مجله سلامت و بهداشت
سال دوازدهم شماره 1 (پیاپی 49، بهار 1400)

Pharmaceutical wastewater contains high concentrations of organic matter, high salt and difficult biodegradability, so it must be treated before discharge to the environment. In this study, it is aimed to evaluate the treatment of pharmaceutical wastewater (methadone feedstock and neutralized capecitabine) using chemical and biological methods.

The laboratory evaluation of this study was performed in two parts: The first part included the study of wastewater treatment of methadone production using chemical coagulation and flocculation method with FeCl3, PAC and Alum as coagulants (at concentrations of 100 mg/L, 500 mg/L, and 1000 mg/L), and cationic flocculant (at concentration of 1 mg/L), and at two pH values of 7.5 and 14 in the Jars test apparatus. The second part included of the treatment capability of wastewater produced during neutralization section of capecitabine drug according to the following steps: a) the chemical pretreatment using PAC and Alum coagulants (at concentration of 4000 mg/L) and anionic, cationic and neutral flocculants (at concentration of 20 mg/L), followed by the anaerobic biological treatment for 67 hr, and b) the anaerobic biological treatment for 41 hr followed by the chemical treatment using PAC and Alum coagulants and anionic and cationic flocculants. In this study changes in chemical oxygen demand (COD), pH, turbidity and total dissolved solids (TDS) of wastewater were investigated.

At pH=7.5, the best treatment efficiency of methadone feedstock production wastewater was observed at 100 mg FeCl3/L (COD removal of 35.8±0.8%, turbidity removal of 99.4±0.1%, and TDS removal of 7%) and at pH=14, the best performance was obtained using 1000 mg FeCl3/L (COD removal of 42.5±0.0%, turbidity removal of 97.6±0.1%, and TDS removal of 51.6%). The highest combined chemical and biological treatment efficiencies were obtained for wastewater including neutralized capecitabine by Alum coagulant and cationic flocculant (COD removal of 61.3%). While, the highest combined biological and chemical treatment efficiency for this wastewater was obtained by Alum coagulant and anionic flocculant (COD removal of 39.0%).

Due to the characteristics of the pharmaceutical industry wastewater, the use of chemical methods, in addition to having good removal efficiency as the main stages of treatment, can also be used as pre-treatment for biological processes.

Hand Hygiene by health care providers is a key factor in patientschr('39') health. The aim of this study was to determine knowledge, attitude and practice (KAP) of nurses working in Valiasr Hospital in Meshginshahr regarding hand hygiene in 2018.

In this cross-sectional study, 100 nurses working in all wards of Valiasr hospital in Meshginshahr in 2018 were selected by census method. Nurseschr('39') knowledge, attitude and practice questionnaire about hand hygiene was used for data collection. Data were analyzed by SPSS software version 16 and Kruskal-Wallis, Mann-Whitney and Pearson correlation tests. In all cases of statistical analysis, p-value less than 0.05 were considered significant.

The mean age of the nurses was 32.9 years. The mean score of knowledge, attitude and practice of nurses regarding hand hygiene were 9.5±1.5, 3.6±0.36, and 4.5±0.41, respectively. This study showed that the most unfavorable score of knowledge (29%) was related to the phrase "hand hygiene is not necessary after office works". The most unfavorable attitude score (30%) related to "I think the lack of an acceptable soap product can be one of the reasons not wash your hand" and the most unfavorable performance score (57%) was related to "Washing hands after touching healthy skin".

According to the present study, nurses have a good knowledge, attitude and practice about hand hygiene. But there is still a gap with ideal situation, which due to the undeniable importance of hand hygiene in improving the quality of patient care; interventions should be made in this regard.

Marital satisfaction is a very important aspect in the relationship between couples and plays an important role in family health, so it is very important to study the factors affecting it. The present study aimed to predict marital satisfaction based on attachment styles with the mediating role of triangulation in couples of the University of Medical Sciences.

The research method was descriptive and correlational in the form of path analysis. To conduct this research, 254 married individuals of Tehran University of Medical Sciences were selected by convenience sampling method. The research instrument was Enrich Marital Satisfaction Questionnaire, Adult Attachment Style Scale and Triangulation Questionnaire. The collected data were analyzed through AMOS software.

The results showed that anxiety and avoidance attachment styles reduce and safe attachment style increases marital satisfaction in couples. Alsp anxious and avoidance attachment styles increase triangulation in couples. Triangulation also has a negative and significant relationship with marital satisfaction. The results of indirect communication showed that the role of mediator of close triangulation in the relationship between avoidance and anxiety attachment styles with marital satisfaction is significant. None of the triangulation variables of children and relatives had a mediating role in the relationship between secure attachment style and marital satisfaction.

Marital satisfaction can be predicted through their attachment styles, and triangulation with others can also affect this relationship. Necessary interventions in this field can greatly increase peoplechr('39')s marital satisfaction.

Contamination of water resources is one of the most important health and environmental concerns related to textile wastewater. In the present study, sodium alginate natural polymer was implemented as adsorbent for the adsorption of an organic dye (Basic Red 46) in aquatic phase. As a novel approach, adsorption process was enhanced using ultrasonic irradiation.

In this study, at first, sodium alginate polymeric adsorbent was synthesized. Then, the enhanced adsorption process of the dye was performed in a discontinuous flow experimental reactor located inside an ultrasonic bath. The effects of parameters such as initial pH, reaction time, dye concentration and adsorption content on the enhanced adsorption of the target pollutant were investigated. Residual concentration of the dye in the solution was measured using a UV-visible spectrophotometer at 530 nm.

The results showed that adsorption alone was responsible for the decolorization efficiency of 20.8%, while ultrasound-assisted adsorption of organic dye resulted in the enhanced removal efficiency of 63.2%. Increasing initial concentration of the dye from 3 to 10 mg/L led to decreasing the removal efficiency from 83.1 to 42.9%, respectively. With increasing adsorbent dosage from 0.3 to 0.7 g/L, the removal efficiency increased from 41.9 to 67.3%, respectively. Increasing the amount of adsorbent to 1.0 g/L resulted in the remarkable reduction in the removal of organic dye. The adsorption data obeyed the Langmuir model with the maximum adsorption capacity of 9.2 mg/g.

It can be indicated that the ultrasound can be applied as an efficient physical agent for the enhanced adsorption of organic dyes onto natural polymeric compounds like calcium alginate.

LAS is a major component of household and industrial detergents, which has caused many problems in the biological and non-biological sectors during the last decade due to the discharge of raw urban sewage into aquatic ecosystems. Considering the importance of this issue, the present study examines the concentration, distribution and evaluation of the ecological risk of this pollutant in the Anzali International Wetland.

50 stations from Anzali wetland water were selected for sampling. After measuring some water qualitative factors such as temperature, acidity, electrical conductivity and dissolved oxygen at the sampling site, samples were transferred to the laboratory and analysis and extraction of samples was performed using Methylene Blue method. Statistical analysis was performed using SPSS-22 software, pollution concentration zoning map using the conventional kriging method in ArcGIS 10.3 software and LAS risk estimation calculations using RQ formula in Excel software.

Based on research findings, LAS concentration was in the range of 0.01-3.93 mg/L. The highest concentration of LAS was observed in stations of central and eastern part of the wetland and the lowest concentrations in western and Siyah Kashim stations. The results of calculating the risk assessment (RQ) and the zoning of this pollutant showed a higher risk in many areas of the wetlands.

Considering the high concentrations of LAS in most areas of Anzali Wetland, it is necessary to pay more attention to management of urban wastewaters discharge and treatment of municipal wastewater of Anzali port and its adjacent areas and to control the entry of raw wastes into the wetland.

The increase in the metropolitan population and, consequently, the increase in traffic, the urgent need to reduce pollution and traffic, and so on, have led to the expansion of the metro lines. In this regard, it is important to survey the physical and mental health of workers in these fields, because of its impact on their behavior, performance and productivity.

The present study was a cross-sectional descriptive-analytical study with the 176 shift workers in a tunneling workshop with a mean age of 28.7±4.8. A general health questionnaire (GHQ-28) was used to assess the general health status of these workers and demographic and occupational information were added to collect the required data. The total cut-off point was 22 and a score of 6 was considered for each scale. As a result, score above 6 on each scale and a total score above 22 on all four scales indicate the presence of disease symptoms in individuals. The results were tested by three statistical tests of independent t-test, one-way ANOVA and correlation test, using SPSS-21 software.

The results showed that according to the cut-off point, the prevalence of physical symptoms was 37%, anxiety and insomnia 24%, social dysfunction 57% and severe depression 11% and in total, 51% of workers had mental disorders. The factors of marriage/Single (p<0.03), Native/non-native (p<0.02), distance to home (p<0.001), level of education (p<0.03), work experience (p<0.05), Job scheduling (p<0.001), and job satisfaction (p<0.001), all had a significant effect on general health.

The results of this study showed that improving the working conditions of workers in tunnel construction operations such as providing job security, improving job satisfaction, modifying the work schedule especially eliminating permanent overnight work, continuing education and marriage is necessary.

Menopause is associated with many annoying symptoms of estrogen deficiency. These symptoms affect womenchr('39')s health and quality of life during this period. The aim of this study was to investigate the relationship between regular exercise and menopausal symptoms in postmenopausal women in Tuyserkan in 2018.

The present study is a descriptive study recruiting 90 postmenopausal women with health records in two health centers in Tuyserkan. The reserarch instruments used were Greene Climacteric Symptoms Scale, and a 19-item demographic information questionnaire. The collected data were analyzed using SPSS and the Kolmogorov-Smirnov and Analysis of variance.

The overall score of severity of menopausal symptoms was 28.02±11.43 which showed a significant difference in term of exercise (p<0.001). In other words, women with regular and irregular exercise had fewer symptoms than those without exercise.

Regarding the results of this study, it seems that exercise is effective in improving menopausal symptoms in postmenopausal women and it is recommended to use it along with other methods in the prevent and treatment of such symptoms.

Air pollution is one of the most important environmental problems that have become a serious threat to human health in recent years with the development of societies and industrialization. Ammonia is one of the most important pollutants. The spray tower is a wet scrubber used for ammonia purification, so the present study was conducted to investigate the change of physical parameters using a 2500µm nozzle and acidic water solution on ammonia removal in a spray tower under standard conditions.

In the present study, the amount of ammonia gas removal was investigated by changing parameters such as air pressure, pollutant density and number of nozzles, using a washing tower at two inlet and outlet locations and a total of 162 test times with three replicates. Data were analyzed by One-Way ANOVA in SPSS-21 software.

The results showed that increasing the number of nozzles and the spray pressure of the spray tower significantly increased (p<0.05) and increasing the inlet load significantly decreased the efficiency (p<0.05) of ammonia gas removal efficiency.

By increasing the number of nozzles, the pressure of the dilute sulfuric acid solution and reducing the density of the pollutant gas, good efficiency can be achieved in removing ammonia gas from the air stream using spray tower.

Fiscal policies can play an important role in the behavior and health of consumers. This study aimed to analyze the trend of bread consumption in Iran and changes in the amount of subsidy paid to it.

In order to achieve the objectives of this study, the amount of bread consumed in Iranian households was extracted from the balance sheet of food products of the Islamic Republic of Iran during 2002-2011 and the amount of subsidy paid to it was obtained from the documents and statistics available at the ministry of economic affairs and finance and consumer and producer protection organization. Data analysis was conducted with SPSS, version 16, using descriptive statistics, Pearson correlation test and linear regression with 95% confidence interval.

Linear regression results showed statistically significant difference between subsidies for bread, bread consumption (p=0.019 and r=0.720) and energy level produced in the body (p=0.003 and r=0.824). For each one miliard Rials increase in subsidies paid for bread, 63.712 tons of bread consumption and 0.014 kilo-calories of daily energy consumption were decreased.

In order to hold bread price constant, huge money is spent as subsidies for this product every year. Not paying attention to flour quality and low quality of bread produced in bakeries has caused a part of subsidies to be spent for bread waste and per capita consumption of bread has decreased as a result.

Considering the role of medical universities leaders, because of diversity of administrative, educational and medical affairs and communicating with different staff, faculty members, students and clients, in order to better performance of tasks is the key to achieving leadership competency. The aim of this study was to develop a model of educational leadership competency in clinical departments of medical universities.

To achieve this goal, a qualitative research method was used. The study population consisted of 15 deputies and managers of clinical groups (in the northwestern cities of the country). Semi-structured interviews were used to collect the required data. The text of the interview with the experts and the categories extracted from the analysis of interviews were analyzed separately by qualitative content analysis method.

The results obtained by eliminating duplicates and merging similar cases finally indicated the identification of 37 competencies in five categories of leadership competencies in clinical education, self-assessment and evaluation of educational performance, development of student clinical skills, individual competence and human resources. This included 12 clinical leadership, 5 assessments and 7 student skills enhancement, 10 individual and 2 human resource competencies.

The results of this study showed that the managers of the educational departments have different skills, which seems to be necessary, with special measures of the ministry of health regarding the challenges of the educational managers and leaders, as well as passing a short course of clinical management methods.

Considering the effects of pollutants of industrial origin, such as heavy toxic metals-containing wastewater, on rivers and surface waters and the importance of their removal, in this study, the preparation, characterization and evaluation of zinc oxide nanophotocatalyst based on magnetic organic-metallic frameworks (ZnO@IL-mSiO2@Cr-MIL-101), abbreviated as ZISM nanophotocatalysts, was evaluated in removing of lead (Pb2+) and arsenic (As3+) metals from aqueous samples.

This experimental study was performed using a ZnO-based nano-photocatalyst and a reactor consisting of an ultraviolet (UV) source and a reaction chamber for water samples contaminated with lead (Pb2+) and arsenic (As3+). To determine the removal efficiency of contaminants by ZISM nano-photocatalyst, the effect of various parameters including contaminant concentration, amount of nano-photocatalyst, pH and reaction time were investigated.

The results showed that with increasing the amount of ZISM nano-photocatalyst and pH, the removal of lead and arsenic increased. The maximum removal of Pb2+ and As3+ was obtained 99.8 and 98.3, in initial concentration of 5 mg/L, nano-photocatalyst dose of 250 mg/L, pH =8 mg/L and reaction time of 60 min.

According to the results, the ZISM nano-photocatalyst emerged as an efficient and recyclable nano-photocatalyst, which was a potential and environmentally friendly process for the removal of toxic heavy metals as hazardous water pollutants. This photocatalyst showed good recyclability in 5 consecutive periods.