Journal of School of Public Health and

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Background and Aim: In breach of all international conventions, Iraq frequently used chemical weapons against both military and civilian targets in its 8-year war with Iran. The most frequently used agent was sulfur mustard. The effects of mustard gas may be divided into early and late categories. Late lesions, due to the agent's mutagenic and carcinogenic potential, are mainly the results of its action on intracellular particles, probably nucleic acids. Although the occurrence of cancer has been proved following long-term exposure, the presence of a carcinogenic effect in acute, short-term contact is still in doubt.
Materials and Methods: To determine the relationship between cancer and acute exposure to mustard gas, a historical cohort study was carried out in Isfahan province, involving 500 chemically-injured soldiers with at least one episode of exposure to mustard gas. The incidence of cancer and the death rates in these subjects were compared with similar rates from i) 500 unexposed soldiers in the same area and ii) nationwide figures.
Results: All the subjects were male. The mean age in the exposed and unexposed groups were 41(±10.8), and 40(±7.6) years respectively. Within the exposed group, the mean age at first exposure was 24.1(±13) years the mean age at first injury in the unexposed group was 23(±11) years. Eighty-one percent of the cases lived in cities and 19% in rural areas. For 395 persons (84.5%) in the exposed group, education was at high school level or below. Within the same group, 481 subjects (96.2%) were married. Sixty-three people (12.6%) were servicemen and 366 (73.2%) had civilian jobs. Three cases of cancer were observed in those exposed to mustard gas. No cases occurred in the unexposed group. Ten people in exposed group and 7 in the unexposed group were dead at the time of the study. Relative risks for cancer and death were estimated at 4.02 (CI 95% = 0.45-36.1) and 1.44 (CI 95% = 0.54-3.81) respectively.
Conclusion: The results failed to show a statistically significant relationship between cancer incidence and acute exposure to sulfur mustard.

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Background and Aim: Priority setting is one of the most important issues in health research systems. No national health system can afford to finance all research projects proposed by researchers, especially in developing countries. Therefore, we decided to set the main national health research priorities in Iran using the Essential National Health Research (ENHR) method.

Materials and Methods: All of the Iranian universities of medical sciences and other stakeholders collaborated in this study. The methodology for research priority setting was based on needs assessment and ENHR. 

Results: The total number of research priorities gathered from universities of medical sciences was 6723. The proportions of topics related to basic science, applied and development subjects were 17%, 78% and 5%, respectively. Further analysis of the data showed that almost half (46.3%) of the research priorities were descriptive, 36.0% analytical, and 17.6% interventional. The research priorities were divided into 9 main areas, namely, communicable diseases, noncommunicable diseases, health system research, pharmaceutical sciences and industrial pharmacy, basic science, traditional and herbal medicine, nutrition, environmental health, and dentistry.

Conclusion: Up to now the common procedure for research priority setting has been, with a top-to-bottom approach, managed by a limited number of researchers and experts, while in the method presented in this paper a bottom-to-top approach is used, which is more effective.

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Background Aim: Job burnout among health educators is increasing with serious physical, psychological and social consequences. The purpose of this study was to explore the causes of job burnout from the perspective of health educators and identify their needs for reducing it.
Materials and Methods: This qualitative study was carried out in comprehensive health service centers of Sanandaj, west of Iran, in 2017, including 15 health educators selected by purposive sampling. The data were collected through individual interviews and semi-structured group discussions, observation and field notes and analyzed using the conventional content analysis approach with due consideration of acceptability, verifiability and transferability to ensure the accuracy and strength of the data.
Results: The causes of job burnout were extracted in 5 categories including "issues related to comprehensive health service centers", "individual challenges of staff members", "management weakness", "executive system challenges" and "issues related to clients". The participants emphasized the following actions for reducing job burnout: strengthening individual skills, effective evaluation and management support, providing recreational and welfare facilities, reducing job stress, and strengthening intra- and inter-sectoral communications.
Conclusion: The results of this study show that various factors contribute to job burnout among health educators. Improvements in management, laws and welfare facilities not only would reduce job burnout but also may increase the efficiency of health education programs.