---

Background & Objective: The rate of using contraceptive methods in an important criteria for evaluation the performance of family planning in women aged 15-49 years. The aim of this study is to determine the 7-year trend of contraceptive methods in population of rural area in Babol. Materials & Methods: This study was performed based on the existing data in family planning program charts in area under coverage of Gatab health center in Babol from 1994 to 2000. A sample of 400 women aged 15-49 years were selected using systematic sampling technique within each year based on the list of women who had husband aged 15-49 years in family planning books. In overall, 2800 women examined during 7 years of study. The data of type of contraceptive method and the calendar year were extracted from family planning charts. We used Z-test and Chi-square test in statistical analysis. Results: The results showed that the rate of tobactomy increased significantly from 26.2% in 1994 to 36.7% in 2000 (P<0.05). The use of condom and IUD changed from 3% to 7.5% and from 5% to 8.5% respectively. The percentage of women did not use any contraceptive method decreased from 27.5% in 1994 to 4.7% in 2000 (P<0.05). While a significant changes neither were observed in using oral contraceptive nor withdrawal methods using 7 years. Conclusion: The rate of using confident methods of contraception increased significantly from 1994 to 2000. In spite of the relative high rate of withdrawal method and due to lack of its confidence, the more research and education for shifting its user to modern form of contraceptive is necessary.

---

Background&Objective: It is very important to choos a proper teaching training method to stimulate people to improve the quality and standard of their life. A proper family planing practic is one of such methods. Materials&Methods: This study is a semi-experimental research which was carried out during 2004 with the aim of comparing the two way of either indivisually or group eduction on the subsequent resuts of family planning practice among the sample populations. Sample population all were the women whome referred to the two health centers in Gorgan. 218 women were choosed by simple methods, and were divided in two groups of 109 randomly. The case and control group were trained in group and in indivisual respectively. Results: After the training of was finshed the women were asked their method of family planning of their choice. 3-6 month afterward this study was focused on the women continuation use of their choices. Collected information was recorded using a questionairs. The results were analyzed using statistic tests such as chi-squar in SPSS software. Conclusion: There was not a meaningfull differences in the efficay of either methods in this sample population, therefore it is suggested to use a group training as it is cheaper and the training is possible to be carried out by few health workers.

---

Background&Objective: Thalassemia is an inherited and chronic hemolytic disorder. Like other diseases it can make psychological, social and financial problems for both patients and families. The necessity of this research is to teach the way of treating the psychosocial problems of this illness and to increase the quality of patients and families life. It is also a descriptive study to examine psychosocial and financial disorders and coping strategies among families with patients suffering major beta thalassemia Materials&Methods: 320 parents (229 of mothers and 91 of fathers) were included in this study. These families were those who were visited clinics associated with Gorgan's University. Data collection was done using a self structured questionnaire as well as Mc Cubin and Thompson scale for identifying coping strategies. Results: Findings revealed many problems, such as: stress for disease (82.8%) and the patients' vague future (81.8%). The mentioned problems were of psychological disorders. And about social problems: 33.8% of patients families were deprived of having picnics in their free times and helping the patient meddles the routine work of homes in 30.1% of families. The financial problems: the cost of traveling and providing the medicine (63.8%). In addition 97.5% of families had faith and reliance in God in order to help them and to believe their child's illness as a reality. It is apparent that families use different kinds of method in order to cope with psychological, social and financial problems and to face the disease. Conclusion: Most of families have a strong belief in religion and as a result they believe that any kind of problems and especially disease is one of ways to reach God. This is the idea which helps them to face this disease stoutly.

---

Background and Objective: Failure of tuberculosis (TB) treatment is a major problem of health systems in developing countries. This study was done to identify the Risk factors of tuberculosis treatment failure in the Sistan and Bulochestan province, the high risk region in South-East of Iran. Methods: This case – control study was carried out on 52 tuberculosis patients (smear -positive and category- I therapy) treated during six months period. Patients with treatment failure were considered as cases and patients with negative smear after 6 months of treatment with anti-tuberculosis (TB) medicines were considered as control group. Demographic, clinical and treatment outcomes were recorded for each patient. The multivariate logistic regression was performed to determine the predictors of treatment failure. Results: Family history of tuberculosis (95% CI: 1-12.56, OR=3.55, P=0.04,), smoking (95% CI:1.58-51.21, OR=9, P=0.01), drug addiction before or during the treatment period (95% CI: 5.28-123.91, OR=25.6, P=0.0001) and low body weight (95% CI:1.05-12.6, OR=3.65, P=0.04) were risk factors for treatment failure. Conclusion: Family history of tuberculosis, weight loss during treatment, smoking and drug addiction, were considered as risk factors for treatment failure in National Tuberculosis Control Programme (NTCP) in south-east of Iran.

---

Background and Objective: Family violence is known as a painful reality which does impact on all aspects of the victims' lives. The burden of family violence on the health of 15-44 year old women is more than that of breast cancer, womb cancer and the accident. This study was done to determine the effective factors on confronting violence on married women. Methods: This descriptive - analysis study was done on 273 married women whom referred to health centers in Kordkuy city in Golestan province, north of Iran during 2011. The sample size has been made through casual classification out of proportionate sharing. The rate of exposure to physical, psychological and sexual violence was recorded in questionnaire for each subject. Results: The average age and marital age of women and their husbands was 29.4±7.8, 19.6±3.7 and 23.6± 3.9 years, respectively. 86.2% of the women were housewives. The exposure rate of physical, psychological and sexual violence was: 32.8%, 49% and 33.7%, respectively. The important factors related to womens and husbands were education of women and their husbands, women employement, marriage age of women and their husbands (P<0.05). The important factors related to family were number of children and household income (P<0.05) Conclusion: Level of education, employee, marriatal age and family income were the effective factors in confronting violence on married women in northern Iran.

---

Background and Objective: Hospitalization of patients in the intensive care units frequently results in anxiety of the family members. This study was performed to investigate the effect of a family-centered clinical intervention on the anxiety of family members of the patients hospitalized in intensive care units.

Methods: In this clinical trail study, eighty family members of the patients hospitalized in the intensive care units were randomly divided into interventional and control groups, respectively. In the interventional group, the family members were allowed to be present at the bedside from the second till the sixth day.The participant's level of anxiety was assessed in the second and the sixth day of patient's hospitalization using hospital anxiety and depression scale. Oral information about the equipment and the regulations and, a daily information card consisting of treatment and care activities, vital signs and patient's level of consciousness was delivered to the participants and their questions were answered.

Results: In the the sixth day, there was a significant difference between the mean anxiety scores in the intervention (11±3.22) and control group (7.05±3.44) (P<0.05). Also, the frequncey of anxiety in the interventional group (56%) was significantly higher than the control group with 15% (P<0.05). The odds ratio for anxiety in sons/daughters was lower than other family members in the sixth day (P<0.05).

Conclusion: Providing information, presence at the bedside and participation in the care of their patient increase the anxiety of family members in the first week of patient hospitalization in the intensive care unit.

---

Background and Objective: Childhood behavioral and emotional problems may be continus to puberty, even extend to elderly. This study was carried out to determine the role of family accommodation of child symptoms, parenting style and parental stress in prediction of anxiety disorder in children with 6 - 10 years old in Golestan province, north of Iran.

Methods: In this descriptive-analytic study 300 children with 6-10 years old and their mothers were selected by randomized cluster sampling method during 2017. The questionnaires of family accommodation scale-anxiety (FAS-A, 2013), parent stress index-sort form (PSI-SF, 2000), Bamerind parenting styles questionnaire 1973 and Spence child anxiety scale-parent form (SCAS-P, 1998) were completed by the mothers.

Results: Increasing family accommodation and parenting stress significantly correlated with increasing children anxiety (P<0.05). The authenticated childbearing style by parents significantly correlated with reducing the anxiety in children (P<0.05), but authoritarian parenting and permissive parenting by parents significantly correlated with increasing the anxiety in children (P<0.05). Authenticated childbearing style along with authoritative parenting style, parental stress and family support could predict 49% of children's anxiety (F=97.91, P<0.0001).

Conclusion: Authoritative and authoritarian parenting, parenting stress, family accommodation has an effective role in predicting children's anxiety.

---

Background and Objective: Performance and interactions of the couples having important roles in family sustainability. This study was done to evaluate the effectiveness of emotion-focused therapy on the performance component of couples referring to counseling centers.
Methods: In this clinical trial study, 28 couples with marital problems were randomly divided into intervention and control groups. Subjects had score lower than the cut-off point (120 points) using McMaster Family Assessment Device. Subjects in experimental group participated in ten sessions of an hour and a half of the emotion-focused therapy. Pre-test, post-test and one month follow-up were performed for each subject.
Results: The therapy had impact on increasing all of the performance components of couples, and the survival of the effect of treatment was evident in one month follow up. There was a significant difference between the scores of the two groups in all of the components of the post-test variable of family functioning (P<0.05). The difference between the pre-test and post-test scores of couples in the test group was 20.536±4.842 (P<0.05) and post-test-follow-up was 1.286±4.487. Also, the effectiveness of emotional therapy in components, general functioning of couples, affective responsiveness, behavior control, communication, problem solving, roles, and affective Involvement, significantly were remarkable.
Conclusion: The emotion-focused therapy intervention has a significant role in changing the components of couple’s performance. Therapists can use this approach in educational centers and counseling to help couples seeking divorce and incompatibility to improve the reduction of marital problems and increase their satisfaction and improve the general functioning of couples, affective responsiveness, behavior control, communication, problem solving, roles, and affective Involvement.

---

Background and Objective: Anxiety disorders are one of the most common psychiatric disorders in childhood. Some studies have identified the household dimension as an important factor in causing these disorders. However, no convincing results have been achieved. The aim of this study was done to determine the frequency of anxiety disorders among of 8-12 years old children in families with single and multiple children.
Methods: This descriptive-analytical study was performed on 732 children (343 boys and 389 girl) referred to Taleghani hospital (except than psychiatric clinic) and offices of pediatricians in Gorgan, north of Iran during 2017. Subjects were recruited using available sampling method. Demographic questionnaire and Spence Anxiety Scale (SCAS) were completed. Variables including separation anxiety, social anxiety, general anxiety, panic attack, agoraphobia, obsession and compulsion, fear of physical damage were evaluated.
Results: In all anxiety subgroups except general anxiety, mean scores were significantly higher in children with multiple children than single children (P<0.05).
Conclusion: This study showed a high prevalence of anxiety disorders in multi-child families compared to single-child families.

---

Background and Objective: Breast cancer is one of the most common diseases worldwide and the second leading cause of death among women. Immune responses play a critical role in inhibiting the onset and progression of this disease. Given the important role of T lymphocytes in identifying and preventing the spread of breast cancer tumor cells, this study was conducted to simultaneously evaluate the regulatory molecules CXC chemokine receptor 3 (CXCR3), programmed cell death protein 1 (PD-1), natural killer group 2 member D (NKG2D), and transforming growth factor beta 1 receptor II (TGF-βRII) on T lymphocytes of newly diagnosed breast cancer patients.
Methods: This case-control study was performed on 26 newly diagnosed breast cancer patients (mean age = 46.2±9.5 years) admitted to the Fifth Azar Educational-Therapeutic Center in Gorgan, Iran, and 12 non-breast cancer individuals (mean age = 42.9±9.9 years) selected from the staff and students of Golestan University of Medical Sciences during 2018-2019. First, blood sampling was performed and peripheral blood mononuclear cells (PBMCs) were isolated. Then, using flow cytometry, different cell populations were evaluated for the expression of CXCR3, PD-1, NKG2D, and TGF-βRII. Plasma levels of interferon gamma (IFN-γ) and major histocompatibility complex class I chain related gene-A (MIC-A) were measured by enzyme-linked immunosorbent assay (ELISA).
Results: The mean percentage of T lymphocyte population in newly diagnosed breast cancer patients was significantly lower compared to healthy individuals (P<0.05). Also, the mean percentage of T lymphocytes expressing PD-1 and TGF-βRII was higher in the case group compared to the control group, while the expression of NKG2D and CXCR3 showed lower levels (P<0.05). The results of comparing plasma concentrations of IFN-γ and MIC-A indicated that the case group had higher levels of MIC-A than the control group (P<0.05); however, no statistically significant difference was found regarding IFN-γ.
Conclusion: It seems that the increased expression of TGF-βRII and PD-1 along with the decreased expression of NKG2D and CXCR3 and the reduced level of MIC-A in newly diagnosed breast cancer patients may be related to upregulation and potent suppression of T lymphocyte immunity and their dysfunction in breast cancer disease.