Journal of School of Public Health and

Background and Aim: Patients with hemophilia and thalassemia are at high risk for hepatitis C virus (HCV) infections. Unscreened blood and blood products are thought to be the most important risk factors in these two groups.

Materials and Methods: Blood samples were collected from 98 thalassemia patients and 74 hemophiliacs in Markazi province. The presence of anti-HCV antibody was tested by a third generation enzyme immunoassay. All ELISA-reactive samples were tested with the confirmatory third-generation recombinant immunoblot assay RIBA. We used a specially designed questionnaire to obtain data from patients and the software package SPSS 11.5 for statistical analysis.

Results: HCV antibody was detected in 5 thalassemia patients (5.1%) and 31 hemophiliacs (41.9%). Anti-HCV positivity in patients with thalassemia was associated with the total volume of the transfusions, splenectomy, and the duration of treatment. In hemophiliacs, seropositivity was significantly associated with the duration of transfusion treatment (P=0.01) and disease severity (P=0.00). The prevalence of HCV antibody in thalassemia subjects dropped from 8.1% to 0% after the implementation of anti-HCV screening in1996.

Conclusion: In Markazi province, the current policy of screening donors for anti-HCV and the strict safety controls on factor concentrates can effectively protect thalassemia and hemophilia patients from HCV infection.

Background and Aim: The lack of balance between job needs and workers' physical capacity may lead to work-related musculoskeletal disorders (Wises). WMSDs are one of the most important occupational health problems in developing countries. These problems are due to risk factors such as poor work postures, excessive force applied, repetitive movements, vibration, prolonged work duration, and psychological factors, leading, ultimately, to disorders ranging from mild low back pain to severe disabilities. This study aimed at determining the prevalence of WMSDs in different body regions, assessing posturing, and detecting ergonomic and individual risk factors causing musculoskeletal disorders, in Araki bakery workers in Arak, Iran.

Methods and Materials: In this cross - sectional study 233 randomly selected bakery workers in Arak were included, and the prevalence of symptoms of musculoskeletal disorders and their risk factors, with particular emphasis on work posture, was determined in them. The method used was OWAS and the NMQ Questionnaire.

Results: The highest prevalences of musculoskeletal disorders were in the knees (62.2%), low back (58.8%), legs (53.9%) and shoulders (44.6%) of the workers. Low back and shoulder injuries in Shaaters (workers in charge of baking the bread) and elbow, thigh and low back disorders in Choongeers (workers in charge of dividing and rounding the dough) were more prevalent than in other occupations. There is a positive association between type of occupation and these disorders (p<0/05). According to the OWAS's classification, the distribution of bakery workers' working postures was as follows: 58.5% in the action category 1 (natural posture), 34.7% in the action category 2 (stress posture), 4% in the action category 3 (harmful posture), and 2.5% in the action category 4 (very harmful posture). There was a significant relation between work service record and neck, elbow, shoulder, and knee disorders (p<0/05).

Conclusion: This study revealed that the working postures of 42.2% of Aaraki bakery workers were slightly to very harmful postures in addition, there was a high prevalence of WMSDS in different body regions of the workers. Ergonomic interventions are essential to improve the situation and protect better the health of the workers.

Background and Aim: Domestic violence against women is a serious public health problem and women adopt different solutions to fight against it. This study was carried out to determine the prevalence of intimate partner violence and views of women
on adopting ways to fight against it in Arak city, Iran, year 2008.

Methods and Materials: In a cross-sectional study in Arak city in 2008, a total of 1037 women were interviewed. The data collected were analysed statistically.

Results: Findings showed that the common types of abuse were emotional (64.6%), verbal (57.1%), financial (32.3%), and physical (26.8%). The women mentioned that the most efficient ways they chose to counteract the abuses were as follows: resuming talking after the settlement of quarrels (93%), keeping silent on the part of one of the partners (81%), and seeking advice from the older members of the family (81%). The considered going into a temporary sulk (51%) and reciprocation (46%) ineffective methods. Correlations were found between violence on the one hand and education, job, addiction of the spouse, income of the spouse, mental disorder of the partner, and number of children on the other hand (p<0.05).

Conclusion: Results of this study show that a large number of women are subjected to different types of violence. It seems that increasing awareness of married women and girls concerning effective counteractive methods can be an effective step in solving this social problem.

Background and Aim: Domestic violence against women is a serious public health problem and women adopt different solutions to fight against it. This study was carried out to determine the prevalence of intimate partner violence and views of women
on adopting ways to fight against it in Arak city, Iran, year 2008.

Methods and Materials: In a cross-sectional study in Arak city in 2008, a total of 1037 women were interviewed. The data collected were analysed statistically.

Results: Findings showed that the common types of abuse were emotional (64.6%), verbal (57.1%), financial (32.3%), and physical (26.8%). The women mentioned that the most efficient ways they chose to counteract the abuses were as follows: resuming talking after the settlement of quarrels (93%), keeping silent on the part of one of the partners (81%), and seeking advice from the older members of the family (81%). The considered going into a temporary sulk (51%) and reciprocation (46%) ineffective methods. Correlations were found between violence on the one hand and education, job, addiction of the spouse, income of the spouse, mental disorder of the partner, and number of children on the other hand (p<0.05).

Conclusion: Results of this study show that a large number of women are subjected to different types of violence. It seems that increasing awareness of married women and girls concerning effective counteractive methods can be an effective step in solving this social problem.

Background and Aim: Pressure ulcer is a common problem and a large drain on hospital resources, especially in wards such as ICU where patients stay for a long time. The aim of this study was to explore the likely factors contributing to pressure ulcers in the ICU units of Tehran University of Medical Sciences teaching hospitals, Tehran, Iran.

Materials and Methods: This project was conducted in all the seven ICUs of four teaching hospitals affiliated to Tehran University of Medical Sciences. In the first phase the researcher performed a direct observation of all the 90 patients who were admitted to the ICU units to check the presence of any pressure ulcer. In the second phase, 310 patients discharged from the same ICU units between March 2007 and February 2008 was randomly selected and their medical records reviewed. A structured questionnaire was used to collect the data.

Results: Pressure ulcer occurred more frequently in the elderly women patients who were less active and had less mobility, hospitalized for a long time, or those with fever, diabetes, high blood pressure, paralysis, or respiratory diseases. In addition, pressure ulcer was seen more frequently in the patients hospitalized in the general ICUs, as well as in those with infections and different types of tumors.

Conclusion: Using a standard risk assessment tool and paying attention to the main risk factors of pressure ulcer can be a useful method for identifying the high-risk patients before admission in order to prevent them from developing such ulcers.

  Background and Aim: High fruit and vegetable intake has been introduced as one of the key factors of healthy diet to prevent chronic disease. This study attempts to explore the fruit and vegetable intake in Arak city and its relationship with demography and socio-economic factors.

  Materials and Methods : In this cross sectional study, 660 people in 18 -70 age range were selected with a two-stage cluster sampling and were interviewed for demography and socio – economic questionnaires and a 56- items semi-quantitative food frequency questionnaire to assess fruit and vegetable intake. After univariate analysis, the association of the significant variables with fruit and vegetable intake was also evaluated with multiple linear regression.

  Results: In this study, over 60 percent of subjects consumed less than the minimum recommended amount of fruit and vegetable (5 servings or 400 gr a day).The total consumption of fruit and vegetable indicated an inverse significant relationship with age (p =0.04 and β = - 0.02), and a direct significant relationship with economic status (p <0.001and β =0.10). The father's educational level (p =0.005 and β =0.38 for diploma level and p =0.03 and β =0.36 for academic education) and physical activity level (p =0.001 and β =0.03 per hour) were factors associated with fruit consumption. The gender was only associated with vegetable consumption so that women had higher consumption in this study (p =0.03 and β=0.23).

  Conclusion: The findings of this study indicate low fruit and vegetable consumption in the population under study. In this study, age, physical activity, and socioeconomic status and fathers’ education were the factors that were significantly associated with fruit and vegetable consumption.

Background and Aim: Currently there is no standardized and validated questionnaire for assessing the care of danger signs in children less than 5 years by the mothers based on behavioral patterns. The aim of this study was to develop and evaluate psychometrically an instrument for assessment of the care of danger signs in children less than 5 years old by the mothers based on the Health Belief Model.

Materials and Methods: This cross-sectional study was carried out on 350 mothers in the City of Arak, Iran. After reviewing the related literature, an instrument was designed and its content validity ratio (CVR), content validity index (CVI) and face validity were measured. To measure the reliability of the scales, the internal consistency method was used. Data analysis was done using the SPSS software.

Results: The scores of the CVI and CVR of the 81 items were found to be 0.79 and 0.62, respectively, the items being classified into seven categories. Based on the Cronbach's alpha, the overall reliability was 0.86. The reliability of the questionnaire for checklists of performance was 0.99, followed by those of perceived benefits (0.90), severity (0.83), perceived barriers (0.68), knowledge (0.66), perceived susceptibility (0.65), self-efficacy (0.63), and cues to action (0.56). Conclusion: The output of this psychometric process study is a valid and reliable instrument for measuring symptoms of risk behaviors in the care of vulnerable children based on the health belief model constructs, which can be used in health sciences research aiming at helping to protect the health of children.