Health Promotion Perspectives
Volume:1 Issue: 1, Jul 2011

This systematic review seeks to define the general advantages and disadvantages of accreditation programs to assist in choosing the most appropriate approach. Systematic search of SID, Ovid Medline & PubMed databases was conducted by the keywords of accreditation, hospital, medical practice, clinic, accreditation models, health care and Persian meanings. From 2379 initial articles, 83 articles met the full inclusion criteria. From initial analysis, 23 attributes were identified which appeared to define advantages and disadvantages of different accreditation approaches and the available systems were compared on these. Six systems were identified in the international literature including the JCAHO from USA, the Canadian program of CCHSA, and the accreditation programs of UK, Australia, New Zealand and France. The main distinguishing attributes among them were: quality improvement, patient and staff safety, improving health services integration, public’s confidence, effectiveness and efficiency of health services, innovation, influence global standards, information management, breadth of activity, history, effective relationship with stakeholders, agreement with AGIL attributes and independence from government. Based on 23 attributes of comprehensive accreditation systems we have defined from a systematic review, the JCAHO accreditation program of USA and then CCHSA of Canada offered the most comprehensive systems with the least disadvantages. Other programs such as the ACHS of Australia, ANAES of France, QHNZ of New Zealand and UK accreditation programs were fairly comparable according to these criteria. However the decision for any country or health system should be based on an assessment weighing up their specific objectives and needs.

Use of anabolic androgenic steroids (AAS) has been associated with adverse physical and psychiatric effects and it is known as rising problem among youth people. This study was conducted to evaluate anabolic steroids preventative intervention efficiency among gym users in Iran and theory of planned behaviour was applied as theoretical framework. Overall, 120 male gym users participated in this study as intervention and control group. This was a longitudinal randomized pretest - posttest series control group design panel study to implement a behaviour modification based intervention to prevent AAS use. Cross - tabulation and t-test by using SPSS statistical package, version 13 was used for the statistical analysis. It was found significant improvements in average response for knowledge about side effects of AAS (P<0.001), attitude toward, and intention not to use AAS. Additionally after intervention, the rate of AAS and supplements use was decreased among intervention group. Comprehensive implementation against AAS abuse among gym users and adolescences would be effective to improve adolescents’ healthy behaviors and intend them not to use AAS.

Disordered eating attitudes are contributing factors to the development of eating disorders. Adolescent girls are at high risk for eating diseases. In Iran, there is few data on the subject, especially in Azarian adolescent girls, so we did this study for assessing disordered eating attitudes and their correlates among Iranian Azarbaijani high school girls. In a cross-sectional study, 1887 high school girls were selected. Eating Attitude Test-26 (EAT-26) and socio economical questionnaires were used. The EAT-26 score of 20 or higher defined as disordered eating attitudes. Data were analyzed using the Statistical Program for Social Sciences, by using from descriptive and analytical statistics. Reliability and validity of the translated EAT-26 were 0.80, 0.76, respectively. In studied subjects, mean (SD) of EAT-26 was 11.71(8.48). Totally, 16.7% (C.I with 95%: 15.1- 18.3%) of students had disordered eating attitudes. About half of the participants were unhappy with their body weight and considered themselves as obese. Mean of EAT-26 was higher in this group. Groups, who intent to weight loss, were smoker, and who had age of menarche less than 11 years, also had higher EAT-26 scores. Parent’s literacy or job, birth order, family size or income and house ownership had not any significant effect on EAT-26 score. Persian version of EAT-26 has good reliability and validity for assessing disordered eating attitudes in Azarian girl adolescents. Prevalence of disordered eating attitudes among Azarian adolescent girls are in the range of some studies, but are less than Arabian countries, and some European ones. In adolescent girls, body weight dissatisfaction, smoking and early menarche has important role in eating attitudes.

Leukemia is cancer of the blood or bone marrow, characterized by an unusual increase in white blood cells. It is the sixth most common malignancy in the country in both males and females. The aim of this study was to document some epidemiological features of leukemia in the Northwest of Iran. The study subjects (n=669, including 377 males and 292 females) comprised all leukemia cases registered/notified to the clinical and pathology centers of Tabriz and Ardebil cities, from 2003 to 2006. All patients were classified using the ICD-10 based coding system (C91-C95, C77 and C42). Ninety-five percent confidence intervals were calculated to assess the statistical significance of the data. Annual incidence of leukemia was 3.7 [95% CI: 3.3–4.0] and 4.9 [95% CI: 4.2–5.6] per 100 000 population in Tabriz and Ardebil, respectively, with an overall case fatality rate of 13.5 percent [95% CI: 10.8–16.0]. The sex ratio (male/female) was 1.23. Myeloid leukemia (C92) and Hematopoetic and Reticuloendothelial system (C42) accounted proportionally for more than 47 percent of cases in the region. Over the study period, the annual occurrence of leukemia in the region increased from 3.9 [95% CI: 3.4–4.5] to 4.1 [95% CI: 3.5–4.6] per 100 000 population (P>0.1).Conclusions- The data from this cross-sectional study of leukemia in the North-West of Iran may be used as the baseline information to establish a population-based registry of hematologic disorders in the area for health care and research purposes. However, more investigations are needed to develop effective strategies to control the relevant disorders in high-risk groups.

Insufficient and inappropriate daily fluid intake in a long period may have adverse effect on human's health. Therefore, the present study evaluated the amounts and sources of fluids consumed by university students to determine whether these amounts and sources of fluid were enough and appropriate. In this descriptive study, 245 (142 females and 103 males) volunteer students of Tabriz University of Medical Sciences in 2009 were recruited. Food and fluid intake of subjects were assessed by 24-hour recall method of 3 days (two week days and one week- end included). Dietary intake of subjects was analyzed by Nutritionist III software program. The mean total fluid intake (drinking fluid values merged with data on the water content of foods) and the rate of metabolic water were figured out. Comparisons of the results with recommended dietary values were made using student's t-test.. Data of dietary intakes for two under-reporter female subjects were not included in the statistical analysis. Daily total mean of fluid intake for girls (1598±40ml) and boys (1861±59ml) reflect the sum of beverages (Girls, 818±29ml; boys, 1147±57ml) and food water (Girls, 780±47ml; boys, 714±86m). The most consumed beverage for girls and boys were water (40%) and tea (49%) respectively. Daily mean intake of milk for girls and boys were 106.31±10ml (13%) and 57.30±11ml (5%), respectively. The mean daily fluid intake of subjects, specially water, and milk was lower than recommended values. Therefore, there is an urgent need for tailored nutrition intervention targeting the young adults to improve their beverage choices.

Pollution due to mining activities could have an important role in health and welfare of people who are living in mining area. When mining operation finishes, environment of mining area can be influenced by related pollution e.g. heavy metals emission to water resources. The present study was aimed to evaluate Valiloo abandoned arsenic mine effects on drinking water resources quality and possible health effects on the residents of mining area in the North West of Iran. Water samples and some limited composite wheat samples in downstream of mining area were collected. Water samples were analyzed for chemical parameters according to standard methods. For determination of arsenic in water samples, Graphite Furnace Atomic Absorption Spectrometric Method (GFAAS) and for wheat samples X – Ray Fluorescence (XRF) and Inductively Coupled Plasma Method (ICP) were used. Information about possible health effects due to exposure to arsenic was collected through interviews in studied villages and health center of Herris City. The highest concentrations of arsenic were measured near the mine (as high as 2000 μg/L in Valiloo mine opening water). With increasing distance from the mine, concentration was decreased. Arsenic was not detectable in any of wheat samples. Fortunately, no health effects had been reported between residents of studied area due to exposure to arsenic. Valiloo abandoned arsenic mine has caused release of arsenic to the around environment of the mine, so arsenic concentration has been increased in the groundwater and also downstream river that requires proper measures to mitigate spread of arsenic.

To investigate of physical activity distribution bases on stages of change among Isfahan University of Medical Sciences central part of Iran. Exercise behavior stages of change construct questionnaire were collected from 504 participants by using a convenience sample in May 2010. 73.8% of subjects were in earlier stages of exercise behavior (Precontemplation, contemplation, and preparation stages) and tended to be inactive. The exercise behavior was not influenced by age, education levels, and marital status. The majority of the university students are suffering physical inactivity that need to design more effective physical activity promotion programs in the community and universities level.

Schoolchildren usually use school bags to carry their school materials. Carrying heavy school bags can cause several problems such as musculoskeletal problems among schoolchildren. The aim of this study was to investigate the association between the weight of school bags and the occurrence of low back, shoulder and hand/wrist symptoms among primary school children. This cross-sectional, descriptive-analytical study was conducted among a sample of 307 elementary school children in Tabriz, Iran. Data were collected using a questionnaire and from measurement of the school bag weight, body weight and height of each participant. Data were analysed using SPSS software. The average load carried by schoolchildren was 2.9 kg, representing approximately 10% of the children's body weight. Girls and lower grade children carried a greater percentage of their body weights. Approximately 86% of the children reported some kind of musculoskeletal symptoms. The occurrence of shoulder, wrists/hands, and low back pain among schoolchildren was 70%, 18.5% and 8.7%, respectively. The results of binary logistic regression indicated that the school bag weight (expressed as a percentage of body weight) was only significantly associated with hand/wrist symptoms (P<0.05). Girls were more likely to complaint from low back pain than boys were. Age was significantly negatively associated with hand/wrist symptoms. Body mass index was also significantly associated with shoulder symptoms. The results indicate a high prevalence of musculoskeletal symptoms among elementary schoolchildren. Preventive measures and appropriate guidelines with regard to safe load carriage in schoolchildren are therefore needed to protect this age group.