Objective There is a relationship between pesticide exposure and farmworkers’ health. Well-conducted evaluations can provide an insight into how to develop and implement more effective interventions to prevent farmers and farmworkers’ exposure to pesticides. This review aimed to summarize the literature on the effectiveness of interventions to promote pesticide safety and reduce pesticide exposure among farmers and farmworkers. Methods A comprehensive search on PubMed, Embase, ISI Web of Science, Scopus, Science Direct, Agricola, NIOSHTIC, and Agris databases was performed to identify relevant studies published from 2000 to 2019. Randomized controlled trials (RCTs) and quasi-experimental studies assessing the effectiveness of interventions on a variety of outcomes related to pesticide exposure were considered. The searches were restricted to articles written in English. The methodological quality of included reviews was appraised using the Effective Public Health Practice Project quality assessment tool (EPHPP). Results The initial search led to 47912 records, 31 studies of which including nine RCTs and twenty-two quasi-experimental studies met the criteria. The majority of the included studies focused on the educational/ behavioral approach. The studies that applied this approach were effective in improving the participants’ knowledge and attitude; however, these interventions were less effective in terms of making changes in participants’ behaviors and their risk of exposure to toxic pesticides. Multifaceted interventions were moderately effective in terms of improving farmers’ and farmworkers’ behaviors and reduction in exposure to toxic pesticides. We did not find any studies that had evaluated the effectiveness of engineering/technological, and legislation/enforcement interventions. Conclusions Although the majority of studies were based on an educational/behavioral approach and did not assess the effect of interventions on objective measures, the results of this review highlight the significant effectiveness of educational programs and some potential key elements of these interventions. These findings may inform policymakers to develop interventions to reduce pesticide exposure among farmers and farmworkers.

The number of sexual transmission of HIV is increasing globally. Sexual and Reproductive Health (SRH) issues and HIV/AIDS related problems are rooted in common grounds such as poverty, gender inequality, and social exclusion. As a result, international health organizations have suggested the integration of SRH services with HIV/AIDS services as a strategy to control HIV and to improve people's access to SRH services.

Background and Objective: One of the important determinants of health in every society is health literacy. The present study was conducted to determine health literacy status of employees of Hamadan University of Medical Sciences and related factors. Materials and Methods: This cross-sectional study was performed in 2016 among 188 employees in Hamadan University of Medical Sciences. The participants were selected through the stratified sampling method. The data collection instrument was Health Literacy for Iranian Adults (HELIA), which was completed through self-report. Data were analyzed using independent t-test, Pearson's correlation coefficient, one-way ANOVA, and linear regression in SPSS version 22. Results: Most of the participants (74.5%) received health-related information through the Internet. Among the five dimensions of health literacy, the comprehension dimension of health information was more desirable. The highest correlation coefficient between health literacy dimensions was related to the relationship between comprehension and decision-making (r=0.582, P<0.01). On average, health literacy of employees was borderline, and age, marital status, educational status, and sources of information were predictors of health literacy (P<0.05). Conclusion: Overall, the results of the study showed that the average health literacy of employees was borderline. It seems that interventions based on demographic characteristics are required to improve the health literacy status of employees.

Since the mean age of breast cancer in women living in developing countries, compared with those in developed countries, is lower by about 10 years, repetition of mammography can play an important role in reducing morbidity and mortality. Hence, this study aimed to investigate the relationship between family history of breast cancer and risk perception and its impact on repetition of mammography. In this cross-sectional study, 1,507 women aged 50 years and older, referred to the mammography center of Regions 1 and 6 in Tehran, Iran, were enrolled. Data were collected using a self-report questionnaire and analyzed using SPSS and LISREL. According to our findings, knowledge about the time interval of mammography was found to have the highest correlation with repetition of mammography (r =0.4). Among the demographic variables, marital status (β= -0.1) and family history of breast cancer (β=0.1) had the most direct and significant impact on repetition of mammography (P <0.05). Among the other variables studied, knowledge (β=-0.5) had the highest direct and significant impact on repetition of mammography (P <0.05). Family history of breast cancer was one of the predictors of repetition of mammography, but the results did not prove any relationship with risk perception. Further studies are needed to assess the effect of risk perception and knowledge about time interval on the initiation and continuation of mammography.

Background Shortage of organs for transplantation is still considered to be a global concern, especially in developing countries such as Iran. Identifying factors contributing to the individual's decision to be a donor in a given society is critical to address the shortage of organ donors. The purpose of this study was to use a culturally modified Organ Donation Model (ODM) to explore the significant factors and ways in which these factors could influence signing the donor card.Methods This study was a cross-sectional design conducted among 600 employees from 57 offices in Hamadan, in the west of Iran, in 2018. Participants were selected randomly and surveyed on being a donor and as well on their perceptions regarding signing the donor card. Structural equation modeling (SEM) was conducted to determine the inter-relationship between the studied variables.Results: The mean age of participants was 39.5 (SD=7.0). Twenty percent of participants (n=120) had a signed donor card. Overall structural model provided a good fit with the data[χ2= 1172.964 (df=643, p<0.001), CFI=0.910, TLI= 0.902, RMSEA=0.037 (90% CI, 0.034 - 0.040). descriptive norms (β= 0.53, p<0.001), non-cognitive beliefs (i.e; Jinx factor, Ick factor, mistrust to medical system and body integrity (β= -0.33, p<0.001), anticipated regret (β= 0.28, p<0.001) and subjective norms (β= -0.17, p<0.01) had significant direct effects on signing the donor card.Conclusions This study provides socio-culturally informed evidence on individuals' signing donor card. To combat the shortage of organs for transplantation, these factors could provide a guide to policymakers in developing the community- based interventions.

Background Fertility and childbearing are the most important determinants of population variation around the world. This study was conducted with the aim of determining the psychological and sociodemographic factors predicting fertility intention among women referred to comprehensive health centers in Hamadan based on the beliefs, attitudes, subjective norms, and enabling factors (BASNEF) model. Methods This descriptive analytical study was performed in comprehensive health centers in Hamadan in 2016. Through a multi-stage sampling method, 484 women were enrolled in the study. The data collection tool was a selfreport questionnaire based on the constructs of the BASNEF model. Data were analyzed using linear regression, independent t-test, and a one-way analysis of variance using IBM SPSS software ver. 22.0 (IBM Corp., Armonk, NY, USA). Results The mean±standard deviation of the women’s age was 31.85±6.13 years. The variables of motivation to comply (β=0.228), enabling factors (β=0.162), subjective norms (β=0.134), and attitude (β=0.122) were the predictors of fertility intention in women. This model was able to explain 16.8% of variance in behavioral intention. Also, lower age, higher education, shorter duration of marriage, and having a daughter resulted in a greater fertility intention. Conclusion It seems that designing and implementing educational programs to improve attitudes, promoting positive subjective norms, and enhancing enabling factors can play a major role in increasing fertility intention in women.

Introduction Trauma is one of the important issues in public health because it is responsible for 90% of mortality in Low and Middle-Income Countries (LIMCs). The present study aimed to determine the epidemiological pattern of trauma patients in a regional trauma center in the Midwest of Iran from 2014 to 2020. Methods This study was a retrospective study that was performed on 29,804 trauma patients admitted to Be′sat Hospital in Hamadan from January 2014 to December 2020. Data was collected using Health Information Management (HIM) Center of the Be′sat Hospital. For investigating the relationship of the characteristics of trauma patients and the mechanisms of trauma, Multiple Multinomial Logistic Regression (MMNLR) model was used. All statistical analyses were performed using the IBM SPSS Statistics version 24. Results The mean age of all patients was 35.4 (SD = 21.9) years. Most of them were men (71.7%). The most common mechanism of trauma was road traffic accidents (RTAs) (39.6%) followed by falls (30.2%), other (19.7%), violence (6.2%), and burn (4.4%). 1.5% of the trauma patients expired. The results of multiple multinomial logistic regression indicated that significant affected factor on odds referring because of RTAs compared to other mechanism were: season and hospital length of stay (LOS); in falls and violence: age, sex, season, and LOS; and in burn: age, sex, season, evening time, and LOS (p < 0.05). Conclusion Based on the investigation of 29,804 trauma patients, in Iran as a developing country, RTAs and falls were two common mechanisms of trauma. It seems that as a short-term plan, it is possible to focus on road safety, to improve the quality of vehicles, to hold training courses for drivers. Also, as a long-term goal, considering that the elderly population in Iran is increasing, it is necessary to pay attention to fall reduction programs.

Background One of the most common problems that the elderly with chronic diseases, especially diabetes, faces is lack or poor medical adherence. The aim of this study was to determine the effect of interventions in increasing medical adherence in the elderly with type 2 diabetes. Methods The databases of Cochrane, Embase, PubMed, Scopus, Science Direct, and web of science were searched until April 2017 free from time and language limitation. In review, only randomized controlled trial (RCT) design studies were investigated. The studies of interest were evaluated from three perspectives: educational intervention with or without theories/models of health education and promotion, educational intervention (individual or group education), and noneducational intervention to increase medical adherence. The qualification of RCTs was evaluated through Cochrane Collaboration Risk of Bias Tool. Results Finally, five studies were considered in this systematic review. Educational interventions were used in all of the studies, and in three of these studies, noneducational interventions such as support group, psychiatric consultation, and phone consultation were implemented along with educational intervention. In all studies, medical adherence in the intervention group increased when compared with the control group or basic conditions ( p < .05). All RCTs had high risk of bias. Conclusion This review provides evidence which must be considered in the elderly with diabetes a combination of the educational and noneducational methods to increase medical adherence. It is necessary to conduct studies with higher quality to assess the efficacy of interventions.