نشریه طلوع بهداشت
سال هفدهم شماره 6 (پیاپی 72، بهمن و اسفند 1397)

health physical, mental and social young couples with health family is related fertility of new slip. Participation in premarital education and counseling program, may couple's first encounter with the health care system. service perception and satisfaction, will play an important role continuation of health service utilization. This quasi-experimental study,before and after the 230 couples attending pre-marriage counseling classes during June to December 2016 premarital counseling center was down.The questionnaire was made based on the objectives of the study was designed and its validity and reliability was approved.The questionnaire consisted of demographic information, knowledge,attitude in three areas of was set up in two stages,before and after intervention training program and completed.Collected data using parametric and nonparametric statistical tests and meaningful outlets α = 0/05 were analyzed. The average age of the couples studied,22/97 ± 4/77 years was.Knowledge couple before and after the educational intervention,respectively 6/33 ± 3/89 and 15/37 ± 3/84 was. Attitudes of couples before and after the intervention to the 65/94 ± 8/92 and 76/56 ± 9/92 was.Average score of knowledge and attitude before and after the intervention in the areas of reproductive health, hereditary diseases and blood-borne and sexually showed statistically significant differences. (P = 0/000) According to the results of the study, it is necessary to increase the couple's health literacy about the topics (Blood and sexually transmitted diseases, reproductive health and hereditary diseases) headlines and take the time to do a more comprehensive programming classes.

Asthma is the most common chronic airway disease in children, which is caused by genetic and environmental factors such as obesity. The aim of this study was to evaluate the relationship between obesity and asthma severity in children. This cross-sectional descriptive study included 200 asthmatic children aged 6 to 12 years in Yazd Shohadaye Kargar hospital in 2015 - 2016. The participants' demographic data were recorded. According to the Australian National Asthma Campaign, they were categorized into mild, moderate, and severe groups considering their severity of asthma. In order to compare the studied variables t, chi-square, and Mann-Whitney tests were used by SPSS 18. The results showed that 11 (27.5%) obese children had severe asthma, but only 7 children (4.4%) with normal BMI had severe asthma (P <0.001). It was also found that the mean BMI in children with severe asthma was 21.68, in children with moderate asthma was 19.73, and in children with mild asthma was 18.27 (P <0.001). Other variables including age, birth weight, maternal age, socioeconomic status, and educational level did not have any significant effect on the severity of asthma (P> 0.05). Our study showed that the prevalence of severe asthma was high in obese children and this relationship was stronger in boys. Therefore, obese children have a higher risk for severe asthma. To reduce obesity in children,  treatments such as regimen are required.

By increasing the amount and diversity of bio-environmental wastewater pollutants, it is essential to be controlled and planed the environmental contaminants to eliminate or minimize. Cardboard recycling industry wastewater has the potential of environmental pollution; it is contaminated with various fungal species that may be effective in the decomposition and removal of pollutants. The aim of this study was the isolation and identification of native fungal species that decontaminate organic pollutants in the cardboard recycling industry wastewaters. In this study, which is a descriptive study, samples were randomly taken from different area of wastewater of cardboard recycling industry. Samples were cultured on Saboraud dextrose agar medium for isolation of probable fungal species, which decomposers of wastewater. The isolated fungal colonies were enumerated and purified based on morphological characteristics and microscopic analyzing as far as possible. The average count of the total number of fungi species in wastewater of cardboard recycling industry was 2.5×102 CFU/ml of these 2.1×101 were saprophytic fungi. The most prevalent fungal species were identificated from the wastewater include Aspergillus niger, Aspergillus flavus, Penicillum, Geotrichum, Mucor, Drechselera, Paecillomyces, Alternaria, Fusarium and Absidia. The highest frequency of fungal species Aspergillus nige, Aspergillus flavus and Penicillum were 30.89%, 22.76% and 14.63% respectively. It seems that native fungi isolated from the cardboard recycling industry wastewater in this study are from fungi that have the potential for bioremediation of wastewater contaminants based on scientific literature and can be used for evaluating of their ability to decompose wastewater from this industry.

Studies showed that about 25 percent of children with less than 5 years of age were underweight to varying degrees in Iran. Mothers, as the most influential group in family education, play very significant roles in preventing growth retardation and regular monitoring. The aim of this study was to determine the effect of educational intervention based on reasoned action theory on the behavior of mothers with malnourished children. This experimental study was conducted on 130 mothers with malnourished 2-5 year-old children in Sepidan city. Participants were divided into two groups (65 in the case group and 65 in the control group). Data were collected using a questionnaire containing demographic data and a questionnaire based on the structures of the reasoned action theory. Data were analyzed by SPSS 16. The mean score of attitude in the intervention group increased from 33.1± 5.2 to 38.5±3.8, their intention score from  24.4±3.3 to 30.03±3.1, and practice score from  31.6±4.9 to 42.5±3.8, which were statistically significant (p<0.001). However, the mean score of subjective norms increased from 31.4±5.5 to 32.7±5.3 and the difference was not statistically significant. The weight mean of children in the intervention and control groups were 1.1 ± 1.6 and 11.5 ± 1.5 kg before the intervention, respectively. After the intervention, the weight mean of children in the intervention group increased to 12.05±1.4, which was statistically significant. On the other hand, weight gain in children of the control group was not statistically significant. Educational intervention based on reasoned action theory was effective on behaviors of mothers with malnourished children. So, this theory can be used as an educational framework to prevent malnutrition in children.

Physical-motor injury is a type of injury that limits one or more of the basic activities of a person's life and prevents the physical and mental development of an individual. Therefore, men with this type of disability will face certain challenges and problems during their lifetime. One of the most important challenges is marriage and the choice of the spouse to support the emotional, psychological and physical aspects of the man. The aim of the present study is to explain the lived experiences and challenges of men with marital-related physical-motor injuries. This research was carried out in a qualitative way, through the phenomenology of lived experiences, via a purposive sampling technique and in-depth interviews with 16 males with physical-motor injuries. The interviews were recorded, then recorded in transcripts and analyzed by Colaizzi's method. The findings of the lived experiences and challenges of men with physical-motor injuries were summarized in 6 main themes (occupational concerns, fear of disability in sexual relations, fear of rejection, therapeutic problems, religious beliefs, self-affirmation in life), and 20 sub-themes coded as subcategories of the main themes. These findings can provide the necessary data for recognizing the main problems, concerns and challenges of men with physical-motor injuries in their marriage, and provide a platform for many professionals and authorities to provide services and supports for social rehabilitation of the physical-motor disabled.

Hospital managers routinely make complex and important for the health of their Society.The quality of these decisions depends on the amount of information, experience and knowledge of the managers. This study aimed to identify barriers to the  knowledge sharing among managers  of educational hospitals in the south-east of the country. This is a qualitative study that was done using the phenomenological method. The research community was composed of all managers of selected educational hospitals in Fars and Kerman provinces. The research sample was selected through in-sample sampling and among managers who were somehow involved in the dissemination of knowledge. The total number of statistical population consisted of 40 hospital managers, with 26 of these semi-structured interviewers. Sampling was carried out to the extent that the data from 26 interviews reached the saturation level, then the results were analyzed using a seven-step method. The results of this study showed that the main barriers to knowledge dissemination among hospital managers in seven main sections, each in subcategories including: cultural barriers in 9 sub categories, financial facilities in 2 sub categories, development and promotion of education in 13 sub categories , Policies, rules and regulations in 9 sub-categories, communications in 8 sub-categories, human resources in 9 sub-categories, and management policies in 10 sub-categories. Knowledge dissemination among managers is essential in order to increase their level of knowledge and their ability to make better decisions. With the importance of proper education, the culture of studying and the transfer of experience and knowledge in hospitals and universities, the culture of collaborative learning is institutionalized. Review some of the laws of the media to support managers and their job stability and their educational policies, and increase the quality of education in universities. Managers use appropriate methods and communication skills and have individual and organizational interactions. Due diligence and attention to the ability of managers, proper information and managers' moves towards collaborative and team processes can remove barriers to knowledge dissemination.

Since proper use of drugs by patients is under the influence of their beliefs and attitudes, we decided to conduct a study to determine the effect of training of asthmatic patients for appropriate use of inhaled corticosteroids sprays (ICS) on their attitude and asthma control. This study was semi-experimental with two groups of case and control. One hundred ninety patients were enrolled in the study and randomly were allocated to either two groups. Ninety patients in each group finished the study. Pre-training researcher made questionnaire was completed by all of the participants. Nine sessions of one-hour training on how to properly use the inhalers, were held for patients in the case group. Two months later, the questionnaire was completed by all the patients again. Student and paired T-test and one-way ANOVA were used to analyze data. Demographic characteristics of two groups were similar. Training could reduce patients’ anxiety (p=0.0001) and increase their interest (p=0.0001) and self-esteem (p=0.0001). Overall attitude score in the case and control groups were 68.23 ± 6.69 and 58.69 ± 10, respectively (p=0.001). Average score of asthma control in the trained group was significantly higher than the other (p=0. 001). Control of asthma did not have a substantial relationship with the level of education (p=0.061) and gender (p=0.116) of patients. Overall, education could have a positive effect on patient attitude and improve control of asthma. Therefore, training patients could increase the effectiveness of therapy and lower the costs on patients and the society.

Today, the contamination caused by rapid rate of developing industries has been drawing attention from scientific and environmental communities to itself. This study was conducted to investigate the concentration and distribution of heavy metals in topsoil of industrial area in Ardakan city. For this porous, sampling of topsoil (0-5 cm) was performed using 5 transects in an area of 20000 hectares. Concentrations of As, Cd, Cr, Ni, Mo, Pb, V and Zn were measured in 45 samples based on ICP-OES method. Then, Indices including: Contamination level of heavy metal ( ), Potential Ecological Risk of Heavy Metals ( ) and Total Potential Ecological Risk (RI) were calculated. Also Pearson’s correlation was used to assess the relationship between heavy metal’s concentrations. Results indicated that mean value concentrations of As, Cd, Cr, Mo, Ni, Pb, V and Zn were repectivley 9.85, 0.31, 35.33, 1.001, 43.28, 18.51, 44.8 and 78.3 (mg/kg) in topsoil of studied area. Maximum concentrations of all heavy metals was found in samples collected from downwind and near the major industries except for Mo and Ni.  and RI indices also showed an increase downwind areas. Strongest correlations were found between Cr-Ni, Cd-Zn and As-Cr which indicates that these metals probably have the same source. Although the ecological risk of the whole area was low in the risk class, the increase in ecological risk in the surrounding and lower parts of factories such as steel and pelletizing, and tile and ceramic industries indicated the dominant role in the distribution and spread of pollution and the necessity of attention to the site selection studies of these industries. Also the results of the present study indicated the necessity of preventive measurements such as Phytoremediation in the lower parts of industrial area of this region.