مجله سلامت و بهداشت
سال نهم شماره 2 (پیاپی 36، بهار 1397)

Pollution of water sources with pesticides is one of environmental problem that threatens the health of communities. The aim of present study is the determination of residual organic phosphorous pesticides including diazinon, malathion, chlorpyrifos and glyphosate in surface and ground water on Kermanshah province (2015).
In this cross sectional-analytic study, 50 water stations in 5 geographical regions (north, south, east, west and central) was surveyed. Pesticide measurement was accomplished by extraction of liquid phase and mass gas chromatography. Data is analysis by SPSS software.
The residual organic phosphorus pesticides were not observed in any source of springs and aqueducts. The highest average residue (µg/L) of diazinon, chlorpyrifos, glyphosate and malathion were 1.45±0.2, 6.84±0.28, 0.005±0.001, 1.01±0.012, respectively. The wells at the central station was the highest and mirage in the in the northern station was the lowest total pesticide residue. The remaining amount of glyphosate was lowest. The total residues of glyphosate and malathion pesticides in the wells was below the maximum permitted concentration set by the European :union:.
Regarding the concentration of total organic phosphorus pesticides in the studied wells over the maximum permitted concentration of the European :union:, in the absence of control of the use of pesticides, the lack of regular monitoring of this important source of water and preventive programs for the health of water users in Kermanshah province with a serious threat.

Salmonellosis is an important zoonotic disease in worldwide that causes food-borne disease, gastroenteritis, enteric fever and bacteremia in humans. The purpose of this study was to determine the prevalence of salmonella common serotypes in broiler flocks of Ardabil province and their antibiotics resistance rate to five antibacterial agents widely used in the Iranian medical field.
One-hundred and eighty nine samples including 70 liver, 70 heart and 49 intestine were collected for identification of salmonella. After microbial culture and isolation, serotyping with O monovalent and H monovalent antisera was performed. The antibiotic resistance rate of isolates was determined by disc diffusion test.
7.93% samples were positive to Salmonella spp. The most common serotypes isolated from positive samples were Salmonella enteritidis (86.6%), Salmonella typhimurium (6.7%) and Salmonella thompson (6.7%), respectively. The highest isolation of Salmonella was observed in liver (40.0%), then in intestine (33.4%) and heart (26.6%). In view of salmonella contamination in different seasons, the highest rate of prevalance was in winter (p The results of this study show the dominant serotype was Salmonella entritidis and the high frequency of resistance to the three drugs tetracycline, cotrimoxazole and amoxicillin widely used in the Iranian medical field. These findings are important for public health.

One of the important stages in women's life is pregnancy, which causes a lot of physiological changes and it can cause to complications in pregnant women. The aim of this study was to evaluate the effect of nutrition education on the improvement of complications in the third trimester in mothers referring to Ardabil health centers.
This study was a intervention and was conducted on 330 pregnant women who referred to Ardabil health centers in 1395 in two groups of case (110) and control (220). A researcher-made questionnaire was used to collect of data which includes 22 questions about demographic variables such as age, mother's occupation, income, level of education and type of pregnancy, diabetes and knowledge and practice. Data were analyzed by descriptive statistics, t-test and ANOVA by using of SPSS-16 software.
There was a significant difference between the use of multivitamin and iron in the case and control groups. However, there was no significant relationship between education and occupation between the two groups. Also, before the intervention, the knowledge and practice of the test and control group were low, but after intervention, the knowledge and practice of the test group increased significantly. But, the increase in control group's score in terms of performance was not significant.
Considering the effectiveness of nutrition education in improving pregnancy complications it should be used from all media to education of pregnant womens.

Health tourism is one of the types of health service trades. Iran has high potential in developing this field. The aim of the current study was investigating the relationship between medical curative tourism and the rate of tourism attraction in Ardebil province.
current study was an applied one with descriptive-analytical method of study. Samples were statistically estimated and study setting included 8 public and 2 private hospitals, mineral spas, residential places (hotels, inns and guest rooms) of Ardebil. Data gathered using a check list prepared by the researcher regarding the terms and regulations of the centers for health tourism, an standard checklist of evaluation of the international patients unit medial institution of Ministry of Health that its face validity approved by the experts. To implement the field research, 3 samples of each hospital with total of 30 check-lists and 99 controls were prepared by health tourism experts of the university, funding department of the hospital and the researcher. For data analysis, Cosmograph-Smirnov test used to determine the normality and multi-variable regression and Pearson Correlation test used to measure the relationship between variables using SPSS Statistical software.
Results of the study indicated that the highest and lowest mean were related with having general qualifications of tourism attraction (1.85) and lower costs and ability to communicate (1.26), respectively. Among variables of medical therapy tourism (country status, condition of hospitals, medical team condition and the mineral spas condition), the general condition of the hospitals and the condition of medical team had no meaningful relationship with the rate of tourism attraction. Therefore, the general hypothesis was confirmed that there was a significant relationship between medical tourism and the rate of tourism attraction in Ardebil province (p Results of the study indicated that among different factors of country status, condition of hospitals, medical team and the mineral spas, the factor of hospital condition due to the lower gradation and standards of the Ardebil hospitals and the factor of medical team condition due to poor understanding and awareness of the medical team of the regulations and their poor ability in obtaining the required skills, no significant relationship found between medical tourism and the rate of tourism attraction in Ardebil province. Therefore, it is suggested that the authorities in the field of health and tourism help in more development of this industry by providing the necessary substructures of this sector and execution of macro politics.

Quality of health services is one of the main concerns in worldwide. Clinical governance as a new approach has been introduced to improve quality of health care delivery. In addition, nurse performances play an important role in patient satisfaction. This study aimed to evaluate the effect of clinical governance on the performance of nurses.
This descriptive-correlational study was conducted in Ardabil Imam-Khomeini teaching hospital. 217 nurses were randomly selected to participate in this study. Clinical governance and nurses’ performance were evaluated using a questionnaire. Collected information were analysed using SPSS.
In this study, the average score of clinical governance in all dimension and the mean score of nurses performance in all dimensions were 60.57 and 32.09 , respectively. There was statistically positive correlation between clinical governance and performance of nurse.
Findings revealed that clinical governance has statistically positive effect in the performance of nurse in the fields of knowledge, ethic and behavior.

Inappropriate nutrition places employees at risk of being overweight or obese, and not only affect their health but also indirectly may affect patients. The trans-theoretical model is one of the most common models of health promotion. It is recognized as one of the ways of identifying and changing diet, especially increasing the consumption of fruits and vegetables. In this model, behavioral changes can be seen in stages. Therefore, this study designed to determine the status of cognitive and behavioral processes and its stages of change for fruit and vegetable consumption.
This cross-sectional study was conducted with the participation of 300 nursing and midwifery staffs of Ardabil hospital using systematic random sampling method. Data gathering instrument was a validated questionnaire to collect information on demographic characteristics, stages and the process of change for fruit and vegetables consumption. The data was analyzed by SPSS (ver. 23) to measure central tendency, spearman correlation test, ANOVA, and Post-hoc.
Average age and BMI of participants were 31±7.05 and 25.7±3.5 respectively. The majority of subjects (77.3%) were in the early stages of change (pre-contemplation, contemplation, and preparation) for fruit and vegetable consumption while, only 22.7% was in active stages (action and maintenance). The mean scores of cognitive and behavioral processes were at a higher level in the maintenance stage and the lowest in the contemplation. Finally, the mean scores of social liberation, environment re-evaluation, self re-evaluation, stimulus control and counter conditioning processes increased from the inactive stages to the active stages.
Findings support the effect of processes of change in fruits and vegetables consumption among nursing and midwifery staffs, so that using behavioral process of change such as stimulus control and self liberation can lead to positive progress in stage of change. We suggest educational programs to increase consumption of fruits and vegetables, particularly considering individuals’ current stages and processes of change.

Bacterial bio-aerosols are considered to be one of major harmful agent for respiratory tract diseases. It plays an important role in the development of various infections. In this study, we aimed to investigate the exposure of municipal waste workers to the bacterial bio-aerosols in work areas.
This cross-sectional study was carried out among municipal waste workers in Ardabil 2017 of whom 83 persons were randomly selected. ZTHV02 sampler was used to collect a sample from breathing air. The average sampling time was 10 minutes. The collected samples were cultured in agar medium plate containing Cyclohexamide antibiotic after 48 hour's incubation.
Average total concentration of bacterial bio-aerosols in respiratory was 48 CFU/ m3 with a minimum and maximum of 7 and 242 CFU/ m3 respectively. The highest exposure was observed in sanitary workers while those working as a truck driver were at lower risk. The most common bacteria observed in this study were Pseudomonas, Escherichia coli and Enterococcus.
Sanitary workers are at risk of high exposure to the bacterial bio-aerosol which can affect their health status.

Dyes are one of the most important existing pollutants of textile industry wastewater. They are often toxic, carcinogenic, teratogenic, and non-biodegredable. This study was conducted to evaluate efficiency of Steel/Pb/PbO2 electrode in the removal of Reactive Blue 29 and Reactive Red 198 Azo dyes from aqueous solutions using Electrochmical Process.
Concentration of colors was measured before and after Electrochemical Process. Moreover, the intensity of the electric current, the reaction time, the pH, and the initial dye concentration were measured on the efficiency of the removal process and the amount of electrical energy consumed.
The results of the experiments showed that the process efficiency increased by increasing reaction time and electrical current intensity. It was also decreased by increasing pH and initial concentration of color. Under constant operating conditions (pH=4, electric current intensity of 0.5 mA cm2, reaction time of 60 minutes and color concentration of 150 mg/l), the efficiency of this process were 94% and 88% in the removal of Reactive Red 198 and Reactive Blue 29, respectively.
According to our findings, the Electrochemical Process with Steel/Pb/PbO2 was very efficient and economic process in removing color from wastewater.

Intellectual capital is a new field in management that has a special place in administrative issues. Weaknesses in the management of intellectual capital lead to a loss of about 60 percent of real potential of companies. Therefore, managers have found it as the most important source of competitive and value creation in the organizations. This research was designed to investigate the status of the three dimensions of intellectual capital (human, structural and customer) in two levels of organizational excellence within selected teaching hospitals of Tehran University of Medical Sciences.
In this cross-sectional study, the sampling framework was teaching hospitals of Tehran University of Medical Sciences in 2011. The research was carried out through a census method and information was collected using a questionnaire. To determine the reliability of the test-retest, the correlation coefficient and ICC index were used. In addition, the internal consistency measured by Cronbach’s α.
The human dimension of intellectual capital in Hasheminejad and Farabi teaching hospitals were in top rank as they appreciated by crystal trophy for high level of organizational excellence. The structural dimension was high in Farabi and medium in Hashemi-Nejad hospital. Finally, in customer dimension Hashemi-Nejad was evaluated as high level and Farabi as medium level teaching hospital.
Managers of teaching hospital are mostly unfamiliar with the concept of knowledge management, particularly, intellectual capital. Thus, training programs for them and other staff will improve service delivery in such organization. It is recommended to evaluate intellectual capital routinely in the hospitals. Establishment of organizational excellence leads to the identification of the organization's strategy, clarification of processes, attention to the employees and customers’ satisfaction, which all contribute to the promotion of intellectual capital.

The concept of the competence in schools as an educational organization is different from other organizations. Mental health is one of the components of leadership competence that helps to improve quality of services in different setting particularly in the educational organization. Despite importance of this competency, it has not been completely evaluated. Therefore, this study was conducted to identify the effective high schools competency components of having a mental health approach.
This study was conducted using sequential exploratory mixed method. The sampling framework of this study was the Ardabil’s public high school principals with work experience more than 5 years. Information was collected primarily by focus group and indepth interview. Later 178 subjects were interviewed using a 5_degree Likert questionnaire with 56 items. Data were analysed using the SPSS-22 & Amos softwares.
Resultes: According to this study, there is four components, (knowledge, skills, attitude & mental health) for effective school leadership competencies. Mental health with six sub-components is the highest priority in terms of importance with 98.16% of respondents from focus groups. The fitting index of this component with the 30.44 indicates its suitability for fit.
In order to increase the productivity of work force, it is necessary to do some revision in schools to promote mental health. These changes are; facilating legal conditions for appropriate staffing in school, as a learning / teaching organization, revision of student selection criteria at "University of Farhangian" to select candidates who are likely to demonstrate higher quality in their future careers. Revision of Article 46 of the State Service Act, focusing on mental health, graduation and recruitment of an employee under the title of director and finally providing facilities to improve mental health of manpower in the school for better performance.