Journal of School of Public Health and

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Backgrounds and Aim: Increased life expectancies and decreased fertility rates have led to ageing populations worldwide. This phenomenon is one of the most important public health challenges of the current century. Previous studies have shown that identifying factors affecting lifestyle and educational needs help in designing new strategies for health promotion. This study was conducted to investigate the preparedness of the elderly to adopt a healthy lifestyle and factors affecting it in the City of Tehran in 2007.
Materials and Methods: This qualtative study included 60 elderly persons from Tehran elderly centers, using the focus group discussion method. Sampling was targeted and a qualitative methodology was used for analysis of the data collected.
Results: The results shows that different elderly persons have different views with regard to what physical and mental health is and what factors cause healthiness. They believe that regular physical activity is very beneficial but that there are many difficulties in performing regular physical activity. Most of the subjects are in the prepation, action and maintenance stages as regards physical activity. On the other hand, nearly all the subjects are in the precontemplation stage with regard to fruit and vegetable consumption, despite the many obstacles in following a healthy diet.
Conclution: The findings of this study show that many factors influence adoption of a healthy lifestyle by the elderly. Bearing these factors in mind, appropriate educational strategies aiming at facilitating adoption of a healthy lifestyle can be designed.

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Background and Aim: Hospital disaster-management planning and preparedness are essential, considering earthquake threats in Iran. The objective of this study was to assess preparedness of hospitals affiliated to Iran University of Medical Science (IUMS) in Tehran against earthquakes in 2007 (1386 Iranian year).

Materials and Methods: This was a cross-sectional, descriptive-analytical study, involving 21 governmental and private hospitals affiliated to IUMS selected by random sampling. Data were gathered using checklists, questionnaires, interviews, and observation. The SPSS software was used for analysis of the data, and the Fisher exact test was employed for statistical analysis.

Results: The data showed that, on the whole, 28.6 %, 61.9 %, and 9.5 % of the hospitals were at a weak, moderate, and good preparedness level, respectively. The hospitals preparedness level with regard to equipment safety and hazardous materials planning increases with their degree of specialization, the association being statistically significant (p = 0.038). The findings also show that there is a significant relationship between the hospital preparedness level (as regards planning for building dangers reduction) and crisis management training courses (p = 0.034).

Conclusion: Training courses are very effective for creating hospital preparedness against earthquakes.

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Background and Aim: By providing the greatest amount of direct service to patients, nurses play an extremely valuable and unmatched role in the quality and efficiency of care and curative services. Workplace violence is regarded as one of the factors which can reduce job satisfaction and the quality of working life of nurses and their interaction with patients, as well as the work efficiency of nurses and hospitals. In this study, after translating and validating tools of violence measurement in the health sector, the exposure of nurses to psychological violence was measured in a large teaching hospital in Tehran

Methods and Materials: A descriptive-cross sectional design was used in this study in summer of 2009 (1387). The study population included all the nurses (n=413) working in a large teaching hospital in Tehran. The questionnaire used for collecting data was adopted from a standardized questionnaire designed jointly in 2003 by the International Labor Office, the World Health Organization, the International Council of Nurses, and the Public Services International. Analysis of the data was made using the descriptive statistical methods and the Chi square- and t-tests.

Results: Sixty-nine percent of the nurses had experienced workplace violence. The most common forms of violence were verbal abuse (%64) and bullying-mobbing (%29). On the whole, 26% of the nurses had experienced both forms of violence in the previous year, while 335 had not faced any form of violence in their workplace. Nurses working in outpatient clinics and emergency wards experienced the highest number of encounters with verbal abuse. Encounters with bullying and mobbing were more common among female nurses than the male ones. Overall most of the violent behaviors were committed by patients and their relatives.

Conclusion: Exposure of nurses to psychological violence is considerable and comparable to that reported by previous investigators in other countries. Thus it is highly crucial to adopt appropriate management policies aiming, particularly, at educating the medical personnel in ways of preventing and reporting violent behaviors.

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Background and Aim: Length of stay (LOS) in a hospital is one of the best hospital indicators that can be used for various purposes. In this survey, we studied the hospital LOS and its associated factors in Tehran University of Medical Sciences Women's Hospital (a teaching hospital) in Tehran using the Cox proportional hazards semi parametric model and compared the results with the results obtained using the multiple linear regression.

Materials and Methods: This was a descriptive-analytical study in which we reviewed 3421 files of inpatients hospitalized in, and those discharged from, the oncology, surgery and obstetrics units in 2008. The required data were collected using a data collection sheet and inpatient interviews. A P<0.05 was considered statistically significant.

Results: The median of patients' LOS in the hospital was 50.8 hours, that in the obstetrics, surgical and oncology units being 48.5, 54.4 and 94.2 hours, respectively. Of all the patients, 2632 (76.9%) had been discharged with a recovery status and the rest (23.1%) with a no-recovery status. Results of the Cox proportional hazards model showed that the following variables had increased LOS: a distance longer than 200 km between a patent's residence and the hospital, hospitalization in the surgery and oncology units, admission on a Thursday, admission by an internist, hospitalization for neoplastic, endocrine, nutritional, or genitourinary system diseases (P<0.005), as well as a high number of diagnostic laboratory tests, radiographies or sonographies (P<0.001). Patients admitted and hospitalized as an emergency case had a shorter LOS (P<0.001) than others. On the other hand, based on the multiple linear regression model results, some occupations (being a worker, a farmer, a stockbreeder, or a retired spouse) admission on a Thursday, (The first day of the weekend in Iran), suffering from a neoplastic disease, and a high number of diagnostic tests or radiographies or sonographies increased, and admission by a resident decreased, patients' LOS (P<0.05).

Conclusion: Considering having censored data, the Cox proportional hazards model is a more suitable model than the multiple linear regression models for identifying factors influencing patients' LOS in a hospital. From among the LOS Cox model's associated factors as identified in this study, policy-makers and managers can only change admission days and the number of diagnostic tests. That is to say, they should try to prevent admission on a Thursday (unless emergency cases) and also perform the required primary diagnostic tests before admitting a patient into the hospital, which would lead to a more effective utilization of hospital beds and other resources.

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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.

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Background and Aim: In social marketing, the common techniques of commercial marketing are used to increase the chances of acceptability of an idea or action by the target group. In this study, we determined the impact of an intervention based on social marketing to reduce risky driving behaviors among taxi drivers in Tehran.

Materials and Methods: This was a quasi-experimental study, consisting of a quantitative and a qualitative part, on taxi-drivers in 2 regions (an intervention and a control groups) in the City of Tehran. Based on a formative research approach, the components of social marketing, namely, the product (reminder message for concentrating on avoidance of two target behaviors, tailgating and not driving between lines), price, place and promotion were determined. An 8-week educational program was implemented, the components being installation of stickers before the driver's eyes, distributing a pamphlet, and transferring messages through taxi route supervisors as opinion leaders. After six weeks, risky driving behaviors were assessed by checklists and compared.

Results: The intervention resulted in statistically significant reductions in the two target behaviors in the intervention group as compared with the control group. Furthermore, logistic regression showed that the odds ratio for avoiding both behaviors increased significantly in the intervention group. 

Conclusion: Determining specific target groups, designing interventions based on actual needs and wants of the target group, and focusing on the factors influencing the behavior market are the basic elements of social marketing. Due consideration of these elements when designing behavioral interventions would lead to reductions in risky driving behaviors.

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Background and Aim: Malaria threatens more than half of the world's population in about 100 countries. During the period 1921-1951 malaria was one of the most important public health issues in Iran, no other disease causing as much financial loss and mortality as malaria did. The objective of this study was to investigate malaria epidemiology in Iran during the period 1940- 2006 (65 years), in the hope that the infotmation and experience will be used in the future.

Materials and Methods: This study included a review of the available literature on the suject, as well as a study of health systems, existing records, and analysis of data and information on malaria in Iran. Data were colected from three main sources: national or international electronic sources (26 sources) non-electronic sources, including theses, journal articles, and various documents and reports, as well as data obtained from the national malaria surveillance system (a total of 180) and interviews with five informed and expert individuals. In addition, national documents prepared by the Center for Disease Control, Ministry of Health and Medical Education, during the previuos 6 months were made available to, and used by, the research team.

Results: The findings show that, despite several annual fluctuations, the trend of incidence of the disease during the 65-year period, from 1940 to 2006, was a downward trend. The incidence declined from 250-333 per 1000 people in the early 1940's to 0.22 per 1000 people in 2006.

Conclusion: The changes in incidence of malaria show that elimination of malaria is a possible and feasible goal. The experiences achieved in controlling this disease can be utilized for controlling other diseases as well.

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: Materials and MethodsThis study was a randomized controlled trial including 396 patients, conducted in 10 randomly health centers allocated as intervention or control groups. The data were collected using questionnaires. The educational intervention included holding educational classes, distribution of pamphlets, hanging posters/flyers, ResultsAnalysis of the data showed statistically significant differences between mean scores of the health belief model components (knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers) and practice in both the intervention and control groups before and after the educational intervention (p < 0.01).

: <span lang="EN" times="" new="" roman";="" "times="" "b="" lotus";="" en;="" major-bidi;="" major-bidi;"="">Considering the self-reported increased awareness and decreased practice in the intervention group, it seems that the health belief model is an appropriate model for reducing arbitrary use of antibiotics.