فصلنامه بهداشت در عرصه
سال سوم شماره 1 (پیاپی 9، بهار 1394)

Patient absconding is a major health issue with economic, social, and health costs and consequences. The present study aimed to investigate the absconding rate from a emergency department and its financial burden in a public hospital in Tehran, IRAN. This retrospective and descriptive study was carried out in the emergency department of a large public and teaching hospital in Tehran. Data were collected using the absconded patient records from 23 September 2013 to 22 September 2014. Data were analyzed using descriptive statistics.Concerns about medical ethics, including patient’s confidentiality and hospital name were observed at all stages of study. The results of this study indicate that 774 patients had left the hospital without permission or a notice to staff, so the absconding rate in this study was about 2.4 percent. Young, male, married and uninsured patients were more absconded. Average billing per absconded patient was 1,449,738 Iranian Rials (IRR). The hospital was consequently incurred financial losses amounted to 1,122,097,212 IRR as a result of patient absconding. In order to preventing and reducing the abscond rate, the following strategies are recommended: the identification of high-risk patients for further care, regular monitoring of emergency departments, good communication and interaction with the patient and his family, introducing the discharge against medical advice (DAMA) policy to patients, accurate recording of patient information to reduce the risk of abscond or access to him/her after the absconding.

Humic Acid (HA) is the most important combination of water humic materials. Removal of this compound leads to decreased production of chlorination by-products. This study set out with the aim of assessing the efficiency of O3، UV and UV/O3 in a plug-flow reactor in order to remove HA from water. The removal efficiency was assessed at three distinct steps through raw synthetic water samples containing specific concentrations of HA and treated water measurements of humic acid. Experiments were carried out in a laboratory scale plug-flow combined UV and ozonation system. The first question in this study sought to determine the compounded impact of ozone and UV on HA removal. The subsequent second and third questions in this research were to determine the separate effects of ozone and UV on the removal of target compound. HA removal was slightly augmented in simultaneous presence of UV and ozone reaching 74. 7% at initial HA concentration of 15 mg/L، pH 8، and reaction time of 25 min. However، on the question of separate effects of ozone and UV، this study found that the removal rate of HA، at similar situations، were 69% and 21%، respectively. Integrated application of UV and ozone outperformed conventional separate use of them in terms of HA removal. Higher removal efficiencies which achieved during ozone treatment، as compared with UV، might be due to higher oxidation power of ozone and OH radicals.

Gastrointestinal parasites are worldwide in distribution; the developing countries are more prone to parasitic diseases causing important public health concerns. The aim of this study was to determine the prevalence of intestinal parasites among patients referred to the laboratories of Masjed Soleiman city, Khuzestan Province in the first half of 2013. In a cross-sectional study during 6 months, a total of 6062 stool samples from patients referred to the laboratories were tested. Stool examinations were performed by direct method and Scotch tape test for detection of protozoa and helminthes infection, respectively. All stages of this study, was in conformity by the ethical principles. Overall, the prevalence of intestinal parasites was 13.92% (844 cases). Among 6062 samples 14.84% of men and 13% female were infected. Majority of patients were infected by Giardia lamblia (54.98%), Entamoeba coli (20.14%), followed by Entamoeba histolytica (14.33%) Blastocystis hominis (3.55%) and Trichomonas (0.59%). While Hymenolepis nana (0.47%) and Enterobius vermicular (2.36%) are exhibited the minimum prevalence. The highest prevalence was seen in summer and July. Statistically there was a significant correlation between sex and infection rate (P<0.05). The notable finding of this study is the high prevalence of G. lamblia and E. coli, which may be derived from poor personal hygiene, unsanitary wastewater disposal, and use of contaminated water and food.

One of the most important issues of today’s world is water scarcity and pollution of the environment with heavy metals. This study aimed to investigate the removal of lead and cobalt ions by functionalized and non-functionalized single-walled carbon nanotubes from aqueous solution. The present research was an experimental and laboratory -scale study to evaluate the removal of lead and cobalt from aqueous solution with functionalized and non- functionalized single-walled carbon nanotubes in a batch system. Samples were prepared in lab and in synthetic scale. Factors such as pH, adsorbent dosage, lead and cobalt concentrations, reaction time and reaction temperature were investigated. The concentration of metal ions was measured using atomic absorption spectrometry. According to the results, functionalization of single-walled nanotubes, increasing the adsorbent dosage, temperature, pH and initial concentrations of lead and cobalt resulted in increased removal of lead and cobalt. Most of the removal of studied metal ions was in 75 mg of adsorbent dosage, 3 mg/L of lead and cobalt, as well as 15 and 10 minutes of contact time at 35 ° C for cobalt and lead, respectively. Furthermore, the results showed better agreement with Langmuir isotherm. It was found that, compared with non- functionalized nanotubes, functionalized nanotubes revealed higher adsorption capacity.

Job stress is one of the most important professional issues that poses high costs on organizations. It may result in reducing efficiency, feeling fatigue, which subsequently leads to employee dissatisfaction in him/her workplace. This study was designed to assess the employees’ job stress in a Spinning industry. The present cross-sectional descriptive-analytic study was performed on 230 workers at a spinning industry. The standard job stress questionnaire of England HSE Institute was used to determine job stress. The employees were requested permission and their answers were treated as strictly confidential. The obtained data were analyzed by SPSS (version19), using descriptive statistics and Spearman & Pearson correlation coefficient, independent t-test, Kruskal-Wallis, ANOVA and Mann-Whitney Tests. Statistically meaningful relationship (p >0.05) was observed between job stress and education level, the more education the less job stress. Age factors and working units indeed showed a similar relationship. There was only limited and not statistically significant (p>0.05) evidence for an increased job stress and sex, marital status, as well as job experience. The current study further found that the different job opportunities have high stress for 29.2 % employees, average stress for 69.5% employees and low stress for 1.3%. Considering the harmful physical and emotional responses of job stress, managing and controlling¬ of work-related stressors is recommended. This may worked out through identifying resources to significantly reduce the stress level and increase productivity in the workplace.

Mortality risk and therefore the likelihood of in-hospital death for a patient owing to nosocomial infection in health care centers has always existed. The majority of nosocomial infections are transmitted through direct contact, primarily with environmental surfaces or equipments. This study was aimed to determine the microbial contamination of environmental surfaces in two teaching hospitals of Mazandaran University of Medical Sciences. In this cross-sectional study and by kind permission of hospital managers, a total of 120 samples were collected from PICU, ICU, ENT units, Operating room, Burn ward and Recovery section in both studied hospitals. Identification of microbial agents was carried out using standard biochemical and microbiological methods. Data obtained were analyzed using Stata12 software & Chi- Square test. A p-value less than 0.05 was considered to be statistically significant. The results showed bacterial contamination in 48 cases (40%). ENT unit with 80% and Burn ward with 40% revealed the highest contamination rate in hospital (1) and hospital (2), respectively. Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumonia, Enterobacter aerogenes, Acinetobacter, and Enterococcus faecalis were the most common isolated bacteria A high percentage of bacterial contamination was found in both studied hospitals. Implementing prevention guidelines and collection of periodic culture are necessary to reduce the rate of bacterial contamination in these hospitals.