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

Environmental Sustainability Assessment of Sufian Cement Industry On the Basis of Circular Economy Model

Saeed Motassadi Zarandi

Background and Aim: Cement production is the source of 7% of global CO2 emissions. In order to reduce emissions by 0.7% annually until 2030, the cement industries can adopt the circular economy model. The present study aimed to assess the environmental sustainability of the Sufian cement industry based on the circular economy model.
Materials and Methods: Based on the circular economy model of the Ellen MacArthur Foundation, this research was conducted in three steps in the Sufian Cement Factory in 2021-22: Step1. Data were collected on fuel consumption, electricity, water, production waste, released gases and costs; Step 2. Based on literature review and experts opinions strategies and solutions to move towards a circular economy were determined; Step 3. The index of linearity and rotation in the current and future state was calculated for the Sufian cement industry.
Results: The data obtained showed that the Sufian cement industry is currently heavily dependent on primary raw materials and operates in a linear economy. Implementing the recommended strategies would be expected to reduce the linearity index to below 1 and increase the rotation index to above 0.1. These findings indicate a positive shift towards a circular economy.
Conclusion: The findings of this study reveal that the Sufian cement industry is currently totally based on linear economy, but it can, through implementing the relevant strategies, potentially transit to a circular economy, which will increase the factory’s net profit, protect resources and reduce CO2 emissions.

Estimation of Survival Rate in Transplanted Kidney in Chronic Renal Failure in Zahedan City, Iran

Majid Sartipi

Background and Aim: Kidney transplantation is the treatment of choice in most patients with kidney disease. It is a surgical operation in which a person’s kidney with chronic failure is replaced with a healthy kidney. The present study was conducted with the aim of estimating the survival probability of a transplanted kidney in patients with chronic kidney failure in Zahedan city, Iran.
Materials and Methods: This was a descriptive-analytical retrospective cohort study using the survival analysis method carried out in 2020. The sample size was estimated to be 211 patients.
Data were analyzed with SPSS.VER22 software using descriptive tests, the Kaplan-Meier method and the Cox proportional hazards model of survival.
Results: The data obtained showed that in general 45 (21.3%) clients had been rejected. In the multiple logistic regression model of kidney transplantation several variables, including survival time, patient survival variables, marital status, donor status, blood pressure and diabetes remained in the model (P<0.05). Further analysis of the data revealed that in the kidney disease patients with transplant survival in Zahedan city, only donor status variables, high blood pressure and diabetes remained in the final multiple Cox regression model.
Conclusion: Based on the results, it can be said that the probability of survival of kidney disease patients is independent of the type of donor and the characteristics of the recipient, which indicates the evolution of kidney transplant management over the past few years; dialysis before kidney transplantation also has an effect on the probability of survival. These factors can help to increase the probability of kidney transplant survival.

Critical Assessment of Drug, Alcohol and Tobacco Prevention Services Based on the Information Available in the Office of Psychosocial Health and Addiction of the Health Deputy Section in the Primary Health Care System

Zoha Hajiha

Background and purpose: The purpose of this research was to write a critical review of the available service packages in the Mental and Social Health and Addiction Office (MSHAO) of the Ministry of Health and Medical Education in the areas of drugs, alcohol and tobacco, which are currently used in the primary health care system. The content analysis method was used to extract the specialists’ critiques.
Materials and Methods: Initially the MSHAO sent 1362 pages of information in the form of 47 files to researchers to be reviewed. The files were classified, eliminating/removing additional, unrelated and duplicated items; finally 840 pages in 29 files were studied and carefully examined. Then, seven experts in the field of addiction were asked to criticize the packages, using the content analysis method to extract the experts' critiques.
Results: The findings showed that comprehensive information about drugs, alcohol and tobacco addiction is provided to the clients. However, based on a critical review of the existing packages four main critiques were extracted, namely, sources/references, epidemiology, incompatibility of Iranian-Islamic culture, and technical-specialist issues. In addition, criticisms were also extracted in the following areas/services: the number of files and the variety of interventions, editing and writing problems, interventions and discussions with inappropriate in-text sources/citations, some old sources/references (published in 2013 and 2014), old interventions, lack of appropriate compatibility with the culture of the Islamic society of Iran, and direct translation of some parts of the original texts and documents of international meetings/gatherings.
Conclusion: Despite the efforts of the Mental and Social Health and Addiction Office to cover the needs of the majority of people referring to the primary care system, it seems that the high number of interventions and additional information can cause confusion of/for the physician, mental health care provider, family health care provider, general health care provider and other relevant individuals. It is, therefore, suggested that some packages be merged with each other, duplicate items be removed and specific sections be added, some packages be fundamentally revised based on the suggested items, and updated packages be developed with due consideration of to the culture of the Iranian society.

Socio-Demographic Predictors of Health Literacy Among Women Referring to Comprehensive Health Service Centers in Zahedan in 2022

Fereshteh Narouei

Background and Aim: Women referring to health centers are one of the most important groups at risk of disease. Thus, in order to enjoy a high level of health, it is necessary for them to have health literacy. The purpose of this research was to find the demographic predictors of health literacy in women referring to comprehensive health service centers in Zahedan, Iran.
Materials and Methods: This was a descriptive-analytical study including 400 women selected by random cluster sampling from health centers under coverage of Zahedan University of Medical Sciences in 2022. The short form of the HELIA standard questionnaire was used to measure health literacy of the women. Data were analyzed using SPSS-22 software, the statistical tests being ANOVA, Kendall's correlation, and multiple regression.
Results: The subjects were between 18 and 60 years old. They were found to have obtained most of the information related to health and disease by asking doctors and healthcare workers (about 52.25%). The scores of the components of the subjects’ health literacy were as follows: average health literacy 69.91±23.34, reading 72.17±29.80, access 34.73±27.91, understanding 71.41±29.43, assessment 62.10±25.51, and the scope of decision-making and behavior 71.49±20.27. The strongest predictor of health literacy was found to be education, such that with an increase in the level of education, the health literacy of a woman would increase by 0.53 units. In addition, education variables, income level, age and ethnicity would predict 55% of the health literacy of the women.
Conclusion: This study shows that the health literacy score is related to age, education level, marital status, occupation, economic status and ethnicity, the strongest predictor of health literacy being the a high level of education. Therefore, considering the available evidence on the importance of health literacy and factors related to it and the low level of health literacy of women in this study, it is clear that women need to acquire, process and understand the basic information on health and therapeutic services in order to be able to make appropriate decisions. Briefly, women need to receive simple and understandable information and have more time to communicate with the health service personnel to understand health information.

Hesitancy Toward COVID-19 Vaccine Among Medical University Staff: The Role of Mandatory Vaccination Policies and Corona Anxiety

Tayebe Rahimi Pordanjani

Background and Aim: Vaccination, as one of the most cost-effective medical interventions, has significantly reduced the incidence of many infectious diseases. This study aimed to examine the moderating effect of mandatory vaccination policies on the relationship between corona anxiety and vaccine hesitancy among the employees of medical universities.
Materials and Methods: A descriptive-correlational study was conducted using convenience sampling on a sample of 152 employees selected from a medical university in North Khorasan Province, Iran. Data were collected using a researcher-made questionnaire on mandatory vaccination policies and vaccine hesitancy and Corona anxiety questionnaires. Pearson correlation coefficient and hierarchical regression were employed to test the research hypotheses, and data analysis was performed using the SPSS and AMOS software.
Results: The findings showed that 77% of the employees supported mandatory vaccination policies in the workplace. In addition, the correlation coefficients between Corona anxiety and mandatory vaccination policies with vaccine hesitancy were significant (p<0.001). Furthermore, the interaction of Corona anxiety and mandatory vaccination policies accounted for an additional 2% unique variance in the model (R²Δ=0.02, FΔ=4.02, p=0.05).
Conclusion: Based on the findings of this study it can be said that mandatory vaccination policies can moderate the relationship between Corona anxiety and vaccine hesitancy among employees of medical universities. It is, thus, recommended to use appropriate and cost-effective policies and executive guarantees to improve vaccination attitudes in employees with anxiety.

The Effect of Emotion Regulation Group Therapy on the Symptoms of Social Anxiety Disorder Comorbid with Generalized Anxiety Disorder

Mehran Farhadi

Background and Aim: Considering the high prevalence of anxiety disorders, the high comorbidity of social anxiety disorder and generalized anxiety disorder, and the negative and lasting effects of social anxiety disorder on various aspects of a person's life, the present study investigated the effect of emotion regulation group therapy on the symptoms of social anxiety disorder comorbid with generalized anxiety disorder.
Materials and Methods: This was a quasi-experimental study with a pre-test and post-test design with control and follow-up groups. The statistical population included all the patients with social anxiety disorder comorbid with generalized anxiety disorder referring to psychotherapy clinics in Shiraz, Iran, from among whom a sample of 30 people were selected by the available sampling method. Data were collected using Structured Clinical Interviews for DSM-5 (SCID-5), Generalized Anxiety Disorder Scale-7 and the Social Interaction Anxiety Questionnaire (SIAS) and analyzed with SPSS version 27 software using the analysis of variance method with repeated measurements
Results: The data obtained showed that emotion regulation group therapy could significantly reduce the symptoms of social anxiety disorder (p<0.001) and generalized anxiety disorder (p<0.001), the results remaining stable in a three-month follow-up (p<0.05)
Conclusion: Based on the findings of this study it can be concluded that group therapy of emotion regulation is effective in, and can, thus, be used as a therapeutic intervention for, social anxiety disorder comorbid with generalized anxiety disorder.

Davood Jalili Naghan

Background and Aim: Air pollution has been widely established as an important risk factor for heart and respiratory diseases and mortality. The aim of this study was to compare the relationships between short-term exposure to air pollutants and hospital admissions, cardiovascular and respiratory deaths and total deaths in Ahvaz and Shahrekord, Iran.
Materials and Methods: In this ecological and time-series study data were collected on hospital admissions, cardiovascular and respiratory deaths and total deaths between 2012 and 2018. For data analysis Quasi-Poisson regression combined with linear distributed lag models were used and adjusted for trend, seasonality, temperature, relative humidity, weekdays and holidays.
Results: Data analysis showed that in Ahvaz there were statistically significant direct correlations between PM₁₀ exposure and respiratory admissions, PM_2.5exposure and total deaths and cardiovascular admissions, O₃ exposure and total deaths, and CO exposure and cardiovascular admissions. As regards Shahrekord, there were statistically significant direct correlations between PM₁₀ exposure and respiratory deaths, PM₁₀ exposure and cardiovascular deaths, PM_2.5exposure and cardiovascular and respiratory admissions and respiratory deaths, O₃ exposure and total deaths, and CO exposure and respiratory deaths.
Conclusion: It seems there are statistically significant relationships between air pollution and hospital admissions and deaths in Ahvaz and, to a lesser extent, in Shahrekord.

Explaining the Experiences of Family Physicians of Rural Centers and Managers after Implementation of the Health Transformation Plan of the Public Health Section in Zahedan University of Medical Sciences in 2023

Jalal Big Mohammadi

Background and Aim: The Health Transformation Plan (HTP) has been developed to be implemented in the rural areas with the goal of easy access of the villagers to the physician, their equitable benefit of the public facilities and improving the outpatient services. The present study was conducted to find and explain the experiences of family physicians of the rural centers and managers after the execution of HTP of the public health sector in Zahedan University of Medical Sciences (ZAUMS), Zahedan, Iran.
Materials and Methods: This was a qualitative study using the content analysis method conducted in 1402 in the public health section in ZAUMS. The research population was the physicians and managers working in the rural areas of ZAUMS between 2015 and 2022; a sample was selected using the purposeful sampling method. Data were collected using the semi-structured interview based on the interview guide; content analysis was done using contract analytics.
Results: A group of 31 individuals including 20 men and 11 women and 19 physicians and 12 managers entered the study. Data were collected, analyzed and grouped in 6 main classes, namely, service delivery, integrated health system, resources, people and service recipients, monitoring and supervision, and suggestions; 12 sub-classes were extracted.
Conclusion: Based on the results of this study it can be concluded that appropriate training, service quality, financial support, and sustainable skilled manpower are the factors that will help solve the challenges in the Health Transformation Plan. On the other hand, considering that one of the components of the health system for successful implementation of the Health Transformation Plan is human resources, the ability and flexibility of the personnel play an important role in the speed of service delivery and service quality.