Mental Health Status (Depression, Anxiety and Stress) of Employed and Unemployed Women in Yazd, Iran, 2015

Background: Women are one of the sensitive groups that in comparison to men are at higher risk of mental disorders. Women's mental health has a close relation with family and community health. This study was performed to determine the mental health status (depression, anxiety and stress) of employed women and housewives in Yazd City in 2015. Methods: This cross - sectional study was conducted on 120 employed women and 120 housewives visiting health centers in Yazd in 2014. Data were collected through random sampling and by using a questionnaire including demographic information and the DASS-21 questionnaire. Data analysis was performed through SPSS16 software and using t-test and ANOVA. Results: The mean scores of depression and anxiety were significantly lower in employed compared to unemployed women (P<0.001). Among employed women, those in the private sectors had the highest stress and anxiety and workers had the highest depression. Furthermore, physical activity and educational level showed significant inverse correlations with mean scores of depression, anxiety and stress. In terms of marital status, divorced women had the highest rates of depression and anxiety and single women had the highest stress. Conclusion: Results of this study showed higher levels of depression and anxiety in unemployed compared to employed women. Effective interventions for reducing depression and anxiety in housewives are suggested

Health Belief Model and Reasoned Action Theory in Predicting Water Saving Behaviors in Yazd, Iran

Background: People's behaviors and intentions about healthy behaviors depend on their beliefs, values, and knowledge about the issue. Various models of health education are used in deter-mining predictors of different healthy behaviors but their efficacy in cultural behaviors, such as water saving behaviors, are not studied. The study was conducted to explain water saving beha-viors in Yazd, Iran on the basis of Health Belief Model and Reasoned Action Theory. Methods: The cross-sectional study used random cluster sampling to recruit 200 heads of households to collect the data. The survey questionnaire was tested for its content validity and reliability. Analysis of data included descriptive statistics, simple correlation, hierarchical multiple regression. Results: Simple correlations between water saving behaviors and Reasoned Action Theory and Health Belief Model constructs were statistically significant. Health Belief Model and Reasoned Action Theory constructs explained 20.80% and 8.40% of the variances in water saving beha-viors, respectively. Perceived barriers were the strongest Predictor. Additionally, there was a sta-tistically positive correlation between water saving behaviors and intention. Conclusion: In designing interventions aimed at water waste prevention, barriers of water saving behaviors should be addressed first, followed by people's attitude towards water saving. Health Belief Model constructs, with the exception of perceived severity and benefits, is more powerful than is Reasoned Action Theory in predicting water saving behavior and may be used as a framework for educational interventions aimed at improving water saving behaviors

The comparison of depression and anxiety between fertile and infertile couples: A meta-analysis study

Background: Depression and anxiety are the most common reaction in infertile couples. Several studies have been conducted to examine the psychiatric disorders among infertile and fertile couples. Objective: This meta-analysis was conducted to compare the depression and anxiety in fertile and infertile couples in various studies. Materials and Methods: The authors searched articles published in multiple databases including World Health Organization, PubMed, Cochrane Library, Scopus, Science Direct, Medline EMBASE and Persian databases including Scientific Information Database (SID) and IranMedx between 2005 and 2017. The main keywords used for searching the databases were: depression, anxiety, infertility, and fertility. Statistical analyses were performed using Comprehensive Meta-Analysis/2.0 software. Results: The authors found 42 related articles after searching the databases. 11 articles entered the meta-analysis after considering the inclusion and exclusion criteria. Finally, eight articles were chosen for the comparison of depression and anxiety, two published articles for the comparison of depression, and one published article to compare anxiety in fertile and infertile couples. The results of the heterogeneity test showed a significant heterogeneity among all articles that were analyzed in this meta-analysis in the field of depression and anxiety. The results showed that depression (p = 0.0001; Hedges’g= 1.21; 95% CI 0.63–1.78) and anxiety (p = 0.00001; Hedges’g = 0.63; 95% CI 0.54–0.73) were higher in infertile couples than fertile couples and that the possibility of a publication bias does not exist in this study. Conclusion: The analysis of articles used in this meta-analysis showed that depression and anxiety scores in infertile couples were higher than fertile couples. Key words: Depression, Anxiety, Infertility, Meta-analysis

Awareness and use of evidence based medicine (EBM) in medical trainees

The concept of evidence based medicine (EBM) involves a systematic approach for integration of best available research evidence into medical decision making for physicians, medical trainees and researchers. The EBM process includes five essential steps: formulating the questions, searching for evidence, appraising the evidence, and applying and evaluating the results (1). In a descriptive study, the data about EBM skills obtained from the medical trainees showed that printed textbooks served as the first source of information in 80% of cases and followed by E-books as the second source. The hard copy journals in libraries had the lowest use. Easy access to information was selected as the main reason for using printed resources. Also, fast access to information was the most important reason for using electronic resources. In a study conducted by Rohani, it was found that physicians used printed sources more than e-books (2). This was due to their easy access to the printed reference books. Considering the fact that it takes a lot of time for new medical information to log in into the reference books, effective treatment of a disease may be entered in printed sources after its efficiency is confirmed. 45.2% of the participants were familiar with INLM. 32.1% of the students had attended the training course on INLM. 85.7% of the participants were familiar with the PubMed, 28.6% with the Elsevier and 16.7% with Science direct. 31% of the participants were familiar with the concept of EBM, but 7.1% were aware of the resources of EBM, and 12.2% had attended the special courses on EBM. The results of the recent data taken from internet showed that 53.8% of participants sometimes used it in diagnosis and treatment process and 28.2% of them used it after being developed into textbooks. Also, this information was sometimes useful for 75.8% of participants. Half of the students were familiar with the concept of EBM, but a few had attended the introductory course on EBM. Hanson in his study maintained that only 1.9% of physicians used specific methods to find valid evidence of medicine (3). Taheri showed that medical students were satisfied with the workshop on EBM and stated that familiarity with EBM was essential for proper functioning (4). Therefore, it seems necessary to organize the training workshops on the concepts of EBM as a part of formal training for medical trainees to change the students' attitudes

Clinical education stressors in medical trainees in Shahid Sadoughi University of Medical Sciences, Yazd

Introduction: Stress is an important factor in the educational process. Teaching and learning are stressful processes. This stress can affect one’s ability and change his/her performance. The purpose of this study was to investigate stressors of clinical education from the perspective of medical students in Yazd University of Medical Sciences. Methods: This descriptive-analytic study was conducted in Yazd University of Medical Science during year 2014-2015. The sample size was 170 medical students who were selected randomly. The data were collected by a questionnaire including four components: interpersonal relationship, educational environment, clinical experience and the unpleasant emotions. A significance level of 0.05 was considered for analysis. The statistical analyses included descriptive statistics, ANOVA and T-tests, using SPSS software, version 14. Results: The results showed that the highest domain score belonged to interpersonal relationship (3.33±0.3) followed by unpleasant emotions domain (3.3±0.3). The lowest domain score of clinical education stressors was educational environment (3.12±0.1). The results showed that the mean score of interpersonal relationship domain was more in women than in men (p<0.05). Conclusion: The relationship between teachers and students is an effective factor in all dimensions of clinical education stressors. So proper measures such as the promotion of scientific awareness of teachers and educational staff about factors that lead to stress and the best way to communicate with students should be taken to reduce the students’ stress

Talented Students’ View Points on the Educational Problems in Shahid Sadoughi University of Medical Sciences in 2010

Introduction: Distinguished work force is a major factor for growth and development of all countries and training programs should be designed based on their needs. Interviews with students provide an insight into the challenges of learning environment. This study investigated the educational problems from the viewpoint of talented students of Shahid Sadoughi University of Medical Sciences. Methods: In this qualitative study, 55 talented university students expressed their educational problems during three focus group sessions. At the end of each session, the data were classified and organized and findings were sorted, categorized and tabulated, based on the frequency of statements in group discussions. Results: Most problems were related to the areas of educational objectives, planning, and management. The main reported problems were inclusion of a number of unnecessary content materials in the syllabi, low emphasis on research, unrealistic teacher evaluations, and inharmonious educational departments. Conclusion: Except for a few problems such as changing some parts of curricula that must be resolved at country level, there are many less important problems that influence the effectiveness of the educational outcomes. These problems do not need much effort to eradicate, as more cooperation of teachers, students, and managers can remove them

Agreement between ten-years cardiovascular disease risk assessment tools: An application to Iranian population in Shahedieh Cohort Study

Background and aim: Cardiovascular risk-prediction models are efficient primary prevention tools to detect high-risk individuals. The study aims to use three tools to estimate the 10-year risk of developing cardiovascular disease (CVD) and investigate their agreement in an Iranian adult population. Methods: The current cross-sectional study was carried out on 8569 adults between 35 and 70 who participated in the first phase of the Shahedieh cohort study in Yazd, Iran, and were free of CVDs (cardiac ischemia or myocardial infarction or stroke). World Health Organization/International Society of Hypertension (WHO/ISH) chart, Laboratory-Based (LB) and Non-Laboratory-Based (NLB) Framingham Risk Score (FRS) were used to predict the 10-year risk of developing CVD. The agreement across tools was determined by Kappa. Results: WHO/ISH chart indicated the highest prevalence of low CVD risk for males (96.10%) and females (96.50%), while NLB Framingham had the highest prevalence of high CVD risk for males (19.40%) and females (5.30%). In total, there was substantial agreement between both FRS models (Kappa = o.70), while there was a slight agreement between WHO/ISH and both FRS tools. For under 60 years males and females, substantial agreements were observed between FRS methods (kappa = 0.73 and kappa = 0.68). For males and females over 60 years, this agreement was moderate and substantial, respectively (kappa = 0.54 and kappa = 0.64). WHO/ISH and LB Framingham model had substantial agreement for over 60 years females (kappa = 0.61). Conclusions: Framingham models classified more participants in the high-risk category than WHO/ISH. Due to the lethality of CVDs, categorizing individuals based on FRS can ensure that most of the real high-risk people are detected. Remarkable agreement between FRS methods in all sex-age groups suggested using the NLB Framingham model as a primary screening tool, especially in a shortage of resources condition