Journal of community health research

140-146

Authors: Zohreh Karimian Kakolaki, Seyed Saeed MazloomyMahmoodabad, Sakineh Gerayllo, Fatemeh Heidari, Bahareh Motaghi Dastenaei, Firoozeh Sharifi

Introduction: Marital satisfaction is defined as individuals’ global subjective evaluation of the quality of their marriage. Quality of Life (QOL) is a multidimensional concept and includes all aspects of individuals’ lives. Premenstrual Syndrome (PMS) is characterized by a wide variety of emotional and physical symptoms and behavioral changes. The purpose of this study was to determine the role of marital dissatisfaction and premenstrual syndrome in the emotional dimension of quality of life. Methods: This cross-sectional study was conducted on 246 women who referred to the health centers in the suburbs of Yazd. Tools for data collection were Quality of Life questionnaire SF36, Premenstrual Syndrome Screening Tool and Index of Marital Satisfaction (QOL &PSST & IMS). The collected data were coded by SPSS18; descriptive statistics were used to summarize and organize the data. Then, data were analyzed using Path Analyze Test. Results: Marital dissatisfaction (p = 0.021) and premenstrual syndrome(p = 0.001) has a direct negative effect on the quality of life's emotional dimension, and the severity of premenstrual syndrome has a stronger effect. Also, marital dissatisfaction with the effect on the severity of premenstrual syndrome (p = 0.001) indirectly affects the quality of life's emotional dimension. Conclusion: The findings of this study emphasize that women with premenstrual syndrome and marital dissatisfaction have problems in their emotional dimension. Therefore, women should be educated in order to have a better mental health, overcome complications of marital life, and recognize the symptoms of premenstrual syndrome. They also need to learn the improvement strategies overcome the premenstrual factors and increase their quality of life.

155-163

Authors: Kanuda M. Mandago, Fabian P. Mghanga

Introduction: To assess patients’ awareness on the risk factors, complications, and prevention of complications of hypertension. Methods: This cross-sectional study was carried out on a non-random sample of hypertensive patients attending Songea Regional Referral Hospital, Tanzania using an interview-based questionnaire. Data entry and analysis were performed using SPSS v.14. Results are expressed as Mean ± SD for continuous data and proportions for categorical data. Logistic regression was performed to assess the association between variables and patients’ awareness on risk factors, complications, and prevention of complications of hypertension. Results: Four hundred and fifty hypertensive patients with a mean age of 57.00 ± 12.60 years were enrolled in the study. Females accounted for 52.90% of the study population. More than one-third (35.60%) of patients had the low level of awareness on the risk factors, complications and preventive measures of the complication of hypertension. Having a higher education level, having a long-standing history of hypertension of more than 5 years, and a positive family history of hypertension were all associated with a high level of awareness among hypertensive patients. Conclusion: The findings show that a considerable number of hypertensive patients are not aware of the risk factors, complications and preventive measures of hypertension. Assessing patients’ awareness of risk factors and complications of hypertension during follow-up visits may improve patients’ control of blood pressure and slow down the progression of complications.

173-182

Authors: Marjan Khosravi Asl, Mansoureh Nasirian, Alireza Bakhshayesh

Introduction: The existence of female-headed households is a global fact. These women are the most vulnerable members of the society, who experience some degrees of emotional distress, general signs, and symptoms of anxiety and depression. So, this study was conducted to evaluate the effect of emotion-focused therapy on anxiety and depression of the female-headed households. Methods: This quasi-experimental study had a pretest-posttest design in which the experimental and control groups were investigated. The study was performed on 30 women who headed the households and were supported by the Imam Khomeini Relief Foundation of Yazd city. The participants were selected randomly in 2016. The data collection tool for this study included the Beck anxiety and depression questionnaire. Finally, the collected data were analyzed using SPSS version 20. Results: The findings showed that the emotion-focused treatment method reduced the anxiety of the participants. Moreover, the effect size was equal to 0.52, which indicated that 52 percent of the variance changes were attributed to the independent variable. In addition, the emotion-focused therapy reduced the level of depression among the women. The reported effect size was 0.734, which showed that 73 percent of the variance changes were due to the independent variable. Therefore, we can conclude that the emotion-focused therapy had a significant effect on the anxiety and depression of the female-headed households (p < 0.001). Conclusion: According to the results of this study, the multivariable model of covariance analysis indicates that changes in the groups can be caused by the intervention. Therefore, it can be concluded that the emotion-focused therapy was effective on the anxiety and depression of the women. Consequently, this therapy can be used to reduce the anxiety and depression of the female household heads.

192-199

Authors: Sahar Jafarzadeh Rastin, Elaheh Khoshnevis, Seyed Mahmood Mirzamani Bafghi

Introduction: Abnormalities and genetic disorders in the fetus are one of the most important traumatic events for mothers, which can cause discomfort and stress. This study aimed to determine the effectiveness of training based on problem-focused coping strategies on Quality of Life (QOL) in pregnant women with a genetic risk of fetal abnormality. Methods: The current study is an experimental method of field trial type with a pretest-posttest and a control group. After the random selection of 30 pregnant women with genetic risk of fetal abnormalities, a pretest of the quality of life questionnaire was done and they were randomly divided into two groups (experimental and control). Then, the experimental groups during twelve sessions (once a week, for 60 minutes) were trained coping strategies and after completion of training, from both groups, QOL post-test was performed and the descriptive statistical index and covariance analysis test was used to analyze. Results: Results showed that Mothers' QOL scores increased significantly in post-test compared to pre-test, and significantly different. After the intervention, there was a significant increase in various dimensions of QOL including Physical Functioning (PF), Role Physical (RP), Bodily Pain (BP), General Health (GH), Vitality (VT), Social Functioning (SF), Role Emotional (RE), and Mental Health (MH). In the intervention group compared to the control (F= 67.48, P< 0.01). Conclusion: It can be concluded that coping strategies training on QOL pregnant women with genetic risk of fetal abnormality are statistically significant in its effectiveness. In addition, it can be deduced that training of problem-focused coping strategies can serve as an effective instructive approach to prevent risks of stress among pregnant women with genetic risk of fetal abnormality.

74-84

Authors: Aliakbar Vaezi , Mohammad Hassan Lotfi, Maryam Shaker

Introduction: The elderly are among the most vulnerable group in the society, and elder abuse is poses a challenge in the domain of elderly care and support. The present study was conducted with the aim of exploring the effect of implementation of an elderly respect education program in families on the elder mistreatment in the city of Yazd in 2016. Methods: The present study was an experimental study of the field trial type that was conducted on 80 elderly people over the age of 65 years who were covered by Yazd Comprehensive Health Service Centers. This sample was randomly divided into two groups: the intervention group (n= 40) and non-intervention group (n= 40).The sampling units were invited for participating in the study through phone call by healthcare providers. Then, the interviewer completed the questionnaire, after introducing himself and giving explanations on the objective of the study. The data collection tool was the Elder Abuse Scale that included 49 items in eight subscales: care neglect, psychological abuse, physical abuse, financial abuse, authority deprivation, rejection and financial and emotional neglect. In the next step, the families of the elderly in the intervention group were invited to participate in the educational program. The content of this program included different elder abuse subjects, the importance of respecting the elderly in the family and the society, and the role of families in supporting and protecting the elderly. One month after the end of the educational program for families, the elderly in both the intervention group and non-intervention group were invited to be interviewed and the questionnaire was completed. Data analysis was done using software SPSS and through the independent t-test and chi-squared test. Results: Analysis of the mean of elder abuse dimensions in the intervention group indicated that there was a significant difference between the scores before and after the intervention (P< 0.05). The highest level of abuse was seen in the dimension of emotional neglect with the mean of 25.3 and the lowest was seen in the dimension of rejection with the mean of 2.7.The study of the mean of abuse dimensions in the elderly non-intervention group, no significant difference was seen before and after the intervention (P> 0.05). The highest level of abuse was seen in the dimension of emotional neglect and the lowest in the dimension of rejection. Conclusion: The findings indicated that the implementation of the program for educating elderly respect in family was effective in abuse reduction. Therefore, training elderly respect programs are recommended. Also, clarification of this phenomenon from different aspects is better to be considered as a priority.

95-104

Authors: Ali Dehghani , Marzieh Sobhani , Mahmoud Nouri Shadkam, Hossein Fallahzadeh, Masoud Mohammadi, Aboalfazl Sharifi

Introduction: One of the most valuable indicators determining the health status of a community is the birth weight of infants. Thus, the purpose of this study was to investigate risk factors affecting low-birth-weight infants born to mothers visiting community health centers in the city of Yazd in Iran. Methods: The present study was a retrospective cohort research on 280 mothers visiting to community health centers in two groups of mothers with infants weighing less than 2500 grams (case) and those with babies weighing more than 2500 grams (control). The data were also collected by interviewing mothers and reviewing the information inserted in their health records. Such data were then entered into the SPSS software (Version 19) and analyzed through Chi-square test, independent t-test, as well as logistic regression analysis. Results: The mean and the standard deviation of birth weight in the case group were 2171.4 ± 339.85 grams and they were equal to 3222.5±390.78 grams in the control group. Besides, the results of the analysis revealed that maternal education (P= 0.05), type of delivery (P= 0.02), birth order (P= 0.02), maternal occupation (P= 0.03), pregnancy-induced hypertension (P= 0.008), and gestational age (P= 0.000) were correlated with low-birth-weight infants. Conclusion: Considering that low birth weight was related to factors that could be controllable in most circumstances, measures such as training mothers, promoting quality of prenatal care, and planning for childbearing among mothers are recommended.

112-118

Authors: Zohreh Bakherad , Javad Feizy

Introduction: Aflatoxins (AFs) are a group of mycotoxins created as metabolic items for the most part by three types of Aspergillus including Aspergillus flavus, Aspergillus parasiticus and the uncommon Aspergillus nomius. Eighteen aflatoxins have been identified up to now, but only six of them have been found in food and feed. Methods: The occurrence of aflatoxins in 32 samples of roasted red skin peanut was determined using HPLC with a Chromolith column. All samples were purchased from retail shops and local markets in Mashhad city. The method was based on the extraction of samples and aflatoxins determination after post-column derivatization by Kobra Cell and fluorescence detection at excitation and emission wavelengths of 365 and 435 nm, respectively. Results: Mean levels of aflatoxins B1, B2, G1, G2 and total aflatoxins were found to be 57.17, 2.56, 12.51, 1.42 and 85.16 ng g-1, respectively. Aflatoxins B1 (AFB1) was detected in 12 samples (37.5%) with a mean value of 57.17 ± 90.32 ng g-1 and a maximum level of 243.61 ng g-1. AFB1 levels exceeded Iran maximum tolerate limit (5 ng/g) in 7 out of 32 peanut samples. 21.8% of these peanut samples exceeded the maximum tolerate limit set for total aflatoxins by codex and Iran (15 ng g-1). Conclusion: According to the obtained results, more effort is needed to control aflatoxin levels in Mashhad’s peanut. This survey provides valuable information on aflatoxin contamination in peanut products marketed in Iran as well.

127-133

Authors: Naghmeh Ghorashi, Abbas Alavi Rad

Introduction: The national trend indicates that various provinces of Iran have experienced attaining economic growth exclusive of parallel observing a boost in CO2 emissions. It is clear that the effects of CO2 emissions on health indicators such as death rate, infant mortality, and health expenditures have been ignored by policy makers over the past decades. Methods: This study utilizes 1989-2016 panel data of the three economic sectors (agriculture, industry and services) of Iran to examine the effect of financial development on CO2 emissions using Pooled Mean Group (PMG) and Mean Group (MG) Regression techniques for the first time in previous literature in Iran. The potential impact of government size and capital stock on CO2 emissions is also analysed. Results: According to empirical results, in the long-run, government size and capital stock increase CO2 emissions, while financial development compact it. However, the results show these variables don’t have statistically significant effect on CO2 emissions in short-run. Conclusion: The study opens up new policy insights to control the environment from degradation by financial development on economic sectors. It recommends that policy makers should realize the potentiality of the financial development in minimizing the CO2 emissions. Therefore, the policy makers need to facilitate more financing at lower costs for investment in environmental projects.

11-17

Authors: Leila Zameni*, Abbas Bahram, Hasan Khalaji, Farhad Ghadiri, Seyed Ghasem Hasani

Introduction: Participating in regular physical activity has positive effects on the health and behavior of adolescents. Physical activity is multifaceted and has both interrelated psychological, biological and environmental effects. Therefore, this study was conducted to determine the level of physical activity of female students and its relationship with their socioeconomic status. Methods: 630 junior high school students in Mazandaran were selected based on randomized multistage cluster sampling in the year 2017. The tools used for collecting data were pedometers, and demographic and Ghodratnama socioeconomic status questionnaires. Data analysis was done using SPSS23 software with descriptive and inferential statistics (the Kolmogorov-Smirnov test, the one-way analysis of variance [ANOVA], and the Pearson correlation coefficient) at a significance level of P ≤ 0.05. Results: The results showed that the level of physical activity of students decreased as grade level increased. An ANOVA showed a significant difference between the level of physical activity of students in 7-9 grades, but Tukey’s post hoc test showed a significant difference between the level of physical activity of 7th grade students with 8th and 9th, while the difference between the students of grades 8 and 9 was not significant statistically. Out of all students, 30.72% of students were active and 69.28% inactive. The Pearson correlation coefficient showed that there was no significant relationship between socioeconomic status and level of physical activity. Conclusion: A vast majority of adolescent girls do not do the amount of physical activity recommended for good health, which is a worrying issue. It is suggested that relevant authorities mobilize basic strategies for changing the lifestyles of adolescent girls, including the development of a comprehensive program of physical activity by specialists.

24-31

Authors: Khadije Moeil Tabaghdehi, Marjan Ghazisaeedi, Leila Shahmoradi*, Hosein Karami, Azadeh Bashiri

Introduction: In modern medicine, large amounts of data are produced. However, there is always a gap between their collection and their understanding and interpretation. In this way, minimal data sets are prepared. Thalassemia major is a chronic genetic disorder of the blood and the most common genetic disorder in the world. Thus, the purpose of this study was to define a set for personal health of patients with major thalassemia. Methods: This present applied research was done descriptively in a cross-sectional manner by Delphi method. To determine the dataset, the manual health records of thalassemia major patients were first evaluated based on the standard paper forms of the Ministry of Health, and the data required were collected according to the checklist. The questionnaire was first reviewed by a team of six experts in the field. Its content validity was determined by the team and its reliability by Cronbach's alpha as 96%. Then, a researcher-made questionnaire was prepared and surveyed among 113 experts on blood and oncology specialists around the country (Iran). Results: from the 126 information element data surveyed, 117 IEDs were identified as the main elements with the agreement of more than 75% in the range of high and very high, while nine elements with the agreement of less than 50% in the range of low and very low were excluded from the elements list of personal health records of thalassemia patients. The information element data with the agreement of 50 to 75 in the range of moderate to high was not found in the survey. Finally, the minimum data set of individual health records of patients with thalassemia major was provided in 9 groups of demographic information, health history information, assessment information, laboratory data, drug information, blood transfusion, physical examinations, immunization (vaccination) and dental care. Conclusion: In this study, the data elements were defined for personal health record of thalassemia patients. These data elements are considered as an appropriate data set for inclusion in the manual systems and electronic medical records and based on the patients' needs can be changed to be used as a national document.

42-47

Authors: MoradAli Zareipour, Vahid Ayuoghi Rahnema*, Afshin Mokhtari Tavana, Zahra Moradi

Introduction: Cardiovascular disease is one of the most common causes of death in the world. Because of uptrend and staggering expenses of health care and remedies, this study was investigated with goal of exploring the relationship between life style and ischemic heart disease. Methods: This study was as case-control study. It consists of 360 participants for case group and 360 participants for control group in health centers of Uremia. Both groups were compared regarding age, sex, and location. Data collection tool was a standard questionnaire of lifestyle which explored 10 types of life style. SPSS v.20 software has been used for data analysis of T-test, Chi-square test, and Logistic Regression in 0.05 significance level. Results: The results of this study showed that, the mean difference between two groups was significant in terms of weight and nutrition control exercise and health, physical health, social health, spiritual well-being, psychological health, and disease prevention. Case group is exposed to high risk of catching the ischemic heart disease due to less mean from analysis. Conclusion: The findings of this study indicate that insufficient mobility, high fat and low fiber diets, as well as poor mental status can be major causes and risk factors for the incidence of cardiac ischemia.

57-61

Authors: Masoud Amiri, Mehdi Naderi Lordjani*, Hasan Asgarpour

Introduction: Scorpion sting is one of the major health risks in many countries around the world. . Lordegan is one of the areas where several reports of scorpion stings occur. The purpose of this study was to describe the epidemiological and demographic characteristics of selected scorpions for preventive measures. Methods: This descriptive cross-sectional study was conducted to collect information about all the scorpion patients in Lordegan city health center during 2014-2017 Results: The results showed that the total number of scorpion stings was 2,422, of which 1,124 cases were female (46.4%) and 1,298 cases were male (53.6%). Of the total number of stings, 2 deaths occurred. Death rate of the cases in this area is about .01 % in 1000 people. It’s worth noting that 2,060 of the cases were rural (85.1%) and 362 were urban (14.9%). 764 (31.5%) people’s visits to the hospital lasted less than 1 hour and 30 minutes, and 749 people (31%) stayed between 1 hour and 30 minutes to 3 hours and 909 people (37.5%) stayed more than three hours. 39% of victims were stung on the leg, 35% on their arms, 20% on their trunks, 6% on their head and necks. 99.9% of victims recovered from the stings, and 0.01% died from the stings. The majority of recorded stings took place from April to October. The 15- to 24-year-old age group suffered the highest number of stings, and the 65-year-old and older age group suffered the lowest number. 80.6% of stings were by yellow scorpions and 19.4% by black scorpions. Conclusion: Scorpion stings are common in Lordegan, especially in the summer months. Public education, as well as the risk-reduction strategies of individuals can prevent scorpion stings.

207-213

Authors: Nader Sharifi , Farangis Sharifi

Introduction: Osteoporosis is a chronic disease which influences the life of people considerably, especially the women. Most women are not aware that osteoporosis is preventable. Although there is a higher risk of osteoporosis in postmenopausal women, but bone loss can begin at the age of 35. This research was conducted to design and implement educational interventions to empower female students to prevent osteoporosis. Methods: This interventional study was a controlled trial. This study was conducted on female students of Shahrekord Islamic Azad University. A two-stage stratified random sampling was used for recruiting samples. The sample size was set at 150 (75 interventions and 75 controls). A demographic questionnaire and a self-made questionnaire of self-empowerment for the prevention of osteoporosis were used to collect information. Data were collected before the intervention and three months after the intervention. The educational intervention was conducted in two months with eight education sessions. For statistical analyses, the SPSS software version 23 was used. Results: The mean age of the intervention group was 20.69 ± 2.24, and the control group was 20.29 ± 2.04, besides, there was no significant difference between the two groups (P= 0.26). The test indicates a significant difference in mean variance of the intervention group compared to mean variance of the control group in knowledge (P< 0.001), attitude (P< 0.001) and self-efficacy (P= 0.006). The difference in mean variance of the intervention group compared to the mean variance of the control group was not significant in life skills (P= 0.23). Conclusion: The results generally reflect the effect of educational interventions in improving the abilities of female students to prevent osteoporosis. It is suggested to design and implement educational programs to empower women to prevent osteoporosis.

222-230

Authors: Seddigheh Ravati, Malihe Farid

Introduction: Health literacy is defined as the ability of an individual to acquire, interpret, and understand the basic information about health services and to use them. Health literacy is a strong predictor of health. Its low level is germane to health problems of people and society as well as economic costs. This study was designed to determine the level of health literacy considering socio-demographic factors in residents of Alborz province in 2015. Methods: This is a cross-sectional study in which 465 people aged between 18 and 60 years old living in Alborz province were evaluated using two-stage random sampling technique (stratified and cluster sampling). In this study, Iranian Health Literacy Questionnaire (IHLQ) and socio-demographic Information Questionnaire were used to collect the required data. The data were analyzed using descriptive statistics as well as T-test, Mann-Whitney test, and Spearman correlation test using SPSS software. Results: The mean age of participants was 36.57(±11.08) years old and 68.2% of them were female. 22.4% of people had adequate, 44.3% had a moderate, and 33.3% had a poor level of health literacy. Health literacy in all dimensions of IHLQ except individual empowerment and social empowerment was moderate. People's access to health information also was moderate. The T-test indicated that the health literacy score was significantly higher in the individuals with the educational level of diploma and higher (p= 0.000), in Persian people (p= 0.008), and in unemployed people (p= 0.006). Conclusion: The high level of inadequate (moderate and poor) health literacy of 77.6% of the Alborz province population should be taken into consideration in health system policies to apply an effective strategy for promoting health literacy that results in better health status, regarding effective socio–demographic factors for each dimension of health literacy.

242-249

Authors: Azam Shams, Khalil Alimohammadzadeh, Seyed Mojtaba Hosseini

Introduction: Recording medical information of hospital records is in fact the documentation of the medical team activities in the hospital. Therefore, correct, accurate, and timely record of patients' information can play a vital role in improving the educational, medical, research, legal, and statistical activities. This study aimed to investigate the type and number of errors in medical records documentation and its effective factors in Ayatollah Taleghani Hospital. Methods: This descriptive-analytic study was cross-sectional. A sample of 330 patients' records in Ayatollah Taleghani Hospital was investigated through a self-made checklist. Data were analyzed using the SPSS software and descriptive and analytical methods. Results: The number of errors in the records showed that, among the examined errors, No Specify the type of diagnosis and take medicine Time in more than 50% of the cases were not accurately recorded. The least error was due to the absence of time and stamp. There was a significant relationship between medical record errors and some demographic characteristics. Conclusion: According to the results and the existence of errors in recording files, hospital doctors and nurses' efforts to promote the documentation of cases were necessary. Rewardingly, some methods, such as initial training of newly arrived residents, encouraging methods, and periodic evaluation of cases can be used.

256-264

Authors: Hamed Seddighi, Ibrahim Salmani

Introduction: Volunteering is a way for community participation and involving local social capital. Volunteering has the potential to enhance well-being and reduce health inequalities. The aim of this study was to evaluate the effects of online volunteering on people’s well-being and the reduction of inequalities. Methods: In this narrative review, using related keywords, 326 studies were found in the initial search in PubMed, Sage, Springer, Google Scholar, Elsevier, PsycINFO and finally 57 studies were selected for review. Results: The study found that virtual volunteering in organizations is a combination of offline and online volunteering, and fewer volunteers are online volunteers. One of the main features of online volunteering is the maximum use of time, and the reduction of travel time. This type of volunteering can be done 24 hours a day and seven days a week. Online volunteering can involve all people, including young people, the elderly, people with disabilities and disadvantaged groups and minorities. One of the main benefits of this type of volunteering is that many people who cannot attend the organization can participate in this way. Online volunteering also could reduce the discrimination and health inequalities. . Conclusion: Although online volunteering is developing globally, volunteer-based organizations have not yet adopted their strategies, rules, and procedures for new volunteers. It seems online volunteering will also enable different groups to participate in activities and promote the health of different groups.

200-206

Authors: Vida Rezaei Hachesu, Shadi Naderyan Feli, Mohammad Javad Zare Sakhvidi

Introduction: Cardiovascular diseases are the first cause of death in the world. Taxi drivers are a high risk group for developing cardiovascular diseases, due to exposure to unhealthy working conditions. The aim of this study was to assess the prevalence of cardiovascular risk factors among taxi drivers. Methods: This cross-sectional study was conducted in 2016 on 110 taxi drivers that were selected by a simple random sampling method. Prevalence of dyslipidemia, obesity, smoking, hypertension and diabetes were estimated. Descriptive statistics and the extended Fisher exact test were used for data analysis. Results: In this study, all participants were male, with mean age and experience of 46.4±11.6 and 11.3±8.8 years, respectively. Among all subjects, 89.1% had at least one risk factor, 30% two risk factors, 22.7% three risk factors, 14.5% four risk factors, and 4.5% five risk factors. This study showed that prevalence of hypertension, diabetes, dyslipidemia and smoking among subjects were 35.5, 10, 66.4 and 12.7, respectively. Also 45.45% and 25.45 % of individuals were overweight and obese, respectively. Conclusion: The results of this study showed a high prevalence of cardiovascular risk factors (especially low HDL-C) among taxi drivers.However, training courses for lifestyle modification can potentially be effective in preventing the occurrence of cardiovascular diseases in these people.

216-222

Authors: Saeed Hosseini, Mohammad Reza Baneshi, Razieh Khaje Kazemi, Minoo Mashayekhi, Yaser Gharaei Khezripour, Farzaneh Zolala

Introduction: Animal bites are one of the serious threats to human health, leading to numerous consequences such as fatal disease of rabies. Due to the importance of animal bite throughout the country, the purpose of the present study was to investigate the geographical distribution, time trend and epidemiological characteristics of animal-bite cases in Bardsir County, Iran. Methods: This cross-sectional study was conducted on the records of people suffering from animal bite from April 2010 to March 2014 in Bardsir County. Data were analyzed in SPSS v.20 software using descriptive statistics including frequency and percentage, log-linear model and time series model. Arc GIS software was employed to plot the geographical distribution of animal-bite cases. Results: The findings of this study indicated that 1500 cases of animal bite had occurred during the study period in totall. Mashiz district (with 695 cases of bite) had the most animal bites. In terms of time, animal-bite cases had no particular trend. The results showed that the incidence rate of bite in men was 2.12 times more than in women (p<0.001). In the age group of 31- 45 years compared to the reference age group (0-6 years), the rate of bite was 5.98 times greater (p<0.001). The incidence rate of animal bite in homemakers was 4.96 times greater (p<0.001) than the reference group (children). Among the biting animals, dogs were responsible for the most bites (76.9%). In terms of bitten organs, limbs were bitten frequently (52.8%). The majority of victims had received the vaccine in accordance with the three-dose immunization schedule (91%). Conclusion: It seems that the determinants regarding high incidence of animal bite in Bardsir County are the type of activities and occupations. Therefore, special and preventive educational programs might be useful in high-risk groups.

229-239

Authors: Mahdieh Mojibian , Reza Jafari Nodoushan, Hamideh Shekari, Zahra Salmani, Majedeh Heidari, Hamideh Mihanpour

Introduction: Reduction in risk possibility in hospitals is an important and vital issue for improving the quality of health care. This research was conducted with the aim of identifying, analyzing and prioritizing risks, providing solutions for reducing or controlling identified risks and examining the effective basics of risk management. Methods: Hospital risk management team consists of 10 experts along with participation of experienced medical staff, tried to identify existing risks in the various hospital departments by FMEA method through inspection, observation and review of processes, within a year. These risks were identified in different classes and finally, the risk priority number (RPN) was calculated using the Excel software and the corresponding formula. Results: Errors in nursing care were identified as the most important nursing work processes in the hospital. Among identified risks, 22 risks were assigned a RPN higher than 150, where corrective proceedings were a priority. The highest RPN (448) was related to lack of implementation for blood injection guidelines and medicate - missed dose process whit PRN (336) got the second place. Conclusion: Major corrective proceedings include the formulation of educational programs, the adoption of policies and procedures, and the establishment of monitoring and evaluating programs to streamline risk management as well as reduction and control the risks in the hospital is considered as main part of the human resource management (HRM).

248-257

Authors: Mohammad Sasanipour *, Sajjad Asadi

Introduction: During the last half century, all indices of mortality imply the prompt and continuous decrease of nationwide mortality. Alongside reduction of mortality, there are comprehensive forms of mortality transition causes, from epidemical and other communicable diseases such as mothers' (birth giving) mortalities and birth related ones, to other causes like chronic diseases related to lifestyle and aging. Methods: This study investigated stages of epidemiological transition in Iran with emphasis on the third transition and finally predicted this trend in future decades. Results: the results show that Iran has been through the third stage of epidemiological transition for two recent decades since large proportion of deaths are related to chronic disease such as cardiovascular disease and life expectancy at birth has decreased to 70 years. Furthermore, signs of the fourth transition in Iran have been observed in recent years, because as deaths caused by chronic diseases have increased, the mean age of death has also increased remarkably. Conclusion: epidemiological transition dynamic and changes of death causes must be considered according to other demographic components. Reduction of death rate, fertility related changes, and as a result changes of age structure are some causes that influence on the epidemiological transition in Iran and will be impressive in the coming years.