مجله سلامت و بهداشت
سال هفتم شماره 2 (پیاپی 26، بهار 1395)

Health globalization leads to the formation of a new type of tourism are known as health tourism. In the medical tourism as a branch of health tourism has grown rapidly over the other branches and many countries already have programs for the development and utilization of it. Because, as a bordering province, Ardabil province is likely to progress in the field of medical tourism and Due to numerous problems in this area, this paper examines the barriers to the development of this type of tourism in the province of Ardabil.
To analyze the data, student t-test and Friedman test was used. The findings showed, Medical tourism are the barriers in Ardebil: barriers information systems and marketing with an average rating of 29.75 First step, And other policy and legislative barriers to the rank 25.14, 24.92 infrastructural barriers, barriers product development and quality of service, 24.80, 24.49 administration's attitude barriers, barriers manpower 22.46, 20.54 and socio-cultural barriers economic barriers, with mean scores of 16.19 in the Report next is.
The results showed that each of these barriers have an essential role in preventing the development of medical tourism in this area And sub-indices act as barriers to the development of the sector. In the end we presented suggestions for tourism development and removing barriers.

In addition to determining the chemical characteristics of particles in the air of cities, investigating the physical properties and their role in environmental pollution is also important. So the aim of this study is the investigation of morphological and mineralogical of PM2.5 particles in the air of Tehran, relying on the analysis of EDX-SEM images and XRD analysis.
In this study, samples of PM2.5 particles in the air of Tehran Sina Hospital area were collected by frmOMNITMAmbient Air Sampler with PTFE filter with a diameter of 47 mm. Evaluation the mineralogical composition, size, and size percentage frequency and Finally, to determine the shape of particles XRD analysis and EDX-SEM images were used.
The results of EDX-SEM images analysis showed that the most important elements in PM2.5 particles are oxygen (07.43-32.39%), calcium (49.7- 48.5%), aluminum (72. 5-32. 5%), iron (42.3- 21.3%), magnesium (79.1-19.1%), potassium (57.1-5.1%), zinc (48.1- 28.1%), and some particulates, sulfur (61.4%), sodium (66.0-51.0%), fluorine (61.0%) and titanium (53.0%) have also been found. XRD results showed that the mineral constituent of the samples studied,are mostly in the fourth phase of the mineral core containing carbonate (mostly calcite), clay (Askm Tate and Kahn Ditte), silicates (mainly quartz) and Philo silicates (mainly kaolinite). Minor phases include minerals such as muscovite, illite, calcite and Palygurskyt.
These elements are defined and identified as components originating from the Earth's crust and human activities have no large role in the production and release of these elements. In most particulate matter, carbon element has also been detected in some particles, although the carbon could not be identified. The high percentage of carbon in some aerosolsof this element is to indicate the origin of fossil fuels. Comparing the results of XRD and SEM-EDX analysis, itshowed that these results are well proved.

Direct household spending for health care can be estimated as the largest component of household expenditure after food costs. The purpose of this study is Inequality in health expenditure and impoverishment impacts resulting from it in Kerman.
This is a cross-sectional study. For sampling the Quota sampling method was used. To explore the possibility exposure of households with impoverishment health expenditures and its relationship with Predisposing variables the Chi-square test and Pearson cross-tabulations were used in Excel and Stata and for determining the concentration index the Gini Coefficient was used.
The study revealed important variables such as Household economic status, head of household sex, head of household education and existence of persons over 65 years had a key role in impoverishment health expenditures. Concentration index in exposure with impoverishment health expenditures was -0.69 and for health expenditures was -0.385.
Inequality in health expenditures depend on some predisposing variable that were shown in this study and with improving socio-economic variable can reduce the inequality in health expenditures and their impoverishment effects.

Air pollution threatens the health of urban dwellers. Tabriz city is among the seven megacities of Iran with air pollution dilemma. The aim of study was to survey and characterize air pollution in the city of Tabriz regarding air quality parameters and administrative problems.
This is a descriptive- analytic study which Tabriz ambient air was the study area. The data obtained from five air pollution monitoring stations was used in this study in the period of 2012-2013. Air quality data and meteorological characteristics were integrated to demonstrate spatial and temporal variations of air quality. Approximately, at 30 to 50% of the times, the data has not been recorded at the monitoring stations. Inverse Distance Weighting (IDW) method was used to analyze allocation of air pollution at other parts of the city.
The highest concentration of PM10 was related to summer and winter seasons with about 117 µg/l which mostly were excessive than the air quality limits. Carbon monoxide was at the highest amount of 7.66 µg/l at the cold months and brought about unhealthy condition. Concentrations of O3, NO2 and SO2 mostly were less than the permissible limits and at about 5% of the events led to initiate unhealthy conditions. Estimations show that the numbers of monitoring stations are not sufficient and additional 21 stations are required.
PM10 and CO are attribute to the main pollutants of air in Tabriz city and the most events of air pollution take place at cold seasons. Increasing the number of monitoring stations and establishing appropriate daily measurement systems of pollutants is one of the important management measures to control air pollution in Tabriz.

Formaldehyde is one of the volatile organic compounds and classified as probably carcinogenic. The aim of this study was to determine the dominant microorganism in biodegradation of formaldehyde from the air.
This study was an experimental study that an aerobic biofilter reactor made ​​of steel with mixture of compost and wood chips (50/50 percent in terms of volume volume) in the first step of operation and pumice ston and compost mixture (80% pumice and 20% compost in terms of volume) in the second step were used as beds for microbial growth. First and second step experiments started with concentrations of 20±2 and 24±3 mg/m3, respectively, and completed with concentrations of 276±4 and 224±5 mg/m3, respectively. Sampling and measurement was done using the 3500 method National Institute for Occupational Safety and Health.
The maximum of formaldehyde removal efficiency in both the first and second in empty bed residence time of 180 seconds was achieved at about 91% in the operation first stage and 88% the operation second stage. Also, after some tests done to determine the dominant microbial population it was found that the Citrobacter freundii was the dominant microorganism to formaldehyde biodegradation in the study.
The results showed that by increasing the inlet concentration of formaldehyde and reducing the EBRT, the formaldehyde removal capacity of the system decreases. The present study introduced this process as an effective method for removing formaldehyde from the air stream. As well as the results, significant differences in terms of the removal efficiency with different substrate materials in two operation steps do not showed. However that the sustainability of the system capacity to remove formaldehyde in the operation first stage was observed more than the second stage.

Back ground & Phenol is known as the most toxic agent in environment as well as creating unpleasant flavor and smell in water resources. The present research is to assess the effect of different chemical agents in adsorption capacity improvement of ARH a cost-effective absorbent a promising approach for phenol removal.
This study is of experimental-intervention type that for capacity improvement rice husk ash and the effect of different chemical used of( Mgo, CaCL2, KOH, MgCL2, NaOH, SO4NH4, NH4CL, ZnCL2).Then to influences of various factors, such as pH, contact time, initial phenol concentrations, adsorbent dose and temperature on the sorption capacity of ARH were examined
Study showed that improvement rice husk ash with ammonium sulfate had the highest efficiency 94.85% and no treat had lowest efficiency 54.7% for phenol removal. Process sorption of phenol followed Longmuir isotherm (R2≥0.99) and the kinetic model of pseudo second-order (R2≥0/99). The maximum adsorption capacity was calculated 66.6 mg/g based on Langmuir isotherm. Also, the calculated values from thermodynamic parameters showed that the adsorption of phenol on ARH is endothermic and spontaneous
These results indicate that ammonium sulfate increases the efficiency of rice husk ash as sorbent increased. Due to the availability of rice bran and easily modified, it can be absorbing the water and wastewater industry for the removal of aromatic compounds to use.

Microbial, physical and chemical characteristics of drinking water depending on the type and quantity is the basis of water as whether it would be drinkable . In addition, each of the above mentioned characteristics has a great impact on quality enhancement, increase of acceptance level and threat on consumer health. Regular monitoring on quality of urban drinking water network and the remediation of old pipes has also essential role on human health. The purpose of this study is to know the value of physical, chemical and microbial parameters of Lahijan urban drinking water according to the type of pipe from distribution network and urban structure and to compare their values with national and international standards.
In this research based on 3 types of asbestos, galvanized and polyethylene piping, 50 Samples were taken on May and June 2012 from drinking milk houses and public places. Parameters including chlorine residue and pH were determined and microbial analyzes were also done. Possible effects on health and the properties of bulk water were questioned from users through the questionnaire.
The amount of residual chlorine and pH were in the range of 0.2-0.5mgL-1 and 6.74-7.40, respectively. The averageof residual chlorine and pH were 0.235±0.097 and 6.88±0.14, respectively. None of the specimens tested for coliform bacteria contamination was seen.
Based on the results of the questionnaire and public Dissatisfaction of the municipal drinking water, continuous chlorination and water quality have to be monitored more closely.

One of the most important issues for economic prosperity is the evaluating of how to govern income and expenditure and effects of them on the national production. Reliance on oil income due to the amount of sales and price fluctuations will make the government face with crisis to achieve its sovereign goals. The aim of this study was to investigate the effects of the expenses (spending) in various sectors such as health and sanitation area and government incomes on the country national production.
To prove the model is used John Minard Keans aggregate function in four states. The first state is the policy that the government does not intervene in the economy. That does not make any cost including social and economic and does not receive income from the people as tax income. The second state is the policy of government intervention (to the extent that the cost of taxes paid) and the impact that will have on the country. The third state is the policy with government intervention only through cost. The fourth state is the policy with government intervention only through tax incomes.
Research finding showed applying expansible financial policy and contractible financial policy (simultaneous) is better than not implying that case. The effects of simultaneous tax receiving and costing by the government will be positive on the national production. The government in doing his sovereign duties with sanitary and therapeutic expenses, educational, redistribution incomes and improving sovereign indicators requires a stable and reliable financial resources and applying the appropriate financial policy.
Experience in developed countries has showed that creating the infrastructure by the government motivate the entrance of private sector on investment in production. Having a strong and effective budgeting with reliable and secure financial resources is necessary to manage the country successfully. Due to the need of country for economic growth and development in all fields especially in health and education, the necessity of government interference for necessary expenses is inevitable. Changes in taxes and national costs impress the national income and simultaneous changes in tax and government costs not only reduces one another to a degree, but also at least the size of government costs on the national production will be more affected.

Due to the increasing number of elderly population in recent years and considering oral health is an integral part of public health, the aim of the present study is the evaluation of oral health of elderly referring to Khatam ol Anbia clinic in Yazd in 2014.
In this cross-sectional study, 251 patients aged over 60 were selected randomly. Demographic characteristics, condition of teeth and periodontium were recorded. Data were analyzed using SPSS.16, Mann-Whitney test, Chi-Square test and Kruskal–Wallis.
Among 251 elderly patients studied, 74 patients were (29.5%) men and 177 (70.5%) women with a mean age of 76.39± 9.98 (age range 61 to 102 years). Mean DMFT was 26.69±3.18 (8 to 28). There was no statistical relationship between DMFT index and demographic variables except age. There were statistical relationships between CPITN, sex (p=0.000), smoking (p=0.009) and age (p=0.000).
The results of this study showed that elderly patients are not in a good condition by the aspect of dental and periodontal status, so it is important to arrange more educational and therapeutic programs for this group.

Psychological problems of chronic patients, especially diabetes, that often are ignored, need special attention to proper treatment. The aim of this study was to investigate the effectiveness of acceptance and commitment therapy on psychological symptoms, coping styles and quality of life in patients with type-2 diabetes.
The research design was a semi-experimental one with pretest-posttest and control group format. The sample included all in patients with type II diabetes who referred to Taleghani Diabetes Hospital in Kermanshah city in 2014-15 (N=490), who were assessed based on DSM_IV_TR criteria, DASS-21, WHOQOL-26, and coping styles. Those who got highest scores were selected. The study subjects, were randomly divided into experimental and control groups (n1=n2=8). The experimental group was exposed to 8 sessions of two hours ACT. The data was analyzed using descriptive statistics and multivariate analysis of covariance (MANCOVA) by SPSS-16 software.
The results showed significant difference between experimental and control groups total scores in depression, anxiety, stress, coping styles (Problem Solving, Emotional, Avoidance), (p0.05).
The results emphasize the importance of this intervention in psychosomatic and chronic diseases and provide new horizons in clinical interventions.