Depression and anxiety in sterilised women in Iran

Sterilisation is an effective and convenient means of contraception and has become increasingly popular as a birth control technique throughout the world during the past 40 years. However some women who choose sterilisation may suffer a neurotic syndrome, which is manifested in the form of pain, depression and loss of libido.1We undertook a study designed to investigate depression, anxiety and post-operation regret rate in sterilised women referred to health centres in Tabriz, Iran in 2006. The study design was descriptive-analytical. The study participants comprised 300 women in the age range 25–45 years, of whom 150 women were sterilized between 1 and 10 years ago and 150 were a control group of non-sterilised women who used condoms, withdrawal or safe period methods for contraception. The control group was selected by a cluster random sampling method. Fifteen health centres were selected as a cluster from 96 health centres located in Tabriz. Ten women were selected randomly from each health centre using health documents. Women were eligible for inclusion in the study if they were aged between 25 and 45 years at the time of sampling, and if they had no history of psychological disorders and no recent sorrowful events. There were no differences between the two groups as regards the number of children, income or demographic characteristics. The women were contacted by telephone at their last known address and were asked to complete questionnaires. Data collection was done using Zung’s self-rating depression and anxiety scale in addition to questions about post-sterilisation regret. Data were collected from the subjects anonymously and analysed using SPSS (v. 11.5) statistics software. Analysis employed t-test, Chi-square test and descriptive statistics. The comparison of the means for depression in the two groups was not significantly different (p = 0.96), however the mean of anxiety in the case group was remarkably greater than the control group (p = 0.03). Insufficient poststerilisation rest was a significant risk factor for depression and anxiety (p = 0.008 and p = 0.02, respectively). Requesting information about reversal after tubal sterilisation was 2.7% and the post-sterilisation regret rate was 6%, which was significantly related to women’s conflict with their husbands about the decision-making process prior to sterilisation (p<0.001). The study findings as regards psychological disorders of sterilisation suggested that women undergoing sterilisation should ensure that they have a good rest after their operation in order to reduce the extent of psychological disorders. Unlike studies undertaken in other countries,2–4 women’s age, parity, marriage duration and the timing of sterilisation was unrelated to the women’s regret in our study. The earlier the sterilisation is carried out, the longer the woman’s remaining period of fertile life and the greater the chances of changes in her marital status and/or the loss of a child, both circumstances that may lead to a change in the desired family size and expression of regret. In our study, probably one of the reasons why women’s regret did not appear to be significantly related to young age of sterilisation was the infrequency of divorce or remarriage in our study population. Consistent with our study, Jamieson et al. reported that women who had substantial conflict with their husbands or partners prior to sterilisation were more than three times as likely to regret their decision and more than five times more likely to request a reversal than women who did not report such conflict.5 In our study, pre-sterilisation counseling was reported by 29.3% of subjects. With respect to personality and adaptability differences in facing the changes, pre-sterilisation counseling and post-sterilisation follow-up systems have an important role to play in women’s psychological and psychosexual health promotion

Psychometric evaluation of a self-reported physical activity questionnarie used in the pilot phase of the AZAR Cohort Study

Background: The purpose of this study was to assess the psychometric properties of a self reported physical activity (PA) questionnaire based on data from the pilot phase of the AZAR Cohort Study. Methods: In this cross-sectional study, all 35-70 years old people living in Khameneh, a city in East Azarbaijan, Iran were invited to take part in the pilot phase of the AZAR Cohort Study. A total of 952 people completed the self-reported PA questionnaire and the International Physical Activity Questionnaire (IPAQ). Construct validity was evaluated by exploratory and confirmatory factor analyses (EFA and CFA). Spearman’s correlation coefficient between the scores of the two instruments was used to examine the concurrent validity. Reliability was measured using intraclass correlation coefficient (ICC) and Cronbach’s alpha coefficient. Results: In EFA applying principal component analysis with varimax rotation, four factors were identified including recreational leisure time (variance = 52.73%), sedentary leisure time(variance = 38.68%), household/gardening work (variance = 38.66%), and occupation work(variance = 12.67%). The extracted factors were also supported by the CFA (CFI = 0.98, GFI =0.936, RMSEA=0.057). The results indicated moderate concurrent validity (ρ = 0.62, P < 0.001).ICC and Cronbach’s alpha were 0.59 and 0.7, respectively. Conclusion: These results showed acceptable and moderate psychometric properties for the self-reported PA questionnaire to assess PA in this population-based study

The effect of a pedometer-based program improvement of physical activity in Tabriz University employees

Background: Regular physical activity (PA) has been shown to reduce risk of morbidity and overall mortality. A study has displayed that achieving 10,000 steps/day is associated with important health outcomes and have been used to promote PA. Pedometers are a popular tool for PA interventions in different setting. This study investigated the effects on pedometer-based and self-reported PA among Tabriz University employees. Methods: This experimental study assessed the effects of 16 weeks pedometer-based workplace intervention. Participants (n = 154) were employees of two worksites. Pedometer-based and self-reported PA from one intervention worksite was compared with the data of a comparison workplace. International Physical Activity Questionnaire (IPAQ) for self-reported measure of PA, and demographic (age, marital status, educational level, employment status, and stage of change) variables were obtained. To measure PA objectively pedometer was used. Results: Participants reported to increase the step counts from baseline (end of summer) to posttest (winter). The intervention effect revealed significant increase in the intervention group (8279 ± 2759 steps/day than in the comparison work place (4118 ± 1136). Self-reported based on IPAQ concluded women in intervention worksite had a significant increase in the leisure time domain, but similar finding was not found in the comparison worksite. Conclusions: Pedometer used might rather benefit those individuals who want feedback on their current PA, also walking should be considered to increase PA in employee women

Additional file 1 of Psychometric properties of the Last-7-Day Sedentary Time Questionnaire (SIT-Q-7d): Testing the validity and reliability among general population

Additional file 1: Sup. Table 1. The Association between demographic variables and different domains of sedentary behavior (n=290). Sup. Figure 1. The results of structural equation modelling for the confirmatory factor analysis of last-7-day sedentary time questionnaire (SIT-Q-7d); LWD, Sitting for lunch at week days; LWD, sitting for lunch at weekend; BWN, Sitting for breakfast at weekend; DWN, Sitting for dinner at weekend; D W. D, Sitting for dinner at week days; BWD, Sitting for breakfast at week days; WN, weekend; WD, week days

School Food Environment Promotion Program: Applying the Socio-ecological Approach

Background Despite of healthy nutrition recommendations have been offered in recent decades, researches show an increasing rate of unhealthy junk food consumption among primary school children. The aim of this study was to investigate the effects of health promotion intervention on the school food buffets and the changes in nutritional behaviors of the students. Materials and Methods In this Quasi-interventional study, eight schools agreed to participate in Tabriz city, Iran. The schools were randomly selected and divided into an intervention and a control group, and a pretest was given to both groups. A four weeks interventional program was conducted in eight randomly selected schools of the city based on the socio-ecological model. A check list was designed for the assessment of food items available at the schools’ buffets, a 60-item semi-quantitative food frequency questionnaire (FFQ) was used to assess the rate of food consumption and energy intake. Results evaluation and practice were analyzed using the Wilcoxon, Mann Whitney-U and Chi-square tests. Results The findings revealed reduction in the intervention group between before and after intervention with regard the range of junk food consumption, except for the sweets consumption. The number of junk foods provided in the schools buffets reduced in the intervention group. After the intervention on the intervention group significant decreases were found in the intake of energy, fat and saturated fatty acids compared to the control group (p = 0.00).   Conclusion In order to design effective school food environment promotion programs, school healthcare providers should consider multifaceted approaches

Drivers' unsafe behaviors in Iran : an investigation in West Azerbaijan

BackgroundThe present study aims to investigate one of the major causes of traffic accidents: drivers' unsafe behaviors while driving. MethodsIn this cross-sectional study, the behaviors of 946 drivers at traffic lights were observed in the morning, at noon, and in the evening using direct in-field observation. The unsafe behaviors of the drivers included not fastening the seat belt, using a cellphone or handsfree device, smoking, being distracted by a child, talking with passengers, not observing the stop line, eating and drinking, and getting out of the car, letting out a passenger, or arguing with a passenger at the traffic light. ResultsOf the drivers at the traffic light, 60% did not obey the stop line, and 72% did not fasten their seat belt. Also, 13.6% used their cellphones, and 22% talked with passengers. The frequency of the other unsafe behaviors was <3%. For wearing seat belts, drivers aged 41-50 years wore seat belts almost five times more than drivers under 25 years of age (4.94 [2.36-10.320]; p < 0.001), and drivers aged 50 years and older were almost three times likelier to wear seat belts than drivers under 25 years of age (2.8 [1.31-6.08]; p < 0.001). The results showed that the drivers were significantly likelier to wear seat belts on Saturdays (after the weekend) (0.56 [0.40-0.78]; p = 0.001). Regarding using mobile phones while driving, women were twice as likely to use mobile phones as men (2.20 [1.30-3.72]; p < 0.001). Drivers aged 26-40 years used mobile phones significantly less than drivers under 25 years of age (0.24 [0.14-0.43]; p < 0.001) and drivers aged 41-50 years were significantly less likely to use mobile phones than drivers under 25 years of age (0.19 [1.31-6.08]; p < 0.001). ConclusionThe results showed that the occurrence of wearing a seat belt in Shahin Dej was low. We observed a significant association between wearing a seat belt, age, whether it was Saturday (a day after weekend for Iranians). Additionally, similar associations were observed between using mobile phones and gender, age, and day of the week

Parents’ knowledge and socio-demographic determinants toward child’s restraint system use

Abstract Background Lack of protection or improper protection, is one of the most important reasons of child passenger’s death and injury in traffic crashes. Based on what we see on the roads, Iranian children are unrestrained inside the car. The aim of this study was to investigate children restrained system (CRS) use rate, its socio-demographic determinants and parents’ knowledge toward CRS use among Iranian parents. Methods Using multi-stage cluster sampling and direct in filed method of observation, the behavior of 700 children in cars was observed in the current cross-sectional study. Socio-demographic determinants and parents’ knowledge, toward using the CRS were evaluated using questionnaires. The study was performed from July to August 2019 in Tabriz city, northwestern Iran. Results The rate of child safety seat (CSS) use was 15.1% CI 95%:(12.5%,18.0%), and the rate of booster use was 0.6%; CI 95%:(4.3%,8.0%). The majority of parents [e.g. 64.3%; CI 95%: (60.7%,67.9%)], had low knowledge about the use of CRS. The most important reasons for not using CRS was lack of laws and policies [e.g. 59.7%; CI 95%:(12.5%,18.0%)], lack of knowledge [e.g.59.6%; CI 95%:(57.9%, 63.3%)] and the high cost of CRS [e.g. 57.6%; CI 95%:(53.81%,61.2%)]. The most important predictors of not using CRS were the child's age, parental knowledge, and the socioeconomic status of the household (p < 0.05). Conclusions Most children did not have CRS. The parents with higher education and those with higher socioeconomic status had higher rate of CRS use. Based on the low rate of CRS use and poor parental knowledge about it, education of parents toward boosters use and benefits of using CRS, enforcing mandatory laws and ploicies for CRS use in Iran, and allocation of government subsidies to low-income families for purchasing CRS are suggeted as essential strategies to increase CRS use

Table_1_Drivers' unsafe behaviors in Iran: An investigation in West Azerbaijan.docx

BackgroundThe present study aims to investigate one of the major causes of traffic accidents: drivers' unsafe behaviors while driving.MethodsIn this cross-sectional study, the behaviors of 946 drivers at traffic lights were observed in the morning, at noon, and in the evening using direct in-field observation. The unsafe behaviors of the drivers included not fastening the seat belt, using a cellphone or handsfree device, smoking, being distracted by a child, talking with passengers, not observing the stop line, eating and drinking, and getting out of the car, letting out a passenger, or arguing with a passenger at the traffic light.ResultsOf the drivers at the traffic light, 60% did not obey the stop line, and 72% did not fasten their seat belt. Also, 13.6% used their cellphones, and 22% talked with passengers. The frequency of the other unsafe behaviors was ConclusionThe results showed that the occurrence of wearing a seat belt in Shahin Dej was low. We observed a significant association between wearing a seat belt, age, whether it was Saturday (a day after weekend for Iranians). Additionally, similar associations were observed between using mobile phones and gender, age, and day of the week.</p