Background: Tobacco smoking is one of the most important public health problems that may be prevented. There is limited information about its relationship with communication skills. Findings on the relationships between self-esteem and cigarette/hookah smoking are inconsistent. The aim of this study was to investigate the relationships between cigarette and hookah smoking,self-esteem and communication skills among a representative sample of high school students. Methods: In this cross-sectional study, a sample of 1321 tenth-grade students (14-17 years) was selected through multi-stage proportionally cluster sampling in Tabriz, 2017. The participants completed a self–administered multiple choice questionnaire including questions about cigarette smoking, hookah smoking, self-esteem, and communication skills. Results: After controlling for potential confounders, the results demonstrated that higher score of self-esteem protects students against being in advanced stages of cigarette smoking (odds ratio [OR] = 0.95, 95% CI: 0.92-0.99, P=0.012). However, there was no significant association between self-esteem score and the hookah smoking. Also, there was no significant association between communication skills score and cigarette and hookah smoking. Conclusion: According to our findings, self-esteem was associated with cigarette smoking, but not with hookah smoking. Furthermore, there was no statistically significant association between communication skills score and cigarette and hookah smoking.

Background: In order to understand how people perceive, process, and respond to COVID-19 risk information, a valid and reliable instrument is needed. This study aimed to develop an instrument to measure the risk perceptions of people about COVID-19 based on the Extended Parallel Process Model (EPPM). Methods: This cross-sectional study was conducted in Tabriz, Iran. First, a comprehensive literature review was conducted to develop the initial draft of Risk-percept COVID-19. Then, in order to obtain a pre-final version of the instrument, face and content validity were conducted. After that, construct validity (exploratory and confirmatory), internal consistency using test-retest reliability and Cronbach’s alpha of the instrument were measured. Results: Forty two item were initially generated. During the content validity, it was reduced to 29 items. The exploratory factor analysis (EFA) revealed four factors (perceived response efficacy, perceived threats (severity and susceptibility), perceived self-efficacy, and defensive responses (denial, avoidance and reactance) that accounted for 49.97 of the observed variance. The confirmatory factor analysis (CFA) designated a model with appropriate fitness for the data. Cronbach’s alpha coefficient for the dimensions ranged from .697 to .793, and the Intraclass Correlation Coefficient (ICC) ranged from .71 to .80 within acceptable ranges. Conclusion: the current findings show that the Risk-percept COVID-19 is a valid and reliable instrument to assess the cognitions and perceptions of adults.

This study was conducted to develop and assess psychometric properties of the "Measure of Perceived Adherence to the Principles of Medical Ethics in Clinical Educational Settings: trainee version (PAMETHIC-CLIN-T)" as a data collection tool to enhance research performance rigor in future medical ethics studies. Patients and Methods: A multi-tiered six stage procedure was applied to develop the PAMETHIC-CLIN-T and assess its psychometric properties in a sample of Iranian medical science undergraduate students (n=263). The final constructed item pool contained 16 questions with the response options in five Likert-type categories. The higher total score indicated better compliance with the ethics and professional conduct regulations. Internal consistency reliability was examined and exploratory factor analysis (EFA) with direct oblimin rotation and principal components analysis (PCA) were carried out to reduce the overall constructed items into latent factors based on commonalities within the data set. Findings: Factor analysis results revealed a 4-factor solution. All 16 items had factor loading greater than absolute value of 0.3 that accounted for 60.57% of the variance. The value of Kaiser Meyer Olkin (KMO) measure of sampling adequacy for factor analysis (0.909) and also Bartlett's test of sphericity (X 2 =1630.63, df=120, P-value<0.001) approved interpretability of the EFA output. Conclusion: Feasibility testing and psychometric analysis of the constructed scale yielded research evidence to support a four-factor model to be applied in future studies about the extent of perceived adherence to the principles of medical ethics in clinical educational settings.

Screening is a way of looking for patients who do not seem to have major medical problems. Screening tests usually include several phases. In double phase screening, one test is to find the potential patient, and then another test is to prove the disease in those patients. The combination of these two tests is important and can be either "in series", where running or not running the second test depends on the results of the first one, or "in parallel" where the second test is independently performed regardless of what the first test result is.In this article we compared the combined tests based on their final sensitivity and specificity using mathematical analysis to determine how the order of different tests with different sensitivity, and specificity can impact the final specificity and sensitivity of the combined tests.We could prove that in none of the combined tests the final sensitivity and specificity is affected by the sequence of the tests, but the amount of intermediate false positive is affected, so that if the first test is more sensitive, we will have more false positives after the first test.The type of screening we choose relies on what our aim is for doing that screening, and a combination of tests should be selected, so that the selected tests are acceptable in terms of false positive but whether, to do the more sensitive test first or the more specific one, there is no difference in the final sensitivity or specificity.

Background: A Based on the World Health Organization's reporting, over 1.25 million people die annually in traffic accidents worldwide. Traffic accidents are the ninth main cause of death worldwide, with an average age range of victims of 15 to 29. Broadly speaking, 90% of traffic accidents happen in the lowand middle-income countries that comprise 82% of the global population, and these countries account for half of the world's vehicles. One of the goals of the National Road Traffic Knowledge Development Trustee is to plan and implement training courses (content design, design and implementation and evaluation) for target groups. To achieve this goal and due to the lack of academic programs on traffic safety in Iran, a single-credit course, "Safety and Traffic," was developed to be run as a compulsory academic course in all universities across the country. Methods: This course was administered as a national pilot study in four phases and in 17 medical universities across the country. All experts and national authorities in the Ministry of Science and the Ministry of Health and Medical Education were requested to provide feedback. Afterwards, the results and comments were forwarded to the Supreme Council of Cultural Revolution for further investigation. Upon approval of the Council, the course will be implemented in all universities across the country. Results: Results from the pre-test showed that the level of students' knowledge was low before attending the training courses. Surveys also revealed that the two items of "pedestrian safety" and "first aids in RTCs" were the most useful and applicable subjects. The percentage of wrong answers ranged from 61 to 98%. Conclusion: Considering the importance of traffic accidents and people's role in traffic-related issues, it seems that it is necessary to provide university courses for traffic safety education.