مجله تحقیقات نظام سلامت
سال دهم شماره 3 (پاییز 1393)

This study is a systematic review of unhealthy dietary pattern and its effects on the incidence and control of insulin resistance and diabetes mellitus type 2 The survey is performed in ISI, Cochrane Central Register of Controlled Trials databases, Pubmed, Iran Medex and MagIran for the main keywords which were consists of: "diabetes mellitus", "insulin resistance", "metabolic syndrome", "dietary pattern" and other related key words All journals, E-books, seminars and symposiums were focused. The search is limited to 1992 to 2011. The prospective cohort study, randomized clinical trials and cross sectional studies were selected based on their title, abstract and full text of the materials. After deleting the experimental surveys and studies which were focused on children and adolescents, 738 materials were extracted. The results show that “Western” dietary patterns rich in: red meat, fried and processed dishes, refined cereals, carbohydrate with high glycemic index has statistically significant effects in incidence of hyperglycemia. Adherence to the unhealthy food habits which is rich in trans fatty acids and saturated fatty acids, refined carbohydrate with high glycemic index is related to the insulin resistance, hyperglycemia and risk of diabetes type 2.

Periodontal disease is a common oral disease, which oxidative stress plays an important role in its pathogenesis. The onset and progress of this disease is influenced by balance between oral biofilm and host response. Regarding with the role of oxidative stress in the pathogenesis of periodontal disease and reduction of total antioxidant capacity in patients with periodontal disease, it is suggested that a sufficient dietary intake of antioxidants would be beneficial in the treatment of these patients.The aim of this review article was to evaluate the role of dietary antioxidants in periodontal diseases The literature review has been performed in the database Pubmed, Google Scholar and Iranmedex from 1991 until 2013.after studying of 60 articles, fulltext of 30 articles were assessed. Assayed studies indicated that dietary antioxidants including vitamin C, vitamin E, carotenoids (a and b –carotene, beta-cryptoxanthin and zeoxanthin) and polyphenols (proanthocyanidin, Flavonoids) have an important role in protection against oxidative stress in periodontal disease. Based of the finding of this review study, It can be concluded that dietary antioxidants can be efficient in the prevention and treatment of patients with periodontitis.

Diabetes is a major problem for health systems and physical activity is one of the most important modifiable and life style factors to management of diabetes. This study aimed to determine the status of physical activity (PA) in patients with type 2 diabetes based on Trans Theoretical model (TTM). This study was conducted on 393 diabetic patient’s type 2 diabetes in 2013 at the city of Khorramabad, participants were selected by convenience sampling method. Data were collected through a questionnaire consisted of 5 parts and were analyzed with using the statistical software SPSS-18 and Pearson correlation coefficients, chi-square test, t-test and ANOVA test. The P-value for statistical significance is defined as P < 0.05 In this study the majority of participants (48.9%, 192 patients) were in pre contemplation stage and only 15% of them were in the action and maintenance stages. Mean minutes of PA was 20.6±11.9 and the mean of PA in maintenance group was significantly higher than other groups. A negative significant relationship was found between the average daily PA and perceived benefits, and a positive significant correlation with processes of change, self-efficacy and decision balance. Frequency of PA in week had a positive significant correlation with self-efficacy. The majority of patients had no a plan to exercise in the next 6 months and physical activity levels of the patients were poor. Regarding the relationship between self-efficacy and decision balance with an average of exercise time in day and frequency of exercise in week provision of educational programs focusing on these structures can help to improve the level of physical activity.

Heat stress risk assessment, as a harmful agent at workplace, is essential for controlling heat strain and heat stress effectively. This study is concerned with the Relationship between Physiological Strain Index (PSI) and Wet Bulb Globe Temperature Index (WBGT) in Women in the Climate Chamber. This experimental study was carried out on 36 healthy females in sitting state under thermal conditions (22 - 32 C) in environmental chamber for 2 hour. In order to calculate physiological strain index (PSI), oral temperature and heart rate were measured every 5 minutes. The data were analyzed using correlation and regression. The average heart rate and oral temperature, during the heat exposure 87.91 bpm, 36.89 C, respectively. The min and max Index WBGT, 25.49 C and 32.1 C respectively, and the min and max heart rate 83.01 and 90.97 bpm, and the min and max oral temperature 36.7 C, 37.01 C, respectively. Also, the results have revealed a direct and significant correlation among WBGT with PSI (r = 0.71, P< 0.001), oral temperature (r = 0.98, P< 0.001) and heart rate (r = 0.77, P< 0.001) indices. The results showed that the WBGT index with physiological variables, heart rate, oral temperature and PSI index thermal range (22 - 38 C) and 40% relative humidity (RH) had direct and significant correlation in women with Islamic clothing. Also simultaneous with WBGT increases heart rate, oral temperature and PSI index increased.

Processes such as drying, sauce making, extracting and doping reduced nutritional value and unique sensory characteristics of pomegranate. On the other hand, the difficulty in peeling and removing the arils has limited its fresh consumption. For this reason, the “ready-to-eat” pomegranate may represent a possible option to implement fresh fruit consumption. In this study, the effects of modified atmosphere packaging on quality of pomegranate arils were evaluated. Low density polyethylene (LDPE, 100μm) used for packaging materials and stored for 11 and 9 days at 4 and 10C respectively. At storage period Headspace gas composition and quality parameters (acidity, pH, TSS, firmness and color) were measured. During storage, both Oxygen concentration in head space and acidity of arils reduced but carbon dioxide concentration increased. Temperature and weight of arils in package had a significant effect (p≤0.05) on gas composition. Total soluble solid, firmness al color of arils have no significant change during storage period. LDPE pouch and storage at 4 and 10C, provided reliable shelf life of 7 and 5 days, respectively. At higher temperature macro/micro perforations would be essential on the LDPE film in order to avoid critical levels of O2 and CO2.

Fresh bread has a short shelf life and by considering this matter, its acceptability by consumer dramatically would reduce by increasing the time between baking and consumption. Use of frozen dough technology is one of solution for this problem. Therefore in this current study the impact of freezing storage and pre-fermentation in Sangak frozen dough and its bread was considered. Dough was prepared in three form of non fermented, pre fermented and formed and pre fermented and non formed. Time of pre-fermentation for all samples was 30 min. Then dough wasfrozen under -25˚C in air blast freezer. After freezing, the dough pieces were stored at -18˚C for 24 hours, 4, 7, 10 and 13 weeks. Sangak frozen dough and its bread quality was assessed by measuring yeast survival and dough expansion after thawing and by measuring density and texture after baking. Results showed viability of yeast and dough expansion decreased by freezing and longer storage time. Also density and firmness of bread increased whit longer storage time. Pre-fermentation for 30 minute decreased quality of frozen dough and its bread Therefore, quality of frozen dough and its bread affected significantly by freezing of dough and its storage.

Access to the Internet is a growing phenomenon. Every day more people are among the Internet users. This study aimed to investigate Internet addiction and its effective factors among students in Hormozgan University of Medical Sciences. This study was of a descriptive, cross--sectional type which aimed to investigate Internet addiction and effective factors among students in Hormozgan University of Medical Sciences The research community consisted of all students in Hormozgan University of Medical Sciences in year 2013 studying and Was proportional stratified sampling. Data gathering tool was Yang standard internet addiction questionnaire. SPSS software model 16 was used for data analysis research. p <0.05 was set as the level of significance. From total of 500 students that participated in the study, 166 patients (33.1%) were male and 334 (66.7%) were female. 409 patients (81.6%) were single and 91 (18.2%) were married. Results of the study indicated (226 patients) as the user at risk (205 patients) as a normal user, and (69 patients) another addicted user. There was significant relation Between variables such as gender (p=0.003), field of study (p=0.002), marital status (p <0.001), age (p <0.001), educational level (p <0.001) and using Internet (p=0.005) with Internet addiction. But the location was no significant associated Internet addiction. The correct teaching for the students to use the Internet and making culture, educate families, schools and universities, to solve the problems of young people, creating a fun and engaging programs are effective in reducing the rate of Internet addiction.

Release of volatile organic compounds (VOCs) in industrial and urban area have adverse effects on human health and environment. The aim of this study was removal of gaseous toluene, as the most of pollutants among VOCs, by using of TiO2 nanoparticles coated on nickel foam substrate. TiO2 nanoparticles prepared by sol gel method and coated on nickel foam. Morphological and structural characteristics of photocatalyst was determined by XRD and SEM. Photocatalytic conversion of toluene in the gas phase under UV-A irradiation by injected of samples into the GC-FID was measured. TiO2 nanoparticles was obtained in anatase and rutile phase, respectively, 61.1% and 38.9%, with dimensions of 18 and 24 nm from the sol-gel solution and coated on nickel foam. After determined the optimal level of relative humidity, adsorption of toluene was determined about 55%. Finally, after constant toluene concentration in the reactor, by using of the photocatalytic activity 55% of toluene concentration was removed. By using of TiO2 nanoparticles coated on nickel foam, in two steps of adsorption and photocatalytic conversion, more than 80% of the toluene was removed, so that the concentration of toluene was 100 ppm to 20 ppm.

In the past two decades psychoactive drugs especially among adolescents and youth are common, these drugs located in the second row of drug abuse in the world. Present study performed with aim of determinant of predictors of psychoactive drugs use among adolescents and youth in Kermanshah city based on theory of planned behavior. This cross-sectional study was performed among 385 adolescents and youth in Kermanshah. Participants were selected in simple random. The questionnaire consisted of three parts: demographics, knowledge Questions about the consequences of psychoactive drugs and Structures questionnaire of the theory of planned behavior that completed by participants in self-report. The data collected were analyzed by SPSS-21 with utilizes of regression tests and Pearson correlation. 7.2 and 4.2 % of the participants were experienced Cristal and Ecstasy. Subjective norms (OR=1.455), perceived behavioral control (OR=0.793) and behavioral intentions (OR=1.440) predicted psychoactive drugs use. It seems that drug use by close friends and peer pressure as encouraging factors provide the conditions for the use of psychoactive drugs.

Nowadays, eating fast food among youth is one of the health issues in Iran as well as other countries around the world, and nearly one-third of these people eat such food. This study was meant to evaluate attitudes, normative and control beliefs as well as self-efficacy of students regarding consumption of fast food among students of Hamadan University of medical sciences. This is a descriptive-analytic and cross-sectional study which was carried out on 250 students in 2012. Students completed a researcher-made questionnaire that its reliability and validity were certified. Data were collected and were analyzed using SPSS 16. There seen a significant correlation between students’ attitudes with their type of diet and living place. Moreover, normative beliefs had significant correlations with gender and education of students. Also, there found a significant correlation between self-efficacy of students with their age and gender. Indeed, females more like to eat fast food than males. Control beliefs showed no relations with any of the studied variables. Data from this study indicates that fast food consumption is high among dormitory residents and males represents the need to correct the attitudes and beliefs in relation to fast food consumotion among students.

Depending on the importance of a good performance appraisal system to achieve organizational strategies, Balanced Scorecard technique provides a comprehensive foundation for interpreting and translating organization’s vision and strategy in a set of performance measures by regarding an overall view of organization in four perspectives included customer, internal processes, learning-growth and financial. In this study a combination of fuzzy theory, analytic network process (ANP) and LINMAP are used to resolve the defects of this technique. Most important indicators in four perspectives of balanced scorecard were extracted based on the strategic program of public hospitals using balanced score card, viewpoints of the experts and professors in the field of health, and searching the literature. After identifying the indicators and forming the hierarchical tree of strategic map, dependencies between different parts of this hierarchical tree are determined by expert opinions. Then FANP is formed with the matrix of paired comparisons and the weights of indicators are determined. The five public hospitals in Yazd were selected. And then the two MCDM analytical tools of SAW, and LINMAP were respectively adopted to rank the hospital performance and improve the gaps with five hospitals as an empirical example. It shows that the proposed FMCDM evaluation model of hospital performance using the BSC framework can be a useful and effective assessment tool.

Marital commitment is an important predictor between couples for satisfactory and stable marriages. Lifelong commitment to marriage, loyalty to one’s spouse, strong moral value, respect for one’s spouse as a best friend and a commitment to sexual are of satisfactory marriage characteristics. The aim of this study was to determine the efficacy of Islam-based cognitive-behavioral couple therapy training on Qom women’s marital commitment. This study is semi-empirical and pretest-posttest with control group was used. The study population included those referred Couples Family Counseling Center in 2010-2011, which were referred to their representative. The sample consisted of 80 women who participated in the study voluntarily and were randomly available into intervention and control groups. The trial of cognitive behavioral group training was Islam-based. Study instrument of Demographic and marital commitment questionnaires were used. For data analysis, SPSS-16 software using descriptive statistics and analysis (ANCOVA) with P<0.05 was used. The results indicated that Islam-based couple therapy had promoted couple’s martial commitment and its aspects, that is personal and behavioral and structural commitment of couples) p> 0.001). Given the role of religion in marriage, this approach could be adapted to other aspects such as satisfaction and. .. They also have a direct or indirect effect on marital commitment are to be effective.

Today, increasing of the number of patients with diabetes in the world has become the disease the world's largest epidemic. The patient's self-efficacy is a key element in the prevention and treatment of diabetes. This study aimed to Assessing Self Efficacy with Health Belief Model component type 2 diabetic patients referee to Iranian Diabetes Association in 2012-2013. This study was a cross sectional on which 80 persons referee to Iranian Diabetes Association in 2012-2013 were selected by convenience non-randomly method. Instrument of data gathering was a two part one included demographic variables (9 items) and self-administered diabetes assessment based on HBM (51 items). Data was analyzed with SPSS software version 18 using independent t test, ANOVA and person correlation coefficient. Significant level was set at 0.05. Mean and SD of participant age was 55.16± 8.89 years. Mean and SD of perceived threat and cues to action were the most and the least on (60.42± 31.08) and (49.64± 18.76) respectively. Self Efficacy had significant relation with perceived threat, cues to action and perceived benefits and barriers. Perceived barriers among various structures had the greatest impact on patient's self efficacy. Based on the results in this study perceived barrierswho had their effectiveness overshadows that. So Health Education and promotion interventions to Improving patient’s perceive about barriers and Enhance their ability to solve problems leads to improving self-esteem and self-worth is suggested as a necessary step toward Self Efficacy promotion.

A healthy organization is a place that people like to work and they are proud of being a part of it. This study aimed to evaluate the relation between organizational health indicators and organizational effectiveness among employees of Isfahan University of medical sciences. This cross – sectional study was done on 672 employees in seven staffs of IUMS. Samples were selected as 185 people calculating by stratified random method. Data were gathered by Hoy and Feldman organizational Health and parson's effectiveness questionnaire and were analyzed using t-independent test, ANOVA and Pearson's correlation coefficient by SPSS software. Organizational Health mean was generally 164.66 ± 11.86 towards employee's attitude and it was 98.66 ± 8.22 for organizational effectiveness. Also in structural level the index of uniqueness, in the technical level the index of mood and in the official level the indices of chairperson Influence and cautiousness had a strong, direct and significant relation with organizational effectiveness (P-Value<0.05). Organizational health and its indices were higher than average and in a favorite level In IUMS and its indices had a positive, direct and significant correlation with organizational effectiveness.

Obesity represents one of the most important nutritional problems worldwide.Obesity in childhood can cause variety of health issues such as orthopedic, neurological, pulmonary and gastroenterological disorders in the future, although no side effects were reported from malignant obesity during childhood. In this paper, we presented a computer-aided diagnosis system to predict the obesity based on input features obtained from the life style and other factors of the subjects. The total number of 9795 subjects (49.17% boy) aged 6 to 18 years taken from the CASPIAN IV study participated in this study. The input parameters of the proposed system were taken from the dietary habit, physical activity, family history, social economic status, and other features. Then, the obesity was predicted using the data mining and artificial intelligence techniques. Feature Selection (FS) methods were also used to improve the performance of the proposed system. The performance of the diagnosis system was assessed based on the hold-out validation framework. The performance of the classifications method has been validated by hold-out cross validation. Among the different classification techniques tested, SVM with FS showed the best performance. The accuracy and precision of this method were 63.3% and 83.7%, respectively. Some features such as age, physical activities, birth feeding and family history of diabetes mellitus detected as the most effectivefactors with obesity in both gender. Designing of an intelligentdiagnosis system with the input parameter such as life-style, socioeconomic status and genetic information can help predict obesity in children to modify their life-style to improve theirqualityof life in the future. A web-based version of this intelligent system can easily provide the obesity prediction facilities for the families at home.

Despite the plenty of information about work-related musculoskeletal discomforts and different risk factors leading to the presence of these symptoms, the effect of physical activity as a preventative factor in this field seems unclear. Handicraft industries in Esfahan impose repetitive motions and awkward postures to the individuals and are considered as high risk jobs regarding the musculoskeletal discomforts. Therefore, some interventions including doing regular physical activities are essential for the occupants. This study was done to evaluate the effect of physical activity on musculoskeletal discomforts among the occupants of one of the handicraft industries in Esfahan. This cross-sectional study was an analytical descriptive work performed on 100 occupants in one of the handicraft industries in Esfahan. The census sampling was done in all workshops. The information of individual characteristics including physical activity was collected through a demographic form. The musculoskeletal discomforts data was gathered through Cornell questionnaire. The data was analyzed using Chi-square, Independent-t and one way variance analysis tests and then evaluated by SPSS18. The highest individual complaint of reporting sever musculoskeletal discomforts was related to the musculoskeletal discomforts in right shoulder (36%), right wrist (26%) neck, (25%) and upper right arm (24%).Some significant relationship was found between left wrist(P =0.01), lower back(P =0.01), neck (P =0.006) and physical activities. Based on the study results, it can be concluded that regular physical activity, but not too heavy, can have a positive impact on reducing musculoskeletal discomforts.

Heat is one of the most important of harmful agents in many working environments such as bakeries that can cause prevalence of diseases related to heat and falling of efficiency. Aim of this study was exposure evaluation of Isfahan bakers to heat Stresses in their working environment through evaluation of relationship Among Wet Bulb Globe Temperature index (WBGT), Oral Temperature & Heat Strain Scoring Index (HSSI). This cross-sectional study was conducted on 82 men that works in the 43 bakeries in Isfahan city in both May and July 2013. In this study used Wet Bulb Globe Temperature index for evaluation of heat stress and used oral temperature and Heat Strain Scoring Index for evaluation of heat strain. Finally to study of relationship among Wet Bulb Globe Temperature index, Heat Strain Scoring Index and oral temperature, pearson correlation was applied. Bakers were exposed to heat stresses in their working environment. more than 50 percent of workers were suffering from heat strain. Heat stresses in bakeries with traditional cooking technology were in high levels as compared with bakeries that their cooking technology was mechanical. So that more than 68 percent of employed persons in bakeries with traditional cooking technology had impermissible exposure to heat stress. Findings demonstrated that pearson correlation coefficient between Wet Bulb Globe Temperature index and Heat Strain Scoring Index was higher than 0.62. On the basis of results of this study heat stress condition was worrying in bakeries of isfahan city. It seems that planning in order to control of heat stresses in bakeries of isfahan city is necessary. In this study Heat Strain Scoring Index demonstrated significant and direct relation with Wet Bulb Globe Temperature index therefore it seems that can use Heat Strain Scoring Index for evaluating of heat strain in hot environments like bakeries.

The aim of this study was to compare the efficiency of conventional slow sand filter with modified filter bed with crushed recycled glass in removing of turbidity and total and fecal coliforms from water resources. In this study efficiency of conventional slow sand filter and modified filter bed with crushed recycled glass during 4 months was compared and their performance in removal of turbidity and total and fecal coliforms in synthetic water (influent turbidity and total and fecal coliform bacteria) with two separate filters which were operated in parallel and continuous flow was investigated. The turbidity removal by conventional slow sand filters and modified filter bed with crushed recycled glass were % 97.28 and %96.93, respectively and the average of turbidity effluent were 0.49±0.19 and 0.55±0.36 NTU, respectively. The total and fecal coliform removal by conventional slow sand filter were 2.89 and 2.29 log, respectively and for modified filter bed with crushed recycled glass were 2.62 and 2.46 log, respectively. Both filters have slightly effect on other measured physicochemical parameters and their values in water below WHO and Iran standards. The efficiency of modified filter bed with crushed recycled glass in removal of turbidity and total and fecal coliforms is approximately similar to a conventional slow sand filter. The crushed glass medium in comparison with conventional sand filter generate smaller head loss and smaller clogging, which is cost effective and environmental friendly and shows significant promise as an alternative to silica sand in slow sand filtration.

Since Preeclampsia is a potentially dangerous and fatal complication in pregnancy, this research is aimed to determine the daily intake rate of Antioxidant's nutrients and their relation to Preeclampsia among Tehrani pregnant women in 2012. This prospective study was conducted among 1033 pregnant women in prenatal clinics in Tehran. A general questionnaire and a food frequency questionnaire (FFQ) were completed for all participants by face to face interview before the 20th week of pregnancy. The nutritional information obtained through each researched unit, in which the consumed nutrients by mothers had been registered during the previous month, was changed to Gram by the researcher. This obtained information was measured by N4 software in order to calculate the received nutrient amounts by mothers. Pregnant women were looked after and followed up since they participated in the study until the delivery time. Preeclampsia was diagnosed in case there was a 140/90 mmHg hypertension and any proteinuria after the 20th week of pregnancy. Applied tests were meaningful less than 0.05. Women of 1033 (1.9%) turned out to suffer from Preeclampsia. Independent T test result demonstrated a significant difference in daily intake average of Antioxidant's nutrients (Zinc, vitamins A,C,E) between the affected group and the unaffected group, The mean intake level of these nutrients is lower in the women affected to preeclampsia. Results showed that diminishing daily intake of Antioxidants is associated with Preeclampsia occurrence.

Fisheries safety control and considering heavy metal accumulation is one of the most important factors in maintaining health society and assuring the safety of this valuable food. The purpose of this study is evaluating the potential of bioaccumulation and exposure to lead and cadmium due to consumption of Penaeus semisulcatus in Tehran city 2012.. Samples were collected randomly from four main market retail in south, north, east and west in Tehran city 2012 in time interval that Penaeus semisulcatus was delivered in fresh and non-freeze form. After preparation and digestion of muscle and skin parts, the lead and cadmium was determined by inductively coupled plasma – optical emission spectroscopy (ICP-OES) and the exposure of the consumers to these elements was evaluated. The results revealed that the mean value for lead accumulation in skin and muscle were 5.37±1.59 and 5.59±1.12 and for cadmium were 1.11±0.61 and 1.79±0.62 μg.Kg-1 respectively. The mean concentration of lead and cadmium in muscle part was greater than its skin. The difference between lead and cadmium accumulation in edible part was not significant. The exposure of consumers to lead and cadmium due to the consumption of edible part of Penaeus semisulcatus were fifty and thirty times less than its regulated value for provisional tolerable daily intake. The lead and cadmium mean concentration in edible part of Penaeus semisulcatus were less than national and international limits and so its consumption is not risky for human health. The useful results of the survey from market retail can be used as a model for monitoring the safety of shrimp and other aquatics.