مجله تحقیقات نظام سلامت
سال پانزدهم شماره 1 (بهار 1398)

 Obesity is an excessive amount of energy stored in a form of fat in body, which is a serious medical, social, and economic problem. The factors affecting obesity include geographic location, environment, genetic effects, energy imbalance, inappropriate diet, and physical inactivity. It has been shown that green coffee extract can affect weight by changing plasma adiponectin levels, distributing body fat, and decreasing the concentration of fatty acids. This study aimed to summarize the data from clinical and laboratory trials related to the effect of green coffee supplementation on weight and parameters associated with obesity.  To conduct the study, the articles published between 1990 and 2018 related to the effect of green coffee supplement on weight loss were searched in PubMed, Scopus, ISI, and Google Scholar databases. The search process was accomplished using the keywords of Green Coffee, Green Coffee Extract, Roasted Coffee, Decaffeinated Coffee, Chloronergic Acid, Obesity, Overweight, Body Fat Percent, BMI, Abdominal Fat, Antiobesity Agent, Weight Loss, Weight Decrease, Weight Gain, and Weight Control.  The exact mechanism of green coffee extract in weight loss, BMI, and body fat percentage is still unknown. The findings suggest that chlorogenic acid plays a major role in weight changes due to its various antioxidant properties and its effect on anti-inflammatory factors, which can be manifested by a reduction in weight loss, BMI, or other parameters. Some studies have also shown the effects of green coffee bean extract on the changes in liver PPAR expression.  Green coffee can affect lipid and glucose metabolism, which includes reduction of serum insulin as a result of a reduction in glucose uptake, inhibition of glucose 6 phosphatase activity, as well as suppression of lipid absorption, decrease of lipogenesis, and increase of lipolysis. These changes lead to weight loss, reduced fat percentage, and decreased BMI.

One of the major aspects of waste management is recycling. Planning for recycling requires having an accurate estimation of the knowledge, attitude, and performance of the community about waste recycling. Therefore, this study aimed to investigate the levels of awareness, attitude, and performance of women of Hassanabad city in Isfahan province, Iran towards waste recycling.

This descriptive cross-sectional study was performed using a researcher-made questionnaire as the data collection tool. The validity of the questionnaire was approved by Cronbach’s alpha. The samples were selected through cluster sampling from the study population of women in Hassanabad town. For this purpose, two clusters were chosen randomly from five zones of the city (i.e., north, south, east, west, and center). Each cluster included one region and 25 households were selected out of each cluster. It should be noted that the questionnaire entailed five parts, namely demographic characteristics, awareness, attitude, performance, and satisfaction level. All the data were analyzed using the SPSS software version 22.

Our findings showed that the mean age of the subjects was 38.37±10.9 years. Moreover, the knowledge level was weak, moderate, and good in 20%, 38.4%, and 41.6% of the participants, respectively. Approximately 24.8%, 48%, and 27.2% of the women had weak, moderate, and good attitudes toward recycling, respectively. Furthermore, 49.6% of the individuals showed weak performance, while 34.4% were moderate and 16% were of good performance. It should be noted that the socio-demographic characteristics, including age, education, and family size were significantly associated with the awareness, attitude, and performance of the participants. The satisfaction level of women with the performance of waste management plan was evaluated as moderate.

According to the results of this study, The level of awareness, attitude, and performance of women in Hassanabad city was high, moderate, and low, respectively. Therefore, educational workshops and motivational programs for recycling and improving the performance of urban waste management can result in increased participation and better recycling.

Noise is one of the most common stress-inducing factors in a workplace and can cause many detrimental effects. Regarding this, the present study was conducted to investigate the effects of exposure time to noise and sound pressure level on mental fatigue and release of noradrenaline in the human body under lab situations. This study was conduced on 10 students of Isfahan University of Medical Sciences, Isfahan, Iran, during 4 consecutive days. The subjects were exposed to the noise levels of 85 and 90 dB on the first (0.5 h)/second (1 h) and third (0.5 h)/fourth (1 h) days, respectively. They solved 20 mathematic questions before and after exposure to noise every day, and then marked their fatigue severity on a visual analog scale. In addition, blood samples were collected before and after exposure to noise. The data were analyzed in SPSS software (verion 20). The noradrenaline level estimated after 0.5 h exposure to 90 dB was significantly different with the level obtained after 1 h exposure to the same sound level (P=0.037). However, no significant difference was observed for other exposure durations. Furthermore, the mental fatigue degrees evalauted before exposure to the sound pressure levels of 85 and 90 dB were significanty different form those measured after exposure to these pressure levels in all situations. As the findings indicated, the elongation of time exposure to noise led to the elevation of mental fatigue; however, it resulted in no change in the level of noradrenaline. Furthermore, the rise of noise level from 85 to 90 dB did not lead to the elevation of mental fatigue and noradrenaline release. Consequently, it seems that increased exposure time to noise is more important in causing mental fatigue than the sound pressure level in a short period of time.

Body mass index (BMI) is one of the physical features of individuals that is related to physical health. The maintenance of this index at a normal range during childhood play a significant role in avoiding complications, such as diseases associated with underweight or overweight. The purpose of this study was to determine the mean BMI in primary school and also compare the obtained results with those of the global average. This descriptive-analytic and cross-sectional study was conducted on 384 children within the age range of 7-12 years old using a cluster random sampling method from a population of 154853 schoolchildren in Isfahan, Iran. Regarding gender distribution, an equal number of male and female students were enrolled in the current study. To this end, the height and weight were measured using a standard meter and scale to determine body mass index. Moreover, One-way ANOVA was used to compare the means of the present study with those of Centers for Disease Control and Prevention (CDCs). The Excel software was utilized for figures. The means BMI for boys and girls were 17.06 and 17.47, respectively. There was no significant difference between the mean values of the present study with those of global standard (P= 0.764). The comparison of the results of the present study with the standard values of CDCs showed that the health status of girls and boys in the city of Isfahan is similar. Furthermore, the CDCs tables can be used for children within the age range of 7-12 years.

Hospitals are among the most susceptible places to the distribution of bioaerosol-related infections given their potential for a high microbial density and Low immunity of a number of patients. Accordingly, the investigation of the types and concentration of fungal bioaerosols, as well as the implementation of periodic monitoring and constant control, in hospitals can play a significant role in controlling nosocomial infections. Regarding this, the aim of the present study was to investigate the types and concentration of fungal bioaerosols in the indoor air of different units of three teaching hospitals. This descriptive cross-sectional study was conducted on 272 samples obtained from selected units, with an emphasis on the special units of three teaching hospitals, during the first six months of 2016. The sampling was performed using the Quick Take 30 sampler according to a standard method recommended by the National Institute for Occupational Safety and Health (0800), as well as the Andersen single-step sampler. After identification by standard methods, they were analyzed. The mean fungal concentrations were estimated at 96, 65, and 44 CFU/m3</sup> in the H1, H2, and H3 hospitals, respectively. Accordingly, the air quality of the different units under investigation was ranked intermediate based on the standard of the European Union Good Manufacturing Practice. The results demonstrated a strong correlation between population density and fungal concentration in the indoor air of H1 and H3 hospitals. Based on diagnostic findings, Penicillium, Aspergillus, Cladosporium, and Alternaria species were the most common fungi in the studied hospitals. Based on the findings, the periodic monitoring and constant control of fungal bioaerosols in the indoor air of hospitals should be prioritized in the hospital management process. This end can be accomplished by the establishment of active committees controlling infection and environmental health.

The present study aimed to evaluate the efficacy of qualityof-life therapy on perfectionism and rumination in patients with migraine. This quasi-experimental study was conducted using a pretestposttest design with a control group. The statistical population of the study included all patients with migraine headache referred to hospitals and medical centers of Torbat Heydarieh, Khorasan Razavi, Iran. The study sample consisted of 30 people who were randomly divided into two groups (n=15). The research instrument included Frost Multidimensional Perfectionism scale (1990), Ahwaz migraine headache questionnaire (AMQ), and the rushing responses questionnaire (RRS) of Hoeks and Muro that were completed before and after the intervention by both groups. The collected data were analyzed using SPSS software (version 22). The results of covariance analysis showed that the effect of quality-of-life therapy on the rumination of migraine patients was significant (P<0.05). However, the effect of this treatment on perfectionism was not significant (P>0.05). On the basis of the results, the quality-of-life therapy therapy was helpful in reducing rumination in patients with migraine. However, the findings indicated that this therapy did not have a sitgnificant effect on perfectionism, which needs to investigated in future studies. Therefore, the need for the attention to the quality of life treatment is necessary to treat migraine headaches.

Diclofenac with the chemical formula C14H11Cl2NO2 is a non-steroidal anti-inflammatory drug used to reduce inflammation and relieve pain in conditions, such as arthritis or acute injury. High levels of this type of pollutant in the environment have caused major concerns, such as bacterial resistance and human hormonal disruption. Therefore, the purpose of this study was to evaluate the efficacy of ultrasonic oxidation in removing diclofenac from aqueous solutions.

This experimental-interventional study was conducted to investigate the removal of diclofenac from aqueous solutions through ultrasonic oxidation in laboratory conditions on synthetic samples. Finally, an MSC-equipped GC-MS with splitless/splitless injection was used to measure Diclofenac. Data analysis were performed using ANOVA in Design Expert software.

The obtained results showed that the maximum degradation efficiency of Diclofenac (95.8%) by ultrasonic process occurred under the optimum conditions of the power of 70 W, pH of 9, the reaction time of min 10, and drug initial concentration of 1 mg/L. Regarding the effect of factors, it was shown that the efficiency of Diclofenac degradation increased by decreasing the initial concentration of the drug as well as increasing the ultrasonic strength, reaction time, and initial pH. The high R2 value and P-value less than 0.05 were indicative of appropriateness of the model.

According to the results, it can be concluded that the ultrasonic process alone is a suitable process for the decomposition of Diclofenac from aqueous solutions.

 As a maladaptive psychological function, psychological distress has been predicted by different variables. The aim of the current study was to predict variations in psychological distress according to attachment anxiety with regard to the mediating role of perfectionism.  This descriptive and correlational study was conducted on 280 bachelor and master students of Shahed University, Tehran, Iran. The study subjects were selected using a cluster sampling technique among those studying in the first semester of 2017-18. The employed tools in the present study included Depression, Anxiety and Stress Scale-21 item (DASS-21), Experiences in Close Relationship-Revised (ECR-R), and Frost Multidimensional Perfectionism Scale (FMPS). The obtained data were analyzed using SPSS software (version 23) and AMOS (version 18).  The findings demonstrated that attachment anxiety had a positive significant relationship with anxiety, depression, stress, and perfectionism (P<0.01). Findings in structural equation modeling confirmed the mediating role of perfectionism in the relationship between attachment anxiety and all three dimensions of psychological distress.  The obtained results of the current research confirmed the mediating role of perfectionism in the relationship between attachment anxiety and psychological distress. Therefore, the roles of the mentioned variables are considered important in the development of interpersonal, family, and therapeutic relationships.

 The occurrence of fire in buildings inflicts considerable damage on communities and individuals. This issue is very important in multi-story commercial buildings due to the high fire load, large and untrained population, high value of building and its equipment, complexity of emergency evacuation, and firefighting operations. This study was conducted to evaluate the fire risk of multi-story commercial buildings in Shiraz, Iran.  This descriptive cross-sectional study was carried out in 22 multi-story commercial buildings of Shiraz with an average of four floors. A field survey was performed using the checklist extracted from the National Fire Protection Association 101 standard. Then fire risk was assessed with regard to three aspects, including the requirements of fire control, requirements of egress routes, and requirements of general fire safety, using the Computerized Fire Safety Evaluation System software. The final results of the study were analyzed using Excel 2013 software.  According to the obtained results, among the fire safety parameters studied in the buildings, the parameters of construction, as well as the parameters of smoke and sprinkler control, had the best and worst conditions, respectively. In addition, final results of fire assessment risk indicated that 50%, 73%, and 45.5% of the buildings had unacceptable risk regarding the aspects of fire control, egress routes, and general fire safety, respectively. In general, fire risk was acceptable from all three aspects in only five buildings (22.7%) of all the surveyed samples.  The fire safety condition was undesirable in the studied buildings; therefore, it is necessary to implement measures, such as the modification of egress routes, installation of automatic systems of fire detection, fire alarm, and fire suppression, as well as the development of an emergency response plan.

Despite the recent decrease in heart disease mortality in developed countries, ischemic heart disease (IHD)-induced mortality is still ranked first in Iran. However, there is no conceptualization of changes occurred in the disease process and the role demographic variables may play in this regard. Age-period-birth cohort (APC) analysis can deepen the understanding of mortality process, and help its prediction in the near future.

The present study was a panel of cross-sectional cohort estimating IHD-induced mortality rate during 2004-2013 with the use of the "APC model. Moreover, this study aimed to this mortality rate for 2014-2018 using the mortality-incidence analysis model-MIAMOD software. The study sample consisted of individuals selected from the database collected at Monitoring and Registration Unit of the Cardiovascular Diseases in Isfahan Cardiovascular Research Institute, Isfahan, Iran.

The age-adjusted death was higher in men than in women. The age-adjusted mortality rate of IHD during 2004-2013, on average, increased by 13.6% and 14.7% for men and women, respectively. Furthermore, it is predicted that the mortality rate would increase by 14.1% and 10% for men and women during 2014-2018in each year, respectively. The obtained results indicated that the increase of age led to the increase of mortality rate, meaning that mortality was higher in the subjects born during 1932-1936, compared to those born in 1972-1976.

The obtained results were indicative of the increasing trend of mortality in Isfahan among both men and women. Moreover, the estimation and prediction based on the (APC) Model can be used as a basis for the management of health services.