Journal of School of Public Health and

  Backgrond and Aim: Demodicosis is a common skin disease. Great number of admissions to the clinics is occurring in the country. Regarding the high prevalence of this parasitic arthropod, investigating on pathogenesis, route of transmission and the complications they may produce, is considered of great importance. Generally, demodex parasites often exist in the skin tissue and tend to live in the face specifically in cheeks, forehead and nose, where sebum excretion is active and may provide a favorable habitat for living and breading the parasite. Diagnosis is carried out during an exploratory skin test for a cne, pityriasis rosacea and ophthalmic infectious diseases such as blepharitis. Determination of their biological role in chronicity of general skin disorders is an interesting topic in research.

  Materials and Methods: Patients were admitted to the Razi hospital, Research Center for skin diseases and leprosy, and three other clinical laboratories considered for assays. The questionnaire was filled for each patient and the sample was taken from the affected area. Ecto parasites were transferred to the potassium chloride solution 10% and studied under a light microscope.

  Results: A total of 100 patients were studied, from which 78 patients were diagnosed as infected with the Demodex folliculorum. Of these, (%92) were female and (%7.6) male (p <0.05). The highest frequency was observed in the age group 41 to 50 years (P <0.05).

  Conclusion: In this study, the relative frequency of demodicosis was more common in women and in the middle-aged group. Generally this high level of frequency will intensify the necessity of the identification of parasites and its pathological effects in chronic infectious diseases.

  Background and Aim: Water and food born diseases are one of the important causes of morbidity and mortality in through the world. The objective of this study was to investigate factors affecting the persistence of diarrheal cases after the explosive epidemic phase of diarrheal disease in Yazd province.

  Materials and Methods: We designed a match case control study that was performed on base of incidence cases of diarrhea since 24 Aug, 2013 to 03 Sept, 2013.Characteristics of cases and control were obtained by interviewers using a pre-determined questionnaire. Logistic regression was used at 0.05 significant level.

  Results: Totally 69 incidences cases of diarrhea were compared with 138 controls. Incidence rate of diarrhea in Yazd province was 13.79 per thousand. The adjusted odds ratio estimate for presence a patient stricken with gastroenteritis in the household was 3.63 [95% CI: 1.43, 9.20]. The adjusted odds ratio for low education, history of the trip, history of contact with patient and eating outside the home were 1.75, 1.55, 1.93 and 1.37 respectively, that increase odds of disease but their effects was not statistically significant.

  Conclusion: In this study the most important risk factor for diarrhea was history of contact with the person with the disease in the household. This result may indicate the lack of personal hygiene by patients and their relatives and thus transmission of disease to others peoples. Therefore the role of health education and informing about transmission and preventive ways is very important in prevention and control of outbreaks of diarrhea diseases.

  Background an Aim: Aging trend especially in developing country is increasing. This study aimed to assess the nutritional status of the elderly and its associated factors in Gorgan .

  Materials and Methods: This is a cross sectional study that two-stage cluster sampling method was used for considering participant. The data were collected using Mini Nutritional Assessment and anthropometric questionnaire which was referred to the elderly inhabitant in urban area. 541 elder were interviewed and data were analyzed by chi square, independent T test and one way ANOVA tests.

  Results : The prevalence of malnutrition was %4/8 and nearly %44/7 of the elderly were at the risk of malnutrition. %51/9 of the elderly were on a special diet due to a disease or specific condition. Malnutrition frequency and the risk of it were higher in woman than men and the difference between sexes was statistically significant. BMI, mid arm circumference and calf circumference measures in elderly with malnutrition were less than elderly with good nutrition, and the difference was statistically significant

  Conclusion: The risk of malnutrition in elderly who exposed to socio-economic, mental and also dental difficulties, living alone and female old age was higher than others groups. The implementation of supportive and nutritional programs is more important in this group.

  Background and aim: In Iran, HIV prevalence in sex workers is reaching to an epidemic, but still consistent use of condoms is low. This qualitative study aimed to assess barriers to condom use in female sex workers (FSWs).

  Materials and Methods: We conducted individual in-depth interviews with 40 FSWs and 12 partners in the year 2010 in Tehran. The FSWs were purposefully selected from four different groups based on the level of socioeconomic status and history of using substance. Findings were extracted and coded manually and the responses of the groups were categorized and compared.

  Results: Almost all FSWs had not used condoms regularly in the past six months. The main barriers of condom use were: lack of awareness of the modes of transmission of HIV and prognosis of the disease, doubt on the role of condoms in preventing sexually transmitted diseases and HIV, fear of violence or rejection by male customers, reluctance of sexual partners to use condoms due to diminution of sexual pleasure, and believing in health of some customers.

  Conclusions: Increasing awareness of the FSWs through education about HIV, ways to prevent the disease and empowering them on negotiating skills to use condoms as part of harm reduction programs are recommended .

  Background and Aim: Economic factors, including life insurance in financial sector may have a significant effect on health sector and consequently on the life expectancy of the society. The life insurance effects on health index indirectly through economic growth and directly through bringing mental relaxation and social welfare for the person applying for life insurance. The main purpose of this study was to investigate how life insurance demand and other economic factors effect on life expectancy index of the society.

  Materials and Methods: In this study, the relevant data with respect to life expectancy as dependant variable and economic factors including life insurance demand have been collected from Organization of Islamic Conference ( OIC) countries for the years 2011 to 1998 using panel data analysis .

  Results: The results of the study indicate a significant and statistically positive effect of life insurance demand on life expectancy index of the selected OIC countries. On the other hand, the variables such as financial development and per capita income also have significant positive effect, while the variables such as unemployment and inflation have significant negative effect on life expectancy index of health.

  Conclusion: The results suggest that economic conditions improvement through lowering rate of unemployment, lowering rate of inflation, increase in per capita income and the financial market development could probably improve the condition of life expectancy in a society. Therefore, that is recommended for the planners to take into account the fundamental economic indicators specially life insurance consumption while planning for health and welfare betterment of the society.

  Background and Aim: The aim of the present study was to investigate the views of policy makers and key persons about national AIDS control politics.

  Materials and Methods : This qualitative study used purposive sampling. To collect data, the perspectives of six experts about AIDS were inspected. Framework analysis was used to analyze the data.

  Results: The results of this study showed that beside the strengths there are also significant weaknesses in making the policies, administering the existing policies, executing the programs in organizations, and planning new policies to control AIDS hence these problems and weaknesses must be identified to achieve the main goals of AIDS control program.

  Conclusion: AIDS is not only a health problem but a social, economical and cultural problem, which requires more attention from authorities and related organizations for developing and implementing policies in accordance with international guidelines. To achieve Millennium development goals (MDGs) in the context of AIDS it is essential for policy makers and key figures to consider more effective activities and measures in their agenda.

  Background and Aim: Chlorophenols are acidic Organic compounds and priority Pollutants. One of the best ways to removal chlorophenols was using different absorbents . In this study, removal efficiency of ortho- chlorophenol as one of the most common organic contaminants in aquatic environments was investigated with absorption method using activated Fly Ash.

  Materials and methods: In this experimental study, Fly ash of collected from Zarand Power plant was activated by sulfuric acid. Factors affecting in sorbent activation process including temperature, time, amount and concentration of the acid and also factors influencing in the adsorption process were adjusted for optimum conditions. Experiments was followed on real wastewater samples from coal washing plant of zarand . Data was analyzed by SPSS software.

  Results : The sorbent activation was performed in optimized condition acid concentration 1.8 mM, time 5h, temperature 29±2˚C and acid/fly ash ratio 7. Removal efficiency of zarand coal washing plant Effluent at the optimal conditions (pH: 2, adsorbent doze: 1g, time: 3h) was 84.4%.

  Conclusion: In addition to the high efficiency of ortho-chlorophenol absorption because of sorbent activation does not require complex and expensive technology, the adsorbents can be used to remove these contaminants from industry effluent.

  Background and Aim: Health-risk behaviors are socially constructed and influenced by the given culture. Therefore, the health-risk behaviors are prioritized differently in diverse cultures. In this study, we aimed to explore the priority of health risk behaviors among high school students in Tehran.

  Materials and Methods : In this qualitative study using rapid assessment approach, we interviewed 130 individuals who voluntarily participated in the focus group discussions (FGDs, n=17). They were students (n=9 FGDs), the parents (n=5 FGDs), and the teachers (n=3 FGDs). Four of the principals were individually interviewed. Interviews focused on (1) perceptions about and description of healthy or unhealthy behaviors (2) priority of health risk behaviors in adolescents (3) perceptions and beliefs about the formation of the risk behaviors among adolescents. All sessions were embarked on the public schools located in the area five in West Tehran. After obtaining a written consent form from the participants, primary investigators and three of the trained facilitators (male and female) conducted the sessions. We employed content analysis to extract the major themes and sub-themes. The rigor of the data was obtained.

  Results : Addiction, risky sexual behavior, and social misconduct ion (aggression) were identified as the main concerns for the boys. Risky sexual behavior, early marriage, eating unhealthy habits, physical motionless, and fear of the future (job, education, marriage) were identified as the main health-risk behaviors for the girls.

  Conclusion : According to our findings, health risk behaviors are classified differently for boys and girls. However, sexual risk behaviors are common findings for both groups. The adolescents' risky behaviors are formed throughout their socialization and seriously influenced by the given culture. Understanding of gender schema was identified as an important factor in the way participants do priority health-risk behaviors of young people. Comprehensive and holistic health education and promotion programs targeting adolescents as well as training programs for parents are suggested.

  In this article 40 years of Iranian experience in primary health care in west Azarbaijan and behvarzs is presented. In this regard quantitative development of PHC during this period will be discussed, moreover challenges and opportunities of this program will be analysed. Finally family physician program should be considered as an appropriate tool to achieve universal coverago of PHC in iran.

  Background and Aim: Addiction behaviors have been established among high risk behaviors among different age groups in Iran. This study aimed to investigate the effects of a designed educational program on high risk behaviors of a sample of addicts in Qom, Iran.

  Materials and Methods: Totally, 128 men with addiction history in self help groups referred to health centers in Qom were studied. The instruments used to collect data were a self administered demographic questionnaire and the designed scale high risk behavior based on Health Belief Model (HBM).

  Results: The mean age of participants was 32.4 years. There were no significant difference between two groups at baseline in terms of all demographic data and all HBM constructs. The mean scores of HBM constructs, improved significantly in comparison with baseline. (p < 0.05).

  Conclusions: This study indicated that designed educational program could improve all HBM constructs after intervention. Additionally, behavior intention might be changed after intervention significantly.

Background and Aim: Cancer is the third cause of mortality in Iran, killing more than 30000 persons annually. The Motivation Theory is a useful approach for predicting and planning intervention programs to change behaviors related to cancer prevention and early detection. Considering the absence of a valid and reliable protection motivation theory questionnaire for cancer early detection in Iran, this study was conducted to design such a questionnaire and assess its psychometric properties in Yazd

Materials and Methods: This was a cross-sectional study. A questionnaire was designed based on similar questionnaires currently in use and its validity and reliability were determined. The reliability coefficients were calculated by Cronbach α and intraclass correlation coefficients. To determine the validity of the scale, two methods were used, namely, face validity and content validity. Confirmation factor analysis was used to determine factorial validity using Amous 21 software .

Results: The CVR for all items of the questionnaire, CVI, ICC and internal consistency of the questionnaire were found to be 1, 0.97-1.0, 0.71-0.98, and 0.65-0.93, respectively. The confirmation factor analysis revealed that the questionnaire fitted the Iranian population. The Cronbach alpha coefficient for the questionnaire constructs varied between 0.71-0.98 and 0.65-0.93

Conclusion: The validity and reliability of the Persian version of PMT scale for cancer early detection are acceptable and suitable, so it can be used in similar research.

  Background and Aim: Suicide by burning is one of the main health problems very common among women living in the west part of Iran. The objective of this study was to explore its causes and preventive strategies from the viewpoint of healthcare providers .

  Materials and Methods: This was a qualitative study, using semi-structured interviews, carried out in Kermanshah. The participants were the health care personnel working in Imam Khomeini Hospital, a teaching hospital and referral center in the west part of Iran. Sampling was purposeful and continued until data saturation. Data analysis was conducted through thematic analysis.

  Results: Four themes were extracted for the causes of self-immolation including cultural context, mental health problems, self-immolation as a way to highlight the outcry, and economic problems. As regards prevention strategies, two main themes, namely, cultural changes and mental education and services, emerged.

  Conclusion: Self-immolation is a multi-dimensional phenomenon. Different factors interact, resulting in self-immolation by women in stressful situations. Comprehensive preventive strategies such as education, as well as cultural changes, can help to reduce the burden of self-immolation.

Background and Aim: Children who work or live in the streets are one of the high-risk groups for HIV. The high population of street children and lack of comprehensive intervention programs for them increase their risk for HIV in Iran. This study intended to explore the situation of drug abuse in street children in Tehran, the capital city.

Materials and Methods: This paper reports part of a comprehensive rapid assessment and response (RAR) research project on street children in Tehran during 2012-13. Data were collected by interviewing subjects using questionnaires. The sample size was 289 street children selected by time-location sampling in Tehran.

Results : Data showed that about 25.6% of the street children had had some history of cigarette smoking, alcohol abuse, and/or drug abuse. Most of them were boys aged 15-18 years. The prevalence rate of cigarette and/or hubble-bubble smoking, alcohol consumption and drug abuse during the preceding 6 months 12.1%, 11% and 6.9%, respectively. Significant associations were found between alcohol consumption and drug abuse on the one hand and the children’s age, type of occupation and home-leaving experience on the other. Further analysis of the data showed that the main reason for drug abuse was curiosity (56.6%), followed by mere enjoyment (39.6%) and leisure (35.8%) .

Conclusion : It can be concluded that drug abuse among street children is highly associated with gender, age, alcohol consumption, cigarette smoking and leaving home experience. Therefore, it is recommended to start drug abuse prevention programs at lower ages, with particular emphasis on boys. In addition, family intervention and improvement of children’s lifestyle aiming at preventing home-leaving could be a main strategic plan for reducing drug abuse among street children.

  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: The community assessment is the basis of strategic policies for health professionals and managers. The aim of community assessment is collection of the data that relating to public health problems, data analysis and concludes about necessary capacities for providing the necessary resources to resolve problems.

  Materials and Methods: In this study the databases of Scientific Information Database, MagIran, MEDLINE, Google Scholar, and IranMedex were searched up to April 2014 (farvardin1393). All papers of community assessment in the country according to our standard community assessment model were included in this study.

  Results: Overall 11 studies were evaluated and the common feature of all research is to identify problems of society and local problems. The drug addiction was classified in 3 of the studies as a main problem and in 7 of studies was classified in the ten major problems. Poverty and unemployment are allocated to the next priority, the second priority in 2 studies, the third priority in 3 studies and the fourth priority in 3 studies. Environmental health problems and socio-cultural problems were the next priorities.

  Conclusion: The proposed model can be used to suggest new health services with due consideration of community problems, as well as develop suitable, effective intervention strategies. This type of community study should not be conducted only once. Rather, it should be repeated periodically in any community, results compared and used for policy-making.

  Background and Aim: The role of nutritional quality of the diet in the development and progression of multiple sclerosis (MS) is not yet well understood. The aim of the present study was to determine the association between index of nutritional quality (INQ) and MS.

  Materials and Methods: In this case-control study, 70 patients with a definitive diagnosis of MS in the preceding year and 140 frequency-matched hospital controls were selected from among 20-50 year-old patients referred to Sina and Lolagar hospitals in Tehran. The subjects’ dietary intakes were assessed using a valid and reliable semi-quantitative food frequency questionnaire. INQs for all the nutrients were then calculated for every participant, and logistic regression analysis was used to calculate the odds ratios for having MS in relation to every nutrient’s INQ.

  Results: After adjusting for potential confounders, it was seen that subjects who had higher INQs for alpha-linolenic acid, vitamins A, D, K, B₁, B₂, B₅, B₆, folate, B₁₂, and C, and minerals calcium, phosphorus, zinc, and potassium were less likely (p<0.05) to have MS as compared to subjects with lower INQs for these nutrients.

  Conclusion: The findings of the present study show inverse associations between the INQ of many nutrients and risk of having MS. Therefore, it seems that overall improvement of the nutritional quality of the diet might be an appropriate approach for prevention of this disease.

 Background and Aim: Sand flies are responsible for transmission of leishmaniasis, papatasi fever and carrion disease. Warning of sand fly population is the first step for the establishment of baseline data for the vector control operations of visceral leishmaniasis (VL). In order to attempt to the difference between species composition and bieocology of sand flies, the comparative research was carried out in west and east of Meshkinshahr district where having high and low prevalence of VL as well as mild semiarid and semiarid steppe climates respectively.

 Materials and Methods : Sand flies were biweekly collected using sticky paper traps from indoor and outdoor shelters from four villages at west and east of Meshkinshahr district. The specimens was removed from sticky paper traps and washed in acetone and preserved in 70% alcohol. The preserved sand flies were mounted using Puri’s media and identified using valid keys. The labeled specimens were deposited in Medical Entomology Museum, School of Public Health under code GC22ST6-93 .

 Results: During this study, totally 783 and 400 sand flies were respectively caught from indoor (19-27%) and outdoor (73-81%) of both at west and east. The sex ratios of collected sand flies were estimated 2.3 and 1.9. in latter areas. The genera percentage of sand flies were 66.3-64.5% for Phlebotomus and 33.7-35.5% for Sergentomyia compromising of 7 subgenera which included in 20 and 17 species respectively in west and east areas. For the first time, Se.sintoni and Se.mervynae was reported in Meshkinshahr district.

 Conclusion: The Ph.kandelakii and Ph.perfiliewi were introduced as prevalent species in the west area compared to the east. In the west area, activity duration and number of generation was higher than east. The prevalent species in the east area was Ph.papatasi. The high density of Ph.anderjevi was seen in both studied areas. The most proven vectors of visceral leishmaniasis were revealed in the west of Meshkinshahr district.

Background and Aim: Food poisoning occurs under circumstances where proper action for protecting foods from microbial contamination and chemical toxins is not taken. In the Iranian society women have an important role in preparing food in the home. The objective of this study was to assess the knowledge, attitude and practice (KAP) of women living in Yazd, Iran regarding food poisoning.

Materials and Methods: This was a cross-sectional descriptive study. Data were collected through interviewing 266 women living in Yazd, selected randomly by calling at their homes. Data analysis was performed using SPSS version 18. The minimum and maximum accessible scores for knowledge, attitude and practice were 0 and 15, 15 and 45 and 0 and 20, respectively.

Results: The mean (± SD) score of knowledge, attitude and practice was 11.13 ± 2.54, 39.98 ± 4.52 and 17.73 ± 1.96, respectively. Further analysis of the data showed that 63.2% of the women had no knowledge about safety of refrigerated cooked foods and 41.4% had an erroneous attitude about fruit and vegetable cleaning, believing that merely cleaning them would make them safe to eat. As regards practice, 68.8 % of the women prepared and ate semi-cooked eggs.

Conclusion: Yazdi women lack a sound knowledge about (a). some agents of food poisoning such as, for example, Salmonella and (2). food cooking and preserving temperatures. It is recommended to plan and execute educational programs aiming at promoting knowledge and improving practice of women in these areas.

  Background and Aim: The aim of this study was to assess exposure of workers in a metal industry to nickel and lead.

  Materials and Methods: Extraction was done using the solid-phase extraction on Chromosorb-102 resin to prepare, concentrate and purify biological samples of urine, hair and nails of workers working in metal industries. The variables influencing response (pH, loading flow rate, elution solvent, and amount of resins, elution volume, and sample volume) were examined and the procedure was optimized. The optimized procedure was, then, validated based on the “within-day” and “day-to-day” reproducibility experiments, using low, medium and high concentrations, leading to a satisfactory accuracy and precision. Finally, lead and nickel samples were taken from the workers and their concentrations determined voltammetrically.

  Results: The optimum values for the examined parameters were as follows: pH = 9, ligand concentration = 0.05%, loading flow rate = 5 ml/min, elution solvent = 2M HNO₃, amount of resins = 500 mg, elution volume = 15 ml, and sample volume up to 500 ml. A good reproducibility and repeatability was obtained for the optimized method under the existing conditions. Lead and nickel could be extracted with recoveries in the range of 94-100%. On the whole, the concentrations of nickel and lead in the workers’ biological samples were above the respective maximum permitted levels.

  Conclusion: Solid-phase extraction procedure is a fast and simple method for preconcentrating and isolating analytes from biological samples. Considering the low concentrations of the analytes and presence of confounding factors in such samples, the procedure can be very effective for their preparation. The application of the developed method indicates that trace metal ions can be effectively purified and preconcentrated from different matrices like urine, hair and nail samples to assess occupational exposures.

  Background and Aim: It is known that personal behavior influences one’s health. The present study was designed to investigate lifestyle of non-medical students of governmental and private (Azad) universities in Kashan, Iran and factors affecting it.

  Materials and Methods: A cross-sectional study was carried out on 520 non-medical students in Kashan, Iran, selected by convenience sampling, in academic year 2013-14. Data on demographic characteristics and health behaviors were collected using standard valid questionnaires, for the latter the questionnaire being the Pender’s Health Promoting Lifestyle Profile II (HPLP II). The data were analyzed using the Kolmogorov-Smirnov test, followed by t-test, and U Mann-Whitney test to compare the means of the two populations. 

  Results: The m ean age of the students was 21.75 ± 2.5 years. Their overall health-promoting lifestyle score was of 2.43 (SD = 0.38). This score, as well as scores for the subcategories ─ nutritional behavior, spiritual development, physical activity, health responsibility, and stress management ─ were lower for the subjects with an experience of stressful events. Further analysis of the data showed that t here were significant differences between boys and girls as regards physical activity (P = 0.000), between single and married students as regards nutritional status (P = 0.032), and between working and non-working students as regards spiritual development (P = 0.014).

  Conclusion: The findings indicate that experienced stressful events lay the ground for the adoption of risky behaviors in university students. Therefore, universities should design and implement programs aiming at improving lifestyle of the students and promoting their health.