Journal of School of Public Health and

Background and Aim: Breast cancer is the most common cancer worldwide and the cause of about 18% of all malignancies in females. By breast self-examination (BSE) it is possible to diagnose a breast tumor in the preliminary stages and treat it. Basic changes in the knowledge, attitude and practice of women as regards regular BES and follow-up will lead to considerable success in campaigns against breast cancer. Considering the role and responsibilities of community health workers (CHWs) in the health services delivery system in the Islamic Republic of Iran, this study aimed at determining the knowledge, attitude and practice of female CHWs as regards BSE in 2006.

Methods and Materials: This was a cross-sectional study conducted on 89 female CHWs in the Iranian Mako township health houses. The data was collected through interviews using a questionnaire consisting of 4 sections, the first section containing 10 demographic questions, and the second to fourth sections containing 33 questions on knowledge, attitude, and practice. The validity and reliability of the questionnaire were confirmed using the repeat testing with r=85%. The data were analyzed using the SPSS software (version 11).

Results: The data showed that the BSE knowledge of 50.6% and 49.4% of the subjects was good and moderate, respectively 76.4% of them had a positive attitude towards BSE. The reasons for not self-examination were as follows: inability to do it alone (12.4%) fear of a positive result, i.e., existence of a tumor (1.1%) having no time (2.2%) fear of increased anxiety (5.6%) not believing in BSE, even if it was likely to have a tumor (11.2%). Further analysis of the data showed the practice of the subjects to be good, moderate, and weak in 9%, 61.8%, and 29.2% of the cases, respectively.
There were significant associations between knowledge and a positive attitude (p=0.038), between attitude of the unmarried subjects towards performing BSE as compared to the married subjects (p=0.00), and between attitude and practice (p=0.045).

Conclusion: This study showed a moderate to good knowledge, a relatively good attitude, and a moderate practice among female CHWs in the Makoo Township, Iran, with regard to BSE. Considering the role of CHWs, improving their knowledge, attitude , and practice of BSE is essential.

Background and Aim: Natural organic matter (NOMs), measured on the basis of organic carbon, produces disinfection by-products precursors (DBPs) during the chlorination process. Some DBPs are carcinogenic. NOMs are not completely removed by conventional water treatment. As a result, in addition to forming DBPs, they support bacterial regrowth in the water distribution systems and cause unpleasant odor and taste and other problems. The objective of this study was to determine organic carbon concentration and DBPs formation potential in drinking water of the water distribution system in Tehran, Iran.

Methods and Materials: Water sampling was done by standard methods, monthly between August 2006 and Feb 2007, at four points of the drinking water distribution system in Tehran. Quantitative parameters, including pH, EC, UV254 (UV absorbance at a wavelength of 254nm), dissolved organic carbon (DOC), and specific UV absorbance (SUVA) were determined. DOC and UV-254 of the samples were determined using a Total Organic Carbon (TOC) analyzer and a Lambda 25 UV/Vis spectrophotometer, respectively. SUVA (L/mg.m) was calculated as thea ratio of the UV absorbance at 254 nm (1/m) to DOC (mg/ L).

Results: The water content of DOC at the four points of the distribution system was less than 0.7 mg /L. The mean DOC concentration was 0.3±0.14mg/L, ranging between 0.12 and 0.687mg/L, with no monthly variation. The mean SUVA was 1.3±0.7.

Conclusion: It can be concluded that the Tehran water treatment systems cannot eliminate completely natural organic matter. SUVA values show, however, that the system can eliminate the majority of hydrophobic compounds. Therefore, formation of haloacetic acids is more probable than that of trihalomathanes.

  Background and Aim: Investigation of seasonal suicide might help in learning about the etiology of suicide committers’ behavior. Literature search indicates that a large number of preliminary studies have been carried out on this subject, in many of which seasonal and climatological aspects of suicide have been investigated. In the present study, the seasonal and time pattern of suicide incidence in Iran was determined based a systematic review.

  Materials and Methods : Search was performed in the national databases, namely, SID, Iranmedex, Magiran and Medlib, as well as international databases such as PubMed, Scopus and Google scholar, using such keywords as Iran/Iranian, seasonality and suicide. The technical quality of papers was assessed using checklists. Data of each of the preliminary studies were extracted in terms of general variables and such specific variables as season, month, hour, weekdays and climatic conditions.

  Results: Of a total number of 49,522 documents obtained from a primary electronic search, eventually 32 papers were included in this study. The highest numbers of suicides committed were 7 and 8 in summer and spring, respectively. Similarly, among the primary studies that had reported only the monthly occurrence of suicide, the highest rate in 7 cases was spring and 7 in summer. In most of the studies (8 cases) the highest number of suicides had taken place between 1:00 and 6:00 PM.

  Conclusion: These findings indicate that suicide occurrence in Iran has a seasonal pattern, most cases committed being in spring and summer.

Background and Aim: Availability of  preliminary data on fauna and distribution of forensically important insects in a region is very important. Considering absence of such data in the north of Iran, this was study was undertaken with  the aim of finding the fauna of insects on rabbit carcasses as an animal model in Babol, a city in the north of Iran.

Materials and Methods: This study was conducted in three areas, that is, urban, semi-urban and rural, in summer and autumn in 2014. Using Schoenly traps, samples were collected once daily until the decomposition of the rabbit carcasses was complete.

Results: A total of 1978 adult flies from 17 species were identified. The main fly families included Calliphoridae, Sarcophagidae, Muscidae and Fanniidae. On the whole, the families with the highest and lowest numbers were Muscidae and Phoridae, respectively. Some families of minor medical importance, such as Anthomyiidae, Sepsidae, Phoridae and Stratiomyidae, were collected in small numbers. The Sarcophaga melanura was introduced in  Iran for the first time.

Conclusion: The main finding of this study is identification of some of the most important flies and other anthropoda, which can be very helpful and useful in forensic investigations – finding time and place of death. Classification of the data on species based on their ecosystems is another important finding emphasized in this study, something of practical importance in scene of crime investigations.

Background and Aim: Thalassemia major (ThM) is one of the most common autosomal recessive genetic disorders in the world. Its prevention and control is a priority in the disease prevention programs in the Iranian health system. The ThM screening program (screening at the time of marriage) has been an important step in its prevention in Iran. This study aimed to evaluate this program.

Materials and Methods: This was a descriptive-analytical study in Babosar District consisting of two phases. The first phase was a retrospective descriptive study aiming at finding the background causes of the diseases in subjects under 18 years old (born after March 1997). In phase 2, then, in an interventional analytical study, screening was repeated along with laboratory tests before, or at the beginning of, pregnancy (n = 5500).

Results: Phase 1(cross-sectional descriptive): There were 25 cases of ThM under 18 years old, parents of 15 of whom (60%) had married before 1997 and 4 (16%) had children suffering from ThM (S2). The parents of the remaining 10 (40%) had married after 1997 (S1). Phase 2: Considering the findings of Phase1, an interventional program called thalassemia screening was started in September 2006 including 9750 pregnant or pre-pregnanct mothers. The program led to identifying 20 new beta-thalassemia-carrier couples, including 10 couples married before 1997 and 10 married after 1997 (without official marriage registration, laboratory errors and hemoglobinopathies). All the 20 couples were quickly referred to the Genetic Center, which resulted in prevention of the birth of 4 ThM neonates. 

Conclusion: The 9-year intervention (2006-2015) resulted in timely action, preventing birth of 4 thalassemia major babies. Considering incidence of the disease during the previous 9 years (1997-2006), it can be concluded that the before-after randomized clinical trial is an effective way to reduce thalassemia major incidence.