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

Training and research in malaria Parasitology in last FiftyYears in Iran

Mehdi Nateghpour

Background and Aim: specific and scientific study in the field of malaria in Iran commenced simultaneouoly with establishing the Instituted of Malariology in Tehran University. Subsequently the Institute was changed to school of Public Health and Institute of Public Health. Research which this new situation resulted in increasing studies and researches in the field of malaria based on three main items as entomology and vector control, parasitology and epidemiology. Historical study of malaria prepares a worthy opportunity to remind the pioneers and those who dedicated their life for combating malaria. In this study the situation of published papers, prepared theses by Iranian researchers and specific training and fresher training courses in the filed of malaria parasitology during the last fifty years were considered.

Materials and Methods: This study was conducted as a retrospective study based on the collecting all available data from internal and external electronic sources, papers, books, reports, theses. Moreover, some interviews were made with relevant knowledgeable individuals, in the field of malaria parasitology in Iran.

Results: In this study 143 papers in the field of malaria parasitology were collected in Persian and English languages. Thirty five MSPH, MPH, PhD these and forty four specific courses were recorded as well.

Conclusion: The collected data indicating the correct comprehension of Iranian researchers from importance of malaria infection and its parasitology in Iran. The facts also show that specific training and retraining of malaria microscopy played considerable role in the control of malaria in Iran.

Organizing and policy-making as a key factor to establish hospital clinical risk management system

Amir ashkan Nasiripour

Background and Aim : It is impossible to deny the threats and risks endangering the process of health care when offering the services. Confirming this fact does not mean ignorance the risk, or allowance to medical and nursing mistakes to happen however, it can mean approaching the problem to come up with practical solutions and minimize the risks in the process of providing health care services. The present study was conducted periodically as an applied multi-stage research.

Materials and Methods : To do a model of clinical risk management, different authentic texts on risk management in health sector were reviewed focusing on the models available. All such models were tabulated, analyzed and compared together which resulted 62 primary variables. The variables were, then, validated being used in a questionnaire responded by 20 nurses and doctors which, this time, produced a confirmed questionnaire of 40 variables. After that, 215 subjects chosen through a random and a stratified sampling were asked to respond to that questionnaire, making an exploratory factor analysis as well.

Results : This study was done, using principal components analysis as with a rotation of Varimax loadings showed a variety of factors (19 factors) available in the models of clinical risk management were loaded as "organizing and policy-making" factor. This factor illuminated a sum of 25.3% of variances in the model of clinical risk management. The results also showed the loading factor of variables as among 0.5 and 0.7 which indicated a fine correlation among them and the participants' view.

Conclusion: It was concluded that "the best care of the patient is accepted as a common perspective in organization" and "the effect of the treatment team's clinical performance on their financial payments" are the most and the least important variables respectively with 0.739 and 0.548 as factor load.

Survival nalysis of gastric cancer patients after surgery based on a flexible model in competing risks

Mahmood Mahmoodi

Background and Aim: In many diagnostic studies, including surveying the survival of patients with gastric cancer where each individual after surgery can experience more than one type of event, and the occurrence of one type of event hinders the occurrence of other types of events, the question of competing risk is raised. For checking the effect of each covariate on the occurrence of any event and estimating the hazard function, Cox and Fine and Gray models are used. In the event that the assumptions of two models do not hold, using them will be an incorrect course of action. One way to overcome this problem is to use models that have higher flexibility.

Materials and Methods: In this study, the demographic, clinical and therapeutic characteristics of 330 patients with gastric cancer who referred from January 1996 to April 2000 to the Cancer Institute of Iran Imam Khomeini Hospital and underwent surgery, including their type, and the time of occurrence of the first event (locoreginal replace/death) for each patient from medical records were collected and evaluated. Using this information, the cumulative hazard function of relapse of disease was plotted by means of three models Cox, Fine and Gray and the flexible one, and was checked against the observed cumulative incidence function of recurrence of disease and, finally, their performance was evaluated.

Results: Nearly, for each event, the proportionality assumption holds for all the variables . According to the graph of cumulative incidence function for the event of interest (recurrence), it can be seen that the Cox model, has overestimated the cumulative incidence function and the curves of two other models are very similar and also similar to the observed curve. However, the cumulative incidence function of the flexible model is smoother than the others.

Conclusion: In the competing risk framework, Cox model is not very useful in practice while it seems that the flexible model is not only a good alternative to the Fine and Gray model but will also be superior to it when the assumption of proportionality does not hold.

Evaluation of Effectiveness of Shift Schedule Change on Reducing the Shift Work-related Problems in a Petrochemical Industry

Ahmad Soltanzadeh

Background and Aim: After conducting a comprehensive study on shift work systems in petrochemical companies and recommending appropriate shift schedules, some companies changed shift patterns. After a year, the present study was carried out at a petrochemical company which changed its shift pattern from 4-4-4 to 3-3-3. The objective of the study was evaluation of effectiveness of shift schedule change on shift workers’ health problems.

Materials and Methods: In this study, samples consisted of 195 shift workers of the present study and 44 shift workers from the previous study. Data were collected by an anonymous questionnaire, in which questions on demographic characteristics, health problems and workers’ opinions about shift pattern change were included. Data were statistically analyzed using SPSS 11.5.

Results: The results showed that prevalence of gastrointestinal, cardiovascular, and musculoskeletal problems were not statistically different between the two groups (p>0.05), but prevalence of some psychological disorders were lower in the present study subjects as compared to the individuals of the previous study (p<0.01). The results revealed that from the viewpoint of shift workers new shift pattern improved quality and quantity of sleep. The findings showed that 76.8% of the subjects evaluated the new shift schedule to be better than the previous one.

Conclusion: Based on the findings, changing the shift pattern from 4-4-4 to 3-3-3 resulted in reduction of prevalence of psychological problems. Therefore, the change implemented in the shift pattern was useful.

Urinary Incontinence, its Related Disorders and Risk Factors in Women

Farideh Dehghan Manshadi

Background and Aim: Urinary Incontinence (UI) as a main health problem affects on Quality of Life negatively. UI prevalence is reported between 3-57.1% in different countries. Nevertheless, there are limited studies about probable risk factors, e.g. type and number of delivery and related disorders such as anal incontinence. This study was aimed to investigate the UI risk factors and related disorders in our society.

Materials and Methods : A cross-sectional study was conducted on 166 women with UI and 90 healthy subjects, aged 26-70(45.3±7.9) and 20-64(38.2±8.4) years respectively. After completing a designed questionnaire, assessment of vaginal tone, Pelvic Floor Muscles'(PFM) strength and endurance carried out. Independent t-test and Pearson correlation test were used to analysis the data. Values of p<0.05 were considered to be significant.

Results: Our data showed that the mean of age, Body Mass Index (BMI) and number of deliveries in women with UI were significantly higher than that women without UI were (P<0.05).There was a significant difference regarding to the prevalence of anal incontinence and constipation between two groups (P<0.05). Reduced vaginal tone and lower strength and endurance of PFM were seen in women with UI (P<0.05).

Conclusions: Regarding high prevalence of some pelvic floor disorders such as constipation in incontinent women, we recommend performing further epidemiologic and etiologic investigations , also emphasis on establishing multidisciplinary approach health/therapeutic centers to provide better services to these patients.

Child sexual health: qualitative study, explaining the views of parents

Naria Abolghasemi

Background and A im : sexual health in children is difficult subject, does not deal with it formal method. Importance of Sex education of children is accepted in the world. The aim of this paper is describing the concept of sexual health from the viewpoint of children's famil y and identification norms of child sex education and determining sex education priorities of the parent's viewpoint.

Materials and Methods: This is qualitative study. Samples were selected by targeted method of student's parents of five regional educated o f Tehran. Data were collected by focus group interview and discussion and were analyses by subject and content analysis.

Results: The findings were classified in three main areas: 1) Family management 2) the role of school 3) framework of the religion an d traditions.

C ~~ONCLUSION~~ onclusion : Most participants believed sexual health behavior in children is not health indicators. They implemented their family policies in management of Sexual behavior o f their children. In Family control was meant: restriction of sexual behavior in child as a norm. Culture of silence and connivance in management of children's behavior has become norm, because child's sexual behavior is inconsistent with traditional values of family. In identifying priorities of sexual education of children, progression interaction between home and school was known as the most deficits. They are acting their internal values in educational system of children because their conflict of values, norms and tastes difference has not been challenge. It is important and priority of parents to being prepared for the management of their children's sexual behavior .

Forecasting ambient air pollutants by time series models in Kerman, Iran

Narges Khanjani

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Scientific Journal of School of Public Health and Institute of Public Health Research /85

Vol. 11, No. 2, Summer 2013

Forecasting ambient air pollutants by time series models in Kerman, Iran

Mansouri, F., MS.c. Student, Dept of Environmental Health Engineering, Faculty of Public Health, Kerman Medical University, Kerman, Iran

Khanjani, N., Ph.D. Assistant Professor, Department of Epidemiology and Department of Environmental Health, Faculty of Public Health, Kerman Medical University, Kerman, Iran - Corresponding author: n_khanjani@kmu.ac.ir

Rananadeh Kalankesh, L., MS.c. Student, Department of Environmental Health Engineering, Faculty of Public Health, Kerman Medical University, Kerman, Iran

Pourmousa, R., MS.c. Lecturer, Department of Statistics, School of Mathematics and Statistics, Shahid Bahonar University, Kerman, Iran

Received: Apr 3, 2012 Accepted: Feb 14, 2013

ABSTRACT

Background and Aim: Air pollution is one of the most important problems of big cities in developing countries and can have several negative health effects on humans. Therefore studying these pollutants can help in developing programs for air pollution control. The aim of this study was to estimate and predict the changes of air pollutants in Kerman, Iran.

Materials and Methods: In this ecological study, data about seven important air pollutants in Kerman including NO, CO, NO₂, NO_x, PM₁₀, SO₂ and O₃ from March 2006 until September 2010 was inquired from the Kerman Province Environmental Protection Agency. Then the data was calculated as averages per month and by incorporating time series models, predictions were done for each pollutant.

Results: All of the pollutants were steady in Kerman, except CO which is significantly decreasing and PM₁₀ which is increasing. All of the pollutants had a seasonal pattern. Time series models with a 12, 3, 8, 12, 12, 12 and 6 month seasonal pattern were fit for O₃ , SO₂ , PM₁₀ , NO_x , NO₂ , CO and NO consecutively.

Conclusion: The production of ambient CO is decreasing in Kerman and one reason is probably replacing and retiring old automobiles. However PM₁₀ is increasing in Kerman and in most seasons it is above standard and therefore control initiatives should be implemented.

Designing questionnaire of assessing mental workload and determine its validity and reliability among ICUs nurses in one of the TUMS’s hospitals

Adel Mazloumi

Background and Aim: One of the most important problems in intensive care unit is high nursing workload. High workload may lead to increased human errors, compromised quality and safety of care, and reducing quality of working life. The purpose of this study provides valid and reliable tools to assess the mental workload of the ICU nurses and also identify inducing factors that will create workload.

Materials and Methods: This study had two phases. 1- Determine the face validity and reliability of the NASA-TLX (to assess the workload) by Backward Translation method and Cronbach's alpha method. 2–Designing the performance obstacles and facilitators questionnaire by interview and pilot study.

Results: Face validity and reliability of NASA-TLX method was confirmed (α=0.897). The performance obstacles and facilitators questionnaire for ICU nurses provides in 53 questions and 10 subscales. Relevancy is 97% and Clarity is 96%. Overall, 90% of nurses assessment comprehensiveness of the questionnaire was very comprehensive and comprehensive.

Conclusion : According to the results, can be used NASA-TLX method and the performance obstacles and facilitators questionnaire to assess workload of ICU nurses.