rate of use of television health information among citizens of Tehran is significant. Also, Internet search and social networking sites for health information should be taken into consideration by health care providers.

Media are the most important source of people’s health information. This study was conducted to compare people’s trust to health messages in the national media and Persian-language satellite networks.
This was a cross-sectional study carried out in Tehran, Iran. A valid and reliable questionnaire was used to collect data. Data were analyzed using Wilcoxon and Kruskal-Wallis tests using SPSS software.
In all 493 individual took part in the study. The results showed that the use of the national TV with some exceptions was higher in both genders, age, educational and occupational groups as compared to satellite networks. Similarly the level of trust to the national TV was higher among participants with different socioeconomic backgrounds compared to satellite networks. While 65% stated that trust the national TV very and very much, only 32.2 % reported that they trust satellite networks.
The findings suggest that the national TV should see the use and trust as positive opportunity and take action in order to strengthen the quantity and quality of health-related programs.

Food fortification is one of public health strategies to prevent and control anemia and iron deficiency. Flour fortification with iron and folic acid launched in 2001 in Iran. Thus the present meta-analysis conducted to assess the impact of flour fortification on hemoglobin, serum ferritin, anemia, iron deficiency and iron deficiency anemia.
We searched English and Persian databases up to December 2013 to identify relevant studies. Quality assessment was conducted according to the EPOC (Cochrane Effective Practice and Organization of Care) statement. Meta-analysis was carried out using the Comprehensive Meta-Analysis version2 software. Random effects model was used due to the heterogeneity between the studies. Subgroup analysis and sensitivity analysis performed using CMA-2. Begg and Mazumdar’ Rank Correlation Test and Egger’s linear regression were adopted to test the possible publication bias.
A total of 42 articles (consisted 80 trials) were included in the study. Meta-analysis of “before-after studies” showed that flour fortification with iron resulted in a significant increase in hemoglobin levels (0.342 g/dl; 95% CI: 0.216 ~ 0.416, pThe present meta-analysis provided evidence of the effectiveness of flour fortification with iron for improving hemoglobin and ferritin levels and reducing the risk of anemia. However, evidence of effectiveness for reducing the risk of iron deficiency was limited and there was no effect on iron deficiency anemia. It should be considered that controlled trials have provided more valuable results than before and after studies, and also chemical compound of iron was found to be an important factor in the effectiveness of flour fortification with iron.

There is a relationship between health and religion and spirituality. Thus in designing a health model for Iranian women (Farmehr) this relationship was considered. The Farmehr model is a comprehensive conceptual model aiming to represent all factors affecting Iranian women's health and their interactions. This paper deals with stating religion and spiritual factors and their position in the Farmehr model.
This was a qualitative study. In all 23 experts were interviewed. Content analysis was performed to explore the data. The data further were examined and modified through deep interviews and focused group discussions with experts and policy makers.
The findings revealed that the relationship exist between health and "attitudes and believes", "values", "morality", and “religious and spiritual capital and resources in society”. Also it was found that they affect the health of whole society and thus were considered as the fundamental axis in the Farmehr model. Other factors that affected by the religion and spirituality were religious and spiritual behaviors and family background that were recognized respectively in the layer of life style and family relationships in individual level of the model. The spiritual factors have been indicated in some other health models such as social determinants of health model as social, cultural, and spiritual values, forces, or assumptions.
The Farmehr women's health model suggest that the set of indicated factors have a significant impact on understanding and interpretation of individuals about their own health and that of the others, their health behaviors and other behaviors that affect the health of family and society and even on thinking behind making policy and planning in public and health system.

During recent years fertility rate is decreasing in Iran. This study aimed to assess reasons for fertility desire and disinterest among Iranian married adults.
This was a population-based study. A sample of married individuals living in all 31 provinces in Iran enteed into the study and were asked whether they intend to have a child at present. Participants were interviewed via a structured questionnaire including items on socio-demographic and reproductive information. Participants were asked to indicate reasons for desire or disinterest for fertility. Participants were free to name several reasons as they wish. Descriptive analysis was used to explore the data.
In all 20935 individuals (10388 male and 10547 female) were interviewed. The mean age of participants was 36.28 (SD= 8.23) years. Overall 31.8% of respondents indicated that they wish to have a child while the remaining 68.2 said that they did not. The most important reason for fertility desire was interest in having children (93.5%), followed by wish to experience parenthood (92.2%). The most important reason for disinterest for fertility was worryness about the future of a new child (76.1%) followed by economic problems (71.0%).
The findings suggest that willingness to experience parenthood and economic hardship are the most common reasons for fertility desire or fertility disinterest respectively. Perhaps interventions aiming to focus on joyful parenhood experiences might be helpful to encourgare young couples for having children.

During recent years fertility rate is decreasing in Iran. This study aimed to assess fertility desire, its correlates and reasons for fertility desire or fertility disinterest among Iranians.
This was a population-based study. A sample of married individuals living in all 32 provinces in Iran were asked whether they intend to have a child at present. Participants were interviewed via a structured questionnaire including items on socio-demographic and reproductive information. Participants also were asked to indicate reasons for desire or disinterest for fertility. Participants were free to name several reasons as they wish. Descriptive analysis was used to explore the data. Logistic regression analysis was performed to assess the association between fertility desire and independent variables.
In all 20935 individuals (10388 male and 10547 female) were interviewed. The mean age of participants was 36.28 (SD= 8.23) years. Overall 31.8% of the respondents indicated that they wish to have a child while the remaining 68.2 said that they did not. The most important reason for fertility desire was interest in having children (93.5%), followed by wish to experience parenthood (92.2%). The most important reason for disinterest was worry about the future of a new child (76.1%) followed by economic limitations (71.0%).
The results obtained from logistic regression analysis showed that infertility disinterest was significantly associated with older age [OR= 1.10, 95% CI(1.09-1.11 )], younger age at marriage [OR= 0.93, 95% CI(0.92-0.94)], female gender [OR= 1.44, 95% CI(1.24-1.67)], having more children at present [OR= 1.88, 95% CI(1.79-1.98)], lower number of abortion and stillbirth [OR= 0.86, 95% CI(0.82-0.92)] and living in urban areas [OR= 1.36, 95% CI(1.26-1.47)].
The findings suggest that willingness to experience parenthood and economic hardship are the most common reasons for fertility desire or fertility disinterest. The findings might help policy makers to implement appropriate interventions if they wish to improve population growth rate for the country.

Equity in distribution of health services is one of the goals of health policy makers. Thus, an study entitled “modeling geographical access to medical laboratory services in Iran” was conducted in 2014. The present article is a case study using this model for site selection of new medical laboratories in Shiraz, Hamadan and Shushtar cities, Iran.
The study units included medical laboratories located within the city borders but outside of hospital and clinic settings. The main analysis task was layer and maps creation based on Geographic Information System (GIS). Spatial analysis performed using the ArcGIS software.
According to the geographical accessibility model, total area of lands valued as excellent and good for the establishment of new laboratories (outside of hospital and clinic settings) were identified in Shiraz and Hamadan and Shushtar. In Shiraz, at the time of present study, there were 64 medical laboratories outside of hospitals and clinics and there was possibility of construction of approximately 241 new laboratories in the city. The total area of lands valued as excellent and good for the establishment of new laboratories were about 2661 square meters. Therefore it was possible to establish 120 out of 241 new medical laboratories in the horizontal expansion of the city in these lands in Shiraz. In Hamadan, there were 24 medical laboratories outside of hospitals and clinics and there was possibility of construction of approximately 143 new laboratories in the city. The total area of lands valued as excellent and good for the establishment of new laboratories were about 130700 square meters. Therefore, it was possible to establish all proposed new medical laboratories in these lands in Hamadan. In Shushtar, there were 3 medical laboratories outside of hospitals and clinics and it was possibility of construction of approximately 9 new laboratories in the city. The total area of lands valued as excellent and good for the establishment of new laboratories were about 36800 square meters. Therefore it was possible to establish all proposed new medical laboratories in these lands in Shushtar.
It is possible to use geographical accessibility model for site selection of new medical laboratories in cities. The accuracy of selected sites should be confirmed with field visits.

Health education campaigns play an important role in improving public’s health. This study aimed to evaluate the Health Citizen’ campaign in Tehran, Iran. The campaign was launched by the Tehran municipality and included health statements on nutrition, physical activity, smoking and risky behaviors using billboards and lasted for a month (January 2016).
A population-based survey was conducted in Tehran and a random sample of adults living in different districts of Tehran was interviewed using a structured questionnaire. They were asked whether they have seen the campaign or not. Then a number of questions related to the campaign including items on attention, remembering the main idea, relevance, design and place were examined. Descriptive statistics were used to explore the data.
In all 1196 individuals took part in the study (561 female and 615 male). Of these 491 (41%) indicated that they have seen the campaign. Of those who seen the campaign 85% (n = 415) said that they could remember the main idea, and 95% of participants (n = 466) believed that the campaign was informative, convincing (n = 426, 87%), believable (n = 455, 93%), and well done (n = 387, 79%). In addition the data analysis showed that 90% (n = 443) of participants indicated that messages were worth remembering, interesting (n = 437, 89%), and personally relevant (n = 331, 67%). Participants also indicated that the best way for communicating health messages are electronic media (n = 287, 58.5%), and billboards (n = 279, 56.6%).
It seems that communicating health messages via billboards received well by participants and could be repeated in different occasions in order to put health in public’s agenda.

To develop a valid and reliable instrument for assessing hospital preparedness against nuclear and radiologic events.
This cross-sectional study was conducted through two stages: preparing initial framework for providing the instrument through literature review and a panel of experts; and then determining facet and content validity through impact factor (IF), content validity index (CVI) and reliability through Cronbach's alpha coefficient. The participants included experts and key informants of related disciplines (n=60) selected by purposive sampling method. Data were analyzed using SPSS software.
The final valid and reliable tool consisted of five domains and 56 questions. Preparing physical environments, equipments, human resources, communication, and organizational coordination have been extracted as the main aspects of the tool. Accordingly, all validity and reliability indicators were examined and were found satisfactory (IF ≥ 1.5, CVI ≥ 0.8, Cronbach's alpha ≥ 0.7)
Using such valid and reliable tool for assessing hospital preparedness against nuclear and radiological events can provide valid data for health managers in order to be prepared for such events. Further research is needed for developing valid and reliable tools to assess hospital preparedness against all man-made hazards.

One of the major goals of policy makers is planning for facilitating population access to health services. In this regard, the study entitled “modeling geographical access to medical laboratory services in Iran” was conducted and the detailed methodology and geographical accessibility model were reported. The present article is a case study of the application of the model in Qom, Iran.
The study units included medical laboratories located within the city borders. Data were analyzed using Geographic Information System (GIS). Spatial analysis performed using the ArcGIS software.
There were 53 medical laboratories including 25 laboratories outside of hospitals and clinics in Qom. According to the model of geographical access to medical laboratory services, the sites for new laboratories were identified for Qom. The model indicated that an estimation of 7306 square meters - in the horizontal expansion of the city- for possible establishment of 35 new medical laboratories outside of the hospitals and clinics is required.
It is possible to use the geographical accessibility model for site selection in many cities, but the accuracy of selected sites should be confirmed with field visits and opinions of local experts, because some factors such as economic and legal issues influences the possibility of the usage of proposed lands.