مجله تحقیقات نظام سلامت
سال بیستم شماره 1 (بهار 1403)

Anxiety is one of the common problems of childhood which, if not treated, may be associated with problems such as depression, substance abuse, suicide, academic problems, low participation in school activities, bullying, and reduced enjoyment of academic and social aspects. The aim of this study was to investigate the psychometric properties of the second edition of the Multidimensional Anxiety Scale for Children-Parent Form (MASC2-P).

This was an applied research in terms of purpose, and a psychometric study in terms of methodology. The statistical population included all parents of students aged 10 to 18 years in districts 2, 4, 7, and 12 of Tehran, Iran, that 425 people (183 men and 242 women) were selected as the sample by available sampling method and responded to the MASC2-P. To investigate the validity of the construct, confirmatory factor analysis (CFA) was performed using LISREL software, and to investigate the reliability, Cronbach's alpha coefficient and omega coefficient were used using SPSS software.

The results of CFA showed that this scale using 50 items measured 8 factors of injury avoidance, stress and restlessness, panic, obsessive-compulsive disorder, functional fears, ridicule and rejection, generalized anxiety, and separation anxiety. Fit indices of chi-square to degree of freedom (χ2/df) ratio, root mean square error of approximation (RMSEA), parsimonious normed fit index (PNFI), comparative fit index (CFI), normed fit index (NFI), non-normed fit index (NNFI), incremental fit index (IFI), and relative fit index (RFI) were obtained 2.93, 0.07, 0.86, 0.95, 0.92, 0.94, 0.95, and 0.92, respectively. Cronbach’s alpha and omega coefficients for all factors were greater than 0.83.

MASC2-P is a suitable tool to identify and screen the anxiety of children and adolescents.

The relationship of safety climate and mental workload with stress, anxiety, and depression is one of the performance indicators of occupational health and safety management in the workplace, which evaluates the attitude of employees towards safety issues. The purpose of this study is to investigate the relationship between safety climate and mental workload with stress, anxiety, and depression in ABFA Company personnel in Isfahan Province, Iran.

This is a descriptive-analytical and cross-sectional study. The statistical population included 254 employees of the water and sewage incidents team in six regions of Isfahan City and the water and sewage crisis team and the relevant supervisors. The data collection tools in this research were the standard Depression, Stress, and Anxiety Scale (DASS-21), the standard NASA Task Load Index (NASA-TLX), and the standard Nordic Occupational Safety Climate Questionnaire (NOSACQ).

The increase in depression, anxiety, and stress was associated with the increase in mental workload in the target group (P < 0.05). Besides, the calculated beta coefficients were negative, which indicates an increase in depression, anxiety, and stress with a decrease in safety atmosphere in the target group personnel (P < 0.05)

The crisis team has a significant mental load in today's work environment because the tasks they perform require extreme caution and attention and must be free of any mistakes. Therefore, efforts should be made to reduce their mental load so that they can perform better. Increased depression may significantly affect people's physical and mental health and reduce their performance, commitment, quality of life, and satisfaction. Hence, the components of mental loads should be controlled and relevant measures should be taken to reduce the workload.

One of the principles of diabetes control is to maintain a healthy body mass index (BMI) and adhere to treatment. Health literacy can significantly impact the management of diabetes. This study aimed to determine the relationship between health literacy, treatment adherence, and BMI in patients with type 2 diabetes.

This cross-sectional descriptive study was performed on 145 patients with type 2 diabetes who were referred to the Yazd Diabetes Center, Iran, and selected using a convenience sampling method. To gather data, questionnaires on Iranian health literacy and adherence to treatment were used. BMI was calculated using the measured height and weight. The data were analyzed using descriptive and inferential statistics with SPSS software.

The average health literacy score was 145.17 ± 18.75, and the majority of participants (63.4%) demonstrated an excellent level of health literacy. The average adherence to treatment was 176.23 ± 7.03, and 93.5% exhibited a very high level of adherence to treatment. Moreover, the average BMI was 27.09 ± 4.05 kg/m2, and the majority (45%) were classified as overweight. Pearson's correlation test showed a positive and significant relationship between health literacy and adherence to treatment (r = 0.325, P = 0.001), as well as a negative and significant correlation between health literacy and BMI (r = -0.518, P = 0.001).

Improving health literacy leads to increased treatment adherence and decreased BMI. Therefore, health service managers can enhance treatment adherence and reduce BMI by prioritizing infrastructure and management planning to promote health literacy.

Heat exposure, as a work-related risk factor, can have a significant effect on human health. This study aimed to design and manufacture evaporative cooling pants and evaluate their effectiveness in reducing heat strain under controlled laboratory conditions.

The study consisted of three stages: developing evaporative cooling pants, assessing their cooling power in a laboratory and evaluating their effectiveness. 12 men wore regular pants and then switched to evaporative cooling pants while their heart rate, skin and ear temperature, and PSI were measured every 5 minutes. Data was analyzed using SPSS software.

The study revealed that the specially designed evaporative shorts lowered the temperature of the thigh skin by 3 °C (P < 0.05). However, there was no significant relationship between the two groups in terms of physiological parameters such as heart rate, ear temperature, and Physiological Strain Index (P > 0.05).

The use of designed evaporative cooling pants can have a positive impact on reducing skin temperature. However, it is recommended to test in actual work environments.

Happiness, cheerfulness, and a positive attitude toward life events play a prominent role in marital satisfaction can significantly contribute to creating a sense of security and optimism for couples. The purpose of this paper is to examine the impact of happiness training on students' marital satisfaction.

This quasi-experimental study was conducted on 64 students at Gonabad University of Medical Sciences in Iran. Participants were selected using a systematic sampling method and were randomly assigned to intervention and control groups using permuted blocks of size 4. The happiness training intervention consisted of six 2-hour sessions, conducted once a week by a psychiatric nurse exclusive for the intervention group. A demographic form and the Enrich Scale were used before and after the intervention in both groups. The data were analyzed using SPSS software, including descriptive statistics and analytical statistical tests such as chi-square and paired t-tests. The significance level was determined to be less than 0.05.

The comparison of mean marital satisfaction between the two groups did not show a significant difference before the intervention (P = 0.630). However, the mean marital satisfaction after the intervention had a statistically significant difference (P < 0.001). Comparing the mean marital satisfaction before and after the intervention in the intervention group revealed a significant difference (P < 0.001), but this difference was not significant in the control group (P = 0.520).

The results indicate that happiness training has a practical impact on the marital satisfaction of married students. An important step to reduce marital conflicts and increase couple's satisfaction is to hold workshops focused on happiness training.

Cyberbullying has harmful legal and psychological consequences for adolescents, which can cause a serious disturbance in their development. Therefore, it is important to validate reliable measurement tools in order to identify it as early as possible and determine the factors affecting it. This study aimed to evaluate the psychometric properties of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) in Iranian adolescents.

The current research was a descriptive study that was conducted among 291 high school students in Ahvaz, Iran. The samples were selected by a multi-stage random method and responded to ECIPQ. The reliability of the questionnaire was determined by Cronbach's alpha, Spearman-Brown split-half, and Guttman correlation coefficient, and its validity and factor structure were determined by construct and concurrent validity methods in SPSS and Amos software.

There were 142 (48.8%) male students and 149 (51.2%) female students with an average and standard deviation (SD) of age of 15.61 ± 1.72 years. Cronbach's alpha, Spearman-Brown split-half, and Guttman correlation coefficients for the whole questionnaire were 0.88, 0.82, and 0.86, respectively. The results of confirmatory factor analysis (CFA) showed that the ECIPQ measurement model had a relatively good fit, and its 2-factor structure was confirmed [comparative fit index (CFI) = 0.92, goodness of fit index (GFI) = 0.91, and root mean square error of approximation (RMSEA) = 0.078]. The concurrent validity of the bullying and victim factors of this questionnaire was also confirmed by correlating its items with the items of the Cyber-Aggression Questionnaire for Adolescents (CYBA) and the Bullying in School Scale (BS) (P < 0.05).

ECIPQ is a valid and reliable questionnaire for measuring cyberbullying in two dimensions of bullying and victimization among Iranian adolescents.

The coronavirus was first detected in December 2019 in Wuhan, China, which quickly spread worldwide and became one of the main health crises. With the spread of coronavirus, health personnel in all parts of the world were faced with a sudden change in care roles, which caused them anxiety. The purpose of this research was to investigate the anxiety caused by coronavirus and its relationship with the job performance of health personnel during the coronavirus pandemic.

The present cross-sectional study was conducted by cluster sampling method on 730 health personnel in Chaharmahal and Bakhtiari Province, Iran, in 2021. The data were collected using Corona Disease Anxiety Scale (CDAS) and Paterson's job performance questionnaire. In order to check the correlation between anxiety score and job performance, the correlation coefficient and linear regression were used as well as multiple regression. Data were analyzed using SPSS software.

The mean and standard deviation (SD) of anxiety and job performance score was 11.44 ± 31.08 and 7.41 ± 54.33, respectively. As the anxiety score increased, the job performance of healthcare workers decreased significantly. However, it was not significant after controlling the confounder variables.

Considering the negative impact of anxiety caused by coronavirus on the job performance of health personnel, it seems necessary to have an appropriate plan to reduce the anxiety of health personnel during the epidemic of infectious diseases in order to increase their job performance.

In recent decades, there has been a growing concern about the presence of antibiotics in water resources. The presence of these micropollutants even in low concentrations has significant effects on the environment and human health, and their entry into the soil and especially receiving waters should be prevented as much as possible. As effluents from wastewater treatment plants (WWTPs) are significant sources of antibiotics in the environment, this study aimed to investigate the efficiency of antibiotics removal in municipal WWTPs.

In this study, Isfahan East WWTP with a combination of stabilization ponds and an aeration lagoon, and Isfahan South WWTP with conventional activated sludge treatment were selected as well as four antibiotics from the beta-lactam group including ampicillin, amoxicillin, cephalexin, and penicillin, and their removal efficiency was investigated in both WWTPs. Samples were collected from the influent and effluent of both WWTPs on 13 occasions and analyzed immediately after being transferred to the laboratory. The concentration of antibiotics was determined by high-performance liquid chromatography (HPLC).

In the Isfahan East WWTP, the average removal efficiency was 86.22 ± 19.84% for ampicillin, 34.35 ± 31.38% for amoxicillin, 78.75 ± 23.81% for cephalexin, and 89.80 ± 19.42% for penicillin. In the Isfahan South WWTP, the average removal efficiencies of amoxicillin, ampicillin, cephalexin, and penicillin were equal to 54.82 ± 33.29%, 66.85 ± 24.88%, 87.65 ± 21.76%, and 82.76 ± 21.85%, respectively.

The study's findings revealed that Isfahan municipal WWTPs were unable to fully eliminate antibiotics. According to statistical analysis, there were significant differences in the concentration of antibiotics in both WWTPs, and no critical correlation was observed between the removal efficiency of antibiotics and other principal wastewater parameters. Consequently, there is a need for stricter control over the discharge of effluent into the river or its use for agricultural irrigation.

The present study aimed to investigate the attitude towards marriage based on schema mentalities with emphasis on the mediating role of interpersonal emotional regulation in students.

TThis cross-sectional study was conducted using structural equation modeling (SEM). The statistical population of the study consisted of all undergraduate students of Islamic Azad University, Najafabad Branch, Najafabad, Iran, in 2019, which included 13254 people. Based on the theory of Muller, 320 people were selected from the community using convenience sampling and completed the Schematic Mindset Questionnaire (SMQ), Braaten and Rosen Marriage Attitude Scale (MAS), and the Interpersonal Emotional Regulation Questionnaire (IERQ). Data were analyzed using SEM and maximum likelihood estimation (MLE) method in AMOS software.

TSchema mentalities including childish mentality, dysfunctional coping mentality, dysfunctional parenting mentality, and healthy adult mentality had a direct effect on attitudes towards marriage (P < 0.05). The results of this study also showed that interpersonal emotional regulation played a mediating role in the relationship between childish mentality, dysfunctional coping mentality, and dysfunctional parenting mentality with attitude towards marriage (P < 0.05). However, it did not mediate the relationship between healthy adult mentality and attitude towards marriage.

Based on the results obtained, to improve the attitude towards marriage, protocols based on changing schema mentalities and interpersonal emotional regulation can be used.

Malta fever or brucellosis is still one of the most challenging issues related to health and economy in many countries such as Iran. The purpose of this study was to investigate the epidemiological situation and the trend of disease incidence during the years 2015 to 2018 in Lorestan Province, Iran.

This research was a retrospective analytical-descriptive cross-sectional study that was conducted on people with brucellosis using the data available in the health centers of Lorestan Province. The disease incidence index was calculated by year for all years. The relationship between the incidence of disease with age, gender, employment status, place of residence, contact history, contact type, and livestock vaccination history by city was analyzed using chi-square test and SPSS software.

5841 cases of brucellosis patients were identified. The highest rate of incidence was in 2015 in Sepid Dasht City with 1783 cases and the lowest rate was in 2018 in Kuhdasht City with 30 cases per hundred thousand people. One of the reasons for the difference in the incidence of the disease at the province level was the different ratio of urban and rural population in each city. In all the studied years, there was a significant difference between the frequency of contact with livestock and the city of residence (P = 0.001).

According to the obtained results, it is possible to use the necessary training for high-risk groups and effective health behaviors to prevent and reduce the disease.

Cardiovascular disease (CVD) is an important public health issue in the world as its morbidity and mortality rate is increasing which depends on several factors. The purpose of this study is to investigate the relationship between carbohydrate intake and premature heart diseases.

This case-control study was conducted on 972 people (450 women and 522 men) who referred to Chamran and Asgariye hospitals in Isfahan, Iran, for angiography. Based on the results of angiography, patients were divided into two groups: case and control. In order to evaluate dietary intake over the past year, the food frequency questionnaire (FFQ) was used. The relationship between carbohydrate, fiber, and simple sugar intake with premature heart disease was investigated using simple and multiple logistic regression with adjustment of confounding variables.

The mean age of the subjects was 51.13 ± 6.90 years. There was no significant association between dietary carbohydrate [odds ratio (OR): 1.22, 95% confidence interval (CI): 0.72-2.07], fiber (OR: 0.94, 95% CI: 0.63-1.41), and sugar (OR: 1.35, 95% CI: 0.96-1.90) with incidence of premature heart disease after adjusting for the variables of age, sex, smoking, physical activity, education, job, family history of heart attack, daily energy intake, and body mass index (BMI).

Our results suggested that dietary carbohydrate, fiber, and sugar were not associated with the risk of premature heart disease.

In recent decades, significant advancements have been made in understanding the role of food in improving health. Therefore, this research aimed to investigate the possibility of producing a useful kiwi and apple drink containing Spirulina platensis and Moringa oleifera.

Fruit beverages were prepared using a 1:1 ratio of natural apple and kiwi juice, along with 0.1% stevia and 5% inulin. Then, different levels of Spirulina platensis (0%-2%) and Moringa oleifera (0%-2%) powders were added. The treatments were prepared in four groups: T0 (control sample), T1 (containing 2% Moringa oleifera), T2 (containing 2% Spirulina platensis), and T3 (1% Moringa oleifera + 1% Spirulina platensis). The physicochemical properties, antioxidant activity, some nutritional properties including the content of elements and fatty acid profile, and sensory properties of the substances were investigated.

A significant increase in pH, acidity, ash, brix, and protein was observed in all treatments compared to the control sample (P < 0.05). The highest amount of pH, acidity, and protein was reported in T2 (P < 0.05) and the highest ash and brix levels were observed in T1 (P < 0.05). The analysis of the antioxidant activity of beverages showed a significant increase compared to the control (P < 0.05). The T1 treatment exhibited the highest antioxidant activity, while the T0 treatment showed the lowest (P < 0.05). The analysis of beverages' elements, including calcium, iron, and potassium content, revealed that the T1 treatment exhibited the highest nutritional value (P < 0.05). The analysis of the color characteristics of the beverages showed that the addition of Spirulina platensis led to a decrease in the L*, a*, and b* values of the samples (P < 0.05), while Moringa oleifera leaf powder increased the a* and b* values significantly (P < 0.05) and had the L* value higher than that of other samples (except the control) (P < 0.05). The fatty acid profile indicated the lowest amount of omega-3 in the control group (P < 0.05). T1 had the highest amount of omega-6 (P < 0.05). Additionally, the highest and lowest amounts of saturated fatty acids were observed in T1 and T2 samples, respectively (P < 0.05). The highest and lowest levels of monounsaturated fatty acids (MUFAs) were observed in the T2 and control samples, respectively (P < 0.05). The sensory evaluation of the samples showed no significant effect on the color of the beverages (P > 0.05). T1 samples had the highest scores for taste, mouthfeel, and overall acceptance (after the control sample) (P < 0.05). The maximum consistency score was associated with the T2 sample (P < 0.05).

Given the high acceptance score of Moringa oleifera leaf powder in the preparation of functional beverages, it is recommended that this potential be used in various sectors of the food industry within the country.