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Aims: Diabetes as the most common diseases caused by metabolic disorders is an important global challenge. This is a disease that requires lifelong self-care; because the self-care and improvement of the life quality is cost effective .The aim of this study is to determine the effects of the self-Efficacy education program on reducing blood sugar levels among the type 2 diabetic patients. It was conducted in Zahedan. Methods and Materials: 138 diabetic type 2 patients were selected in Zahedan Diabetic Center and divided randomly into control groups (n=69) and test group (n=69); and special checklist and health belief model questionnaire were applied as data collection instruments. Reliability and validity of the questionnaire was evaluated and confirmed. The data collected before intervention was analyzed, then educational design method executed 3 and 6 months after intervention and the collected data was analyzed using SPSS software. Findings: According to the results, there is a significant statistical difference in average number of models before and after educational intervention (pConclusions: Self-efficacy training in striation improves knowledge, attitude and self-care behaviours performance of the subjects and the related average of HbA1c and FB. The training seems to increase the learners' active participation in caring themselves, because they have experienced the results of the training program and they are motivated to enhance their better self-care behaviours.

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Background: Chronic Low back pain (CLBP) is one of the most prevalent health problems which is affected by psychological disorders. The aim of this study was to evaluate the role of psychological intervention on chronic low back pain among a sample of Iranian nurses.
Material and Methods: This is a randomized clinical trial. The participants of this study consisted of 84 nurses suffering from chronic back pain and working in Valiasr hospital, Tehran-Iran. The recruited nurses were randomly assigned to intervention and control groups (42 nurses in each group). The demographic questionnaire and Visual Analog Assessment scales (VAS) and a Depression Anxiety Stress Scale (DASS) were used to collect data at the beginning of the study and 3 months following completion of the intervention. Data were analyzed using Chi-square, T-test and paired T-test.
Results: Forty-two nurses, with a mean age of 32 ± 8.2 and 31.5 ± 7.4 years in the intervention group and control group respectively, took part in this study. The two groups were not significantly different at the beginning of the study in terms of demographic data (P > 0.05). At the 3-month follow up, the pain rate in the intervention group was significantly decreased from 4.47 to 4.09 (P < 0.0001). Furthermore in intervention group, the mean scores of anxiety intervention group were decreased from 17.73 to 9.76 (P < 0.0001). Decreased Stress scores decreased from 15.52 to 9.52 (P < 0.0001), and the depression score from 17.66 to 10.45 (P < 0.0001).
Conclusions: The findings of this study showed that psychological interventions reduced stress anxiety, depression as well as low back pain among Iranian nurses. It is recommended that further research with larger sample and longer follow up be conducted to confirm the findings of this study.

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Aim: Tobacco use is one of the major causes of death worldwide and the most preventable risk factor of the coronary heart disease. The purpose of this study was to determine attitudes, risk perception and perceived vulnerability toward to water pipe (WP) smoking among male students in Zarandieh city of Iran. Methods: This cross-sectional descriptive study was carried out on 400 male adolescents in 2011-2012. A multiple-stage sampling protocol was used. The participants completed a self-report questionnaire about demographics, knowledge, attitude and beliefs about WP smoking and their tobacco use background. Data were analyzed by SPSS16. Findings: The prevalence of WP smoking was 72 (18%). Also 50% of participants believed water pipe smoking is less harmful compared to cigarettes. The mean score of knowledge, attitude, and risk perception for non smokers was higher from smokers (knowledge 4.9±2.1, attitude 19.5±4.3 and risk perception 18.6±3.3 versus 3.4±1.5, 15.6±5.5 and 15.4±4.3 respectively), whereas smokers reported a fairly high level of perceived stress and depression (perceived vulnerability). Conclusion: Noticing the side effects of tobacco use and the high prevalence of incorrect perceived WP smoking beliefs among students, provision of educational programs for the correction of the beliefs of students regarding WP smoking is recommended.

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Aims: The oral health is one of the most of public health problems and women with pregnancy have high risk for dental caries and need more attention. The purpose of this study was to assess the effectiveness of a health education intervention based on the Health Belief Model (HBM) on oral health behavior in pregnant women. Methods: This is a quasi-experimental study carried out on 130 pregnant women selected with random sampling method from health centers in Arak in 2011 (case and control groups each of 65 women). Data collection with questionnaire was based on construct HBM, as well as their knowledge and performance about oral health. The women of the case group participated during the two month of intervention and again two month after، with 2 session meeting classes as the follow up after intervention. The data were collected 3 months after intervention and analyzed. Findings: Our findings indicated that mean scores of HBM Model variables, i.e susceptibility, severity, benefit and barriers perceived, were significantly increased in the case group compared to the controls after intervention. Also, oral health care (before intervention 45 ±9.2, after three months 77±9.7) improved significantly among the case group, compared to the controls (p<0/001). Conclusion: Applying the HBM Model is very effective for developing an educational program for oral health in pregnant women. Besides such programs, follow up education on controlling and monitoring is highly recommended.

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Aim: Substance abuse is a substantial threat and problem to public health. The goal of drug abuse treatment is to return people to a productive normal situation in the family, workplace, and community. Treatment dropout is one of the major problems, encountered by the treatment programs. The maintenance of treatment is associated with retention in treatment, and many factors are associated with retention. The main purpose of this study is to examine the factors that play important role in retention of addiction treatment. Methods: This is a qualitative research with conventional content analysis method. Purposive sampling was applied and continued until data saturation was achieved. The participants were 22 volunteers, including outpatients, physicians and psychotherapists. The method of data collection was semi-structured face to face interview (30- 40 minutes). All interviews were recorded and transcribed verbatim. Findings: By content analysis, two categories were obtained, including emotional and informational support. The main common theme of categories was social support, which was the major requirement to retain the treatment among drug abuse outpatients. Conclusion: The findings of this study showed that social support is one of the essential services to stop or reduce substance abuse. Recognizing this factor could improve interaction between the family, clinical staff and patients in addiction treatment retention.

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Aim: Recently, prevention of osteoporosis has become the goal of many health professionals. Behavior change is one of the most powerful strategies for osteoporosis prevention. This study aimed to determine calcium intake in order to identify osteoporosis preventive behavior in women aged 30-50 years in Khorramabad city, Iran. Methods: This descriptive cross-sectional study included 269 women aged 30-50 years who were selected from all the health centers of Khorramabad city according to the inclusion criteria of the study and by cluster and systematic sampling. The tools for data collection were valid and reliable questionnaires of demographic information, stages of change, decisional balance, self-efficacy, and calcium intake. Chi-square test and logistic regression were applied to analyze the data. Findings: The mean age of the subjects was 38.72±7.003, and the mean total calcium weekly intake was 3191.03±3869.24. The results also showed that self-efficacy among the constructs of the Trans-theoretical Model (TTM) was a significant predictive of dietary calcium intake for the behavior. Conclusion: The results showed that the weekly intake calcium in women was low. Self-efficacy among the constructs of the TTM was the only significant predictive for osteoporosis prevention behavior. Therefore, the findings of this study can be considered when designing educational interventions for prevention of osteoporosis by health authorities.

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Aim: Identification of contributory factors in smoking and gaining insight into the roles played by each of these factors including health literacy (HL) may account for quitting or decreasing the prevalence of smoking. The aim of the current study was to identify the effects caused by different HL levels on smoking.
Methods: 347 students inhabiting the dormitories of Shahid Beheshti University of Medical Sciences were included in a cross-sectional correlational study. Random cluster sampling was used for the selection of participants. HELIA questionnaire (used for HL measurement in Iranian urban population between 18-65 years of age) and a researcher-made questionnaire (for determining the status of smoking in individuals) were used to collect information from the participants. All data were statistically analyzed by SPSS software.
Findings: The mean and standard deviation of HL score was 70.52±14.12 out of 100. The results indicated that among the university students, 59.7% (201 people) were non-smokers, 23.1% (78 people) were smokers, and 17.2% (58 people) had experienced smoking. These findings reveal that HL is significantly correlated with smoking in university students. Also different levels (insufficient, relatively sufficient, and sufficient) of HL show its significant correlation with smoking, meaning that less HL levels are accompanied by a higher chance of smoking.
Conclusion: The relatively high prevalence of smoking in university students and the impact of HL on smoking highlight the need to increase the level of HL in university students and develop an efficient tool for measuring smoking literacy in all age groups.

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Aim: The aim of this study was to design a tool and to assess its validity and reliability based on native culture characterization to evaluate the health belief model (HBF) constructs about prenatal care.
Methods: 215 pregnant women covered by the health centers of Iranshahr in the age group of 18-35 years and the least ability of reading and writing participated in this cross-sectional study. After reviewing the literature, the tool was designed, and its validity and reliability were approved based on psychometric data of the target group and the view of a panel of experts through calculating the content validity ratio, content validity index, exploratory factor analysis, and internal consistency.
Findings: The validity of 42 items was assessed through calculating the index score of the item effect above 1.5, content validity ratio more than 0.80, and content validity index higher than 0.79. By using exploratory factor analysis with a special value greater than 1, six factors and 35 items remained that were classified into six categories based on the literature review and content items, which were able to predict 77.095 % of the total variance of the tool. The reliability of the research tool was calculated using Cronbach’s alpha equal to 0.816.
Conclusion: The results of this study provide proper evidence about the strength of structural factors and the reliability of the assessment tool for the structures of HBM about prenatal care. It can be considered by the researchers in developing a tool for research, education and action.

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Aim: Smoking is one of the most important causes of respiratory, cardiovascular and cancers diseases. This study examined the smoking-related knowledge, attitudes and practices of dormitory students of Shahid Beheshti University of Medical Sciences in Tehran. The specific aim is to determine the correlation between the main variables' affect on smoking habits, knowledge and attitudes.
Methods: In this cross-sectional study conducted with descriptive and analytical approach, 340 students were selected through random cluster sampling. The participating students completed an interview measuring demographic characteristics and smoking-related knowledge, attitude and practice. Data were analyzed using Chi-square and Pearson's tests in SPSS (ver. 21).
Findings: The mean and SD of the participants was 22.93±4.05 years. Accordingly, 23% (n=78) of the subjects were current smokers and 17.1% (n=58) had experienced smoking. The knowledge of 1.8% (n=6) of the subjects was weak about smoking's health effects, 9.97% (n=332) had average and 0.3% (n=1) had good knowledge. Attitude of 8.6% (n=29) of the participants about smoking was poor, 29.5% (n=100) average and 61.9% (n=210) good. Relationship between knowledge and attitude about the harms of smoking (r=0.35, p<0.001), between knowledge and smoking (r=0.2, p<0.001), and between attitude and smoking (r=0.45, p<0.001) was significant.
Conclusion: There was a moderate level of knowledge and attitude about smoking hazards among the participants. Also the prevalence of smoking was relatively high. With regard to the statistically significant relationship between knowledge and attitude with smoking, declared health educational programs may enrich current knowledge, and promote the attitudes related to smoking risk and effects on the students' health.

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Aims: There is evidence that physical activity plays an essential role in preventing illnesses during pregnancy. This study aimed to determine facilitators, barriers, and structural factors of physical activity in nulliparous pregnant women: A qualitative study using Maxqda.
Participants & Methods: This qualitative study was conducted from January to June 2020 in nulliparous pregnant women. Forty participants selected randomly from the Pounak Health Center of Tehran City, Iran, answered open-ended questions about the obstacles that deprived them of physical activity during pregnancy. Data were analyzed by MAXQDA 12 software.
Findings: According to the results, 620 primary codes, 42 secondary codes, 11 sub-themes, and 6 themes were extracted. These themes were divided into the PEN-3 categories; facilitators, barriers, and structural factors. The nurture factors as facilitators had communication and support from others as sub-themes. Barriers consisted of socio-cultural (participate in pregnancy loss with a companion; social beliefs; culture of poverty), socioeconomic (financial problems), individual factors (physical, psycho-emotional, and spiritual dimensions), and structural factors consisting of environmental (equipment) and organizational (possibilities in health centers) factors.
Conclusion: It is essential to comprehend why pregnant women face obstacles to physical activity. Many issues are proposed: the need for enough information on the advantages of physical activity and the role of nurturing factors that need to be motivated to physical activity. Therefore, its a need to investigate structural problems in the community to provide facilities for pregnant women to have physical activity during pregnancy.

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The purpose of this study was to analyze effects of using Farmer Field School (FFS) on the economic, social, production, and knowledge status of greenhouse owners in Tehran Province and surrounding, Iran. The research method was a comparative causal study. The statistical population was composed of 80 greenhouse owners who had participated in FFS program as treatment group and 716 owners who had not participated in this program, as the control group. Sample size for non-participant group was determined to be 152 people using the Cochran formula. They were chosen by simple random sampling method. The results of comparative tests indicate that the two groups significantly differ in crop marketability, job creation, production risk, cooperation, participation in social organizations and entities, use of macro and micro fertilizers, application of organic fertilizers, application of pesticides, and technical knowledge of safe crop production. However, there were no significant differences in annual income, marketing, and crop yield. The structural analysis also indicates that the FFS program has had some positive effects on participants in economic, social, production, and knowledge aspects.
 

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  The appearance of animal images on the archaeological remains is always considered as an evidence to determine their natural living and their role in human's cultural and ritual life. Animal imagery is found in every medium of art in the Proto Elamite period include stone statuette, pottery, metalwork and finally seal impressions. The glyptic art and pottery through their diversity and the nature of their symbols provide the researchers with the basic information with which to piece together the iconography and the social and economy history of the Proto Elamite period. This paper examines serpent, turtle and feline imageries and related pastiches on two media at Tepe Sofalin, including seal impressions and pottery fragments.