Individual and External Catalysts and Barriers of Biking: A Community Based Study in a Metropolis

Biking has proven health, environmental and traffic benefits. To prevail biking at community infrastructures and "BicycleSharing Systems (BSS)" have been developed, but their effectiveness is dependent on people's attitudes and perceptions.We aim to investigate attitudes of people toward biking and related infrastructures with regard to demographic factors inMashhad, Iran-a metropolis with unsuccessful BSS. The present work was conducted as a cross-sectional study at Mashhad,Iran, in 2015. In a multistage sampling, adult inhabitants were selected and data about their perceptions of benefits andbarriers of biking were collected through a researcher-designed questionnaire. Of 437 study participants with a mean(±SD) age of 29.9 (±11.3) years, 250 (57.3%) were female. Only 3 (0.7%) of respondents used bikes. Positive attitudeswere significantly associated with gender, marital status and occupation of participants. Car ownership was accompaniedby higher perceptions of "tiredness of biking"(p=0.02), its "low safety" (p=0.02) and "time wasting" (p=0.01). According tothe results, cultural interventions are needed for biking promotion regardless of their socioeconomic status. Educationalprograms at academic settings are also valuable. Safety, convenience, and affordability of different groups of populations(like elderly and deprived people) should be regarded during designing and constructing biking infrastructures and settingparticipation rules

Predictors of Stages of Change in Fruit/Vegetable Consumption based on Trans-Theoretical Model: A Population-based Study

Background and Objectives: Low Fruit/Vegetable (FV) diet seems to be a global public health problem. The&nbsp;trans-theoretical&nbsp;stages of change&nbsp;model&nbsp;have long been considered a useful interventional approach in lifestyle modification programs. The aim of this study was to find the most important intermediating factors of FV consumption in Mashhad, Iran. Materials and Methods: In this cross-sectional design, 777 participants were included with a convenient method from the general population in public places all around the Mashhad City, Iran in 2014. A standardized checklist about socio-demographic characteristics and possible related factors and stages of change questionnaire (6 stages: pre-contemplation, contemplation, preparing, action, maintenance, and termination) were used for data collection. Data were analyzed by SPSS 11.5 software using Chi-square test, Mann-Whitney U test, and Multiple Logistic Regression. Results: Totally, 254 (47.7%) and 299 (59.8%) of participants were in pre-action stages of FV, respectively. Smoking (OR=3.2, p=0.02) and believing that this is good for the body (OR=0.12, p=0.001) were predictors of the pre-contemplation stage for fruits. Being physically active (OR=2, p=0.008), low agreement with health benefits of vegetables (OR=8, p<0.001) and low agreement with &ldquo;vegetables make more diet variability&rdquo; (OR=4, p<0.005) were predictors of pre-contemplation stage for vegetables. Conclusions: Understanding the pros and cons of changing lifestyle can help public health specialists to perform targeted interventions. Keywords: Behavior, Fruit, Vegetable, Trans-Theoretical Model, Urban populatio

Knowledge, attitudes, and practices regarding pandemic h1n1 influenza among medical and dental residents and fellowships in Shiraz, Iran

Background: Influenza disease is one of the oldest medical problems that can cause severe illness and high mortality rates, worldwide. In flu pandemics, medical and dental students′ knowledge, attitudes, and practices (KAP) is critical to save patients life. The aim of this study was to determine the score of KAP toward the Pandemic H1N1 and their predictor factors among the medical and dental residents and fellowships of Shiraz University of Medical Sciences, Iran. Methods: In 2009, 125 participants were recruited in a convenient sampling cross-sectional survey. Self-reported questionnaire were used and results were analyzed applying appropriate statistical tests. Results: The mean score of participants′ knowledge, attitude and practice were 22.6, 21.1 and 26.5 respectively. Participants practice had significant linear positive correlation with knowledge and attitude. Also, their age was significantly and directly correlated to knowledge and practice. The educational major, age, and sex were significant predictors of responder′s knowledge score and age was the only significant predictor of both attitude and practice scores. Conclusions: High knowledge is not sufficient lonely for improve attitude and practices.It seems that traditional educational models are not efficient and governments should emphasize to advanced and motivational education methods including health belief model and motivational interview at postgraduate levels. Perhaps younger students, dentists and males have less motivation to change their attitude and behavior, so we can focuses our interventions in these groups

Predictors of public transportation in Mashhad: A population-based study

Background: The development of public transportation (PT) is a crucial issue in the modern societies. The aim of this study was to assess the status of PT usage among the population residing in Mashhad. Materials and Methods: In a cross-sectional design, 464 citizens of Mashhad filled a checklist about PT-use (i.e., bus, taxi, and metro) to find their supporting and opposing factors in 2014. Chi-square, Mann–Whitney, Student's t-test, and logistic regressions were used for inferential analysis in SPSS 11.5. Results: Mean age was 30.02 ± 11.24 years and 57% (263) were female. Bus (169, 50%) was the most popular PT means, followed by metro (98, 29%) and taxi (74, 21%). Most transportations were happened at morning (248, 35%) and evening (221, 31%). Increasing age (odds ratio [OR] =1.04, confidence interval [CI] 95% = 1.008–1.07), higher education (OR = 2.91, CI 95% = 1.14–7.38), being homemaker (OR = 2.97, CI 95% = 1.19–7.36), or student (OR = 2.91, CI 95% = 1.14–7.38) were predictors of PT-use. Conclusion: Individual preference between PT and driving is associated with social, economic, and cultural aspects of a population. Recognizing the influencing factors can help to design population-oriented services

Smoking during Pregnancy and Maternal and Neonatal Complications in Mashhad, Suburbs, and Subsidiary Villages: A Population-based Cross-Sectional Study

Background: Smoking is very important during pregnancy because of severe fetal and maternal complications. No community-based studies have been conducted on pregnant women in Iran. This study aimed to investigate the prevalence of smoking during pregnancy, as well as maternal and neonatal complications in Mashhad, Iran, during 2017.Methods: This cross-sectional study reviewed the information of 1140 and 92,225 smoking and non-smoking pregnant women during pregnancy, respectively, and 3-5 days after delivery using Sina Electronic Health Record System in Mashhad, Iran, during 2017. All data were extracted, encoded, and entered into SPSS software (version 16).Results: Out of the total of 93,365 pregnant women with a mean age of 22.36 years, the prevalence of smoking during pregnancy was significantly higher among those who live in the city (i.e., Mashhad), compared to individuals living in the suburbs or villages. The mean rates of stillbirth, prematurity, very-low-birth-weight, and low-birth-weight were higher in smoking pregnant mothers, compared to non-smoking ones (p <0.0001). The prevalence of smoking among literate and employed pregnant mothers was significantly higher than illiterate and unemployed pregnant women (p <0.0001). The mean birth weight of newborns of smoking mothers (1528gr) was less than the half mean of the birth weight (3180gr) of newborns of non-smoking mothers (p <0.0001).Conclusion: The prevalence of smoking in mothers living in Mashhad, Iran, was 1.2%, which is less than the global average. The results of this study showed that smoking during pregnancy has many maternal and fetal complications

Cluster analytical approach to Lifestyle characteristics: A population based study in Shiraz, Iran

Introduction: A limited number of risky behaviors cause most morbidity and mortality. The aim of this study was to determine the possible clustering of lifestyle behaviors, including transportation behaviors, diet, physical activity, and smoking in Shiraz, Iran. Methods: There were 776 representative Shirazi adults who participated in this cross-sectional study. The questionnaires were completed via person-to-person interviews. The datasets were searched for any clustering patterns. Cluster analysis was used for statistical analysis, and the data were analyzed using SPSS version 11.5. Results: Three distinct clusters were identified. Cluster 1 was named "Healthy," and it included non-smokers, safe drivers, appropriate or acceptable fruit, vegetable, and fast-food consumers, and physically-active people. Cluster 2, "Moderately Healthy," was relatively risky drivers who had appropriate behaviors on the rest of the health-related behaviors. Cluster 3, "Unhealthy," was smokers, risky drivers, inappropriate or unacceptable fruit, vegetable & fast-food consumers, and a sedentary lifestyle. Conclusions: It was obvious that health-related behaviors were clustered together and unhealthy behaviors were not established in isolatio

The pattern of antibiotic administration for toddlers and infants with acute respiratory infections (Mashhad- Iran)

ABSTRACT Background: Acute respiratory infections (ARI) are the main cause for antibiotic (AB) use in all age groups specially the first two years of life. The local information about the pattern of AB prescription in ARI is a necessary part for any program which aims logical use of AB. The current study was designed to find the frequency and types of AB administration for ARI in young children (<2years) in Mashhad, Iran. Method: This is an observational cohort study which was started in November 2005 and ended up at May 2006. The study group was composed of 1000 infants between 6 month and 20 months old. The children were followed monthly by telephone calls (up to six month after the first interview) and were asked about signs and symptoms of acute respiratory infection and systemic antibiotic use during each month. Results: The average monthly incidence of ARI was 34.5% in the study population, 66.3 %( mean) of the children with ARI were visited by a doctor, which led to AB prescription in 32.7 %( mean) of times. The frequency of inject able antibiotics was almost two times of oral Abs, and benzatin penicillin was the most prescribed AB (54%of all Abs). Conclusion: The rate of AB administration for infants with ARI is not very high in Mashad, but the frequency of AB injections is unacceptable

Improving advanced cardiovascular life support skills in medical students: simulation-based education approach

Objective: In this trial, we intend to assess the effect of simulation-based education approach on advanced cardiovascular life support skills among medical students. Methods: Through convenient sampling method, 40 interns of Mashhad University of Medical Sciences in their emergency medicine rotation (from September to December 2012) participated in this study. Advanced Cardiovascular Life Support (ACLS) workshops with pretest and post-test exams were performed. Workshops and checklists for pretest and post-test exams were designed according to the latest American Heart Association (AHA) guidelines. Results: The total score of the students increased significantly after workshops (24.6 out of 100 to 78.6 out of 100). This demonstrates 53.9% improvement in the skills after the simulation-based education (P< 0.001). Also the mean score of each station had a significant improvement (P< 0.001). Conclusion: Pretests showed that interns had poor performance in practical clinical matters while their scientific knowledge, such as ECG interpretation was acceptable. The overall results of the study highlights that Simulation based-education approach is highly effective in Improving ACLS skills among medical students

Are the predictors of hookah smoking differ from those of cigarette smoking? report of a population-based study in Shiraz, Iran, 2010

Background: The aim of this study was to determine the prevalence of tobacco use and effect of lifestyle factors on cigarette and hookah use among adult residents of Shiraz, Iran. Methods: In 2010, 1,000 participants were recruited in a multistage, random sampling cross-sectional population-based survey. Results: Response rate was 98%. Prevalence of cigarette smoking was 9.7%. Among cigarette users, 12.6% reported smoking 2 years. Almost half of those surveyed (48.9%) smoked 20 cpd. Almost a quarter (20.4%) of the cigarette smokers tried to quit in the past year. Being male, married, aged 37-54, having higher perceived levels of stress, a non-manual occupation, and sedentary lifestyle were positively associated with cigarette smoking. Manual labor occupations, housewife/jobless status, and going frequently to restaurants were positive predictors of hookah smoking. Conclusions: Compared to cigarettes, hookah smoking was more prevalent among Iranian adults. Approximately, the prevalence of hookah smoking in women is the same as men, whereas cigarette use was 31 times more common in men. Cigarette and hookah smoking were associated with less healthy lifestyle habits in both men and women