Background: The purpose of this study was to examine the relationship between perceived social support (PSS) and dimensions of health-related quality of life (HRQoL) and to examine possible gender interaction in the mentioned associations. Methods: A community-based cross-sectional study conducted among 644 participants over the age of 60 years old in Tehran. The data were collected through face-to-face interviews conducted in their own homes, by using a structured multi-sectional questionnaire. The version 1 of the SF-12 scale was used to measure the HRQoL, consisting of two summary measures; PCS (Physical Component Score) and MCS (Mental Component Score). The Persian version of the Social Provisions Scale (SPS) was used to measure PSS. Four multilevel mixed-effects logistic regression models were used to examine the associations. Results: Older people with poor SPS score were 1.8 times more likely to be in the worst quartile of the MCS distribution (CI=1.11-2.93, P=0.021), and twice as likely to be in the worst quartile of the PCS distribution (CI=1.18-3.54, P=0.011). We found strong evidence to support the hypothesis of gender interaction in the association between economic status and PCS [Men: OR 0.28, CI (0.11-0.71); Women: OR 1.00, CI (0.53-1.88); P of Interaction 0.021], and a borderline evidence for gender interaction in the association between physical activity and PCS [Men: OR 5.32, CI (2.14-13.20); Women: OR 1.80, CI (0.82-3.93); P of Interaction 0.051]. Conclusions: Social support could be regarded as one of the main social determinants affecting HRQoL among older people. Men with poor economic status and poor physical activity, compared to women, are more likely to suffer from poor quality of life, thus men should be prioritized in financial support and life style and physical activity interventions.

Background: The determinants and correlates of severe mental disorders are less understood compared to the common mental disorders, both in the world and in Iran. In this study, we aimed to identify a wide range of determinants of severe stress, severe anger, and severe sadness among Iranian population. Methods: This study is part of a large nationwide cross-sectional survey entitled STEPs conducted using a comprehensive questionnaire to determine the prevalence of main preventable risk factors of non-communicable diseases (NCDs) in Iran by age and sex groups in 2016. In total, 30541 people aged 18+participated in this study. Univariate and multivariate logistic regression analyses were used to examine the associations between the dependent variable, which is severe mental disorders, and independent variables including socio-economic factors, lifestyle and selected NCDs. Results: The prevalence of severe stress, severe anger and sever sadness in the Iranian society was 33%, 35%, and 25%, respectively. Of the investigated socio-economic factors, being men, older, never married and living in rural areas were associated with significantly lower experience of severe mental disorders compared to other groups. For education, income and wealth index, there was no linear and clear pattern. Among lifestyle factors, being nonsmoker, having low physical activities, and higher intake of fruits and vegetables were found to be preventive of severe mental disorders. Additionally, having NCDs including hypertension, high cholesterol, diabetes and heart attacks were also significantly correlated with severe mental disorders. Conclusion: determining factors associated with severe mental disorders in this study would help in raising people’s awareness on avoiding harmful factors, and taking healthier lifestyle such as quitting smoke, and consuming enough vegetables and fruits. Screening high risk people in terms of mental health could contribute to the reduction of mental disorders in the Iranian community.

Background Iran has experienced a very fast fertility transition. The process of demographic transition, coupled with modernization, has had considerable consequences for the structure and function of families. There is rising concern in Iran about a potential decline in family care and support for older people as a result of these changes. The main aim of this study was to provide a benchmark by examining current associations between family factors and older people’s social support, both perceived and received. Methods We conducted a cross-sectional survey of a random sample of 644 people aged 60 + years resident in Tehran stratified by socioeconomic status of area. Multilevel mixed-effects models were used to examine the hypotheses. Results The analyses showed that most of the family factors measured, including family size, living arrangements, and amount of contact with family members were associated with older people’s receipt of instrumental social support, as expected. Living arrangements and quality of relationships with family members were associated with older people’s perceptions of social support. Conclusion Implications of these findings for older people currently living in Iran are considered. These findings may also provide important insights into the implications of demographic and associated family changes for older people in the future.

Background: The retention of physicians' policy is recommended by the World Health Organization (WHO) to achieve the goals of the health system and justice in access to health services. The aim of this study was policy analysis of retention of physicians in deprived areas and providing some recommendations for improvement of this plan. Methods: This was a qualitative study regarding policy which used Walt and Gilson's triangle framework and Kingdon's multiple streams. Data were collected using a deep semi-structured interview with 30 participants and a review of upstream laws and regulations. After that, all the interviews were recorded, transcribed, and reviewed. Then, data were analyzed through MAXQDA/12 and content analysis. Results: The findings of this study were categorized according to the policy context, content, and process, and actors who played a significant role in designing and implementing this policy. Conclusion: The policy of retaining physicians in rural areas requires the support of the majority of the country's political and health authorities, and providing infrastructure for health providers. This policy not only increases the quality of services, but also is effective in increasing the patients' access to healthcare services in deprived areas.

-the Active Ageing (AA), as the process of health promotion, collaboration, andsecurity opportunities to increase the quality of life in old age, may be astrategy to prevent many of future challenges in countries like Iran with rapidpace of population ageing. The aim of this study was to measure the AAdimensions in Iran and examine their associations with mental health of Iranianelderly. Methods- A quantitativecross-sectional survey of a random sample of 623 community resident people ofTehran aged 55+ years was conducted. In total, 590people responded. The AA was measured using Active Ageing Index (AAI), including four domains and mentalhealth of participants was measured using 15-item GHQ scale. Associationsbetween them were examined using Mixed-Effect Linear Regression analysis.- The overall AAI score was calculated at 26.8 (men 33.9 vs. women 20.6) out of100. Higher scores in the first domain (employment) and lower scores in the 3rddomain (independent, healthy and secure living)andthe 4th domain (enabling environment)were linked withpoorer mental health, but the 2nd domain (participation in society) showed noassociation.Conclusions- Different aspects of AAI showed differenteffects on mental health. In addition, it seems that the AAI, as a tool formeasuring the AA, needs a profound modification in the Iranian context, usingqualitative studies in Iran.