Journal of Health System Research
Year:2023 | Volume:19 | Issue:3|Papers Count:10

Nowadays, the application of kinetic models based on physiology in modelling and predicting the level of toxicity of chemical substances is developing rapidly. The data extracted from these models are being used in environmental risk assessment. They are also widely being used in various industries and research sectors such as drug development, product safety evaluation, and clinical or pharmaceutical procedures. These models are also considered a suitable alternative to animal models. With the progress of computer science, many software programs have been designed to model and better understand these models. Each of these software programs has a range of specific user features and provides various modelling capabilities based on the user's needs. In this study, several software programs that perform modelling based on physiologically-based pharmacokinetic (PBPK) models are introduced, and the advantages and disadvantages of each are stated.

Background: Bisphenol A is known as one of the emerging micropollutants with harmful effects on human health. This pollutant enters the environment through the discharge of municipal wastewater treatment plants. In this research, the salting out dispersive liquid-liquid microextraction method was investigated for pre-concentration of bisphenol A in drinking water and urban sewage effluent samples. Due to the high enrichment factor, this method enables the measurement of small amounts of bisphenol A in the examined samples. Methods: In this method, bisphenol A forms a colored hydrophobic derivative of antipyrine with 4-aminoantipyrine in the presence of potassium hexacyanoferrate. In order to extract the resulting derivative, 250 μ, l of 2-phenoxyethanol was dissolved in 10 ml of the sample. Then, by adding 0. 7 g of sodium chloride to the sample, fine droplets of extracting solvent were formed in the sample and the solution became cloudy. After centrifugation, the extraction phase containing bisphenol A derivative settled at the bottom of the test tube, and then, 20 μ, l of methanol was added in order to reduce its viscosity. The measurement was performed by a high-performance liquid chromatography at a wavelength of 480 nm. To optimize the process, the effect of the amount of 4-aminoantipyrine, potassium hexacyanoferrate, and buffer was investigated. Then, the figures of merit of the method were obtained and the performance of the method was evaluated on drinking water and urban sewage effluent samples. Findings: Under optimal conditions (2-phenoxyethanol: 250 μ, l, 4-aminoantipyrine 1%: 100 μ, l, potassium hexacyanoferrate 10%: 80 μ, l, buffer pH 10: 10 μ, l, and sodium chloride: 0. 7 g per 10 ml of sample), the enrichment factor of 106, the detection limit of 0. 1 ng ml-1, the limit of quantification of 0. 3 ng ml-1, and the relative standard deviation (RSD) of 3. 2% were obtained. Meanwhile, the correlation coefficient (CC) of the calibration curve was equal to 0. 9985. Moreover, the results of the analysis of water and urban sewage effluent samples showed that the developed method had suitable performance for the measurement of bisphenol A in real matrix samples. Conclusion: Considering the low detection limit, high enrichment factor, and proper performance in real samples, this method can be introduced as a sensitive and efficient method for the measurement of very low amounts of bisphenol A in water and wastewater samples.

Background: Waste separation education is very important for students because of the important role of this group in attracting parental involvement. Therefore, this study was conducted to investigate the effect of educational intervention based on the theory of planned behavior on the promotion of waste separation at source behavior among the primary school students in Khorramabad City, Iran. Methods: This randomized controlled interventional study was conducted during the academic year of 2020-2021 among the primary school students in the city of Khorramabad. Eight schools were selected in a multi-stage method and the sample size was estimated at a total of 200 people, taking into account at least 100 samples in each group (test and control). Then, the educational intervention was performed based on the results of needs assessment for the experimental group during one month and in the form of three sessions of 60-minute training. The data were collected 2 months after the intervention and were analyzed using SPSS software by using independent t-test, paired t-test, and chi-square test. Findings: Before the educational intervention, except for the score of awareness variable, all variables were not significantly different between the two groups,however, after the intervention, the two groups had significant differences regarding all of the studies variables (P < 0. 050). The performance of the intervention group before training was 2. 34 ±,0. 73, which increased significantly to 3. 11 ±,0. 45 after training (P < 0. 001). Conclusion: Educational intervention based on the theory of planned behavior by promoting attitudes and evaluating the behavioral consequences of students in the field of waste separation behavior at source eventually improved the behavior of students,it is suggested that this educational method be implemented in other schools as well.

Background: Since sponge iron is the main feed of steel furnaces for the production of crude steel, especially in electric arc furnaces, the production of quality sponge iron is one of the concerns of the steel industry. The reduction process, which is the conversion of pellets into sponge iron using reduction gases, has been used in Iran for many years. Therefore, there is a necessity for a proper environmental assessment to reach the minimum level of negative impact on the environment. This study aims to investigate the environmental impacts of sponge iron production by Midrex method using natural gas and to compare the effects associated with different production processes. This paper identifies the processes and significant inputs that affect the environmental impact of sponge iron production and proposes effective methods to diminish contamination. Methods: The OpenLCA software with the Ecoinvent database was used by using IMPACT 2002+ evaluation method. Life cycle inventory data were obtained from the average performance of factories in one year, and 1 ton of produced sponge iron was considered as the functional unit. Findings: Among different types of environmental impacts, non-renewable energy, mineral particle respiration, and global warming had the most significant effects, respectively. These three categories of impact together accounted for about 87. 5% of the total environmental impact of the whole process. Among the processes, the greatest impacts were related to the production of sponge iron (62. 8%), followed by the pellet production process (37. 8%), and the greatest environmental impacts of input materials were related to natural gas (44. 3%) and iron ore (23. 9%), respectively. Conclusion: Despite significant advances in sponge iron industries in recent decades, they still have high energy consumption as well as mineral particles and carbon dioxide emissions. Conducting a life cycle assessment allows producers to identify the most polluting processes in order to make the necessary plans to improve them.

Background: Patients with coronavirus disease 2019 (COVID-19) experience symptoms of cognitive impairment. These patients perceive a lot of stress and are required to comply with quarantine conditions. Remote stress management training, in accordance with the principles of quarantine of these patients, can be effective in their recovery process. Therefore, this study was conducted with the aim of investigating the effect of remote stress management training on the cognitive status of patients with COVID-19. Methods: In this randomized clinical trial, the research population was all the patients with COVID-19 referred to Gharazi Hospital in Isfahan City, Iran, in the winter of 2021. Seventy patients were selected by available sampling method and divided into two intervention and control groups (35 people) by limited randomization method. For the intervention group, the remote stress management online training program was implemented in five 60-minute sessions over two weeks. The control group did not receive training. The cognitive status index was measured using Folstein et al. 's brief cognitive status examination questionnaire [Mini-Mental State Examination (MMSE)] before and after the training sessions. The data were analyzed with SPSS software at two levels of descriptive and inferential statistics and by performing chi-square test, independent t-test, paired t-test as well as the analysis of covariance (ANCOVA). Findings: The comparison of the average scores of the cognitive status in the pre-test and post-test phases of the two groups showed that the remote stress management training had a significant effect on the cognitive status of the patients with COVID-19 and improved this index in the intervention group (P ≤,0. 05). Conclusion: Based on the results, remote stress management training can improve the cognitive status of patients with COVID-19. Therefore, this method of training is recommended due to the convenience and possibility of using it in the quarantine conditions of these patients.

Background: The impaired balance is one of the most obvious movement disorders in children with autism spectrum disorder (ASD). The purpose of current study was to investigate the effectiveness of simultaneous musicalmotor activities on balance improvement in children with high-functioning autism. Methods: This was a quasi-experimental study with pretest-posttest design and a control group. The participations were 22 children with high-functioning autism with mean age of 8. 50 ±,1. 05 years,they were randomly divided into two intervention groups including with and without music, and a control group. The motor intervention was performed for 12 weeks, three sessions per week and 45 to 60 minutes for each session. The Orff music was used during the sessions. The Movement Assessment Battery for Children-Second Edition (MABC-2) test was used to evaluate the balance of these children. Moreover, data were analyzed using univariate analysis of covariance (ANCOVA). Findings: F-value was significantly different between the three motor intervention groups with and without exposure to music and control group (P < 0. 001) in the static balance (F = 52. 17) and dynamic balance (F = 24. 33) post-test scores in children with high-functioning autism. Conclusion: According to the findings, musical-motor activities can be recommended as a motor therapy intervention to improve static and dynamic balance for these children.

Background: Extensive job performance factors can be influenced by employees' personality traits. The aim of this study was to determine the relationship between personality traits and job performance of health workers. Methods: In this descriptive-correlational study, 175 health workers were studied. To collect the data, a form including three different questionnaires was used: 1) demographic questionnaire, 2) the standard 240-item NEO Personality Inventory, and 3) Work Performance Questionnaire. Finally, the data were analyzed in SPSS software. Findings: No significant relationship was observed between NEO personality traits with job knowledge and job skills (P > 0. 05), while being conscientious had a direct and significant effect on job attitude (P = 0. 038). Conclusion: Conscientiousness can be a significant predictor of health workers’,job performance.

Background: Unwanted pregnancy can cause multiple psychological problems in parents and disrupt their emotional bond with the fetus. Therefore, in the present study, the comparison of psychological characteristics and attachment of parents to the fetus in wanted and unwanted pregnancies has been discussed. Methods: The statistical population of the study included all pregnant women who were referred to the women's clinic of the Amir-Al-Momenin Hospital in Semnan, Iran, who were selected purposefully by examining their medical records and according to the inclusion criteria. They were placed in two groups of wanted and unwanted pregnancy (104 couples: 51 wanted, 53 unwanted). To collect data, personal information forms, Depression, Anxiety and Stress Scale-21 Items (DASS-21), Maternal-Fetal Attachment Scale (Cranley), and Paternal-Fetal Attachment Scale (Cranley & Weaver) questionnaires were used. To analyze the data, multivariate analysis of variance (MANOVA) was used. Findings: There was a significant difference between the fathers of the two groups in the subscales of “, anxiety, selfsacrifice, differentiation between self and fetus, and total attachment”, . In addition, mothers with wanted pregnancy had significantly less stress, anxiety, and depression. The average scores of the subscales of “, attributing specific characteristics to the fetus, self-sacrifice, differentiation between self and fetus, and total attachment”,in mothers with wanted pregnancies were significantly higher than those in mothers with unwanted pregnancies (P < 0. 005). Conclusion: According to the findings of the present study, an unwanted pregnancy can endanger the psychological conditions of parents, especially mothers, and reduce the attachment of parents to the fetus, which can cause irreparable damage to the health of the mother and child. For this purpose, appropriate psychological interventions can be used during pregnancy to reduce psychological harm to parents.

Background: Depression and blood pressure are the common disorders in the elderly and are effective in beginning and intensifying each other, so that mental disorders are the fourth main cause of death in the world. The aim of this study was to determine the structural model of the relationship between depression and blood pressure with the mediation of nutritional habits in the elderly. Methods: This research was a descriptive study based on structural equation modeling (SEM). The research population included all the elderly people who referred to the health center of Falavarjan City, Iran, in 2019-2020, and 360 of them were selected by convenience sampling. Research tools included nutritional habits questionnaire, elderly depression questionnaire, and the Integrated Health System (SIB). Data analysis was done using descriptive and inferential statistics tests in AMOS and SPSS software. Findings: According to the regression coefficient of-0. 266 and the critical value of-3. 57 and P = 0. 051, the variable of nutritional habits can play the role of a mediating variable between the predictor variable of depression and the criterion variable of blood pressure and can explain it. In fact, the model had the ability to predict and fit. Conclusion: According to the results of this research based on the relationship between depression, blood pressure, and nutritional habits in the elderly, simultaneous attention to somatic and psychological problems is necessary. Therefore, planning to diagnose and treat depression and its factors on time can be effective in improving health in the elderly, especially improving their mental health.

Background: Increasing awareness and creating culture in the field of waste management can be a solution to this important environmental issue. The purpose of this study was to determine the effect of educational intervention on knowledge, attitude, and practice (KAP) of housewives in Dastja Village of Isfahan Province, Iran, in the field of recycling in 2021. Methods: In this descriptive-interventional study, which was conducted in a cross-sectional way, 60 housewives were selected by systematic random method and completed the KAP questionnaire towards recycling. Then, education related to recycling was presented to the target group, including 3 face-to-face sessions of 40 minutes and one hour of virtual education. The questionnaire was completed again after two months. One-way analysis of variance (ANOVA), independent t-test, and Pearson's correlation test were used to analyze the data. Findings: The average age of the investigated women in the target and control groups was 34. 9 ±,9. 6 and 36. 4 ±,9. 2, respectively. After the educational intervention, the level of awareness change in poor, medium, and good groups was-34. 69%, +7. 72%, and +26. 97%, respectively. Besides, the rate of change of attitude scores in poor, medium, and good groups was-11. 29%,-12. 33%, and +23. 62%, respectively. In the practice section, change values in the poor, medium, and good groups were-19. 98%,-9. 99%, and +30. 06%, respectively. Conclusion: Considering the significant improvements in KAP of housewives in Dastja Village after training, by including the education while cooperating and coordinating with the village council and officials in order to develop recycling in rural areas, important steps can be taken and good results can be achieved.