مجله تحقیقات سلامت در جامعه
سال چهارم شماره 3 (پاییز 1397)

Health literacy refers to the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. This concept is an important element of a person’s ability to engage in health promotion activities. Regarding this, the present study was conducted to evaluate health literacy among the urban and rural communities of Behbahan County in Iran. This study descriptive analytical study was performed on 794 literate individuals aged 17 years or higher. The study population was selected using cluster sampling method. The data were collected using the Iranian Health Literacy Questionnaire. The mean age of the subjects was 40.2±14.21% years. About 53% of the subjects were male. In terms of education level, 32.5% and 18.6% of the participants had diploma and bachelor’s degrees, respectively. Furthermore, the mean health literacy of urban and rural communities was obtained as 70.22%. The results revealed no significant differences between the urban and rural communities in terms of health literacy (P>0.05). The findings indicated that overall health literacy was at a desirable level in Behbahan County. However, given a lower health literacy in women, village residents, and elderly and middle-aged groups, health providers should adopt more effective methods for the transmission of information to these people.

Introduction and The quality of service is an important factor in improving the satisfaction of clients referring to community health centers and the primary health care system. The aim of this study was to determine the quality of physician services of community health centers in Ahvaz, Iran, during 2016. This cross-sectional study was conducted on 200 patients referring to physicians at 14 community health centers. The participants were selected through a random sampling technique. Data were collected using Quality of Service questionnaire (Servqual), which evaluates the quality of services in five dimensions (22 questions). In this study, 73% of the patients were female and the mean age was 32.8±8.6 years. The mean of the waiting time for the service was 11.09±10.8 min and the mean of visit time was 5.92±3.9 min. The findings showed that the most desirable aspect of the quality of the physician services was "assurance". The weakest aspect of quality was "responsiveness” dimension. Among the dimensions of service quality, responsiveness and tangibility need improvement. Health managers should strengthen these dimensions with effective interventions in order to increase patient satisfaction.

Introduction and Urban outdoor air is contaminated with a variety of harmful agents that can lead to an increase in mortality and morbidity rate through short-term exposure. In recent studies conducted in Iran, the health effects of suspended particles with a diameter of less than 2.5 micrometers (PM2.5) have been investigated and the results of many studies have proven the adverse effects of air pollutants on human health. The present study investigated the air quality and evaluated the health effects of PM2.5 on the residents of Semnan in 2017. The air quality index (AQI) introduced by the Environmental Protection Agency was used in order to evaluate the air quality. In addition, for the purpose of health effects evaluation AirQ software was utilized, which is proposed by the World Health Organization. It is worth mentioning that AQI was calculated by the interpolation between the concentration of the pollutants for PM2.5 and classified based on standard charts and tables. In AirQ software, the concentration of PM2.5 was utilized to assess human exposure and health effects in terms of the ratio attributable to the health implications, annual number of deaths for all causes, as well as cardiovascular and respiratory diseases. According to the obtained results of this qualitative study, it was revealed that air quality has exceeded the standard level almost 18% (AQI>100); it was reported as unhealthy and dangerous in 6% and 2% of the days of the year, respectively. Based on the findings, the annual average of concentration was estimated as 18 μg/m3. Moreover, the maximum number of exposure days to PM 2.5 was related to the concentration of 13-25 μg/m3. Furthermore, more than 80% of the cardiovascular and respiratory mortalities, as well as the referrals of outpatients with respiratory and heart diseases, belonged to the same concentration class. Despite the limitations of using AirQ software (version 2.2.3) this method is an effective, easy, and helpful tool for decision-making.

Introduction and Needlestick injuries are among the most common types of occupational injuries in nursing. The importance of this type of injury lies in the fact that it has the potential risk of the transmission of blood-borne infectious disease. This cross-sectional study was conducted on four hospitals staff in 2017 in order to identify the causes and frequency of these types of injuries. Among 212 medical workers that were selected using census method, 132 individuals filled the questionnaires. Data were analyzed using SPSS (version 21) through logistic regression, analysis descriptive, and the Chi-square test. The obtained results showed that 60.6% of the subjects were female, and 39.4% of them were male. The needle stick exposure did not significantly differ between males and females. In addition, 38.1% of the questioned staff had a history of needle injuries in the previous year. Among the accidents caused by a sharp instrument, needle stick injuries had the highest frequency (64.7%). Furthermore, the most common reaction was wound washing with water and soap (82.4%). On the basis of the results, 62.7% of the need stick injuries were due to the high level of nurses’ workload. Regarding the high frequency of needlestick injuries among nurses, nursing managers should consider preventive approaches, such as the maintenance of safety measures in work environment, accomplishment of complete vaccination coverage, and provision of a reliable reporting system, to confront with this problem.

Introduction and Human malaria is one of the widespread vector-borne diseases worldwide. Lots of efforts have been made to control and eliminate the vectors of the disease. Anopheles gambiae and Anopheles stephensi (A. stephensi) are the main vectors of malaria in Africa and Asia. The members of Anopheles gambiae complex contain the vector and non-vector species. A. stephensi has three biological forms with different vector capacities. The phenotypic and genotypic diversity has made it more difficult to identify vector populations and consequently the surveillance and control of malaria. The present study aimed to compare the morphological and molecular diagnostic characteristics of the two important malaria vectors in the two world continents. After searching, studying, and organizing published papers related to the subject, Anopheles gambiae and A. stephensi species were compared based on the morphological and molecular characteristics. Different morphological keys for the two species, the specimens from the insectarium of Urmia University of Medical Sciences, as well as the present species of national insectarium in Pasteur Institute of Iran, were used for morphological comparison. In addition, all the present sequences of five molecular markers, including COI, COII, D3, ITS2, and OBP1, were extracted from GenBank and analyzed using bioinformatics software. Based on the obtained results of the present study, the number of ridges on Anopheles gambiae eggs was more than that on A. stephensi eggs. However, unlike A. stephensi in Anopheles gambiae, the number of ridges was not a diagnostic characteristic for the identification of Anopheles gambiae complex. There were four diagnostic characteristics in the larvae comparison of the two species and there were three different characteristics in adults. All the molecular markers were capable of separating the two species; however, ITS2 and D3, as well as COI, COII, and OBP1 markers were preferred for inter-species and intra-species comparisons, respectively. The combination of traditional diagnostic and new molecular methods can be simultaneously used in inter-species separation. As a result, in order to eliminate malaria in Iran and the countries covered by The World Health Organization Regional Office for the Eastern Mediterranean, it is recommended that the combination of morphological, molecular, and field epidemiological data can provide practical solutions for vector control programs. Obviously, none of these data exclusively respond to the needs of the mentioned programs. Furthermore, the coordination, design, implementation, and evaluation of applied projects, as well as executive actions, are necessary for the success of these programs regarding the elimination and eradication of malaria and other vector-borne diseases.

The personnel of the hospital operating room are constantly exposed to a level of anesthetics. The long-term exposure to anesthetic drugs is associated with adverse health effects, such as neurological effects, liver damages, spontaneous abortion, and congenital bnormalities. Considering the high level of isoflurane use and its anesthetic complications, the present study was conducted to investigate the concentration of soflurane vapor in the respiratory zone of operating room personnel in the hospitals of Sari, Iran. In this descriptive analytical cross-sectional study, the sampling was carried out from the concentration of isoflurane vapor in the respiratory zone of personnel in nine operating rooms of three hospitals in Sari based on the Occupational Safety and Health Administration 103 method using a personal sampling pump and an absorbent tube (Anasorb 747) filled by activated charcoal. The samples were analyzed and determined using a gas chromatograph-flame ionization detector. The mean score of exposure of operating room personnel to isoflurane vapor was reported as 3.73±6.17 ppm with a maximum of 26.25 ppm and a minimum of 0.04 ppm. The concentration of isoflurane vapor in the respiratory zone of the operating room personnel was higher than the Recommended Exposure Limit by the National Institute for Occupational Safety and Health but lower than Occupational Exposure Limit proposed by the Health and Environment Center of Iran. It is worth mentioning that there was a significant and inverse relationship between the mean score of exposure and the duration of operation period. However, there was no significant difference between the mean scores in close and far positions. The obtained results of the present study showed that the exposure level of the operating room staff to isoflurane vapor was higher than the recommended exposure levels. Moreover, based on the results, it could be stated that different surgical conditions and operating room, as well as the duration of surgery, are the most effective factors on isoflurane vapor concentration in the operation room.

One of the important problems in the management of waste is the health and environmental hazards of the leachate leakage of urban waste landfills to groundwater. This research aimed to investigate the improvement of the landfill properties using recycled polymer. In this study, PET: Polyethylene Terephthalate and clay were mixed with the ratio of 0, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9 and 1 wt%. Moreover, Moreover, its effect on the quality parameters of clay, including consolidation, settlement, shear stress, adhesion, and infiltration were determined in soil mechanics laboratory located in the city of Gorgan. All experiments were conducted based on American Society for Testing and Materials. Results showed that the internal friction angle in clay and clay composed with polymer were 20.93 wt% and 30.3 wt%, respectively. Moreover, the compaction of clay decreased from 0.163 g/cm2 to 0.110 g/cm2. Permeability results showed that the use of PET decreased the permeability of soil from 1.82 E-3cm/min to 1.57 E-3cm/min. The use of recycled polymer can improve the soil conditions of landfills in terms of permeability and resistance to leaching, which could reduce the volume and the recycling process of waste. Moreover, this issue contribute to the quality and strength of the substrate to prevent environmental contamination as well as groundwater polution.

Introduction and Non-alcoholic beer is a product that is made of mixing malt or malt extract, water, hops, carbon dioxide, and permitted additives with or without sweetener. In this regard, the present study aimed to compare and evaluate major carbohydrates in classic and flavored non-alcoholic beers using high-performance liquid chromatography and refractive index detection. In this study, 45 non-alcoholic beer samples, including 15 simple classic, 15 lemon flavored, and 15 apple flavored samples were randomly collected and examined in a post-market surveillance program in Tehran in 2016. The mean scores of the concentration of fructose, glucose, sucrose, and maltose were reported as 216.43, 116.28, 0.0, and 104.47 mg/100 ml in the classic group and 266.46, 348.97, 0.0, and 116.02 mg/100 ml in the flavored group, respectively. The mean scores of the total concentration of carbohydrates in all of the five investigated brands were 145.5 and 243.84 mg/100 ml for the classic and flavored groups, respectively. This result showed a lower concentration of simple carbohydrates in classic non-alcoholic beers, compared to that of the flavored ones. The results of statistical analyses revealed that there was no significant difference between the mean scores of maltose concentration, as a major rbohydrate, in the classic and flavored malt products (P>0.05). There was a significant difference in the mean scores of glucose concentration between the two groups (P<0.05). Therefore, the control of simple carbohydrate profile in non-alcoholic beers regarding the nutritional value and health effects, as well as engineering, quality control, and adulteration can be crucial.