Journal of Health Sciences and Surveillance System
Volume:5 Issue: 2, Apr 2017

Discharge of raw or treated wastewater containing linear alkyl benzene sulfonate (LAS) into the environment causes significant public health and environmental problems. The purpose of this study was the treatment of hospital wastewater using an intermittent cycle extended aeration system (ICEAS).
Experiments were carried out on Yazd Shohaday-e-Kargar hospital wastewater treatment system and samples were collected in a 2 month period from the influent and effluent of the system. The used pilot study carried out consisted of two zones: pre-react and main react zones. They were divided using a baffle wall. Firstly, wastewater enters a pre-react zone and then through the opening at the bottom of the baffle wall it enters the main react zone. The cycle time and flow rate for the system were considered 6 h and 2 L/h, respectively. Then, the necessary tests were performed on the system’s influent and effluent.
The removal of BOD5, COD, and LAS by ICEAS were 94.54%, 92.97%, and 84.99%, respectively. The averages of SVI, F/M, MLSS and MLVSS in the system were 113 mL/g, 0.086 Kg.BOD5/Kg.MLSS.d, 4327 mg/L and 3172 mg/L, respectively.
This work showed the excellent efficiency of ICEAS to effectively remove BOD5, COD, and LAS from hospital wastewater. The results of this research can help to manage wastewater treatment in hospitals.

The present study was conducted to investigate the relationship between socioeconomic status of parents and their knowledge, attitude and tendency toward different forms of fluoride therapy for their 7-9 year-old primary school children in Shiraz.
A total of 444 subjects were selected through multi-stage random sampling. The subjects were parents of 7-9 year old boys and girls attending primary schools in 4 districts in Shiraz. They were asked to fill out a questionnaire containing a number of questions regarding their knowledge, attitudes and tendency toward fluoride therapy for their children.
The mean scores for parental knowledge, tendency and attitude toward fluoride therapy for their children were 8.05 ± 2.46, 3.38 ± 1.73 and 54.66 ± 5.89, respectively. As to the parental knowledge, 25.23% and 72.52% of the subjects had either poor or average knowledge, respectively. Similarly, about 32% and 39.6% of the parents had a poor or average tendency toward fluoride therapy and 42.57% and 57.43% of them held a strong or mild positive attitude toward it, respectively.
The findings of the present study indicated that the majority of parents did not have sufficient knowledge about different types of fluoride therapy and their caries-preventive effect. They lacked a positive attitude and a strong tendency to practice fluoride therapy for their children. There was a significant association between socioeconomic status of parents and their knowledge, attitude and tendency toward fluoride therapy for their children.

Serum vitamin D (VIT D) concentration has been inversely associated with the prevalence of metabolic syndrome (MS), but the relationship has remained unclear.
We evaluated the prevalence of VIT D deficiency, and its association with MS, and its components in the adult population in a sunny tropical region (Lamerd: a city in the south of Iran)
Patients and Totally, 210 patients referring to different medical centers across the Lamerd city participated in this cross-sectional study through January and February of 2016. To select medical service center, we used a one-stage cluster sampling method. Anthropometric indices and dietary intake were measured using modified food frequency questionnaire (FFQ) and blood samples collected. Data were analyzed using SPPS version 16, Pearson’s correlation was used to investigate the bivariate relationships between the variables, and unpaired t-test was used to determine the differences between genders for all variables. A P-value Overall, 62 menand 144 womenwith a mean age of 35.84± 10.84 years old completed this study; the prevalence of VIT D deficiency among the participants equaled 64.1% (women=66.7% and men=58.1%). A significant positive relationship between sun exposure time on the serum VIT (p= This study showed that lower VIT D concentrations were associated with increased MS risk factors.

Implementing the healthcare reform plan in our country has forced the medical centres to pay more attention to the patients’ rights and their satisfaction. The aim of this study was to evaluate the patient's satisfaction levels and the gap between their expectations and perceptions in Shahid Rajaee Hospital in Shiraz.
This cross-sectional study was performed aiming at evaluating the patient's satisfaction levels and the gap between their expectations and perceptions in Shahid Rajaee Hospital of Shiraz in 2015. In order to collect the data, 98 questionnaires were distributed among the patients using randomized sampling method; their validity and reliability were confirmed. Finally, through SPSS 20 software, we used descriptive statistics and the one-sample t-test for data analysis.
Results showed that amongst the patients’ perceptions, the highest mean belonged to Reliability dimension (3.50), and the lowest one to Assurance (3.23). In terms of the patient's expectations, the highest mean belonged to Reliability dimension (4.30) and the lowest one to Physical aspect (4.18). Of the 5 dimensions in this research, the largest gap between the patient’s expectations and perceptions belonged to Responsiveness, and the smallest one to Physical aspect.
The results indicated that there was a significant difference between the patients’ expectations and perceptions, and the quality of services provided by the hospital needed further attention. It seems that it is necessary for managers and policy makers to plan for this issue and take measures to reduce these gaps in the quality and promote better health care services.

Patient satisfaction is an integral component of service quality and obtaining feedback from patients about the quality of primary health care is the best way to extend more patient-centered goals to health care delivery. This study was conducted to measure the level of client satisfaction with Urban Family Physician and Referral System (UFPARS) program
This repeated cross-sectional study was done in Fars province, South of Iran, at two sections. Totally, 5901 patients in two sections (6 and 24 months after the UFPARS startup) were selected using multi-stage random sampling. The participants answered a self-administrated questionnaire. We measured the client satisfaction using 5-point Likert-scaled score and combined the questions; for each component of UFPARS, 6 satisfaction dimensions were made. We compared the participants’ level of satisfaction in two parts, using t-test.
Reliability was acceptable, and equal to 85% or more in all domains .In all components of UFPARS, the mean client satisfaction score was higher than 3 out of 5. The lowest client satisfaction scores were seen in the outpatient services. In three components of UFPARS including enrolment, family medicine and para-clinics, the mean satisfaction scores significantly decreased (PThe level of satisfaction with UFPARS in Fars province was shown to be relatively medium to high. Low client satisfaction between the two sections could be a bad sign and we recommend that the problems should be tackled gradually. Although family physician program in Iran has some limitations, implementing this plan step by step can lead to a medical reform in Iran. We can develop better programs based on the comments from service recipients, and prompt the project and some program processes.

Air pollutants have harmful impacts on human health and aggravation of diseases and mortality. This study was conducted to investigate the impact of PM10, NO2, SO2, and O3 on cardiovascular and respiratory mortality and hospital admissions in Shiraz during 2012-2013.
The health impact of pollutants was quantified using AirQ2.2.3 model provided by WHO Regional Office-European Center for Environment and Health. In addition, Generalized Additive Model (GAM) in R was used to investigate the relationship between pollutants and disease and mortality.
According to the results of quantification with WHO’s default values for Baseline Incidence (BI) and Relative Risk (RR) as well as the number of hospital admissions related to PM10 (1,375 cases in 2012 and 874 ones in 2013), it has been observed that respiratory diseases have had the highest health impacts. On the other hand, an assessment using regional values for BI and RR indicated that the highest health impacts were related to respiratory diseases due to exposure to O3 with 134 and 252 cases in 2012 and 2013, respectively. Moreover, significant relationships were observed among PM10, NO2, and O3 and respiratory mortality, hospital admissions due to cardiovascular diseases, and hospital admissions due to respiratory diseases in patients aging 65 years and older.
Overall, the results showed that due to different geographical, statistical, and climatic features of each region, WHO’s default values for BI and RR cannot be used normally in some cases. Thus, calculated BI and RR values should be used for such cases. However, further research is needed to assess the health impacts of air pollutants in terms of BI and RR specific to the study region.

Most workers are exposed to a variety of hazards in their workplace. Devising a comprehensive checklist and developing an index for Occupational Safety and Health (OSH) assessment could be useful. This study was conducted in a heavy automotive company with the aim of developing and validating an OSH assessment index.
Methods and Materials: We used the experiences and comments of OSH experts to devise a checklist for OSH assessment. Weighting various harmful factors was done using Analytical Hierarchy Process (AHP) technique. Intra-class Correlation Coefficient (ICC) was applied to measure the reliability of the checklist (SPSS version 20). In the studied industry, 150 workstations were assessed using the developed comprehensive checklist. In order to validate the total index, we assessed its correlation with 4 groups of occupational statistics (i.e. accident frequency, severity rates, lost working time rate, and occupational disease incidence rate). A p value of Among 7 sub-indices, sub-indexes of occupational health and the workplace order (w=0.21) and housekeeping (w=0.04) had the highest and the lowest AHP weights, respectively. The mean of ICC was found to be 0.978. The total index (OSHITotal) and the Accident Severity Rate (ASR) had a strong inverse significant correlation (r = -0.774, P=0.002).
The developed index covered important occupational hazards. The inter-evaluator reliability for this index was high.

Soft drinks consumption is a major world public health concern. This study investigates the factors which influence the students’ intention to consume fewer amounts of soft drinks, using The Extended Parallel Process Model.
This cross-sectional study was conducted on 320 high schools boys in Yazd, Iran (2014). A 15-item, 5-point Likert-type scale questionnaire was used to measure the participants’ perceived susceptibility, severity, response-efficacy and self-efficacy and intention about soft drinks’ consumption. Internal consistency (Cronbach alpha >0.7 for each construct) and external consistency: r = 0.79, P. =0.01) of questionnaire was approved. Data were analyzed by SPSS 16, using descriptive analysis, bivariate correlation, and stepwise multiple regression analysis. The level of significance was set at 0.05.
The participants’ average soft drink consumption was 3±3.4 daily glasses. Danger control processes had more frequency over fear control ones (57.7% vs. 42.3% of participants). The intention of fewer amounts soft drinks consumption was positively correlated with perceived response efficacy, self-efficacy and total efficacy. 16% of the participants’ intention variations were explained by self-efficacy. The odds of intention towards not to consume soft drinks were significantly higher for the high efficacy/ low threat category (OR=1.51, p= 0.04) compared with low efficacy / low threat category.
The results revealed that inducing fear is not an effective way to promote healthy drinking behavior and the choice of fear appeals is often a poor choice in this subject. It can be suggested that health educators should move from traditional threatening fear arousal messages to improving their target audience’s self-efficacy.