Suicidal thoughts and behaviors among untreated illicit substance users: a population-based study.

OBJECTIVES: Research regarding the contribution of specific psychoactive substances to suicidality has yielded equivocal results. The present study examined the prevalence and factors associated with suicidal thoughts and behaviors among a population-based sample of untreated illicit substance users. METHODS: A total of 616 illicit substance users who were recruited from high-risk areas of Shiraz using snowball sampling participated in the study. Eligible participants were individuals aged 18 years and older who regularly used one illicit psychoactive substance (e.g., opioids, heroin, cannabinoids, stimulants, hallucinogens) for at least one year and who had received no treatment for their drug use during the past year. Data were collected regarding socio-demographic characteristics, mental history, and substance use habits. Data regarding suicidal thoughts and behaviors were assessed using the Beck Suicidal Ideation Scale (BSIS) and self-reports of previous suicide attempts. Multiple logistic regression analysis was used to identify independent variables associated with suicidality. RESULTS: Among the participants, 23.6% reported having had suicidal thoughts during the past week and 6.7% reported having attempted suicide during the past year. Methamphetamine was reported as the primary substance of use among approximately half of the participants who attempted suicide during past year (49.2%). Multiple logistic regression analysis showed that current suicidal thoughts were independently associated with having no job, a history of mental health condition, previous suicidal attempts, concurrent use of more than one substance, and using methamphetamine and heroin as the primary substances. Suicidal thoughts were not associated with increased odds of regular opium and cannabis use. CONCLUSION: Both methamphetamine and heroin use are significantly associated with current suicidal thoughts. Evaluation of the risk of suicidality by physicians and mental health care professionals in both community and outpatient settings would be especially appropriate among those individuals using these psychoactive substances.

Investigating the effect of education based on PRECEDE-PROCEED model on the preventive behaviors of musculoskeletal disorders in a group of nurses.

Background: One of the most important occupational complications that could occur in nurses is musculoskeletal disorders. In this study, we designed an educational intervention based on the PRECEDE-PROCEED model to investigate its effects on a group of nurses on preventive behaviors of musculoskeletal disorders. Methods: A total of 120 nurses working in Izeh City, Iran, participated in this semi-experimental study. The sampling was performed through a convenient sampling method, and the participants were randomly assigned to the experimental and control groups (60 participants for each group). Both groups filled out a questionnaire based on the PRECEDE-PROCEED model before and 2 months after the educational program as part of the data collection process. The data were examined using a paired t-test, an independent t-test, and a chi-square test after being entered into SPSS version 24. Results: According to the findings, prior to the intervention, there was no difference between the two groups in terms of their knowledge (p = 0.221), attitude (p = 0.136), enabling factors (p = 0.325), reinforcing factors (p = 0.548), self-efficacy (0.421), and behavior (0.257) levels. However, following the intervention, a substantial rise was witnessed in the experimental group in each of the mentioned variables (p = 0.001). Conclusion: In the current study, education based on the PRECEDE-PROCEED model led to the improvement of knowledge, attitude, enabling and reinforcing factors, self-efficacy, and finally preventive behaviors with musculoskeletal disorders in the participants. Considering the importance of the role of health education in promoting behaviors related to musculoskeletal disorders in nurses and the importance of observing related behaviors in preventing long-term complications, the necessity of education in a wider dimension and with different tools is felt more and more in society. Therefore, longer interventions with this aim could be carried out on nurses and other healthcare personnel.

Environment Intensifies Imbalance and Fear of Falling: Comparing Urban and Rural Aging Communities.

BACKGROUND: The relationship between environmental diversity and the health status of older adults has been less considered in studies. This study seeks to investigate the causal relationship among the environment, falling, fear of falling, and the imbalance of older adults in southern Iran in 2021. OBJECTIVE: The investigation into the relationship between environmental pollution to the imbalance and fear of falling, especially in comparing urban and rural aging societies is the aim of current study. METHODS: In a cross-sectional study, 489 older samples from rural and urban areas were chosen randomly and their experience of falling, fear of falling, imbalance, and IADL were examined. The ordinal and nominal logistic regression and ANOVA were performed using IBM-SPSS. RESULTS: With a mean age of 71.8 (SD = 8.3), older participants have long time chronic disease (69.6%) and falling experience twice a year (42.7%). The values of effect size indicated the high effectiveness of settlement in explaining IADL, health situation, experience and fear of falling, and imbalance (Eta squared > 30). The odds ratio for being in the urban settlement was 5.51, indicating the imbalance score increased by approximately 5.52 times. CONCLUSION: Imbalance in older people leads to the fear and experience of falling. This imbalance is strongly influenced by the environment. Urban pollution can contribute to this problem. Future studies on aging need to focus on environmental pollution and diversity in the experience of falling and imbalance.

The effect of training intervention based on the theory of planned behavior on oral and dental health behaviors in pregnant women.

BACKGROUND: Pregnancy is a transient physiological condition that causes adverse oral and dental consequences. The present study aimed to determine the effect of a training intervention based on the theory of planned behavior on oral and dental behaviors in pregnant women. METHODS: This quasi-experimental study was conducted on 140 pregnant women (70 in the intervention group and 70 in the control group) supported by comprehensive health centers on the outskirts of Shiraz, Iran, in 2019-2020. The sampling was performed in each center by a simple random method. The tool included a demographic characteristics questionnaire, a questionnaire based on the theory of planned behavior, a self-care behavior questionnaire, and checklists for recording DMFT(Decayed, Missing due to caries, and Filled Teeth(DMFT)) and dental plaque indices. The questionnaires were completed before and 3 months after the intervention by both groups. The intervention group received six 50-min training sessions. The data were analyzed using SPSS 22, the chi-squared test, independent t-test, paired t-test, and descriptive statistics (p < 0.05). RESULTS: The mean ages of the intervention and control groups were 32.28 ± 6.14 and 31.84 ± 6.71, respectively. The results showed that the average scores of all constructs of the theory of planned behavior, dental plaque indices (PI), and MDFT in the intervention group significantly changed after the intervention (p < 0.001). CONCLUSION: According to the results, training based on the theory of planned behavior was effective on dental and oral health behaviors in pregnant women and improved the clinical results of their self-care behaviors. Therefore, training sessions will increase the knowledge of pregnant women, and providing timely consultations and examinations can be helpful and effective in developing oral and dental health behaviors in pregnant women.

An application of a series of theory-based educational intervention based on the health belief model on skin cancer prevention behaviors in female high school students.

Background: Cancer is a leading cause of death globally and the second cause of death in developed countries. Having a rising incidence, skin cancer is the most prevalent cancer in Iran. Long-term UV radiations, particularly during childhood and adolescence, is a major cause of skin cancers. The Theory of Planned Behavior as the most precise indicator of behavior, contains motivational factors affecting behavior. This theory has been successful in predicting factors related to chronic diseases, especially cancer. As this model was successful in assessing sun-protective behaviors in previous studies, this study was designed to figure out how a theory-based educational intervention can affect the skin cancer prevention practices of Iranian female high school students. Methods: This experimental investigation was carried out 2019-2020 using multistage cluster sampling method on 400 female high school students in Fasa, Fars, Iran. A questionnaire consisting of demographic data and a questionnaire including the components of the Theory of Planned Behavior was used to assess skin cancer preventative behaviors of both the trial and control groups of the study. An educational program based on the Theory of Planned Behavior was held for the experimental group for eight weeks regarding skin cancer preventive behaviors. The two groups completed questionnaires three months following the intervention for a second time. Results: The study's findings revealed that prior to the intervention, there was no considerable distinction between the two study groups with regard to knowledge, attitude, subjective norms, perceived behavioral control, behavioral intentions, and skin cancer prevention behaviors; yet, three months later, the experimental group demonstrated increases in each of the mentioned variables with a significant difference. In contrast, the control group showed no discernible difference. Conclusions: The findings of this investigation highlighted the success of the Theory of Planned Behavior for designing educational interventions aimed at encouraging skin cancer prevention in a population of female high school students.

Investigating the factors affecting health care workers' intention to remain in villages.

Background: Settlement in a village and being native is one of the special conditions for choosing to be a health care worker as they must be accessible day and night and provide people with health services when needed. The aim of this study was to investigate the factors affecting health care workers' intention to remain in villages covered by Jundishapur University, Ahvaz, Iran. Methods: This is a cross-sectional study in 2019. The total number of health workers working at Ahvaz Jundishapur University of Medical Sciences and Health Services, Iran was 1034, amongst whom 280 individuals participated in this study. The data collection tool was a questionnaire consisted of two parts, in the first part of which there were 11 questions on personal information of the participants. In the second part, a total of six measures (physical, social, educational and cultural, occupational, welfare, personal and family) were used to examine the factors affecting the health workers' intention to remain in rural areas. Results: The results of this study showed that the current residence of 55% of the health workers was villages while 45% of them lived in urban areas. The results indicated that there was a significant relationship between physical, social, educational and cultural, occupational, welfare, personal and family factors and the health workers' intention to remain in rural areas. Besides, female HCWs were more affected by personal and family factors compared to the male participants. Conclusion: Increasing the quality and paying more attention to physical, social, educational and cultural, occupational, welfare, personal and family factors can cause health workers to remain longer in rural areas.

Effect of educational intervention based on health belief model on nurses' compliance with standard precautions in preventing needle stick injuries.

BACKGROUND: The increasing prevalence of needle stick injuries among nurses and the arising risks double the need to pay attention to improve their knowledge and change their behavior using effective educational models. The present study aimed to investigate the effect of educational intervention based on the health belief model on nurses' compliance with standard precautions in preventing needle stick injuries. METHODS: This quasi-experimental study was conducted on 110 nurses working in medical training centers in Shiraz and Fasa in 2019. Subjects were selected using a simple sampling method and were randomly divided into two interventions (n = 55) and control (n = 55). The intervention included 7 sessions of 50-55 min. Before and 3 months after the intervention, the health belief model questionnaire was completed by both groups. The data were analyzed using SPSS software version 22 through chi-square, independent, and paired t-tests (P < 0.05). RESULTS: Based on independent and paired t-tests, there was no significant difference between the control and intervention groups regarding the mean score of health belief model constructs before the intervention. However, there was a significant difference regarding the mentioned scores 3 months after the educational intervention. Based on the paired t-test, the mean score of awareness, perceived sensitivity, perceived severity, perceived benefits, self-efficacy, cues to action, and behavioral performance in the intervention group significantly increased after the educational intervention (P < 0.05). Also, there was a significant decrease in perceived barriers (P < 0.05). CONCLUSION: It is recommended to apply the proposed model as an effective and cost-effective method along with other methods in training programs for nurses and other health workers exposed to invasive procedures, contaminated blood, and secretions.

Effect of educational intervention based on theory of planned behaviour on promoting preventive behaviours of oral cancer in rural women.

BACKGROUND: Oral cancer has created an alarming situation around the world, and being the 16th most common cancer worldwide, it has become a global concern. The present study aimed to investigate the effect of educational intervention based on a theory of planned behavior (TPB) on promoting preventive behaviors of oral cancer in rural women. METHODS: This quasi-experimental study was conducted on 120 female hookah users referring to rural health centers in Fasa and Shiraz city, Fars province, Iran. The subjects were divided into experimental and control groups by simple random sampling. The educational intervention for the experimental group consisted of 8 training sessions of 50 min. Both groups completed a questionnaire including demographic characteristics and constructs of TPB before and four months after the educational intervention. Data were analyzed using SPSS 22 software through independent t-test, chi-square, and paired t-test (p = 0.05). RESULTS: The mean age of the experimental and control group subjects were 41.12 ± 8.86 and 40.63 ± 9.62 years, respectively (p = 0.185). The mean age of onset of hookah use in the experimental and control group was 24.16 ± 9.50 and 23.35 ± 9.44 years, respectively (p = 0.182). Also, before the educational intervention, there was a significant difference between the experimental and control groups in terms of knowledge (p < 0.189), attitude (p < 0.122), perceived behavioral control (p < 0.142), subjective norms (p < 0.236), behavioral intention (p < 0.126), oral cancer prevention behaviors (p < 0.108) and nicotine dependence (p < 0.218); however, four months after the educational intervention, there was a significant increase in the experimental group in all variables except nicotine dependence (p < 0.005). CONCLUSION: Due to the alarming situation of oral cancer and the prevalence of hookah use among women, educational programs based on TPB could effectively prevent hookah use and oral cancer.

Effect of educational intervention based on protection motivation theory on preventive behaviors of respiratory infections among hospital staff.

Background: Hospital staff represent a vulnerable population for respiratory diseases. Consequently, the implementation of training programs becomes imperative as a preventive measure against such infections in these populations. The current study was conducted to examine the impact of an educational intervention based on the Protection Motivation Theory (PMT) on preventive behaviors for respiratory infections among a group of hospital staff. Methods: This experimental study involves a sample of 150 hospital staff from Gachsaran City, Iran, in 2021-2022. The sampling technique involved the utilization of a random assignment approach to allocate individuals into two distinct groups: the experimental group, consisting of 75 participants, and the control group, also including 75 individuals. The data collection instrument was a questionnaire designed in accordance with the PMT. This questionnaire was administered to both the experimental and control groups prior to the intervention as well as two months following the intervention. The intervention program consisted of a total of five sessions, each lasting for 60 min, for the experimental group. These sessions were conducted on a weekly basis over a period of two and a half months. Specifically, there were two sessions held every month and one session held every two weeks. Following the completion of the program, the data was entered into SPSS-24 statistical software for analysis using paired t-tests, independent t-tests, and chi-square tests. Results: The results indicated that prior to the intervention, there was no significant difference between the two groups in terms of perceived vulnerability constructs (p = 0.25), perceived severity (p = 0.63), perceived response (p = 0.32), and perceived reward (p = 0.11). Besides, there was no considerable distinction in perceived self-efficacy (p = 0.84), perceived response cost (p = 0.33), fear (p = 0.45), behavior motivation (p = 0.51), knowledge (p = 92), or vaccination behavior (p = 0.12) before the educational intervention. However, a significant change was noticed in each of the mentioned variables between the two groups after the intervention (p < 0.05). Conclusion: The results of this study indicated that the implementation of an educational intervention grounded in the PMT yields positive outcomes in enhancing preventative behaviors pertaining to respiratory infections. Hence, it is recommended to utilize an intervention grounded in this theory among hospital staff as a viable approach to mitigating the occurrence of respiratory infections.

Suicide attempts and related factors in patients referred to Gachsaran Hospital, Iran.

Background: Suicide is considered as an important, widespread phenomenon in the world, causing numerous deaths annually. This study is going to investigate how suicidal attempts are affected by several demographic and other underlying factors. Objective: The present study was designed to investigate suicide attempts and its related factors in patients referred to Gachsaran Hospital, Iran. Materials and methods: This cross-sectional study was conducted on 348 people who had attempted suicide (Please note that 348 was the number of suicidal attempts not the number of suicidal deaths). The data were collected by consent of Shiraz University of Medical Sciences and necessary coordination with the Emergency Management Statistics Center of Shahid Rajaee Hospital in Gachsaran city. The data analysis was performed through the logistic regression test using SPSS software version 19. The significance level was considered 0.05. Results: A total of 348 individuals with a mean age of 23.9 ± 8.1 had attempted suicide in Gachsaran. Of these, 185 were female (53.2%) and 163 were male (46.8%). The results of multivariate regression showed that, after controlling the effect of probable confounding variables, the following variables had a significant relationship with suicide attempts in the individuals who had attempted to suicide: male gender, unemployment, and love problems. Conclusion: Considering the high rate of suicide attempts among unemployed male individuals during one year, counseling centers in Gachsaran city should pay special attention to this group of people. Measures such as creating jobs for young people can help prevent this social dilemma.

The effect of educational intervention based on theory of planned behavior on mothers' skills in sexual care of children.

BACKGROUND: The parent's and especially the mothers' skills play a major role in the the education of healthy sexual behaviors in children. This study investigates the effect of educational intervention based on the Theory of Planned Behavior (TPB) on mothers' skills in the sexual care of children in Fasa city, Fars province, Iran in 2019. METHODS: This study was a quasi-experimental intervention with a control group. 200 mothers of children aged 5 to 6 years in Fasa preschool were selected using a multi-stage random sampling method and were divided into two groups of intervention (100) and control (100). After providing a pre-test to both groups, only the experimental group received training on sexual care of children's abilities based on the Theory of Planned Behavior constructs. The educational intervention consisted of seven 55-60-minute sessions in which the presenter gave a presentation, asked and answered questions, and used posters, brochures, films, animations, and PowerPoints. Both groups completed the questionnaire three months following the intervention. A questionnaire and Theory of planned behavior constructs were used to collect information. The data was analyzed with SPSS22 software using paired t-tests, Chi-square tests, and independent t-tests, with a significance level of 0.05. RESULTS: Before the intervention, there was no significant difference in the constructs of theTheory of planned behavior between the two groups (p>0.05), but after the intervention, knowledge scores from 8.33±2.97 to 20.67±2.84, attitude scores from 29.80±4.27 to 62.22±4.34, subjective norms from 20.12±4.55 to 42.28±4.20, perceived behavioral control from 20.24±4.36 to 42.88±4.52, behavioral intention from 3.24±1.60 to 7.44±1.59 and behavior from 2.98±1.13 to 8.14±1.08 in the intervention group (p< 0.001). CONCLUSION: This study showed TPB constructs' Effectiveness in adopting the level of mothers' skills in the sexual care of children. Hence, this model can act as a framework for designing and implementing educational interventions for the sexual care of children.

Exploring the challenges to telephone triage in pre-hospital emergency care: a qualitative content analysis.

BACKGROUND: One of the important indices for the efficacy of pre-hospital emergency services is telephone triage. The dispatching team members are faced with many challenges in telephone triage which can adversely affect their performance. This study was conducted in the south of Iran to determine the challenges to telephone triage in pre-hospital emergency services. METHOD: The present study is qualitative-descriptive where the sample was selected purposefully. Data were collected through 18 semi-structured, in-depth interviews with 18 dispatching team members in pre-hospital emergency care. The collected qualitative data were analyzed using the content analysis approach recommended by Graneheim and Lundman. RESULTS: Analysis of the data resulted in the emergence of three themes and ten sub-themes. The three main themes extracted from the data included inefficient interaction, insufficient and unreal information, and professional challenges. CONCLUSION: The dispatching unit personnel in pre-hospital emergency care are confronted with various interactional, organizational, and professional issues. Accordingly, the senior managers in emergency departments should take effective measures to remove the existing barriers toward improving the efficacy of telephone triage and, by extension, the quality of pre-hospital emergency care services.

The effect of educational intervention based on theory of planned behavior on behavioral responses of premenopausal women in prevention of osteoporosis.

BACKGROUND: Osteoporosis is one of the most prevalent bone diseases which is preventable. Implementing educational programs is an important step in prevention of chronic diseases in the community setting. One of the theories used for predicting behavior and performing educational intervention is theory of planned behavior (TPB) which predicts the intention of an individual toward doing a specific behavior. This study was conducted to assess the effect of educational intervention based on TPB on behavioral responses of premenopausal women in prevention from osteoporosis in Fasa city, Iran. METHODS: This study is a quasi-experimental study performed on 200 women aging from 35 and 55 years who referred to health centers in Fasa city; iran in 2019. Simple random sampling was applied to assign participants to control and intervention groups (100 participant for each group). Data were gathered by a "valid" and "reliable" questionnaire arranged based on the constructs of TPB, nutrition performance and physical activity. An educational program on osteoporosis prevention was conducted. educational intervention was performed in six sessions through group discussions and educational films and booklet for experimental group and then the changes in the scores of the two groups were evaluated and compared. Obtained data were analyzed by SPSS-22 software through Chi-square, independent t-test, paired t-test and ANOVA tests. RESULTS: The mean ages of studied participants in experimental and control groups were respectively 43.39 [Formula: see text] 5.20 and 42.94 [Formula: see text] 5.52. In experimental group, the average scores of knowledge [2 weeks (31.12 [Formula: see text] 4.20) and 2 months (39.04 [Formula: see text] 4.10) after educational intervention (p < 0.001)], constructs of theory of planned behavior [attitude construct: 2 weeks (89.32 [Formula: see text] 9.22) and 2 months (98.57 [Formula: see text] 9.13) after educational intervention (p < 0.001), Subjective norms construct: 2 weeks(88.39 [Formula: see text] 8.84) and 2 months (122.57 [Formula: see text] 8.58) after educational intervention (p < 0.001), Perceived behavioral control construct: 2 weeks (88.56 [Formula: see text] 8.38) and 2 months (120.15 [Formula: see text] 8.33) after educational intervention (p < 0.001), Behavioral intention construct: 2 weeks (54.44 ± 4.72) and 2 months (60.26 [Formula: see text] 4.12) after educational intervention (p < 0.001)], nutrition performance [2 weeks (19.88 ± 2.56) and 2 months (24.14 [Formula: see text] 2.36) after educational intervention (p < 0.001)] and physical activity [2 weeks (16.75 [Formula: see text] 1.42) and 2 months (18.94 [Formula: see text] 1.68) after educational intervention (p < 0.001)] had more significant enhancement than control group 2 weeks and 2 months after educational intervention. DISCUSSION: TPB was effected in nutrition performance and physical activity in osteoporosis prevention of subjects. This theory can be used as a framework for designing and performing educational intervention for preventing osteoporosis and promoting women's health.

The Effect of Educational Intervention on Knowledge, Attitude, and Practice of Women towards Breast Cancer Screening.

Background: Early identification of breast cancer may result in earlier treatment and a lower mortality rate. This fact has resulted in the development of screening programs to detect breast cancer in its early stages; thus, the current study sought to investigate the influence of educational intervention on knowledge, attitude, and practice about breast cancer screening in Izeh, Khozestan Province, Iran. Materials and Methods: This experiment was carried out on the women of Izeh city in 2019. This study included 120 women who were randomized into the experimental and control groups at random (60 in the experimental and 60 in the control groups). Before and two months after the intervention, data were collected using a researcher-created questionnaire by the control and education groups. The intervention program for the intervention group included eight educational sessions over the course of two months. The SPSS 20 statistical program was used to examine the data, as well as the paired t-test, independent t-test, and Chi-square. Results: There was no significant difference between the experimental and control groups' mean scores of knowledge, attitude, and practice prior to the educational intervention, but a significant difference was observed after the intervention, with the experimental group obtaining significantly higher mean scores of knowledge, attitude, and practice (P = 0.05). Conclusion: In the present study, the educational intervention on the knowledge, attitude, and practice towards breast cancer screening led to the increased scores of the experimental group compared to control group.

Nudging physical distancing behaviors during the pandemic: a field experiment on passengers in the subway stations of shiraz, Iran.

BACKGROUND: The possibility of the emergence of new pandemics necessitates further research into using simple strategies to promote social distancing behaviors in public. Most of the current evidence on effectiveness of physical distancing interventions is based on self-report and measure of intention which will not necessarily predict actual behavior. METHODS: A field experimental study was conducted in the subway stations of Shiraz, Southern Iran. The interventions were based on intuitions from protection motivation theory and consisted of using environmental nudges to notify the passengers of the pandemic situation (threat appeal) and a verbal advice on keeping a safe physical distance as an effective method of protection against COVID-19 (coping message). Average physical distancing was estimated as the number of steps between two consecutive passengers and was compared between interventions (n = 1045) and the control (n = 855) groups. RESULTS: A total of 1900 people riding on subway escalators were directly observed during two intervention conditions and the control condition. Under either threat or coping-based interventions, passengers were two times more likely (OR 2.0, 95%CI 1.5-2.7, P <  0.001) to keep a physical distance of at least 1.2 m from the traveler in front compared with those who did receive no intervention. The Kruskal-Wallis test revealed that there was a significant improvement in physical distancing behaviors with coping advice compared with threat appeal and the control conditions (χ2 = 120.84, df = 2, p <  0.001). CONCLUSIONS: Our findings suggest that simple and inexpensive theory-based interventions can be used in crowded public spaces to promote physical distancing within the context of the pandemic.

Faculty retention in regional medical schools in Iran: a qualitative content analysis.

BACKGROUND AND PURPOSE: Recruitment and retention of competent faculty members are important in maintaining and improving the quality of education and research performance of universities. The aim of the present study was to find out the faculty members' views, experiences, and attitudes to identify the reasons for faculty attrition and retention in regional medical schools in Iran. METHODS: In this qualitative study, we used a content analysis method. The participants included 12 faculty members who had been transferred to type I universities, four faculty members who had applied for transfer, four with more than 10 years of experience and working in the type 3 universities with no intention to be transferred. Data were collected using semi-structured interviews, which were conducted either face-to-face or via phone calls. The interview was developed for this study (Supplementary file). To measure the trustworthiness of the data, we evaluated four components of credibility, transferability, dependability, and conformability, as proposed by Lincoln and Guba. RESULTS: The findings were classified into three categories and 14 subcategories. The first category was "retention facilitators" including four subcategories of facilitated communication, proximity to major universities, gaining experience, and support by authorities. The second category was "retention threats" including six subcategories of social infrastructure, individual dimension, occupation dimension, economic dimension, sense of respect, and executive management. The third category was "retention strategies" which included four subcategories of recruitment and promotion processes, inter-university collaboration with type I universities, facilitation of the scientific growth, and fulfilment of the safety needs. CONCLUSION: Several factors play a role in the faculty members' retention in regional medical schools in Iran. Authorities can create a more positive environment by devising a suitable reward system, supporting academic activities, and increasing the level of faculty autonomy practically to develop a sense of belonging among them and reduce the intention to be transferred among their human resources.

Effect of educational intervention based on the PRECEDE-PROCEED model on preventive behaviors of cutaneous leishmaniasis among housewives.

Leishmaniasis is an endemic disease in Iran. Since education to prevent the disease is important, this study aimed to determine the effect of educational intervention based on the PRECEDE-PROCEED model on preventive behaviors of cutaneous leishmaniosis among housewives. In this quasi-experimental study, 240 housewives under the coverage of health centers, who lived in the endemic area of Mianshahr, Fasa city, Fars Province, Iran in 2016, were selected (120 people for the experimental group and 120 for the control group). The educational intervention for the experimental group was based on the PRECEDE model, which consists of seven 50-60-minute sessions of lectures, group discussions, role playing, practical displays, and video and PowerPoint displays. These sessions addressed the familiarity with cutaneous leishmaniasis and its different types and carriers, methods of preventing and fighting against it, personal protection, sanitation of the environment and drinking water, spraying of sites, use of mosquito nets, etc. Data were collected before educational intervention and three months after educational intervention. The mean age of the experimental group was 39.24±9.12 years and that of the control group was 38.84±9.28 years. Three months after the intervention, the experimental group showed a significant increase in knowledge, attitudes, reinforcing factors, enabling factors, and performance compared to the control group. The education based on enabling factors, reinforcing factors, and predisposing factors had a significant effect on the preventive behaviors of cutaneous leishmaniasis among housewives.

The performance of rural family physicians in Fars province, Iran.

BACKGROUND: Family physician (FP) program is a complete health-care system whose most important results are elimination of individuals' confusion when going to the doctor and increase in their satisfaction with health services. This study aimed to evaluate the performance, strengths, and weaknesses of FP program. MATERIALS AND METHODS: In this cross-sectional study, 52 FPs in Fars province were selected via stratified sampling and their performance was investigated. The data were collected using FPs performance questionnaire that included five domains, namely, management, performance, contract guidelines, community involvement, and outcomes. Then, the data were entered into the SPSS statistical software, version 19, and were analyzed using t-test, ANOVA, and Pearson's correlation coefficient. RESULTS: Among the 52 FPs under study, 56.9% were male and 43.1% were female. The lowest and highest scores were related to community involvement (3.93 ± 0.81) and outcomes (23.52 ± 3.04), respectively. The results showed significant relationships between most domains (P < 0.05). However, no significant correlation was found between gender and different domains (P < 0.05). CONCLUSION: Considering diverse activities done by FPs, the wide area of our country, and issues related to increasing satisfaction among physicians and individuals covered by the program, further researches are required in this area.

Catalytic ozonation process using a MgO nano-catalyst to degrade methotrexate from aqueous solutions and cytotoxicity studies in human lung epithelial cells (A549) after treatment.

Pharmaceutical compounds which enter the environment are classified as emerging pollutants. Among different drug compounds, anti-cancer drugs like methotrexate are of more concern due to their mutagenic, carcinogenic, and genotoxic properties. Therefore, the main objective of this study was to use catalytic ozonation processes (COPs) as novel advanced oxidation processes to degrade methotrexate from aqueous solutions. The calcination method was used to obtain a nitrate magnesium oxide nano-catalyst. The main variables considering the effect of single ozonation processes (SOPs) and COPs on the target pollutant were initial methotrexate concentration, contact time, solution pH, and MgO dosage. The BET results indicated that the surface area of the MgO nano-catalyst was 140.031 m2 g-1. Based on the BJH plot, the size of the MgO nano-catalyst and average pore volume were 44.5 nm and 0.4454 cm3 g-1, respectively. The weight percent of Mg and O was 61.09% and 38.91%, respectively. In acidic and alkaline pH, the degradation rate of methotrexate showed a higher increase in SOPs and COPs than at neutral pH. The degradation rate of methotrexate decreased with increasing concentration. By increasing the contact time, the degradation rate of methotrexate of both SOPs and COPs increased. Actually, the methotrexate degradation in COPs was faster than in SOPs. When using tert-butanol as a scavenger, the reduced removal efficiency in SOPs and COPs was 32% and 31%, respectively.

The Effect of Educational Program Based on PRECEDE Model in Promoting Prostate Cancer Screening in a Sample of Iranian Men.

Prostate cancer is one of the most prevalent diseases among men. This study aimed to assess the effect of educational program based on Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation (PRECEDE) model in promoting prostate cancer screening in a sample of Iranian men. This is a quasi-experimental study carried out on 300 men aged 40 to 70 (the subjects 150 experimental and 150 control groups) in Shiraz City, Fars Province, Iran, in 2016. The participants of the intervention group attended training based on the PRECEDE model. The study compared mean scores of knowledge, attitude, enabling factors, perceived social support, quality of life, general health, self-efficacy, and screening behaviors of the subjects before and 6 months after intervention in experimental and control groups. The mean age of experimental group was 56.45 ± 8.65, and the mean age of the control group was 55.64 ± 8.71 years (P = 0.521). The study showed that there was a significant increase in the mean score of knowledge, attitudes, perceived self-efficacy, enabling factors, perceived social support, quality of life, public health and screening behaviors of the experimental group; however, no significant change was observed in the mean score of knowledge, attitudes, self-efficacy, quality of life, general health, perceived social support, enabling factors, and screening behaviors of the control group. Our findings showed that the health education programs designed based on PRECEDE could positively affect prostate cancer screening behaviors of individuals by improving their knowledge level and attitude, enabling factors, perceived social support, quality of life, general health, and self-efficacy.