مجله تحقیقات سلامت در جامعه
سال پنجم شماره 4 (زمستان 1398)

Air pollution has been recognized as the most important environmental risk factor worldwide. Benzene which is one of the four pollutants attributed to BTEX (Benzene, Toluene, Ethylbenzene, and Xylene) has been proven to be a carcinogenic component. These pollutants can be easily absorbed and taken into the body via inhalation. With this background in mind, the present study aimed to investigate the concentration of benzene and its zoning in Tehran air using Geographic Information System (GIS)  within 2016-2017.

In the present study, 26 sampling stations were selected in different parts of the city and sampled in four seasons to determine benzene concentration, as well as other meteorological parameters, such as temperature, humidity, and wind velocity. Thereafter, the obtained data were analyzed in SPSS software (version 22) using the one-way analysis of variance and correlation. Subsequently, modeling of pollutant distribution was performed using ArcGIS software. 

The obtained results demonstrated that in terms of location, the maximum and minimum annual mean concentrations of benzene were calculated at 45.12±15 and 12.36±8 μg/m3, respectively, in the center and north of the city. Temporally, the maximum and minimum values were measured at 47±17 µg/m3 in autumn and 9.82±7 µg/m3 in spring, respectively. Statistical analysis revealed that emission of this pollutant showed a significant relationship with geographical direction and wind velocity (P<0.01).

The average annual concentration of benzene in different geographical areas of Tehran was higher than the standard values of clean air. Therefore, it is suggested that fundamental measures be implemented to control this chemical compound.

Students’ perceptions of the learning environment play a vital role in the process of education, buoyancy, and academic performance. This study aimed to investigate the capability of explaining the academic buoyancy and academic performance of health students of Semnan University of Medical Sciences, Semnan, Iran, based on their perception of learning environment.

The statistical population of this descriptive-correlational study consisted of all health students who were studying at Semnan University of Medical Sciences, Semnan, Iran, in the academic year 2018-19. A total number of 138 students were selected through systematic random sampling. The data were collected using a Dundee Ready Educational Environment Measure (DREEM), academic buoyancy questionnaires, and grade point average. Moreover, simple and multiple regressions were used for data analysis. 

The results showed that 16.1% (R=0.408, R2=0.167, Adjusted R2=0.161, F=27.212, P<0.01) of the variance of academic buoyancy can be explained by the overall score of students’ perception of the learning environment. Furthermore, according to the regression coefficients, the subscale of students’ perception of educational climate had a significant role in explaining academic buoyancy. According to the findings of the study, 13.3% (R=0.373, R2=0.139, Adjusted R2=0.133, F=21.971, P<0.01) of the variance in academic performance could be explained by the overall score of students’ perception of the learning environment. In addition, the subscales of students’ perceptions of learning and social conditions of education had a significant role in explaining academic performance.

Given the positive role of perception of the learning environment in explaining academic buoyancy and academic performance based on the study findings, it is very important to conduct comprehensive assessments, identify strengths and weaknesses, and perform educational interventions to enhance students’ perception of the learning environment.

Head lice as external parasite contamination is one of the health-threatening issues that despite the upgrading of health, is still a health problem.

This clinical trial study was carried out on 3062 elementary school female students examined for head lice infection in Mashhad, Iran, using cluster-randomized sampling method. The infected individuals were divided into six treatment groups. Three types of drugs, including lindane 1%, permethrin 1%, and dimethicone 4%, along with vinegar were used in this study. The results of the treatment were recorded after 7, 14, and 21 days during the reanalysis of the students. The results were analyzed by the Chi-square test and logistic regression.

The results showed that 417 (13.6%) students were infected with head lice. The levels of efficacy in the treatment groups of permethrin 1%, lindane 1%, and dimethicone 4% were 27.2%, 31%, and 30.4% after 1 week of treatment, 83.2%, 69.8%, and 69.6% after 2 weeks, and 96%, 91.5%, and 91.4% after 3 weeks, respectively. The levels of the effectiveness of the shampoos with vinegar were 64.2%, 96.1%, and 67.6% after 1 week, 90.6%, 100%, and 100% after 2 weeks, and 100%, 100%, and 100 % after 3 weeks, respectively.

According to the obtained results of this study, permethrin 1% and dimethicone lotion are recommended for the elimination of head lice contamination in children. Moreover, the efficacy of permethrin 1%, lindane 1%, and dimethicone 4% after 3 week, compared to their use, along with vinegar was shown to be 100%.

Poor medication adherence may result in adverse outcomes, such as a higher rate of hospitalization and increased costs of healthcare. In this regard, the present study was designed to determine the relationship between cognitive status and medication adherence among elderly patients with hypertension.

In this cross-sectional study, 180 elderly patients with hypertension were selected from Imam Reza Hospital in Amol, Iran, (2018) using convenience sampling. Cognitive impairment and medication adherence were assessed using the Cognitive State Test and Morisky Medication Adherence Scale, respectively. The data were analyzed by SPSS software (version 16) using the independent t-test, Chi-square test, and logistic regression. 

Out of 180 participants, 66.1% (n=119) of them were female. The mean age of the patients was 72.87±7.63 years. The mean values of medication adherence and cognition score were reported as 5.21±2.29 and 26.03±3.21, respectively. There was no significant relationship between medication adherence and total cognition score (P=0.322). Medication adherence was two times higher among those who were reported with no anxiety, compared to those who suffered from anxiety (β=-0.67; odds=0.51; P=0.008). The obtained results also showed medication adherence increased twelve times with one unit increase of verbal fluency. Moreover, medication adherence enhanced eight times with one unit increase of abstract thinking and judgment.

The subdomains of cognition, such as verbal fluency, as well as abstract thinking and judgment, had a significant relationship with medication adherence in elderly patients with hypertension. In this regard, it is suggested to assess cognitive status among elderly patients with hypertension and design appropriate interventions.

Risk assessment of toxic or hazardous chemicals enables industrial hygienists to make appropriate decisions regarding management provisions in a healthy workplace. Exposure to total fumes and manganese during welding can have harmful effects on welders’ health. Therefore, the present study was conducted in the metal industry to evaluate the concentration and determine the risk of welders’ exposure to total fumes and manganese in 2018.

In this descriptive-analytical and cross-sectional study, welding fumes were sampled in the breathing zone of 35 welders using filters and cyclones moreover, the concentration of fumes was determined by a weight method. The samples were analyzed according to NIOSH 7301 method using an Inductively Coupled Plasma-Optical Emission Spectrometry to determine the manganese concentration in the fume. Moreover, health exposure risk assessment of workers exposed to welding fumes was performed using the recommended method by the Singapore Health and Safety Association method. The data were analyzed in MINITAB software (version 17). A p-value less than 0.05 was considered statistically significant.   

The mean concentrations of total fumes and manganese produced in Shielded Metal Arc were 9.56±1.67 and 0.45±0.08 mg/m-3, respectively. These values are about 2 and 22 times higher than the recommended occupational threshold limit for total fumes and manganese according to the American Conference of Governmental Industrial Hygienists, respectively. The risk assessment results showed that the mean values of exposure to total and manganese fume for the welders were moderate and high, respectively.

Due to the high level of welders’ exposure to manganese during welding in the metal industry, preventive measures, such as engineering and management control techniques are recommended to reduce exposure to these fumes.

Diabetic retinopathy is the most common cause of blindness in adult diabetic patients. Therefore, it is necessary to provide patients with appropriate training programs, such as multimedia education as a new and effective method to enhance their understanding of self-care. This study aimed to evaluate the effect of multimedia education on disease perception and eye care performance in type 2 diabetic patients  referring to Birjand Diabetes Clinic in 2019.

This controlled clinical trial included 70 patients who were divided into two groups according to the inclusion criteria.The intervention group received 4 multimedia educational sessions (one session per week). The relevant parameters were measured before and after the intervention . Moreover, the data were analyzed in SPSS  software (vesrion18).   

The results of this study showed a significant difference before and after the intervention in the case group in terms of the mean score of eye care performance (P=0.005). Moreover,  a significant difference was observed  before and after the study regarding the mean diastolic pressure in the case group (P=0.05). However, there was no significant difference between the two groups before and after the intervention in terms of the mean score of perception of disease (P=0.35), blood glucose changes (P=0.13), hemoglobin A1c (P=0.86), and systolic blood pressure (P=0.89).

In this study, the implementation of multimedia method improved the performance of eye care in diabetic patients. Therefore, it is recommended to use this educational method to improve self-care in type 2 diabetic patients.

One of the most important factors in the contamination of aquatic ecosystems is agricultural pesticides. Paraquat is a water-soluble and non-selective herbicide, which has adverse health effects, such as respiratory distress and even death. This study aimed to evaluate the degradability of paraquat toxins using photochemical oxidation processes based on hydrogen peroxide (UV/HP) and persulfate (UV/NaPS/Fe2 +).

This experimental study investigated the effects of pH variables, concentrations of UV/HP and UV/NaPS/Fe2+, as well as the initial concentration of the pollutant on paraquat toxicity removal in a laboratory scale using a batch reactor of one liter. Moreover, the concentration of the residual paraquat and the amount of organic carbon removal were measured using High Performance Liquid Chromatography equipped with a visible Ultraviolet (UV) detector at 259 nm and a Total Organic Carbon (TOC) meter.   

The UV/HP and UV/NaPS/Fe2 + processes were able to remove 87.75% and 92.31% paraquat, respectively, at 120 min under optimum conditions. In addition, the amount of TOC removal in the UV/HP and UV/NaPS/Fe2 + processes  were 77.29% and 82.16%, respectively. The results showed that the kinetics of the UV/HP and UV/NaPS/Fe2 + processes  followed the first-order reaction.

The UV/NaPS/Fe2 + process was more effective than that of UV/HP regarding paraquat removal. As a result, the studied processes are proposed as effective, fast, and efficient methods to remove paraquat from aqueous solutions, which is economically feasible due to the low reaction time. The use of this process is also recommended as a complete refinement or pre-treatment process.

Accreditation is a method used for the improvement of the quality of hospital services. It refers to the systematic evaluation of the health centers based on specific standards. The present study aimed to critically review the implementation of accreditation standards in hospitals.

This critical review investigated all the articles that were published during 1993-2019. In order to find the sources, the authors referred to various databases, namely ISC, DOAJ, PubMed, ProQuest, Embase, Science Direct, Scopus, and Web of Science. The keywords used for the search included Mesh terms and common keywords related to the subject of the study, including challenges, barriers, hospital management, accreditation, hospital, or accreditation hospital. Finally, the full texts of 16 articles were reviewed for the purposes of the study. 

According to the results, various issues, such as the accreditation organization independence, staff and physician participation, number, structure, and content of standards, structural and contextual problems, importance of human resources, financial and capital resources, organizational and management issues, other plans, role of evaluators and their evaluation methods, role of stakeholders, and impact of accreditation on the patients and teaching atmosphere of the hospital were executive challenges of hospital accreditation.

In order to increase the impact of accredition and significantly address its challenges, there should be emphasis on performance indicators, preparation by training and raising awareness of the personnel, budget allocation, and development of plans on accreditation.