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

Community-based health promotion programs over the last 30 years in Iran: typology of interventions

Nastaran Keshavarz

Background an Aim: Community-based health promotion program encompasses actions aiming at enabling individuals, organizations and communities for enhancing behaviors and creating a healthier environment. Considerable experiences regarding community health promotion and community-based health promotion exists in Iran, but they have not been documented adequately.

Materials and Methods: This paper reports some of the findings of a situation assessment project of community-based health promotion programs in Iran, including typology of community-based health promotion programs and critical analysis of challenges and threats, discussing potential opportunities to improve community-based health interventions. All the available reports, official documents, information and published papers related to community-based health promotion programs implemented in Iran were examined.

Results: The majority of health-related interventions excluding three national programs, namely, the volunteers, community health workers (Behvarzes) and polio eradication programs, were categorized in three large groups ─ community-based initiatives, community-based participatory research, and community-based addiction prevention. Many of these programs were not community-based in the true sense of the word.

Conclusion: The findings indicate that in Iran, unlike many other countries, the majority of the interventions are initiated and implemented at the national level with good organizational support. Although implementation of such programs is generally considered feasible in Iran, it seems that the available opportunities have not been adequately exploited for their implementation.

Psychometric properties of Harter’s bullying scale in primary schools of Semnan

Siyavosh Tlepasand

Background and Aim: Bullying a form of persecution, physical, sexual and psychological one or more students against another student repeatedly over a period of time. The aim of this study was to evaluate the psychometric characteristics of the bullied scale in elementary school.

Materials and Methods: The study population all elementary students in Semnan in the 2013-14 school year. To this end, 607 students of Semnan were selected by using a stratified sampling method. All of them Harter's bullying Scale, Illinois bullying and Harter’s motivation questionnaire to complete. Data in the context two classical theories and the test-questions theory analyzed. Exploratory factor analysis, item-total correlation and reliability analyses were undertaken to assess the psychometric properties of the Harter's bullying Scale. The Sami Jima answers Scaled model Fitness data were used for analysis.

Results: Results showed Harter’s bullying scale of factor is saturated. Rating scale using Cronbach's alpha coefficient bullying Harter’s 0.74 respectively. Harter's bulling scale significant positive correlation with absence from school and with academic motivation, academic achievement and discipline scores showed a significant negative relationship. Data answer questions Harter’s scale with Samejima model had a good fitness and more information about the test showed that the slopes of -0.8 to +2.2 continuums feature.

Conclusions: Persian version of Harter's bullying scale had acceptable psychometric properties and could be used as reliable and valid instrument in psychological research.

Assessment of service quality of Tehran clinical diagnostic laboratories using the SERVIMPERF model

Hossein Rastian Ardestani

Background and Aim: This study was conducted to assess customers’ perceptions of the quality of services in clinical diagnostic laboratories

Materials and Methods: Based on the SERVEIMPERF model, different dimensions of quality of services in terms of performance (current situation) and importance (weight) of each of the dimensions were assessed. A sample of 328 persons consulting Tehran clinical diagnostic laboratories, selected by stratified random sampling, was included in the study. Data were collected using a questionnaire.

Results: The customers’ scores for perceptions of the quality of services and its dimensions were higher than average. Dimensions of reliability with a mean score of 3.49 and that of empathy with a mean score of 2.73 were considered to be the highest and lowest dimensions, respectively. As regards importance of dimensions of service quality, the customers’ perceptions of assurance with a mean score of 4.448 was assessed to be higher than other dimensions, while  the dimension of tangibility with a mean score of 3.983 was considered to be lower than other dimensions.

Conclusion: In can be concluded that different customers do not have the same perception of the various dimensions of quality of services and do not evaluate them in the same way. Thus, the differences should be taken into consideration when designing plans to improve the quality of services and deciding about priorities. It seems that the dimension of trust in the customers’ perceptions of the quality of services in clinical diagnostic laboratories is the most important and the first priority.

Effect of ultraviolet-B irradiation on physiological and pathological characteristics of Candida albicans

Sasan Rezaei

Background and Aim: Candida albicans, the most common human fungal commensal pathogen, is a normal member of the human microbiota which can colonize the oral cavity, vagina and gastrointestinal tract. This opportunistic pathogen can cause diseases ranging from mucosal infections to systemic mycoses, depending on the vulnerability and weakness of the immune system of the host. In addition, it is the most common cause of septicemia with 50-100% mortality. Ultraviolet-B (UV-B) radiation is an electromagnetic radiation with a wavelength of 100-400 nm. It reduces the synthesis of proteins and nucleic acids, retards growth, and causes mutation in eukaryotic and prokaryotic cells. Previous investigators have reported on the different effects of UV irradiation on Candida albicans including cidal effect, inhibitory growth, as well as phenotype switching. In the present study we investigated the effect of UV-B irradiation on C. albicans’s growth in a solid medium, production of chlamydoconidia, carbohydrate assimilation and pathogenesis in mice.

Material and Methods: C. albicans was grown in a SC medium, followed by incubation at 30° C for 24 hours and irradiating the cells with UV-B for 5,10,15,20 min at 302 nm wavelength by transilluminator. A sample of non-irradiated yeast cells served as control.

Results: After 24, 48 and 72 hours of irradiation growth rate was reduced, the maximum reduction occurring after 20 minute. There was no difference between irradiated and non-irradiated C. albicans samples as regards sugars assimilation. Irradiation could inhibit production of chlamidoconidia by the fungus, the magnitude of inhibition increasing with increasing length of exposure to irradiation, such that after 20 minutes no chlamidoconidia could be seen in the medium. Further analysis of the data showed that pathogenicities of the fungus in irradiated and control samples were not statistically different. Neither was there any difference between them as regards size or number of bands of DNA molecules on 1% agarose gel.

Conclusion: The findings throw some light on how UVB irradiation can affect the phenotype of C. albicans isolates. Certainly more studies, e.g., on gene regulation, are required to find the effects of UVB at the molecular level in this fungus.

Lifestyle of university students in Kashan, Iran and factors affecting it

Hashem Mohammadian

Background and Aim: It is known that personal behavior influences one’s health. The present study was designed to investigate lifestyle of non-medical students of governmental and private (Azad) universities in Kashan, Iran and factors affecting it.

Materials and Methods: A cross-sectional study was carried out on 520 non-medical students in Kashan, Iran, selected by convenience sampling, in academic year 2013-14. Data on demographic characteristics and health behaviors were collected using standard valid questionnaires, for the latter the questionnaire being the Pender’s Health Promoting Lifestyle Profile II (HPLP II). The data were analyzed using the Kolmogorov-Smirnov test, followed by t-test, and U Mann-Whitney test to compare the means of the two populations.

Results: The m ean age of the students was 21.75 ± 2.5 years. Their overall health-promoting lifestyle score was of 2.43 (SD = 0.38). This score, as well as scores for the subcategories ─ nutritional behavior, spiritual development, physical activity, health responsibility, and stress management ─ were lower for the subjects with an experience of stressful events. Further analysis of the data showed that t here were signiﬁcant differences between boys and girls as regards physical activity (P = 0.000), between single and married students as regards nutritional status (P = 0.032), and between working and non-working students as regards spiritual development (P = 0.014).

Conclusion: The findings indicate that experienced stressful events lay the ground for the adoption of risky behaviors in university students. Therefore, universities should design and implement programs aiming at improving lifestyle of the students and promoting their health.

Biological evaluation of occupational exposure to nickel and lead with the solid-phase extraction method using Chromosorb-102 resin

Seyed Jamaleddin Shahtaheri

Background and Aim: The aim of this study was to assess exposure of workers in a metal industry to nickel and lead.

Materials and Methods: Extraction was done using the solid-phase extraction on Chromosorb-102 resin to prepare, concentrate and purify biological samples of urine, hair and nails of workers working in metal industries. The variables influencing response (pH, loading flow rate, elution solvent, and amount of resins, elution volume, and sample volume) were examined and the procedure was optimized. The optimized procedure was, then, validated based on the “within-day” and “day-to-day” reproducibility experiments, using low, medium and high concentrations, leading to a satisfactory accuracy and precision. Finally, lead and nickel samples were taken from the workers and their concentrations determined voltammetrically.

Results: The optimum values for the examined parameters were as follows: pH = 9, ligand concentration = 0.05%, loading flow rate = 5 ml/min, elution solvent = 2M HNO₃, amount of resins = 500 mg, elution volume = 15 ml, and sample volume up to 500 ml. A good reproducibility and repeatability was obtained for the optimized method under the existing conditions. Lead and nickel could be extracted with recoveries in the range of 94-100%. On the whole, the concentrations of nickel and lead in the workers’ biological samples were above the respective maximum permitted levels.

Conclusion: Solid-phase extraction procedure is a fast and simple method for preconcentrating and isolating analytes from biological samples. Considering the low concentrations of the analytes and presence of confounding factors in such samples, the procedure can be very effective for their preparation. The application of the developed method indicates that trace metal ions can be effectively purified and preconcentrated from different matrices like urine, hair and nail samples to assess occupational exposures.

Food security and factors related to it in households under coverage of urban health centers and health houses in Mehriz, Iran

Fereydoun Siasi

Background and Aim: Food insecurity is a major public health problem in developing and developed countries , underlying developmental and psychological problems , nutrient deficiencies and chronic diseases . The aim of this study was to determine food security status and factors associated with food insecurity in households with children 4-5 years old under coverage of urban health centers and health houses in Mehriz, Iran.

Materials and Methods : This cross-sectional study was conducted in 2013 on 500 households with children 4-5 years old under coverage of urban health centers and health houses in Mehriz, Iran. The subjects were selected by cluster sampling. To determine household food security, the USDA 18-item food security questionnaire was used. Economic and socio-cultural status were assessed using a general-information questionnaire. The data obtained were analyzed using the Chi-square and independent t-tests and multiple logistic regression.

Results: The prevalence of household food insecurity was 39.6% (food insecurity without hunger 23.2%, and moderate and severe food insecurity with hunger 15% and 1.4%, respectively). Food insecurity was negatively correlated with parental education, parental occupational, monthly household income and maternal height ( p <0.008) and positively correlated with maternal age and family size ( p <0.004) . Based on the results of multivariate logistic regression , father's occupation and education level were predictors of food insecurity .

Conclusion: The prevalence of food insecurity in the population studied is high. Based on the results of this study, promotion of parental education, family job security and improved economic status, and control of family size are essential measures that should taken to improve household food security.

Social loafing and organizational justice among nurses: A case study in a teaching hospital

Elahe Khorasani

Background and Aim: Social loafing is the phenomenon of people deliberately exerting less effort to achieve a goal when they work in a group as compared to when they work alone. People who feel they are being treated unfair in an organization would be more likely to show this phenomenon. This study investigated the social loafing among nurses and its relationship with organizational justice in Tohid Hospital in Sanandaj, Iran.

Materials and Methods: This was a correlational descriptive-analytical study conducted in 2012. The study population was all nurses working in Tohid Hospital in Sanandaj, Iran. Data were collected using a valid questionnaire. For data analysis SPSS-20 software was used, the descriptive statistics being frequency distribution, mean, standard deviation, and the Spearman, Mann-Whitney, and Kruskal-Wallis tests .

Results : The highest organizational justice component was found to be organizational justice (0.086 ± 3.39), and the mean of social loafing was higher in comparison with organizational justice. According to the Spearman test, all organizational justice components had inverse relations with social loafing. Only distributive organizational justice was significantly related to social loafing (p<0.05).

Conclusion: It can be concluded that the personnel are highly sensitive to distributive justice and managers need to create the feeling that the organization has a fair distribution of resources. Hospitals should try to minimize the negative effects associated with loafing by creating an environment that discourages social loafing. One way to achieve this goal is to try to impress the personnel by telling them that their functions are important , such that they feel their job is important and that the role of nurses in connection with the patients is of value and significant.