Journal of Health System Research
Year:2023 | Volume:19 | Issue:4|Papers Count:12

Many people around the world are exposed to different chemicals in various occupations. Contact with chemicals can lead to numerous health effects. There is a growing need for risk assessment of hazardous chemicals and related processes that impact the health of individuals who are exposed to them. Chemical risk assessment enables us to make informed decisions regarding control measures and to safeguard employees from the adverse effects of chemicals. Health risk assessment methods are performed in two ways: qualitatively (using a risk assessment matrix) or quantitatively. Common methods used in the field of chemical exposure risk assessment include the semi-quantitative risk assessment (SQRA) method, United States-Environmental Protection Agency (USEPA) method, Department of Occupational Safety and Health (DOSH) method, Department of Occupational Safety and Health (DOSH) method, Chemical Hazard Risk Management (CHARM) method, and Korea Occupational Safety and Health Agency (KOSHA) method. Due to the lack of epidemiological data and the complexity of quantitative methods, some studies employ semi-qualitative methods, such as SQRA, for assessing the risk of exposure to hazardous chemicals. In this review study, the SQRA method for semi-quantitative risk assessment of chemicals in the workplace will be introduced.

Background: The outbreak of coronavirus disease 2019 (COVID-19) has harmed the health dimensions of people, especially nurses who were at the forefront of fighting this disease. Undoubtedly, they endure a lot of work pressure in these conditions, which can affect different aspects of their health. The present study was designed and implemented to investigate the stress, anxiety, and depression of nurses caring for patients with COVID-19 in Isfahan, Iran, and its relationship with spiritual well-being and demographic variables. Methods: This cross-sectional study was a descriptive-analytical one, conducted on 297 nurses who met the inclusion criteria working in the clinical wards of COVID-19 hospitals affiliated to Isfahan University of Medical Sciences. The data collection instrument included Depression, Anxiety, and Stress Scale-42 (DASS-42), and Paloutzian and Ellison Spiritual Well-Being Scale (SWBS). The data were analyzed by SPSS software using descriptive and analytic statistics. Findings: More than one-third of nurses (35.3%) and about one-third of them (27.2%) had significant levels of anxiety and depression. The results of the Pearson test showed that there was an inverse and significant statistical relationship between the stress, anxiety, and depression of nurses working in the COVID-19 wards with spiritual well-being. Conclusion: According to the results of the present study, it seems that attention and strengthening of the spiritual dimension of nurses in crises, along with financial and union support, will improve the mental health of nurses and consequently, will improve the service process for patients.

Background: Food preferences determine food choices, which are significantly associated with overweight/obesity and health outcomes worldwide. Obesity and overweight is one of the health problems of adolescents in the world. This study aimed at determining the relationship between food preferences, body mass index (BMI), and demographic variables among second-year primary school students of Malekan City, located in East Azerbaijan Province, Iran, during 2022 to 2023. Methods: This cross-sectional and descriptive-analytical study was conducted on 582 male and female primary school students in the second grade in both public and private schools of the three towns of Malekan City (Malekan, Lilan, and Mubarakshahr) with a two-stage random cluster sampling method. A two-part online questionnaire including questions on background information and a researcher-made checklist of food preferences was used to collect data. Content validity ratio (CVR), content validity index (CVI), and Cronbach's alpha were used to check the validity and reliability of the questionnaire, respectively (CVI = 0.98, CVR = 0.91). Data were analyzed using Mann-Whitney test, t-test, one-way analysis of variance (ANOVA), Kruskal-Wallis test, and chi-square test at a significance level of 0.05 using SPSS software. Findings: There was a significant association between food preference and sex (P < 0.001), age (P = 0.027), educational grade (P = 0.027), mother’s education (P = 0.028), mother’s job (P = 0.002), father’s education (P = 0.046), residence (P = 0.001), and family income (P = 0.002). There was a significant relationship between BMI with school type (P = 0.002), father’s education (P = 0.033), and mother’s age (P = 0.013). Conclusion: The results of this study indicate the relationship between food preferences, BMI, and demographic variables of adolescents. Paying attention to the potential strategies to strengthen healthy eating patterns of adolescents and providing an educational program that can improve children’s eating behavior and reduce the possible burden of diseases related to eating behavior such as obesity on the country's health care system seem necessary.

Background: Pomegranate paste is one of the nutritionally valuable foods due to its high content of minerals and antioxidant compounds, but adulteration can occur during the manufacture while it is sold as pure pomegranate paste. In this study, the quality and purity of 5 samples of industrial and 5 samples of traditional pomegranate paste available on the Iranian market have been investigated. Methods: Physicochemical properties such as water-soluble solids, acidity, pH, formalin index, sucrose and ash contents, the presence of starch and benzoic acid, and the amount of 5-hydroxymethylfurfural (HMF) were measured and compared with the national standard of Iran. To investigate the type and amount of organic acids and the possibility of adulteration with cheaper concentrates, liquid chromatography-mass spectrometry (LC-MS) was used. Findings: The amount of soluble solids in the samples was within the national standard range. The acidity of the traditional Isfahan sample (8.90%) was higher than the standard acceptable level, and the pH (2.19) was less than the standard acceptable level. Formalin index in one of the industrial samples was 35.12% and within the permissible range of the national standard, and in other samples, it was less than the standard level. The sucrose amount in all samples was less than 6%, indicating that no sugar was added to the samples. The total ash content of the samples was within the acceptable standard level. In 4 traditional samples, the presence of starch was confirmed as an adulteration. None of the samples contained benzoic acid. The amount of HMF in the traditional samples was more than the industrial samples, and in the Saveh traditional paste, with a value of 52.13 ppm, was higher than the standard limit. Organic acids profile showed that citric acid, malic acid, and oxalic acid were the predominant acids in the samples, respectively, and the amount of tartaric acid was less than 1% or not detected. Conclusion: According to the present results, pomegranate paste is more likely adulterated with starch or flour. In addition, it seems that in traditional pomegranate paste, due to the impossibility of control by the relevant organizations, adulteration is more likely, and also due to poor control of thermal process, the occurrence rate of Maillard reaction and HMF production is likely to be higher.

Background: Healthcare workers play a crucial role in combating the coronavirus disease 2019 (COVID-19) pandemic, being at the forefront of the battle against this disease. Due to their direct exposure to the virus, they often experience heightened levels of anxiety. This study aimed to determine the anxiety levels caused by COVID-19 and assess the impact of an educational program, developed according to the stages of change model, on the anxiety levels of healthcare workers in the city of Gonabad, Iran, during the outbreak of COVID-19. Methods: This study was conducted as a field trial. The population of this study consisted of the staff members working at the Gonabad Comprehensive Health Service Centers in 2021. In order to identify individuals with moderate to high levels of anxiety, the Coronavirus Anxiety Scale (CAS) was employed. Subsequently, participants were randomly assigned to the intervention or control group. A virtual training program was specifically designed for the intervention group and implemented over the course of one month, comprising six sessions conducted through the Skyroom application. Generalized estimating equations (GEE) were used for the test. Findings: The results of the GEE model indicated that following the intervention, there was a significant increase in the average pre-thinking score (2.954 units), thinking score (3.091 units), preparation score (2.924 units), action score (4.454 units), and retention score (3.136 units) in the test group compared to the control group. Additionally, for each unit increase in time, the average total anxiety score in the test group was significantly lower (6.727 units), including mental anxiety (5.167 units) and physical anxiety (1.561 units), compared to the control group (P < 0.001). Conclusion: The results of study showed that the educational program designed based on the stages of change was effective in reducing anxiety caused by COVID-19 disease. Therefore, it seems appropriate to design educational program interventions based on this theory to reduce anxiety levels during a similar epidemic to COVID-19.

Background: One of the health problems is the increasing tendency towards fast foods consumption. Evidence also indicates rapid changes in the structure of consumption and prevalence of obesity in developing countries. Social marketing, as a behavior change framework, has shown its effectiveness in improving society, especially reducing consumerism. Aiming at reducing fast food consumption among students, this study was designed and implemented a social marketing campaign. Methods: A pre- and post-test study with a control group was conducted on 352 middle school students in Yasuj City, Iran, in the period from October 2018 to January 2019, using a two-stage simple random sampling method. The campaign was designed and implemented based on a ten-steps model. A formative research also has been used to design the intervention mix. Findings: A significant decrease in two behavioural variables of the amount of consumption and its trend was observed after campaign in the intervention group compared to the control group (P < 0.05) and compared to the values of these variables before the campaign (P < 0.01). Other campaign evaluation indicators such as campaign awareness with 81.1%, message recall with 79.4%, weekly food plans with 60%, the ability to calculate body mass index (BMI) with 67.7%, and monthly spending limit with 38.9% indicated the success of the campaign. Conclusion: Utilizing a social marketing approach as well as appropriate intervention mix, based on a mix-method research, this study can be used as an effective pattern to reduce fast food consumption among students.

Background: The sense of place is one of the criteria for evaluating qualified environments in architecture. It is a positive experience of place, formed based on cognitive, emotional, and behavioral interaction between people and place. Children's hospital evokes negative feelings such as fear, stress, and distress in the child; reaching a sense of place to generate a positive emotional relationship between a child and the environment can not only neutralize these negative effects, but can speed up the healing process as well. The objective of this study was to find the factors affecting the formation of the sense of place in children's hospitalization space. Methods: This qualitative study was conducted by thematic analysis method with Braun & Clarke approach. The statistical population of the study was children between 7 to12 years old, hospitalized in Imam Hossein Hospital in Isfahan, Iran. The sample size was carefully selected according to the purpose of the study to achieve theoretical saturation. In order to grasp their idea of a qualified hospital room, 20 semi-structured interviews with targeted children's parents were conducted by thematic analysis method and then analyzed by ATLAS.ti software. Findings: According to the parents’ perceptions and ideas, the quality of hospital room could be influenced by five main themes including items and features located in room, providing safety and physical health, positive distractions, a sense of security and mental peace, and providing environmental comfort and 22 subthemes. According to the parents, a high-quality hospital room is a place that can take the child's attention away from the painful environment of the hospital and provide the ground for imagination and creating positive feelings in him, a place whose physical components provide both the child's physical health and environmental comfort, and also the basis for the child's sense of peace and psychological security. Conclusion: According to the outcomes of the research, the themes obtained from the opinions of parents provide the three physical, emotional, and behavioral dimensions, effective in the sense of place formation model. By using these themes in the design of the inpatient space, the physical environment will be able to influence the child's behavior and perception by providing the physical and mental needs of the child leading to the establishment of the child's emotional relationship with the place, and ultimately the formation of a sense of place.

Background: Given the close communication and interaction between military forces and police station personnel with the public and the risk of contracting and transmitting coronavirus disease 2019 (COVID-19), this study was conducted to investigate the impact of an educational intervention based on the motivational theory of protection on preventive behaviors against contracting COVID-19 in police station employees of Yazd City, Iran. Methods: This semi-experimental study was conducted on 66 employees of police stations in Yazd City. The data collection tool was a researcher-made questionnaire, with a confirmed validity and reliability and a Cronbach's alpha value above 0.80. First, pre-test questionnaires were completed by both groups. Then, an educational intervention based on the protection motivation theory was implemented for the intervention group, while no intervention was performed for the control group. Three weeks after the educational intervention, the post-test was completed. Data analysis was conducted using SPSS software and appropriate statistical tests. Findings: The results of the Mann-Whitney test comparing the average score after training showed that the average score of behavior after training in the intervention group was higher than that in the control group (P < 0.001). The results of the Wilcoxon test to compare before and after the training showed that after the training, the average behavior score in the intervention group increased significantly (P < 0.001), but there was no significant change in the control group (P = 0.831). Conclusion: The use of a training package designed based on the protection motivation theory to train police station employees can be effective in improving preventive behaviors against contracting COVID-19.

Background: Suicide is a serious problem in the field of public health and is currently the tenth leading cause of death worldwide. Shockingly, statistics show that every 11 minutes, one person loses their life to suicide. Suicide is a complex phenomenon involving individual, emotional, social, psychological, and genetic factors. People who commit suicide have diverse lived experiences. Since unsuccessful suicide attempts are more common in women than men and it is one of the important risk factors for future suicide, the purpose of this study was to investigate the emotional lived experiences of women who have attempted suicide. Methods: To conduct the present study, from all women attempting to commit suicide who had referred to the Social Emergency of Meybod City, Iran, 9 people were selected using purposive sampling. In order to collect data, semi-structured interviews were conducted, and data analysis was performed using the 7-step Claizian method. The reliability and validity of this research were based on the criteria of "transferability, reliability, verifiability, and authenticity". Findings: The findings from emotional experiences included 7 main categories: "experience of spouse betrayal", "experience of marital problems", "emotional inefficient coping methods", "experience of negative feelings", "experience of lack of warmth and support from the family", "experience of parental marital discord", and "experience of sexual abuse in childhood and adolescence" and 15 subcategories. Conclusion: Most women who commit suicide have experienced sexual, physical, and emotional abuse during their childhood and adolescence. Therefore, it is necessary to prioritize the implementation of support and educational programs aimed at preventing and reducing the harm caused by experience of sexual, physical, and emotional abuse for women in health, medical, and educational centers.

Background: In recent years, due to the increase in suicide attempts and the resulting social problems, the need to pay attention to planning for suicide prevention is felt more than ever. The aim of the present research was to investigate the effectiveness of group-based reality therapy on direct and indirect self-destructive behaviors in adolescent girls who have attempted suicide. Methods: This was a semi-experimental study with a pretest-posttest design and a control group. The statistical population included all high school adolescents who had attempted suicide in the first and second high schools of the district 17 of Tehran, Iran, in the academic year of 2021-2022. There were 65 of them, of which 16 people were randomly selected in two experimental (8 people) and control (8 people) groups using available sampling method. The experimental group received 8 one-hour sessions of reality therapy training. The control group did not receive any training. Klonsky and Glenn utilized questionnaire on self-destructive behaviors to gather data. The obtained information was analyzed using analysis of covariance (ANCOVA). Findings: The reality therapy approach had a significant effect on reducing direct and indirect self-harming behaviors, and the effectiveness of reality therapy on direct self-destructive behaviors was more than indirect self-destructive behaviors. Conclusion: Reality therapy can be effective in controlling the behavior of teenagers and fostering their sense of responsibility towards their work.

Background: Using a hearing protection device is one of the ways to control noise pollution in the industry. The purpose of the present study is to evaluate the changes in the sound absorption coefficient of some commonly used earmuffs in laboratory conditions at various sound levels and frequencies. Methods: In this study, four earmuff models, including TASCO2550, AKHAVAN (VENUS-740), 3M optime98, and Parkson ABZ, were prepared. The absorber of the earmuffs was then cut to a diameter of 3 cm and a thickness of 1.2 cm. The absorption coefficient of each sample was measured using an impedance tube and VA-Lab4 software at three sound levels of 75, 85, and 95 dB. Finally, the data were analyzed using SPSS software. Findings: There was no significant difference in the average absorption coefficient between sound levels of 75, 85, and 95 dB. However, in middle and high frequencies, the average absorption coefficient increased. TASCO2550 earmuff absorbent samples showed the highest absorption coefficient at frequencies of 2000-2500 Hz. While AKHVAN (VENUS-740) and 3M optime98 absorbent samples showed the highest average absorption coefficient at the frequency of 4000 Hz. Also, The Parkson ABZ absorbent sample had the highest average absorption coefficient at a frequency of 5000 Hz. In general, The TASCO2550 earmuff absorbent sample showed the highest absorption coefficient, while the 3M optime98 absorbent sample showed the lowest absorption coefficient. Conclusion: By selecting an earmuff with efficient absorber, we can increase sound absorption rate to achieve the desired results of reducing noise pollution.

Background: Considering the importance of heavy metal pollution and fuel oil on human health, this research was done to investigate the effect of zinc (Zn) nutritional element and fuel oil pollution on lead (Pb) sorption by the wheat plant in a soil treated with vermicompost under drought stress. Methods: The current research was conducted as a factorial experiment in the form of a randomized complete block design. The amount of biodegradation of fuel oil in soil was measured by weight method and the amount of Pb and Zn in the wheat plant was extracted by hydrochloric acid (HCl) 2N and then measured by atomic absorption device. Findings: The application of 15 and 30 t/ha of vermicompost decreased the amount of Pb sorption by the wheat plant by 12.3% and 13.8%, while the bio-degradation of fuel oil increased by 13.9% and 22.2%, respectively. Application of 40 kg/ha of pure Zn in the form of Zn sulfate and Zn chelate caused an increase in the biodegradation of fuel oil in the soil by 21.4% and 32%, respectively. Meanwhile, the activity level of ascorbate peroxidase (APX) enzyme decreased by 11.4% and 12.8%, respectively. Conclusion: Using 40 kg of pure Zn from the Zn sulfate and chelate source has been able to play an effective role in reducing the Pb concentration in the wheat plant cultivated in the soil contaminated with fuel oil. The application of vermicompost has also played an effective role in reducing the availability of Pb in the soil.