مجله تحقیقات نظام سلامت
سال دهم شماره 4 (زمستان 1393)

Malnutrition is of importance factors that cause the increasing of hospitalization duration and effects on the development of main diseases. Therefore, we are going to assess the nutritional indices among ICU impatients. Height, weight, received necessary energy for subjects were measured. Also circumference of mid-arm and body temperature was measured twice within a week interval. Biochemical indices including Albumin, Creatinine, counting of Lymphocytes, Sodium, Potassium, Phosphorus and Magnesium were measured. Among qualitative indices, kind of disease, infection, bedsore, taking oral ventilation and the kind of nutrition can be mentioned. Analysis of data has been carried out by SPSS16 software. Energy intake in 61% of ICU impatients is less than their energy needing and just 39% of them had sufficient energy intake. Serum potassium, magnesium and albumin were in normal range. The mean of creatinine level was higher than the normal range. The most type of nutrition that they take the energy by it was Gavaj about 54%. The most common cause for hospitalization in this ward has concerned about all kinds of surgery, especially post-accident surgery including driving accidents surgery. ICU impatients have been exposed to hospital malnutrition and need special nutritional care.

Macro-ergonomic risk assessment is one of risk assessment method that has been used for identification occupational hazard that human exposed with it in workplaces. One of macro-ergonomic risk assessment is relative stress index (RSI) which Able to identify risk factors associated with the incidence of occupational hazards in the work environment. The aim of present study was macro-ergonomic risk assessment with relative stress index in textile industry. This study was conducted base on Census method among 154 workers in textile industry in Isfahan that work in three shifts. Risk assessment based on relative stress index divided in three main sections; job description, checklist and RSI. For computation this method, different equations has been defended that by their computation was performing. The final values for the RSI are a scale between zero to 10 where zero implies on dangerous, insecure no efficient and number 10 indicated safe, secure and being efficient. ANOVA test showed that among six categories in this study, hand work and sensory in different shifts among textile industry had significant relationships with occupational hazard (P<0.05). Also posture with mean 6.19±0.11 and manual material handling with mean 9.14±0.41 had lowest and highest score, respectively Based on the findings of the study, the posture at work and hand work were the most influential factor in the incidence of Occupational hazards among workers in the textile industry. So keep a good posture and reducing the level of hand work activity during each shift can have a significant impact in reducing occupational hazards.

Emotional intelligence as the ability to understand one and others, to communicate with people, to adapt and cope with environmental stress is defined. Skills such as self awareness, selfmanagement, emotional awareness, emotional intelligence, relationship management as a recognized are four skills. This descriptive cross-sectional correlation in the 92-91 school year, 248 students (137 boys and 111 girls) from a total of 740 boys and girls students of institutions of higher learning west of the center of Ilam were selected using Category run was. To examine the role of gender in the four skills of emotional intelligence, emotional intelligence questionnaire Bradbry - Graves 28 questions was used. Data analysis using spss software version 20 statistical test and Pearson correlation, multivariate analysis was performed. The results showed that among the four skills of emotional intelligence (self awareness, selfmanagement, social awareness, and relationship management) there is a significant difference between the mean scores of boys and girls in the four skills of emotional intelligence, and more girls than boys. Gender was associated with emotional intelligence and emotional intelligence skills the one hand emotional intelligence skills can vary in girls and boys.

The pressure of consumption spots in eater supply systems is one of the most important hydraulic parameters can be used in optimized management of water distribution networks. Since the pressure has some different effects on various parameters of the network management including its hydraulic functions, reliability, stability and leakage, its control is of great importance in different management levels. Performing the plan for two water supply systems, this paper aimed to analyze and compare the pressure, leakage and quality of water in different spots of the network. For modeling the network, the software of Water Gems v3/0 was used. It designed and modeled the current network in forms of gravity distribution and direct pumping. at the minimum time of consumption, the pressure in 45 percent of junctions of the gravity distribution network is more than 70 meters; while in the direct pumping, except two junctions, it is not more than 60 meters. At the maximum time of consumption, pressure in 15 percent of junctions of the gravity distribution network and 35 percent of the direct pumping is less than 30 meters. The rate of water leakage in gravity distribution network at the minimum time of consumption is 43 percent more than that of direct pumping network. The rate of remained CL in 62 percent of pipes of direct pumping network is standard and in 100 percent of pipes of gravity distribution network is less than standard. Comparing the parameters of pressure, leakage rate, water age and rate of remained CL between two systems of gravity distribution and direct pumping, this study indicated that all of these parameters in direct pumping network are in better conditions and closer to its standard rates.

Given the fact of irrecoverable consequences of noise in industrial societies and the environment, acoustic filter (Silencer) is an instrument which obstacles the transmission of sound waves. A sort of this silencer is Helmholtz Resonator (branch amplifier) which comes to sound appropriate for low and below 200 Hz frequencies in fan and channel noise. The purpose of this article is investigating the efficiency of designing resonator in decreasing low noises. This is an experimental study. The designed Helmholtz resonator was installed in a channel analogous to ventilation channel. Through using MATLAB software, there were produced signals at very low frequencies of 250-500 Hz and transmitted through a channel by means of a speaker. Afterwards, Comparing the sound pressure level before and after (existence of) Helmholtz resonator, the rate of decreased sound in various frequencies was considered and then the MATLAB software was used to process intra channel signals and to prepare sound Algorithm in the channel. The most decrease of sound in the frequency of 125 Hz among Helmholtz resonators befalls when there is chamber diameter of 63 millimeters and resonator's 1cm caliber. The decrease of sound was at its pinnacle at the frequency of 125 Hz and at its nadir at the frequency of 500 Hz. Given the fact of already conducted measurements at the frequency of 125 Hz, forthwith the increase of sound through resonators and also increase in diameter of resonator's mouth, the rate of sound resonance will be decreased. This research showed that the designed and installed-in-channel Helmholtz resonators at a certain frequency of low-frequency sound demonstrated the soundest decrease. This very decrease was more obvious in smaller resonators. Additionally, the increase in the Helmholtz resonator's chamber volume and their neck's pass area are negatively associated with the rate of sound resonance. As a result, determining the effective frequency range of the Helmholtz resonator, this very kind of resonator could be applied as an effective and efficient instrument of removing or decreasing noise.

To get intersectoral collaborations is one of the strategies considered for the goal of health for all by the year 2000 which has been emphasized in the 21th century again. If the members of local Organizations are more satisfied, they will collaborate in the improvement of health programs more. This study was performed to assess the Satisfaction rate of the members of local organizations about the health services of health units in Rural regions of Northern Provinces of Iran. This Cross-Sectional study was performed in the second half of the year 2012. %25 of health Centers doing FP Program in three Provinces of Golestan, Mazandaran, Gillan (totally 139 Centers out of 552 units). In each selected center, available members of dispute resolution council, village council, health council, village major, school manager and native teacher were enrolled in the research. A researcher- made questionnaire which its validity and reliability were Confirmed was used for data gathering. Data analysis was Performed by SPSS17 with Significant level of P<0.05. Mean of satisfaction level about health home was 4.3± 0.6 about health center was 3.7 ± 0.7 (out of total score 5). The lowest satisfaction level was related to incomplete services provided and high service costs. There were significant relationships between the level of satisfaction in the members of local Organizations about health home in Northern Provinces of Iran (p=0.005). There were no significant relationships between the work type of local organizations and general satisfaction rate of health home and health center (p=0.149 & p=0.893). The results of this study showed that the overall satisfaction level of local organizations about the service provided at the first level was favorable, therefore healthy system must explore this positive potential for improvement of health status.

Measurement of grip strength is important in medical and ergonomy science. This study has two main aims. First, determine the relationship between anthropometric variables and grip strength, tow Prioritization of these variables in predicting grip strength. In this applied research, 204 people were participated and their hands were measured by Digital caliper (Model: Mitutoyo Corp., Tokyo, Japan, resolution 0.01 mm and precision 0.01 mm). Grip strength was measured using the Jamar hand dynamometer The testing position was as recommended by The American Society Of Hand Therapists (ASHT). The results showed that there is a direct relationship between the hand dimensions and Grip strength. Pearson correlation coefficient indicates a direct relationship exists between the hand dimensions, height, body mass index, and grip strength. Dominant hand was significantly stronger than the other (p<0.001). The results show a strong correlation between anthropometric factors and grip strength. Height factor with a correlation coefficient of 0.63, then the maximum width (vertical) with a correlation coefficient of 0.33 have had a significant role in grip strength. Therefore, the height and hand width parameter scan be used to predict grip strength.

Breast cancer is the most common invasive cancer and is considered as the second cause of cancer death in most countries all over the world. Screening methods are very important in the early diagnosis of breast cancer. The knowledge and health beliefs about mammography in women older than 40 years have investigated in this study. This is a cross-sectional study, which has been performed on 384 women who have referred to the health centers in 1389-90. Samples selected by available through non-random sampling. Data were collected by self-report questionnaire. The outcomes were analized by SPSS software, X2, one way tests, and descriptive statistics were applied. The results indicated that most women (86.9%) had not undergone mammography screening test. About 48.7% of patients had moderate awareness; and approximately 37.2% of patients reported the absence of recommendation from physicians as their main reason is not taking any mammograms. There is a significant correlation between education level and knowledge (P = 0.001). Also, there is a significant correlation between education level and perceived severity (P<0.004), perceived benefits (P<0.001), and perceived barriers (P<0.001). But, there was no significant correlation between education level and perceived susceptibility (03/0 = P) was observed. The results of this study calls for health planners more attention in education and promotion of screening methods in order to overcome obstacles. Also, it is recommended to implement a routine and free mammography as a screening test in women over 40 years old referrals to health centers.

The pressure of consumption spots in eater supply systems is one of the most important hydraulic parameters can be used in optimized management of water distribution networks. Since the pressure has some different effects on various parameters of the network management including its hydraulic functions, reliability, stability and leakage, its control is of great importance in different management levels. Performing the plan for two water supply systems, this paper aimed to analyze and compare the pressure, leakage and quality of water in different spots of the network. For modeling the network, the software of Water Gems v3/0 was used. It designed and modeled the current network in forms of gravity distribution and direct pumping. at the minimum time of consumption, the pressure in 45 percent of junctions of the gravity distribution network is more than 70 meters; while in the direct pumping, except two junctions, it is not more than 60 meters. At the maximum time of consumption, pressure in 15 percent of junctions of the gravity distribution network and 35 percent of the direct pumping is less than 30 meters. The rate of water leakage in gravity distribution network at the minimum time of consumption is 43 percent more than that of direct pumping network. The rate of remained CL in 62 percent of pipes of direct pumping network is standard and in 100 percent of pipes of gravity distribution network is less than standard. Comparing the parameters of pressure, leakage rate, water age and rate of remained CL between two systems of gravity distribution and direct pumping, this study indicated that all of these parameters in direct pumping network are in better conditions and closer to its standard rates.

Nowadays, large amounts of surfactant containing SDS are seen in domestic and urban waste stream and the input of the treatment plant. The aim of this study was to evaluate the effectiveness adsorption of surfactant sodium dodecyl sulfate (SDS) on montmorillonite soil as an inexpensive adsorbent is available in Iran. This research is empirical. Impact of initial sodium dodecyl sulfate (SDS) concentration, absorbent mass, and reaction time on the removal of sodium dodecyl sulfate by soil absorbent montmorillonite was studied. Experiment was carried out by synthetic samples containing different concentrations of 10, 30 and 50, mg dodecyl sulfate. Dodecyl sulfate concentrations were determined by spectrophotometer at a wavelength of 625 nm. Values 0.1, 0.25 and 0.5 g mass of adsorbent at pH 4, 7, 10 in terms of complete mixing with air at time (2.5, 5.10, 20, 30) minute was examined. In different stages, SDS quantity and COD was measured. With increasing of absorbent mass and reaction time removal of pollutant was increased and with increasing initial concentration dodecyl sulfate was reduced. The data showed that the maximum dodecyl sulfate absorption by montmorillonite is in test duration of 30 min and reached in Equilibrium. Most of removal and absorption capacity in optimum conditions (initial concentration 10mg / l, mass of absorbent 0.5 g/l and pH=7), was happened. SDS and COD removal was 77.5 and 76 percent. Evaluateion the efficiency of SDS absorbed on soil particle indicated that minor changes in different pH so that the pH increased from 4 to 10 the removal efficiency slightly increased but no significant difference between the values of the efficiency of different pH is. Absorption process is also influenced by the mass of absorbent and initial concentration of SDS that with increasing of absorbent mass and reducing initial concentration of pollutants the efficiency of absorption is increased.

Mental workload is a general concept in the literature of ergonomics and human factors That are affected by external working demands, environmental, psychological and organizational factors, organizational and mental abilities. The aim of this study was to assess the mental workload and its impact on musculoskeletal disorders among nurses employed at different parts of the hospital. This descriptive, cross-sectional study was performed in summer 2013 on 247 randomly selected nurses were employed In the Alzahra hospitals in Isfahan. The Persian version of NASA TLX (measuring mental load) specialized questionnaire and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) were used for data collection. Data collected analyzed use to SPSS 20 statistical software and Pearson, Spearman and multiple linear regression tests were performed. Pearson and Spearman correlation test showed significant there was relationship between the nurses musculoskeletal disorders and dimensions of workload frustration, total workload, temporal demand, effort and physical demand (r=0.304,0.277,0.277,0.216, 0.211) respectively. But was no significant relationship between the nurses musculoskeletal disorders and dimensions of workload performance and mental demand (P>0/05). The nurse's frustration was a direct correlation with musculoskeletal disorders. This shows that stress is an inseparable component in hospital workplaces. Thus reduce stress should be one of the main priorities of hospitals administrators in the nurse workplace.

In Iran Gastric cancer is the second most common cancer and the most cause of death cancer, the aim of this study is provide map geographical distribution of Gastric cancer and detect high risk cluster with use of space-time scan statistic. This was an applied study. The data is provided from reports published by Center for Disease Control Office in Ministry of Health; also the data is registred by province for a period of 5 years from 2005 to 2009. For analyzing the data and detecting the cluster, we use SaTScan software and for mapping the distribution of Gastric cancer and showing the cluster in the country we use ArcGIS10. We find three high risk clusters. The most likely cluster which is statistically significant were contain provinces Ardabil, Gilan, Zanjan, East Azerbaijan, Qazvin, West Azerbaijan, Kurdistan, Hamedan, Tehran and Mazandaran during 2008 to 2009. In addition to the most likely cluster we find two secondary cluster.The first secondary clusters which were statistically significant contain provinces South Khorasan, Kerman and Khorasan Razavi. The second cluster that is not statistically significant contains just Kohgiloye and Boyer Ahmad). High risk point that was detected by space-time scan statistic include province in north, northwest and center of Iran specially Ardabil, Mazandaran, Gilan and Kurdistan. This study suggests screening tests in the high risk point and do more epidemiological study for implementing prevention programs.

Keratoconus is a bilateral corneal disease, which one way to cure it is to transplant. The transplantation may be rejected by recipient's immune system, which leads to failure of the graft. This study aimed to analysis the factors affecting bilateral corneal graft rejection based on copula function. A sample of bilateral graft rejection times was assessed. Since correlation exists between the times of corneal graft rejection, Clayton Archimedean copula was used. The parameters estimation was performed using Bayesian analysis based on Markov Chain Monte Carlo methods by WinBUGS. For modeling hazard function, Weibull hazard model was used. Corneal vascularization in the first graft and corneal freshness in the second graft had a significant impact on graft rejection time. The age at transplantation had also a significant partial effect on both the first and the second rejection. The correlation parameter of Clayton copula was estimated as 0.98, so Kendall,s tau correlation coefficients between the first and the second corneal graft rejection time obtained as 0.3. Results indicate a correlation between the first and the second transplant rejection time. Aging increases partially the graft rejection risk. Maintenance of corneal in solution and also presence of corneal vascularization increase the risk of corneal graft rejection.

Functional or nutraceuticals foods are known as food-drugs which have therapeutic effects in prevention and treatments of various kinds of degenerative diseases and cancers. The consumption of bioactive compounds of different food sources according to the intrinsic temper, lifestyle, physical and psychological body function and also the principles of traditional sciences, can be beneficial in the control of chronic disorders and economical costs. So, in this study, we assessed beliefs and attitudes of people about food-drug properties of diet, based on their hot or cold effects. In this cross-sectional study, 700 household Isfahanian women were selected by systematic cluster sampling methods, between April and Febrary Of 2012. The beliefs and attitudes of them about food properties were asked by questionnaire and then they compared to the key references of Traditional Medicine such as “Law in Medicine”, “Alshamel fi alsanaet altaiebeh” and “Makhzan aladvieh”. Data were analyzed by Crosstab and McNemar test with SPSS software, version 20. Data showed that 30 mentioned types of food items and products were briefly from spice and seasonings, fruits, meat types, various kinds of simple carbohydrate sources and sweets. The comparison shows that approximately 50 percents of women’s beliefs were similar to the documents of traditional sciences. The assessment of the agreement percent between food item's properties and documents shows that focus on enhancing the education and recognition about food-drug properties are necessary for women as responsible of family feeding in order to disease prevention, control and treatment.

Today, given the changes made in the organizations and their environment, the importance of human resources has increased. One of the issues raised in this regard is the organizational silence. The main purpose of this research is to study the manner of impact of self-concept, organizational identity and organizational values on organizational silence of employees of Hazrate Zahra Hospital in Isfahan and also to examine the existence of the balancing role of self- concept and organizational values variables in the relationship between organizational identity and organizational silence. This research was conducted using descriptive-metrical method and is five Hypotheses. To investigate this hypothesis, questionnaire which was made by the researcher containing 49 questions was used. Overall reliability coefficient 0.912 was obtained which had the necessary reliability. The population size is about 160 people. Therefore, based on random sampling, statistical sample was selected, Finally 70 questionnaires were collected. Also the SPSS software is used for analyzing the data. The finding of this research reveals that organizational silence is affected by organizational identity and self-concept.and each variables of organizational identity, self concept and organizational values have positive correlation with organizational silence. Also, results demonstrate that self concept balances the relationship between organizational identity and organizational silence. The results also indicate that organizational values have not a moderator role in relationship between the organizational identity and organizational silence. By reinforcement organizational identify, self-concept and organizational values organizational silence can be reduced among individuals.