فهرست مطالب

Health Scope - Volume:6 Issue: 4, Nov 2017

Journal of Health Scope
Volume:6 Issue: 4, Nov 2017

  • تاریخ انتشار: 1396/10/11
  • تعداد عناوین: 14
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  • Yadollah Ghafuri, Hossein Kamani, Edris Bazrafshan, Zahra Atafar, Mohammad Khazaie, Amir Hossein Mahvi * Page 1
    Arsenic is a toxic element, which is found naturally in water sources. Due to its high toxicity it has become a serious problem in drinking water sources and also affects the health of communities. Therefore, in the present study, risk estimation and the probability of adverse health effects of exposure to arsenic from drinking water was evaluated in the rural areas of Qom province. Water samples were taken from 44 rural areas with regard to the number of rural areas and also the type of water distribution systems. The intensity, duration and frequency of exposure to arsenic in drinking water were determined. Then the hazard quotient and cancer risks ware calculated. Results showed that more than 16% of the rural population was exposed to arsenic with level above 10 μg/L in the rural regions of Kahak County (10 ± 6.29 μg/L). Results of risk assessment showed that hazard quotient (HQ) were 1.7 and 2, while the cancer risk (CR) were 76 × 10-5 and 42 × 10-4 for 2 groups of age 1 and 2, respectively. The results indicated that the hazard quotient is higher than 1 (HQ > 1) for group 1 and group 2. For carcinogenic effects, the study indicated that the population in the Kahak region are exposed to arsenic in drinking water with the concentration of > 10 µg/L and they are at a very high risk for cancer, due to the fact that the cancer risk for the 2 groups are more than 7.6 and 42 times the environmental protection agency (EPA) criteria, respectively. Therefore it is recommended that at first, the source and water supply system in Kahak region is to be substituted with safe drinking water and to provide health facilities and screening tests for exposed populations.
    Keywords: Risk Cancer, Arsenic, Drinking Water, Risk Assessment
  • Mohammad Sahebalzamani, Farhad Adhami Moghadam, Sahar Geravandi *, Mohammad Javad Mohammadi, Majid Naghipour, Ahmad Reza Yari Page 2
    Background
    Patients’ safety is one of the most important factors in health care system, which medication errors can threat it. It is of great importance to identify factors that cause medication errors.
    Objectives
    The current study aimed at evaluating refusal to report the medication errors by nurses in Golestan educational Hospital after the healthcare reform from 2014 to 2015.
    Methods
    The current cross sectional study was conducted in Golestan educational hospital of Ahvaz, Iran, after the healthcare reform from 2014 to 2015, prospectively. The data collection tool was a questionnaire including 2 parts, demographic characteristics and reasons “not to report medication errors”. The results were analyzed by Excel and SPSS 16.0.
    Results
    The results showed that 64% of medication errors were reported by the subjects. Among all causes, fear of reporting consequences had the highest score. The results showed that the most important reasons not to report medication errors were related to the fear of the consequences of reporting (3.64 ± 1.226). Factors related to the process of reporting were 3.41 ± 0.867 and managerial factors were 3.08 ± 1.126, respectively.
    Conclusions
    According to the results of the current study, some hospitals could reduce not reporting medication errors by paying attention to local standards, encouraging nurses to report medical errors, encouraging hospital managers to give a positive response to them, and promoting an effective communication with nursing staff for reporting errors, without any stress.
    Keywords: Medication Errors Report, Healthcare Reform, Nurses, Golestan Educational Hospital, Ahvaz, Iran
  • Hossein Kiashemshaki, Amir Hossein Mahvi, Ali Asghar Najafpoor *, Ahmad Hosseinzadeh Page 3
    Background
    The organic compounds that are present in water facilitate the formation of Trihalomethanes (THMs) and mutagenic substances and consequently undermine the suitability of drinking water.
    Objectives
    This work aimed to investigate the extent to which total organic carbons (TOCs) are efficiently removed in the Jalaliyeh water treatment plant.
    Methods
    Water samples, which included raw water, the effluent after the accelerator process, and the effluent after the filtration process, were taken from the Jalaliyeh water treatment plant over the course of six months. Three samples of each type were taken on two specific days of each week, equating to 24 samples in each month and 144 samples in total. TOC measurements were taken using a spectrophotometer at a wavelength of 555 nm.
    Results
    When the input TOC was at its maximum value, TOC removal efficiency was around 80%. This could potentially be increased by augmenting the amount of coagulant substance or through the use of coagulant aid. The removal efficiency reduced as the concentration of TOC input reduced.
    Conclusions
    The accelerator eliminated TOC with an acceptable level of efficiency. The samples taken after rainy days contained higher organic matter content, especially TOC, than on the days following no rainfall.
    Keywords: Water Treatment Plant, Total Organic Carbon, Trihalomethanes
  • Saeid Rostami, Abooalfazl Azhdarpoor*, Mohammad Reza Samaei Page 4
    Background
    Polycyclic aromatic hydrocarbons (PAHs) are a recalcitrant group of contaminants, known to be highly persistent in the environment. Most of these compounds are persistent pollutants in the soil.
    Objectives
    This study aimed to investigate the use of Pseudomonas aeruginosa and Sorghum bicolor in improving phytoremediation of soil contaminated with pyrene.
    Methods
    During 3 months of the experiment, soil samples were collected and analyzed once a month to determine the pyrene removal rate. After the experiment, the plant biomass was measured, and the number of bacteria in the rhizosphere was counted.
    Results
    The results showed that pyrene removal rate was 35 - 47% in the unplanted treatment. Use of Sorghum bicolor alone reduced soil pyrene by 53 - 70%, whereas the combination of this plant with Pseudomonas bacteria reduced pyrene by 66 - 82%. Moreover, the number of bacteria in the rhizosphere and pyrene removal rate significantly increased in the planted treatments, compared to the unplanted treatment.
    Conclusions
    Based on the findings, root exudates and Pseudomonas bacteria through stimulation of root development could increase the number of bacteria and enhance the efficiency of pyrene removal. Therefore, combination of phytoremediation with bioremediation can be a suitable alternative for remediation of pyrene-contaminated soils.
    Keywords: Soil, Pseudomonas, Sorghum Bicolor, Pyrene, Phytoremediation
  • Sanaz Sohrabizadeh, Azin Rahimi Page 5
    Background
    While men also have a number of disadvantages at the time of disasters, little attention is paid to their status. The term “invisible men” refers to ignoring men's status in different catastrophes and not investigating their post-disaster challenges as much as it should. The current study was conducted to fill this gap by exploring the factors concerning men's status in the recent natural disasters of Iran.
    Objectives
    The current study aimed at exploring the aspects of affected men's status as well as eliciting the factors of men's coping capacity after the recent disasters of Iran.
    Methods
    A qualitative content analysis using in-depth unstructured interviews and field observations were employed to explore the status of damaged men. A total of 22 participants, 18 affected people and 4 key informants were interviewed using the purposive sampling method. The conventional content analysis using the Graneheim approach was performed to analyze the transcribed interviews.
    Results
    Three main categories and 6 subcategories were extracted from the data. The main categories included men's livelihood, health, and capability. All categories had their specific subcategories integrated based on discrete features in a given category.
    Conclusions
    Providing supportive livelihood plans and entrepreneurship projects with the focus on economical independency of damaged men are highly recommended in the disaster-stricken regions. In addition, local health centers can provide some essential public health services for free and encourage affected men to use such services. Further research is required to identify other probable aspects of men's health status and capabilities related to wider cultural settings.
    Keywords: Disasters, Health, Men, Gender, Content Analysis, Iran
  • Masomeh Rostami-Moez, Seyed Mohammad Mahdi Hazavehei, Manoochehr Karami, Akram Karimi-Shahanjarini, Farzad Nazem, Forouzan Rezapur-Shahkolai Page 6
    Background
    Physical activity provides extensive health benefits during adolescence; however, many adolescents do not achieve the recommended level of regular physical activity (RPA). The age-related declin in regular physical activity throughout adolescence has been documented in some studies in western countries but by our search, there has been no study in eastern countries.
    Objectives
    The aim of this study was to determine the decline in RPA among Iranian girl students aged 10 to 16 and the related factors.
    Methods
    This cross-sectional study included 1164 students who were selected via multi-stage random sampling in Hamadan, Iran, in 2015. They filled out a self-administered questionnaire. A number of 105 students out of the above-mentioned sample were selected randomly for using pedometers. The questionnaire included demographic variables, physical activity questionnaires (PAQs), questions on height and weight measurements. Join Point regression, t-test, ANOVA, and logistic regression were used to obtain PA decline age, associations, and odds ratio.
    Results
    The results showed that about 83% of the students did not engage in 60 minutes moderate to vigorous physical activity (MVPA) per day. In addition, 46% of the students watched TV more than 2 hours/day. There was a significant association (P
    Conclusions
    This report showed RPA declined by age during adolescence in girl students. Motivating students toward RPA and providing facilities to do RPA can prevent this problem.
    Keywords: Adolescents, Female, Motor Activity, Schools, Iran
  • Azita Noroozi, Farideh Esmaili, Rahim Tahmasebi *, Katayon Vahdat Page 7
    Background
    For efficient HIV treatment, it is necessary to follow a precise therapeutic plan. Thus, the present study aimed at using the health promotion model (HPM), which is in adherence to Antiretroviral Therapy (ART), as a theoretical framework to design an educational plan for HIV- infected patients.
    Methods
    This controlled trial study was performed on 61 HIV positive patients under antiretroviral therapy. Face to face training was provided to 31 patients of the intervention group in 2 educational sessions with a 2-week interval, and 30 patients in the control group received standard clinic treatment in the center during the study period. Data collection tool in this study consisted of 3 sections: (1) individual characteristics, (2) constructs related to behavior-specific cognitions and affects, and (3) adherence to therapy questionnaire. Data were analyzed using SPSS software Version 18.0.
    Results
    In this study, the difference was statistically significant between the 2 groups in all constructs after the intervention. All constructs increased (P
    Conclusions
    This study revealed that education based on HPM is effective for promoting beliefs and adherence to ART therapy.
    Keywords: Acquired Immunodeficiency Syndrome, Medication Adherence, Health Promotion Model, Education
  • Zahra Moradpour, Farshid Ghorbani Shahna, Abdulrahman Bahrami *, Alireza Soltanian, Ghasem Hesam Page 8
    Background
    The operation of petroleum refineries and petrochemical plants is associated with the emission of organic compounds into the atmosphere, causing local and regional pollution that is harmful to people’s health.
    Objectives
    The present study aimed at determining and evaluating personal exposure to hazardous compounds in ambient air of petrochemical complex in south of Iran.
    Methods
    A total of 716 air samples were collected at 18 complexes of an Iranian petroleum complex. A charcoal desorption tube was used to obtain samples from VOCs, and a gas chromatography equipped to flame ionization detector (GC-FID) was used for analyzing the compounds. A gas chromatography-mass spectrophotometer (GC-MS) was used to determine the quantity of the compounds.
    Results
    More than 40 VOCs were detected in all samples and high concentrations of benzene were observed in 12 complexes, but the concentrations of non-carcinogen compounds were below the occupational exposure limit. The greatest amount of exposure to the VOCs occurred in the groups of operators, site workers, analyzers, mechanics, samplers, and site men. Other possible carcinogenic compounds such as epichlorohydrin ethylbenzene were above the occupational permissible exposure limits in a few petrochemical complexes. The mean ratios of benzene to toluene (B/T), (benzene to xylenes) B/X, ethylbenzene to toluene (EB/T), and ethyl benzene to xylene (EB/X) were, respectively, 1.2, 1.9, 0.12, and 1.2 during the summer and were less than the same ratios in the winter.
    Conclusions
    The results of this study revealed that benzene is a major pollutant in workplaces and is distributed throughout petrochemical complexes by wind. Thus, there is an urgent need to control the spread of benzene through air. Photochemical reaction is also an important factor in pollution in different seasons of the year.
    Keywords: Benzene, Volatile Organic Compounds, Photochemical Processes, Petroleum
  • Soheyla Reshadat, Farid Najafi, Behzad Karami-Matin, Moslem Soofi *, Eshagh Barfar, Nader Rajabi-Gilan, Seyed-Ramin Ghasemi Page 9
    Background
    Protecting people from catastrophic health payments is widely recognized as an integral component of health systems and universal health coverage.
    Objectives
    This study aimed to measure the financial protection against catastrophic health expenditure among hospitalized patients in Kermanshah, western Iran, after the implementation of the health sector evolution plan of Iran.
    Methods
    This was a cross-sectional study. A total of 544 patients were selected using the proportional allocation to population size technique. A translated version of the world health survey questionnaire was used to collect data. Catastrophic health expenditure was calculated using WHO recommended methodology. Data were analyzed using STATA v.13. The statistical test performed included descriptive statistics and logistic regression.
    Results
    About 4.8% of households with hospitalized patients were faced with catastrophic health expenditures. The total mean out-of-pocket (OOP) medical expenditures of being hospitalized was 819,220 Rials per patient. Mean OOP in patients with catastrophic payment was 2,220,500 Rial. Major determinants of catastrophic payment were associated with surgical cost (OR: 8.09 P Value = 0.000), chronic disease (OR: 2.78 P Value = 0.025), household size (> 6) (OR: 6.70 P Value
    Conclusions
    The Health Sector Evolution Plan should target and extend aids especially for chronically ill patients, those who need surgery, and those at poorest quintile due to the fact that they are more vulnerable to catastrophic health expenditure. These groups should be the priorities in the health sector evolution plan revision to achieve a more desired outcome.
    Keywords: Financial Protection, Catastrophic Health Expenditure, Out-of-Pocket Payment, Hospitalized Patients, Health Reform
  • Mohammad Faridan, Ali Khavanin *, Ramazan Mirzaei, Mojde Salehnia Page 10
    Background
    Occupational noise exposure is one of the leading factors for developing noise-induced hearing loss (NIHL), particularly among workers worldwide. The literature review reveals that beside conventional strategies for preventing NIHL, multiple interventions can be applied to reduce or prevent such disorders. The present study aimed to investigate the preventive effects of normobaric hyperoxia pre- and post-treatment on the development of NIHL in rats.
    Methods
    Four groups of male Wistar rats were exposed to pure oxygen alone, noise alone, or oxygen plus noise for 6 hours a day, 5 days a week for 4 weeks. One group served as the control and received neither noise nor oxygen. Animals in the noise groups were exposed to high-pass white noise of 100 dB SPL, centred at 8 KHz. The treatment protocols were based on inhalation of pure normobaric oxygen (95%) for 3 hours in a chamber either before or after noise exposure. The auditory brainstem responses (ABRs) for click and 4, 6, 8, 12, and 16 kHz stimuli, as well as distortion product otoacoustic emissions (DPOAEs) at 4, 6, 8, and 10 kHz, were recorded to assess the level of hearing impairment before exposure and 4 weeks post-exposure.
    Results
    The results showed that pre-treatment of rats with 3 hours of normobaric hyperoxia contributed to a significant reduction in ABR threshold shifts, while improving the DPOAE amplitudes (P 0.05).
    Conclusions
    Pre- and post-treatment with normobaric hyperoxia seem to produce protective effects through either boosting cellular oxygenation or maximizing antioxidant enzyme activities and tolerance against noise-induced ischemia and hypoxia in the cochlea. Therefore, application of normobaric hyperoxia pre- or post-treatment, along with other conventional protective strategies, can be helpful in the fight against NIHL.
    Keywords: Normobaric Hyperoxia, Noise-Induced Hearing Loss, ABR, DPOAE, Rat
  • Seyed Mohsen Zahraei, Mohammad Mehdi Gouya*, Mahdi Mohammadi, Seyed Mehdi Tabatabaei, Mehdi Zanganeh, Iraj Zareban, Malek Kiani, Hosein Ali Adineh, Azam Sabouri, Alireza Ansari-Moghaddam, Feiz Mohammad Elhami, Alireza Khorram Page 11
    Background
    Supplementary Immunization Activities (SIAs) have been considered as a strategic key towards elimination of measles and rubella. This study aimed at identifying the coverage of vaccination in target population children.
    Methods
    The study was carried out in South-East of Iran on a total of 6838 randomly selected children. Information was collected by trained interviewers using a validated questionnaire. The data was analyzed through descriptive statistics (i.e. frequencies and percentages) and 95% confidence interval.
    Results
    Overall, 98.7% of children were vaccinated during SIAs campaign. Vaccination cards were available for about two-thirds of the participants at the time of home visits while 95.3% of them reportedly received an immunization card. Refusal to vaccinate (31%), not informed (24.2%), children being sick (22.4%), and travel (20.2%) were the main reasons for not vaccinating children (n = 86) during the campaign. The main sites for vaccination were school (46.5%) and health centers (46.4%). Fever (44.8%) and severe pain at the injection site (36.2%) were reported as the most frequent complications by the study participants. Prevention of measles and rubella (66.6%) and health staff recommendations (31.4%) were the main vaccination incentives.
    Conclusions
    To sum up, Supplementary Immunization Activities (SIAs) are a good approach towards high coverage of immunization and attain measles and rubella elimination.
    Keywords: Measles, Rubella, Mass Vaccination, Adverse Effects
  • Abolfazl Payandeh, Yadollah Mehrabi *, Farid Zayeri, Zahra Rezaei Ghahroodi Page 12
    Background
    Equity in health is the focus of attention in the world health circles in recent decades. The financing of household health expenditure is, therefore, a concern in any region.
    Objectives
    The current study aimed at exploring the determinants of household health expenditure in Sistan and Baluchistan province, Southeast of Iran.
    Methods
    The data of the current study were a part of the Iranian households’ income and expenditure survey, administered by the Iranian statistical center (ISC) from March 2013 to March 2014. A 3-stage stratified cluster sampling method was employed in the current cross sectional survey. A total of 1391 households from Sistan and Baluchistan province were randomly selected. The study employed quantile regression modelling to determine the effective explanatory variables of household health expenses. R programming language version 3.3.2 was used for data analysis.
    Results
    It was found that annual median per capita medical expenditure was US$ 5.36 (first quartile = 0; third quartile = 38.31). Households also spent about 3.9% of their annual income on health expenses per capita. Literacy, occupational status of household head, and family income had significant effect on the median of household health expenses.
    Conclusions
    Researchers and policy makers should pay more attention to household health expenses, as it is an important matter in the low-income and deprived areas.
    Keywords: Health Expenditure, Household, Quantile Regression, Sistan, Baluchistan
  • Mohammad Javad Tarrahi, Asghar Mohammadpoorasl, Hossein Ansari *, Younes Mohammadi Page 13
    Background
    Risk-taking behaviors have negative consequences on adolescents and young adults’ health. Numerous studies have revealed that the prevalence of risk- taking behaviors in college students is high. However, little information is available about risk- taking behaviors in freshmen students.
    Objectives
    The present study was conducted to determine the prevalence of risk- taking behaviors and related factors in freshmen students of Khorramabad universities.
    Methods
    This study was performed in 3 universities in Khorramabad, west of Iran, from January to February 2015. A total of 1181 students were selected proportionally and randomly. A self-administered questionnaire was used to measure risk- taking behaviors, including cigarette smoking, hookah smoking, alcohol use, and drug abuse, as well as demographic and related risk factors. Logistic regression model was performed to analyze the data.
    Results
    The prevalence of ever cigarette smoking was 3.7%, the prevalence of ever hookah smoking was 21.7%, almost 2.4% of students had used at least one illicit drug, and 5.5 % of students had used alcohol at least once in their lifetime. After adjustment for other factors, being male, presence of any smoker in the family, and having smoker friends were factors associated with students’ risk- taking behaviors. The results showed co-occurrence of risk- taking behaviors.
    Conclusions
    The prevalence of risk- taking behavior in freshmen students was pretty low compared to other studies. Nevertheless, this study demonstrated the co-occurrence of risky behaviors, which emphasizes the importance of interventions that are aimed at reducing or preventing different high- risk behaviors simultaneously during university years.
    Keywords: Substance Abuse, Risk-taking Behaviors, College Students
  • Animesh Biswas *, Koustuv Dalal, Toity Deave, Saidur Rahman Mashreky Page 14
    Introduction
    This paper describes a case of pregnant mother who died of burn injury in order to understand the societal factors related to the event. We reviewed the case in the rural community. Initially, the case was reported as a maternal death to maternal and neonatal death review (MNDR) system being conducted in Bangladesh within exiting health system to explore the medical and social causes of maternal and newborn deaths. However, during the verbal autopsy, it was found that the mother died of bun injury. Therefore, we performed detailed case study.
    Case Presentation
    A woman aged 18 years was nine months pregnant in a rural community in Moheskhali upazila of Cox’s Bazar district. During the wintertime, the mother feels cold and goes near to the oven in the yard to be warm. Suddenly, part of her clothing (Anchal of Sari) catches fire; she does not recognized and starts to walk towards her room. A neighbor notices and starts to shout. The woman scars and tries to run. The neighbors come with a bucket of water. By this time, the fire spreads over whole body and cloths. Immediately after the event, she is transferred to a medical college hospital.
    Conclusions
    Doctors tried to do immediate cesarean section; however, they could not save the life of the baby inside. The mother who was severely burnt also died after 10 days. Rural community in Bangladesh still does not have adequate awareness and knowledge about risk of burn. The scarce knowledge of appropriate steps immediately after burn was explored. Moreover, delays in decision-making and transferring the patient to the facility were identified. Specific interventions need to be taken to increase knowledge and awareness in the community, which could save thousands of lives.
    Keywords: Burn Injury, Pregnancy, Prevention, Bangladesh