Journal of Health Scope
Volume:6 Issue: 3, Aug 2017

Leachate contains a large amount of pollutants that make it very complicated and expensive for treatment. Hence, leachate treatment generally requires various combined processes that must be done carefully.
The aim of this study was to determine the sequencing batch reactor (SBR) performance in treatment of composting plant leachate.
In this experimental study, an aerobic biological SBR with 2 liters capacity was used for treatment of leachate from composting plant of Isfahan, Iran. The organic loading rate (OLR) increased from 0.25 to 6.3 g COD/L.d in 11 runs during 280 days. To determine the reactor performance, COD, SCOD, rbCOD, BOD5, TKN, and TP were measured in accordance with standard methods. Finally, the data were analyzed using Excel 2007 software.
In this study, the highest removal efficiency in SBR was obtained at 0.75 to 1.5 g COD/L.d loading rate. The maximum removal rates for COD, SCOD, rbCOD, and BOD5 were 92.45, 93.33, 99.8, and 96%, respectively. The average removal efficiencies for total nitrogen and phosphorus were 73.6 and 66.5%, respectively.
According to the results, SBR performance in the removal of organic matter, nitrogen, and phosphorus at low loading rates is satisfactory, while the removal efficiency decreased by increasing loading rate and decreasing retention time.

Malnutrition and failure to thrive (FTT) is a delay or a halt in children’s growth, which leads to serious compilations if it is left untreated. Malnutrition due to its prevalence is the most important nutritional disease in developing countries and has the most prevalence among infants and preschool children. This study aimed at rating and determining the effective factors of malnutrition incidence and growth delay among 0 to 24 months children.
To identify children under 2 years of age, we referred to health centers and health stations in the city of Shahroud (Northeast of Iran) in 2015. Using cluster sampling, 706 children were surveyed.
Anthropometric indices with international reference standards were compared. The values obtained for less than 2 standard deviations as stunting, underweight, wasting, and FTT were defined. All statistical analyses were performed using SPSS software with significance level set at 0.05.
The results indicated the existence of malnutrition in the region. Based on the findings, the percentage of underweight, wasting, stunting and ratio of head circumference with age was determined to be 1.7%, 5.4%, 9.5%, and 8.6%, respectively; and considering the category of growth disorder, Type 1, 2, and 3 were, respectively, 1.7%, 5.2% and 3.1%. Factors affecting malnutrition included age, birth weight, birth spacing, and the mother’s BMI at child birth.
Tracking the status of children with growth disorder and malnutrition, offering appropriate interventions, considering the nutrition status of mothers during pregnancy, and providing appropriate nutritional counseling are of prime importance to attend to this problem.

A four-step map of financial reform in Iranian health sector has been proposed with the aim of increasing efficiency and resource allocation.
This study was conducted to investigate the necessary requirements to establish the three last phases of this reform in Iran, during year 2015.
A qualitative study in the form of framework analysis approach was conducted. An interview guide was used for interviewing 22 purposefully selected experts individually in a semi-structured format and data were saturated at this level. Data were analyzed using five-stage method of framework analysis (familiarization, identifying a thematic framework, indexing, charting and mapping, and interpretation) using the Atlas Ti software, by two experts with no conflicts of interest.
Six main themes and 18 sub-themes were extracted that introduced six groups of requirements including economic, functional, legal, organizational, informational, and educational, as the most vital needs for conducting financial reform in the Iranian health system.
Findings showed that there are numerous problems with conducting financial reform despite spending a decade after its implementation in the Iranian health system. Therefore, the current results as well as planning to recognize and promote the modifiable parts in this field might be beneficial for policy-makers of the country to make a definite plan for revising this process with drafting a long-term perspective and a tailored context for complete and successful executing.

College students are particularly vulnerable to developing Internet addiction. Understanding students’ needs for preventing as well as managing Internet addiction should be considered.
The purpose of this study was to explore the multidimensional needs of students for the prevention of Internet addiction.
This qualitative study was performed in Sanandaj, Iran, between September and December 2015. Fifteen participants who are addicted to the Internet, based upon a self-reported questionnaire, were purposefully selected from 3 local universities. Data was collected using focus groups, individual semi-structured interviews, and drawings. Conventional content analysis methods were utilized to analyze data.
Fifteen students (mean age 26.3 ± 3.2 years) with an average score for Internet addiction of 59.3 participated in the study. Students’ needs for the prevention of Internet addiction included 4 major categories: social support, personal competence, appropriate culture, as well as maintenance and improvement of health.
Prevention programs for Internet addiction need to promote social supports, teach personal competence, establish an appropriate culture, and prioritize good health.

Mineral oils, a complex mixture of chemicals, are primarily used in metalworking processes. Due to different toxicity levels found in mineral oils, two threshold limit values are given for the evaluation of mists of highly and poorly refined mineral oil.
The objective of this study was to explore a new method for the analysis of 2 classes of mineral oils by the FT-IR.
Highly and poorly refined mineral oil samples were prepared by spiking the filters in the range of 10 to 2,250 µg/sample. Samples were extracted with 10 mL of carbon tetrachloride, subsequently analyzed by Fourier Transform Infrared (FT-IR) in the region of 3031 to 2,796 cm-1. Mineral oils (highly and poorly refined) were distinguished qualitatively, according to the FT-IR spectroscopy to determine the presence of formaldehyde using functional groups C = O and C - H, N-Nitroso compounds, and functional groups of N-N and N = O. Method validation parameters, such as precision, accuracy, detection limit and comparison of identical samples with the reference method by NIOSH No.5524 were considered.
According to the FT-IR spectroscopy in this study, highly and poorly refined mineral oil samples were distinguished according to their spectral absorption of the functional groups. The FT-IR spectroscopy analyzed highly and poorly refined mineral oil samples in the linear range of 10 to 2,250 µg/sample. The coefficient variations of inter-day and intra-day were 3.61 and 5.08 for highly refined mineral oil, and 5.23 and 5.18 for poorly refined mineral oil, respectively. The average accuracies for highly and poorly refined oil samples were 1.4% and 0.54%, respectively.
The statistical average differences in the results drawn from the FT-IR method and actual spiked samples were significantly lower than the differences measured by the NIOSH No.5524 method and spiked samples. Therefore, this study demonstrates a viable alternative method for the analysis of mineral oils in future studies.

The education presented to the clients by the health care personnel can guarantee the well-being of the individuals and stimulate sound health care behaviors in them. Recognizing the barriers to health education enhances the understanding and knowledge of preventive services.
The present study aimed at investigating the perspective of health care providers about barriers of instructional programs in Iran.
This qualitative study was conducted in the urban health care centers of Sanandaj, West of Iran, in 2016. Using purposive sampling, 15 experienced employees in charge of health care education were included in the study. Data were collected through individual interview and group discussions, observation and field notes, were and analyzed by conventional content analysis. To confirm the accuracy and strength of the data, credibility, confirmability, and transferability components were taken into account.
The results of data analysis yielded 5 major categories: (1) health center related problems; (2) lack of preparation for education; (3) clients’ problems; (4) personal problems of the personnel; and (5) organizational factors. The participants reported the significance of intra- and intersectoral cooperation and coordination in implementation of health care education programs and the need for further attention from authorities to health care education.
The findings revealed that presentation of health care education is a complicated issue, which is influenced by various factors. Also, the success of educational programs in health care centers is not merely an intrasectoral enterprise rather it requires the cooperation of the public media and related organizations, support of the society and attention of families and authorities to health education.

Fertility pattern is influenced by economic, social, cultural, and environmental factors. Sistan and Balouchestan province has the highest household size and total fertility rate in Iran. In this study, we aimed to evaluate the fertility pattern and determinants of the desired number of children among rural and urban women in Zahedan, Sistan and Balouchestan province, Iran in 2015.
In this cross sectional study, 160 urban and rural couples were evaluated in Zahedan. The data collection tool was a questionnaire, including demographic information, fertility pattern, and family planning details. Chi square, independent t test, and Mann-Whitney U test were used to analyze the data. Binary logistic regression test was used to determine the association of different variables with the desired number of children.
Coverage of family planning programs was significantly lower for rural women, compared to their urban counterparts. In addition, the percentage of unsafe delivery was higher in rural women. The mean desired number of children was 3.18 ± 1.7 for urban and rural women and 3.56 ± 1.19 for their partners. As the binary logistic regression analysis showed, preference for a male child and Balouch ethnicity were significant predictors of the desired number of children for women and their partners (P Fertility pattern and determinants of reproductive performance can vary in different populations. Sistan and Balouchestan province has the lowest coverage of reproductive health programs and a high unsafe delivery rate. Therefore, reproductive and pregnancy health programs should be supplemented, parallel to policies concerning population growth.

Nowadays, more than 1 billion people suffer from food insecurity worldwide. Food insecurity is recognized as an important determinant of health, and both food insecurity and diseases are public health concerns. This study aimed at determining the association between food insecurity and self-reported history of infectious and parasitic diseases among household mothers in Zahedan, southeast of Iran.
This cross-sectional study was conducted on 2160 households in Zahedan. Food insecurity of the households was assessed through USDA 18- item questionnaire. Demographic data and questions about history of infectious and parasitic diseases in mothers were collected through interviewing the mothers. The data were analyzed using chi-square test and logistic regression model.
Of the household mothers, 58.8% experienced food insecurity, 11.5% reported history of infectious diseases, and 1.1% experienced parasitic diseases in the last 3 months. After adjusting for the selected variables, a positive association was detected between food insecurity and history of infectious (OR, 2.29; 95% CI, 1.66 - 3.18) and parasitic diseases (OR, 3.86; 95% CI, 1.07 - 13.93) in mothers.
Food security seems a controllable environmental factor that may cause some positive results in the fight against diseases. On the other hand, preventing and controlling infectious and parasitic diseases may in turn result in reduction of food insecurity.

Out-of-hospital cardiac arrest is the leading cause of death. learning of basic life support (BLS) skills is necessary for rapid management of cardiac arrest.
The current study was conducted to compare the effect of BLS training package and lecture-based training on cardiopulmonary resuscitation (CPR) knowledge and skill of high school teachers.
In this quasi-experimental study with pretest-posttest design, 120 eligible school teachers (60 persons in each group) employed in high schools were selected through convenience sampling and were randomly allocated to two groups of lecture and BLS training package. The instruments were a demographic information form, a knowledge questionnaire, and a skill assessment checklist. The same educational content was presented to both groups designed based on the latest revised standard guidelines of American heart association (2010) and relevant books. In the lecture group, theoretical and practical education was performed. The package content included video and educational pamphlets. The data were analyzed using descriptive statistics, Chi-square test, independent sample t-test, and repeated measures ANOVA in SPSS19. Significance level of 0.05 was considered.
Independent t-test showed that there was no significant difference between the two groups in pretest and posttest scores of knowledge, but there was a significant difference in recall score (P = 0.047). Results of t-test showed that there was no significant difference between the two groups in terms of pretest, posttest, and recall scores of skill, while the mean score was higher in the training package group than the lecture group (12.56 ± 3.97 vs. 11.19 ± 4.8 in recall stage).
The results indicated that both educational methods have the same impact on the knowledge and skill of CPR in high school teachers; thus, the training package can be used as a simple, suitable, and practical method instead of traditional educational methods.

Among the various adverse pollutants in water, coliform bacteria and arsenic are very important. Drinking of arsenic-contaminated water has become a serious threat to public health and has affected millions of people across the world.
The aim of this study was to investigate the removal of arsenic and coliform bacteria from drinking water in small communities with the use of a conventional Slow Sand Filter (SSF) and modified filter by slag (SMF) and Zeolite (ZMF).
In this study, initial concentrations of arsenic were 0.073, 0.11, 0.171, 0.21, 0.24, and 0.33 mg/l and the initial number of coliform bacteria was 4*106 MPN/100 mL. Arsenic and coliform bacteria samples were taken every 24 and 48 hours, respectively. Concentration of arsenic was analyzed by Inductively coupled plasma atomic emission spectroscopy (ICP-AES) and the total and fecal coliforms were measured by multiple probable number (MPN) 9-tubes method.
The results showed that the mean removal efficiency of arsenic (mean 0.189 mg/L) by SSF, SMF, and ZMF was 33.7%, 51.5%, and 66.2%, respectively. It was shown that the filter modified by zeolite had more efficiency in arsenic removal because of higher cation exchange capacity (CEC) than any other media. The removal efficiencies of coliform bacteria by SSF, SMF, and ZMF were 1.97, 1.98, and 1.99 log, respectively.
This treatment method can be used as a simple, cheap, and convenient technique for arsenic and coliform bacteria removal from small communities’ drinking water resources.

Different types of direct and passive smoking have been reported to be associated with conductive and sensorineural hearing loss. In this study, we aimed to investigate the relationship between cigarette smoke exposure and cochlear dysfunction.
In this experimental study, 12 male Wistar rats were divided into 2 groups: control group without exposure and smoke-exposed group housed in a whole-body exposure chamber (exposed to the smoke of 20 cigarettes; 9 ± 1 mg of tar and 0.8 ± 0.1 mg of nicotine per cigarette) for 8 hours a day during 10 consecutive days. The main and side stream smoke was generated in accordance with the federal trade commission (FTC) regimen (2-second puff with 35 mL volume and frequency of 1 puff per minute). Distortion-product otoacoustic emissions (DPOAEs) were evaluated at a frequency range of 4620 - 9960 Hz at baseline and 1, 7, and 21 days after exposure. Repeated measures ANOVA and t test were performed for data analysis, using SPSS version 18.
In the smoke-exposed animals, temporary hearing changes were significantly different from the baseline at a greater attenuation and higher frequencies (P 0.05).
Subacute smoke exposure for 10 days resulted in the temporary reduction of DPOAEs. Chronic and subchronic effects of smoke on permanent hearing damage need to be investigated through further animal studies.

The health transformation plan (HTP) was put into action in Iran, in 2014, with 8 service packages. This plan was not implemented as a pilot and therefore, various problems and barriers have since emerged.
The aim of this study was to identify the economic challenges of inpatient payment reduction directive in HTP from the perspectives of 2 groups of experts in levels of hospital and university held in 2 time periods.
In this qualitative study, data were collected through semi-structured interviews with 20 participants involved in the healthcare reform in hospitals as well as the executive committee of HTP in universities.
Data collection resulted in 36 descriptive codes presenting the economic challenges of the payment reduction directive in thems of insurance / tariffs and financial affairs in the period of 3 months and 1 year since the beginning. Interviewees then suggested their solutions.
Challenges trends over times show that some parts of challenges are changing. In addition, challenges interact with each other and could be avoided just by appropriate planning. On the other hand, execution of this directive was extremely costly for the government; it would be better to allocate resources with meticulous planning and designs.

Intervention mapping (IM) is a systematic development of interventions for designing health promotion programs.

Promoting physical activity (PA) as well as healthy eating (HE) has an important role in improving individuals with cardiovascular metabolic risk factors (CVMRFs). This paper describes development of an intervention based on intervention mappings’ steps to promote PA and HE among Iranian adults with CVMRFs.

We developed an intervention following 6 steps of IM framework and PRECEDE Model. Needs assessment (Step 1) consisted of interviews with 50 adults with CVMRF and 12 healthcare providers (HPs) located in Karaj, Iran to know if their perceptions of risk behaviors are related to the CV risk factors as well as predisposing, enabling and reinforcing factors for PA, and HE behaviors. Next, we conducted a survey with 450 patients to assess the relationship between determinants and 2 behaviors. Then a program was planned for changeable determinants based on 2 - 4 steps of IM, and finally a plan for implementation (Step 5) and evaluation (Step 6) was developed.

Findings of the qualitative part showed unhealthy eating and inactivity as behaviors that predict CVMRFs and also the theoretical determinants that were related to engagement in PA and HE included; self-efficacy and perceived barriers (predisposing factors), individual skills, laws and policies (enabling factors), and social support, motivation to comply and behavioral consequences (reinforcing factors). The steps 2 to 6 of IM was conducted based on the findings of the needed assessment.

IM, as systematic development of a theory-based intervention, is a suitable framework to design comprehensive programs in order to promote healthy behaviors and reduce CV metabolic risk factors.