مجله تحقیقات نظام سلامت
سال دهم شماره 2 (تابستان 1393)

Disease mapping includes a set of statistical techniques that lead to provide clean maps based on estimation of the incidence, prevalence and mortality rates for the users to be able to estimate the distribution of disease reliably. The main aims of disease mapping are to: describe the spatial variation in disease incidence for the formulation of etiological hypotheses; identify areas of unusually high risk so that action may be taken; provide a clean map of disease risk in a region to allow better resource allocation and risk assessment; disease atlas construction. So far, several case studies have been conducted in which the applications of disease mapping models have been used.However, except in a few small studies and in limited situations, disease mapping models have not been compared and their general terms have not been studied. According to the importance of disease mapping and its growing use, in the present study the most important models have been introduced and their theoretical foundations, applications, advantages and disadvantages have been mentioned briefly and their various aspects have been compared.

Colorectal cancer (CRC) is the third most common cancer in the world and one of fifth most common cancers in Iran. Sedentary lifestyle and a diet rich in fat and meat, and poor in cereals, fiber, fruit and vegetable are suggested to increase the incidence of CRC. The aim of this study is to review available studies on fruits, vegetables and colorectal cancer We searched PubMed and Google Scholar databases with keywords Rectal cancer, Colon Cancer, Colorectal cancer, cohort study, Randomized Trial, Fruit, Vegetable. Finally 60 studies were included in this review. The risk of colon cancer in relation to fruit and vegetable consumption has been reported in epidemiologic studies. Results of studies on the effect of fruit and vegetables and adenomatous polyps are inconsistent.In cohort studies, the weaker relationship between consumption of fruits, vegetables and risk of CRC compared to the case – control studies was observed. Components or specific subgroups of fruits and vegetables are associated with CRC risk. Increased consumption of fruits and vegetables does not reduce colorectal cancer risk, but low consumption of fruit and vegetables is associated with increased risk of CRC. Consuming fruits and vegetables have favorable effects on health and reduced risk of other chronic diseases and their recommended daily intake.

About 70% of all pregnant women suffer from pelvic girdle pain (PGP)and/or low and high back pain(LBP,HBP). The risk factors for developing pelvic girdle pain and back pain in general are history of previous low back pain or pelvic or pain in previous pregnancy. In order to study the relative frequency of different kinds of backache in pregnancy and possible risk factors for developing pelvic girdle pain and low or high back pain this study performed. In a cross-sectional study included 265 pregnant women that suffered from pelvic girdle pain (PGP)and/or low and high back pain(LBP,HBP). All pregnant women were underwent a thorough physical examination and then were allocated according to kind of pain into three classification groups: pelvic girdle pain (PGP), low LBP back pain(LBP) and high back pain(HBP) and according to outbreak of pain, into four classification groups: 0-12,13-20, 21-30 and 31-40 week. Data were collected by interviewed using a questionnaire and analyzed by Chi-square, ANOVA, kruskal-wallis and Mann-Whitney tests using SPSS software. In all tests the significance level was P<0/05. A total of 265 pregnant women, majority of women (51/3%) had reported low back pain at the time of the examination. The prevalence of PGP was 27/5%, HBP was 6% and HBP and LBP together were6/8%. In the 0-12 week most backache were in low back area (53/1%), in the 13-24week were in low back area(58/2%), in the 25-30 week were in pelvic area(47/7%) and in the 31-40 week were in pelvic area(42/2%). Most common area for diffuse in women with low back pain was legs and in women with pelvic pain was thigh.The risk factors for developing pelvic girdle pain and back pain in general are history of previous low back pain or pelvic or pain in previous pregnancy. No association was found between obstetric factors and pelvic girdle pain. PGP and LBP have high prevalence in pregnant women and majority of pregnant women report Low back pain (LBP). Therefore PGP and LBP is a major health problem that to solve this problem, an alternative should be considered. To reduce the pain accurate diagnosis and then recommend specific movements and exercises under the supervision of the rehabilitation is important

Oral and dental caries are the most prevalent diseases in the world. The aim of this study was to determine the predictors of oral health care in adults based on health belief model in Isfahan, Iran. In this cross-sectional (descriptive and analytical) study on 274 patients from the School of Dentistry, Isfahan University of Medical Sciences were selected by a simple random sampling. Means of data collection was a questionnaire designed according to oral health beliefs model.The obtained data was analyzed by means of SPSS 20. P<0.05 was taken as the significant level. The mean age of subjects was 30.47 ± 11.47 years. Significant relationship between demographic characteristics, except income did not exist with oral health behavior (flossing and brushing). Perceived barriers were the Most construct of the HBM for predicting of flossing and brushing(r=-0.53,p<0.001). this construct plus to perceived benefits were the greatest predictor of oral health, As it anticipated 38 % of dental floss behavior and 33 % of brushing. Designing and implementing Educational interventions focused on reducing barriers and increasing benefits of oral health behaviors can encourage individuals to prevent dental disease.

colors make many problems and these are major sources of environmental pollution. Therefore, this wastewater should be treated before discharge to environment to reduce the environmental threats. Adsorption is one of the usual processes for color removal from wastewater. Nanotubes are new adsorbents with extend application for adsorption of different compounds. Aim of this study was survey on feasibility of single-walled carbon Nanotubes as adsorbent to reactive red 198 dye adsorption from aqueous solutions. This study was done in a batch reactor. The effects of various parameters such as contact time mixing intensity, initial dye concentration, pH and single-walled carbon Nanotubes dose on removal of Reactive Red 198 color was investigated. The results showed the optimal time for achieve to maximum adsorption and equilibrium is 3 hours. More increasing in adsorbent dose from 0.1 to 0.9 g, more increasing in dye removal efficiency from 91.8% to 100%. It was found that the maximum adsorption capacity of reactive red 198 on single-walled carbon nanotubes was 7.98 mg/gr and it was occurred in acidic condition (pH = 4). Decreasing in initial dye concentration from 50 to 25 mg/l in pH 4 and during 3 hours can cause increasing in removal efficiency from 9/96% to 100%. The results showed reaction kinetic was described by Pseudo-first order equation and adsorption isotherm was followed both Freundlich and Langmuir isotherm models. Due to the small size, high surface area, crystalline shape and unique regularity of the network, the reactivity of single-walled carbon Nanotubes is very high. Single-walled carbon nanotubes have impressive performance as adsorbents to removal of reactive red dye 198.

Social capital involves a set of norms available in social systems which improves the interaction between people and reduces the costs of interactions and communications. Considering the importance of social capital, this research is aimed to study the social capital and factors affecting it among students of Tehran University of medical sciences. 400 Students were participated in a cross-sectional study. They were selected randomly commensurate with the student population of each faculty. 36-item Bullen’s questionnaire having 8 dimensions was used for data collection. Finally, for data analyzing were used with SPSS 18 and Independent T- Test, Pearson correlation and regression. The means of social capital was 44.12. Minimum and maximum mean was measured for “participation in local community” and “family and friends connections” elements, respectively. The study also showed a relationship between social capital with economic status and residency According to the results, there exists a relationship between some dimensions of social capital with economic status, sex, residency and field of study. Authorities could consider these variables and appropriate intervention to increase the social capital of students.

Conflict is the lack of agreement and disagreement between the two men, and behavioral maladjustment or objectives that are in opposition to the other. Destructive conflicts are incidents imposed on one or more than one member of the family or the whole family and affect on them. The purpose of this research is to study the effect of solution - focused short-term approach on marital conflict decrease in Qom. This research is semi-experimental with pretest, posttest and two groups of experimental and control. The populations are couples referring to family counseling centers in Qom and they were self –introduced. The samples were 50 couples who were volunteer to attend in this research, selected available and allocated randomly into two groups of experimental and control. The research measures were demographic characteristics and Sanaei’s marital conflict questionnaire. To analyze the data, covariance analysis and also descriptive statistics were used. The data analysis showed solution-focused approach is effective on couples’ all conflicts (P<0.001, F=24.089). Also, it is influenced on subscales of cooperation decrease(P<0.001, F=7.4), sexual relationship decrease(P<0.001, F=50.4), emotional reactions increase (P<0.001, F=10.89), the increase of child’s support attraction(P<0.001, F=22.3), the increase of relationship with their relatives(P<0.001, F=77.4), the decrease of relationship with the spouse’s relatives and friends(P<0.001, F=31.02), separation of financial issues from each other(P<0.001, F=71.1) and effective relationship decrease Making problem -solving skills in couples can prevent many difficulties. Problem-solving instruction is very important as one of daily life skills and it is used a lot in solution-focused approach. We can help couples solve their problems and increase their marital life satisfaction with these techniques.

Mobile phone has become extremely popular and widely used all over the world. Now a day, consumers around the world can purchase a single product that utility as a mobile phone, camera, camcorder, calculator, game console, text-messaging device, MP3 player, alarm clock, Web browser and email device. The purpose of the present study was to explore self-reported use of various features of mobile phone in university students. This descriptive cross - sectional study was conducted with the 1300 students of the Isfahan University of Medical Sciences in 2011. Data were collected by self report questionnaire. The questionnaire included demographic information, including age, sex, marital status, education, and information about the possibilities of mobile features. The data analyzed by software SPSS 18 and descriptive and analytical statistical methods were used. Girls used significantly more than boys SMS and educational software like dictionaries while boys used more than girls a mobile phone for login the Internet. Overall mean of use of mobile phone features significantly higher in boys than girls as well as, more boys than girls had changed their mobile phone (P ≤ 0/001). Based on the results of exploratory factor analysis features were divided into five groups including: using of multimedia, using of the software, instrumental using, using to remind, punctuality using. Among mobile phone features SMS, alarm clock, aware of the time, the use of educational software such as dictionaries, contacts and Memory Stick will be used more by students. Most students use the multimedia or audio visual features of mobile phone. Mobile phones can be useful as a tool to educate and inform students.

protein is an essential component of our body and also we need it as an energy source. The quality of protein is dependent to its amino acids. After bread, rice is our main food and is cultivated in many regions of our country and also we use importing rice. Therefore it is necessary to determine the content of essential amino acids of each kind of rice for calculating their protein quality. Therefore, The aim of this study was to compare the content of essential amino acids in rice named; Thailand, Northern, Lenjani and Indian in Isfahan city. In this Analytical project we bought 11 samples of each kind of rice in a random manner from main rice sellers, finally 44 samples. Each sample was prepared based on standard method of AOAC NO: 994.12 and we determined essential amino acids by Amino Acid Analyzer. findings showed that the quantity of all essential amino acids including; Valine, Isoleucine, lysine, Leucine, Threonine, Methionine, Phenylalanine and Histidine were different in Thailand, Northern, Lenjani and Indian rice. (P< 0.01) our results indicate that Lenjani rice is the best source of protein and essential amino acids while Thailand rice was the poorest source, this study can be a start point for introducing an Iranian new and complete food composition table.

Patients knowledge and perceptions from hypertension and related nutrition as a central factor has important role in hypertension controlling. This study aimed to determine relationship between illness perceptions and nutritional knowledge with eating behaviors on rural hypertensive patients. In a cross-sectional study, 671 hypertensive patients were selected as a multi-stage random sampling with inclusion criteria from the rural areas of Ardabil city in 2013. Data collecting instrument include from 4-part questionnaire included demographic questions and questions about dietary knowledge, illness perception and 3-day food registering questionnaire. Data were collected by trained health workers with Interview and nutritional data include macronutrients (Fat, Cholesterol, Protein, Carbohydrate and Total Energy) extracted with Nutritionist 4 (N4) software Analyzed using Excel 2007, SPSS - 18 and Pearson correlation, multiple linear regression, considering the significance level at 0.05. 74% of participants were female; mean (SD) age was 50.2 ± 6.4 years, duration of disease 5.9 ± 4 years. Majority of participants 75.9% (509 patients) had elementary education. Patient illness perception and knowledge was moderate. Fat intake was 92.1gr, protein 110.3 g and carbohydrates 317 g per day, also the average daily energy intake was 2539 kcal. Perception scores correlated positively significant with nutritional knowledge (P<0.01, r=0.583) and negatively significant correlated with fat(P<0.01, r= - 0.352), cholesterol(P<0.01, r= - 0.09), energy intake(P<0.01, r= - 0.318), systolic (P<0.01, r= - 0.614) and diastolic blood pressure(P<0.01, r=0.400). Nutritional knowledge as well as was found a significant negatively correlation with mean fat, cholesterol, energy intake, systolic and diastolic blood pressure. Regression model showed that the nutritional knowledge and illness perception can be predicted 47.8% of systolic blood pressure variance. Patients nutritional perceptions was not satisfactory, patient’s energy intake and fat intake were higher than recommended amounts by related scientific organizations.

Due to the lack of proper rail road and air transportation, most commutes in Iran are carried out by buses. In most cases, the water in the busses is used for passengers for drinking usage. Although this kind of water source has provided convince for the travelers, it could be a great risk in disease outbreak. The aim of this study is to determine the water quality in commuting buses of Shiraz Karandish terminal in winter 2011. The study is of descriptive-cross-sectional type. 48 samples were collected through quota sampling. In this study, water microbial contamination (total and fecal coliform bacteria) was studied by method using nine-tube fermentation (MPN). The residual chlorine amount, Turbidity, pH and temperature were measured. SPSS software version 11.5 was used for statistical analysis. Results suggested that 18.75% of total coliform and 4.17 % of fecal coliform were positive. The turbidity in 8.3 % of the cases was at the standard level (0.1-1NTU). Comparing between the results of this research with other studies showed that fecal contamination in bus water fountain of Shiraz was less than fecal contamination in bus water fountain of Kermanshah, Bandar Abbas and Kerman but it was more than Isfahan.

Marital satisfaction is defined as the feeling of pleasure, satisfaction, and joy experienced by the couples. Premenstrual Syndrome (PMS) can cause problem in daily routine relation and activities.The study aimed determining Frequency of marital dissatisfaction in couples who their waives suffer from PMS in the city of Yazd. Sample for this descriptive-analytical study was 240 young couples referred to Yazd Health Care Centers. The tools for data collection were Premenstrual Syndrome Screening Tool, a standard questionnaire Index of Marital Satisfaction (IMS) to determine marital satisfaction and a researcher-designed questionnaire for measuring men's knowledge and practice about the syndrome. A pilot study approved the validity and reliability of the questionnaire. Data was analyzed using SPSS18 software. In analyzing the data, statistical tests such as T-Test, ANOVA, correlation coefficient and 2χ were used. Findings from this study demonstrated that men's dissatisfaction rate was 72/1% and women’s dissatisfaction was 56/7% and there was a significant relation between score marital satisfaction of men and women (p>0/001). The relation was not significant between the score of men's knowledge about PMS with female’s and man’s dissatisfaction. But a significant inverse relation was between the mean score of men’s practice about PMS and woman’s (P>0/001) and man’s (P>0/001) dissatisfaction. Although there was not a significant relationship between knowledge of men about PMS with marital satisfaction, but their practice about PMS influenced on marital satisfaction. With regard to the relationship between knowledge and practice can be expected that the increasing the knowledge of men about PMS may increase marital satisfaction.

Today, in many countries, wastewater treatment plants effluent is an important part of the renewable water resources. In this case, the effluent quality standards are developed and used is important. The aim of this study was to investigate the potential use of wastewater plants effluent Restricted Irrigation. In this descriptive - analytical study, samples was collected from the Isfahan wastewater treatment plants effluent. Effluent quality parameters; BOD5, COD, pH, calcium, magnesium, sodium, electrical conductivity, sodium absorption ratio absorption %Na, SAR, boron and chloride were analyzed. Average of BOD5 and COD parameters in both plants was same as environmental standards but does not meet EPA standards. Both Wastewater effluent pH values were in the range of 9-6. Boron concentration and sodium adsorption ratio in the north wastewater treatment plant was good, for irrigation. %Na, chloride concentration and EC was inappropriate. In the south wastewater treatment plant, boron and SAR was at the excellent level. Chloride and EC was permissible, and %Na was good. Based on independent sample t test, there was significant deference between Isfahan North and South wastewater treatment plants (P<0.05). There was not seen significant deference between effluent quality and standard level in both treatment plants (P>0.05). With proper operation of treatment plants and use of an appropriate disinfection process, the suitable effluent quality for agricultural purposes is provided.

Ritalin is an amphetamine that possible to abuse, especially among college students. This study performed with aim to determine the attitudes, subjective norms, prototype, willingness and behavioral intentions regarding Ritalin abuse among college students. This cross-sectional study was conducted among 264 college students of Isfahan University of Medical Sciences, during spring 2013. Participants selected in random sampling with probability proportional to size, and data were collected by using questionnaire in self-report. Data were described by using SPSS-21. Mean age of students was 23.02±2.28 years. 6.6 percent of students reported having experienced Ritalin abuse. Participants respectively received 47.7, 48.6, 48, 43.5 and 52.6 percent of the maximum score for the domains; attitudes, subjective norms, prototype, willingness and behavioral intention to use Ritalin. Our findings showed, more intention to Ritalin abuse during cores exam, it seem skills study education for student could be beneficial results to Ritalin abuse prevention.

Acute low back pain is one of the most prevalent diseases which more than 90% of the adults experience at least once during lifetime. The present study was conducted to determine the efficacy of duration of hot water bag usageon pain relief in in the patients with acute low back pain. This clinical trial study was conducted on 20- to 50-year-old patients referring Orthopedic Clinic of Ayatollah Kashani Hospital, Shahrekord in 2012-2013. In this study, 60patients with acute low back pain were enrolled per convenience sampling; of these patients, two were excluded from the study because of refusal to continue the treatment. Finally the intervention was conducted on 58 patients who were assigned randomly into two groups (intervention, under treatment with hot water bag accompanied with routine treatment [naproxen] and control, under treatment with routine treatment alone) after homogenization. All patients were examined on first, third, eighth, and 15th days and the patient's pain was measured per McGill Pain Questionnaire and registered. The data were analyzed by SPSS 17 software using descriptive statistics, paired t-test, ANOVA, and chi-square at significance level of p< 0.05. In this study, 52% of the patients were female and 48% were male with mean age of 34 years. The findings indicated that pain intensity was significantly lower in the 15th day examination compared to the seventh and third day examinations in the group under treatment with hot water bag (P≤0.02). The overall mean score of pain in the first and 15th day examinations was respectively 12.70 and 0.75 in the intervention group and 12.96 and 5.58 in the control group. The obtained results indicate that continuous usage of hot water bag along with sedative medications could cause pain to be relieved much higher compared to taking medications alone (control) in the patients suffering from acute low back pain.

The negative side effects of infertility affect not only the relations between the couple but also other aspects of their lives and destroy their personal, social, and professional functions. This research aims to study the social consequences of infertility on families in the city of Isfahan. Sociological and psychological theories provide the theoretical framework of the study. The research method was survey and the data collection tool was questionnaire. The research was conducted on 384 infertile women chosen by simple random sampling from among those going to Isfahan fertility and infertility center. The research instrument had face validity and to test its validity, Cronbach Alpha coefficient was used. These data were analyzed by Chi Square, Spearman and Pearson correlation coefficient. Research results showed a statistically significant relationship between duration of infertility and mental disorders (χ 2 = 15.896, p<0.05) marital conflicts (χ 2 = 21.322, p<0.05), divorce possibility (χ 2 = 38.831, p<0.05) and a decline in social relations (χ 2 = 26.857, p<0.05). There also existed a significant relationship between mental disorders and the level of education (r = -0.151, p<0.05) and religiousness (χ 2 = 18.345, p<0.05) of these infertile women. Research findings, on the other hand, showed no significant relationship between infertile women’s mental disorders, age (r = 0.014, p< 0.05), occupation (r = 0.025, p< 0.05) and place of residence (r = 0.065, p<0.05). The results showed that infertile women, as compared with fertile ones, have considerably more psychological problems and that this issue can negatively affect their marital life and social relations.

Heavy metals in industrial wastewater especially chromium (VI) are considered as the main environmental pollutants. Electrochemical cell made of plexiglass with a volume of 1.95 lit was used. Iron and graphite electrodes, electricity conductor, each with dimensions of 0.1×3×10 cm (width×length×height) were designed and built. Tests were carried out in various conditions of pH, concentrations of input chromium (VI), different amounts of electrolytes, electric currents and retention times. Measurement of samples was performed using of diphenylhydrazine method. Maximum removal efficiency for iron and carbon electrodes at about 99.8% and 88.3% was observed, respectively. The lowest among of Cr+3 in efficiency wastewater of system was recorded about 0.05 mg/l for Fe electrode. The results showed that the operation of the electrochemical cell, efficiency removal of Cr (VI) by iron electrode in the same process conditions is more than carbon electrode. Generally, despite in this method removal efficiency of hexavalent chromium from synthetic wastewater is acceptable however consume a lot of electrical energy. Thus, electrochemical method is usable for the removal of heavy metals in industrial scale.

Bioaerosol is defined as airborne particles such as living organisms include bacteria, fungi and their related metabolites, such as endotoxin. Over the recent years, health effects of bioaerosols such as infectious and respiratory diseases, acute toxic effects, allergies and cancer have been considered. The aim of this study was to evaluate the bacterial and fungal concentrations in indoor air of various environments. This cross - sectional study was conducted in 2013. A single-stage Andersen biosampler was used for the bacterial and fungal collection in the air of indoor environments. A total of 240 samples (60 samples of bacteria and 60 samples of fungus with repeat) were analyzed. The effects of environmental factors such as temperature and humidity on bioaerosol concentrations were also evaluated. The highest average concentration of airborne bacteria was seen in the residential environments 944 CFU/m3 and the highest fungal concentration 102 CFU/m3 was obtained in school classrooms. However, indoor air of offices and university classrooms had the lowest concentration of bacterial and fungal bioaerosols with the overall mean of 132 and 36 CFU/m3, respectively. According to the results, the bioaerosol concentration in the indoor air of some environments was higher than of WHO guideline, which can cause health risks and respiratory diseases, especially in children and people who are sensitive. Increasing the ventilation rate by mechanical equipment or natural systems can be effective in improving indoor air quality

Healthy behaviors in Alzheimer prevention among at risk are very important. This study aimed to assess the effect of educational program based on Health Belief Model on adopting preventive behaviors in Alzheimer among elders under covering Ardebil health care setting. This was a quasi-experimental study which was conducted in 2013 among 148 elders who divided into two groups using random allocation sampling method using a valid and reliable questionnaire. Blended educational program was performed some educational strategies such as lecture, group discussion and face to face approach of during three sessions and telephone recall during 6 months. Data collection was conducted in two stages, before and 6 months after the program in the two groups separately. SPSS software version 16 was used for analyzing the collected data. The significant level was considered at less than 0.05. Mean age of participants were 68/9±7.9 and 68/8±7/6 years in intervention and control groups respectively. There was no significant difference between perceived threatening, perceived severity, perceived benefits and barriers, Cues to Action and performance before intervention (p>0.05). But after educational intervention these changes was significant (p<0.001). Mean score of knowledge and model constructions had increase significantly (p<0.001).Also, mean score of performance had increasing significantly (p<0.001). study results revealed effectiveness of HBM in adopting preventive behaviors among elders about Alzheimer. It has been suggested that intervention program based on HBM usage in other health care setting.

Leachate produced by waste disposal sites can be contaminating groundwater. The contamination vulnerability and groundwater protection assessment has proved to be an effective tool for the delineation of protection zones in area affected by groundwater contamination.The main objective of the study is to evaluate aquifer pollution vulnerability in the new waste disposal site leachate Isfahan city using DRASTIC model combine with GIS. In order to conduct research Seven hydro-geological factors consist of Depth of water, net Recharge, Aquifer media, Soil media, Topography, Impact of vadose zone and hydraulic Conductivity are incorporated into DRASTIC model and the ArcGIS 9.3 were used to create a groundwater vulnerability map by overlaying the available hydro-geological data The study shows that The DRASTIC scores obtained from the model vary from 115, 126, 130 and the contamination of aquifer potential by landfill leachates is medium. The DRASTIC method is valuable to assess the potential contamination of groundwater by leachate from the landfill site. GIS is a useful tool for local authorities are responsible for municipal solid waste disposal management.