Journal of School of Public Health and

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Background and Aim: Experience at the national and international levels shows that internal evaluation, especially at the level of academic departments, can play a critical role in warranting having a university with high standards. The objectives of the present research project were to determine (a). the quality of the structural elements of the Epidemiology and Biostatistics Department (EBD) School of Public Health,  Tehran University of Medical Sciences,  and (b). The strengths, weaknesses, opportunities and threats, on the basis of which action could be taken to improve the quality of activities in the Department.

Materials and Methods: The study was conducted with the collaboration of the head and faculty members, all of the students (residents, Ph.D. and M.S. students), and the graduates, of the EBD. Nine variables were studied, namely, 1). Aims and objectives 2). Organizational and management structure 3). Faculty members 4). Students 5). Teaching and learning process 6). Courses and curricula 7). Graduates 8). Research and educational facilities and equipment and 9). Research activities of the faculty members. First the initial weight of the 9 variables were  determined by opinion poll carried out among all the faculty members of EBD. Then unrelated data were identified through proper tests and omitted and the final weights extracted. The tools used to collect the data included interview, observation, and 7 self-prepared questionnaires and 2 check lists.

Results: The mean score for the 9 factors studied was 59.8%, the range being between 37.0% (for objectives and mission) and 72.0% (for graduates).

Conclusion: The graduate domain is one of the key areas in internal evaluation of the Department of Epidemiology and Biostatistics. On the other hand, the lower score for objective and aims domain implicates the need for future intervention in this domain.

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Background and Aim: The objective of this study was to determine the contents of heavy metals Hg, Cd and Pb in the muscle, liver and gill tissues of Liza abu fish in the Dez and Bahmanshir Rivers in Khoozestan Province, Iran in winter 2010. 

Materials and Methods: The study included 108 samples of Liza abu tissues. The metals were extracted from the tissues using the wet-digestion method and their concentrations were determined by atomic absorption spectrophotometer Perkin Elmer 4100. Analysis of the data was done using the SPSS17 software, the statistical test being the t-test ((p≤0.05).). 

Results: The highest concentrations (mg/Kg) of Hg (0.029±0.005), Cd (0.506±0.047) and Pb (1.07±0.096) were found in the gill and their lowest concentrations, 0.023±0.001, 0.346±0.040 and 0.903±0.030, respectively, in the muscle. The concentrations of Cd in the gull, muscle and liver were significantly different (p≤0.05) between the Dez and Bahmanshir River fish samples, but the differences with regard to Hg and Pb concentrations were not different between the 2 rivers (p≥0.05). 

Conclusion: The mercury content of Liza abu tissues was lower, while the lead and cadmium contents were higher, than the respective WHO standards (permitted levels).

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Background and Aim: Iron nanoparticles are broadly used in medical science, particularly in synthesis of fluorescence biomarkers, cancerous tumor therapy by hyperthermia, and as a contrast agent in MRI. Physical and chemical synthesis methods currently used to produce nanoparticles cause environmental contamination. Certain bacteria are capable of synthesizing significant amounts of iron nanoparticles, quite in conformity with the principles of green chemistry. The objective of this study was to isolate iron nanoparticle-producing magnetotactic bacteria from Arjin ore in Zanjan Province, Iran

Materials and Methods: Serial dilutions were prepared from the soil of iron ore and inoculated on a combined solid agar culture medium specifically used to isolate magnetotactic bacteria. This was followed, after incubation at 30 degree for a week, by transferring samples of colonies to special liquid culture media. After three weeks of incubation, the samples were examined by Gram staining, XRD and of scanning electron microscope (SEM).

Results: The existence of iron nanoparticles was confirmed by analysis of XRD graphs. Furthermore, scanning electron microscopy pictures proved the shape of bacteria and extracellular accumulation of iron nanoparticles produced by them.

Conclusion: Magnetotactic bacteria isolated from Arjin ore in Zanjan Province, Iran are capable of biosynthezing iron nanoparticles.

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  Background and Aim : It is impossible to deny the threats and risks endangering the process of health care when offering the services. Confirming this fact does not mean ignorance the risk, or allowance to medical and nursing mistakes to happen however, it can mean approaching the problem to come up with practical solutions and minimize the risks in the process of providing health care services. The present study was conducted periodically as an applied multi-stage research.

  Materials and Methods : To do a model of clinical risk management, different authentic texts on risk management in health sector were reviewed focusing on the models available. All such models were tabulated, analyzed and compared together which resulted 62 primary variables. The variables were, then, validated being used in a questionnaire responded by 20 nurses and doctors which, this time, produced a confirmed questionnaire of 40 variables. After that, 215 subjects chosen through a random and a stratified sampling were asked to respond to that questionnaire, making an exploratory factor analysis as well.

  Results : This study was done, using principal components analysis as with a rotation of Varimax loadings showed a variety of factors (19 factors) available in the models of clinical risk management were loaded as "organizing and policy-making" factor. This factor illuminated a sum of 25.3% of variances in the model of clinical risk management. The results also showed the loading factor of variables as among 0.5 and 0.7 which indicated a fine correlation among them and the participants' view.

  Conclusion: It was concluded that "the best care of the patient is accepted as a common perspective in organization" and "the effect of the treatment team's clinical performance on their financial payments" are the most and the least important variables respectively with 0.739 and 0.548 as factor load.

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  Background and Aim: There is some evidence that nutrition probably plays a role in the etiology of multiple sclerosis (MS). The present case-control study was conducted in the City of Tehran, Iran with the purpose of finding any possible relations between food groups and MS.

  Materials and Methods: In this case-control hospital-based study conducted in 2011 in the City of Tehran, data were collected on several variables including socio-economic status, life style, and food intakes of 70 MS patients and 140 controls matched for age and gender, through interviews and questionnaires. All the statistical tests were done using the SPSS software version 16. Logistic regression was used to calculate the odds ratio (OR).

  Results: After adjusting for confounding variables, it was seen that subjects in the upper tertile of intakes of the fruit group, tomatoes, other vegetables, and liquid oils, were significantly less likely to be suffering from MS disease, the odds ratio being 68% (OR: 0.32 95% CI: 0.13-0.79), 82% (OR: 0.18 95% CI: 0.05-0.65), 61% (OR: 0.39 95% CI: 0.93-0.16), and 94% (OR: 0.06 95% CI: 0.08-0.58), respectively. On the other hand, subjects shown to be significantly less at risk of the disease were those in the upper tertile of the intakes of non-liquid oil [ 1.58 times (OR: 2.58 95% CI: 1.05-6.33) ] and soft drinks [1.87 times (OR: 2.87 95% CI: 1.17-7.02)] (p for trend < 0.05).

  Conclusion: The findings of this study support the probable role of nutrition in preventing multiple sclerosis.

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Background and Aim: Diabetes mellitus is one of the most common medical problems in pregnant women. Nutrition plays an important role in the prevention and control of this disease. Some studies have found a relationship between gestational diabetes mellitus (GDM) and food insecurity. The objective of this study was to investigate the association between food insecurity and GDM.

Material and Methods: : This case-control study included 274 pregnant women (137 GDM cases and 137 healthy controls) selected by convenience sampling. Data on the subjects’ food insecurity, demographic features and physical activity (MET) were collected by interviewing and their heights and weights measured. For the analysis of the data, the Chi-square test, independent sample t-test and multivariate and univariate logistic regression tests were used, the statistical software being SPSS 16.0.

Results: On the whole, 18.2% and 21.9% of the women in the case and control groups suffered from food insecurity, respectively. There were statistically significant differences between the case and control groups with regard to a previous history of pregnancy, a family history of diabetes in the first and second degree relatives, and a history of giving birth to a baby weighing over 4 kgs.

Further analysis of the data showed a family history of diabetes mellitus and a low socio-economic status to be independent risk factors for GDB.

Conclusion: No statistically significant difference was observed between food insecurity of the women and gestational diabetes mellitus in this study. Despite this finding, considering that there are associations between food insecurity and other types of diabetes mellitus, we recommend further studies on this subject to be able to either accept or reject the hypothesis on the association between food insecurity and gestational diabetes mellitus.

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Background and Aim: Exercise is one of the major factors influencing health. Modern media such as   the Internet can play an important role in shaping an individual’s attitude towards physical exercise and behavior. This study aimed to identify priority of factors influencing use of the Internet to expand physical exercise in a university environment.

Materials and Methods: A 23-item questionnaire (Cronbach’s alpha = 0.98) was designed to test the effect of virtual environment on expanding physical exercise among the university staff, faculty and students (Likert scale; 1, fully disagree to 5, fully agree). A sample of 500 individuals were selected by cluster-sampling and completed the questionnaire.

Results: The data showed that, based on the Friedman test, priority factors were not similar among the different categories of university audiences (p<0/001). While among the students and the staff the communication network factor ranked first, with an average rank of 3.56 and 3.46, respectively, among the faculty members it was information that ranked first, with an average rank of 3.64. Further analysis of the data showed a statistically significant difference among the three groups of university audiences – students, faculty and staff – as regards the total score of cyberspace application in university sport (F= 9.776, p < 0.05). There was no difference between the two genders. (t=0.78, p<0.5).

Conclusion: The findings show that the Internet can be quite effective in expanding university sport. It can provide an appropriate tool or substrate for expanding physical exercise/sport due to its popularity among university audiences. Hence, it is essential that university sport managers and planners use this cyberspace substrate to expand university sport by adopting appropriate relevant strategies.

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Background and Aim: Aspergillus arasiticus species can contaminate agricultural products both on the farm and in storage in tropical regions. In recent years much research has been conducted on extracts of, and chemical compounds derived from, plants to be used potentially to reduce growth of toxin-producing microorganisms. Not much information is available in this area, so this study was conducted to determine the antifungal effect of Pistacia Atlantica subsp. Kurdica on the growth of Aspergillus parasiticus.

Materials and Methods: According to the microdilution method, based on the latest version of the Clinical Laboratory and Standards Institute (CLSI) Document M27-A3, modified M38-A2 protocol, minimum inhibitory concentration (MIC) at different concentrations of Pistacia Atlantica subsp. Kurdica against the standard parasiticus species (ATCC15517) was determined.

Results: Pistacia Atlantica subsp. Kurdica could inhibit growth of Aspergillus parasiticus; the minimum concentration with an inhibitory effect on the growth of the fungus was 125mg/ml.

Conclusion: The Pistacia Atlantica subsp. Kurdica can potentially have a pronounced growth-inhibiting effect on A. Parasiticus. It is recommended to conduct more studies in this area to getinformation on expression of genes involved in the phenomenon.

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Background and Aim: The petroleum contamination is one of the inevitable consequences of population increase and energy consumption. In this study, the method of Bioremediation and Bacillus bacteria have been used in order to remove the petroleum contamination.

Material and Methods: The samples of soil were collected and the bacteria were isolated and identified.Then, the production of Biosurfactant, the rate of naphthalene degradation and appropriate growth conditions of them were examined.

Results: The Bacillus sp. included Bacillus cereus, Paenibacillus lactis, Bacillus fusiformis and Bacillus subtilis. The pure cultures and consortium have surface tension values less than 40 mN/m. Therefore, they were considered biosurfactant producers. The consortium had the tolerance ability of naphthalene up to 1000ppm.The appropriate conditions for the growth of Bacillus consortium was pH equal to 6, shaker rate 150 rpm, nitrogen source of Yeast extract and the concentration of naphthalene equal to 200ppm.

Conclusion: Bacillus consortium had more ability compared to single strains for reducing the surface tension, production of Biosurfactant, growth in culture media containing naphthalene and its degradation. It has indicated in several of the similar researches that Bacillus consortium or other bacteria have more ability in Biodegradation of organic contaminants.

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Background and Aim: Nowadays selecting an appropriate technology for storing and disposal of health care wastes is a difficult task. For example, selecting an optimum technology for storing and disposal of hospital wastes is a complex multi-criteria decision-making process, which requires consideration of qualitative and quantitative factors and criteria. This paper presents a new decision-making model for selecting a better method in the management of health care wastes in the City of Tehran.

Materials and Methods: So far selection of technologies for health care wastes storing has been based on inaccurate information or uncertain data, and linguistic variables have been used by decision-makers (experts) to assess the ranks, criteria and options described.In this study a combinational multi-criteria decision-making model has been used which includes the fuzzy analytic network process technique and the fuzzy MULTIMOORA method. This model uses the fuzzy analytic network process to get the related with criteria and sub-criteria of better health care wastes storage technology and uses MULTI MOORA method for evaluation of five available technologies based on the above-mentioned criteria.

Results:  Analysis of the data showed that the "environmental" and "technical" criteria were the most important criteria for selection of the best technology, while for storing health care wastes "hydroclave" is the most appropriate technology in the City of Tehran.

Conclusion: The proposed framework for assessing health care wastes technologies for storing hospital wastes is effective, and the hydroclave technology is to be considered as the best solution and the most suitable option from the environmental, public health and technical perspectives in the City of Tehran.

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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.

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Background and Aim: Group therapy is one of the selective approacheseffective in addiction treatment, although it is not used extensively.Therefore, it is essential to assessthe current group therapy situation and determine its barriers andreinforcing factors inaddiction treatment settings.

Materials and Methods: This qualitative study was a rapid assessment designed and conducted in 2014-2015. Formal and informal data were collectedfrom 6 selectedcenters (n=55) bya multi-disciplinaryresearch team,using a systematic and semi-structuredapproach. Data were analyzed using thematic analysis.

Results: Based on dataanalysis a descriptive model was obtained with two main items, namely, structure and implementation of group therapy and effectiveness process. These two main items were found to be composed of four descriptive sub-items, including structural determinants and effective determinants in group therapy, contextual features, content, acceptabilityand desirability of treatment.

Conclusion: The findings show that application and effectiveness of group therapy is desirable, but it is not used as a routine approach in addiction treatment centers. Barriers to expansion of group therapy include insufficient content, lack of a structured protocol, and lack of professionalcapacity building. The study also revealsthat group therapy is quite acceptableamong patients who have had the experience of being treated with this approach but less acceptable among those who are not familiar with it.

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Background and Aim: This study aimed to investigate the association of Internet addiction and self-control with mental health among students of the University of Applied Sciences and Technology (UAST) in Ilam city, Iran.

Materials and Methods: Data collection tools included the Mental Health Goldenberg scale, Tanji Self-control Inventory and Young Internet Addiction questionnaires. The sample consisted of 101 UAST students in Ilam City, Iran.

Results: Analysis of the data showed a statistically significant negative relationship between internet addiction and mental health and a positive association between self-control and mental health in male- and female-students.

Conclusion: It can be concluded that he more a student uses the Internet, the more likely he/she is to be less healthy mentally, while if a student has more self-control, he/she is more likely to be healthier mentally.The use of the Internet among the new generation in the society is spreading, becoming an important part of life. It has been said that teenagers are at a high risk. Hence the responsible authorities should consider mental health as a factor preventing extreme behavior of young people.

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Background and Aim: Chlorpyrifos is an organophosphate pesticide used in agriculture for pest control. It is a relatively persistent poison and an environmental pollutant with adverse effects on human health. This study was conducted to isolate and characterize chlorpyrifos-degrading bacteria from rice field soils in Amol City, Iran.

Materials and Methods: In this experimental study, soil samples were collected from rice fields with a history of toxic pollution. A minimal salt broth (Msb) medium containing 100 mg/l chlorpyrifos as the carbon and energy source was used for isolating pesticide-degrading bacteria. The colonies were characterized by Gram staining and biochemical tests and sequencing was done using the PCR method.

Results: Four chlorpyrifos-degrading bacterial strains were isolated from the soils. They included Bacillus licheniformis strain IARI-M-12, Bacillus pumilus strain MS42, Bacillus cereus strain ESB15, and Delftia tsuruhatensis strain SJ113. The effects of temperature and pH on the bacterial strains were investigated. The Bacillus strains showed the fastest growth at a temperature of 35^o C and a pH=7 in a Msb medium containing chlorpyrifos.

Conclusion: The results of this study demonstrate that bacteria in the farmland can degrade the chlorpyrifos poison. Thus, these bacteria can be used to reduce the environmental problems resulting from soil contamination with chlorpyrifos in the ecosystem.

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Background and Aim: Families with diabetic children face various problems and challenges such as child psychological problems, behavioral problems and a low quality of life. The aim of this study was to investigate the effects of promoting the quality of life of parents of diabetic children on clinical symptoms in their children.

Materials and Methods: This was a pre-test and post-test semi-experimental research with a control group. The statistical sample included 32 diabetic children and their parents, selected in 2 stages using the convenience random sampling method from among Tehran Diabetes Association members, randomly assigned to either an experimental or a control group. The experimental group received education about quality of life promotion in ten 2-hour sessions. Data were collected using the child clinical symptoms questionnaire (CSI-4-Child Symptom Inventory) and analyzed by multi-variate analysis of covariance using SPSS 20.

Results: The average post-test scores of emotional-behavioral symptoms in the experimental and control groups were significantly different (F=19.20, F=24.53, F=21.01, P<0.01). Furthermore, the experimental group mean scores were significantly lower than the control values, indicating a positive effect of the comprehensive quality of life promotion program on the children's emotional-behavioral symptoms.

Conclusion: Education about promoting the quality of life imparted to parents of diabetic children can significantly affect clinical symptoms in the diabetic children, decreasing the symptoms. Therefore, such education is recommended in order to promote the quality of life and reduce psychological distress in families of children with diabetes.

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Background and Aim: Medication is a very important part of care and therapeutic services in health service delivery units. Therefore, medication errors in hospitals may cause serious problems in patient care and, even, death. This study aimed to determine the relationship between the type of medication errors reported and patient safety standards in a public hospital in Tehran, Iran.
Materials and Methods: In this study, the establishment of safety standards in 30 departments of Rajaee Hospital in Tehran, Iran and its relation to quality reporting medication errors by the hospital medical staff during the period 1391-1395 were investigated. Data were collected using two separate checklists, namely, "The establishment of medication safety” using the model 6R" and "The quality of reporting medication errors" and analyzed using the SPSS software, the statistical tests being inferential statistical tests including chi-square, phi coefficient and Cramer’s V.                                                                                        
Results: The data showed that the drug safety standards were established as regards five of the six components in this hospital (the sixth was safe patient positioning). The patient safety establishment was statistically significantly associated with the type of medication errors reported in the hospitals.
Conclusion: Since the process of drug therapy is a common practice in nursing services in the cardiac intensive care units, increased knowledge of nurses about the causes of medication errors, in order to prevent and reduce the occurrence of these errors, is considered quite necessary. Recommendations were made to reduce medication errors in hospitals.

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Background and Aim: In the last few decades co-trimoxazole, an antibacterial combination of trimethoprim and sulfamethoxazole, has been used for treatment of bacterial infections, but due to the vast usage of these drugs, resistant strains have appeared throughout the world. One of the reasons for resistance to co-trimoxazole is related to drf genes, which are responsible for trimethoprim resistance, while the sulfamethoxazole resistance is due to sulfonamide sul genes. The aim of this study was to investigate drug resistance and frequencies of resistance genes in gram-negative bacteria isolated from clinical specimens.

Materials and Methods: Clinical samples were collected from patients in Pars Hospital, Tehran, Iran, in which presence of gram-negative bacteria was confirmed by biochemical tests. Then antibiotic susceptibility tests were performed for 5 antibiotics by disk diffusion agar technic. DNA was extracted from bacteria resistant to co-trimoxazole, followed by PCR using specific primers for sul1, sul2, sul3, and drf7 genes.

Results: In the co-trimoxazole-resistant bacteria, 26%, 74%, 2% and 16% of the isolates contained sul1 gene, sul2 gene, sul3 gene and drf7 gene, respectively. Further analysis of the data showed that 51% of the isolates were resistant to gentamicin, 74% to ceftriaxone, 65% to ciprofloxacin and 3% to colistin. For resistance to trimethoprim only the drf 7 gene was used.

Conclusion: The results of this study show that in the isolates of co-trimoxazole-resistant gram-negative bacteria, the sul 2 gene has a major role in development of resistance to sulfonamides. In this study only the drf 7 gene was used to assess the resistance of trimethoprim, so we recommend to conduct studies also on other drf genes, so that the importance of each in resistance to co-trimoxazole can be determined.

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Background and Aim: Nowadays, the need for informing children and teens in different ages, about sexual problems, is felt more than ever before. Sexual training and education; such as every other original training, must be done at the right place and time. On the other hand, this training should be based on a systematic program and educational models to achieve the desire results. The aim of this study is to determine the effect of educational intervention on the BAZNEF Model on mother's skill about sexual care of their children, Tehran 2017.
Materials and Methods: This study was a quasi-experimental intervention with control group. Ninety six mothers of children aged 5-6 were selected in Tehran pre-schools. They were randomly divided into two groups; intervention and control. Data were collected by a researcher made questionnaire based on BAZNEF Model whose the validity and reliability were confirmed. After pre-test, according to educational needs, educational content and program were based on BAZNEF Model and that were conducted in the intervention group. Data were analyzed by SPSS23, independent t, Mann-Whitney and Chi- squar statistic tests. 
Results: The mean scores of attitude, subjective norms, behavioral intention and behavior showed no significant difference before the education in both intervention and control group. However, the result showed compelling difference in mean scores of attitude, subjective norms, behavioral intention and behavior after the education (p<0/001).Enabling factors showed no important variation among intervention and control groups before and after the experiment. 
Conclusion: The finding of current study confirmed the educational intervention, based on BAZNEF Model, was effective on mother's attitude, subjective norms, behavioral intention and behavior about sexual care of their children.                           

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Background and Aim: The objective of this study was to design and examine the effectiveness of a parent-child relationship improvement program in reducing the externalized problems in children with Down's syndrome. A parent-child relationship improvement program was designed, followed by assessing its effectiveness in a random sample of pupils using a quasi-experimental research design with a pre-test, post-test and follow-up.
Materials and Methods: The study population was all the pupils with Down’s syndrome in the schools for exceptional student in Tehran and their parents in the academic year 2016-2017. The parents and their children were divided into two experimental and control groups.
Thirty-six out of 56 mothers were screened based on a diagnostic interview and inclusion and exclusion criteria and completed the CBCL and parent-child relationship questionnaires in the pre-test, post-test, and follow-up stages. Data analysis was performed using the multivariate covariance analysis with repeated measurements.
Results: The results showed that the mean post-test scores were statistically significantly different between the control and experimental groups, the mean scores of the experimental group being lower than those of the control group, which indicates a positive effect of the family-centered intervention.
Conclusion: Based on the findings, it is concluded that the parent-child relationship improvement program can reduce the subscales of conflict and dependence and increase the subscale of intimacy in the parent-child relationships. Moreover, it can also reduce behavioral problems in children with Down’s syndrome.

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Background and Aim: The purpose of this study was to determine the effect of family-based interventions on clinical symptoms and social skills of hyperactive children.
Material and Methods: This was a quasi-experimental study with pre- and post-test. A total of 28 school students with attention deficit hyperactivity disorder (ADHD) referring to a Psychiatric and Rehabilitation Counseling Center along with their parents were selected using the available sampling method as the main sample of the study. They were then divided into two equal groups ─ an experimental group receiving intervention (family therapy) and a control group receiving no intervention. The research tools were the Inderbitzen and Foster Adolescents Social Skills Questionnaire (CWS, 1992) and the Conners Parent Questionnaire (1999). Multivariate analysis of covariance was used to analyze the data.
Results: Analysis of the data showed that family-based interventions can lead to increases in social skills and decrease clinical symptoms in children with ADHD.
Conclusion: It is concluded that family-based intervention can result in enhancing social skills and reducing clinical symptoms in children with attention deficit hyperactivity disorder.