مجله تحقیقات نظام سلامت
سال هجدهم شماره 2 (تابستان 1401)

Estrogens are one of the micropollutants in the wastewater which have detrimental effects on water living organisms. There are many reports documenting the adverse effects of estrogen hormones, such as feminization of fish, in the environment. One of the major sources of these compounds is municipal wastewater effluents. The biological processes at municipal wastewater treatment plants cannot completely remove these compounds. Therefore, a method for the treatment of hormones is needed. The ultrasonic method is an effective process for elimination of micropollutants. This study aimed to model and optimize the removal of two hormones [estrone (E1) and 17 beta-estradiol (E2)] from the wastewater by ultrasound method using artificial neural network (ANN) with genetic algorithm (GA) approach.

A literature review was performed from years 2000 to 2021 and the results of related studies were applied for modeling. A two-layer Feed-Forward Back-Propagation Neural Network (FFBPNN) model was designed. Various training algorithms were evaluated and the Levenberg Marquardt (LM) algorithm was selected as the best one.

Existence of 12 neurons in the hidden layer led to the highest correlation coefficient (r) and the lowest mean squared error (MSE (and mean absolute error (MAE). The results of the GA determined the optimum performance conditions. Therefore, increasing in pH and power density increased the efficiency of removing hormones from the wastewater.

Finally, a sensitivity analysis was performed using ANN-GA and Spearman correlation, and the results were completely compatible.

Women in every society play a central role in the family and at the same time, are highly exposed to the pressures of dysfunctional relationships of economic, social, and cultural institutions outside the family, and if they are constantly exposed to traumatic and critical conditions, they may inflict irreparable damage on themselves in an unwanted helplessness, and by unacceptable behaviors such as violent suicides including self-immolation, endanger their survival as well as that of their family. Accordingly, this study was conducted to identify the social contexts of self-immolation among women admitted to Isfahan Burns Hospital, Isfahan, Iran.

This study was a qualitative content analysis which was conducted on 43 women hospitalized in Imam Musa Kazim Hospital in Isfahan due to self-immolation. Participants were purposefully selected and individually interviewed in a semi-structured interview. Data were categorized and analyzed by qualitative content analysis or thematic analysis.

Totally, the study identified 157 primary codes which were reduced to 16 secondary codes and 5 main concepts including conflict in family, addiction, marriage, poverty and economic difficulties as well as individual and psychological problems were obtained.

The problems of women who attempt self-immolation are related to harassment and dissatisfaction with at least one of their close relatives or difficult and stressful living conditions. The results of this study can be used for national planning by the relevant agencies to respect the rights and security of women in the family and society.

In recent years, psychologists have sought to evaluate the efficiency of the psychological interventions in the field of hypertension (HTN). In this regard, meta-analysis can determine the effect size of different methods by integrating the results of different studies. The aim of this study was to evaluate the effectiveness of different psychological interventions on lowering blood pressure using a meta-analysis research model.

In this study, meta-analysis as a statistical technique was used to collect, combine, and summarize research findings related to interventions effective in lowering blood pressure. The statistical population of the present study was the articles conducted in Iran on the effectiveness of psychological interventions in lowering blood pressure. 10 studies that were methodologically acceptable were selected and analyzed. The research tool was a meta-analysis checklist.

The combined effect size of psychological interventions on systolic blood pressure (SBP) was 1.43 (Z = 11.12, P < 0.001) and on diastolic blood pressure (DBP) was 1.40 (Z = 9.45, P < 0.001), which was significant and the effect size was large.

The metacognitive therapies have a high effect on reducing SBP and DBP. Overall, the evidence for the psychological treatment of HTN is promising.

Food insecurity has attracted the attention of people, experts, and policymakers as a major public health problem over the past two decades. The aim of this study was to determine the prevalence of food insecurity among children aged 6 to 59 months and its relationship with some socioeconomic factors of households living in Mehdiabad neighborhood of Shiraz, Iran, in 2018.

This descriptive-analytical cross-sectional study was performed on 353 households living in Mehdiabad neighborhood of Shiraz. Demographic, social, and economic data of households were collected through a general information questionnaire and food security status was assessed by the 18-item United States Department of Agriculture (USDA) Household Food Security Questionnaire. One-way analysis of variance (ANOVA) was used to analyze the data.

The prevalence of food insecurity in the studied households was 74.5%, so that food insecurity without hunger and with hunger was reported 25.8% and 48.7%, respectively. Food insecurity was significantly associated with thinness, overweight, underweight, and obesity (P < 0.001) and showed a significant relationship with short stature (P = 0.040). Based on the results, a significant relationship was observed between food insecurity and head of household’s level of education, occupational class, and housing status (P < 0.001).

The study population had food insecurity and showed a significant positive relationship with some factors such as head of household’s job and house ownership. The number of thin, overweight, and obese children was higher in the food insecure group. Therefore, the prevalence of food insecurity can be reduced by considering facilities for households living in this area.

The aim of this study was to investigate the psychological well-being of nurses based on the variables of spiritual health, resilience, and emotional atmosphere of the family during the corona pandemic and its effect on nurses' emotional distress tolerance.

The present study was a correlational study. The statistical population of the study includes all nurses of public hospitals in Shiraz, Iran. Due to the corona pandemic conditions, 200 members of the community were randomly selected as the research sample. Data were collected using standard questionnaires of psychological well-being, spiritual health, resilience, family emotional atmosphere, and emotional distress tolerance and were analyzed by structural equation modeling (SEM) using SPSS and Amos software.

The proposed model had a good fit. Based on the results of structural equations, spiritual health (P = 0.170 and P = 0.012), resilience (P = 0.180 and P = 0.008), and family emotional atmosphere (P = 0.360 and P < 0.001) directly affected the nurses' psychological well-being. Moreover, the indirect effects of spiritual health (P = 0.083 and P = 0.012), resilience (P = 0.088 and P = 0.005), and family emotional atmosphere (P = 0.170 and P < 0.001) on the nurses' emotional distress tolerance through psychological well-being was confirmed. Only the direct effect of resilience on emotional distress tolerance (P = 0.030 and P = 0.570) was not confirmed in the model.

The spiritual health, resilience, and emotional atmosphere of the family lead to improvement of psychological well-being and also increase the nurses' emotional distress tolerance.

The coronavirus disease 2019 (COVID-19) pandemic has led to profound changes at various levels of society, and sports is not immune to this. It is very important to study and identify the consequences of COVID-19 in different parts of the sports in Iran. The aim of the present study was to identify the consequences of the COVID-19 pandemic on Iranian student sports with emphasis on beneficiaries.

This qualitative study was an exploratory research and in terms of purpose was considered as applied research. The statistical population of the study included sports teachers, professors of Farhangian University, managers of the General Office of Physical Education and sports experts of the Ministry of Education which were selected through purposive sampling method. In-depth and semi-structured interviews were conducted with participants to collect information and theoretical saturation was obtained with 17 interviews. To analyze the data, the thematic analysis method was used.

The consequences of COVID-19 pandemic on physical education and sports education consist of four main concepts which include “creating a passive lifestyle, behavioral and social harms, technological-digital development, and family sports”.

Considering the results and effects of the COVID-19 pandemic, it is necessary to develop appropriate programs to use the opportunities and manage the challenges of the post-COVID-19 era in the field of physical education and sports education for students in Iran.

Health of mothers and neonates is one of the important indicators of health promotion which determines the health status of the community and future generations. One of the interventional strategies to prevent pregnancy complications is improving the preconception care program and educate the community regarding the goals of the maternal health program. Peer group education is one of the active learning methods. The purpose of this study was to investigate the effect of a training program with a peer-to-peer approach on awareness, attitude, and the population covered by preconception care in Rural Comprehensive Health Centers in Mobarakeh City, Iran.

In this experimental study, 140 married women with inclusion criteria under the coverage of two health houses of Rural Comprehensive Health Centers of Isfahan University of Medical Sciences, Isfahan, Iran, were randomly divided into experimental and control groups. Fourteen women from the test village who met the inclusion criteria in the peer group but did not belong to the test group were selected and trained. First, the experimental group completed the first stage questionnaires. Then, each woman in the peer group trained 5 members of the experimental group. Two months later, the second stage questionnaires were completed. Data analysis was performed with SPSS software using independent t-test, paired t-test, Mann-Whitney test, and Wilcoxon test.

The mean scores of awareness, attitude, and coverage were not significantly different between the two groups before the intervention (P > 0.05), but in the experimental group, they were significantly higher after the intervention (P < 0.05). In the control group, there was no significant difference between the mean scores of pre- and post-intervention (P > 0.05). There was no significant difference between preconception care coverage before the intervention between two groups (P > 0.05). The coverage of preconception care in the experimental group was significantly higher after the intervention (P < 0.05). There was no significant difference between preconception care coverage before and after intervention in the control group (P > 0.05).

Peer education has a positive effect on awareness, attitude, and referrals of the target group.

In the present study, an environmentally friendly microextraction of nickel based on solid-phase method coupled to flame atomic absorption spectrophotometry was investigated. Due to elimination of organic solvents in this method, it can be used as a green technique to extract and reduce the detection limit of nickel in water samples.

By adding 0.06 g sodium borohydride (NaBH4) to 100 ml of the solution containing Fe (II) ions with concentration of 12 mg/l and nickel, these ions were converted to zero-valent particles. The nickel revived particles were trapped in the iron microparticles and deposited with them. After that, the solid phase produced was dissolved in 200 µl  of hydrochloric acid (HCl) 6N and the nickel concentration was measured using atomic absorption method. To optimize the process, effect (1 to 8), the amount of potassium hydrogen phthalate (KHP) (0.02-0.30), Fe (II) concentration (2.20-5.00 mg/l), NaBH4 (0.20-0.01 g), time (0.5-15.00 minutes), and temperature (20° -80°  C) were investigated. In addition, the effect of interfering ions was evaluated. Finally, the figures of merit were calculated, and the function of the method was investigated in the real water samples.

According to the performed optimization, pH = 4.5, NaBH4 = 0.06 g, Fe (II) = 2.5 mg/l, KHP = 0.08 g, time= 4 minutes, temperature = 50° C , and sample size = 100 ml were the optimum conditions. Besides, the concentration factor of 410, the detection limit of 0.3 ng/ml, and relative standard deviation (RSD) of 2.7% were obtained.

Due to the low detection limit and the elimination of organic solvents in nickel microextraction, this method can be a suitable method for determining trace amount of nickel with high efficiency. The low detection limit is due to the high concentration factor, which is significantly higher than the other microextraction methods.

Communication is a special skill to acquire high human values. Lack of this skill creates a serious crisis in the family foundation and doubles the necessity of special behavioral-psychological interventions. The aim of this study was to determine the effectiveness of communication skills training on marital satisfaction of female students of Isfahan University of Medical Sciences, Isfahan, Iran.

The research method was quasi-experimental with pre-test, post-test, and follow-up period with a control group. The statistical population included all female students of School of Medicine, Isfahan University of Medical Sciences, from which 30 people were selected by convenience sampling method and were randomly divided into experimental and control groups. The experimental group underwent communication skills training for ten sessions twice a week and the control group did not receive any intervention. The data were obtained using the Enrich Marital Satisfaction Scale (EMS) (1989). Finally, repeated measures analysis of variance (ANOVA) and SPSS software were used to analyze the data.

In the experimental group, the mean and standard deviation (SD) of marital satisfaction increased from 126.20 ± 8.76 before the intervention to 155.60 ± 9.47 after the intervention and to 162.60 ± 9.26 in the follow-up stage. Moreover, in the control group, the mean and SD of female marital satisfaction decreased from 126.26 ± 10.64 before the intervention to 124.46 ± 10.89 after the intervention and to 121.40 ± 8.74 during the follow-up period (P < 0.01). The difference in the experimental group in all three stages was statistically significant, except for the post-test and follow-up stages, which was not statistically significant (P > 0.01)

Communication skills training with respect to relative values in the face of couples' absolute perceptions reduces the amount of impulsive behaviors and increases the couple's intellectual problem-solving skills, and with this process, the couple's marital satisfaction increases and this effect will remain over time. As a result, this training strategy is recommended for all family specialists and counselors.

Despite the advancement of control mechanisms and automation in industrial processes, there is still the chance of human error and accidents. As a result, this study was conducted in the control room of a cement company to identify human errors and propose control methods to reduce them using the Systematic Human Error Reduction and Prediction Approach (SHERPA).

The data for this cross-sectional descriptive study were gathered through task observation, reviewing technical documentation, and interviews. For the selected tasks, a hierarchical task analysis (HTA) was done, and the human errors of each critical task were assessed using SHERPA. Finally, control methods for reducing the risk of identified errors were proposed.

In this study, 9 main tasks and 103 sub-tasks were assigned for the control room operators. The results of the SHERPA showed that out of 204 identified human errors, 45.1% were functional, 35.3% retrieval, 11.3% communication, 44% checking, and 9.3% were selection errors. C2 (55 cases), C3 (32 cases), and 2D (30 cases) had the highest risk levels, whereas 1E (1 case), 1B (2 cases), and 4C (3 cases) had the lowest.

The most common errors were those relating to performance and retrieval. Operator training, monitoring systems, smart control system utilization, effective instructions, and suitable control measures can help to significantly reduce the number of human errors that result in accidents.