Journal of community health research

194-195

Authors: Samaneh Mirzaei , Leila Mohammadinia

no abstract

203-210

Authors: Fatemeh Ghannadiasl

Introduction: Blood pressure among youth is associated with increased risk of future cardiovascular disease occurrence. The studies done on hypertension prevalence among young population are still insufficient. The purpose of this study was to determine undiagnosed hypertension, based on the Seventh Report of the Joint National Committee (JNC7) on Prevention, Detection, Evaluation and Treatment of High Blood Pressure updated guidelines among the apparently healthy young group of Iranian population. Methods: In this cross-sectional study, 901 volunteers, without previous hypertension history, in the age group of 18-24 years old (body mass index< 40 kg/m2) were assessed in Ardabil city from September 2016 to March 2008.They were apparently healthy youth and reported that their body weight had been stable for at least the last 3 months. Blood pressure was measured by standardized protocols based on American Heart Association guidelines, and the final value was obtained using the mean of the two careful readings of office blood pressure monitoring. Data were analyzed using Statistical Package for Social Sciences version 21.0. One-way analysis of variance was applied to determine the differences among hypertension groups, and p values <0.05 were considered statistically significant. Results: The mean of age, weight and body mass index was 19.48±1.64 (years), 60.54±11.45 (kg) and 21.39±3.17 (kg/m2), respectively. According to the JNC7 updated guidelines (2017), 17.4% subjects fell into elevated blood pressure whereas 2.1% and 1.7% into stage I and II hypertension category, respectively. Males were significantly more likely to have elevated blood pressure and stage I and stage II hypertension than females (p<0.001). Conclusion: According to the JNC7 updated guidelines, there is a significant prevalence of undiagnosed elevated blood pressure and hypertension (21.1%) among Iranian youth population. These results emphasize the need for careful monitoring of the blood pressure even among apparently healthy young adults

220-227

Authors: Seyedeh Sara Shakeri , Jafar Shabani , Hamidreza Aghamohammadian Sharbaf , Seyed Mojtaba Aghili

Introduction: Research results show that unmanaged use of virtual networks is the cause of differences between couples. Accordingly, the present study aimed to determine the mediating role of attitudes toward betrayal and marital conflicts in the relationship between the use of virtual social networks and emotional divorce in married teachers in Mashhad. Methods: The research method was descriptive-correlational and the society included married teachers in seven areas of education in Mashhad city in the academic year of 2017-2018. 375 teachers were selected by quota sampling method and completed questionnaires on social networks, emotional divorce, attitudes toward betrayal and marital conflicts. Data were analyzed using path analysis using Maximum Field Definition (ML). The structural equation modeling was used to analyze data using AMOS software version 25. Results: Based on the findings, the mediating role of attitude toward betrayal was not significant for predicting emotional divorce based on the use of virtual social networks (β = 0.06).The role of conflicting intermediaries is significant for predicting emotional divorce based on the use of virtual social networks. Accordingly, the role of the mediating meanings of marital conflicts along with the non-perceptible role of attitudes toward betrayal, based on the use of virtual social networks, predicts a total of 20% of the variance of emotional divorce. If the direct role of using virtual social networks in predicting emotional divorce along with the role of intermediate variables is considered, 66% of the variance of emotional divorce is predictable. Fit indicators showed the optimal fitness of the model with the collected data. (P <0.05) Conclusion: The results of this study showed that increasing the use of virtual networks with increasing conflicts increases the incidence of emotional divorce in couples.

237-244

Authors: Sakineh Rakhshanderou, Mohtashame Gaffari , Ameneh Pooresmaeildorosteh

Introduction: An unhealthy breakfast and the consumption of low-value meals among students are associated with adverse health consequences and chronic diseases in adulthood. The main purpose of this study was to identify the determinants of preparing healthy breakfast and snacks for school children by mothers in the city of Islamshahr. Methods: 320 boys and girls were selected by cluster random sampling and their mothers were invited to participate in the study. Data were collected using the researcher-made questionnaire that included demographic characteristics, questions were related to knowledge, attitude, perceived benefits, perceived barriers and behavior. The reliability was assessed through the test-retest method, and in order to assess internal consistency, Chronbach’s alpha coefficient was used. Data were analyzed by SPSS 16 software, and Descriptive statistics (Percent & Frequency), Multiple regression and Kendall’s tau-b correlation tests were used. Results: Based on the findings of this study, none of the demographic characteristics had a significant correlation with the behavior of the mother's healthy breakfast and meal (p>0.05) and among variables, knowledge (p<0.001, B=0.40) and perceived barriers (p<0.001, B=0.33) were strong and positive predictors of preparing breakfast and healthy snacks by mothers. Knowledge and perceived barriers predict %28 of variance in mothers’ behavior in preparing breakfast and healthy snacks (p<0.001, R= 0.527, R2=0.278). Conclusion: It is better to put more emphasis on the strategies to promote the knowledge of mothers and reduce their perceived barriers in designing nutritional interventions aiming to prepare breakfast and healthy snacks for children.

129-130

Authors: Seyedeh Mahdieh Namayandeh , Seyedeh Sara Mousavi , Mina Arabian , Javad Kheirandish , Habib Dehghani Ashkezari

Dear Editor, According to the International Agency for Research on Cancer (IARC), Asia has the highest death rates and incidence of breast cancer; 27% of all cancers that occur among women in Iran are attributed to breast cancer. The role of obesity in breast cancer development has been known for decades. S strong evidence exists on the idea that obesity and weight gain during adulthood are associated with increased risk of postmenopausal breast cancer. Furthermore, growing evidence is available on the association of obesity with breast cancer and overall mortality rate in women’s premenopausal and postmenopausal periods (1). Evaluation of the breast cancer risk helps identification of the women with the high risk of developing breast cancer in the future. Some strategies to reduce this risk involve adopting a healthier lifestyle as well as involving diet and exercise in everyday life (2). Obesity and overweight are defined by Body Mass Index (BMI). The effect of high BMI on breast cancer was assessed in selected studies using the odds ratio (OR). The results of the data analysis using the random effects method showed that the risk of breast cancer was higher among the people with obesity (BMI ≥ 30): Pooled OR = 1.81, 95% CI = 1.24 - 2.64 and for overweight (30 > BMI ≥ 25): Pooled OR = 1.46, 95% CI = 1.13 - 1.89(3). According to the care plan for risk factors in non-communicable diseases (Steps 2016), the prevalence rates of obesity and overweight were 29.77% and 34.96% among Iranian women, respectively. Furthermore, population-attributable fractions of these diseases were 13.32% and 11.01%, respectively, which indicates that by eliminating obesity and overweight factors, we can expect 24.33% reduction in the population’s breast cancer. For instance, a well-designed randomized controlled trial in children with a particular disease found that 20% of the control group developed bad outcomes compared with only 12% of the individuals who received treatment. Absolute risk reduction (ARR) – also called risk difference (RD) – is the most useful way of presenting research results to help your decision-making. In this example, the ARR is 8% (20% - 12% = 8%), which means that, if 100 children were treated, 8 would be prevented from developing bad outcomes. Another way of expressing this is the number needed to treat (NNT); that is the number of people who must be treated to benefit one person. It is the inverse of absolute risk reduction. If 8 children out of 100 benefit from a treatment, the NNT for one child to benefit is about 13 (100 ÷ 8 = 12.5)(4). A randomized, controlled, primary prevention trial was conducted in 40 US clinical centers from 1993 to 2005. In this study, a total of 48,835 postmenopausal women, aged 50 to 79 years, without prior breast cancer were enrolled. Women were randomly assigned into the dietary modification intervention group (40% [n = 19,541]) and the control group (60% [n = 29,294]) (5). The baseline characteristics of BMI and breast cancer incidence indicated that overweight ARR rate equals 0.0025 that is 0.25% (NNT: 400), obesity ARR equals 0.0012 i.e., 0.12% (NNT: 833.33) and obesity grade 2 and more equals 0.0033 that is 0.33% (NNT: 303.03). In other words, by treating 400 patients suffering from overweight and 833.33 patients suffering from obesity, we can prevent one case of breast cancer. Overweight, obesity, and abdominal fat are associated with the risk of developing breast cancer in women during the premenopausal and postmenopausal periods. Therefore, in order to prevent breast cancer and its complications, an intervention program should be implemented to control obesity and a breast cancer screening program should be conducted among the obese and overweight women (6). Governments are responsible for maintaining, restoring, and promoting health in the community. In order to make the right decisions and direct resources of the health sector, the most common cancer in women should be investigated as a priority for the health system. Therefore, a special study of breast cancer is necessary considering the mortality rate and disability. In this regard, we decided to investigate the most relevant risk factor and evaluate the risk associated with breast cancer by reviewing articles related to breast cancer. Later, we examined the most effective interventional strategies in this area. Consequently, given high prevalence of the overweight and obesity, intervention plans should be implemented to reduce the risk factors of the breast cancer.

139-147

Authors: Mahnaz Saremi , Rohollah Fallah Madvari , Fereydoon Laal , Najaf Noorizadeh , Ebrahim Rahimi

Introduction: Firefighting is one of the occupations that require high physical and aerobic power due to the nature of the job and the physical demands of this profession. Therefore, the present study aimed to investigate the relationship among Work ability index (WAI), mental workload, musculoskeletal disorders (MSDs) and their effective factors in firefighters. Methods: This study was a cross-sectional study, which was carried out on 250 firefighters in Tehran. Data were collected using WAI, NASA-TLX and Body Discomfort Chart (BDC). Data analysis was carried out using descriptive statistics, linear regression, Pearson correlation and Spearman tests. Results: The mean and standard deviation of the total WAI score was 38.85±1.17. Also, the highest amount of mental workload was devoted to the physical load dimension (93.49±8.93). Meanwhile, the total mental load was also 70.07 ± 6.58. The results showed that the WAI is increased by 0.14 by augmentation of one unit at the academic level of firefighters (P = 0.03). The most common discomfort was reported in the lower (20%) and upper (16.8%) regions of the back. The total WAI relationship with total mental workload was positive and insignificant (P>0.05). There was a significant and reverse association between WAI and discomfort in wrist, leg and ankle. Conclusion: Despite the low rate of MSDs, even mild symptoms of musculoskeletal pain should be considered. Given the high level of mental workload, improving physical, psychosocial and social working conditions is important in increasing the ability of employees and augmenting the ability of their occupational activity

156-163

Authors: Ali Dehghani , Mohamad Hasan Lotfi , Hossein Falahzadeh , Katayon Vahdat , Zahra Shabani

Introduction: It is generally accepted that cutaneous leishmaniasis is an important health problem in the world which is caused by leishmaniasis protozoan. This disease is also considered as a health problem in some regions of Iran including Bushehr province. The present study investigated the geographical dispersion and epidemiological characteristics of subjects with the cutaneous leishmaniasis in this province during 2011-2015. Methods: In this cross-sectional and analytical study, the epidemiologic data including the age, gender, residential area, and counties with this disease was analyzed and collected from 663 patients who were followed up and treated during 2011 to 2015. Results: 422 (63.7%) of studied people were residents of urban areas and 241 (36.3%) lived in rural areas. 59.4% (394 people) were male and 40.6% (269) were female. The mean age of subjects was 21.91± 17.01 (ranging from 1 to 80 years). Kangan County with an average 5-year incidence of 17.72 per a hundred thousand people had the highest incidence, but Tangestan County with the incidence of 8.47 per a hundred thousand people had the lowest average incidence. Based on GIS results, Jam County, which was not recognized as the focus of this disease in the past, has been considered as a new focus of disease in recent years. Conclusion: The geographic information system (GIS) is an effective tool for the organization of diseases and health data. The crisis can be identified and controlled by taking proper measures with the discovery of spatial accumulation of diseases.

177-185

Authors: Gholam Hossein Halvani , Reza Jafari Nodoushan , Elham Halvani , Vida sadat Anoosheh

Introduction: Respiratory disorders, as common problems in farmers, have a high mortality rate in Yazd City. The aim of this study was to evaluate and compare the respiratory parameters as well as the prevalence of respiratory symptoms in three age groups in farmers and non-farmers. Methods: This case-control study was conducted on 300 farmers and 300 nonfarmers in Yazd. The administered questionnaires included cognitive knowledge and symptoms of respiratory diseases. All participants completed the questionnaires and took the lung function tests. Data were analyzed using independent T-t test, Chi square test, or Fisher's exact test by SPSS 24. Results: Spirometry results showed a significant reduction in the respiratory capacity of the farmer group compared to non-farmer. In all three age groups, the prevalence rates of respiratory symptoms in farmers were higher than nonfarmer groups and the prevalence of symptoms increased by increase of age. In the age group of "over 55 years", the risk of cough, phlegm, dyspnea, and wheezing were 17,10.78, 3.58, and 6.61 times more than the non-farmers, respectively. Among the respiratory symptoms, cough had the highest prevalence, while shortness of breath had the lowest prevalence. Discussion and conclusion: In order to prevent high prevalence of respiratory disorders in farmers, the mechanization of agricultural practices, promotion of farmers' health awareness by health professionals, appropriate implementation of training programs by the health department, and assistance of Jihad-eAgriculture are necessary

65-66

Authors: Mehrnoosh Shirdeli , Saeede Sadat Hosseini , Motahareh Sadat Hosseini

Sesame oil, known as Queen Oil, is one of the most nutritious sources. Raw sesame oil contains compounds, such as waxes, free fatty acids, and unsaturated fatty acids. It also contains antioxidants such as vitamin E, gum, small particles, etc. (1, 2). Given the presence of anticancer compounds, such as antioxidants and unsaturated fatty acids, this foodstuff is recommended to patients with cardiovascular diseases (3). However, it should be considered that this oil, similar to all other liquid oils, has high potential for chemical and microbial spoilage due to factors, such as light, exposure to air, temperature, humidity of the environment, and microbial agents. Furthermore, Sesame oil causes hydrolysis and oxidation processes, which increases the necessity of observing the essential points during the production and maintenance. Generally, production of free radicals during the hydrolysis process is very harmful and causes diseases like cancer (4, 5). It should be noted that this oil is produced industrially and manually (in the presence of the customer)

76-82

Authors: Farnaz Mohamadhoseinzadeh Hashemi , Mehrnoosh Jafari , Seyed Mojtaba Hosseini

Introduction: The utilization of the medical research results is one of the most important indicators in the development of this profession, which provides effective care to patients and improves the quality of care. However, performing based on the evidence-based results has been unsuccessful in some cases. This study aimed to investigated and prioritize the factors affecting evidence-based medicine among physicians affiliated to Iranian Health insurance. Methods: This descriptive cross-sectional study was conducted on 150 physicians affiliated to Iranian Health insurance in Tehran city in 2018. The simple random sampling method was used to collect the data. The data collection tool was a questionnaire containing of three parts: demographic questionnaire, Fonk (1995) evidence-based medical barriers questionnaire that included four domains and 25 questions, as well as a researcher-made questionnaire that prioritized the factors influencing evidence-based medicine implementation. Data were analyzed by SPSS version 21 and Expert Choice software using hierarchical analysis method. Results: Most physicians were male (53.3%) and worked as an official employee. Among four dimensions, the highest mean and standard deviation was related to organizational impact, while the lowest was related to the quality of research and possible outcomes. Regarding the factors of organizational impacts, the highest weight or priority was attributed to the feeling of insufficient independence to change care methods with a weight of 0.259. Among the factors related to the research quality, the highest weight and priority was related to the factor of methodological defects in the research with a weight of 0.192. Considering the factors related to the skills of conducting research, the highest priority and weight was attributed to the lack of documentary evidence for the performance change with a weight of 0.320. Moreover, regarding the factors related to communication and access to the findings of the research, the highest weight and priority was in the factor of unavailability of actual articles (0.475). Conclusion: The findings of this study showed that physicians considered problems and barriers related to organization, individual, and quality of research studies. Therefore, facilities should be created for using research findings as well as the conditions for updating physicians' knowledge, skills, and attitudes to use the research results.

92-100

Authors: Hassan Rezaeipandari , Vali Bahrevar , Alireza Babaei Mazreno , Zohreh Rahaei , Saeedeh Zare Jamalabadi , Maryam Jedari Eghbali

Introduction: Ebola is a viral infection with a high mortality risk and health workers are considered as an at-risk group. The main aim of this study was to determine the knowledge and attitude of health workers about Ebola virus disease (EVD) in Yazd city, Iran. Methods: This cross-sectional study was carried out on 110 health workers in health centres of Yazd city, Iran in 2015, who were selected by cluster random sampling method. The tool for data collection was a researcher-made questionnaire including demographic information as well as knowledge and attitude questions about EVD with confirmed validity and reliability. Data were analysed by statistical tests of Student’s T-test, Chi-square, ANOVA, and Pearson correlation coefficient. Results: The mean score of the participants' knowledge and attitude were 25.16± 3.58 (range 0-46) and 46.59±4.05 (range 13-65), respectively. More than half of the health workers did not know transmission routes of EVD. However, 59.6% of them were aware that the one way to prevent the disease was to avoid contact with an infected person. A significant correlation was also found between knowledge and attitude scores (P< 0.001, r= 0.384). Conclusion: Since knowledge of the health workers was at the moderate level, training courses and interventional programs are recommended for health care workers especially about transmission routes and signs of EVD to increase the Knowledge and attitude of the participants.

113-120

Authors: Sayani Dutta , Erach Bharucha

Introduction: Piped water systems are considered to be the gold standard for drinking water according to the Joint Water Monitoring Study. However, poor maintenance of distribution pipes, intermittency of water supply, and sewage water intrusion have contributed to a number of water-borne disease episodes in developed and developing countries. Methods: This study investigated the risk burden related to drinking water and sanitation in population clusters of Pune, western India that are being served by a piped distribution system through a cross-sectional survey. Two-stage stratified convenience sampling was carried out. The city was divided into administrative wards of which the city center, the neo-urban and the peri-urban settlement were selected. In the second step a higher (HSG) and a lower socioeconomic group (LSG) were selected from each of the three studied wards. A questionnaire including close-ended items was used to conduct the survey. Results: In 2711 individuals studied, risk burden related to drinking water and sanitation was found to be higher in the LSG; 60% (677 of 1121), 70% (1029 of 1473) , 74% (1325 of 1791) from the LSGs did not have a private water tap and continuous water supply, and did not treat the water at the household level, respectively. 98% (1403 of 1426) had neither a private water tap nor a private sanitary facility. The socioeconomic difference was significant (p<0.0001). 51 (3.5%) individuals from the LSGs and 42 (3.49%) ones from HSGs reported having suffered from severe diarrhea in the recall period of 2 years. Although the number of disease cases was lower than the overall risk burden, the potential of the latter to cause a disease outbreak cannot be eliminated. Conclusion: The study highlights that piped drinking water system which is considered as a safe source can become a source of pathogenic microorganisms if not properly maintained. A holistic approach to risk assessment, i.e., from the catchment and its source water to the consumer, is required.

1-2

Authors: Motahareh Sadat Hosseini, Mehrnoosh Shirdeli, Saeede Sadat Hosseini

This article has no abstract

11-17

Authors: Shokooh Fazelpour, Narjes Hosseini , Zahra Farzaneh, Farimah Shamsi, Farzaneh Sardari, Jalal Nikukaran

Introduction: Healthy and nutritional habits are formed and consolidated during adolescence. So this research has been done in Ardakan-Yazd province on high school students' attitude to fast food use. Methods: In this cross-sectional descriptive study, 200 students have been chosen by stratified sampling method and the data was collected by a questionnaire which approved its reliability and validity. All the descriptive data has been analyzed by SPSS 16 software through Chi-square experiment and ANOVA tests. Results: The results of the experiment determined that 55% of the students were female, and 93% were single. The students' BMI was as follow: 22% thin (BMI< 18.5) 56% normal (18.5≤ BMI< 25) 14.5% overweight (25≤ BMI< 30) 6.5% fat (obese) (BMI ≥30).The female has a positive attitude to fast foods (P= 0.03). The mean attitude score for eating fast food in 17-18 years old group was more than 15-16 years old students (P= 0.001). The mean attitude score also showed that the single students were more eager to eat fast foods than the married students (P= 0.001) Conclusion: Most of the people who use fast foods are low educated, teenagers, youth and singles. On the other hand, social media like TV and radio and family has a significant effect on correct nutritional habits. So improving family's attitudes and educating students and teachers by social media can help in transferring data to the students and their teachers.

29-37

Authors: Hamideh Shekari

Introduction: Current university students are potential and actual parents of future generations. The level of their health literacy affects health and health literacy level of future generations. Therefore, the purpose of the present study was investigating and prioritizing the factors affecting the health literacy of students in Yazd (a city in central Iran) using an artificial neural network technique. Methods: This study was cross-sectional and descriptive and it was conducted on 400 university students in Yazd during autumn 2018. Data were collected using a questionnaire on health literacy and 14 independent variables. Data were analyzed with SPSS software via descriptive statistics, one sample T-test, and artificial neural network. Results: The mean of students' health literacy was 80.65±12.21. The most important factors affecting the level of students' health literacy were the grade, college, father's education level, age, and residence. Conclusion: Since grade had the greatest impact on health literacy of students, it is suggested that university officials consider the campus to hold classes, lectures, workshops and distribute appropriate resources such as brochures, booklets among students and also provide health information stations at locations such as dining room, university entrance, and dormitory to promote students' health literacy in lower grades.

46-53

Authors: Mohsen Ghane, Nasim Shahmoradi, Mahmoud Moein

Introduction: One of the factors affecting the health of the society is economic factors, and financial literacy and familiarity in the field of electronic banking can affect the economics of individuals. The purpose of this study was to investigate the effect of financial literacy of bank customers on the use of electronic banking and the reduction of traffic accidents. Methods: This descriptive study was conducted in a researcher-made questionnaire using Cronbach's alpha = 0.87. The research community was Yazd banks' customers in 2017. The research sample was determined and 380 people were randomly selected. Data analysis was performed using structural equation modeling (SEM) with partial least squares (PLS) approach. Results: Data analysis showed that 73% of the samples were male and 38% of them were between the ages of 30-39 and 41% had a bachelor's degree. The value of the path coefficient (beta) of the customers’ financial literacy to the use of electronic banking is equal to (0.493). Conclusion: The results indicated a positive and significant impact of financial literacy and its domains on the use of electronic banking, which can indirectly reduce traffic and road accidents.