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

The Effect of Quality Management on the Efficiency of the Respiratory Intensive Care Unit in a Hospital

Ensiyeh Ashrafi

Background and Aim: Quality management, as an organizational strategy, helps enhance hospital effectiveness and efficiency. This study aimed to examine the effect of a quality management model on the efficiency of the respiratory intensive care unit in Labafijejad Hospital, Tehran in 2013-14.
Materials and Methods: This was a participatory action research conducted in the respiratory intensive care unit in Labafijejad Hospital, Tehran in 2013-14. A quality improvement team was formed to implement the quality management system and promote working processes. The team identified and standardized working processes, determined the quality goals for the processes, and improved the processes based on the 10-stage Mosaddeghirad Quality Management model. Performance indicators of the unit (bed occupancy, bed turnover, and bed interval rates; patient average length of stay in the ward) were calculated and compared before and after the intervention.
Results: Implementing quality management brought about an increase of 2.8% and 19.2% in bed occupancy rate and bed turnover rate, respectively, as well as a decrease of 14.1% in patient average length of stay and a decrease of 35.6% in bed interval rate in the respiratory intensive care unit of the hospital.
Conclusion: Implementing quality management can increase the efficiency of the respiratory intensive care unit of a hospital. A suitable quality management system and the commitment of the hospital manager and staff can result in enhancement of efficenicy in a hospital.

Thre Attitude of Food Safety and Hygiene Students Toward Their Field of Study and Future Career in the Iranian Universities of Medical Sciences

Gholam Reza Jahed Khaniki

Background and Aim: Attitude, as the most important social psychology concept, has a special place in research; undoubtedly, in university life having a positive attitude is essential for success in any field of study. The aim of this study was to determine tha attitude of food safety and hygiene students toward their field of study and future career in the Iranian universities of medical sciences.
Materials and Methods: This was a descriptive cross-sectional study, conducted in 2016, including 77 food safety and hygiene students in the Iranian universities of medical sciences, selected by census. Data were collected using a questionnaire containing 24 questions and analyzed by SPSS-24 software, the statistical tests being descriptive statistical tests.
Results: The attitude score (Mean ± SD) of the students toward their field of study was
35.0 ± 12.4, indicating that they had a positive attitude, while the score of their attitude toward future career was 23.05 ± 10.86, which was less than acceptable. Further analysis of the data showed a significant association between the students’ attitude toward their field of study and employment status (p = 0.036).
Conclusion: Based on the results of this study, the food safety and hygiene students have a positive attitude towards their field of study, while their attitude toward future career is lower than acceptable, which demonstrates lack of a desirable attitude. Strengthening of training programs and advice and support for the students can play an effective role in reinforcing their attitude.

Predictive Value of Contextual Factors and Life Skills in Secondary School Male Students’ Mental Health in Ray County, Iran

Gholam Reza Garmaroudi

Background and Aim: Mental health plays a vital role in psycho-social development of an individual in various periods of life, particularly during adolescence. Addressing the mental health problems of adolescents is considered as a global health promotion and disease prevention priority. The aim of this study was to assess the mental health status of adolescent boys and determine the role of contextual factors and life skills in predicting mental health of the students in 2016 and present n appropriate model.
Materials and Methods: This was a cross-sectional study conducted on 550 secondary male school tudents, selected by cluster random sampling, in Ray County, Iran. Data were collected using a standard valid General Health Questionnaires (GHQ-28) and a life skills questionnaire and analyzed using the SPSS software 22.0, the statistical tests being Chi-square and logistic regression.
Results: Analysis of the data showed that 46.9% of the students were suspected of having mental health problems, the rest (53.1%) having no disorder. The most common disorder (56%) was in the social functioning. As regards life skills, the proportions of the students with a low, moderate and high life skills were 35.3%, 32.5% and 32.2%, respectively. Statistically significant correlations were found between mental health and its four dimensions on the one hand and the independent variables, namely, self-awareness, decision-making and age on the other.
Conclusion: The findings indicate a fairly moderate prevalence of mental disorders among the students and demonstrate the role of life skills training in promotimg mental health in adolescents and the youth.

Factors Affecting Long-Term Survival Rate with Cure Fraction Using the Mixture Cure Cox Model in Patients with Gastric Cancer in East-Azerbaijan Province, Iran

Mehdi Yaseri

Background and Aim: Gastric cancer is one the most common gastrointestinal tract cancers in Iran, with East-Azerbaijan Province ranking second in the country. The objectives of this research were to determine the feasibility of using cure models in survival analysis and factors affecting short-term and long-term patient survival rates using the mixture cure cox model.

Materials and Methods: We used the available information on 184 patients diagnosed with gastric cancer in East-Azerbaijan Province cities referring to medical centers during the period 2009-2010 and followed up for 5 years.

Results: The median of survival time was 8.33 months (95% CI = 5.9-10.6). Fitting the univariate and final cox cure models showed that in the short-term survival the effect of the chemotherapy factor was statistically significant (Hazard ratio =0.49, 95% CI = 0.34, 0.69, p-value <0.001).

Conclusion: If the population under study consists of two groups of susceptible and non-susceptible individuals for the intended incident, the mixture cure models can be used for the discrete analysis of long-term and short-term survival of patients diagnosed with gastric cancer and identification of variables affecting the two survival rates.

Assessment of the Explanatory Power of the Expectation-Confirmation Model for the Intention to Continue Fruit and Vegetable Consumption in the Rural Elderly

Hashem Mohamadian

Background and Aim: The prevalence of chronic diseases can be reduced by correcting people's food habits. Therefore, the purpose of this study was to assess the explanatory power of the Expectation-Confirmation Model for the intention to continue fruit and vegetable consumption.
Materials and Methods: This descriptive-analytic study included 332 elderly people with a history of receiving health care services from 8 rural health centers and 40 health houses in Abadan city, Iran in the second half of 2015. Data were analyzed by path analysis and the multicolinearity test using LISREL8.8 and SPSS16 software, respectively.
Results: Less than half (48%) of the subjects consumed 1 to 3 servings of fruit and vegetable daily. The model used could explain 79% of the intention to continue fruit and vegetable consumption. Analysis of the data also showed positive associations between the intention to continue fruit and vegetable consumption and the following variables: self-efficacy (β = 0.09, P <0.01), perceived ease of use (β = 0.15, P <0.01), perceived benefits (β = 0.37, P <0.01), and satisfaction (β = 0.35, P <0.01); however, the perceived barriers had an inverse relationship with that intention (β=-0/2, P <0.01). From among the constructs of the mode, perceived benefits were the most effective factor influencing the intention to continue fruit and vegetable consumption (β=0.85, P <0.01).
Conclusion: The model used in this study is suitable for explaining the elderly people’s intention to continue fruit and vegetable consumption. It is recommended that policy-makers use appropriate strategies to increase the understanding of the benefits of eating fruits and vegetables by the elderly and, thus, sensitize them to increase their consumption through public campaigns and communication with the relevant organizations, families, etc.

Self-Immolation of Women in Ilam City, Iran: A Descriptive Study

Zahra Rezaeinasab

Background and Aim: Self-immolation is the death of a life. It is seen in women who have suffered greatly in life for long years, lost patience totally and found no way out except self-immolation.
The aim of this study was to identify the epidemiologic pattern of women's self-immolation in Ilam Province, Iran during the period 2011-2016.
Materials and Methods: This was a descriptive study in which data were collected based on the files of women who had immolated themselves during the period 2015-2016 and analyzed using the SPSS software, the statistical tests being descriptive statistics.
Results: A total of 129 women, within the age range 11-95 years (mean 24 years), had immolated themselves during the 5-year period (53.5% in the age group 20-35 years), 73.6% of them being married and 77.5% housewives. The average body surface burn percentage was 70%, the range being 15-99%. Most cases of self-immolation had occurred in autumn and spring, mostly in the afternoon. The most common cause of self-immolation had been reported as unknown (38% of the cases), followed by mental disease and depression (30.2%) and family conflicts (17.1%), specially husband and wife conflicts.
Conclusion: Self-immolation is the unusual ending of a life. Young married women are more likely to get exposed to hardships and confusion in the course of family and community life. Depression is one of the most important causes of suicide, a consequence of issues such as violence and harassment by spouse and family, poverty, deprivation and destitution.
Strategies to reduce self-immolation would include comprehensive social support and protection against domestic violence against women, educationg women about techniques to control anger and reduce stress, and informing them about support centers.

Quality of Life Predictors Among Health Volunteers in South Tehran Health Centers

Roya Sadeghi

Background and Aim: Quality of life is considered as an effective indicator for general, as well as mental, health. With increasing longevity of individuals, health-promoting behaviors and rising quality of life will become much more important. This study aimed to determine the quality of life predictors among health volunteers in South Tehran Health Centers.
Materials and Methods: : This cross-sectional study was conducted on 200 health volunteers of South Tehran Health Centers selected by cluster sampling. Data were collected using valid and reliable questionnaires for demographic variables, Health-promoting Behaviors (HPLPII) and Quality of life (SF-36), as well as the BAZNEF model constructs, whose validity and reliability were assessed (α: %88). Data analysis was done using the SPSS24 software, the statistical tests being descriptive statistics and multi-linear regression; a p-value <0.05 was used to show statistical significance.
Results: Regression analysis revealed that the strongest predictors for the quality of life were age (p=0.003), enabling factors (p=0.02) and general health-promoting behaviors (p<0.001).
Conclusion: The findings of this study confirm the suitability of the BAZNEF model for predicting health-promoting behaviors for the quality of life. Using this model can help in identifying factors influencing the quality of life of health volunteers and designing an appropriate educational program for them.

Efficient Removal of Organophosphate Pesticide Imidacloprid from Water Samples by Modified Magnetic-Silica Core-Shell Nanoparticles as a Recoverable Nano-Adsorbent

Seyed Mostafa Khezri

Background and Aim: Agricultural poisons are one of the most important groups of pollutants in agricultural industries that cause environmental pollution. The main objective of this research was to remove imidacloprid from contaminated water by using modified magnetic-silica core-shell nanoparticles.
Materials and Methods: This study was conducted at the laboratory scale and batch system. The physical and structural characteristics of the synthesized adsorbent were determined by scanning electron microscopy (SEM). In addition, the effects of various parameters such as pH, initial concentration of imidacloprid, adsorbent dose, and contact time were investigated in order to determine the equilibrium isotherms and adsorption kinetics. The potential of the adsorbent for removal of imidacloprid showed no significant change after four runs of the reaction.
Results: The highest efficiency was found to be 97.85 %, achieved at the following conditions: a contact time of 67 minutes, an adsorbent dose of 0.06 g/l, an initial concentration of 15.6 mg/l and a pH of 6.5. The correlation coefficient of Langmuir isotherm (R²=0.9843) was higher than that of Freundlich (R²=0.8). Therefore, the Langmuir isotherm model is hereby introduced to be used for predicting the adsorption behavior of imidacloprid onto the nano-adsorbent from an aqueous medium. The reaction kinetics fitted well with the pseudo-second-order model.
Conclusion: A modified magnetic-silica core-shell nanoparticle is a cost-effective and recoverable adsorbent for efficient removal of imidacloprid from contaminated water.