Journal of community health research

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.

132-140

Authors: Hamid Reza Samadifard, Mohammad Narimani

Introduction: General health comprised features that act as a shield in the face of stressful life situations and help couples have better performance in these situations. The present study was conducted to determine the role of cognitive belief, fusion and distortion in predicting the general health of couples. Methods: Descriptive research method was used in this study. Population of the study included all couples in the city of Ardabil in 2016. Three hundred and eighty individuals (190 couples) were selected from parks and other public places through available sampling and the use of Krejcie and Morgan table. Data were analyzed using Pearson correlation coefficient and linear regression analysis. Results: The results of this study showed a significant relationship between meta-cognitive beliefs (r = 0.47, p < 0.05), cognitive fusion (r = 0.33, p < 0.05) and cognitive distortion (r = 0.28, p < 0.05) with general health. Beta coefficients for predictor variables indicated that metacognitive belief (β = 0.34), cognitive fusion (β = 0.28) and cognitive distortion (β = 0.21) can predict the general health of couples (p < 0.05). Conclusion: From the results, it can be concluded that couples with higher levels of meta-cognitive beliefs, cognitive fusion and cognitive distortion had lower general health.

150-164

Authors: Hodjat Hamidi, Rasoul Moradi

Introduction: Mobile personal health is a rapidly growing area of health information technology. Mobile personal health users are able to manage their own health data and communicate with doctors in order to improve healthcare quality and efficiency. In recent years, information and communication technologies improvements, along with mobile Internet, offering anywhere and anytime connectivity, play a key role on modern healthcare solutions. Moreover, data on genetic diseases are no exception to this set of data. Therefore, appropriate algorithm and methods of data analysis should be designed. Methods: The main objective of this research is to investigate the effective factors on more efficiency of medical data. In this article, in addition to analyzing and evaluating the best data mining algorithms used in the medical field, a new combined approach has been provided in order to predict the risk of transmitting genetic diseases. A questionnaire was developed for this task, based on the rigorous study of scientific literature concerning pregnancy and applications available on the market, with 12 data items. The data items contain calendars, genetic diseases and cardiovascular diseases information, health habits, counters, diaries, mobile features, security, backup, configuration and architectural design. Results: Health telematics is a growing issue that is becoming a major improvement on patient lives, especially in elderly, disabled, and chronically ill. The results of the patients clustering were obtained using the risk of transmitting genetic diseases and according to the criteria of similarity in the ways of transmission as well as using a decision tree to predict whether the individual with the related characteristics has the likelihood to transmit the disease or not. 300 participants were recruited, 92% routinely used and 91% owned a mobile phone. 99% were willing to receive mobile health (m-health) advice, and 79% favored mobile medication reminders. 65.2% would send home recorded information on their blood pressure, weight, medication use and lifestyle to a doctor. 81.9% trusted the confidentiality of m-health data, while 77.1% had no concerns about the privacy of their information. Conclusion: M-health system proposes healthcare delivery anytime and anywhere, overcoming geographical, temporal, and even organizational barriers with low and affordable costs. This study reviewed the state-of-the-art on m-health system and technologies.

175-184

Authors: Aboobakr Jafarnejad, Narges Khanjani, Batool Tirgari

Introduction: Addiction is one of the major crises in the world which has many victims and imposes serious damage on the family and society, especially among children who are the most vulnerable social stratum. The aim of this study was to determine the possible causes of drug addiction among children in Kerman. Methods: This case-control study was conducted as a qualitative study. Ninety children aged 6 to 16 years were enrolled. The case group included 30 addicted children supported by the Welfare Organization. The control group included two groups of 30 children, one selected from the Welfare Organization and the other from across the city. All participants were male and groups were matched for age. Then, the probable causes of addiction were compared between these two groups. Data were analyzed by using SPSS22 and by chi-square tests and logistic regression. Results: The mean age of children was 10.8 ± 2.4 in the case group, 11.4 ± 1.8 in the park control and 12.8 ± 1.5 in the welfare center control group. All participants were male. The results revealed that there were significant statistical differences between the addicted and non-addicted children in regard to parent’s religious beliefs, parent imprisonment, history of addiction in families, visiting the park alone and parental employment. Conclusion: Strengthening religious beliefs of parents, teaching life skills to children and their parents, parental control on children, tracking and monitoring the peers; and promoting collaborations between the policymakers, the Welfare Organization, the Municipality, the Universities of Medical Sciences and the Police Force can help to reduce and control addiction among children.

192-195

Authors: Jung Yeon Lee, Judith S. Brook, Kerstin Pahl, David W. Brook

Introduction: In the United States (US), there are 19 million new sexually transmitted disease (STD) infections each year. Untreated STDs can lead to serious long-term adverse health consequences, especially for young women. Centers for Disease Control and Prevention estimates that undiagnosed and untreated STDs cause at least 24,000 women in the US each year to become infertile. This clearly is a public health issue of great concern for young women. Methods: The current cross-sectional study included a community sample consisting of 343 female participants (50% African Americans, 50% Puerto Ricans) at their mean age of 39 years. Regression analyses were conducted to examine the associations of time-varying factors within-person (e.g., substance use) and fixed effects factors between-persons (e.g., race/ethnicity) with the number of male sexual partners. Results: Alcohol use (b=0.14, p<0.01), cannabis use (b=1.10, p<0.01), marital status – unmarried (b=-0.16, p<0.05), and race/ethnicity – African American (b=-0.20, p<0.01) were significantly related to having a higher number of male sex partners in the past year. Conclusions: From a public health perspective, treatment and prevention programs for sexual risk behavior focused on substance use as well as socio-cultural factors (i.e., marital status, race/ethnicity) may be more effective than programs focused only on substance use.

77-84

Authors: Mohammad Hassan Lotfi, Soheila Noori, AliAkbar Taj Firouze, Hossein Fallahzadeh, Jamshid Ayatollahi

Introduction: Iran is majorly affected by the Cutaneous Leishmaniasis (CL). Despite continued efforts toward control, the incidence of CL has increased in the many areas of Iran. The counties of Ardakan, Khatam, Bafgh, Abarkuh, and Yazd are endemic places for CL. An outbreak occurred in the Yazd province them between March 2015 and March 2016.The aim of this paper was to identify the epidemiological and clinical aspects of leishmaniasis in patients that were reported from these five endemic foci during the outbreak. Methods: This descriptive study was conducted on 150 patients suffering from CL who were referred to the provincial health center during the period of outbreak. Clinical and demographic information of the patients were registered and analyzed by the SPSS 23 software. Result: From the 150 cases considered, 121 subjects (80.2%) lived in urban areas. 93 (62%) patients were male. The most frequent age group was 21–30 years old (18.7%). Housekeepers had the highest incidence (22.6%) of CL. 41.3% of patients had elementary education. Monthly family income in over half of the patients was less than a million tomans per month. The maximum number of CL cases was reported in the autumn with (62 patients; 41.3%). 98 (65.3%) patients reported a history of travel in the past year. The highest rates of CL lesions were seen in the feet (18.7%). In over half of the cases (52.7%), the wound size was over than one centimeter and 82 (54.7%) patients had only one wound. Conclusion: In order to further outbreak control, basic measures such as public education and education for people who travel to endemic areas as well as the treatment of patients infected with urban type leishmaniasis (as a reservoir), according to the geographical condition and carrier, can be useful.

93-101

Authors: Zahra Khazir, Morad Ali Zareipour, Mahdi Abdolkarimi, Arefeh Dehghani Tafti, Tahereh Rahimi

Introduction: There has been a recent spike in the use of virtual social networks. However, only a few studies have explored factors that influence the use of social networks by using theories of health education among students. The present study aims to determine the predictive factors of virtual social networks among students of the Yazd University of Medical Sciences based on the constructs of the theory of planned behavior. Methods: In 2016 this cross-sectional study was conducted on 300 students who were selected by the stratified random sampling method. Data was collected from a questionnaire based on the constructs of the theory of planned behavior including attitudes, subjective norms, perceived behavioral control, and behavioral intentions and behaviors. The data collected was then analyzed via the SPSS V.16 software using descriptive statistics, Pearson product– moment correlation test, one-way analysis of variance, and regression. Results: The mean age of the students was 22.28 ± 3.69 years. The results also suggested that 98.3% of them were using virtual social networks. Moreover, the findings of the regression analysis indicated that attitudes, subjective norms, and perceived behavioral control were predictors of intention to use social networks, while attitudes had the highest predictive power for the intention to use social networks (β = 0.38). Furthermore, the results of the regression analysis demonstrated that behavioral intention, attitudes, and subjective norms among the constructs of the theory of planned behavior could predict the behavior to use virtual space. Conclusion: The use of virtual social networks by university students displayed a rising trend. Measures ought to be taken to create a right attitude about the extent and efficient use of virtual networks to ensure that they do not interfere with the students’ educational activities and real relationships.

109-116

Authors: Naghmeh Ghorashi, Abbas Alavi Rad

Introduction: Studies on the causal dynamics between the environment, health expenditures, and economic growth have recently started in the economics literature for both developing and developed countries. Methods: This study examines the causal relationship between CO2 emissions, health expenditures, and economic growth, using dynamic simultaneous equation models for Iran over the period 1972–2012. Results: Our empirical results show that there is a bidirectional relationship of causality between CO2 emissions and economic growth. There is also a unidirectional relationship of causality from health expenditures to economic growth. The positive bidirectional causality relationship between CO2 emissions and economic growth will be very important for environmental quality over the next few years in Iran. Conclusion: It is clear that the government would like to increase economic growth over the period of the next Five-Year Development Plan. It seems that policymakers must examine the requirements for investment to promote environmental protection and increase technological transfers to reduce environmental damage.

124-128

Authors: Leila Nemati Anaraki, Farzaneh Sardari

Human resource is an organizational capital and its mental health is one of the most important dimensions. The mental health has a significant effect on performance of staffs. The current research aimed to examine the mental health and its dimensions in librarians of Shahid Sadoughi university in 2016. This is a descriptive-analytical study with correlational design among librarians working in libraries of Shahid Sadoughi university. Goldberg & Hiller general health questionnaire was used to evaluate general health of librarians. Data were then analyzed using descriptive statistics, independent T test, variance analysis, and Pearson correlation coefficient through SPSS software version 19. Results indicated that the mean score of librarians' general health was 22.8±10.38 which shows that participants were healthy. Furthermore, marital status was associated with health and its components so that married individuals were less healthy. Depression rate of librarians was low but most of them suffered from physical problems, anxiety, sleep disorders, and social conflicts. Therefore, librarians' authorities should consider such problems and develop strategic plans for them.

10-17

Authors: Mahmood Vakili, Mohsen Mirzaei, Zabihullah Mohaqiq, Mansour Ahmadi, Ehsan Alavirad

Introduction: Physical activity and healthy eating at an early age are two key elements in prevention of Non-Communicable Diseases. Therefore, regular physical activity is recommended to improve public health and to reduce the burden of diseases and medical costs in communities. The aim of this study was to determine the status of physical activity in Yazd high school students Methods: A total number of1018 male high school students participated in this cross-sectional study. They were permanent residents of Yazd city in the school year of 2015-2016. Multistage cluster classification and stratified sampling methods were applied to collect samples. A validated Persian standardized World Health Organization questionnaire (GSHS) was used as a data collection tool. After completing the questionnaire by students, data were analyzed by SPSS. Results: only 11.6 % of participants reported physical activity for at least 60 minutes a day. Inert activities such as watching television or playing computer games for more than 2 hours during a typical day was reported by 531 participants (55 %). Based on body mass index, 18.23 % of students were obese and 13.22 % were overweight. Discussion and conclusion: The results of this study suggest that the level of students' physical activities is low. Paying more attention to physical activity and designing curriculums that devote more hours for physical activities are recommended. Encouraging physical activity in leisure time and providing proper facilities for adolescents are further suggestions.

34-43

Authors: Leila Shahmoradi, Amos Otieno Olwendo, Hussein Arab-Alibeik, Khosrow Agin, Sougand Setareh

Introduction: This research was meant to provide a model for COPD diagnosis and to classify the cases into phenotypes; General COPD, Chronic bronchitis, Emphysema, and the Asthmatic COPD using a Bayesian Network (BN). Methods: The model was constructed through developing the Bayesian Network structure and instantiating the parameters for each of the variables. In order to validate the achieved results, the same data set was applied to a neural network application using the Levenberge- Marquardt algorithm. Furthermore, a card Diag, a C++ application that enables graphical classification of COPD into phenotypes and depicts the relationships of COPD phenotypes was developed. Results: The results showed that a Bayesian Network can be successfully applied to develop a probabilistic model for diagnosis and classification of COPD cases into the corresponding phenotypes. Conclusions: A model that classifies COPD cases into phenotypes of general COPD, Chronic bronchitis, Emphysema, and Asthmatic COPD was successfully developed. Moreover, the achieved results also helped to represent graphical representations of COPD phenotypes and explained how the phenotypes relate to each other. It was also observed that COPD is mostly associated with people aged 40 years or older. Overall, smoking is the major cause of COPD.

53-63

Authors: Mohammad Ali Morovati Sharifabadi; Ehsan Movahed, Kheirmohammad Jodgal, MoradAli Zareipour, Somayeh Alizadeh, Rabae Agh Atabai, Vali Bahrevar, Mahboobeh Ameri

Introduction: This is important to consider the health, social support, and marital satisfaction of drivers since they own one of the essential and stressful jobs in society. The purpose of this research was to investigate quality of life, marital satisfaction, and social support of the drivers referring to the cargo terminal of Yazd City. Methods: In order to collect data, 134 drivers in Yazd cargo terminal were selected. The ENRICH questionnaire of marital satisfaction, SF - 36 questionnaire, and social support questionnaire (SSQ) have been used as data collection tools. The collected data were then analyzed by Independent T test, Analysis of Variance (ANOVA), and Pearson correlation. Results: According to the results, the drivers' average age was 40.2 ± 9.17 years old. The mean scores of marital satisfaction, quality of life, and social support were equal to 120.04 ± 20.14 out of 175, 99.69 ± 18.14 out of 149, and 15 ± 4.76 out of 23, respectively. About 60.4 % of drivers were not satisfied with their jobs. There were significant relationships between weight and marital satisfaction (P = 0.02), as well as between job satisfaction (P = 0.003) (P = 0.015) and income (P = 0.047) (P = 0.020), to social support and quality of life. Also, a strong significant positive relationship was observed in correlation coefficient between social support and two variables of quality of life and marital satisfaction (P = 0.000). Conclusion: This can be argued that marital satisfaction, quality of life, and social support of the drivers are lower than the expected levels. Therefore, it can be concluded that physical and mental health of drivers can be effective on safety of roads; thereby it is necessary to improve their conditions in marital satisfaction, quality of life, and social support.