مجله سلامت و بهداشت
سال سیزدهم شماره 4 (پیاپی 56، زمستان 1401)

Background & objectives:

Considering the importance of sanitizing vegetables before consumption, this study aims to evaluate the effectiveness of different stages of the most common vegetable disinfection methods in Iran in reducing total coliform and fecal coliform for the most consumed edible vegetables.

Three stages of disinfection were done, including
Scraping and pre-wash of vegetables (first step),
Separation of parasites by 3-5 droplets of detergent per liter for 5 minutes (second step), and
Disinfection of vegetables with calcium hypochlorite solution (200 mg/l free chlorine) for 5 min (third step).
Finally, disinfected vegetables were washed out with water. MPN test was used to determine total and fecal coliform. The efficiency of each stage was determined using the difference between total and fecal coliforms before and after each and total disinfection stage. 

The fecal coliform amount did not reach zero even after all the disinfection steps in vegetables with more foliage and hidden holes (such as basil and onion). Besides, according to this study's results, radish, onion, and coriander leaves had the highest contamination, and lettuce had the lowest total and fecal coliform. The highest total coliform removal efficiency related to beets (93.3%) was obtained under calcium hypochlorite disinfection, and the highest fecal coliform removal efficiency related to leeks, parsley, and beets (100%) under calcium hypochlorite disinfection.

To achieve the highest efficiency in reducing microbial agents in vegetables, it is necessary to complete the different disinfection stages following its instructions. In this regard, the efforts of the media and health experts are essential.

Background & objectives:

Breast cancer is the second leading cause of cancer mortality for women, behind lung cancer in Iran. Given the high prevalence of breast cancer, it is crucial to determine the reproductive risk factors of breast cancer. 

 A total of 139 female patients with breast cancer (the case group) and 279 healthy females (the control group) that were age-matched participated in the study from March 2018 to March 2019. Demographic and reproductive variables, including the number of pregnancies, breastfeeding, history of oral contraceptive use, abortion, age at first menstruation, and age at first childbirth, were all collected using a questionnaire. Conditional Logistic regression was utilized to calculate OR (CI: 95%), and the classification tree model was used to classify the patients. 

 The mean age of breast cancer patients was 50.8 ± 8.3. Positive first-degree family history, intake of oral contraceptive use, and delaying first pregnancy increased the chance of breast cancer. In contrast, breastfeeding and menstruation after age 14 played a protective role in the development of breast cancer. 

 The findings of this study reveal that the age at first birth, use of oral contraceptives, first-degree family history, and lack of breastfeeding has a significant relationship with breast cancer. Thus, women who have experienced such factors are susceptible to breast cancer and must be prioritized for preventive treatments and screening.

Background & objectives:

 Organizational agility is a competitive advantage and an essential factor for hospital effectivenessThe aim of this study was to investigate the relationship between organizational agility and accreditation of Kermanshah University of Medical Sciences hospitals.

 This descriptive-analytical cross-sectional study was conducted in 2018. The statistical population was the employees of selected Kermanshah University of Medical Sciences hospitals. Willingness to participate in the research, employment in the hospitals of Kermanshah University of Medical Sciences, and having at least two years of work experience were considered as inclusion criteria, and the unwillingness of the participant to cooperate in each stage of the research as well as failure to complete the questionnaire as Exclusion criteria from the research were considered. The sample size was estimated based on statistical formulas of 382 people, and sampling was done by multi-stage random method. The tool for data collection was the organizational agility standard questionnaire. The validity of the questionnaire was confirmed by obtaining the opinions of professors and reviewers, and the reliability of the questionnaire was calculated using Cronbach's alpha method (0.88). Descriptive and inferential statistics (independent t-test and Pearson correlation coefficient) and SPSS16 software were used to analyze the data.

 Findings showed a significant relationship between the component of organizational agility and the degree of accreditation of one and two (p<0.001). Meanwhile, the highest average of organizational agility was related to Shahid Chamran Hospital, with an average of 150.80, and the lowest average was related to Mohammad Kermanshahi Hospital, with an average of 103.52. The component of agility stimuli was not significantly correlated with any of the two degrees of hospital accreditation.

 Considering the positive relationship of organizational agility with the degree of accreditation of hospitals, it is necessary for managers to pay more attention to strengthening the implementation of the accreditation process of centers in order to increase organizational agility and apply corrective measures regarding the content of the standards, the method of evaluation and the training of evaluators.

Background & objectives:  

Due to its competitive advantage and increasing prosperity, health tourism is more critical for countries than other forms of tourism. Identifying factors affecting the development of health tourism and its effects on society's well-being is the aim of the research.

The current research has a mixed and inductive approach. The statistical population of the research in the qualitative phase included university professors, health tourism managers, and specialists. In the quantitative stage, tourism companies, hoteliers, trustees, and employees of health and treatment centers were present. In the qualitative stage, 15 participants were selected using the snowball method, and in the quantitative stage, 306 participants were selected using the stratified sampling method. Data was collected using interviews and questionnaires. Data analysis was done in the qualitative stage with the help of Maxqda-10 software and then using the structural equation method, and in the quantitative stage with SPSS and SmartPLS software.

 In the interviews, the codes of health and treatment facilities, with 41 repetitions, and the codes of development of relations and tourism infrastructure, with 26 and 21 repetitions, respectively, were the most frequent. On the other hand, the codes of service specialization and safety compliance with two repetitions were the least frequent. With open coding, 100 codes were extracted and categorized into 20 main concepts, and the main concepts of the research were identified. In the quantitative phase, the results of Cronbach's alpha coefficient and the combined reliability of the variables, considering the limits of 0.6 and 0.7, with the SmartPLS method for these two criteria in all research structures are more than 0.8 and acceptable.

Conclusion:

The research results show that the development of health tourism is considered a tool for the development of society. It also leads to increased investment in the society's political, social, cultural, and economic sectors, creating employment, income, satisfaction, and vitality. Welfare development also improves their quality of life and well-being.

Background & objectives: 

According to the recommendation of the World Health Organization, health insurance is an effective tool to achieve the global goal of universal health care coverage. The present study was conducted to design and determine a valid and reliable questionnaire to measure universal health insurance coverage in Iran.

 This descriptive-applied study was conducted in 2022. Based on the data obtained from the review and comparative study, an initial questionnaire was prepared based on the balanced scorecard model. Content validity was measured using a panel of 15 experts and content validity ratio (CVR) and content validity index (CVI) for each question. The test-retest method was used in a sample of 30 people to determine the reliability. Data were analyzed using Excel and SPSS 20 software. 

 Validity assessment was done in two stages. The final questionnaire was approved with a total content validity index score of 0.85 and a content validity ratio of 0.67. The results of Spearman's correlation coefficients for the four dimensions of the questionnaire showed the acceptable reliability of the questionnaire components. 

 Considering that the designed questionnaire was approved in terms of validity and reliability, it can be a suitable tool for determining the requirements for achieving universal health insurance coverage in Iran.

Background & objectives:

 Improving and modifying lifestyle is necessary for health maintenance and promotion. Health-promoting lifestyle is one of the health criteria. Various factors are involved in the implementation of this lifestyle. This study aimed to evaluate the status of health-promoting lifestyles in nursing students of Ardabil School of Nursing and Midwifery.

This cross-sectional study was performed with the participation of 215 nursing students. The sampling method was census. Demographic information and the Walker health-promoting lifestyle questionnaire were used to collect data. Data were analyzed using descriptive statistics, independent t-test, and One-way analysis of variance using spss22 software.

The mean score for a health-promoting lifestyle was 107.88±7.37. There was a significant relationship between spiritual growth, health responsibility, stress management, nutrition, and physical activity with gender. The lowest mean and standard deviation among the dimensions of health-promoting lifestyle were related to the dimension of stress management 15.18±2.71, and the highest score was related to the dimension of health responsibility 20.97±3.89.

Health-promoting lifestyle status in nursing students of Ardabil School of Nursing and Midwifery was unfavorable. Therefore, there is a need for more careful planning to improve the health-promoting lifestyle of nursing students.

Background & objective: 

Good employment, continuing education, attitude towards the field, and satisfaction with the place of study are the indicators of the responsibility of universities. This study aimed to determine the employment status and examine its relationship with attitudes and satisfaction about the place of study of graduates from 1390-1395 of Ardabil School of Health in 1400.

 In this cross-sectional study, the census selected 340 graduates of the Faculty of Health. Data were collected by attitude and satisfaction questionnaires and analyzed in SPSS18 software.

 It was found that 20 to 32% of graduates still need to be recruited. Seventy-nine people (more than 23%) have continued their education. Fourteen people (4.1%) had dissatisfaction, 16 people (4.7%) had low satisfaction, 69 people (20.3%) had moderate satisfaction, 146 people (42.9%) had high satisfaction, and 95 people (27.9%) %) were very satisfied with the place of study. 58% had a positive attitude (good and very good) towards the place of study, and 20% had a negative attitude. Employees' attitudes and satisfaction were better than those of the unemployed, and there was a significant relationship between age, gender, marital status, and employment (p=0.001).

 The results showed that graduates' employment and continuing education status were not favorable, but the attitude and level of satisfaction with the place of study and field of study were good. Faculty and university administrators can help make rational decisions, primarily through skill-based training courses and increase student's ability to start businesses. In addition, the Ministry of Health can recruit students based on the needs of the provinces instead of recruiting students by volume.

Background & objectives:

One of the reasons for women's desire to choose cesarean section is a lack of sufficient knowledge and a negative attitude toward natural childbirth. This quasi-experimental study aimed to investigate the effect of childbirth preparation classes on the knowledge, attitude, and preference of the type of delivery of nulliparous mothers.

A total of 100 primiparous mothers without definite indication for cesarean section with a gestational age of more than 19 weeks from the comprehensive health centers of Kaboudar Ahang City were divided into two experimental and control groups by multi-stage sampling and then through allocation sequence. The intervention group participated in 12 hours of group counseling sessions (8 sessions of 90 minutes, 45 minutes of theory, and 45 minutes of practice). Education includes the benefits of natural childbirth, the risks of cesarean section, postpartum's health and care, warning signs and exercise, grief, breastfeeding education, pregnancy modification, stretching exercises, breathing exercises, relaxation, and the role of the wife during pregnancy. The control group received only routine care. Demographic and midwifery information, knowledge, attitude, and preference for the type of delivery before and after the study were completed and compared within the two groups.

There was no statistically significant difference between the two groups in terms of mean age, level of education, employment status, insurance coverage, and household income. The mean scores of knowledge, attitude, and frequency of choice of delivery method in both groups before the start of the study did not show a statistically significant difference. After the intervention, the mean scores of attitude and knowledge in the intervention group increased with a statistically significant difference (p=0.001). At the end of the study, 83% of the intervention group and 56.2% of the control group preferred to give birth by vaginal delivery (p=0.015).

 Childbirth preparation classes can help build positive awareness and attitude towards natural childbirth and help to prefer childbirth consciously.

Background & objectives:

 Corona pandemic has caused unfortunate human losses worldwide by challenging health and medical institutions and arrangements. This study aimed to examine the relationship between mental workload and job burnout of healthcare workers in health centers and collective corona vaccination centers in Ardabil city. 

 The present study was a descriptive-correlation type conducted in 1401. The statistical population of the research included all the health care workers of health centers and collective corona vaccination centers of Ardabil city, numbering 184. The sampling method was total count. The data were collected using Meslach's mental workload and job burnout questionnaires, the validity of which was confirmed by expert professors. Meanwhile, the reliability of the mental workload and job burnout questionnaires through Cronbach's alpha were estimated at 0.90 and 85.0, respectively. Pearson correlation test and one-sample t-test were utilized using SPSS-18 software.

 There is a positive and significant relationship between the components of mental workload and job burnout of healthcare workers (r=0.82 and p≤0.001). Also, there is a positive and significant relationship between their age and job burnout (p≤0.001, r=0.77). On the other hand, there is an inverse and significant relationship between age and the mental workload of healthcare workers (p≤0.001, r= -0.29). Mental workload (67.35) and job burnout (3.27) of healthcare workers were higher than average.

 The corona pandemic has increased the amount of mental workload and job burnout among healthcare workers. Therefore, it is necessary to perform psychological interventions and support measures to maintain employees' health during and after the epidemic.

Background & objectives:

 Oral health is an indicator of the whole body that affects individuals' mental and functional aspects. Deterioration of oral health is one of the most critical challenges facing health policies, and improving social factors is one of the ways to overcome this problem. This study aimed to investigate the socioeconomic factors affecting DMFT in adults in Shahdiyeh in a cohort study in 1395.

 This study was based on the cohort protocol of Shahedieh Yazd and was performed on adults aged 35-70 years. Socioeconomic variables were extracted from the relevant questionnaire, and their relationship with the DMFT index was examined.

 The mean age is 48.48. The average DMFT is 19.77, and the marital status is not related to the DMFT index, but there is a significant relationship with the number of decayed teeth. The lowest DMFT index is in the group with a Ph.D. level. Brushing has a meaningful and direct association with the DMFT index. The highest average number of restored teeth was found in the group with high salt intake, and the DMFT index has a significant relationship with the frequency of dental floss.

 Dental caries is a multifactorial illness with many factors affecting it. However, the role of education and socioeconomic status as factors influencing oral and dental health as the main factor in reducing this disease is fundamental and directly increases the level of awareness, attitude, and practice of individuals and subsequently improves the situation of oral hygiene.

Background & objectives: 

Lighting is one of the most critical environmental factors affecting visual comfort, sleep quality, occupational accidents, and musculoskeletal disorders. This study aimed to design and develop a tool for the subjective assessment of lighting in hospital workplaces.

 This study was conducted on 180 hospital personnel in Iran. First, the existing questionnaires were reviewed, and questions were collected as a questionnaire. This questionnaire consisted of 7 main sections and a section entitled "Suggestions for improving lighting". The validity of the questionnaire was determined based on expert comments and the CVI index. Its reliability was assessed by completing the questionnaire for hospital staff. According to the North American Society of Lighting Engineers (IESNA) standard, illumination was evaluated and compared with the questionnaire results.

 The Cronbach's alpha coefficient and CVI value of the questionnaire were estimated to be 0.901 and 0.97, respectively. The minimum and maximum local illuminances were 55.67 and 980.80 lux, respectively. There was a significant positive relationship between the mean score of the questionnaire and the illuminances in the workstations (r =0.716, P<0.001). 72.8% of the workstations had good lighting, and the results of the questionnaire evaluation in these stations showed good and excellent lighting conditions.

 The designed subjective lighting assessment questionnaire had good validity and reliability. This tool is recommended to assess and improve the lighting of the hospital working environment due to its simplicity, the inclusion of different aspects of lighting comfort, and solutions to improve the lighting system.