مجله تحقیقات نظام سلامت
سال نهم شماره 2 (اردیبهشت 1392)

Adiponectin، hormone secreted by adipose tissue، which is inversely associated with body fat mass. This hormone has anti-inflammatory and anti-atherogenic properties. Concentration of adiponectin reduces in metabolic syndrome، cardiovascular diseases and dyslipidemia. Thus، the aim of the present study was to review the recent evidences about association between serum adiponectin level and lipid profile. PubMed was searched from 2002 to October 2011، by using the following key words: dyslipidemia، lipid profile، triglyceride، high or low density lipoprotein cholesterol (HDL-C or LDL-C)، total cholesterol and adiponectin. Twenty-five articles were recruited in this review. Serum adiponectin level positively regulated plasma HDL-C concentration. Adiponectin was inversely significantly associated with serum triglyceride. Plasma adiponectin had a potential inverse correlation with very low and low density lipoprotein cholesterol (VLDL-C and LDL-C). Adiponectin R2 receptors had an important role on metabolism of VLDL-C and TG. Adiponectin was reduced in abnormalities of lipid profile and had an important role on metabolism of plasma lipids.

Statistics showed that cardiovascular diseases (CVD) are the cause of approximately half of mortalities in industrial countries and fatty acids consumption can increases hypercholesterolemia. One of the major sources of dietary fats is dairy products. This article reviews the studies and papers on the relationship between dairy fats and lipid profiles. After searching in PubMed database using keywords such as “cholesterol، milk cream، dairy fat، blood lipid، milk fat and cardiovascular disease”، more than 200 articles were obtained. Then we limited our search to English language، full text available and published from 2002 to 2011. Finally، 14 articles were selected. Some cohorts indicated that dairy fat increased the risk of cardiovascular disease; however، other studies revealed no association between dairy fat intake and cardiovascular risks. In a study، for example، the effect of dairy consumption had an inverse association with metabolic syndrome and another study showed the low prevalence of CVD among subjects that had high consumption of milk in their diets. There were conflicting results on the relationship between dairy fat and CVD. Further prospective studies are required to better distinguish this associations.

Given the significant role of research activities in production of science and the vital position of universities in conducting research activities، present study aimed to determine the research activities of academic and faculty members of Rafsanjan University of Medical Sciences during 1995 to 2006. In this cross-sectional study، all the research activities of academic members including research proposals، Persian and English articles، theses in addition with the year، place and gender of its first author were collected via Research Unit of University. All the research activities consisted of 1145 activities، which included 322 medical theses (28. 1%)، 198 dentistry theses (17. 3%)، 443 research proposals (38. 7%)، 118 Persian articles (10. 3%) and 64 English articles (5. 6%). The year 2006 with 191 (16. 7%) and the year 1995 with 33 cases (2. 9%) had the most and the least research activities، respectively. There were significant associations between year، place، gender and number of researchers with the type of research activities. Having considered the increasing trend in research activities of academic and faculty members of Rafsanjan University of Medical Sciences over time، one might be optimistic about the enhancement of such activities in this university. However، more attention should be paid to the role of females in such activities. Moreover، it is important to provide more facilities to encourage teamwork in research activities.

According to the statistics of the World Health Organization (WHO) in 2003، sedentary lifestyle has led to 1. 9 million deaths worldwide. Despite many benefits of physical activity، more than 60% of adults worldwide and more than 80% of Iranian adults are inactive in terms of physical activities. Studies in Iran show that women’s health in this domain is at higher risk than men. Trans-theoretical model is a model that is known as a comprehensive model of sport. The aim of this study was to determine the effectiveness of education in physical activity among housewives in Zahedan، Iran. In this case-control study، 220 housewives (aged 19-52 years) living in apartments in Zahedan were studied (110 subjects in intervention group and 110 subjects in control group). Blocks sampling method was simple random sampling، then sequence number، the other blocks were sampled until sampling was completed. A multi-sectional questionnaire containing demographic characteristics، physical activity، stages of change and decisional balance were used. Its validity was determined by content validity and its reliability was determined by Cronbach''s alpha. This study indicated that before training، there was no significant difference between groups in terms of awareness، attitude and structures of trans-theoretical model. However، after the training، a significant increase was observed in the mean scores of awareness، attitudes، and model structures in the intervention group (P < 0. 001). According to the study، educational intervention on physical activity was effective. Corresponding institutions should include universities and other centers to develop and implement physical activity training programs.

The evaluation of growth in children in addition to show nutritional status and health of children in each community is considered as a valid tool for measuring quality of life (QoL). UNICEF reported a total of 40،000 daily deaths due to malnutrition. The present study was conducted to review the nutritional status of rural children under 6 in Zahedan، Iran. In a cross-sectional study، 514 rural children 6 to 59 months by multistage random sampling and by questionnaire، interview and house-to-house survey in Zahedan were studied. Data collection tools were scale، questionnaire and metric measurement. Data analysis performed by Nutritional survey، besides anthropometric data were compared to National Center for Health Statistics (NCHS). According to these criteria، the moderate and severe underweight، wasting and stunting was Z score ≤ -2 and severity of malnutrition was defined as mid-upper arm circumference (MUAC) less than 115. 17. 3%، 25. 5% and 6. 8% of the studied children had moderate to severe underweight، stunted and wasted، respectively. Overall average height (83 ± 11. 4 vs. 82 ± 12. 2)، weight (11 ± 2. 6 vs. 10 ± 2. 6) and MUAC (145 ± 14. 3 vs. 141 ± 16. 2) in the boys was higher than the girls. The prevalence of stunting (29. 7% vs. 22. 5%)، underweight (20. 7% vs. 15. 7%) and wasted (9. 8% vs. 4. 4%) were higher in boys than in girls (P > 0. 05). The findings indicated that the prevalence of malnutrition is one of public problems in the rural children under 6 in Zahedan. Thus، this suggested that the gap might be filled by improvement in nutrition and health services along with the socio-economic development.

It has been shown that lactic fermentation of both milk and soy milk could boost their ant oxidative properties، in our previous study، using a native strain of lactobacillus planetarium for ultra-high-temperature (UHT) processed milk and soy milk fermentation، resulted in an increase in anti-oxidative properties of UHT milk، where the output was opposite for UHT soy milk. Since the obtained results were not expectable، here، in this study the effect of fermentation of the given samples were studied using three different lactobacillus strains as well as using less heated commercial milk and soy milk. The objective of the present study was to compare the lactic fermentation effects on anti-oxidative properties of sterilized and pasteurized milk and soy milk using three different lactobacillus strains. Commercial UHT milk and soy milk and their pasteurized type of products were used; Lactobacillus acidophilus، Lactobacillus Plantarum and Lactobacillus Rhamnosus were used as the lactic cultures and DPPH radical scavenging effect was applied as anti-oxidative index. The DPPH radical scavenging effects of unfermented UHT and pasteurized soy milk were obtained as 31. 8 ± 6. 7 and 35. 9 ± 1. 0، respectively; such data، for milk were shown to be 15. 0 ± 2. 3 and 15. 2 ± 2. 4. For both UHT and pasteurized milk، by individual usage of all three strains، fermentation increased the anti-oxidative index. Accordingly، despite different types of fermenting microorganism، the average of the observed data were 24. 4 ± 4. 0and 25. 1 ± 5. 2; however، in sterilized soy milk، DPPH (1، 1-diphenyl-2-picrylhydrazy) radical scavenging activity decreased to 24. 4 ± 12. 1، whereas the pasteurized one showed a considerable increase in this property up to the value of 45. 0 ± 3. 5 after fermentation. Difference in fermenting microbial stains did not make significant difference on the change in antioxidant properties of soy and soymilk. The results of this study confirmed our previous results that lactic fermentation would reduce the anti-oxidative characteristic of UHT soy milk. The type of thermal processing must be considered as the main reason; the fact that after fermentation، the pasteurized soy milk just showed as increase in anti-oxidative property as the milk samples.

Sound is one of the most important physical factors، which is considered hazardous in industrial environments. Noise had auditory and non-auditory effects such as damaging hearing system، effect on the organ of vision، balance system، electrolytes، neurological and psychological effects، physiological and mental effects. Thus، this study carried out to determine the effects of noise exposure on serum cortisol levels and some blood parameters in steel industry workers.

The number of 50 employees of steel industry as the subject group participated in this cross-sectional study. Demographic information was collected using a questionnaire. In order to review the blood parameters changes such as serum cortisol level، lipid profile and sugar، blood sample was taken from participants before and after the work shifts. Energy averaging (LAeq) was measured by CEL 440 sound level meter and noise equipment analyzed in octave-band frequencies. This study was carried out in field and experimental conditions. In the experimental condition، workers exposed to noise at 85، 95 and 105 dBA for 5 minute in three consecutive days. Finally the results from blood tests were analyzed.

Laboratory findings showed that serum cortisol levels at all of the three sound levels (85، 95 and 105 dB) increased after the noise exposure; however، this change was not statistically significant (P > 0. 05). Lipid TG levels also decreased after noise exposure، but this finding was not significant either (P > 0. 05). HDL and LDL at noise level 85 dBA had descending trend، but compared with pre-exposure time، there was no significant change (P > 0. 05). The fasting blood sugar (FBS) was increased in all the three noise levels، which this change in 95 dBA was statistically significant (P < 0. 001).

The present study showed that exposure to high sound levels led to changes in physiological parameters such as serum cortisol، lipid profile and blood sugar; however، except FBS parameter difference in noise level 95 dBA، other changes in parameters was not statistically significant. Therefore، the noise cannot be considered as a factor affecting the clinical parameters.

One of the most important risks in hazardous material handling is transportation accidents that have destroyed effects on environment and safety of the road. Using risk management method could control accident causing factor. All factors that affect the environmental risks of oil products transportation was specified from storage to end of the path and weighted by analytic hierarchy process (AHP) model. The final model was then attained using the acquired model on the basis of failure mode and effect analysis (FEMA) and the handling path was evaluated. The risk value for oil handling tankers at various areas except of two areas that located outside or within the town or with lower control of police is accessible. The reason for risk incensement in these two areas is due to existence of agriculture، residential hoses and high slope path. Transmission of oil storages inside and outside town and precise control of the driver ability by police is essential in reduction of environmental pollution risk of handling the oil products.

Despite importance of physical activity in health، welfare and quality of life، today most people do not have adequate physical activity. The aim of this study was to evaluate the effectiveness of interventional program based on trans-theoretical model to promote regular physical activity in office workers in Ilam University of Medical Sciences. This was a pre and post-interventional study which was conducted on 97 employees in Ilam University of Medical Sciences. First، participants were selected by random sampling and then they completed the trans-theoretical model self-report questionnaire. Participants received educational package including a pamphlet، booklet and physical activity video CD that designed based on trans-theoretical model. After three months to determine the effectiveness of intervention، the trans-theoretical model questionnaire was completed again. The mean age of the participants was 32. 16 ± 6. 7 years. 42% of the study subjects were males and 55% were females. Findings showed that participants were interested in walking (42. 3%)، recreational swimming (52. 6%)، gym sports (3. 1%) and climbing (1. 2 %) as regular physical activities. Comparing the results of physical activity changes showed that the interventional program significantly improved participants'' stage of change (P < 0. 05). In addition، comparing the mean score of decisional balance، process of change and physical activity self-efficacy indicated a significant increase in trans-theoretical construct in post-interventional phase compared with the pre-interventional phase (P < 0. 05). Findings indicate a significant increase in mean score of consciousness raising، dramatic relief، counter condition، stimulus control، supportive relationships، self-liberation after the intervention compared with the post-interventional phase (P < 0. 05). However، increase in mean score of other cognitive and behavioral processes levels was not significant. According to the results، design and implementing of interventional programs based on behavioral change models could improve health-related behaviors.

High intake of nitrate and nitrite is harmful for human health. Vegetables are the major source of nitrate and nitrite in human diet. The objective of this study was to compare the amount of nitrate and nitrite in vegetables irrigated with Zayandehrood’s water and well water. 106 samples of eight top used vegetables (cucumber، tomato، onion، leek، lettuce، potato، parsley، and spinach) irrigated with Zayandehrood’s water and 106 samples of those vegetables irrigating with well water from east of Isfahan were randomly selected، and nitrate and nitrite levels were determined by spectrophotometric method. The mean value of nitrate in cucumber، tomato، onion، leek، lettuce، parsley، spinach، and potato irrigated with Zayandehrood’s water was 30 ± 1. 1، 30. 7 ± 1. 4، 45. 2 ± 2. 6، 230. 7 ± 4. 3، 173. 8 ± 19. 3، 319. 7 ± 8. 4، 321. 2 ± 18. 5 and 62. 2 ± 2. 0، respectively. The mean nitrate level in cucumber، tomato، onion، leek، lettuce، parsley، spinach and potato irrigated with well water was 26. 7 ± 0. 9، 26. 7 ± 2. 8، 28. 4 ± 2. 9، 161. 8 ± 20. 6، 275. 7 ± 58. 2، 312. 5 ± 37. 4، 311 ± 28. 7 and 116. 9 ± 0. 06، respectively. Independent t-test showed that mean nitrate level in cucumber، tomato، onion and leek irrigated with Zayanderood’s water was significantly higher than those vegetable irrigated with well water (P = 0. 001). The mean nitrate level in parsley and spinach had no statistically significant difference. In different vegetables، the mean nitrate level was not equal. In these samples، cucumber and tomato had the lowest amount of nitrate. Parsley and spinach had the highest amount of nitrate. The mean nitrate in the most of vegetables irrigated with Zayandehrood’s water was significantly higher than those vegetable irrigated with well water; thus it is necessary that industrial wastes is disposed correctly because they treat our life.

Malaria is one of the three important diseases in the world. 65% of malaria cases in Iran are reported from Sistan and Baluchestan province. The physicians are the head of health services in rural and urban areas in Iran and have essential role in malaria control. This study evaluated an educational package to increase cognitive and behavioral skills of physician about malaria control. A pre and post-interventional study was conducted in 2009 in Sistan and Baluchestan province، Iran. An open-ended questionnaire including 62 questions and the checklists for measuring 13 behavioral skills were developed to assess cognitive skills. Four booklets were designed about different subjects related to malaria control and some films and PowerPoint about the required skills. Thirty physicians participated from four districts of the province. Results of this study showed that cognitive skills were increased from 28 ± 13. 8 in pre-interventional phase to 74. 8 ± 15. 4 significantly in post-interventional phase (P < 0001). The behavioral skills were enhanced from 30. 5 ± 10. 3 in pre-interventional phase to 51. 6±11. 3 significantly in post-interventional phase (P < 0001). The results showed that an educational package was a simple and economic way for building capacity among physicians who have essential role in malaria elimination program in malaria areas.