JOURNAL OF SCHOOL OF PUBLIC HEALTH AND INSTITUTE OF PUBLIC HEALTH RESEARCH
Year:2009 | Volume:7 | Issue:2|Papers Count:9

Background and Aim: Factors determining the health care-seeking behaviors of an individual are social, cultural, and economic (treatment costs). Utilization of a health care system by a person will, on the whole, depend mainly on the socio-economic and demographic factors, cultural beliefs and practices, gender discrimination and women's status, the economic and political systems, environment, patterns of illness, and the health care system itself. The main objective of the present study was to examine current patterns of health care-seeking behavior in residents of Tehran, Iran in 2007.Methods and Materials: In a cross-sectional study a two-stage cluster sampling method was used to select neighborhoods at the first stage and households at the second. The sample included a total of 1882 individuals over 18 years old in the households. The data were collected using a questionnaire. For analysis of the data the exact fisher test, X2, and multivariate logistic regression were used; the software used was SPAA.3Results: About 22.9% (431 persons) of the participants reported 1-2 illnesses during the previous month. Multivariate logistic regression indicated that age, sex, perceived severity of the illness, educational level, and marital status were all statistically associated with an attempt to seeking care, whether self-treatment or consulting a health center. The effects of different variables on decisions related to seeking care from a health care center versus self-care were also examined. The data showed that age, sex, perceived severity of the illness, income, educational level, household size, and method of payment were statistically the most significant variables affecting seeking care from a health center.Conclusion: Based on these findings, it may be concluded that increasing social awareness about side effects of medicines, potential dangers of self-treatment, continuous education and training of physicians and pharmacists, improving health insurance systems and universal insurance coverage will be appropriate strategies for better utilization of health care services by the people.

Background and Aim: Thalassemia is one of the most common worldwide single-gene diseases. On the molecular level, it is a heterogeneous disease. So far, beside large deletions, more than fifty point mutations have been identified for this disease around the world. Four to ten percent of Iranians are carriers of thalassemia-affected genes. In this study we determined the relationship between the value of MCV/MCH and the type and severity of mutations in alpha thalassemia carriers.Methods and Materials: The major abnormality in alpha thalassemia carriers is decreased values of MCV and MCH. A total of 104 adult alpha thalassemia heterozygotes, 20-40 years old, including 33 persons from Khoozestan Province and 71 from Khorasan Province, were included in the study. Two hundred and eight chromosomes were isolated from peripheral blood leukocytes using standard procedures. DNA samples were amplified by Gap-PCR. Results: Only one ao mutation (MED) was found in 2.9% of the population. The carriers of this mutation had virtually identical ranges of MCV and MCH. In contrast, a+ mutations were associated with significant differences in mean MCV and MCH values. The various mean MCV/MCH ratios of ao carriers were statistically significantly lower than those of a+ heterozygote. The results indicated that the degree of reduction in MCV and MCH is directly related to the severity of the mutations. Deviations, in cases, were associated with lower numbers of the carriers.Conclusion: Only one ao mutation (MED) was found in 2.9% of the population. The carriers of this mutation had virtually identical ranges of MCV and MCH. In contrast, a+ mutations were associated with significant differences in mean MCV and MCH values. The various mean MCV/MCH ratios of ao carriers were statistically significantly lower than those of a+ heterozygote. The results indicated that the degree of reduction in MCV and MCH is directly related to the severity of the mutations. Deviations, in cases, were associated with lower numbers of the carriers.

Background and Aim: Adolescence is the transition period between childhood and adulthood, a period in life that begins at puberty. It is one of the fastest growth periods in a person's life. During this time, physical changes affect the body's nutritional needs, while changes in one's lifestyle may affect eating habits and food choices. Nutritional health during adolescence is important for supporting the growing body and for preventing future health problems. In Iran, the prevalence of anemia, obesity, and other chronic nutritional diseases has increased in recent years due to undesirable eating habits. This survey was conducted to determine consumption of the four major food groups (vegetables, fruits, milk products, and meat) among a group of high school students in Zanjan Province, Iran.Methods and Materials: A descriptive, cross-sectional study was carried out on 1500 students, selected by random cluster sampling, in Zanjan high schools, Iran in 2005. The daily intakes of the 4 food groups during the previous week were determined using a food frequency questionnaire. The potential determinants of the pattern of food consumption were also determined.Results: The proportions of the students not having consumed fruits, vegetables, and meat during the weak were 16%, 6.8%, and 10%, respectively. More than 95% of the students said that they had consumed milk/milk products at least once a day. Only 8.7% consumed fruits and 27% consumed vegetables 3 times or more daily.Conclusion: The consumption of the 4 food groups of large proportions of Zanjan Province adolescents is below the current recommendations. Health and nutrition educational programs would be a valuable tool to correct erroneous food habits of the adolescents leading to improvements in their nutritional status.

Background and Aim: By providing the greatest amount of direct service to patients, nurses play an extremely valuable and unmatched role in the quality and efficiency of care and curative services. Workplace violence is regarded as one of the factors which can reduce job satisfaction and the quality of working life of nurses and their interaction with patients, as well as the work efficiency of nurses and hospitals. In this study, after translating and validating tools of violence measurement in the health sector, the exposure of nurses to psychological violence was measured in a large teaching hospital in TehranMethods and Materials: A descriptive-cross sectional design was used in this study in summer of 2009 (1387). The study population included all the nurses (n=413) working in a large teaching hospital in Tehran. The questionnaire used for collecting data was adopted from a standardized questionnaire designed jointly in 2003 by the International Labor Office, the World Health Organization, the International Council of Nurses, and the Public Services International. Analysis of the data was made using the descriptive statistical methods and the Chi square- and t-tests.Results: Sixty-nine percent of the nurses had experienced workplace violence. The most common forms of violence were verbal abuse (%64) and bullying-mobbing (%29). On the whole, 26% of the nurses had experienced both forms of violence in the previous year, while 335 had not faced any form of violence in their workplace. Nurses working in outpatient clinics and emergency wards experienced the highest number of encounters with verbal abuse. Encounters with bullying and mobbing were more common among female nurses than the male ones. Overall most of the violent behaviors were committed by patients and their relatives.Conclusion: Exposure of nurses to psychological violence is considerable and comparable to that reported by previous investigators in other countries. Thus it is highly crucial to adopt appropriate management policies aiming, particularly, at educating the medical personnel in ways of preventing and reporting violent behaviors.

Background and Aim: Organizational centralization, an important concept/system in management, relates to hierarchy of authority and degree of participation in decision-making. In this study we aimed to determine the extent of organizational centralization in hospitals affiliated with Tehran University of Medical Sciences (TUMS), Tehran, Iran and identify factors affecting the organizational centralization at the level of executive managers.Methods and Materials: All the managers and head nurses of 13 TUMS hospitals (26 subjects) were included in this cross-sectional study in 2005. Data, collected using questionnaires, were analyzed using the following tests: t-test, ANOVA, Pearson and Spearman, the software being the SPSS. The extent of organizational centralization was categorized into centralized, semi-centralized, and uncentralized.Results: Five of the 5 variables studied were statistically significantly associated with organizational centralization. They were gender (p=0.001), organizational position (p=0.005), attending management courses (p=0.001), and financial burden of decisions (p=0.03) in the hospital managers group, and possibility of controlling the decision (p=0.014) in the head-nurses group.Conclusion: The average organizational centralization in the hospitals was 75.38%; it was 76.3% and 73.38% for hospital managers and head-nurses, respectively. On the whole, the management system of TUMS hospitals is a semi-centralized system.

Background and Aim: Breast cancer is the most common cancer worldwide and the cause of about 18% of all malignancies in females. By breast self-examination (BSE) it is possible to diagnose a breast tumor in the preliminary stages and treat it. Basic changes in the knowledge, attitude and practice of women as regards regular BES and follow-up will lead to considerable success in campaigns against breast cancer. Considering the role and responsibilities of community health workers (CHWs) in the health services delivery system in the Islamic Republic of Iran, this study aimed at determining the knowledge, attitude and practice of female CHWs as regards BSE in 2006.Methods and Materials: This was a cross-sectional study conducted on 89 female CHWs in the Iranian Mako township health houses. The data was collected through interviews using a questionnaire consisting of 4 sections, the first section containing 10 demographic questions, and the second to fourth sections containing 33 questions on knowledge, attitude, and practice. The validity and reliability of the questionnaire were confirmed using the repeat testing with r=85%. The data were analyzed using the SPSS software (version 11).Results: The data showed that the BSE knowledge of 50.6% and 49.4% of the subjects was good and moderate, respectively; 76.4% of them had a positive attitude towards BSE. The reasons for not self-examination were as follows: inability to do it alone (12.4%); fear of a positive result, i.e., existence of a tumor (1.1%); having no time (2.2%); fear of increased anxiety (5.6%); not believing in BSE, even if it was likely to have a tumor (11.2%). Further analysis of the data showed the practice of the subjects to be good, moderate, and weak in 9%, 61.8%, and 29.2% of the cases, respectively.There were significant associations between knowledge and a positive attitude (p=0.038), between attitude of the unmarried subjects towards performing BSE as compared to the married subjects (p=0.00), and between attitude and practice (p=0.045).Conclusion: This study showed a moderate to good knowledge, a relatively good attitude, and a moderate practice among female CHWs in the Makoo Township, Iran, with regard to BSE. Considering the role of CHWs, improving their knowledge, attitude, and practice of BSE is essential.

Background and Aim: In the initial preparation stage, before feeding worms with organic wastes, the wastes are pre-composted for some time. This was done so that the thermophilic phase of organic wastes degradation is passed, no harm is done to the worms which are sensitive to high temperatures, production of fertilizer faster is quicker, and biological contamination is reduced. The length of this preparation time is important with regard to the quality of the compost obtained, the vermicomposting process, and space and facilities needed. The purpose of this study was to determine the effect of preparation time of food wastes on the vermicomposting process without any preliminary action or continuous aeration.Materials and Methods: The Eisenia Foetida species was used for vermicomposting. Food waste preparation times of 0, 6, 12 and 18 days were attempted, and factors such as pH, C%, N%, C/N ratio, and the process rate were monitored during the process.Results: The lowest and highest final C/N ratios were seen on days 6 and 18 of preparation, respectively. The data also showed that the highest reduction (64.93) in this ratio was observed on 6 day and the lowest (36.56) on day18.Conclusion: On the basis of these findings it can be concluded that there is a significant difference among various food waste preparation times with regard to C/N ratio (p-value<0.05), the preparation time is effective on the C/N ratio, and the most appropriate length of time for preparation is 6-12 days.

Background and Aim: Determination of the age of vector mosquitoes is of particular importance in epidemiological studies of diseases transmitted by them, such as viral and parasitic diseases. The objective of this study was to determine the daily age of Anopheles stephensi based on changes in pteridine concentration in female mosquito cuticles by liquid chromatography (HPLC).Methods and Materials: Females of Anopheles stephensi were raised in an insectary (28oC, 70% relative humidity). At 1, 5, 10, 15, 25, 30 days post-emergence they were divided into groups of 10 mosquitoes each. The mosquitoes in each age group were further divided into 3 subgroups of 10 each for chromatographic (HPLC, emotion = 355 nm and excitation= 465 nm) pteridine extraction. The chromatograms obtained were compared with the respective standards to determine the types of pteridines.Results: Four types of pteridines were detected in the cuticle of Anopheles stephensi, including isoxanthopteridine, pteridine-6-carboxylic acid, biopteridine, and xanthopteridine. They were all present in all the cuticle of the mosquitoes; however, no biopteridine in the head or xanthopteridine in the thorax were found. Generally, as the age of the mosquitoes increased, pteridine concentrations kept declining, such that after 30 days the total concentration reached 10% of the original.Conclusion: The findings indicate that there is a negative correlation between the concentration of pteridines in the cuticle and daily age of female mosquitoes. The method described can be used as a standard method to determine the daily age of Anopheles, as well as of other mosquito species, since it is fast and precise and needs small samples. Its major limitation is non-availability of HPLC in many parts of the country, although it is possible to freeze dead mosquitoes and transfer them to centers where HPLC is available.