Journal of community health research

232-233

Authors: Mohammad Hassan Lotfi , Nafiseh Nikbagh , Mohammad Mahdi Lotfi

No Abstract

240-248

Authors: Ali Fattahi Bafghi, Mahdi Eftekhari, Somayeh Ahmadi, Mojtaba Moghateli

Abstract Introduction: Cutaneous Leishmaniasis is considered as an important health problem in Iran. This disease begins as small papules and then they gradually grow and turn into wounds. Since the epidemiological study of this problem is effective in preventing and controlling it, the current research was conducted on epidemiological pattern of Cutaneous Leishmaniasis in the province of Fars, Iran (2010-2014) Materials and Methods: This cross-sectional study was conducted on the registered information (20601 patients) and documents of the patients having problem in Fars province remedial and health care centers over the last 5 years. First, the registered demographic and epidemiological data of patients were extracted and then analyzed through by using SPSS software. Results: A total of 20601 patients including 10607 males (51%) and 9994 females (49%) participated this study. Patients were in the age range of 20-29 years old and minority of them was 5-9 years old. Most lesions were on the hand and leg of the patients. It was also found that there was a significant relationship between age groups and types of Leishmaniasis (P<0.05) as well as gender and type of Cutaneous Leishmaniasis (P<0.05). Conclusion: According to this is investigation, there was an ascending trend in disease frequency which was based on the descending process. This indicates promotion of educational- hygiene status as well as observance of personal hygiene principals.

260-269

Authors: Ali Jafari Nodoushan, Fariborz Dortaj, Reza Jafari Nodoushan

Introduction: ADHD is one of the most common disorders among school children throughout the world. Parents of these children are faced with more conflicts than normal children's parents. The Purpose of his study was to evaluate and compare the mental health status of mothers having children with attention deficit / hyperactivity disorder versus mental health of mothers having normal primary school children, Yazd, Iran. Materials and Methods: The sample consisted of 160 mothers of primary-school children who were selected through random cluster sampling; 80 of them had children with attention deficit / hyperactivity disorder and the remaining half had normal children. Also, for the diagnosis of children with attention deficit / hyperactivity disorder, the Conners test as well as test of General Mental Health (GHQ) were used to measure mothers' mental health. The data were then analyzed in two levels of descriptive and inferential statistics (T-test and analysis of variance) Results: Comparison of mental health and its subscales indicated that mothers of children with ADHD disorder were lower in all aspects of mental health than mothers of normal children. Conclusion: According to the research results, mothers of children with attention deficit/hyperactive disorder have lower levels of mental health than mothers of normal children. So, it is recommended that education and health officials provide training courses for these parents to promote their mental health status and consequently their quality of family life.

279-288

Authors: Mohammad Sadeghi, Abbas Yazdanpanah, Somayeh Hesam

Introduction: Hospitals as one of the main organizations of rendering services and the most costly operational units of the health system are of special importance. Meanwhile, nurses play a vital role in continuity of care, improvement of health, and productivity of the entire organization. This study was conducted with the aim of ranking hospitals of Yazd medical sciences university based on the national nursing indicators and with an AHP-TOPSIS combined approach. Materials and Methods: This cross-sectional study was carried out in 2016. The statistical population consisted of 25 experts, including hospital directors and faculty members of care and health services' as well as health economics' management. The tools used were the nursing work index questionnaire and the index data collection form, validity and reliability of them were confirmed. For this purpose, initially by applying Analytic Hierarchy Process (AHP), weight and priority of nursing and then hospitals' indicators were calculated and ranked by TOPSIS technique. Prioritization of indicators was performed by Expert Choice software. Results: Based on the AHP method and pairwise comparisons within nursing indicators, the highest weight or priority was related to nursing staff ratio indicator of female /male with a weight of 0.290. However, the lowest weight or priority was related to the average of nursing staffs' overtime hours' indicator with a weight of 0.038. Based on the results and according to the national nursing indicators, city of Yazd gained the best situation totally and was then placed in the developed group. The worst situation was related to Mehriz and Taft cities. Conclusion: In order to reduce the differences of national nursing indicators among cities and to achieve a fair and balanced situation of health at the provincial level, it is recommended to reduce the gap among cities in enjoying from the health and care facilities by considering cities' developmental situation in this field and planning based on facts. It is also suggested to observe the sexual ratio in allocating nurses to hospitals.

149-157

Authors: Fereydoon Laal, Elham Ahmadi, Roya Arbabi, Mahdi Mohammadi, Nasimeh Jamil

Abstract Introduction: With ever improving technology and increasing the use of high-voltage power in industrial environments, concerns about the destructive effects of electromagnetic waves on human health have increased. Thus, the present study aims to evaluate the effects of electromagnetic waves on the general health of Zahedan gas power plant personnel. Materials & Methods: The present case-control study investigated the health of people at one point of time and their amount of exposure to electromagnetic waves at the same time. The data collection tool in this study was a 28-item general health questionnaire (GHQ-28). After measuring the electromagnetic waves at distances of 1, 1.5, and 3 meters at high voltage power substations and data extraction, the data were fed into SPSS software and then analyzed by descriptive statistics, t-test, and chi-square. Results: In this study, the age and experience variables were not significantly different in two groups (p> 0.05). The strongest magnetic fields in high voltage power substations were at a distance of 1 meter in the substation 607 (28/1 mG) and in precision tool work units (7.03 mG). The results showed that the depressive and general health symptoms were significantly different between the exposed and unexposed groups (p = 0.04), however, the difference was not significant in terms of physical performance, anxiety, and social performance (p> 0.05). Conclusion: Although the level of exposure was lower than the standard level determined in Iran, the significant difference of the general health and depression between the two groups, explains the necessity of conducting more studies in this regard. Also by reducing the exposure time and increasing people’s awareness, it is possible to take important steps to reduce exposure and complications.

169-181

Authors: Habib Janadeleh,Sadigheh Jahangiri

Abstract Introduction: Heavy metal pollution is one of the most serious environmental issues globally. This research investigated the heavy metal concentrations in sediments and fish in Persian gulf. Materials & Methods: For determination of heavy metal concentrations in sediments eight sampling stations were selected to measure Cd, Zn, Ni, Pb, and Fe in the sediments and in the muscle tissue of Otolithes ruber from the northern part of the Hormuz strait )Persian gulf). Samples were then prepared according to MOOPAM for metal analysis. Heavy metal concentrations were analyzed using inductively coupled plasma-optical emission spectrometry (ICP-OES). Analysis of variance (ANOVA) was done to evaluate significant differences in elements' concentrations during sampling periods. Results: Analysis of the potential ecological risk of sediment heavy metal concentrations showed that most sample sites in the northern part of the Hormuz strait (Persian Gulf) presented a low ecological risk. Regarding enrichment of Cd, Zn, Ni, Pb, and Fe the highest EF belonged to Pb. The obtained mean enrichment factor (EF) values for various metals were between no enrichment and moderate enrichment. Conclusion: The concentrations of heavy metal in the edible part of O. ruber did not exceed the permissible limits proposed by NOAA, FAO, and WHO standards and thus are suitable for human consumption, except for Pb and Cd.

195-201

Authors: Tahere Soltani, Mohammad Hossein Baghianimoghadam, Mohammad Hassan Ehrampoush , Najmeh Baghian, Abdolkhalegh Jafari

Abstract Introduction: Natural disasters are considered as events that are beyond human control and usually result in death and different injuries; they also significantly affect public health. The lack of proper sanitation and communal life creates numerous problems. The aim of this study was to determine the knowledge, attitudes, and performance of nurses (since nurses work more than others in disasters) in disaster management. Materials & Methods: This was a cross–sectional and descriptive study. The 220 participants of this study were selected by stratified random sampling method. Data was collected by questionnaire taken from similar studies in the field of nursing whose reliability was confirmed by the relevant specialists and its validity was confirmed by Cronbach's alpha (0.83). Data analyses included Spearman Test, analysis of different levels of the independent variables (Mann-Whitney, Kruskal-Wallis test) or T- Test, and comparing means as well as the related data (non-parametric). Results: In this study, the average age of staff was 33.94±6.4 and years of their work experience was 10.5 ±7.14. The nurses' average level of knowledge about crisis management was 13.05±5.24 out of 22. The mean grade scores of attitude to crisis management was 28.94±3.39 out of 33, further, their function in crisis management was 45.88±6.5 out of 57. Discussion: Due to the increased frequency of occurrence and consequences of the disaster and the special role of health care services before, during, and after the occurrence of such incidents, the results were not suitable. Then, it was concluded that proper preparation is essential for nurses as the largest providers of information and health services to people, so their performance must be measured which is the objective of this study.

211-219

Authors: Nooshin Yoshany, Hamide Mihanpour, Khair Mohammad Jadgal, Maryam Dori

Abstract Introduction: Breast cancer is the most common cancer and one of the major causes of cancer deaths in women. Early diagnosis leads to significant reduction of mortality from breast cancer, in other words it can increase the lifespan of people with this cancer. This study aimed to determine the effect of education on knowledge and performance of 20-60 year old women in Yazd city about Breast Self Examination (BSE). Materials & Methods: In this study, 100 women aged from 20 to 60 years old who referred to Yazd health centers were selected. They were matched in terms of cultural, social, and economical aspects. In this quasi-experimental study, data was collected through administration of questionnaires before and after training in two stages. The collected information were then analyzed using the statistical software SPSS (version 18) by T-tests and ANOVA. The significance level was set at 0.05. Results: The results of statistical analyses revealed a significant difference between participants' knowledge and performance scores before and after training (0.05> p). In this study, age, marital status, education level, history of breastfeeding, and its duration had a significant relationship with participants' knowledge; also, positive family history of breast cancer had a significant relationship with their performance (0.05> p). Between the subjects' performance was a significant difference in two groups with negative and positive family history of Brest cancer before and after two months of educational program. (0.05> p). Conclusion: According to the achieved results and the positive impact of education on the increase of knowledge and performance, educational programs in the field of breast cancer and its screening methods are recommended to be held for all age groups. In order to promote women's health from puberty to menopause more attention should be paid to the follow-up and training.

64-72

Authors: Hossein Fallahzadeh, Mahdieh Momayyezi, Hamide Nasirzadeh

Abstract Introduction: Breastfeeding produces an important effect on the physiology of the body, metabolism and human clinical status. Available evidence suggested that breastfeeding has a prophylactic effect on adiposity, blood pressure and other chronic diseases. Thus, this study was conducted to determine the association between infant breastfeeding and blood pressure status in early adulthood. Materials & Methods: In this descriptive cross-sectional study, the sample size was determined to be 300, and the study data were collected through cluster sampling method in 2013. The data collection tool was a researcher-made questionnaire, which its reliability and validity have been confirmed. The statistical analyses were performed using SPSS Software (ver.16) applying independent t-test and ANOVA. Results: The mean systolic pressure and diastolic pressure were 113.6±13.1 and 72±11.6 respectively. The mean systolic and diastolic pressure in males was higher than females. Moreover, increased BMI and age were associated with a significant growth in systolic and diastolic blood pressure. The present study demonstrated a significant positive correlation between systolic and diastolic blood pressure. However, the results did not show a significant relationship between duration or exclusivity of breastfeeding and systolic and diastolic blood pressure in adulthood. Conclusion: The study findings revealed no association between the duration or exclusivity of breastfeeding and systolic and diastolic blood pressure in later life. Keywords: Blood pressure, Bottle feeding, Breast feeding, Hypertension, Infant nutrition

90-97

Authors: Malihe Khoramdad, Fateme Gholami, Yousef Alimohamadi, Zeynab Alavi, Jabbar Shafiei, Alireza Firouzi

Abstract Introduction: Smoking is regarded as one of the major causes of death caused by chronic diseases which begins during adolescence. Considering the fact that the age of smoking onset in both developed and developing countries is decreasing, the current study aimed to determine the prevalence of lifetime smoking and its determinant factors in high schools of Shiraz. Materials and Methods: In this cross-sectional study, 750 students (569 males and 181 females) participated who were selected via multi-stage cluster randomized sampling. The study data were collected using a checklist designed under the supervision of a team of specialists, that was responded by self-reports of the students. The collected data was statistically analyzed applying SPSS software (ver. 20), via χ2 and logistic regression tests. Results: 85% of students mentioned they had not had smoking experience, and 15% reported experience of smoking. The prevalence of smoking among the boys was 15/3% and it was reported 12/2% within the girls. Most smoker students cited smoker friends and close relatives as the most important factor in encouraging them to smoke. In the present study, the relationship between smoking and the following parameters was examined: age, gender, educational status, field of study, and parents’ educational level; however, the sole significant relationship was observed between smoking, educational status (P=0.025), and field of study (P=0.032). Conclusion: As the findings of the present study revealed, more attention to adolescents and related planning are needed to deal with the problem of cigarette smoking among this stratum of society. Keywords: Adolescents; High School Students; Shiraz; Smoking

110-120

Authors: Hojat Hamidi, Atefeh Daraei

Abstract Introduction: Myocardial Infarction, also known as heart attack, normally occurs due to such causes as smoking, family history, diabetes, and so on. It is recognized as one of the leading causes of death in the world. Therefore, the present study aimed to evaluate the performance of classification models in order to predict Myocardial Infarction, using a feature selection method that includes Forward Selection and Genetic Algorithm. Materials & Methods: The Myocardial Infarction data set used in this study contains the information related to 519 visitors to Shahid Madani Specialized Hospital of Khorramabad, Iran. This data set includes 33 features. The proposed method includes a hybrid feature selection method in order to enhance the performance of classification algorithms. The first step of this method selects the features using Forward Selection. At the second step, the selected features were given to a genetic algorithm, in order to select the best features. Classification algorithms entail Ada Boost, Naïve Bayes, J48 decision tree and simpleCART are applied to the data set with selected features, for predicting Myocardial Infarction. Results: The best results have been achieved after applying the proposed feature selection method, which were obtained via simpleCART and J48 algorithms with the accuracies of 96.53% and 96.34%, respectively. Conclusion: Based on the results, the performances of classification algorithms are improved. So, applying the proposed feature selection method, along with classification algorithms seem to be considered as a confident method with respect to predicting the Myocardial Infarction.

131-139

Authors: Hadis Barati, Mohammad Hassan Lotfi, Gholm Ali Mozaffari, Mohamad Barati, Hamid Reza Dehghan, AliAkbar Taj Firouze

Abstract Introduction: Cutaneous leishmaniasis is recognized as one of the important neglected parasitic diseases worldwide. The present study aimed to determine the epidemiological patterns of cutaneous leishmaniasis in a period of ten years in Yazd province in Iran. Materials & Methods: This ecological study was performed on 5784 recorded cases within 2004-2013in health centers in Yazd. Meteorological data including maximum and minimum temperature, relative humidity and rainfall, received from Yazd Meteorological Organization. In order to analyze the study data, descriptive statistics, linear regression, spearman correlation and delay time were applied. Results: Out of a total of 5784 cases of cutaneous leishmaniasis, the most cases were observed among males (61.3%). The majority of cases were reportedin cities of Khatam, Yazd and Bafgh, respectively. The maximum incidence was observed in October in the autum. The correlation results between disease incidence and climatic factors revealed a weak correlation in regard with the temperature, whereas no significant correlation was observed with respect to the mean relative humidity and rainfall. Furthermore, the results of correlation analysis with a time delay of 9, 10, 11 months demonstrated that the disease incidence has a relatively strong negative correlation with the temperature parameters as well as a relatively strong positive correlation with the relative humidity and precipitation. Conclusion: Regarding the relationship between these three climatic factors with cutaneous leishmaniasis in Yazd province, we recommended climatic and environmental factors affecting disease to be measures in this area. Keywords: Climatic conditions; cutaneous leishmaniasis; Epidemiology; Yazd 

1-10

Authors: Mohammad Hossein Baghianimoghadam, Tahereh Rahimi, Zoya Khajedehi, Fatemeh Jowzi, Hava Daryafti, Zahra Akbari, Esmat Rahavi, Tahere Soltani, Najme Baghian

Abstract Introduction: Daily milk consumption can be introduced as a healthy dietary pattern associated with a range of health benefits. This study aimed to determine factors associated with milk consumption among students of Yazd university of medical sciences based on the theory of planned behavior. Materials & Methods: This cross-sectional study was conducted on 385 students in 2014, who were selected via stratified random sampling. The study data was collected from a questionnaire based on the indirect construct of theory of planned behavior. Finally, the study data were analyzed using the T-test, Chi-square, and Fisher's exact tests. Results: In the present study, 64% of the students consumed milk daily. The behavioral intention, behavioral beliefs, normative beliefs, control beliefs, and perceived power were significantly associated with the milk consumption (p<0.05). Conclusion: Educating the students in regard with the importance of receiving enough amount of milk, modifying their misconceptions as well as reinforcing positive beliefs can be effective in increasing milk consumption. In addition, increasing access to milk in university campuses should be taken into consideration. Keywords: Milk consumption; Students; Theory of planned behavior

20-28

Authors: Mohammad Hassan Lotfi , Mohammad Javad Amirian, Ali Dehghani, Hossein Fallahzadeh, Omid Emami

Abstract Introduction: Death is defined as the permanent loss of all signs of life at any time after birth (Irrevocable disappearance of all vital signs after birth). Unnatural deaths seem to be either suspicious or unexpected. Deaths that occur suddenly and their causes need to be investigated, are termed unnatural deaths. According to the death certificate contents of Ministry of Health and Forensics, if the cause of death is unnatural, the corpse will be submitted to the forensic medicine departments in 19 cases in order to determine the death cause and to issue the burial permit. Material & Methods: In this descriptive study, the data were extracted from unnatural death cases in the province of Yazd during 2003 to 2013 recorded by Yazd Forensic Medicine. Results: During 2003 -2013, 5552 cases of unnatural deaths were recorded by the Forensic Medicine of Yazd, out of which 4373 cases of unnatural deaths were caused by road traffic accidents (outside and inside the city), 89 deaths from electrocution, 439 deaths from poisoning, 72 deaths from drowning, 129 deaths from asphyxia (by carbon monoxide), 56 deaths from work incidents, and 394 deaths from burns. The group of males aged 20-29 years allocated the highest number of unnatural deaths to themselves. Conclusion: Road traffic accidents are the second leading cause of unnatural deaths in Iran. The number of unnatural death incidents in men is more than women indicating that men are more exposed to risk factors than women, though regarding the deaths due to the burns, women are exposed to the high risk factors. Keywords: Epidemiology; Forensic medicine; Unnatural death

36-44

Authors: Egbuchulem Kelvin Ifeanyi, Adeleye O.A., Adekanbi Adesina Omololu Ayodele, Evbuomwan Eronmwon A., King-Inneh O.A., Obiagwu Adaora

Abstract Introduction: HIV counseling and testing are regarded as a vital preliminary interventional step aimed at reducing the spread of HIV infection. Therefore, the present study was designed to determine the attitude of health care professionals towards voluntary counseling and testing (VCT) for HIV/AIDS at Irrua Specialist Teaching Hospital. Materials & Methods: In this descriptive cross-sectional prospective study, a self –administered structured questionnaire was used, which contained sections on bio-social variables aimed at fulfilling the objectives of the study. The study participants consisted of medical doctors, nurses, medical laboratory scientists, radiographers, social workers and pharmacists.The data were collated, inputted into a computer and statistical analysis was performed using SPSS software(ver, 22). Descriptive variables were summarized using percentages and proportions for the categorical variables. Moreover, bivariate analysis was performed to test the association between categorical variables using the chi square test and p value of < 0.05 was considered statistically significant. Multiple logistic regressions were performed to identify the predictive variables appropriate for the association between socio-demographic and willingness to go for screening. Results: In the present study, questionnaires were administered and statistically analyzed. The study participants consisted of workers who were mostly females (55%) aged 21-30 years. Regarding the bio-social variables (47.8% of the participants were married, 52.5% were Christians, 96.2% were medical doctors, and 49.2% were of Esan extraction. The participants' marital status and occupation significantly influenced their attitude towards voluntary counseling and testing for HIV/AID. A good percentage of the respondents revealed a right attitude towards VCT of HIV/AIDS. Conclusion: This study finding revealed that a good percentage of the respondents had a right attitude towards VCT of HIV/AIDS, while a lesser proportion was reported to have a negative attitude. Keywords: Professionals, Counseling, Testing, HIV/AIDS

57-63

Authors: Mahdi Barkhordari Firouzabadi; Shahriar Mohammadi

Abstract Following the advances in mobile communication and information technology, smart phones have been used in a wide variety of commercial, social, entertainment, file sharing and health transactions and applications. The current procedures in healthcare environment for patient registration, appointment scheduling and payment are time consuming and somehow tiresome. Traditionally, patients were supposed to fill out registration forms, wait for being called, and finally stand in long lines for payment procedures. In some places, appointment could be done online via web but still the patient has to walk in with appointment card and in our case, provide the insurance booklet to the front desk personnel to pay for services and receive discounts for insurance. Therefore, the present study intended to propose a model using Near Field Communication-enabled mobile application for a medical clinic which currently offers online and call services for making an appointment, though patient waiting time is still too much in the current process of payment for services. Keywords: Healthcare; Mobile payment; Near-field communication; Smart health card