Aim:  To estimate the prevalence of dysmenorrhea in Iranian women and investigate associated risk factors. Material & Methods:  In a cross‐sectional study in Tehran, Iran in 2007, 381 women (81% response rate, age 16–56 years) were selected through a stratified random sample of 22 different districts and completed a questionnaire about dysmenorrhea. Descriptive statistics, spearman rank correlation statistic, and ordinal logistic regression models were used. Confounding and effect‐modification were explored for each association. Results:  The prevalence of no, mild, moderate, and severe menstrual pain was 10%, 41%, 28%, and 22%, respectively. Older age and high intake of fruits and vegetables were protective factors for menstrual pain while women with family history of dysmenorrhea, higher stress and depression tended to have more severe pain. Body mass index, parity, smoking, and physical activity were not significantly associated with dysmenorrhea after controlling for potential confounding factors and effect modifiers. Conclusion:  Menstrual pain is a common complaint in Iranian women. The inverse association between fruit and vegetable intake and dysmenorrhea, and reduction of stress and depression need to be further explored and considered in terms of recommendation to reduce dysmenorrhea.

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Building a basis for action using the seven themes articulated, especially by incorporating innovative ideas, we presented here, can help enhance global capacity in chronic disease surveillance, prevention and control. Informed initiatives can help achieve the new World Health Organization global goal of reducing chronic disease death rates by 2% annually, generate new ideas for effective interventions and ultimately bring global chronic diseases under greater control.

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I n discussing Loh and Harvey's article, 1 I will focus on the medical officer of health (MOH)* role and training for this role, and also comment on how these relate to primary care practice and practitioners. I note that public health practice as an MOH is only one of many potential career paths for public health and preventive medicine (PHPM) † specialists. 2,3 Positions in the provincial or federal health ministries or centres of disease control, academic positions as a researcher/teacher, or a career in global/international health or occupational/environmental health, to name the more common ones, can be attractive options. ‡

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