Journal of School of Public Health and Institute of Public Health Research

DIETETIC RISK FACTORS AND ISCHEMIC HEART DISEASE

H.H Salimzadeh

As adoptin and maintenance of healthy eating behaviours is an important factor for Ischemic Heart Disease (IHD) prevention , this research was conducted to determin dietetic risk factors in relation to IHD. This is a case – control study conducted in fall 2003 in Tehran Heart Center and Tehran Shahid Rajaii hospital. 100 subjects with IHD, as cases and 100 controls with no cardiovascular disease in their medical history, participated in the study.Nutritional data was collected by Food Frequencey Quastionnaire. Some important risk factors including hypertention, hyperlipidemia,diabetes, Body Mass Index (BMI) and physical activity were evaluated. There was a positive association between IHD and consumption of fats and a negative association between IHD and consumption of fruits and vegetables.The most important factors were low intake of fish and high intake of fried foods that increased the risk of disease 13.96 and 54.65 times, respectively. Also 73% of patients had high risk diet while only 17% of controls had high risk diet. High risk diet increased the risk of cardiovascular diseases approximately 20 times. The main dietetic risk factors in this study were : low intake of fish, fruits and vegetables and lower consumption of oiles while hydrogenated fats with undesirable trans-fatty acid content, were the main source of dietary fat, in case group. Therefore community-based educational programmes are nesseary to promote healty nutrition.

ASSESSMENT OF THE MASS CAMPAIGN FOE MEASLES – RYVELLA COMPLEMENTARY IMMUNIZATION PROGRAM WITHIN THE POPULATION COVERED BY TEHRAN UNIVERSITY OF MEDICAL CDIENCES

R Majdzadeh

Considering the importance of the mass campaign for measles-rubella vaccination in the elimination of measles and Congenital Rubella Syndrome, and also the necessity of the accurate quantitative and qualitative assessment of the process of this program and the estimation of the information coverage regarding the passive launch of the program, this assessment has been carried out within the population covered by Tehran University of Medical Sciences using a standard method. This study is descriptive- analytical. The necessary sample size was defined as 390 people for the estimation of the immunization coverage, 190 people in each step of the information coverage (and a total of 570 people for the overall three steps), and finally 24 executive teams for the assessment of the quality of the service. Lot Quality Assurance Sampling and subsequent analysis were used for the assessment of service quality, with the upper threshold set at 80% and the lower threshold at 30%. Each lot was defined acceptable or unacceptable based on the quality of the vaccination, the cold chain, the competence of the human resource, and the availability of the necessary materials and equipment. Data analysis was done using the Chi Square and Fisher’s exact tests. 96.4% (95% CI: between 94.6% and 98.2%) of the people between 5 and 25 years old had received the MR vaccine. 7 people (1.8%) of the vaccinated people were not in the target group of vaccination. From the total 190 people who were studied on the basis of information coverage, 152 people (80.9%), 184 people (96.8%) and 190 people (100%) were informed about the mass campaign for MR vaccination in the first, second, and the third steps respectively. More than 80% of the people were informed about the program through TV. The quality of the vaccination was acceptable in 19 executive teams (79.1%) and unacceptable in the other 5 executive teams (20.9%). In this study, the quality of the cold chain was acceptable in 23 executive teams (95.8%) and unacceptable in one team (4.2%). The competence of the human resource, the necessary materials and equipment for MR vaccination was acceptable in all 24 executive teams under study (100%). The enforcement of the mass campaign in such short period of time compared to similar programs in other countries demonstrated the success of the collaborators in the execution of this program. Overall it seems that regarding the quality of vaccination, information coverage, and the provision of materials and equipment in health centers of the districts, the program has achieved its goals.

EVALUATION OF THE KNOWLEDGE, ATTITUDE AND PARACTICE OF RESIDENTS OF THE CITY OF KERMAN TO THE MUNICIPAL SOLID WASTES MANAGEMENT

M Malakootian

Management of solid wastes and improvement of its operational quality is dependent on the functional elements such as generation ,storage , collection,transportation ,processing ,and disposal. When these collections act on the basis of knowledge and sufficient information of present status and according to a set of coordinated guidelines and regulations , it proves useful in the promotion of the health quality of the community .Since it is necessary to know the present status in order to plan a better management of municipal solid wastes, a comprehensive study had been conducted in summer and fall of 1382 to aim at people’s knowledge ,attitude, and practice to the municipal solid wastes management of Kerman. The results of this study showed that the majority of the resident of Kerman enjoyed of sufficient and relatively good information and collectively had high degree of knowledge ,attitude ,and practice. The converge of knowledge ,and positive attitude people was 94.3% and 84.3% respectively ,and 72.4%of subjects was reached to good practice score. These systematic ,coordinated , and good results are indicative of the fact that the community is susceptible to accept amendments and to exercise comprehensive municipal solid wastes management. It is recommended to make advantage of this potential power in promoting the health quality of the community members along with applying functional elements of municipal solid wastes management in order to improve present operational status of the municipality.

STUDYING THE EFFECTS OF MANAGERIAL STYLES OF HOSPITALS HEADS ON THE CHANGE OF 10 IMPORTAN HOSPITAL PERFORMANCE INDICATORS

M Arab

People, government and Health Insurance organization’s (HIO) spend a great deal of mony each year in Health sector. They expect an effective and acceptable outcomes as well as wellutilization of all resources (including Human Resources). The goal of this article is studying the effects of managerial styles employed by Hospitals heads on operational indices among Iran’s public hospitals. The study is a cross- sectional one and data collected cross- sectionally. Study population includes 355 public hospitals which were divided in 3 categories as large (>400 bed) medium (200 – 400 bed) and small (<200 bed). A questionnaire was used for data collection and interviews also conducted for the same purpose. The questionnaire included question about styles of leadership as well as operational indices. Leadership types determined as lycert models (4 styles). Findings demonstrate the effects of Hospitals head’s leadership styles on increase of decrease of outcome indices among study population. A cording to the findings participatory management has had more positive effects on the indices than the 3 other styles had.

F Dehghan Manshadi

A Rabani

COMPARISON OF THE EFFECT IVENSEE OF TWO NUTRIRION EDUCATION METHODS ON THE NUTRITIONAL KNOWLEDGE,ATTITUDE AND PRACTICE OF FIRST – GRADE SCHOOL GIRL STUDENTS IN TEHRAN

M Tslimi Talaghani

Many studies indicate that the nutritional knowledge and practice of adolescent girls are inadequate. Few surveys were performanced about effect of nutrition education on knowledge, attitude and practice in this vulnerable group. The purpose of this study was to compare the effect of two nutrition education methods (guidebook and group discussion) on the nutritional knowledge, attitude and practice of first-grade guidance school girl students in Tehran ’s 8th district, in 2003.A total of 300 students were selected from 11 guidance schools by simple random sampling and divided into three 100-student groups: 1-guide-book, 2-group discussion, and 3-control. Data on the nutritional knowledge, attitude and practice were collected using pretest and posttest questionnaires. The students in group1 were given the guide-book and required to study it at home, while group 2 students were told to discuss among themselves the contents of the guide-book. The control group were given nothing to study or to do. The pre-test showed that the mean scores of nutrition knowledge (K), attitude (A) and practice (P) were not statistically different among the 3 groups. The scores for the 3 variables increased in the guide-book and discussion groups significantly at the end of the study period (in all cases, p<0.001), while the inter-group comparisons also showed that the K and A scores were statistically different among the 3 groups the P, however, was not different among them. Conclusion: Both methods (guide-book and group discussion)increased the level of nutritional knowledge and attitude as compared to (a) – the control group,and (b) – the initial values. Also both methods increased the level of nutritional practice as compared to (b) – the initial values. The group discussion method was more effective than the guide-book method in the promotion of the nutritional knowledge of the students.

THE SURVEY FAUNA OF CALLIPHORIDAE AND SARCOPHAGIDAE FLIES IN TEHRAN AND SUBURB

M Khobdel

Myiasis is always resulted by depositionof egg or young larvae of cyclorrhapha flies’ in live tissus of human or animals,which follows by their Development. Although the survival of mentioned larves is depended on existance of livestock and wild animals, the flies can be seen in parks, dairy farms and certain plants and also solid wasts waiting for proper hosts. The frequent study was carried out in Tehran and suburb and adalt flies were netted in different areas, indoors and outdoors and taken to the laboratory for identification. Twenty-two species of flies were identified. Thirteen species were medically important and four species consisting: Calliphora vomitoria, Lucilia richardsi, sarcophaga fertoni, Sarcophaga peregrina were identified and reported for the first time in Iran.