Journal of community health research

103-104

Authors: Vali Bahrevar , Saeed Hosseini , Mohammad Hassan Lotfi

There is no abstact

112-116

Authors: Chai Li Tay , Noor Afiqah AW

Introduction: Fetal pleural effusion is rarely seen in primary care setting. It is more commonly diagnosed among women with diabetes mellitus in pregnancy. Method: This report illustrates two patients with fetal bilateral pleural effusions, detected at 18-week and 24-week period of amenorrhea (POA) during routine antenatal scans by primary care doctors. Result: These two pregnancies were complicated with hydrops fetalis and resulted in fresh stillbirth and intra-uterine death. Conclusion: Primary healthcare providers play an important role in the early diagnosis of fetal congenital anomaly, counseling regarding the ultrasonography findings, neonatal outcome, and referral to obstetrician for further management and monitoring for maternal complications, such as polyhydramnios, preeclampsia, mirror syndrome, and depression as a result of hydrops fetalis.

128-135

Authors: Hassan Zareei Mahmoodabadi , Leila Akrami

Introduction: The problems of girls and boys with mild intellectually disable (MID) increases with age gradually. Due to the emerging changes, puberty is a significant period for adolescents with MID. The aim of this study to investigate sexual abuse in girls and boys with mild intellectually disable in the puberty period. Methods: This research is a cross-sectional study. The statistical population consisted of all boys and girls with mild intellectual disabilities between the ages of 12 and 16 from exceptional public schools and their mothers in Yazd, Iran. 300 MID adolescents (150 girls and boys each) were selected by multi-stage sampling. To study sexual abuse, a self-designed questionnaire was used. The questionnaire comprised two sections. Kuder-Richardson coefficient obtained for boys and girls with MID turned out to be 0.80 and 0.84, respectively. Using frequency, percentage, and correlation coefficient (p<0.05). Data were analyzed with SPSS 24. Results: In this study, 2.67% (n = 4) of girls and 4% (n = 6) of boys with MID were abused. Also, their psychological and physical signs of sexual abuse were assessed (depression: girls,0.75% (n = 3), boys, 33.33% (n = 2), aggression: girls,0.75% (n = 3), boys, 66.66% (n = 4), avoiding certain adults, 0.50% (n = 2), boys, 33.33% (n = 2), sleep and eating disorder, 0.25% (n = 1), boys, 16.66% (n = 1) . Some of their parents pointed that their children had not received training in this area. There was a significant positive correlation coefficient between the mother's educational level and receiving training by schools and family with sexual abuse knowledge (p<0.05). Conclusion: The irrational reaction of families, the community, and the lack of adequate training lead to an increasein sexual abuse in such individuals. Hence, training these young individuals seems essential both before and during puberty.

150-158

Authors: Mohammad Tavakkol , Seyyed Mohammad Ali Mousavi

Introduction: Health is considered of utmost importance and can be assessed from various aspects. The social health assessment can be a good basis for planning to improve the general health of the target community. The present study was conducted to investigate the social health of Lamerd residents, a small town in Fars Province. Methods: The present study is descriptive and uses a researcher-made questionnaire as the instrument. The research population of the study is 60319 Lamerd residents over 20 years old in 2016, and using Cochran’s formula, a total of 382 people were selected through cluster sampling method. To describe social health, central tendency index of mean and dispersion index of standard deviation were used in SPSS version 24. The significance level was set at 0.05. Results: In this study, 382 people were studied. Out of this number, 89 percent were male, and 66 percent were single. Most of the respondents belonged to the 30-35 age bracket. The findings showed that the mean social health (M=3.03, Sd=0.35) was at an average level. Among the evaluated dimensions of social health, the economic dimension was favorable (M=3.09, Sd=0.96). The social trust, as the most significant social capital index, was assessed and the results showed that the institutional trust was low (M=2.14, Sd=0.65). On the contrary, interpersonal trust was at a high level (M=3.14, Sd=1.13). The social harms indicator was at a high level (M=3.07, Sd=0.87), yet physical and mental health were rated as average and low, respectively. Considering life expectancy, the sampling assumed that the life span of the residents has shortened (M=3.75, Sd=0.76), and on education and literacy, their responses proved a moderately high tendency towards academic promotion and towards studying technical majors (M=3.14, Sd=0.9). The environmental condition indicator was also rated as unfavorable, and noise, air, and marine pollution were high (M=2.84, Sd=0.84). Conclusion: Considering the importance of social health, investigating its different aspects through panel designs can be an appropriate analytical instrument for sociologists, pathologists, and health planners to move from unfavorable conditions to an optimal state.

167-174

Authors: Mohammad Hasan Lotfi , Hosein Malekafzali , Parisa Shojaei , Salime Zare Abdollahi

Introduction: Implementing any intervention in the community requires identifying and organizing the community as well as actively involving members of the community. This study was conducted to identify and organize one of the suburbs of Yazd in 2019. Method: This research was a community-based participatory research (CBPR), which was handled in the Yazd Eskan neighborhood. Considering the potentials of this neighborhood, including high social cohesion and the existence of a dynamic and popular non-governmental organization, since 1396, this place has been a candidate for the implementation of empowerment and optimal development of neighborhood health (Tabassum project). The steps of this project involved five steps of area identification, organizing, empowerment, requirement assessment, and intervention, and action. In this paper, the identification and organizing steps are explained. Frequency and percentage were used for descriptive statistics. Results: The executive steps in the identification phase were stakeholder justification and census, in which most of the study population were women (51.5%), age group 59.9-30 years (40.1%), diploma (27%), with an income of 1-2 million (49.1%). %) Formed. Selected neighborhoods included 61.4% women, 37.08% aged 30-50 years, 28.13% bachelors and 53.13% housewives. According to the results of this study, most of the people in this community who were more willing and free to participate in this project were young housewives with a bachelor's degree. In the phase of organizing the neighborhood clustering steps , the selection of Sarkhosheh, The Forming a Neighborhood Health Club (NHC), The Foundation Of Thought & Credit Fund (TCF) was done. Conclusion: Identifying and organizing the community, especially in the suburbs, provides a transparent and logical process for the community to participate purposefully in identifying the problems of their neighborhood. Paying attention to the basic needs of neighborhoods can lead to better participation in neighborhood development.

4-11

Authors: Vivek Baliram Waghachavare , Girish Bhimrao Dhumale, Jitesh Hanmantrao Kadam

Introduction: Gender stereotyping is the generalized and ambiguous impression of an individual's roles in society based on one's gender, remarkably difficult to abandon. These biases play an important role in vocational choices. The aim of the current research was to study attitudes towards women, gender stereotyping, and gender biases among adolescent boys and girls from a rural area. Methods: It was a cross-sectional study conducted from Sept. 2016 to Aug. 2017 among rural school-going adolescents. A total of 826 samples were included in the study with convenience multi-stage sampling. Statistical analysis was done using descriptive statistics, chi-square test, and Mann-Whitney U test. The data entry and analysis were performed using MS Excel and SPSS-22 with 5 % significant level. Results: The mean age of 826 participants was 13.99 years with 297 (36%) being males. A higher percentage of the participants had a positive attitude towards females (83.9%) as well as a positive attitude towards crime against women (79.1%). However, gender stereotyping (54.6%) and male bias (58.6%)were present in the majority among them. There was a significant correlation between all the scales and gender (p<0.05); with better attitudes among females. Conclusion: Although the overall attitude towards females was better in adolescents, gender bias remains an important problem.

22-32

Authors: Diba Norouzi , Shaghayegh Vahdat , Somayeh Hesam

Introduction: Designing and constructing hospitals using green approach, renewable resources reduce energy consumption and carbon emissions, and improve environmental air quality. The purpose of the present study was to determine Green hospital's criteria in Fars province, Southwest of Iran, 2019. Methods: In the Qualitative study, first, the criteria were identified systematically. Then, the criteria for establishing a green hospital were determined by content analysis and software methods. Then, for localization, using the Delphi method, the effective criteria for establishing a green hospital in Fars province were selected. Thirty experts in the field were selected using purposive sampling. Excel 2016 software was used for analysis. This study was a mixed-method study that was conducted from 2018 to the first half of the year 2019. At first, the criteria were identified by the systematic review method, and then the data extraction was analyzed using the content method. Finally, the criteria identified by the questionnaire were provided to 30 health experts. Experts were selected by purposeful sampling. In the present study, Excel 2016 software was used for analysis. Results: Green Hospital's criteria were 72 criteria out of 21 common angles in the systematic review stage. In Fars province, 34 criteria in 13 dimensions of site stability, construction stage (architecture), environmental quality, management, resources, bio purchase, Experts selected energy efficiency, water, wastewater, waste and waste recycling, transportation, healthcare, and innovation. The most important aspects for Fars province are the management costs. Conclusion: The approved criteria for Fars province, as well as other valid models in the field of the green hospital, management, water efficiency, and energy, were approved. In general, the reasons for choosing approved dimensions can be due to the various models emphasizing these dimensions and the relevance of dimensions to hospitals' challenges.

41-51

Authors: Mohammad Azimi

Introduction: Health education is an inseparable part of a curriculum for all students. Health education should represent the essential knowledge, attitudes, and skills. So, the present research aimed at investigating health system assumptions in fourth-grade elementary textbooks. Method: This research is applied and descriptive-analytical has been done manually by Shannon's entropy content analysis, which suggests a quantitative approach to data processing. The research has investigated the respondents' viewpoints about the content of fourth-grade elementary textbooks and 12 major components (Physical health, Nutritional health, Environmental health, Natural environment health, Family health, Safety incidents, Physical activity, Mental health, Prevention of high-risk behaviors, Control, and prevention of diseases, Disability, Public health, and school health) and 58 minor components of health education and promotion. Results: In this research, all fourth-grade elementary textbooks have been reviewed. According to Shannon's entropy content analysis results, mental health has the highest frequency with 277 components, and disability has the least frequency with 12 components. Among the 1157 health components in fourth-grade elementary textbooks, there are 81 physical health components, 263 nutritional health components, 57 environmental health components, 33 natural environment health components, 227 family health components, 19 safety incident components, 73 physical activity components, 277 mental health components, 25 component of prevention of high-risk behaviors, 14 components of disease control and prevention, 12 disability components, and 58 components of public health and school health. Conclusion: According to the content analysis, there is no normal distribution between the components of health education and health promotion among the components studied in the content of the fourth-grade books, so that little attention has been paid to health education components in fourth-grade elementary textbooks.

60-67

Authors: Fatemeh Seyedi, Mohammad Ali Shahabi-Rabori, Seyed Hassan Eftekhar-Vaghefi

Introduction: With the alternation of the educational system from a three-stage into a two-stage system in Iranian schools since several years ago, five-year-old children entered from kindergartens to primary schools. This study was conducted to investigate the harmonization of classroom furniture with anthropometric dimensions in preschool students. Methods: In this cross-sectional study, 366 male and female preschool students were selected by cluster sampling method in Kerman, Iran. Some of the anthropometric dimensions such as shoulder, elbow, and popliteal height, popliteal buttock length, and buttock breadth were measured. mean, maximum, minimum, standard division, and 5th, 50th, and 95th percentiles were calculated for both the sexes and were compared with five dimensions of the existing seats. Next, the dimensions of the standard seats were determined according to the anthropometric dimension’s students. Data were analyzed using SPSS 21 . Results: Results of this research indicated that there is no consistency between the seats and pre-school student's anthropometric dimensions in Kerman city. Seat height was matched with popliteal height in 28.7% and less than 1% of boy and girl student's anthropometric dimensions respectively. Backrest height and seat depth matched with shoulder height and popliteal- buttock length separately in fewer than 10% and armrest height was too smaller than elbow height and seat width was too larger than buttock breadth in both sexes. Conclusions: Due to adding a new grade to primary school, it seems that no work has been done for improving the furniture. Therefore, in this article, we presented the dimensions of an appropriate seat. This may help not only save production costs in the industry but also increase the matching between students' anthropometric and seat dimensions.

83-87

Authors: Moslem Heydari Pur, Mohamad Mehdi Bahri, Ebrahim SHeykhi

Introduction:Burn injuries are among the most important causes of disability and medical problems in the world. Weakness and inability of the burn is greater than the pain of the burn. Methods:This is a cross-sectional study-analysis in which the case of 126 patients admitted to the Shohada Mehrab Hospital, affiliated to the Shahid Sadoughi University of Medical Sciences in Yazd during the first six months of 2019, has been reviewed. Data were collected in a checklist designed by the researcher, and demographic variables and using the chi-square test, mean comparison, and using descriptive and analytical statistics and linear regression in the SPSS V.24 software was analyzed (p>0.05). Results: The findings of this study stated that 73.8% (93people) of patients were male and 26.2% (33 people) were female. 67.5% (85 people) were burned with thermal flames (p>0.019) and 13.5% (17 people) with boiling water (p>0.44). 77% (97people) of home accidents, 22% (28people) occurred at work, and 1% at other places (farm, car, etc.). 47% of these patients were 20% and 23% between 21-40 percent burns, 18% between 41-60 percent burns and burns 8% between 61-80 percent and 4 percent are between 81-100 percent burned.This study results showed that the main cause of burns is fire (67.5%). Conclusion:The results of this study showed that most burns are among men, and about 70% of deaths are among men. The average length of hospital stay was 12 days, 22 patients died, and the fatality rate was 17.5%. This study showed that 67.5 % of burns were of the thermal type and hot water and hot liquids were the next cause of burns (13.5 %). Effective factors are fatality, patient age, and total body surface area (TBSA). 77% of burns occurred at home, 22% at work, and 1% at other places (farm, car, etc.). High incidence of burns and the loss of active community force will result in cost and disability. Treatment of burns requires a long hospital stay, which in addition to the high cost, can cause mental and psychological injuries to the patient.

215-221

Authors: Nasim Namiranian, Seied Saman Mansouri , Mohammad Shafiee

Introduction: Considering the increase in Internet addiction rate, we tried to investigate the rate of internet addiction among medical students of Shahid Sadoughi University of Medical Sciences in Yazd in 2016. Methods: This analytic-cross-sectional study was performed on 350 students of Shahid Sadoughi University of Medical Sciences in Yazd. The data collection tool was a demographic questionnaire, and Yang's Internet addiction inventory. The questionnaire contains 20 questions, according to which the person is placed in one of four classes: normal, mild, moderate, and severe. After collecting the data, the data were entered into SPSS 16 software and analyzed using Chi-square and independent t-tests. The significance level was considered less than 0.05. Results: According to Internet addiction, students were 65% normal, 33.3% border lip and 1.7% were addicted to the Internet. The results also showed that there was a significant statistical relationship between the prevalence of internet addiction among students and sex, smoking, and registration in cyberspace (p<0.05), and there was no significant statistical relationship between the prevalence of internet addiction and marital status, place of residence and birthplace (p>0.05). Conclusion: According to the results of the study, it can be concluded that by increasing the awareness of medical students, the rate of Internet addiction in them can be minimized

233-240

Authors: Hassan Zareei Mahmood Abadi , Razieh Heydari Sooreshjani, Fatemeh Rajaei Rizi, Leila Akrami

Introduction: Drug addiction, is one of the major challenges in human societies. This study aimed to investigate religious orientation, locus of control, and the tendency toward substance abuse in addicts and non-addicts in Isfahan, 2018. Methods: A case-control method was used, and the study population was 200 men who participated in Isfahan. Cases were selected from drug-dependent using cluster sampling method. Allport’s Religious Orientation Scale, Rotter’s Locus of Control Scale, and Scale of Tendency toward Substance Abuse were used for data collection. The mean ± SD age of addicts was 34.8 (±4.35) years. Most addicts were illiterate 33% (33), and about 30% (30) had academic degrees. Finally, data analysis was done by SPSS version 16 and confidence Level was 95%. Results: The groups were homogeneous in terms of income, number of children and residential area. The mean ± SD of religious orientation was in normal group 60.39 ± 3.26, addicted group 40.25 ± 7.8 and locus of control was in normal group 59.13 ± 3.17, and addicted group 45.45 ± 1.33 that findings of t-test showed that there was a significant difference in religious orientation (t= 5.40, p<0.003), and locus of control (t= 4.37, p<0.001) between addicts and normal individuals. There was a significant relationship between religious orientation (r=-0.328, p<0.04) and locus of control (r= -0.365, p<0.01) in addicts with a tendency toward substance abuse. confidence Level was 95%. Conclusion: Poor religious orientation and lack of internal locus of control are important causes of the tendency toward substance abuse, which demands measures to be urgently taken.

256-264

Authors: Mohammad Taghi Sohrabi Renani, Fahimeh Nourafkan, Fariba Fathimard, Kaveh Sadegheyan khashoei , Roghayeh Mazarei

Introduction: Since diabetes is a complex network of psychological and healthcare factors, this paper aims to investigate the relation between type 2 diabetes and mental health Method: This study was analytical cross-sectional research on 60 diabetic patients referring to Kazerun health care centers, southwest of Iran, in 2018. The samples were selected by convenience sampling method. The data were collected using the Demographic Profile Questionnaire, General Self-Efficacy Scale (GSES), Health Literacy Questionnaire (HELA), and Mental Health Continuum (MHC-SF). Data analysis was performed in APSS v21 and from descriptive statistics including mean and standard deviation and using the statistical tests of Spearman correlation coefficient and multiple regression analysis (P <0.01). Results: Mental health has a significant positive relationship with health literacy (p <0.001). Thus, individuals with better mental health evaluate their level of health literacy better. However, no relationship was found between self-efficacy and health literacy(r= -0/19, p >0.001). Besides, regression results indicated that mental health can predict a 54% variance of health literacy (R2= 0.54, p <0.001). Conclusion: The findings of this study shows that boosting an individual’s mental health leads to an increase in health awareness in patients afflicted with diabetes which after all, can cause a better coping capability in these people.

273-281

Authors: Mohammad Reza Sadeh , Reza Sharifatp

Introduction: Muscle weakness and balance problems are limiting factors in Multiple sclerosis patients that can be improved due to physical activity. The purpose of this study was to investigate the effect of 8 weeks of aerobic exercise on balance function and Physiological Cost Index in patients with MS in Yazd city in 1394. Methods: This quasi-experimental study was conducted in two stages: pretest and post-test. The subjects were selected by targeted and available sampling and randomly divided into training and control groups that included 30 patients (15 in the experimental group and 15 in the control group). The subjects were randomly divided into two groups of experimental and control. Subjects in the experimental group participated in an aerobic exercise program for eight weeks, three days a week, each session of 60-90 minutes with an intensity of 50-70% of maximum heart rate. For statistical analysis we used descriptive statistics such as mean, standard deviation, and the Shapiro-Wilk test used to measure the normality of the data, independent t-test and the covariance (ANCOVA). The significance level of the tests was p < 0.05 by using the SPSS-25 software. Results: ANCOVA results revealed that the selected aerobic training significantly increased both static balance (p = 0.007) and dynamic balance (p = 0.001). Moreover, aerobic training positively influenced the physiological cost index (P = 0.001. Conclusion: aerobic exercise can improve both static and dynamic balance and increase the Physiological Cost Index in M.S patients. Therefore, these exercises are recommended for patients with MS.

141-148

Authors: Hossein Hatami, Hossein Khani, Mohamad Hassan Lotfi, Aref Atefi, Mahmoud Falahati

Introduction: Tuberculosis (TB) is one of the most important infectious diseases in the recent century caused by Mycobacterium (MB) tuberculosis. Despite new medical technologies and effective drugs, it still causes human deaths. This study aimed to investigate the trend and factors affecting TB prevalence in Yazd city from 2005 to 2014. Methods: In descriptive study, the medical files of TB patients referring to Yazd health and treatment centers from 2005 to 2014 were investigated. frequency, mean, standard deviation, and 95% confidence interval were calculated and reported for quantitative data, and the frequency and percentage are reported for qualitative data.The patients' demographics and disease features were recorded in a checklist and analyzed using SPSS version16 software.Its confidence Level was 95%. Results: In this study, 882 TB patients were studied, out of which 51.9%(458) were male 57.7%(509) were Iranian, 42.3%(373) were from other nationalities, and 33.8%(298) Of Them were over 80 years old . The average age of TB patients studied was 49.32±17. The percentage of patients with pulmonary TB and patients with extrapulmonary tuberculosis was 71%(626) and 29%(256), respectively. Conclusion: This study shows that health officials must pay more attention to TB disease in Yazd city. Enhancing life standards, active case-finding among prisoners, increasing physicians' and people's awareness about the health and treatment system services, and taking samples from suspected patients can play a crucial role in decreasing this disease. Keywords: Epidemiological characteristics, Mycobacterium tuberculosis, Trend of disease, Tuberculosis

159-171

Authors: Mostafa Nasirzadeh, Mahdi Abdolkarimi, Zahra Asadollahi, Maryam Hashemian

Introduction: Regular fruit and vegetable consumption is one of the preventative indicators for the development of obesity, disorders, and diseases. This study aimed to identify the determinants of fruit and vegetable consumption based on social cognitive theory (SCT) among first-grade high school female students. Methods: This Analytical cross-sectional study was performed on 264 high school female students who were selected through multi-stage random sampling from school students in Rafsanjan (Southern Iran). The data were collected through a demographic questionnaire, the seven-day fruit, and vegetable consumption frequency, and its determinants questionnaire that was developed based on the constructs of SCT. Data were analyzed using SPSS-16 software through independent samples t-test, Pearson correlation, one-way Analysis of variance, and multiple linear regression analysis. The alpha is equal to 0.05. Results: The mean (SD) score daily fruit and vegetable intakes were 3.43 (1.67) and 2.30 (1.20) units per day, respectively. The results of multiple linear regression analysis showed that environmental factors (β= 0.165, p= 0.009) and behavioral skills (β= 0.152, p= 0.025) have a significant effect on fruit consumption score. Behavioral skills (β= 0.151, p= 0.022) and social support (β= 0.143, p= 0.049) have significant effect on vegetables consumption score, the constructs of SCT explained 71% of the variances in fruit consumption and 9.8% of the variances in vegetable consumption. Mother's job (p= 0.032) and family income (p= 0.024) have a significant effect on fruit and vegetables consumption. Conclusion: Fruit and vegetable intakes were less than the WHO recommended level. Therefore, attention to environmental factors, behavioral skills, and social support is suggested. Keywords: Fruit, Vegetable, Social Cognitive Theory, Students, Adolescences

184-190

Authors: Reza Sharifatpour, Mahdieh Akoochakian1, Mohammad Hossein Alizadeh, Hamid Abbasi

Introduction: One of the preventing injuries methods is recognizing common injuries in sports and causative factors of injury. The aims of this study was to investigate the injuries of beach soccer players in terms of prevalence and mechanism. Methods: The present study is a Cross-sectional and descriptive research that was conducted as a field study. Forty players were selected randomly from two teams of the Yazd province in premier country league that took place in 2019. For recording prevalence and mechanism of injuries, the modified injury report form by Fuller et al. (2006) was used. The SPSS software version 25 and the chi-square test at a significance level P < 0.05 were used for statistical analysis. Results: In total, the most common injuries of beach soccer were in lower extremities (%69.84), and for injury severity, %31.75 were severed injury, and in terms of the type of injuries, the strain was the most of the injuries occurred (%33.33). The amount of injury during the match (%60.26) was higher than the time of training (%39.68). The degree of contact injuries %73.02 was significantly higher than non-contact injuries %26.98 (p <0.05). Conclusion: Most of the injuries in beach soccer are caused by playing bare foot and lack of shoes and guards on the legs and feet, and then on the knee. Contact of players is one of the main sources of injury in beach soccer, which is likely to be effective in preventing injury by changing training, implementing proper techniques, and improving performance factors by using injuries preventive programs. Keywords: Prevalence, Mechanisms, Injury, Beach Soccer

203-212

Authors: Giti Bahrami, Hassan Rafiey, Alireza Shakiba, Mehdi Noroozi, Homeira Sajjadi

Introduction: Many studies have illustrated climate change effects on social variables and health. This study aimed to identify the SDH associated with climate change. Methods: The present study is a review study with a systematic search. The keywords related to climate change and social variables were searched in the Web of Science and PubMed databases until June 2018. In the initial search 12097 articles were obtained and after the elimination of duplicate and non-related articles, 5932 articles remained After studying the abstracts, 342 articles were excluded based on entry and exit criteria (studies that were not related to climate change and SDH) and 43 articles remained. In the next phase, the full text of the articles was evaluated by two evaluators individually and the consensus method was used. 23 papers were finally included in the study. Results: According to the review, social variables related to climate change were divided into 5 different categories of variables, including structural variables related to climate change (socioeconomic status), variables related to social status and work conditions (access to health services, unemployment, immigration, inequality, education, work condition, food security), variables related to social relationships and social networks (social movements, urban warfare, riot, group protests, interpersonal violence), individual variables related to lifestyle (place of living; city/village), and individual variables (age, race, gender) based on social determinants of health. Conclusion: Climate change has a wide range of social outcomes.. Various groups that are vulnerable to climate change include women, elderlies, children, villagers, and workers. Keywords: Climate change, Health, Social determinants of health,

69-80

Authors: Efat Jabarpour , Amin Abedini , Abbasali Keshtkar

Introduction: Osteoporosis is a disease that reduces bone density and loses the quality of bone microstructure leading to an increased risk of fractures. It is one of the major causes of inability and death in elderly people. The current study aims at determining the factors influencing the incidence of osteoporosis and providing a predictive model for the disease diagnosis to increase the diagnostic speed and reduce diagnostic costs. Methods: An Individual's data including personal information, lifestyle, and disease information were reviewed. A new model has been presented based on the Cross-Industry Standard Process CRISP methodology. Besides, Support Vector Machine (SVM) and Bayes methods (Tree Augmented Naïve Bayes (TAN) and Clementine12 have been used as data mining tools. Results: Some features have been detected to affect this disease. The rules have been extracted that can be used as a pattern for the prediction of the patients' status. Classification precision was calculated to be 88.39% for SVM, and 91.29% for (TAN) when the precision of TAN is higher comparing to other methods. Conclusion: In this study, lactation duration, history of osteoporosis, calcium intake, immune-suppressor drugs, hyperlipidemia drugs, autoimmune diseases, number of pregnancies, hyperlipidemia, vitamin D, hyperparathyroidism, exercising during the week, anti-inflammatory drugs, thalassemia, waist disc, anti-coagulants drugs, hypothyroidism, hypertension drugs, history of surgery, diabetes and diabetes-related drugs were identified as important factors in relation to osteoporosis. These factors can be used for a new sample with defined characteristics to predict the possibility of osteoporosis in a person.

90-99

Authors: Farin Fatemi , Alireza Dehdashti , Besharat Zadehabbas , Hossein Kashani

Introduction: Occupational accidents have been regarded as the third cause of mortality around the world. This study examined the rates, types, and causes of occupational accidents in industrial sites. Methods: In a cross-sectional design, 721 accident reports were examined in the manufacturing sites in Semnan which is located in the central part of Iran from 2013 to 2015. This study used the Social Security Organization database on workplace accident investigation reports. Frequency and percentage were used for the prevalence, whereas Chi-Squarewere used to identify the predictors of occupational accidents. SPSS version 21 was used for data analysis and 0.01 was considered as a cutoff for the significant level. Results: Accident Frequency Rates were 1.46, 1.54, and 1.40 in 2013, 2014, and 2015, respectively. Also, the Safe T-score was calculated between +3 and -3. The majority of accidents occurred in males in the age group 24-45, having the educational level of high school diploma or lower. Furthermore, most accidents occurred during the morning shift. Unsafe actions were determined as the major cause of accidents. The maximum reported statistics related to the type of accidents, injuries, and injured organs of the body were hitting sharp edges or obstacles (25%), bruising (30%), and upper limbs (44%). The results indicated a statistically significant relationship between shift work, accident type, inured organs, and injury type ( p =0.001). Conclusion: This study revealed that workers’ behavior as a main contribution to accidents and injuries in the industry. Health and safety training should be designed according to worker duties.

107-118

Authors: Masoumeh Rahimi , Mahsa Jalali , Robabeh Nouri , Mojgan Rahimi

Introduction: The coexistence of mental health problems in diabetic patients can lead to poor disease management. This study aimed at investigating the mediating role of resilience and diabetes distress in the relationship between depression and treatment adherence in type 2 diabetes among Iranian patients. Methods: It is a type of analytical study conducted from 2019 to 2020. The statistical population of this study consisted of all-diabetic patients in Tehran. The subjects (200) were selected after purposeful clinical evaluation and qualification of research. In this study, Beck Depression Inventory (BDI), the Persian Version of the Morisky Medication Adherence Scale-8, Diabetes Distress Scale (DDS), Conner & Davison Resilience Scale (CDRS) were used to collect the data. Pearson correlation test by SPSS version 24 and Confirmatory Factor Analysis in AMOS software version 22 were used for analysis (P<0.05). Results: In the present study, most participants (about 36.5%) were in the age group of 56-65 and 58.5% of them were female. According to the results, the variables of depression and diabetes distress has a negative and significant correlation with adherence to treatment (r= -.408, p<0.05). The resiliency has a positive and significant correlation with adherence to treatment (r= 0.414, p<0.05). Conclusion: The findings showed a link between depression, diabetes distress, resilience, and treatment adherence. Resilience and anxiety from diabetes play a mediating role between depression and adherence to care. Paying attention to patient resilience may lead to improved depression and diabetes distress in patients with diabetes, to increase the patient’s involvement in treatment adherence.

129-138

Authors: Dara Rasoal

Introduction: The provision of home health care services increases as a desirable option in western society. Previous studies indicate that health care professionals encounter ethically difficult situations when providing home care services. There is a lack of studies describing ethically difficult situations through observation. This study aimed to explore ethical issues experienced by healthcare staff when providing community home care services. Methods: Qualitative design, using the ethnographical approach. Data gathered as fieldwork in terms of memos, non-participant observation and informal interview with registered nurses (n=8), and nurse-assistants (n=4) during three weeks (in total 148 hours, 7am -5pm) . Results: The result generated two main categories: 1) To balance stakeholders’ requirements, and, 2) Strategy to deal with ethical issues. Coxing was used as a strategy to deal with ethically difficult situations in patient care. The results showed that the complexity of the ethical issues is often related to personal values and organisational impact. The staff experienced need for a structured approach to assist them in identifying, analysing, and resolving ethical issues that arise in clinical practice. Health care organisations, personnel and patients are disagreed about values and choices that could lead to the best course of actions. Conclusion: This study reveals that the ethically difficult situations in the context of community home care services are complex and are influencing the provision of care. The personnel enforced to find a balance between different expectations and from different stakeholders. To deal with these situations coaxing was used as a strategy for managing ethical issues.