مجله سلامت و بهداشت
سال هشتم شماره 3 (پیاپی 32، تابستان 1396)

Antibiotics considered a major problem into the environment due to their accumulation feature and drug resistance. The aim of this study was optimization of ciprofloxacin antibiotic sonochemical degradation in US/PS/nZVI process by Central Composite Design method.
In this experimental study the effects of independent variables such as pH of solution, PS and nZVI concentrations on antibiotic degradation were investigated. After optimization, the synergistic degradation and the effect of detention time was determined. Antibiotic concentration was constant at 50 mg/L for all the samples. Antibiotic concentration was measured on the basis of COD reduction according to 5220 C of Standard Methods. For characterization of prepared nZVI particle, the transmission electron microscope image (TEM) was used.
The results indicated the pH as a principal variable with the optimal value of 4.5 for this process. At initial concentration of 195 mg/L COD (equal 50 mg/L antibiotic), the optimal concentration of PS and nZVI were obtained at 1200 and 120 mg/L, respectively. At this condition removal efficiency of 57% was obtained after 60 min. At optimal conditions for US/PS/nZVI process the synergistic degradation was almost 42.55%. In investigating the effects of detention time, 94% of COD was removed after 180 min.
The results of this study confirmed the acceptable efficiency of US/PS/nZVI process in degradation of ciprofloxacin antibiotic.

The presence, identification, and removal of bacterial pathogens in water and wastewater are the most important health concern. The aim of this study was to identify two important pathotypes of E. coli (enterotoxigenic and enteropathogenic) in hospital, dairy, slaughterhouse, and municipal wastewater treatment plants of Kermanshah city.
In this descriptive study, 64 samples were collected from six wastewater treatment plants under sterile and standard conditions and transferred to the microbiology laboratory. E.coli strains were isolated and ETEC and EPEC patotypes were identified using PCR method.
The differential culture results showed E. coli strains in 90.62% of the 64 studied samples. ETEC strains were identified in 42.85, 33.3, 0, 28.6, 0, and 25 %of the influent and in 20, 0, 0, 16.6, 0, and 20% of the effluent samples taken from municipal , Imam Reza hospital, Farabi hospital, dairy plant, Mohammad Kermanshahi hospital, and slaughterhouse wastewater treatment plants, respectively.
The results showed the presence of pathogenic Enterotoxigenic E. coli in effluent of hospital and municipal wastewater treatment plants and Enteropathogenic E. coli in slaughterhouse effluents. Considering the presence of enterotoxigenic patotype in wastewaters, the importance of removing indicator coliform strains in wastewater treatment plants is highlighted. Therefore, serious measures should be taken to improve efficiency of the systems.

Diabetes is one of the most common health problems in the world that can be controlled through educational programs. Therefore, this study was carried out to evaluate the effect of educational intervention based on extended theory of reasoned action on self-care behaviors in patients with type 2 diabetes.
In this quasi-experimental study, 90 patients with type 2 diabetes were assigned into experimental (45 people) and control (45 people) groups using stratified randomization method. Data collection tool was a questionnaire based on the extended theory of reasoned action and self-care behaviors. Data were collected before and 3 months after the intervention. Data analyses were performed by parametric statistical tests using SPSS-20.
The results showed that mean scores of all structures of extended theory of reasoned action has increased significantly in the intervention group after educational intervention (p0.05). Educational intervention had also significant effect on promotion of self-care behaviors in patients of the intervention group.
The findings of the current study showed that designing interventions based on extended theory of reasoned action can be an appropriate framework to improve self-care behaviors in patients with type 2 diabetes.

Staying at Behvarz position in all the employment period, lack of job promotion, and need to reside in the village can increase burnout in this occupational group. The aim of this study was to determine relationships between job burnout and socioeconomic factors among Behvarzes in Golestan province.
All the 1141 Behvarzes participated in present cross sectional study. Data were collected by Maslach Burnout questionnaire for which the reliability and validity were already confirmed. Data were analyzed by Multinomial Logistic Regression test at a significance level of 0.05 using SPSS-16.
There were significant correlations between intensity of job burnout and income dissatisfaction, job disaffection, number of children, age, years of services, the city where they working, and decrease in level of education. Frequency of job burnout significantly correlated with housing conditions, place of residence, the city where they working, job disaffection, income dissatisfaction, age, years of services, and decrease in level of education.
It is necessary to apply appropriate interventions on Behvarzes who dissatisfy from their job and income, have more children, have lower education, and are older and more experienced than others.

Considering chromium major risks such as lung and skin cancer, and also sever effects on kidney and liver; present study was conducted to investigate removal of Cr(VI) using zeolite clinoptilolite from aqueous solution.
Zeolite clinoptilolite with the size of 4 mm was used to remove Cr (VI) from aqueous solution in present study. Potassium dichromate (K2Cr2O7) and double distilled water were used to prepare aqueous solution of Cr(VI). Residual concentrations of Cr(VI) were measured by a spectrophotometer at 540nm.
The results showed that increasing absorbent mass increased removal capacity and equilibrium time. Decreasing pH from 11 to 4 increased and from 4 to 2 decreased chromium removal efficiencies. Optimum time for zeolite contact was 70 min. In overall, pretreated zeolites (nZVI -modified zeolites) had the highest adsorption (i.e.85%) for Cr(VI), however, adsorption rate for untreated zeolites was less than 25%.
In general, the results show that zeolite modified by nZVI is a high efficiency method to remove Cr(VI) from groundwater.

Health and behavior are related to each other and many diseases are originated from individual's unhealthy behavior and habits. Therefore prediction or determination of the behavior is useful to explore effective measures to promote health and reduce risk of the diseases. This study was aimed to determine the effective factors on healthy nutritional behavior of health volunteers based on precede proceed model.
This research was a descriptive, analytical and cross-sectional study. Research population was all the 153 active health volunteers in Rasht urban health centers and health posts in 2015. Data collection tool was a self-report, reliable and valid questionnaire. Data were analyzed with descriptive and analytical statistics using SPSS18.
The mean age of the health volunteers was 43.03±9.11. All Precede Proceed model structures including: knowledge (β=0.296, p Attitude, knowledge, reinforcing, and enabling factors were respectively the most effective factors on nutritional behavior. Attitude and enabling factors status were desirable and other constructs were in moderate level. Considering positive correlations between Precede model constructs and nutritional behavior of health volunteers; appropriate educational intervention based on Precede Proceed Model is recommended to promote nutritional behaviors.

Nitrate is used as a chemical water quality indicator. Therefore, nitrate removal from contaminated water is considered as an important health and environment issue. The aim of this work was investigation of nitrate adsorption from aqueous solution by Local Green Montmorillonite (LGM) as a novel adsorbent.
This study was conducted in a laboratory batch reactor. The most important variables affecting adsorption process were investigated and adsorption kinetic and isotherms were determined. Spectrophotometer was used for nitrate measurement and adsorbent characteristics were determined by BET, SEM and FTIR examimations. Data analysis was performed by excel software.
The results showed the optimum pH=1.5 and nitrate adsorption increased by increasing contact time and adsorbent dosage. The adsorbent specific surface area of 13m2/g was obtained and FTIR test revealed the functional groups existing on adsorbent surface to have important role in nitrate adsorption. Experimental data was well fitted by pseudo second-order kinetic model. Langmuir isotherm model best represented the experimental data to describe adsorption process and the maximum nitrate adsorption capacity was 89 mg/g.
Overall, data showed that the Local Green Montmorillonite can efficiently remove nitrate from aqueous solution.

This study was conducted to investigate the principal causes for condemnation of broiler breeder carcasses in Namin slaughterhouse in 2014 to prevent diseases common between human and poultary.
Condemned carcasses, their weight, and the reasons for condemnation were characterized by outward signs and gross lesions through frequent inspection of slaughterhouse and monitoring slaughter chain.
185722 poultry were slaughtered with a live wight of 724620 Kg during these hygienic inspections. Out of these, 3829 carcasses, accounting for 2.06% of total slaughter with overall weight of 4680 Kg, were condemned due to different reseaons; 14 (0.36%) due to synovitis and arthritis, 151 carcases (3.94%) because of chronic respiratory disease, 164 (4.28%) for cellulite, 168 (4.39%) for poisoning, 221 carcases (5.77%) due to ascite and peritonit, 415 (10.84%) while transporting, 816 (21.31%) from septicemia, and 1880 (49.10%) due to cachexia. Cachexia and septicemia were two most causes for condemnation accounting for 70.41% of condemned carcasses and 1.45% of total slaughters.
The results of this study showed that the majority of condemnations are caused by diseases which are important in terms of public health. Therefore, improving disease prevention and control programs on farms is necessary.

Increasing mean age of the Iranians has caused the elderly to contribute to significant proportion of the population. In addition to increase in dental and periodontal problems, the occurrence of oral lesions among them may also increase. This study was done to evaluate prevalence of oral lesions among elderly in Yazd Nursing Homes.
In this descriptive-analytic cross sectional study, all the elderly aged over 65 years that inhabit in Yazd province Nursing Homes were evaluated. Their clinical data were collected from their medical files. Their oral and dental status were investigated and recorded through oral examination. Data were analyzed by chi- square and fisher exact tests using SPSS-17 software.
Of the 267 participants, 93 subjects had oral lesions. Of the 177 elderly females participating in the study, 56 and out of 90 elderly males, 37 had oral lesions. Among 267 participants, 7 subjects had natural teeth, 84 persons had dentures and 174 persons have no natural teeth or denture and the difference between groups was significant. 28 persons were smoker, and among these 11 individuals had oral lesions; but no significant correlation was observed.
Due to oral manifestation of some diseases and high incidence of malignant and premalignant oral lesions at old ages, periodic oral checkup in elderly people especially those living in nursing homes is necessary.

Hospitals are the most important healthcare institutions consuming major portion of national health budgets. High operating costs, inefficient, excess capacity of hospitals have increased the necessity for appropriate use of the resources. Many countries use downsizing strategy based on a strategic direction to solve these problems. This study was conducted to design a downsizing model in hospitals of Tabriz University of Medical Sciences.
This research is a qualitative three stage study. First stage was systematic review on hospital downsizing methods using defined keywords. The second stage was holding three focus group discussions. At this stage individuals were selected based on objective sampling method and the data were analyzed using content analysis. Finally, designed downsizing model was finalized based on results of the previous stages using three steps Delphi technique.
The results showed that many countries widely use different methods of hospital downsizing. Participated experts in focus group discussions emphasized on integration and outsourcing (as the methods for hospital downsizing) and meeting general and specific requirements for the method implementation. Determining success indicators and prioritizing hospital units that are subject to integration and outsourcing were other components of downsizing model.
Downsizing is one of the methods that can be used when health organizations encounter with limited resources. However, the success of this method depends on careful planning and appropriate implementation of model steps

Considering conducted studies on trust, health, and organizational entrepreneurship along with the lack of study on relationships among these three important organizational factors; present study aimed to survey correlations among organizational health and trust and entrepreneurship of employees.
This study was a correlational survey. The statistical population included 180 employees of Hamedan district and province health centers who were studied by questionnaire using census method. 122 of the completed questionnaires were reliable. Robbins and Coulter standard questionnaire with 22 questions was used to measure entrepreneurship variant and for the organizational trust and health a researcher-made questionnaire with 30 questions was administered. Reliability and validity were measured on the basis of Cronbach’s alpha and panel of experts. The collected data were analyzed by Pearson correlation coefficient, T test and regression analysis using SPSS software.
The results of the study show that there are positive significant relationships between organizational trust and organizational health as well as the organizational health and entrepreneurship. However, no significant relationship was found between organizational trust and entrepreneurship.
Regarding the results of the study, some comments were given to managers to improve entrepreneurship through increasing organizational trust; with the hope to open new opportunities for further studies.