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

Organizational Culture of the Headquarters of the Iranian Ministry of Health and Medical Education

Behzad Damari

Background and Aim: Considering the key role of the Ministry of Health and Medical Education (MOHME) in the implementation and follow-up of the health system reform, its organizational culture can play an important role in the success of this transformation. The aim of this study was to determine the dimensions and orientations of the current organizational culture of the MOHME headquarters.

Materials and Methods: This was a cross-sectional descriptive and explorative study. The study population was the central staff of MOHME. Data were collected using a questionnaire and analyzed by SPSS version 11.5. Descriptive statistical methods (mean, standard deviation, coefficient of variation and interval) were used to describe quantitatively the cultural dimensions, followed by a qualitative analysis as well.

Results: Analysis of the data showed the following: 1. Organizational cultural dimensions existing at a high level include self-supervision and identity; 2. Organizational cultural dimensions existing at a moderate level include authority and freedom in operations, clear goals and expectations, communication, coordination and coherence; and 3. Organizational cultural dimensions existing at a low level include innovation, learning, fair reward system, acceptance of change, management support and criticism.

Conclusion: Considering the key role of the MOHME headquarters staff in designing and implementing health promotion programs, bringing about changes in the organizational culture should be a top priority of the ministerial high authorities.

A Sexual Health Screening Tool in the Adult Population with Substance Abuse Disorders

Effat Merghati Khoei

Background and Aim: Substance abuse and risky sexual behaviors are intermingled. Both subjects, however, are highly sensitive issues culturally in some societies such as Iran, making assessment of sexual behaviors difficult and challenging. It is particularly difficult to assess and study risky sexual behaviors in the drug-using population. Thus, it seems essential to develop and validate a comprehensive native instrument specific for the Iranian drug-using population to screen their risky sexual behaviors and in treatment settings.

Materials and Methods: A thorough literature review was made to find a tool utilized in addiction treatment settings. The Sex and Drug History Form (SDHF) was translated into Persian. Clients (n = 107) referred to the sexual health clinic in the Iranian National Center for Addiction Studies (INCAS) were selected randomly. Questionnaires were completed through face-to-face interviews by trained research assistants. Data analysis was done using the Cronbach`s alpha and exploratory factor analysis.

Results: Cronbach`s alpha was found to be 0.78. Using the principal component analysis, the Sex and Drug Screening Scale (SDSS) revealed 78.6 of the total variance in two main domains, namely, drug-use behaviors and sexual behaviors. The number of subscales in the original instrument, which was 3, increased to 6.

Conclusion: Substance abuse and addiction significantly affect one's sexual behaviors and safety. The Sex and Drug Screening Scale will enable health workers and therapists to assess the patients' sexual health and risky behaviors at admission, which will facilitate planning, implementing and evaluating intervention programs aiming at treating addiction.

Estimation of the Population of Drug Abusers Using the Network Expansion Method for Assessment of the Community in the Golhesar Village, Tehran

Kourosh Holakouie Naieni

Background and Aim: Nowadays, prioritizing problems and distribution of resources is determined according to the basic needs of the individuals in the population. Based on the study done by researchers in Tehran University of Medical Sciences School of Public Health in Golhesar Village, Tehran, taking action about "drug abuse" was ranked by the community as the first priority. Therefore, the present study aimed to estimate the size of the population of drug abusers using the network expansion method.

Materials and Methods: This cross-sectional study was conducted on a purposive sample of 320 persons 15-65 years old. The study included two parts: 1. estimation of the social network based on 32 population subgroups using the frequency of network expansion approach; 2. estimation of the size of the hidden population. The relevant correction coefficients were used for adjusting errors usually observed in this method. Results: The mean of the social network was 160.79±16.68) 95% CIs: 128.78-194.30.(The frequencies of cigarette smoking, hookah smoking, alcohol consumption, opium use, meth use, crack use, heroin use, injecting drugs and ecstasy were 103.43, 88.25, 96.9, 76.46, 69.37, 30.03, 20.48, 7.36, and 4.23 per 1000; respectively. The percentage of drug abusers was higher among men.

Conclusion: As compared to results of previous reports, the size of drug abuser population in Golhesar Village is currently higher. In order to solve this problem an appropriate action plan should be implemented by the planners and policy-makers in partnership with community members.

Effect of Group Education on Knowledge, Attitude and Practice of Mothers of Adolescent Girls About Sex Education

Gholamreza Garmaroudi

Background and Aim: Sex education is an important health issue among adolescents. Mothers are the most reliable source of information for adolescents’ sex education so they should be equipped with proper knowledge, attitude, and practice to be able to educate their children properly. The present study aimed to investigate the effect of group education on knowledge, attitude and practice of mothers of adolescent girls as regards sex education in Tehran, 2015.

Materials and Methods: This was a randomized controlled trial including 30 mothers of adolescent girls randomly assigned to an intervention and 30 in a control group. The knowledge, attitude, and practice of mothers about sex education of their adolescnt girls were determined using valid and reliable researcher-made questionnaires. Based on the results, the intervention group, then, attended three educational sessions (active learning, group discussions) of 45-60 minutes duration each. The control group received only educational pamphlets. Three months after the intervention outcome variables were measured in both groups. Data were analyzed by the SPSS-22 using the Chi-Square, exact Fisher and T-tests.

Results: There were no statistically differences in the knoweldge, attitude and practice of sex education between the two groups at baseline (p>0.05). After the intervention, the mean scores of the study variables increased significantly (p<0.001) in the intervention group, while there were no statistically significant differences between the mean scores of the variables in the control group before and after the intervention (p>0.05).

Conclusion: It can be concluded that group education could bring about significant changes in the knowledge, attitude and practice of the mothers of adoloscent girls as regards sex education.

Relationship Between Communication Skills and Mental Health Among the Students of Mashhad University of Medical Sciences, Mashhad, Iran

Noushin Peyman

Background and Aim: Communication is one of the oldest and greatest human achievements underlying our social life. Available literature show factors such as self-esteem, interpersonal skills, establishing desirable communication, goal setting and determining individual values have effective roles in the prevention and reduction of susceptibility to behavioral abnormalities and mental disorders (anxiety, depression, etc.), as well as in the promotion of mental health. The objective of this study was to determine associations between communication skills and mental health in Mashhad University of Medical Sciences (MUMS), Mashhad, Iran.

Methods and Materials: This was a cross-sectional analytical study conducted in 2011. The statistical population was all the MUMS students. A sample of 210 students was selected by stratified sampling and signed an informed consent. Data were collected using Communication Skills and General Health Questionnaires and analyzed using the SPSS 16 software, the statistical tests being Kruskal-Wallis, Mann-Whitney U and Chi-square. In all tests the significance level was 5%. To determine correlations between the variables the Spearman coefficient was used.

Results: The findings showed that 130 of the 210 students (61.9%) were suspected of having a mental disorder. Based on the Spearman correlation coefficient there were no statistically significant relationships between mental health and age (p=0.727) or skills such as listening (p=0.653), understanding verbal and nonverbal messages (p=0.857), awareness of the communication process (p=0.626) and assertiveness (p=0.477). However, a significant correlation was observed between mental health and emotion control skill (p=0.010). Furthermore, the Spearman correlation coefficient indicated no relationships between communication skills and age (p=0.228) or social dysfunction (p=0.074), while significant inverse correlations were found between communication skills and anxiety (p=0.043), physical symptoms (p=0.049) and depression (p=0.049). According to Mann-Whitney test no significant relationships were observed between communication skills and field of study (p=0.806), level of education (p=0.406), sex (p=0.404), place of residence (p=0.277), marital status (p=0.875) or employment status (p=0.274), but significant relationships did exist between mental health and sex (p=0.006), field of study (p=0.036)r and marital status (p<0.001). Finally, no significant correlations were found between mental health and level of education (p=0.080), place of residence (p=0.951) or employment status (p=0.978).

Conclusion: Based on the findings of this study, in an attempt to promote the mental health of the students it is recommended to make psychological assessments of the students, provide consultative services to them, and organize communication skills educational workshops for them.

The Prevalence of Active Human Herpesvirus 8 Infection and its Genotypes Among Human Immunodeficiency Virus-Infected Patients

Somayeh Jalilvand

Background and Aim: Considering the lack of information on the occurrence of the epidemic form of Kaposi’s sarcoma (KS) and the high prevalence of human herpesvirus 8 (HHV-8) infection among human immunodeficiency virus (HIV)-infected patients (46%), it was decided to estimate the incidence of KS in this group. Based on the fact that active HHV-8 infection leads to KS development, it is essential to first assess the prevalence of active HHV-8 infection in these patients. Most of the Iranian HIV-infected patients are not aware that they are HIV-positive. If the prevalence of HHV-8 infection is high in these patients, they may spread HHV-8 in the community by high-risk sexual behaviors, which would lead to an increase in the incidence of classic Kaposi’s sarcoma. The objective of this study was to investigate the prevalence of HHV-8 among HIV-infected subjects.

Materials and Methods: One-hundred plasma samples from HIV-infected patients were collected. Genome was extracted and assessed by the nested PCR assay with specific primers for ORF26. Positive samples were amplified for the ORF K1 region by nested-PCR. Subsequently their products were sequenced and their phylogenic trees constructed.

Results: HHV-8 was detected in 8 of the patients (8%). No statistically significant associations were found between age and gender on the one hand and HHV-8 infection on the other (p > 0.05). Two genotypes, namely, A and C, were identified, the former in two patients and the latter in one.

Conclusion: Although the prevalence of HHV-8 infection is high among Iranian HIV-infected patients, active HHV-8 infection rate is low among them. Therefore, it seems that the incidence of epidemic KS is likely to be very low in this group. Certainly more research is needed in this area. As regards genotypes, genotypes A and C are found in the samples.

The Effects of Diclofenac Sodium on Growth and Morphological Changes in Aspergillus Fumigatus and Exploring its Effects on Siderophore Protein by Determining the SidB Gene Expression

Sasan Rezaie

Background and Aim: Considering the increasing drug resistance to Aspergillus fumigatus,

search for genes involved in its pathogenicity and identifying alternative antifungal drugs is of utmost importance. The aim of this study was to determine the effects of diclofenac sodium on the growth and sidB gene expression in Aspergillus fumigatus.

Materials and Methods: In this study, Aspergillus fumigatus was cultured and a fungal suspension prepared, followed by determining the minimum inhibitory concentration of diclofenac sodium at a concentration of 25-1000 µg/ml. Then, RNA was extracted from the suspension at concentrations of 500,700 and 900 µg/ml of the drug. Finally, the extent of expression of the gene was determined by measuring different levels of mRNA-sidB by Real-time PCR.

Results: With increasing concentrations of diclofenac sodium, mycelium production decreased. Concentrations higher than 500 µg/ml had considerable inhibitory effects on the growth of Aspergillus fumigatus.

Conclusion: Findings of this study indicate that diclofenac sodium can cause a sharp reduction in the growth rate of Aspergillus fumigatus. Accordingly, it can be considered as one of the effective pharmacological agents for inhibiting the growth of this fungus.

Self-Medication Among Women in Yasouj City and Factors Associated with it: A Preliminary Study for Designing an Intervention Based on Health Belief Model

Mohsen Shams

Background and Aim: Self-medication, as a common risky health behavior, has financial and non-financial costs for Iranians. This study aimed at determining the situation of self-medication and factors influencing it among women in Yasuj, Iran.

Materials and Methods: This cross-sectional study was performed on 192 women referred to urban health care centers in Yasuj, selected randomly from the existing health files at the centers. Data were collected using a standard questionnaire based on the Health Belief Model and analyzed by SPSS 16 statistical software.

Results: The most widely used medicines for self-medication were those for common cold and antibiotics from among over-the-counter (OTC) drugs and prescription-only-medicines (POM), respectively. Perceived susceptibility (17.63± 3.46) was the main construct associated with self-medication among women.

Conclusion: Once the causes of self-medication and its relationship with the Health Belief Model constructs are known, designing and implementing educational programs aiming at promoting awareness and perception of population groups, especially women, seems necessary.