Journal of School of Public Health and

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The purpose of this study was the creation and measurement of consensus regarding formation of a new Department of Health in Tehran University of Medical Sciences (TUMS). Using a three-iteration Delphi procedure, consensus was built and measured among experts on different aspects of a possible merger between the current Medical Care and Health Care Departments and the formation of a new Department of Health in TUMS. Forty-two experts from the Ministry of Health, TUMS, other medical universities in Tehran, the Management and Planning Organization and other research bodies were included in this study. Feedback from the aggregate responses of the panel was used to construct questionnaires employed in subsequent iterations of the Delphi. We used a Likert scale for assessment of opinions consensus was defined as agreement or disagreement of at least two thirds of respondents on a particular subject. Consensus was attained in 27 out of the 36 items presented in the third round of the study. Consensus on the necessity and feasibility of the formation of the new department in TUMS was achieved after three rounds of the Delphi process. The panel converged to form a consensus on the need for a merger from different perspectives, including the overlapping responsibilities of the two departments, promoting a community-oriented approach, improving the quality of services and bringing the reforms in line with the policies of the Ministry of Health. Conclusion: The experts who participated in this study achieved consensus on the necessity and feasibility of formation of a new Department of Health in TUMS.

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Traffic accidents compromises a large quantity of peoples annually, and is one of the most important causes of death in Iran. Human factors are amongst of the most leading causes of traffic accident mortality and morbidity and this study is conducted to evaluate the Knowledge, Attitude and Practice of drivers regarding driving laws in Tehran. Two hundred and twenty drivers were selected randomly in this cross sectional study. Cluster sampling with 10 participant in each cluster was used for selection of participants. 22 points were defined using a random sample of telephone numbers. Distribution points was such as one point were selected in each zone of municipality zones. Ten consecutive drivers passing the specified point were interviewed by an interviewer and a senior officer of Traffic Control Organization of Tehran was responsible for assessment of practices. Reliability of questionnaire was evaluated using alpha chronbach coefficient and construct validity was assessed by Principal component Analysis method. Chi square and odds ratio (OR) were used for assessment of relation between qualitative variables, when appropriate. Two hundred and twenty drivers were recruited in this study. Suitable Knowledge, Attitude and practice were seen in 67.7, 56.4 and 47.7 percent of respondents respectively. When adjusted using logistic regression analysis, we did not observe any relation between these three variables. There was a significant relation between knowledge and age and also between practice and education, marital status, occupation and type of automobile. We conclude that practice of drivers of Tehran are weak regarding traffic laws and there is an emergent need for research and intervention in this regard.

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Background and Aim: Environmental health impact assessment of industrial estates will help greatly in better planning for sustainable development and reducing disease risk in a community. The objective of this study was to assess the positive and negative effects of establishing an industrial estate in Jovein, Sabzevar, Iran in 2006-7 and suggest managerial strategies to reduce undesirable environmental health impacts.

Methods and Materials: A modified Leopold Matrix and Scaling checklist method was used. The existing environmental situation was investigated and then environmental impact assessment alternatives were determined, bearing in mind the amounts and kinds of predicted pollutants in the construction and operational phases . The assessment was made considering the immediate, direct, and indirect impacts in the short and long terms. It was attempted to use a wide range of values of different factors (-5, +5) in order to estimate the impact of all activities on the environmental status.

Results: The results of the study are presented with two alternatives, i.e., "No" (conducting the project with no concern for environmental issues), and "Yes" (performance of the project with application of methods to reduce the environmental harmful impacts), when establishing the industrial estate, in the construction and operation phases. The impact assessment with the "No" alternative scored -791, meaning that execution of the project had to be rejected. However, after reducing the harmful impacts the score rose to +252, indicating that the project would be accepted.

Conclusion: The method of reducing harmful environmental impacts along with environmental management programs introduced are accepted in this study. It is recommended that the Ministry of Health and Medical Education and The Iranian Environmental Protection Agency collaborate closely in the area of environmental health impact assessment of industries and industrial estates.

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Background and Aim: Rabies, a viral and zoonotic disease, causes acute and fetal encephalitis in humans and other mammals and is a cause of death in developing countries. It is usually transmitted by animal bite, but other routes of transmission are mucus membranes, breathing, placenta, contaminated instruments, and organ implanting. This study shows the mapping of geographical distribution of animal bite cases, rabies, and death due rabies in 3 Caspian Sea littoral provinces, namely, Golestan, Mazandaran, and Gilan.

Materials and Methods: Data on human and animal rabies cases and animal bites were collected from the Reference Rabies Center of the Pasteur Institute in Tehran and the Rabies Diagnosis Section of the Amol Research Center during 2002-2007.The data was analyzed by the SPSS (11.5) software and mapping was done by Arc GIS 9.2.

Results: During the 6-year period, of the 670,743 animal bite cases reported in Iran 63890 (9.5%) had occurred in Golestan, 25,767 (3.8%) in Mazandaran, and 22,874 (3.4%) in Gilan. The distribution of animal bite cases in the 3 provinces was as follows: Agh ghala, Bandar Torkaman, Azad shahr and Kolaleh in Golestan Galugah, Behshahr, Ramsar and Neka in Mazandaran and Shaft, Masal, Siahkal and Fuman in Gilan. The data also showed that of the total 2,312 animal rabies cases, in Iran, 9.22% had been reported from Golestan, 4% from Mazandaran, and 2.6% from Gilan. Furthermore, animal rabies cases had occurred mostly in Gonbadekavoos, Bandar Torkaman, Gorgan and Kolaleh in the Golestan Province Behshahr, Neka and Chalus in the Mazandaran Province and Masal, Fuman and Rezvanshahr in the Gilan Province. The most important disease vector (91.3%) for both human and animal rabies was the dog. A total of 41 human deaths due to rabies had been reported during the period, 2 being from Mazandaran.

Conclusion: The results show that a more effective disease control and surveillance system is essential and can help improve planning for service provision in the health care centers.