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Background and Objective: Postpartum depression has a negative effect on maternal health and adverse effect on psychological development of newborns. Also patterns and personality traits can also be associated with postpartum depression. This study aimed to determine the role of social support and Personality in the incidence of postpartum depression.
Methods: This descriptive-analytical study was performed on 200 mothers referred to health centers by available sampling method between 6 weeks to 6 months after delivery. Data were collected using a Questionnaire Personal Information, Edinburgh Postnatal Depression Scale (EPDS, 1987), NEO-Five Factor Inventory (NEO-FFI, 1985) and Social Support Questionnaire Philips (1977).
Results: Postpartum depression was observed in 49 (24.5%) of mothers. Neuroticism had the highest relationship with postpartum depression. The correlation coefficient of this variable with postpartum depression was 52% and this variable alone was 27% of the variance. There was a significant negative relationship between postpartum depression and social support (r= -0.027, P<0.01). There was a significant positive correlation between postpartum depression and neuroticism (r= 0.52, P<0.01).
Conclusion: This study showed that personality traits and social support are two important factors in relation to postpartum depression.

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In December 2019, the new acute respiratory disease spread in China presented with fever and dry cough known to be resulted from the new Corona Virus as the COVID-19. In Iran, the first case was reported on 20th of February 2020. Our management team in Golestan University of Medical Sciences held an immediate meeting to decide how to manage the cases suspected to the COVID-19.The two main hospitals had been selected as the Corona center in the Golestan province, northern Iran. Admitting patients other than COVID-19 has been stopped in these hospitals, and all patients had been transferred to the other hospital in Gorgan city and those in the recovery state had been transferred to a hotel prepared for this purpose. The capacity of Sayyad-e-Shirazi hospital was 300 bed for admission and 25 ICU beds that had been increased to 44 ICU beds (30 percent increases) to be prepared for COVID-19 admission. Clinical groups and specialists had been organized with special duty for each part. After 3 months of COVID-19 crisis, Sayyad-e-Shirazi hospital with 300 beds is in a good shape and admission of severe cases has been decreased.

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Background and Objective: Diabetes is one of the most common chronic diseases and also the biggest health problem in all countries. The world health organization has called it a silent epidemic. Self-care is one of the most important factors in controlling blood sugar in diabetics’ patients. This study was done to determine the relationship between self-care and glycosylated hemoglobin level diabetic patients in rural area in Golestan Province, northern Iran.
Methods: This descriptive-analytical study was done on 239 male and female patients with type 2 diabetes (56.92±10.70 years) in rural area in Golestan Province, northern Iran during 2016. Data collection tool were a standard diabetes self-care questionnaire with demographic variables and HbA1C test. Completion of data and sampling was done by referring to the health center and calling patients.
Results: There was no significant relationship between glycemic controls with any of the self-care items studied. Mean of HbA1c was 8.23±1.85%. 97 patients (40.6%) had good blood sugar control (less than 7.5%). Patient's self-care had a mean of 3.58, of which the highest score was related to the dietary regimen (6.60) and the lowest was related to self-monitoring of blood glucose (0.88) and regular physical activity (2.3).
Conclusion: Self-care of the patients was moderate. Interventions to increase self-care of patients are recommended in this area.

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Background and Objective: Using chewing tobacco is one of the most important health problems in ports of the southern coast of Iran. The prevention of this problem requires identifying the factors affecting this phenomenon. The aim of this study was to determine the prevalence of chewing tobacco and related factors among adolescents in South- East of Iran (2018).
Methods: This descriptive-analytical study was conducted on 204 male high school students through multistage sampling in two the ports of Konarak and Chabahar located in south - east of Iran during March to June 2018. The data collection tool was a self-administered standardized questionnaire including items about knowledge, attitude and prevalence of chewing tobacco among participants, intimate friends and family members of the study population.
Results: Prevalence of chewing tobacco in life time and current use (pervious 30 days) was 71.8% and 43.1%, respectively. Supari was the main chewing tobacco were used (80.8%) by participants. The negative attitudes about chewing tobacco was a protective factor (OR=0.41) and easy access (OR=6.88), using by family members (OR=2.28), and close friends (OR=3.28) were the most important risk factors.
Conclusion: The prevalence of chewing tobacco was alarming in male high school students in south - east of Iran.

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Background and Objective: One of the most important concerns in children is self- medication that may cause in delay the correct diagnosis, and increases morbidity and mortality. This study was performed to determine the frequency of self-medication of parents in children in need of medical care in Gorgan city.
Methods: This descriptive-analytical study was performed on 270 children referred to the pediatric clinic of Taleghani Hospital in Gorgan, northern Iran during 2018-19. Medications were given to the children by their parents arbitrarily without prescriptions by doctors during the recent week were evaluated.
Results: 58.5% and 41.5% of children were males and females, respectively. The average age of children was 5.79 ±4.15 years. Self-medication was the first choice of 60.4% of parents. In the recent week, 48.9% of parents had self-medicated to treat their child's current illness, of which 31.8% reported antipyretic, 17.4% herbal medicines, 11.4% antibiotics and 23.5% other medicines. 91% of parents were unaware of correct dose of drugs and 96.3% did not have any knowledge about possible side effects of drugs, contraindications and precautions. There was a statistically significant association between parent job (self-employment) and self-medication (P<0.05).
Conclusion: 48.9% of parents were performed self-medication on their children. Out of those parents 91% and 96.3% were not aware from the correct drugs dosage and of possible side effects, contraindications and potential risks respectively.

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Background and Objective: One of the most important attempts in crisis is the nutrition management of affected people during and following the disaster. In March 2019, floods occurred in towns and villages on the outskirts of the Gorganrood River in Golestan province, northern Iran. This study conducted to explain the challenges of nutrition management in the flood crisis of Golestan province.
Methods: In this qualitative study, 31 people affected by floods, urban and provincial managers and experts involved in crisis management were selected by purposive sampling method. Data were collected using an interview guide and semi-structured in-depth interviews. Data were recorded and transcribed and analyzed using the content analysis method and Atlas.ti 8 software.
Results: The managerial challenges included planning, organization, coordination, control, and evaluation. The executive challenges contained food preparation, food distribution, and monitoring. The other challenges included political, economic, cultural, and ecological challenges.
Conclusion: Most of the respondents emphasized the irregularity and confusion in nutrition management during the flood and considered it as a result of managerial challenges, executive challenges, political, economic, cultural and ecological challenges.

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Background and Objective: brucellosis is one of the most common zoonosis diseases. Brucellosis is a systemic disease and affected several organs and tissue in human. This study was performed to determine the knowledge, attitude and practice about brucellosis control among livestock farmers.
Methods: This descriptive-analytic study, was performed on 300 rural literate livestock farmers in BuinZahra, Qazvin Iran during 2019. The knowledge, attitude, and practice, the related factors and demographic characteristics such as age, education level and family count were evaluated by structured six-part questionnaire including 30 questions.
Results: The mean age of the subjects was 41.3±16.4 years. Although 90.7% had heard of brucellosis, only 14% had previous trained. There was a positive attitude about the use of methods to reduce the risk of infection in the family and the seriousness of the issue of animal brucellosis in 19% and 64% of cases, respectively. About 94.7% were attended to veterinarian in suspected cases and 96.7% examined the new animals. 97% were uses of new cheese and milk but the milk was boiled by 89.3%. The mean knowledge was 5.3 ranging from 0 to 8 points in them. There was a statistically significant difference in the knowledge score of individuals according to the information source (P<0.05). Knowledge score and number of household members had positive correlation (r=0.135, P=0.019).
Conclusion: There is medium-level knowledge about brucellosis in livestock farmers. The attitude and some actions (such as dealing with infected livestock) needed to be improved. The probable reason is the high cost of behavior modification in some areas, which has provided the gap between knowledge, attitude and behavior in this area.

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Background and Objective: Infertility is one of the issues that affect many aspects of infertile couples. In this study current infertility in Tehran province is estimated based on clinical, epidemiological and demographic definitions.
Methods: This descriptive-analytical study was performed on 669 women with a spouse aged 15-49 in Tehran, Iran during 2020. Data were collected by using a valid researcher-made questionnaire.
Results: Prevalence of current infertility by clinical, epidemiological and demographic definitions was 9.6%, 8.1% and 5.8%, respectively. As expected, primary infertility is lower (2%-4%) than secondary infertility (1.8%-6.4%). Some couples become infertile after their first pregnancy and the birth of their first child. Infertility has a significant relationship with age (P<0.05), age in the first marriage (P<0.05) and socio-economic statuse (P<0.05).
Conclusion: Current primary infertility is relatively low and normal, but secondary infertility is high. Focus on lifetime infertility shows higher rates of infertility than current infertility in Tehran, Iran.

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Background and Objective: Today, the role of family members in caring for cancer patients is becoming more important. Numerous cancer-associated problems affect both the patients and their caregivers. Little information is available about the social support and spiritual health of caregivers of cancer patients; therefore, this study was conducted to investigate the spiritual health and social support status of family caregivers of cancer patients in northeastern Iran.
Methods: This descriptive-analytical study was performed on 265 family caregivers of cancer patients. The subjects were selected by convenience sampling from inpatient wards and outpatient clinics of Babol University of Medical Sciences in 2019. Data were collected using the Social Support Questionnaire (by Vaux), the Spiritual Well-Being Scale (by Paloutzian and Ellison), and a socio-demographic questionnaire.
Results: The mean scores of social support and spiritual health of family caregivers of cancer patients were 98.86±14.58 and 91.32±11.97, respectively, which are at a desirable level. The age of caregivers and the duration of cancer had no significant relationship with the score of spiritual health and social support.
Conclusion: According to our findings, family caregivers of cancer patients have a desirable level of social support and spiritual health.
 

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Background and Objective: Type 2 diabetes is a common disease that could be prevented or managed with a healthy lifestyle. This study was conducted to determine the effects of self-healing with mindfulness-integrated cognitive behavior therapy on the health-promoting lifestyle profile of patients with type 2 diabetes.
Methods: This clinical trial was done on 45 patients with type 2 diabetes who had been referred to the Sedigeh Tahereh Clinic in Isfahan (Iran) in 2021. The patients were randomly divided into 3 groups of 15 patients: a control group, a self-healing group (first intervention) and a mindfulness-integrated cognitive behavior therapy group (second intervention). Interventions for each treatment were held as a weekly 90-minute online session. Posttest was After 12 sessions and three months after the test was followed up. The research tool was a health-promoting lifestyle profile questionnaire with nutrition, exercise, health responsibility, stress management, interpersonal support and self-fulfillment components. The questionnaire was filled out by each group after the 12 sessions and three months after the last session.
Results: Both the self-healing methods and the mindfulness-integrated cognitive behavior therapy increased the lifestyle scores of patients with type 2 diabetes compared to the control group (P<0.05), and the effect was maintained in both intervention groups in the follow-up phase. No difference was observed between the two treatment methods compared with the control group.
Conclusion: Self-healing and mindfulness-integrated cognitive behavior therapy is both effective in improving the health-promoting lifestyle profile of patients with type 2 diabetes.
 

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Background and Objective: Gene mutations leading to thrombophilic disorders and changes in blood coagulation factors during pregnancy play an important role in the occurrence of recurrent abortions. This study was conducted to determine the relationship between polymorphism of thrombophilic genes and coagulation factors in women with recurrent miscarriage.
Methods: In this descriptive-analytical study, 29 women with a history of recurrent abortions (at least three times) were investigated. Demographic data were collected. Total genomic DNA was isolated from peripheral blood. The presence or absence of mutation in factor II (G20210A), factor V Leiden (G1691A), factor V HR2 (H1299R), MTHFR C677T, and MTHFR A1298C polymorphisms were assessed by PCR.
Results: Coagulation factors and thrombophilic mutations had no significant association with recurrent miscarriage.
Conclusion: The results obtained in this study showed that none of the studied polymorphisms could justify frequent abortions in women. Therefore, it is suggested to evaluate genetic factors in normal individuals or immediate and extended family of the study population with no miscarriage history.
 

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Background and Objective: Middle age is associated with various biopsychosocial changes. Sexual health is one of the most important aspects of health, which is less addressed in middle age. The study aimed to determine the relationship between sexual self-concept and sexual health in middle-aged women in Gorgan, Iran.
Methods: This descriptive-analytical study was carried out on 428 eligible married women (mean age: 46.38±5.46 years) who had electronic records in one of the comprehensive health centers of Gorgan, Iran. Data collection was done in 2019 using a demographic checklist, the Persian version of Snell’s multidimensional sexual self-concept questionnaire, and the sexual health of middle-aged women scale.
Results: The mean score of sexual self-concept was 115.10±26.88 in the positive domain, 18.09±11.22 in the negative domain, and 39.92±11.88 in the situational domain. The mean score of sexual health was 129.18±18.71. There was a significant positive correlation between sexual health and the positive (r=0.67, P<0.001) and situational sexual self-concept (r=0.63, P<0.001). There was also a significant inverse correlation between sexual health and negative sexual self-concept (r=-0.48, P<0.001).
Conclusion: This study showed that the sexual health of married middle-aged women has a direct relationship with the positive sexual self-concept and an inverse relationship with the negative sexual self-concept.
 

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Sports activities are hindered by the lack of clean air in large and industrialized cities, and the countless benefits of exercise are not considered. With the search of the literature, 89094 articles related to air pollution that have been published in SID, PubMed, and Web of Science until December 2021 were found. Ultimately, 80 articles were extracted after selecting the articles and narrowing the search to exercise inflammation and lung tissue. After removing out-of-date articles (not published between 2000 and 2021) and those without full text, 65 articles were included in the review. Based on the review, exposure to air pollution is associated with increased inflammation and decreased cellular immune function, which is characterized by the activation of toll-like receptors and downstream signaling pathways. Regular exercise improves the inflammatory status in different pulmonary diseases. People who exercise in polluted environments are at increased risk of respiratory and cardiovascular diseases due to the elevated amount of pollutants delivered to the lungs. However, studies did not take into account the potential anti-inflammatory effects of exercise training, which could inhibit the pro-inflammatory events induced by air pollution. It seems that regular exercise modifies pulmonary inflammatory responses and body mass and in part decreases the risk of pulmonary diseases.

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Background and Objective: Breast milk has significant benefits for both mothers and babies. Counseling is a beneficial method for the continuity of exclusive breastfeeding. Remote counseling methods are currently being developed. This study was conducted to determine the effects of telephone counseling on the continuity and duration of exclusive breastfeeding among mothers who have had a cesarean section.
Methods: In this clinical trial, 154 mothers who have had cesarean section delivery were randomly divided into an experimental and a control group. The intervention group received seven sessions of telephone counseling for 1-3 months postpartum in addition to the routine breastfeeding training program. The control group only received the routine breastfeeding training program.
Results: After 4 months postpartum, the average duration of exclusive breastfeeding in the intervention group (15.51±0.88 weeks) was longer than that in the control group (10.74±5.33 weeks) (P<0.05). At 3 months postpartum, exclusive breastfeeding in the intervention group was 10.45 times longer than in the control group (OR=10.455, CI=2.547-42.912, P<0.001).
Conclusion: Telephone counseling is effective in increasing the continuity and duration of exclusive breastfeeding in mothers who undergo a cesarean section.
 

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Background and Objective: COVID-19 is a rapidly spreading acute respiratory syndrome worldwide. COVID-19 vaccination has been widely used as a means to control the disease. This study aimed to investigate the relationship between demographic characteristics and COVID-19 vaccination in patients with COVID-19.
Methods: This descriptive-analytical study was conducted on 1124 patients with a definitive diagnosis of COVID-19 in Minoodasht, Iran, in August 2021. The instruments used in this study included a demographic data questionnaire and a checklist assessing patient characteristics.
Results: The majority of COVID-19 patients were men (51.8%), aged between 35 to 45 years (26%), and married (76.5%). COVID-19 vaccination was administered to 26.6% of the patients. Patients who received vaccination (27.1%) used masks less than unvaccinated patients (72.9%) (P<0.05). Of the patients with COVID-19, 8.2% were hospitalized. The mean duration of hospitalization for vaccinated patients (7.8±6.4 days) was lower than that for unvaccinated patients (8.3±5.9 days); however, this difference was not significant. Age, education, underlying disease, and mask usage were associated with COVID-19 vaccination (P<0.05). With an increase in underlying disease and age, vaccination rates increased, while vaccination rates decreased with the use of masks and lower education.
Conclusion: Attention to demographic factors and certain characteristics of individuals is necessary to improve COVID-19 vaccination rates. Previous COVID-19 vaccination does not decrease the number of hospitalization days in patients with COVID-19.
 

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Background and Objective: With the increase in the spread of COVID-19, mental health consequences such as fear, anxiety, and depression have become prevalent. This study aimed to investigate the predictive role of fear of COVID-19 and quarantine fatigue on depression in congenital heart disease patients during the pandemic.
Methods: This descriptive-analytical study was conducted on 105 patients with congenital heart disease (6 men and 99 women) who were referred to Shahid Rajaee Hospitals and Tehran Heart Center during 2021-22. Data were collected using a depression scale, a fear scale for COVID-19, and a quarantine fatigue questionnaire.
Results: The results showed that 28.6% of patients with congenital heart disease experienced mild depression, while 7.6% had severe depression. Quarantine fatigue was found to be mild in 43.8% of patients. Additionally, fear of COVID-19 (r=0.195, P=0.001) and quarantine fatigue (r=0.617, P=0.001) were significantly correlated with depression in congenital heart patients.
Conclusion: Fear of COVID-19 is related to depression caused by coronavirus and quarantine fatigue in patients with congenital heart disease.
 

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Background and Objective: Vaginal delivery is a natural physiological process that can be a critical experience for women. One of the factors involved in avoiding vaginal delivery is childbirth self-efficacy. Self-efficacy affects all aspects of behavior and emotional activities, including attachment. This study aimed to determine the relationship between childbirth self-efficacy and maternal attachment to the fetus in nulliparous pregnant women.
Methods: This descriptive-analytical study was conducted on 323 nulliparous pregnant women who attended health centers in Zahedan city from 2020-2021. Data were collected using participants’ demographic questionnaire, Lowe’s childbirth self-efficacy questionnaire, and Cranely’s maternal attachment to the fetus questionnaire.
Results: Maternal attachment style to the fetus showed a significant direct correlation with childbirth self-efficacy. Maternal attachment style to the fetus predicted childbirth self-efficacy (P=0.003, r=0.16), explaining 2.7% of the variance of childbirth self-efficacy.
Conclusion: The results suggest that helping mothers accept their motherly role and improving maternal attachment to the fetus can increase childbirth self-efficacy. Educational programs during pregnancy should include training related to strengthening maternal attachment to the fetus. As women with high childbirth self-efficacy have a greater ability to perform vaginal delivery, it may increase their desire for vaginal delivery.
 

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Background and Objective: Non-Governmental Organizations (NGOs) have been active in the field of health for a long time and have played a key role in it, but these organizations are less known to the public for the promotion of social health and are not much considered by the planners and managers of the health system. This study was conducted to determine the challenges of NGOs’ to promote social health in Iran.
Methods: In this qualitative study, 15 Iranian managers and scientific and executive experts of the Ministry of Health, Ministry of Interior, Governorate, and Universities of Medical Sciences of the country were selected by purposeful sampling during 2021. Data were collected using an interview guide and semi-structured in-depth interview methods. After recording and transcribing, the data were analyzed by content analysis.
Results: The challenges of NGOs to promote social health in Iran were classified into six main themes of planning, organizing, functional, political, economic, and sociocultural challenges, and 33 sub-themes. Most of the participants emphasized the weak role of non-governmental organizations in improving social health and considered it a result of the mentioned challenges.
Conclusion: Empowering non-governmental organizations by formulating a strategic and operational plan and attracting financial resources from various government, private, and charitable sectors will greatly help to strengthen them to advance social health promotion programs.

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Background and Objective: Due to the spread of the new coronavirus disease 2019 (COVID-19), the amount of physical activity and exercise in people’s lifestyles was greatly reduced to reduce interpersonal contact to control the infection. The current study aimed to investigate students’ physical fitness levels during the quarantine period of COVID-19, and the study examined its changes after four months of training at home.
Methods: This quasi-experimental study was done on thirty-two students (16 males and 16 females) in Shahrekord University, Iran during 2019-21. Physical fitness (swimming, Sit-ups, jumping rope, and flexibility) was measured and compared three times before the start of the Coronavirus, one year after the beginning of the Coronavirus, and after four months of exercise at home.
Results: COVID-19 leads to a decrease in the level of physical fitness in the post-exam phase compared to the pre-exam phase. Due to the restrictions related to the quarantine period, students’ physical fitness levels showed a significant reduction in the post-corona period compared to the pre-corona period. In addition, four months of training at home showed a significant effect on physical fitness indicators, compared to the time of quarantine, in such a way that the average of physical fitness factors increased significantly (P<0.05). Therefore, growing measures are needed to motivate and support students to maintain a conscious level of physical fitness to avoid any threat to the population’s health, especially in quarantine conditions.
Conclusion: The quarantine period during the outbreak of COVID-19 caused a decrease in the physical fitness of the studied students, and performing four-month exercises at home increased their physical fitness.

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Background and Objective: Physical disability caused by multiple sclerosis (MS) increases MS patients' need for support from others. Medication adherence is one of the main success factors in the treatment of chronic diseases, which is influenced by various factors. This study aimed to determine the relationship between perceived social support and medication adherence in patients with MS.
Methods: This descriptive-analytical study was conducted on 110 patients (70 women and 40 men) aged 39±9 years with MS who visited the 2 medical training centers of Isfahan University of Medical Sciences (Kashani and Al-Zahra), Isfahan, Iran during 2021. After sampling by the systematic random method, the data were collected by interviews and using Zimmet's Perceived Social Support Scale (MSPSS) and the Morisky Medication Adherence Scale (MMAS-8).
Results: The mean and standard deviation of the scores of medication adherence and perceived social support were 6.10±1.72 and 62.83±14.97, respectively. According to the Pearson correlation coefficient, perceived social support did not show any significant relationship with medication adherence (r=0.185, P=0.053). Perceived social support showed a statistically significant relationship with income satisfaction (F=4.54, P=0.01), the pattern of clinical course (F=2.95, P=0.03), difficulty in accessing medical care (t=-2.29, P=0.02), and clinical symptoms, including motor (t=-3.72, P=0.001), balance (t=-3.23, P=0.002), and urinary disorders (t=-2.53, P=0.01).
Conclusion: Perceived social support in patients with MS did not cause medication adherence.