فهرست مطالب گلرسته خلاصه زاده

About 40 years ago, the mental health services providing strategies have been dramatically changed worldwide. As well as, it is considered as a new revolution in mental health and named as community-based mental health movement. Moreover, mental health centers in Iran have been established in order to make a change in urban community-based mental health (CMHC). The first CMHC was founded in Tehran 16th district in 2010. In Yazd, it was established in 2010. In this article, the steps for establishment of the first CMHC were described.

Allergic diseases are among the common diseases in children and one of the common causes of disability in many societies. Increased incidence of these diseases in recent years in many countries has been reported. Allergies in children have several risk factors, including maternal stress during pregnancy. In this descriptive-analytic study, 290 pregnant women referred to two general and private hospitals in Yazd were studied. Subjects were selected during 2010 by non-randomized simple sampling. Anxiety level in pregnant mothers was determined by PRAQ (Pregnancy Anxiety Questionnaire). IgE (Immunoglobulin E) levels in Cord blood and maternal blood were determined by ELISA method. The results were analyzed by SPSS version 16. Our findings showed that the average anxiety score in mothers whose newborns had IgE level above 0.35 IU/ml is more than mothers whose babies blood IgE was less than 0.35 IU/ml, and there was a significant relationship between cord blood IgE level and pregnancy anxiety score (P<0.001). There wasnt any significant relationship between other variables such as gender, gestational age and birth weight with cord blood IgE levels (P> 0.05). It seems that anxiety and fear during pregnancy are risk factors for elevation of cord blood IgE level in newborns.

Background and aimsBuilding associated illnesses are a group of illnesses caused by physical or psychological conditions of workplace. One of theses illnesses is sick building syndrome (SBS) which consists of a group of symptoms, including mucosal irritation, headache, fatigue, skin dryness and itching, and nausea that are temporally related to presence in a particular building. This study was designed to assess SBS and factors affecting it in central building of Shahid Sadoughi University of medical sciences. MethodsThis is a cross-sectional study on workers of central building of Shahid Sadoughi University of medical sciences. The prevalence of SBS was determined using self-administered indoor air quality (IAQ) questionnaire for office workers. All workers who worked at least one year in this building and had no other medical illnesses with similar symptoms to SBS, entered the study and the questionnaire was filled out for them. Data was analyzed using chi square test. ResultsPrevalence of SBS among the workers of central building was 35.7% (34.8% in male and 36.9% in female workers). There was no significant association between prevalence of SBS and age, gender, duration of employment and level of education. The most frequent complaints mentioned by participants were fatigue and headache, and the most frequent causes were noise, inadequate physical space and crowded work environment. ConclusionThis survey showed a relatively high prevalence of SBS among office workers in this organization. So considering the effects of SBS on worker's function and productivity, it is recommended to reduce its causes, especially noise and inadequate space.

Addiction as a social, health problem with its specific complications threatens societies. High risk behaviors such as violence, self mutilation, tattooing, shared injections and unprotected sex behaviors are some of the problems in addicts that need to be treated. One of these treatments is methadone therapy. The purpose of this study was to evaluate effectiveness of methadone in prevention or reduction of high risk behaviors in clients of a MMT center of Shaheed Sadoughi University of medical sciences of Yazd. This study was done on 93 clients of a MMT center.Questionnaire for this study included items from MAP and questions about some other risky behaviors. This questionnaire was completed at onset of treatment and 6 months after. Data was analyzed with SPSS software program 89.2% of participants were married and 10.8% were single. 63.5% of them were in the20-40 years age group. Most commonly abused substances were heroin and opium. Before onset of treatment, 37.6% of participants had history of imprisonment, 35.5% had shared injections, 32.3%had had unprotected sex, 22.6%had tattooing and 5.4%had mutilated their own selves. Only 36.6% didn’t have any high risk behavior. These behaviors were more common in heroin users and in the20-40 years age group. After onset of treatment and during 6 month of MMT, 86% of clients didn’t have any risky behavior. Only 14%of them continued to have unsafe sex behaviors Addiction can cause high risk behaviors. Data in this paper suggests that young age, heroin use, low education level and no or inadequate information about addictive substances and their consequences are effective and important factors that cause high risk behaviors. Treatment of addicts with methadone maintenance therapy plays an important role in reduction of risky behaviors. Development of appropriate and more MMT centers are recommended.

Methadone maintenance therapy is a well-known approach to the treatment of drug use disorders and harm reduction. But the main challenge is retention rate in MMT Through simple random sampling, 155 addicts aged between 18-60 years who referred to drug addiction center of university and underwent MMT were followed for at least one year and up to two and half years. Of the total, 3.9% female, 62% married, 37.4% workers and 27.1% were jobless. 80% had education level of less than diploma, 43.2% abused marijuana, 54.2% abused alcohol and 49.7% were living in rented houses. 60% referred to this center because of economical problems, 15.5% because of legal issues and 67.7% because of family pressure. 31.6% were opium and opium resin addicts, 60% were heroin addicts, 8.4% were crack addicts and 21.9% were IV abusers. 76.8% had at least one high risk behavior. Average dose of methadone was 86.5+35 mg/day. Mean survival time was 80 weeks. Relapse rate was 3.3% in the first month, 13.9% in three months, 23.2% in six months, 31.7% in first year and 41. 7% was a total relapse rate. Survival rate had a direct significant statistical relationship with the age, type of drug and method of use. According to the results of the present study that indicate a survival rate of 68.2% in a year and 58.3% after a year and also considering the results of other studies, we can conclude that MMP could be an effective method in the treatment of opiate drug disorders.

Child abuse includes; abuse of the body, mental and sexual abuse or misbehavior against children that leads to damage to the child's heath and comfort. Therefore, the present study was done in order to determine the prevalence of child abuse in opiate addicts referring to addiction withdrawal centers. The cross sectional study included 300 participations (150 addicts and 150 non-addicts) The addicted group comprised of opiate addicts referring to addiction withdrawal centers of Yazd. The non addicted group was selected randomly from healthy people. Data collection was performed via a standard questionnaire. Data assessment was done via statistical analysis (K S) Collected data in the addicted group showed the following results; about 56 percent were child tormentors, 1- 45.3% males, 10.7% females, 2-18.7% uneducated, 3-46% with divorce history in their family and 4-38% child body abuse. The most prevalent type of the body abuse was slapping (24%), mostly because of bad training (26%). Collected data in the no addicted group showed the following results; 42% were child tormentors (26% male and 15.3% female) 23.4% with family divorce history, 30.4% were child body abuse and the most prevalent type of body abuse was slapping (22.79%), mostly because of bad training (33.3%) A direct relationship was observed between child abuse and persons addicted to opiates. Factors playing an important role include; illiteracy, divorce history in the family and history of child abuse in childhood period. Therefore, compilation of rules supporting children, establishment of support and parent education centers can be effective to reduce child persecution.

Child abuse and neglect of children referred to the physical, psychological, emotional or sexual abuse, these circumstances result in detrimental impacts on health, welfare and education of children. Based on these considerations, the present study was conducted to investigate the prevalence of child abuse among addicts referred to the Rafsanjan Addiction Withdrawal Center in 2005. In this cross sectional study, 648 addicts randomly selected. A questionnaire was completed for each particpant and the data were then analysed using X2 test. The findings of this study showed that 81.9% of the participants were child abusers and 87.8% of them were 41-60 years old. The percentages of child abuse found in the participants with a history of parenteral drug-abuse, addiction in their families, divorce, physical harassment, and neglect during their childhood were 93.3%, 89%, 95%, 90.9% and 87.9% respectively. Slapping (17.86%) and deprivation of talking and attention (16.44%) were the most common type of physical child abuse and neglect. In 20.82% cases, the child abuse occurred at the withdrawal period of addiction. The most frequent feelings after child abuse for the child abusers were regret and sadness (36.87% and 35.25% respectively). This study showed that there is a direct relationship between child abuse and addiction to opiates. Also there are other factors related to child abuse including level of education, economic situation, a history of addiction and divorce in the family of child abuse victims. Therefore, the necessity of an organized care system for children and addicted parents and regulating of suppportive rules are obvious and of superme value.

Neonates have complete insight into the pain. Pain not only causes physiologic and emotional alteration in neonates but also has long-term detrimental effects. Circumcision using dorsal penis nerve block is one of the most common surgical procedures in male neonates. Despite this method is effective, it has few complications. For instance, there is the risk of injecting lidocain in the vein and also there is the possibility of formation of hematoma on the injection site. However, lidocain spray does not cause these complications. The present study is conducted to compare the effect of these two methods on the level of pain after circumcision. This randomized clinical trail study was conducted on 54 neonates who were circumcised. Of these, 25 neonates were anaesthetized using lidocain spray 10%. The remaining (n=29) were received dorsal penis nerve block for the local anesthesia. The severity of pain was measured using Neonatal Infant Pain Scale (NIPS) in three different occasions when the circumcision procedure was being condacted (time 0), and 15 and 30 minutes after circumcision. Mann Whitney U test and t-test were used for comparing the severity of pain in the two groups. In both groups severity of pain was decreasing over the time. The severity of pain among those who received dorsal penis nerve block was less than that of neonates in the other group in both occasions during circumcision (time 0) and 15 minutes after circumcision. However, there was no significant difference of pain severity between the two groups 30 minutes after circumcision. During circumaision and 15 minutes after the procedure, the effect of lidocain spray on the pain of circumcision was less than the effect of dorsal penis nerve block. However, 30 minutes after circumcision the effect of lidocain spray on the pain was comparable with the effect of dorsal penis nerve block method. It can be concluded that regarding the physiological and emotional responses after circumcision, in comparison with lidocain spray, dorsal penis nerve block can be a more effective method for relieving the pain caused by circumcision. However, more investigations are needed to study the side effects of this method.