Background: Heavy metals are the most important factors of environmental pollution that are accumulated in soil and plant through irrigation and taking these contaminated herbs by human and animal ultimately hurt community health and cause various diseases including cancer. This study was done to determine the chromium (VI) in almond kernel and investigate almond green hull adsorption to remove this metal from the aqueous solutions. Methods: In this study, the concentration of hexavalent chromium in Birjand almond kernel using SEM and EDX imaging is investigated and its adsorption rate by almond green hull of the area through aqueous solutions was determined by changing the contact time, concentration, pH, adsorbent dose and the temperature. Chromium concentration was determined according to standard method by colorimetric method and using a UV / VIS spectrophotometer at 540 nm. Results: This study showed that irrigating agricultural land of this district does not cause the accumulation of hexavalent chromium in almond kernel. Removal of hexavalent chromium is also highly dependent on pH of the solution so that, the results indicate a high removal at pH=2. Also, with increasing adsorbent dosage, contact time and temperature, the removal rates increased and because of the limited sites in the adsorbent, by increasing the initial concentration of chromium, the removal efficiency decreased. Conclusions: Cr (VI) was not observed in almond kernel, although almond green hull removes this metal effectively from aqueous solutions.

Background: The aim of the present study was to analyze antibiotic susceptibility profileand genetic diversity of L. monocytogenes, isolated from chicken carcasses using RAPD-PCR. Methods: In this study, 26 isolates of Listeria monocytogenes recovered from chicken carcasses were used. Antibiotic susceptibility of these isolates were examined for eleven antimicrobial agents and RAPD-PCR with use of three different primers were applied to detect genetic diversity of the isolates. Results: Some of the isolates showed multidrug resistance to commonly used antibiotics. Totally, 26 L. monocytogenes isolates had 16 different antibiogram patterns. Isolates of A and B clusters showed 7 and 6 different pattern, respectively. 12 Isolates of cluster C showed 7 different pattern. Conclusions: Some of isolates had multidrug resistance to antibiotics. This may raise a public health hazard. RAPD-PCR showed that L. monocytogenes isolated from chicken carcasses had low genetic diversity and there was no clonalrelationship between the isolates.

Background: The increase in the amount of phosphate in aquatic environments disrupts the balance of the growth of aquatic organisms and causes serious environmental problems. The aim of this study is to investigate the removal of phosphate ion using powdered activated carbon coated with magnetic iron nanoparticles. Methods: For this purpose, the synthesis of nanoparticles was carried out through co-precipitation mechanism and the effects of various parameters including the amount of adsorbent dose, pH, initial concentration, temperature, contact time, and also the effect of interaction ions on adsorption performance were evaluated in a batch system. Then, the study of Kinetics and isotherms was performed on the obtained data. To determine the characteristics of the produced nanoparticles, scanning electron microscopy, X-ray Diffraction and infrared spectroscopy were used. Results: The results showed that the maximum adsorption (100%) happened in pH=4 after 90 min of the contact between the solution and the adsorbent. experimental data also matched the Langmuir isotherm. Conclusions: According to the results obtained, as an eco-friendly adsorbent, the powdered activated carbon sorbent coated with magnetic iron nanoparticles has a desirable capability in removal of phosphate.

Background: The increase in the amount of phosphate in aquatic environments disrupts the balance of the growth of aquatic organisms and causes serious environmental problems. The aim of this study is to investigate the removal of phosphate ion using powdered activated carbon coated with magnetic iron nanoparticles. Methods: For this purpose, the synthesis of nanoparticles was carried out through co-precipitation mechanism and the effects of various parameters including the amount of adsorbent dose, pH, initial concentration, temperature, contact time, and also the effect of interaction ions on adsorption performance were evaluated in a batch system. Then, the study of Kinetics and isotherms was performed on the obtained data. To determine the characteristics of the produced nanoparticles, scanning electron microscopy, X-ray Diffraction and infrared spectroscopy were used. Results: The results showed that the maximum adsorption (100%) happened in pH=4 after 90 min of the contact between the solution and the adsorbent. experimental data also matched the Langmuir isotherm. Conclusions: According to the results obtained, as an eco-friendly adsorbent, the powdered activated carbon sorbent coated with magnetic iron nanoparticles has a desirable capability in removal of phosphate.

Background: The increase in the amount of phosphate in aquatic environments disrupts the balance of the growth of aquatic organisms and causes serious environmental problems. The aim of this study is to investigate the removal of phosphate ion using powdered activated carbon coated with magnetic iron nanoparticles. Methods: For this purpose, the synthesis of nanoparticles was carried out through co-precipitation mechanism and the effects of various parameters including the amount of adsorbent dose, pH, initial concentration, temperature, contact time, and also the effect of interaction ions on adsorption performance were evaluated in a batch system. Then, the study of Kinetics and isotherms was performed on the obtained data. To determine the characteristics of the produced nanoparticles, scanning electron microscopy, X-ray Diffraction and infrared spectroscopy were used. Results: The results showed that the maximum adsorption (100%) happened in pH=4 after 90 min of the contact between the solution and the adsorbent. experimental data also matched the Langmuir isotherm. Conclusions: According to the results obtained, as an eco-friendly adsorbent, the powdered activated carbon sorbent coated with magnetic iron nanoparticles has a desirable capability in removal of phosphate.

Background: The increase in the amount of phosphate in aquatic environments disrupts the balance of the growth of aquatic organisms and causes serious environmental problems. The aim of this study is to investigate the removal of phosphate ion using powdered activated carbon coated with magnetic iron nanoparticles. Methods: For this purpose, the synthesis of nanoparticles was carried out through co-precipitation mechanism and the effects of various parameters including the amount of adsorbent dose, pH, initial concentration, temperature, contact time, and also the effect of interaction ions on adsorption performance were evaluated in a batch system. Then, the study of Kinetics and isotherms was performed on the obtained data. To determine the characteristics of the produced nanoparticles, scanning electron microscopy, X-ray Diffraction and infrared spectroscopy were used. Results: The results showed that the maximum adsorption (100%) happened in pH=4 after 90 min of the contact between the solution and the adsorbent. experimental data also matched the Langmuir isotherm. Conclusions: According to the results obtained, as an eco-friendly adsorbent, the powdered activated carbon sorbent coated with magnetic iron nanoparticles has a desirable capability in removal of phosphate.

Background: Crimean-Congo hemorrhagic virus fever is an acute febrile haemorrhagic disease mainly transmitted from animals to men by tick bites. There is the risk of disease transmission in humans during the slaughter of infected animals or a short period after that, following the contact with the skin or carcasses of the animal. Since rural women are the first group who are at risk of developing the disease, this study tried to determine the effect of education based on Health Belief Model on preventive behaviors against Crimean-Congo haemorrhagic fever in rural women. Methods: This randomized controlled field trial was carried out on 138 rural women who were divided randomly into intervention and control groups. The intervention group members participated in an educational program designed based on Health Belief Model which contained five training sessions in the form of lecture together with group and panel discussion. The data collection tool was a researcher-made questionnaire consisting of 8 parts including demographic characteristics and health belief model constructs, which was completed by the researcher before, immediately after, and three months after the intervention. Data analysis was conducted using SPSS software, version 19. Independent t-test, analysis of repeated variance, and post hoc Bonferroni test were used to compare the mean score of knowledge and model constructs and to compare the mean changes in the two groups before, immediately after, and three months after the intervention. Results: Before the intervention, the mean score of knowledge and health belief model constructs had a significant difference between intervention and control groups in the constructs of knowledge (p=0.005), guide to action (p=0.001), and behavior (P<0.001), but there was no significant difference in other constructs. In the intervention group, a significant difference in mean scores of different constructs was observed before, immediately after, and three months after intervention, while in the control group, no significant difference was observed in most of the aspects of the model. Conclusions: Considering the positive influence of the education which is based on this model on the behaviors associated with Crimean-Congo haemorrhagic fever, it is suggested that this theory be used in preventive education programs against Crimean Congo haemorrhagic fever.

Background: Crimean-Congo hemorrhagic virus fever is an acute febrile haemorrhagic disease mainly transmitted from animals to men by tick bites. There is the risk of disease transmission in humans during the slaughter of infected animals or a short period after that, following the contact with the skin or carcasses of the animal. Since rural women are the first group who are at risk of developing the disease, this study tried to determine the effect of education based on Health Belief Model on preventive behaviors against Crimean-Congo haemorrhagic fever in rural women. Methods: This randomized controlled field trial was carried out on 138 rural women who were divided randomly into intervention and control groups. The intervention group members participated in an educational program designed based on Health Belief Model which contained five training sessions in the form of lecture together with group and panel discussion. The data collection tool was a researcher-made questionnaire consisting of 8 parts including demographic characteristics and health belief model constructs, which was completed by the researcher before, immediately after, and three months after the intervention. Data analysis was conducted using SPSS software, version 19. Independent t-test, analysis of repeated variance, and post hoc Bonferroni test were used to compare the mean score of knowledge and model constructs and to compare the mean changes in the two groups before, immediately after, and three months after the intervention. Results: Before the intervention, the mean score of knowledge and health belief model constructs had a significant difference between intervention and control groups in the constructs of knowledge (p=0.005), guide to action (p=0.001), and behavior (P<0.001), but there was no significant difference in other constructs. In the intervention group, a significant difference in mean scores of different constructs was observed before, immediately after, and three months after intervention, while in the control group, no significant difference was observed in most of the aspects of the model. Conclusions: Considering the positive influence of the education which is based on this model on the behaviors associated with Crimean-Congo haemorrhagic fever, it is suggested that this theory be used in preventive education programs against Crimean Congo haemorrhagic fever.

Background: Low birth weight is a major indicator of health assessment in neonates and infants and is associated with increased morbidity and mortality of infants. Low birth weight of newborns can be prevented by identification and control of the associated risk factors. This study aimed to investigate factors associated with low birth weight of newborns in the city of Birjand. Methods: This case-control study incorporated babies born in Birjand in 2015. Newborns weighing less than 2500 grams (N=140) were considered as the case group and those weighing more than 2500 g were regarded as the control group. For every member of the case group, two controls that were closest to birthdate of the case were selected from the Office of Continuous Care for Under One Year Infants. The data obtained were analyzed in SPSS-16, and the significant level was considered at a=0.05. Results: The chance of low birth weight in women with a history of low birth weight labor was 3.54 times greater than other women. The chances were 28.38 and 9.44 times greater in mothers with pluriparity and hypertension, respectively. However, parity rank, interval from previous delivery, type of birth, season of birth, abortion history, gestational diabetes, and preeclampsia were not significantly associated with the incidence of low birth weight. Conclusions: As low birth weight is associated with some preventable factors, measures such as training people, especially women and young girls, and provision of quality care during pregnancy are recommended, especially in the case of high risk pregnancies.

Background: Marital satisfaction is a lofty objective in the realization of a desirable family and acts as a fundamental contributor to the health and development of family members. One of the most important factors influencing marital satisfaction is attachment style. This study aimed to determine the relationship between attachment style and marital satisfaction in housewives. Methods: This cross-sectional study was conducted on 200 housewives referring to health centers of Birjand in 2016. The participants were selected by stratified cluster sampling method. The data collection instruments consisted of the standardized Marital Satisfaction Questionnaires and Collins and Read’s Adult Attachment Style Scale. The data were analyzed in SPSS software (version 19) using descriptive statistics and one-way ANOVA, Pearson correlation coefficient, and stepwise regression analysis. The significant level was set at values lower than 0.05. Results: The anxious attachment style (R=0.28) and avoidant attachment style (R=0.32) were predictors of marital satisfaction. There was a significant negative correlation between marital satisfaction and anxious attachment style (r=0.289), while the correlation between marital satisfaction and avoidant attachment style was significantly positive (r=0.183). Conclusions: As attachment styles are contributory to marital satisfaction, counselors can build on couple therapy approach to have an effective role in modifying attachment styles of the couple and solving their conflicts both before and after marriage.

Background: Breast cancer is the most common type of cancer among women worldwide. Given its low cost, wide availability, and lack of need for complex training, breast self-examination has turned into an important tool for early detection of cancer, especially in developing countries. This study aimed to determine the housewives’ awareness of breast self-examination, stages of change of BSE behavior, and the related factors among women referring to health centers of Birjand city in 2016. Methods: This descriptive, analytic study was conducted on 450 housewives aged between 20 to 40 years referring to healthcare centers of Birjand. Sampling was performed through multistage cluster sampling method. The data were collected using a researcher-made questionnaire which included a demographic characteristics section and various items on knowledge and stages of change. The validity and reliability of the questionnaire were confirmed. The data were analyzed in SPSS-19 using descriptive and inferential statistical tests. Results: Mean age of the participants was 30.7±5.2 years and 97.8% of them were married. According to behavior change stages, 32.9% of the participants were in the pre-contemplation stage, while 19.68%, 23.3%, 18.2% and 6% were respectively in contemplation, preparation, action, and maintenance stages. The mean awareness score was 6.72±2.49. Fisher exact test showed a significant relationship between the stages of change with the level of education (P=0.001), family history of breast cancer (P=0.03), and awareness (P<0.001). Conclusions: Given the low performance of women in breast self-examination, it is required on the part of health authorities to plan and implement the needed educational interventions.

Background: Exposure to chemicals and air pollutants is an important factor of health threat for workers. The present study was conducted with the aim to investigate the relationship between Arsenic metal ions in the air and that of extracted from simulated alveolar fluid. Methods: In this cross-sectional study, personal and environmental sampling was performed according to OSHA standard and leaching testing was conducted in similar conditions of the lungs [pH=7.4, temp. 37?c, Co2=5 %] to measure the rate of solubility. Measurement was done by means of the atomic absorption apparatus, Model Spec AA 220 with a graphite furnace Model GTA 110. Data processing was done by using the SPSS statistical software. Results: The concentration of arsenic metal ion in the air was 0.0078±0.0014 mg/m3. That is lower than the allowable rate (0.01 mg/m3). The amount of metal ions in sustained particles of the environment air was 51.4±4.68 µg/g dust and that of extracted with simulated alveolar fluid in extra corporeal condition was 0.013±0.004 µg/g dust. Pearson correlation test did not reveal any significant relationship between them (p>0.05). Conclusions: Since there was no significant relationship between arsenic metal ion in the air and that of extracted from alveolar fluid and also the solubility of this metal ion depends on many factors, therefore, these findings can be the basis of further deep and precise studies in future.

Background: While maternity can stand as an enjoyable and evolutionary events in their life, this new period can be associated with worry and anxiety for some women. Anxiety in pregnancy can lead to various and irreversible complications. This study aimed to investigate pregnancy anxiety and related factors among pregnant women referred to Birjand-based healthcare centers. Methods: This cross-sectional study was performed on 380 pregnant women referred to healthcare centers in Birjand in 2016. The participants were selected by multistage random sampling method. Data were collected by demographics and disease records forms, questionnaire of personal information and records of pregnancy, Pregnancy–Related Anxiety Questionnaire (PRAQ) and Marital Satisfaction Questionnaire (MSQ). The collected data were analyzed in statistical software SPSS (version 15) using independent t-test, one-way ANOVA, Tukey and Pearson correlation coefficient. P values lower than 0.05 were considered significant. Results: Pregnancy anxiety mean score was 3.77±1.13 (range: 1-7). Pregnancy anxiety total score and some of its subscales correlated significantly with age, maternal education, spouses education, parity, income, and mother and spouse’s occupation (P<0.05). There was a significant negative correlation between marital satisfaction and anxiety in pregnancy and all its subscales (P<0.05). No significant association was found between pregnancy anxiety and its subscales and the type of pregnancy (planned or unplanned), sex of the fetus, and housing status (P>0.05). Conclusions: Considering the high prevalence of anxiety in pregnancy and the impact of various factors on it, it is necessary to highlight the importance and emphasis on psychiatric care during pregnancy and inclusion of training on mental health of pregnant women in routine care during pregnancy and, hence, a step towards increased health of the mother and babies, and ultimately, the health of families and communities. Therefore, vulnerable mothers should be identified and cared for both mentally and psychologically so that pregnancy anxiety can be prevented.

Background: Pay attention to phenol is important because of its sustainability in the environment and creating health problems. Due to the high solubility of phenol in water, it must be removed in order to prevent contamination of water resources and the environment. The aim of this study is to assess the efficacy of M. azedarach seed ash for removal of phenol from aqueous solutions. Methods: In this experimental study, M. azedarach seed ash was used for removal of phenol from aqueous solutions. In this study, the effect of the factors affecting adsorption was studied, including adsorbent dosage, initial phenol concentration, contact time, pH and temperature. Data obtained from the tests were analyzed using Excel software. Langmuir and Freundlich isotherm models were employed to verify compliance of absorption process from the isotherm models. Results: Experimental results indicated that the efficacy of M. azedarach seed ash for removal of phenol had a direct relationship with increasing adsorbent dosage, temperature and contact time, as well as an inverse relationship with increasing pH and initial phenol concentration. According to the correlation coefficient of adsorption isotherm models, adsorption of phenol followed the Freundlich model. Conclusions: The results of the present study showed that M. azedarach seed ash is effective for removal of phenol from aqueous solution. Given the ability to grow of M. azedarach tree in hot and dry climates, it can be used as an inexpensive and accessible adsorbent.

Background: Work related musculoskeletal disorders (WMSDs) among dentists that caused due to physical conditions during dental procedures have become a serious health threat and impose many complications and heavy costs to the dentist and thus the community. In order to avoid these complications it is necessary the causative and predisposing factors to be known and be tackled. Objective: This study deals with the prevalence of musculoskeletal disorders (MSDs) and related factors among dentists Methods: In this cross - sectional study, 116 dentists who were attended in a national continuing education program were participated. The data gathered trough a questionnaire and then were entered into SPSS 18 software and were analyzed using descriptive statistics and Mann-Whitney and Kruskal-Wallis tests at 0.05 significant levels. Results: 116 Dentist with an average working experiences of 11.7±7.2 years participated in the study. 50% were male and the others were female.87 dentists (75%) had MSDs. The highest affected body part were in order the neck (56.9%) shoulders (43.1%), back (43.1%)hand/wrist (28.4%) and hand/ fingers (26.7%). The average number of MSDs in each dentist was 2.71±2.1. 34.5% were currently under treatment. Data analysis revealed no significant differences in MSDs based on gender, work experience; work hours per day, using the dental assistant and the exercise. Conclusions: Considering the high prevalence of MSDs among dental practitioners and lack of knowledge with ergonomic principles, it seems that more attention should be done in college educations and holding retraining courses for dentists to adopt with ergonomics and getting familiar with the new materials and modern equipment.

Background: Students are highly tended to consume junk foods. This study aimed to predict the consumption of low-nutrient junk foods based on the constructs of the Theory of Planned Behavior among male students across Chenaran city in 2015. Methods: This descriptive-analytic study incorporated 143 eighth-grade students who were selected via simple randomization method. They completed the relevant questionnaire. The data were analyzed in SPSS (version 18) using one-way analysis of variance, regression analysis, and Pearson correlation test. Significance level was 0.05. Results: The junk foods most frequently consumed comprised of chocolate, cake, and fizzy drinks. Results indicated that subjective norms and perceived behavioral control could predict 9 percent of changes in low-nutrient junk food consumption. From among the constructs of the theory of planned behavior, attitude, subjective norms, and perceived behavioral control are able to predict 16 percent of behavioral intention changes. Conclusions: Given the tendency of students towards the consumption of low-nutrient junk foods, administration of theory-based educational interventions such as the theory of planned behavior seems necessary.

Background: Health literacy is today viewed as a global issue. Health literacy is the capacity of each individual to obtain, process, and understand basic health information and health services required to make appropriate decisions. Regarding the importance of health literacy in the population covered by family physicians and the limited number of studies in this regard in Iran, this study aimed to determine the status of health literacy in the population covered by family physicians in Askarieh rural health center in 2016. Methods: This cross-sectional, analytical study was conducted in 2016 on 260 clients who were referred to Askarieh rural health centers. A valid and reliable, 49-item, researcher-made questionnaire on health literacy was completed via interview. Data was analyzed in SPSS16 software using t-test, Pearson correlation, one-way ANOVA and multivariate analysis of variance tests. The significance level was considered less than 0.05. Results: The mean age of participants was 31.78±10.66 years, 73.5% were female, and 86.9% married. From among them, 61.5% held secondary and high school diploma degrees and 59.6% had a moderate family income. The results showed that 26.9% had adequate health literacy. Also, women enjoyed a higher health literacy than men (P=0.03) and individuals with higher levels of education had higher health literacy (P=0.008). Conclusions: A higher level of health literacy reduces the cost of treatment on the government and people. Given the importance of health literacy, it is recommended that healthcare authorities design educational interventions to improve health literacy, particularly among men and individuals with low literacy levels.

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Background: Reactive dyes are extensively used in the textile industry due to their superior performance. However, the effluence of the waste containing such dyes into water resources can pose hazardous effects on the environment because of their carcinogenic, mutagenic, allergenic and toxic nature. This study explored the efficiency of the ultrasonic process in removing Reactive Red 198 dye from aqueous solutions. Methods: This research is a laboratory, experimental study carried out in the Environmental Health Engineering Research Center of Birjand University of Medical Sciences. Two ultrasonic devices with a constant frequency and adjustable temperature and time were applied. The effects of various operating parameters and optimal conditions for removal such as initial concentration of dye (20-200 mg/L), contact time (1-90 mines), temperature (20-50 oC), frequency (35,37 kHz) and pH (2-12) were investigated. Results: The mean efficiency rate of removing Reactive Red 198 dye in optimal conditions (with primary dye concentration of 20 mg/L, pH=3, retention time=50 min, temperature=50 oC) at a frequency of 37 kHz obtained 84.82%. This result at the frequency of 35 kHz was 82.6%. The minimum removal at a frequency of 35 kHz with a concentration of 200 mg per liter at a pH of 12 and a retention time of 1 minute was 29.35 and at the frequency of 37 kHz, it was 39.12. Conclusions: The results showed that the ultrasonic process has a high capacity to remove Reactive Red 198 dye from aqueous solutions. Besides, this procedure can prove more efficient in case the effective operational factors are optimized.

Background: Pay attention to phenol is important because of its sustainability in the environment and creating health problems. Due to the high solubility of phenol in water, it must be removed in order to prevent contamination of water resources and the environment. The aim of this study is to assess the efficacy of M. azedarach seed ash for removal of phenol from aqueous solutions. Methods: In this experimental study, M. azedarach seed ash was used for removal of phenol from aqueous solutions. In this study, the effect of the factors affecting adsorption was studied, including adsorbent dosage, initial phenol concentration, contact time, pH and temperature. Data obtained from the tests were analyzed using Excel software. Langmuir and Freundlich isotherm models were employed to verify compliance of absorption process from the isotherm models. Results: Experimental results indicated that the efficacy of M. azedarach seed ash for removal of phenol had a direct relationship with increasing adsorbent dosage, temperature and contact time, as well as an inverse relationship with increasing pH and initial phenol concentration. According to the correlation coefficient of adsorption isotherm models, adsorption of phenol followed the Freundlich model. Conclusions: The results of the present study showed that M. azedarach seed ash is effective for removal of phenol from aqueous solution. Given the ability to grow of M. azedarach tree in hot and dry climates, it can be used as an inexpensive and accessible adsorbent.

Background: Oral and dental diseases have detrimental effects in childhood and old age alike and account for 5 to 10 percent of all health costs. As Stages of Change Model shows the present state of an individual’s behavior and intention to change behavior, this study tried to determine Stages of Change of tooth decay preventive behaviors and its association with knowledge and attitudes of elementary school students in Nehbandan city. Methods: This descriptive-analytical study was performed on 414 fifth and sixth grade students of Nehbandan city. From among 13 primary schools (8 girl schools and 5 boy schools), 32 students of the fifth and sixth grades were recruited using randomized cluster sampling method. The data were collected through a pre-made valid and reliable questionnaire covering demographic characteristics, knowledge, attitude, and Stages of Change of the behavior. The collected data were analyzed in SPSS-18 using descriptive and inferential statistical tests. Results: The mean age of participants was 11.48±0.79 years. The results of the study concerning the Stages of Change of tooth decay preventive showed that in terms of applying dental floss, the brushing teeth, using mouthwash , regular visit to the dentist, and reducing consumption of sugary foods, the most students were at the stages of readiness (34.1%), action (27.8%), pre-contemplation (30.4%), maintenance (26.9%), and contemplation (30.4%) respectively. The mean score of the students’ knowledge about preventive behaviors against tooth decay was 6.14±2.1 out of 11, and the mean score of the students’ attitude towards tooth decay preventive behaviors was 24.48±6.4 out of 60. Based on the Kruskal-Wallis test, there was a significant difference in the mean knowledge scores based on the stages of change of using dental floss (P<0.001), brushing teeth (P=0.004), using mouthwash (P<0.002), and reducing sugary food consumption (p=0.005). Based on the Kruskal-Wallis test, there was a significant difference in the mean Attitude scores based on the stages of change of using dental floss (P<0.001), brushing teeth (P<0.001), using mouth wash (P=0.003), in terms of regular visit to the dentist (P=0/001) and reducing sugary food consumption (p<0.001). The mean value for each of the behaviors was the highest in the stages of contemplation, pre contemplation, pre contemplation,action, , per contemplation. Conclusions: The findings of the study showed that the majority of the students were in the non-active stage of behaviors and probably, in the future, they will be susceptible to more dental decay. Trans-theoretical model can be used to determine the strategies related to each of the stages of change of oral and dental self-care behaviors in order to improve and maintain the behavior in interventions and educational programs.

Background: Transtheoretical Model (TTM) is a new approach to the treatment of addiction. The purpose of this study was to investigate the efficacy of TTM in reducing depression by a pornography mediator variable. Methods: In this quasi-experimental study 72 homosexual males with methamphetamine dependents in Tehran by pretest and posttest were recruited from 15 December 2014 to 20 November 2015 during a seasonal meeting. They were selected by snowball method from among those who obtained the highest scores in the index of pornography (response rate=94%). They were subsequently assigned into experimental (3 levels) and control (3 levels) groups based on the three levels of pornography, i.e., low, moderate and high. The TTM-based intervention was presented to the experimental groups for 12 weeks, and the control groups were placed on the waiting list. The data were collected via a researcher-made demographics form, Beck Depression Scale, and the Stages of Change Readiness and Treatment Eagerness Scale. The data were analyzed using Two-factor analysis of variance (ANOVA) and Scheffe post hoc test in the IBM SPSS Software Version 20 (IBM Corp., Armonk, NY, USA). Results: The TTM-based intervention had a significant impact on the two depressive groups who had moderate (p<0.05) and low (p<0.01) pornography use, but it had no significant effect on high-pornography index (p>0.05). Also, Chi-square test showed that only groups to lower pornography indices had a significant difference in the stages of change. Conclusions: While having applicability in this area, the findings of this study can be helpful in planning supplementary remedial procedures and can help practitioners for better interventions in order to fulfill the needs of individuals depression.

Background: Healthy nutrition is part of a healthy lifestyle. A healthy diet can lead to physical and mental health in people. In recent years, a great deal of attention has been paid to good nutrition as a development index and to women as breeders of the next generation. Most organizations, including the World Health Organization and UNICEF, have highlighted health as one of their priorities with an emphasis on nutritional needs. The present study aimed to evaluate the predicting power of Bandura social cognitive theory for the nutritional behavior of housewives in Sarayan, Southern Khorasan Province, Iran. Methods: This descriptive-analytical study was conducted in Sarayan in 2016 on 400 housewives who were married and aged from 30 to 50 years. Random stratified cluster sampling method was utilized, and a researcher-made questionnaire was used to collect data. The face and content validity of the questionnaire was approved by experts, and reliability was confirmed by calculating coefficient alpha. Data was then analyzed by SPSS-18 software, using both descriptive and inferential statistical tests at the significance level of p<0.05. Results: The mean age of the participants was 38.7±5.9 years. A total of 286 (70.8%) persons had poor nutritional behavior, 102 (25.2%) persons had moderate nutritional behavior, and 16 (4%) persons had good nutritional behavior. From among the social cognitive theory constructs, self-efficacy (p<0.001) and situation (p<0.001) were significant predictors of the nutritional behavior of housewives. These two variables could predict 13.6% of the nutritional behavior of housewives. Conclusions: The results of this study showed that self-efficacy is the most important predictor of the nutritional behavior of housewives. Therefore, designing educational interventions to promote self-efficiency in housewives is recommended.

Background: Lifestyle modification plays the most important role in the prevention of cardiovascular diseases. This study aims to assess the lifestyle of patients admitted to the cardiology department of Vali-e-Asr Hospital in Birjand from August 2014 to April 2015 and determine its relationship with cardiovascular risk factors. Methods: In this cross-sectional study, 400 patients hospitalized in the heart department were incorporated by census. The data were gathered using Breslow Lifestyle Index and a researcher-made questionnaire that included demographic characteristics of patients, history of heart disease, smoking, type of oil daily consumed, the frequency of different foods taken per week, and the results of tests taken on patients. Data were analyzed by SPSS software (version 22) using t-test and ANOVA. Results: The mean age of the patients was 60.7±13.4 years. The majority 203 (50.8%) were male; 190 (47.5%) had diabetes; 181 (45.2%) suffered from obesity and overweight, 25% had high systolic blood pressure; and 10.5% had high diastolic blood pressure. Also, 14.2% were smokers. The mean score of participants on Breslow Lifestyle Index was 5.61±1.11, which was significantly higher in overweight and obese subjects than subjects with normal weight (P=0.001). Conclusions: Some lifestyle indices in patients hospitalized in the heart department of Vali-e-Asr Hospital in Birjand are undesirable, and their lifestyles need to be modified.

Background: School health involves all activities aimed at providing, maintaining and promoting the health of students. The health educator is responsible for providing of health services in schools. The aim of this study was to compare health behavior and its effective factors among the students of primary schools with and without health educators in Zirkouh County, South Khorasan Province, Iran in 2015 Methods: This is a cross-sectional descriptive-analytical study where in a total of 250 primary school students in Zirkouh County (125 with health educator and 125 without health educator) were randomly selected. They were subsequently examined through a researcher-made questionnaire holding 59 items based on a three-point Likert scale. Data were analyzed in SPSS-18 using statistical tests including t-test and univariate and multivariate ANOVA. The significance level was considered at P<0.05 Results: The results showed that the sleep health score was significantly higher in the group with health educator, although the two groups did not differ in terms of health behavior and its other sub-scales (p<0.05). The multivariate ANOVA showed that gender, education, and father’s occupation variables affected the health of students behaviors Conclusions: The results of this study showed that the presence of a health educator in schools had an impact on the health behavior of students, sleep health and personal health; however, it did not affect their nutritional behavior and physical activity. Hence, a great emphasis should be placed on the role and position of health educators, their regular presence in schools, and their interaction with parents

Background: Treatment adherence is proposed as a challenge in diabetes care. The present study was performed aiming to determine the treatment adherence and factors related to it based on the health belief model Methods: In a cross-sectional study type, 205 type 2 diabetic people who referred to Tabriz Diabetes Centers were selected by simple random sampling and entered the study. The data collection tool was a questionnaire including demographic characteristics, factors impacting on the treatment adherence based on the health belief model and treatment adherence behavior. Data was analyzed by SPSS software (version 16) by using statistical independent t-test and one way ANOVA at a significant level less than 0.05. Results: The mean and standard deviation of the people under survey were 53.2 ± 9.5 years and the duration to get diabetes was 6.6 ± 4.5 years. They were about 66.8% women, 24.9% illiterate, and 9.3% had diploma and were academics. The mean of HbA1c was (7.4 ± 1.3), and had about 39% poor treatment adherence. The treatment adherence had significant relationship with perceived severity (R=0.14), sensitivity (R=0.13), benefits (R=0.31), barriers (R=0.47) and HbA1c (R= -0.44). The health belief model structures of perceived benefits (ß=0.17), barriers (ß=0.39) and HbA1c (ß=0.21) predicted about 29% of the treatment adherence variance. Conclusions: Educational interventions based on the health belief model with emphasis on perceived benefits and barriers can be helpful for treatment adherence in people with diabetes.

Background: Nowadays, different methods are applied for the removal of heavy metals from the aqueous resources that the adsorption process is one of them. The chromium VI is one of the most prevalent contaminants which create serious difficulties; so, it should be removed from the contaminated waters by an effective method before being leaved into the environment. The present research investigated the use of dried powder of activated sludge of Kavirtire wastewater treatment plant as bio sorbent for removal of chromium (VI). Methods: In the present experimental study, the effects of pH, adsorbent dose, primary concentration of metal and contact time on the removal of chromium (VI) from the aqueous solutions were studied. Then, the equations of isotherm and adsorption kinetic were specified based on the optimal conditions. The absorbent features were analyzed by SEM and EDX techniques. Results: The maximum efficiency of the removal of chromium (VI) at pH 2, optimal dose of 5 g/L, contact time of 60 min and with primary concentration of 15 mg/L was reported 99.83 percent. The study of relation of the isotherm and kinetic in the reaction revealed that the process of adsorptions of chromium follows the Freundlich model (R2=0.90) and the pseudo- second order kinetic model (R2= 1), respectively. Conclusions: The dried powder of activated sludge can be applied as a proper adsorbent for the removal of Chromium VI from the aqueous resources.

Background: Dysentery is an inflammatory bowel disease infected by microorganisms, which invade the intestinal mucosa. Given the high incidence of dysentery in Darmian city, this research was carried out with the aim of determining the epidemiologic profile of this disease and its related factors in Darmian city during the years 2012-2016. Methods: This descriptive study was conducted on 282 patients with dysentery during the years 2012-2016 in Darmian city. The data collection tool was individual examination form completed in the diseases surveillance system, approved by Diseases Control of Ministry Center of Health and Medical Education. Data were analyzed using SPSS 18 software and Chi-square test and significance level was considered P <0.05. Results: The results revealed that the highest rate of this disease was seen in 2015 with rate of 169.83 per 100000 people and the lowest rate of it was seen in 2013 with rate of 63.81 per 100000 people. This disease was seen more in rural areas (65.2%) and in summer (40.1%) and spring (38.3%) seasons. Most of the patients with dysentery were living in villages with health home (42%) and urban areas (34%).Housewives (29.4%) accounted for the highest rate of this disease and majority of the patients were treated as outpatient (93.3%). Most of the patients used safe water (94%) and had a healthy sewage collection system (94.7%). Conclusions: It seems to be an essential to design and implement interventional and educational programs for those groups of people, who are at high risk of this disease, especially housewives and villagers, in order to prevent and control this disease.

Background: Overriding heart disease, hypertension, and diabetes in prevalence, arthritis stands as the most common disease among the elderly. Studies fail to show a coherent study regarding the knowledge, attitude towards, and preventive behaviors against arthritis among middle-aged women. Therefore, the present study was conducted to evaluate the perceptions of and preventive behaviors against arthritis among middle-aged women in Birjand city. Methods: This descriptive-analytic study was conducted on 325 randomly selected women aged 29-59 years who referred to the Birjand-based healthcare centers. Data were collected using a researcher-made questionnaire that covered demographics and items on knowledge, attitude, and performance. Its validity and reliability were confirmed. Data was analyzed in SPSS-19 using binomial test. Results: The mean age of the women was 39.1±8.4 years. Most of the participants (37%) had primary or secondary school degrees. The mean score of perception constructs were evaluated as follows: perceived susceptibility construct was desirable with a score of 19.5±2.9; perceived severity was desirable scored at 30.3±0.7; perceived benefits was desirable at 17.6±2.6, perceived barriers construct was at a moderate level scored at 25.4±6.3; self-efficacy at 29.7±7.5 was desirable; and performance was moderate at 7.7±2.8. Conclusions: According to the results, it is suggested that educational classes be held with the aim of improving the perceptions and behavior of middle-aged women concerning preventive behaviors against arthritis.

Background: Fertility in Iran has declined dramatically over the last three decades. The rapid decline in fertility in Iran has taken place in all geographical areas and in all social and demographic subgroups. This study aims to evaluate the fertility trend in Sabzevar’s towns and villages during a 13 year period. Methods: The present study is a descriptive-analytic one. The information about fertility was obtained from Sabzevar Health Department according to the age groups and the proportion of married women on an annual basis for urban and rural areas separately. The indexes of fertility rate and age-specific fertility were calculated by using Excel software. The data were analyzed using joinpoint regression 3.4 software at a significance level of P < 0.05. Results: The results of the study showed that in all of the years of the study the total fertility rate in urban areas was higher than in rural areas. The total fertility rate in rural areas has risen from 1.97 in 2002 by 1.5% annual growth to 2.28 in 2014. In urban areas, the fertility rate has reached 2.31 in 2002, with a mean annual increase of 1.7%, to 2.63 in the year 2014. The highest percentage of annual increase in urban and rural areas has occurred in the age group of 15 to 19 years. Furthermore, family planning policies in Iran have had a significant impact on increasing fertility in the age group of 20 to 24 years. Conclusions: Although the overall fertility rate in Sabzevar is almost at the replacement rate, due to the demographic policies of the country – which is aimed at increasing the fertility rate –, it is recommended that, along with the implementation and the continuous monitoring of these comprehensive health policies in this city, health care policymakers perform some programs to reduce pregnancy in high-risk age groups.

Background: Organizational commitment as an attitude and working method can have beneficial consequences for planning, organizing, increasing the efficiency, high performance, reducing absenteeism and delay, and specialized, committed human resources, and consistent with organizational goals have tendency towards the organization membership and work beyond their assigned duties. Therefore, this study was conducted aiming to determine the ratio of organizational commitment and its related factors among the employees working in hospitals affiliated to the Zabol University of Medical Sciences. Methods: This descriptive-analytical study of cross-sectional type was performed on 152 employees working in hospitals affiliated to the Zabol University of Medical Sciences. Data collection tool in this research was Allen and Meyer organizational commitment questionnaire. Data analysis was performed by SPSS19 software and independent t-test and one way ANOVA, Mann-Whitney and Kruskal-Wallis, Pearson correlation coefficient were used and significance level was considered as 0.05. Results: In this study, 152 people were investigated, that 68 (44.7%) people were female and 84 (55.3%) people were male. The mean age of participants and work experience was equal to 31.76±7.51 and 7.38±6.88 years, respectively. There was a significant difference between organizational commitment and normative commitment of people with various employment statuses; there was a significant and negative relationship between education and organizational commitment. Conclusions: According to the results of study, managers should increase commitment (paying attention to the competency and merit of employees in assigning duties to them and identifying their ability and talent) to drive the hospital towards its real purpose: "Maintaining, Retrieving and Promoting Health

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Background: Low back pain is one of the serious health problems in communities. It is the third common cause for medical visits after upper respiratory tract and headache. Based on the studies conducted in this regard, low back pain has different distribution in various kinds of job groups, and most researchers argue that this problem is correlated with job type of individuals. Accordingly, the present study was conducted to evaluate the prevalence of low back pain and affecting factors in employees of Birjand University of Medical Sciences in 2016. Methods: This descriptive-analytical study was conducted on all employees in the deputies of Birjand University of Medical Sciences in 2016. The data were collected using Quebec standard questionnaire and analyzed using SPSS19 software and descriptive and analytical statistics of Mann-Whitney, Logistic regression, Kruskal-Wallis and Spearman at a significant level of a=0.05. Results: 216 people (120 females and 96 males) were examined in this study. Out of 216 people, 184 were married and 32 were single. The mean age of employees was 36.36 ± 8.27 years, their mean weight was 70.04 ± 13.66 kg, their mean BMI was 13.4±43.25, their mean hours of sitting behind desk at workplace was 6.25±1.56 hours, and their mean low back pain score was 19.7 ± 17.15. The highest age group was between 30 and 40 years and 60.6% of them had a history of low back pain. Mann-Whitney test showed a significant difference between the mean scores of low back pain in terms of gender (p=0.008) and history of low back pain in a person (p<0.001). However, this test did not show any significant relationship with other demographic variables. Based on the Spearman correlation test, there was a significant correlation between mean scores of low back pain and mean of employment history (r=0.1, p=0.04). Based on logistic regression test, a significant relationship was found between gender (OR=2.45, CI=195.25, 4.83) and low back pain (OR=10.53, CI=495.24, 26.13). Conclusions: The results of the study showed that as the employment history of the employee increases, their low back pain also increases. Additionally, a small percentage of employees used stretching exercises between their working hours. Thus, given their tendency to manage educational classes, it is necessary to provide educational interventions for them to perform physical activities in order to prevent low back pain in the employees.