Journal of Health System Research
Year:2012 | Volume:8 | Issue:7 (SUPPLEMENT)|Papers Count:37

Nowadays, improvements in the today’s medical world with many advances achieved in different areas caused many incurable diseases to be cured or prevented. Since many of these developments have been based on utilization of chemical drugs, a large amount of side effects inevitably occurs. Therefore, the traditional methods and past views and experiences that guarantee safer human health have increasingly spread. Among these traditional methods, phlebotomy (bloodletting) is one of which with a special place in Iran's medical culture. Opponents and proponents of this approach have provided plenty of reasons for its accuracy or inaccuracy. However, reviewing its place on the human health system and as an issue with an important place throughout the medical history of our country will address the newer areas of access to the use of past experiences and consequently will enlighten newer researches on health system. The author of this paper has tried to show the place and the role of this ancient approach in the new researches and its effects on human health by reviewing the sources and references about the types and methods of blood cupping. Furthermore, reviewing those viewpoints can provide more opportunities for reflecting and reviewing the experts' viewpoints in this regard.

Background: In traditional societies the elderly enjoyed great power and social status. But their situation along with that of the family has changed dramatically in today's urbanized and industrialized society, and this has created many problems for them. The substantial and continuous decline in mortality has increased the elderly population which in return has made them vulnerable to different types of abuses. The aim of the present study was to investigate the sociocultural factors affecting elderly abuse in Isfahan, Iran.Methods: This research employed the survey method and the technique of data collection was a questionnaire. Research population consisted of all the elderly aged 60 years and above who were abused or mistreated and had contacted Isfahan's legal medical authorities. The sample included 62 such individuals. The research instrument had face validity and Cronbach's alpha (reliability) was 0.78. Analysis of variance and Pearson correlation coefficients were used.Findings: Physical abuse was at a minimum and economic and psychological abuses were more prevalent. There was a significant relation between elderly abuse and education (f=3.52, P=0.005), person who resided with the elderly (f=4.42, P=0.002), and socioeconomic status (r=0.592, P<0.001).Conclusion: Physical abuse of the elderly in Isfahan was relatively low but using their property without their permission and psychological abuse was more frequent. Concerted efforts should be exerted to prevent any kind of abuse.

Background: Volatile organic compounds (VOCs) are among the main air pollutants which have destructive effects on the environment and human health. Considering the carcinogenic effects of some of these compounds including benzene, how to control and limit them is considered an important issue in environmental research. The aim of this study was to evaluate the use of the combined ultraviolet (UV)/O3 method in the removal of benzene from the airflow.Methods: The present experimental study was conducted using laboratory methods. The laboratory equipment consisted of air pumps, injection pumps, mixing chamber, rotameter, ozone generator, and a steel reactor with 45 cm length and a usable volume of 1.35 liters in which a 15-watt UV-C diode with a wave length of 254 nm had been placed. Then, the different concentrations of benzene were continuously exposed to UV-C rays, different ozone doses, and simultaneous UV/O3 with varying reaction times (and considering the speed of the input airflow into the reactor). The concentration levels of benzene before and after the exposures were compared with each other and with the above-mentioned variables. The data were analyzed using descriptive and inferential statistics and by three-way ANOVA.Findings: Concentrations of benzene vapored with different values of 10, 20, 30, 50, and 80 ppm passed through the reactor and was exposed to UV-C rays, different ozone doses, and simultaneous UV/O3 in sequence. The findings demonstrated that UV alone can remove benzene from the airflow up to 2%. Ozone can remove 14% of benzene from the airflow, while the concurrent application of UV/O3 can reduce the benzene in the airflow by 24%. The three way ANOVA test showed that there was a significant relationship between the variables of ozone dose, UV rays, and UV/O3 in the one hand, and benzene removal rate from the airflow, on the other hand (P<0.002).Conclusion: Given the small effect of UV alone in separating benzene from the airflow, it can be concluded that advanced osidation process (AOP) reactions which produce active radicals can be used in the filtration of benzene. The findings indicated that the removal rate of benzene during the simultaneous use of UV/O3 is much more considerable than during the use of either of them alone. Additionally, the analysis of variance test demonstrated that the simultaneous use of UV/O3 has a positive cumulative effect.

Background: Cardiovascular diseases are the most common cause of death in people under 70 years of age worldwide (39%). Also in Iran it is the cause of 45% of deaths. Cardiovascular diseases place a huge social, economic and health burden on the society. Patients suffer from this disease when they are at their highest social and economic productivity. The risk of this disease is related to modifiable factors such as smoking and high blood pressure, and also non-modifiable factors such as age and family history. This study aimed to investigate the role of health beliefs in preventive behaviors of individuals at risk of cardiovascular diseases.Methods: This descriptive and analytical study was conducted on 100 people with 30 to 65 years of age at risk of cardiovascular disease who attended to Yazd Khatamolanbiyae clinic, Iran in 2011. Data gathering tool was a questionnaire based on constructs of health belief model including knowledge questions and preventive behaviors.Findings: Participants’ mean age was 43.7±9.6 years. 56% were female, most of them were housewives (43%), 93% of them were married and most of them (37%) did not complete secondary education. Mean score of perceived severity was 23±2.4 (out of 25), perceived susceptibility was 15±2.6 (out of 20), perceived barriers were 20.7±4.4 (out of 30), perceived benefits were 27.05±3.45 (out of 30), knowledge was 22.7±4.9 (out of 33) and preventive behaviors of cardiovascular diseases were 18.11±3.71 (out of 25). Pearson correlation showed statistically significant correlation (P<0.05) between perceived benefits, perceived barriers, self efficacy and knowledge with preventive behaviors.Conclusion: Results indicated lack of correlation of perceived susceptibility and perceived severity with preventive behaviors and correlation of perceived benefit, perceived barriers, self-efficacy and knowledge with behaviors. Educational programs based on health belief model should be performed with emphasis on aspects which have more effectiveness on preventive behaviors.

Background: Addiction or substance abuse is a serious issue that threatens the human society. Several factors are effective on the emergence, persistence and treatment of addiction. Some probable predictors of substance abuse have been studied among which is attachment styles. Attachment is an affective bond between mother and infant in developmental psychology. Insecure experiences of attachment can develop a predisposition toward substance abuse.Methods: Subjects included 120 students and 81 young drug addicts. Convenience sampling was used to select the addicted subjects by referring to the addicts’ welfare centers. Multistage cluster sampling method was used to choose the non addicts by referring to the universities in Ilam, Iran. The instrument for data gathering was adults’ attachment styles of Coolins and Reed.Findings: The regression analysis showed that there was a significant relationship between attachment styles (avoidant and anxiety) and drug dependency, but there was a negative, invers significant relationship between secure attachment style and drug dependency (P<0.01).Conclusion: Lack of appropriate interaction between child and mother during childhood and emotional deprivations leads to child’s addiction. Non responsive and low confidence parents, distance between mother and children, feeling of hostility and lack of child care can also result in drug abuse and addiction.

Background: Cyanide can be removed from aqueous solutions using different but expensive methods. In this study, Lewatit FO36 exchange resin was used to remove cyanide.Methods: Removing cyanide from the aqueous solutions with the Lewatit FO36 exchange resin was studied via considering the effects of absorbent dose, initial cyanide concentration, contact time and pH in batch phase.Findings: In the batch ion exchange process, it was observed that the pH of solution and the contact time of nano particle resin in acidic conditions were very influential in obtaining the maximum removal. The optimum time was reached after 60 minutes of contact. In 60-minute contact time, the removal efficiency decreased from 74% to 42% by increasing pH from 7 to 11. The results showed that at the resin dose of 3 gr/L, contact time of 60 minutes, pH of 7 and cyanide concentration of 2.5 mg/L, the cyanide maximum removal efficiency reached 81%. Lewatit FO36 showed high bonding constant and the ion exchange of cyanide on the cation exchange resin followed first order reversible kinetics.Conclusion: The cyanide removal efficiency was initially fast but slowed down later and the removal efficiency was higher at neutral and acidic pH. However, due to its regeneration characteristic, Lewatit FO36 resin can be used as a convenient option to reduce the level of cyanide from the industrial waste water and specifically electroplating industries, where the problem of cyanide in sewage is ubiquitous.

Background: Iran is one of the countries with the highest rate of deaths due to accidents in the world. Motorcyclists are one of the most vulnerable groups in Iran that 42% of road accidents are attributed to them. The objective of this study was to determine the factors affecting the use of helmets among motorcyclists in Shiraz, Iran.Methods: This cross-sectional study was conducted among 400 randomly selected motorcyclists between 15 to 60 years old in Shiraz, Iran. The level of significance was set at P<0.05.Findings: Only 11.2% of the participants reported that they always use their helmet. Most of the participants (62.5%) declared that they do not use helmet mostly because it is not comfortable. There was a significant relation between using helmet with jobs and education (P<0.05).Conclusion: Using motorcycle helmet was low in the studied population. To increase the prevalence of helmet use, it is necessary to focus not only on police enforcement but also initiatives to make helmets more convenient.

Background: Osteoporosis is one of the metabolic disorders commonly found during elderly period which severely affects the quality of life. Therefore the present study aimed to investigate and compare the quality of life in the elderly with and without osteoporosis.Methods: This analytical descriptive study was conducted on 424 participants over 60 years old who were members of health clinics under the supervision of municipality health office of Tehran East areas, Iran. Subjects were randomly selected. 145 participants with osteoporosis and 279 without any symptoms were chosen. Information was gathered using quality of life SF36 standard questionnaire and was filled out through face to face interviewing.Findings: 63.7% of the particiants were women and 36.3% were men. Mean age was 67.3 with standard deviation of 7.16. Out of all the participants 145 (34.2%) were suffering from osteoporosis. There was a significant relation between mean quality of life score and development of osteoporosis symptoms.Conclusion: Osteoporosis in the elderly results in the reduction in quality of life. Prevention and early treatment of this disease can improve the quality of life in the elderly.

Background: A very few organizations publish suicide data in Iran. Since a national comparative study on the published suicide data is an important issue, the present study aimed to compare Iranian Ministry of Health (IMoH) data with Iranian Statistical Center (ISC) data in 2004.Methods: In this cross-sectional study, all the suicide data for the Iranian provinces that originated from IMoH and ISC were entered into STATA software. In the next step, the population number of each province was also added to the database and then the rate of suicide was calculated by applying the Poisson model.Findings: A total of 3170 and 2486 cases of suicide were recorded by IMoH and ISC, respectively. In all the provinces except Ilam, Zanjan, Qom, Markazi, Hamadan and Yazd, the recorded suicides by IMoH were higher than those by ISC. Based on IMoH data, Ilam province had the highest rate of suicide whilst based on ISC data, Lorestan province had the highest rate of suicide.Conclusion: The higher suicide rate in western provinces of Iran is in accordance with the results of other studies in Iran. Furthermore, the differences between IMoH with ISC data can be attributed to the methods each organization used for collecting the suicide data. These findings not only are important for implementing the suicide prevention plan, but also urge to design and implement a comprehensive surveillance system for suicide data in Iran.

Background: It is necessary to monitor the performance of the industrial wastewater treatment plants in order to achieve the desired environmental standards. This study was carried out to determine the efficiency of the nitrogen removal, phosphorus compounds and chemical oxygen demand (COD) and comparing the effluent standard with the effluent industrial wastewater treatment plant of Agh Ghala, Iran.Methods: The present cross sectional study was conducted in 2011 during six months. Sampling was performed two times per week from the incoming wastewater, pond aeration and effluent. Composite sampling was conducted for the treatment plant input, and for the other units it was done momentarily. Overall, 48 times wastewater sampling and testing was performed.Findings: The mean concentrations of total nitrogen, phosphorus and COD in influent were 7.36±4.23 mg N/l, 68.1±26.4 mg P/l and 5.7±3.6 and 294.2±183.5 mg/l. Total nitrogen, phosphorus and COD showed a removal of about 86%, 67% and 95%, respectively. According to the standard, discharge of effluent wastewater treatment to surface water was acceptable (except phosphorus).Conclusion: The effluent quality of this treatment plant was according to the effluent disposal standards except for phosphorus. However, this problem is solvable by accurate management and supervision on wastewater treatment plant.

Background: The issue of employee turnover is one of the organizational problems that affect organization development. For organization managers who want to save, protect and improve human resources, it is a problem and also requires special attention. Applying proper methods of management and also promoting empowerment of employees increase their motivation to continuously communicate with organization. The objective of this research was to study the relationship between managers’ supportive behaviors and psychological empowerment with intention to stay in the organization.Methods: This research was done in Health Care Organization of Oil Industry of Isfahan, Iran, during the autumn of 2011. Among the employees of organization (in total 354 people), 187 employees were selected by convenience sampling. The research tools included Supportive Managerial Behaviors Questionnaire, The Psychological Empowerment Questionnaire and Intention to Stay Questionnaire. The data was analyzed using Pearson’s correlation coefficient and multiple regression analysis (enter method).Findings: There was a significant relationship between supportive managerial behaviors and empowerment and intention to stay. Supportive behavior and empowerment predicted 12% of the variance of intention to stay (P<0.001).Conclusion: Managerial methods especially supportive behaviors of managers are complementary component to create a proper environment to educate employees and increase their motivation. Furthermore, employees’ realization of their empowerment levels, increases motivation and their organizational commitment.

Background: Identifying and employing appropriate learning styles can ultimately play an important role in selecting teaching styles in order to improve education. The current study was carried out to determine learning styles preferences of first year students at Isfahan University of Medical Sciences (2010).Methods: A cross-sectional study employed visual, aural, read/write, and kinesthetic (VARK) learning style’s questionnaire which was done on 184 first year students of medicine, pharmacy, dentistry, nursing and health services management at Isfahan University of Medical Sciences in 2010. Validity of the questionnaire was assessed through experts’ views and its reliability was calculated using Cronbach’s alpha coefficients (a=0.86). Data were analyzed by VARK software designed in Excel and employing SPSS for Windows 16.0.Findings: Out of 184 participants that responded and returned the questionnaire, 122 (66.3%) were female, more than two-third (68.5%) of the student were in professional doctorate status (medicine, pharmacy, dentistry) and 31.5% were in undergraduate status (nursing and health services management). 89 students (48.4%) preferred single-modal learning style and the rest of the students preferred multimodal learning styles. A significant relationship (P<0.009) was between the gender and single-modal learning styles and also between course level and learning styles (P<0.05).Conclusion: According to the result, male students more than female students preferred to use kinesthetic learning style, while female students preferred aural learning style more. Knowing the learning styles of students in education is a valuable skill that helps trainers to solve learning problems among students, and also helps students to be more effective learners.

Background: The quality of services and customers satisfaction is the most controversial aspects of today’s management service organizations. Customer orientation is the core strategy of all the organizations in the world. The aim of this study was to compare the quality of the presented services in public and collaborative health sites under the coverage of health network of Rey city, Iran in 2011-2012.Methods: This cross-sectional descriptive study was performed randomly on 400 people who referred to public and collaborative health sites. Data gathering was conducted with SERVQUAL questionnaire by face to face interview.Findings: There was a significant difference between the average gap of perception and service quality expectations of tangible and physical aspects (P=0.001), service guarantee commitments (P=0.009) and sympathy (P=0.007) among the two sites. The gap between perception and expectations in the mentioned aspects was more in the public health sites compared to the collaborative health sites.Conclusion: Service quality gap in public health sites was more compared to the collaborative health sites. It is necessary to improve the public health services by applying interventions to improve the physical environment, ensure service commitments, increase sympathy with the clients, and receive feedback on issues and treatment results from the clients.

Background: This study aimed to assess the effectiveness of educational program on lifestyle modification among type II diabetic patients.Methods: This was a quasi-experimental study which was conducted to determine the effectiveness of educational program on lifestyle modification among type II diabetes patients in 2011. Study population included 120 people who suffered from type II diabetes and divided into two groups using random allocation sampling method. In this study, the questionnaire included two parts; i.e. demographic and diabetes lifestyle scale that included assessment of knowledge, attitude and performance on nutrition and physical activity. Educational program was based on face to face approach of the questionnaire. Data collection was conducted in two stages: before and 3 months after the program in the two groups. SPSS software and descriptive statistics were used for analyzing the collected data. The significant level was considered as 0.05.Findings: Study results revealed that educational program had a positive effect on enhancing knowledge, attitudes and practice regarding nutrition and physical activity in the intervention group. This increase was significant based on covariance test (P<0.001).Conclusion: It is necessary to provide educational intervention on lifestyle modification in nutrition pattern and physical activity using health education and promotion by focusing on knowledge, attitude and performance among type II diabetes patients.

Background: The objective of this study was to measure the total suspended particulate (TSP), PM10 and PM 2.5 air particulates in the selected intercity bus stations located in the central square of Hamadan, to review the distribution concentration of the air particulates content and to evaluate its possible health risk to the people who spent little time of their daily time in those places.Methods: This was a descriptive and cross-sectional study. Sampling was done systematically in six bus stations at different time intervals. A portable air sampler, sampled air at 10 liters per minute for suspended particulates (TSP and PM10) measured at 1 meter height above the ground. For measuring PM2.5 after the cyclone, fine particles were collected at a flow rate of 2 liters per minute onto a filter. The suspended particulate was collected on 47 mm mixed cellulose ester (MCE) membrane filters, which must be weighed pre and post-exposure to determine the concentrations in micrograms/cubic meter. Temperature, humidity and wind speed was measured at the sampling locations, and their averages were recorded. To analyze the data, we used statistical analysis Pearson correlation coefficient using SPSS software to study the correlation between the concentration variation of the particulate distribution and humidity, temperature and wind speed as well.Findings: The results obtained for TSP, PM10 and PM2.5 during the sampling period were 1220.9±1418.5, 524.7±217.5 and 386±193.6 mg/m3, respectively. Exposure to these pollutants as time weighted average were 50.872, 21.87 and 16.08 mg /m3, respectively that were lower than the standards set by the accredited organizations. There was no significant relationship between the concentration variation of the suspended particulate and wind speed and air temperature (P>0.05); however, there was a significant relationship between the concentration variation of the suspended particulate and humidity (P<0.05). PM2.5 and PM10 with total suspended particles had correlation coefficient of r2=0.74 and r2=0.78, respectively.Conclusion: Results of this study illustrated that there were particular concerns regarding potential human health impacts for people who spend considerable time at intercity bus stations or close to them. Pedestrians and unofficial business employees are expected to be exposed to high concentrations of suspended particulate pollution because of longer contact time that applied in this study.

Background: In the absence of specific logistics supply, a bioterrorism attack using smallpox virus, including pollution of water and food can devastate the National Health Foundation, and many of the patients and ordinary people may die. One of the most important ways to deal with this issue for bioterrorism attack is enhancement of awareness and attitude of medical staff to identify and react quickly to deal with these events. This study assessed the effect of bioterrorism training through lectures and educational pamphlet on knowledge and attitudes of medical staff.Methods: In a quasi-experimental study, 100 health personnel were selected through the census method. A questionnaire was used to collect the data. A group of participants was given educational pamphlets and the other group was provided with 2-hour lectures. Second step was done a month later.Findings: The results of the study showed that the average scores of knowledge increased in both groups after the training which was statistically significant (P<0.05).Conclusion: Bioterrorism training had a positive effect on knowledge and attitudes of medical staff in both methods but it was more effective in lecture group.

Background: The sensitivity and specificity of body mass index (BMI) percentiles of Centers for Disease Control 2000 (CDC2000) standard was compared with child actual overweight which was identified by fat mass index (FMI) and overweight status in these children based on BMI and FMI.Methods: In this case-control study, elementary school girls (aged 8-10 years) were recruited from schools of Isfahan, Iran. Weight, height and fat mass were measured by body composition analyzer (BCA) and by calculating BMI (weight in kilogram divided by height in meters squared) and FMI (fat mass in kilogram divided by height in meters squared) and then the BMI and FMI were compared. BMI³95th and BMI<95th percentile of the CDC2000 standards were used for overweight and non-overweight definition, respectively. FMI on or above the 90th percentile and FMI<90th percentile based on the reference data were considered as criteria for actual overweight and actual non-overweight, respectively.Findings: Mean (±standard deviation) of FMI and BMI in all children were 6±2.1 and 19.4±3, respectively. The sensitivity and specificity of 95th percentile of BMI to identify children as overweight in comparison with FMI were 57.3% and 98.4%, respectively. 1.6% of the children, who were identified as non-overweight based on FMI, were overweight based BMI, and 57.3 % of the children who were overweight based on FMI, were also overweight based on BMI.Conclusion: It appears that FMI in comparison with BMI has more ability to determine overweight; however, further studies are required in this field.

Background: Petroleum contaminated soil is an environmental problem that affects human health. Phytoremediation is a cost -effective method for removal of petroleum from soil. This paper evaluates the effects of the plant and nutrients on the removal of TPHs from soil.Methods: Soils were collected from Ahvaz desalting unit No.2 and then polluted with 2.5% w/w of crude oil. Microbial number and residual TPHs of the pots experiment were determined at day 0 and 90. TPHs and heterotrophic bacterial number were measured by GC and HPC method respectively. Data were analyzed using the software Statistical Package for Social Sciences (SPSS 17 for Windows) and Excel.Findings: results showed that the average percentage of TPH removal in the rhizosphere soil (»20%) was higher than those in the non-rhizosphere ( »7%). soil. In addition, the average number of heterotrophic bacteria in the rhizosphere soil (7.14 CFU/g) was higher than in the non-rhizosphere (6.16 CFU/g). Also results show that the TPH removal and microbial number in the soil that received nutrient were higher than in the nutrient-free soil.Conclusion: Although high clay and salinity of the soil had an inhibitive effect on phytoremediation efficiency, results show native plants perform phytoremediation properly even in improper condition of environment.

Background: The spread of urbanization in floodplains as well as increase of industrial and agricultural activities in river discharges may lead to water pollution by physical, chemical and biological pollutants. One of the major concerns in monitoring the water resources system is indentifying major quality parameters and determining a relationship between physical and chemical parameters. This is important because the physical parameters are usually related to the natural characteristics of the river basin, while chemical parameters are associated with human-made pollution resources. Thus, if there is a high correlation between these two groups of parameters, it could be concluded that the source of both parameters are identical. However, to achieve this goal, costly and time consuming instrumental techniques and intensive laboratory efforts might be required.Methods: To determine the major quality parameters that cause water pollution in Karkheh River, statistical principal components analysis (PCA) method was employed. Moreover, canonical correlation analysis (CCA) was used to find the relationships between physical and chemical parameters. In this study, discharge rate (Q), turbidity (Turb), temperature (T), dissolved oxygen (DO), total suspended solids (TSS) and electrical conductivity (EC) were selected as representative parameters for the physical characteristics of the river water quality. In addition, pH, 5-day biological oxygen demand (BOD5), chemical oxygen demand (COD), total phosphorous (TP) and total nitrogen (TN) were chosen as representatives of the river chemical attributes. These two groups of quality parameters were measured along the Karkheh River in 18 monitoring stations from March 2006 to March 2007.Findings: Results of PCA analysis indicated that all the selected chemical and physical parameters of Karkheh River were of high importance. Further investigations indicated that in CCA analysis the first three canonical correlations were 0.896, 0.848 and 0.593, respectively, suggesting that turbidity, DO and TSS were three dominant physical parameters in all the canonical variables, whilst BOD5, COD, TP and TN were highly scored among the chemical parameters.Conclusion: According to the CCA results, it can be implied that human activities are the source of the physical and chemical parameters of the river. The utilized statistical methods in this study can be used as an appropriate decision support system for water sector managers regarding water quality management of the river basin when large complex water quality data are involved.

Background: Using the sludge as fertilizer on farms is one of the options to dispose it. Due to variety of pathogenic microorganisms of sludge, it may cause a wide range of bacterial and parasitic diseases in human and livestock. The purpose of this study was to investigate the relationships between several parameters of dried sludge produced in Sewage Treatment Plants to predict sludge quality and the corresponding standards.Methods: In this analytical-descriptive study, three Sewage Treatment Plants of Chaharmahal and Bakhtiari Province including Shahrekord, Farsan, and Borujen were selected due to their similarity in the weather condition and the treatment process. In order to investigate the sludge in its lowest and the highest rate of evaporation in the freezing cold winter and burning hot summer, two winters and two summers were selected as the timeframe. In this study, fecal coliform and total coliform were determined as the sludge microbial indexes and statistical relationships between them were determined using Pearson’s correlation.Findings: Strong statistical relationships were found between parasite eggs and fecal coliform of the samples with the Pearson’s correlation coefficient of 0.926. Pearson’s correlation coefficient between parasite eggs and total coliform was 0.919.Conclusion: As all the correlation coefficients were more than 0.9, these parameters had a proper statistical relationships. Since the best statistical relationships was found between parasite eggs and fecal coliform, other treatment plants with similar weather and process can predict microbial and parasite eggs condition in dried sludge using these relationships.

Background: Nowadays drug abuse and addiction is one of the most important health concerns as well as social and political problems in the world. This study was done to compare substance abuse and its related factors between University of Tehran and Tehran University of Medical Sciences, Iran.Methods: This study was cross-sectional. In this study, 489 students of Tehran University and 488 students of Tehran University of Medical Science were selected through stratified cluster sampling. The data collection tool was a researcher-made questionnaire. Collected data was analyzed by SPSS software version 18 using chi-square test, regression, and Student’s t-test. P<0.05 was considered significant.Findings: The prevalence of drug abuse in students was 33% in Tehran University of Medical Science, and was 37.5% in University of Tehran. First substance use was during student period. In both universities, there were statistically significant relationship between drug abuse and gender, religious beliefs, family history of substance use, and school (P<0.001). The most mentioned way of exposure to substances was friends.Conclusion: Regarding the role of universities as the centers of training and educating, it is proposed to conduct health education programs for prevention of substance abuse in high schools. These preventive programs should be continued at universities.

Background: Smoking hookah habit among the young is rising and it is necessary to pay more attention to this problem. This study aimed to determine the attitude, subjective norms and perceived behavioral control of mail students about hookah smoking cessation in 2012.Methods: This study was descriptive-analytical. After designing and assessing validity and reliability of questionnaires, 90 male hookah smoker students who were resident in the dormitories of Tehran University of Medical Sciences were selected by multistage sampling method. The students were asked to fill out questionnaires. The data were analyzed by SPSS software using chi-square test and independent sample t-test.Findings: The results showed that %58.9 of subjects planned to quit. Although students believed that hookah smoking cessation can prevent many diseases, beliefs such as being non-addictive, reducing anxiety and fatigue, and being worry about break off relation with friends who smoke hookah were their major reason for continuing hookah smoking. Family and community expected students to quit hookah smoking. Students expressed that barriers such as not being able to say 'no' against their friends’ offers, being difficult to overcome hookah smoking temptations as well as not to smoke hookah in the recreational and friendly environments, make it more difficult to stop.Conclusion: The design of interventions for smoking hookah cessation among college students can be focused on eliminating positive attitudes about hookah and developing skills to say 'no', relaxation and coping with smoking hookah temptations.

Background: One of the major steps for planning and making polices in Iranian health and health service sector is to gain information on the condition of such services in each province. Thus, the present study intended to determine the degree of development and ranking of provinces at this sector. It can identify the undeveloped provinces for better planning.Methods: This study applied a library and documentary method for collecting the data which had been provided by the Iranian Statistical Center and its related journals. The study population included the health sector at thirty provinces in 2008. Using methods such as analysis of main components and numerical taxonomy as well as considering seventeen indexes of health and having access to health services, this study dealt with the ranking provinces.Findings: Homogeneity gap was determined through estimation in numerical taxonomy method, based on which North Khorasan, South Khorasan and Hormozgan provinces did not fall within the homogeneity gap; therefore, they were excluded from the sum, and ranking was conducted for the remaining twenty-seven homogenous provinces.Conclusion: Considering the degree of development of the provinces, it was revealed that Ilam, Chaharmahal-Bakhtiari, Isfahan, Yazd, Mazandaran, Semnan and Guilan had the best condition as compared with other provinces. However, Sistan-Baluchistan, Qom, West Azerbaijan, Kohkilouyeh-Boyerahmad, Tehran, and Kerman had an inappropriate condition. In the same year, Ilam and Sistan-Baluchistan were the most developed and the most undeveloped provinces in the health sector, respectively.

Background: Due to the accumulation of pollutants in indoor environment, complaints about the indoor air quality has been increased in recent years. This study conducted in order to investigate the effective factors on indoor air quality in an office building in Tehran, Iran.Methods: In this cross-sectional descriptive study, environmental factors effective on indoor air quality was measured using direct reading instruments. Symptoms of sick building syndrome were investigated using Indoor Air Quality questionnaire.Findings: Nine percent of employees complained about their poor work conditions. The most complaints were related to air heaviness, fatigue and headache. Parameters measured included carbon dioxide, carbon monoxide, particulate matter, volatile organic compounds, ozone, formaldehyde, temperature, humidity, and noise were lower than the recommended limits.Conclusion: While most of air quality indices were below the reference values, only some of employees complained about quality of indoor air in the studied building. It seems that some other factors such as job stress and job satisfaction influence the employees’ perception of indoor air quality which should be considered.

Background: Today many women are at risk of anxiety. Therefore, despite medical advances, a significant number of negative outcomes occur during pregnancy. Due to restrictions during pregnancy, psychological treatment is the most appropriate treatment method. The purpose of this study was to determine the effectiveness of cognitive behavioral stress management on the stress, anxiety, and depression of pregnant women.Methods: From 80 pregnant women who had the highest score of stress, anxiety, and depression in the Depression Anxiety Stress Scale (DASS-42) 24 were selected and assigned to two experimented and control groups (12 in each group). The experimental group received 8 weekly sessions in the Shahid Rajaei Health Centre in Shahreza, Iran. DASS-42 inventory with subscales of depression, anxiety, and stress was used as pre-test and post-test. Data were analyzed by SPSS software (version 16).Findings: The results of covariance analysis showed that the mean score of mental states (stress, anxiety, and depression) in the experimental group was significantly lower than the control group in the post-test.Conclusion: It is concluded that cognitive behavioral stress management can be used, as an interventional method, to decrease stress, anxiety, and depression during pregnancy.

Background: The concentration of aerosols in the atmosphere has increased in recent years. These particles can adversely affect human health. Studies show that indoor air quality is affected by outdoor air. Moreover, people spend a significant portion of their time indoors, and few studies have been done in this area. Therefore, the purpose of this study was to measure the concentration of outdoor and indoor suspended particles in Hafez Hospital, Shiraz, Iran, and determine the relationship between these parameters.Methods: A cross-sectional study was done in Hafez Educational Hospital in Shiraz from October to November 2011. Sampling was done twice a week. The outdoor and indoor air sampling was conducted in each ward of the hospital. 144 samples were collected for analysis; including 24 samples for each ward of the hospital and also for outdoor air. Sampling was performed by using a sampler Aerosol Mass Monitor (Model GT-331, Japan) to measure the particle concentrations of PM10 and PM2.5. To compare the concentration of indoor suspended particles in different wards of the hospital with outdoor particles, one-way ANOVA was used. Then, the data were analyzed using SPSS version 11.5. The results obtained were compared with 24-hour particulate matter concentrations of EPA and WHO guidelines.Findings: Results showed that indoor and outdoor air quality of the hospital in terms of air quality index for PM2.5 is in a good condition. The air quality index for PM10 for the indoor air showed that 95.2% of wards were in good condition, and two obstetric wards were in average condition. Status of outdoor air quality for PM10 is unhealthy for sensitive groups in 75% of samples. To assess the relationship between suspended particles in outdoor and indoor air of hospital wards, Pearson correlation was used. Accordingly a significant relationship was observed in PM10 and PM2.5 of outdoor and indoor air of a number of hospital wards (P>0.05).Conclusion: The average ratio of PM10 and PM2.5 of indoor to outdoor air (I/O) were, respectively, 1.41 and 6.10, which indicated the low ventilation and air exchange within the wards. The results also showed that there is a significant relationship between the concentration of suspended particles in the indoor air and outdoor air. This represented a penetration of outdoor particles into the indoor air of hospital wards. Thus, for hospitals that are located in high traffic areas, utilizing appropriate ventilation systems within the hospital is effective in reducing air pollution.

Background: One of the new concepts that have found their true meaning with technological advancement and the industrialization of societies is leisure time and how it is spent. Recreational sports and frequent leisure activities are the most relevant and essential types of spending leisure time. Therefore, this study attempted to examine how faculty members of Isfahan University of Medical Sciences, Iran, spend their leisure time, with emphasis on physical activities.Methods: This was a descriptive study. The study population included all faculty members of Isfahan University of Medical Sciences, which were 670 members. A sample size of 150 was calculated with a preliminary study and using Cochran's formula. The subjects were chosen by the random stratified sampling method according to variables of gender and School. The data gathering tool was the researcher-made Leisure Questionnaire. The reliability of the questionnaire was 0.82, which was obtained using Cronbach's alpha coefficient.Findings: Results showed that research activities with the average of 3.37 was the first priority, physical activities with 2.49 the second priority, social and cultural affairs with 2.25 the third priority, and personal and family affairs with a mean of 1.89 was the fourth priority of subjects for their pastime (a£0.05). Health maintenance, with the average of 3.94, was the most important motivation to engage in leisure time physical activities. Moreover, there was a significant difference between leisure activities based on gender and work experience.Conclusion: The amount of leisure time of faculty members was low (x=3.44). It seems that society must be informed on the characteristics and methods of community sports and leisure facilities and the necessity to create the appropriate conditions through planning and cultural actions. Moreover, social groups especially the academics should be made aware of the positive effects of healthy leisure and recreational activities.

Background: There is little data available on job stress dimensions and their relationship to musculoskeletal disorders (MSDs) among Iranian nurses. The aims of this study were to investigate job stress dimensions and examine their relationship to MSDs among nurses of hospital affiliated to Shiraz University of Medical Sciences (SUMS).Methods: 385 randomly selected nurses of SUMS participated in this cross-sectional study. The Persian version of Job Content Questionnaire (P-JCQ), Nordic MSDs (NMQ), and demographic questionnaires were used for data collection. Using SPSS (version 11.5) software, descriptive statistics and Mann-Whitney test were applied for data analysis.Findings: The mean±SD of decision latitude, psychological job demands, social support, physical job demands, and job insecurity were found to be 58.15±6.50, 38.19±5.14, 22.67±3.67, 16.03±2.58, and 7.74±3.85, respectively. The results revealed that decision latitude and social support dimensions had low levels, but psychological and physical job demands, and job insecurity dimensions had high levels among the study subjects. The results of NMQ showed that 89.9% of the nurses had experienced some form of MSD during the previous 12 months. Lower back symptoms were found to be the most prevalent problem reported (61.8%). Physical isometric loads was the only sub-scale of job stress dimensions that had significant relationship with MSDs. Psychological and physical job demands were found to have a statistically significant relationship with trunk region symptoms. Physical job demands were associated with upper extremities symptoms. However, decision latitude, and psychological and physical job demands had a significant relationship with lower extremities problems.Conclusion: MSDs prevalence was high among the studied nurses. In the majority of cases, subjects were exposed to high levels of job stress. Based on the results, any interventional program for MSDs prevention should focus on reducing physical and psychological job demands, and increasing decision latitude among nurses.

Background: The ultimate goal of diabetes control is HbA1C improvement. The purpose of this study was to assess the effect of empowerment model on HbA1C among adolescents with type 1 diabetes.Methods: The present semi-experimental study was carried out on some 47 diabetic adolescents in order to investigate the effect of an educational program based on the empowerment model on HbA1C among adolescents with type 1 diabetes. Samples were randomly divided into two groups of case and control. The study tools included the questionnaires of demographic information, knowledge, self-efficacy, and selfesteem.Moreover, the level of HbA1C of the adolescents was evaluated. The validity and reliability of the questionnaires were evaluated by content validity and a-test. After collecting the pre-intervention data and level of HbA1C of the adolescents, the group discussion meetings were performed on the subjects in the case group. Data and level of HbA1C of the adolescents were collected and analyzed 2.5 months after the intervention. Data were analyzed using SPSS software version 11.5.Findings: Study results indicated that there were significant differences between the two groups in terms of the knowledge, self-efficacy, self-esteem, and HbA1C after the intervention (P<0.05).Conclusion: Overwhelmingly, implementation of the empowerment based diabetes intervention has been highly effective on the HbA1C level of diabetic adolescents. It is suggested that this intervention be applied to other age groups in a wider range.