مجله دانشکده بهداشت و انستیتو تحقیقات بهداشتی
سال سوم شماره 1 (پیاپی 9، بهار 1384)

The traditional methods is used to inspect based on the end-products in manufactures, yet. The Global movement is more commonly reffered to use HACCP system which its main characteristics is preventing contorl of hazards at all stages of food productions. The main goals of implementation of this project was based on three following points: 1- Preparation of a guidelines for application of HACCP system. 2- Familizariation of quality control officers and manufacturers with HACCP concepts,its principle,and establishment of HACCP in different food industries. 3- Establishment of HACCP in a selected Dairy plant as a pilot. To implement of this project, central and administrative groups were formed and 15 workshops were organized for introducing of system during 39 days. Then concerning to prerequistics and G.M.P, HACCP system established in selected plant successfully. This plant has been able to get the HACCP certification from a certification body. The result of this project indicated that establishment of HACCP system is possible in food industries.Preparation and implementation of HACCP has an effective movement in improvement of food safety quality management, food hygien, upgrades of food safety and consumer protection. In addition to above subjects, developing of this system throughout the country, could make a good oppourtunity for ability of competition in export fields and international trade such as join to WTO (World Trade Organization).

The purpose of this study was the creation and measurement of consensus regarding formation of a new Department of Health in Tehran University of Medical Sciences (TUMS). Using a three-iteration Delphi procedure, consensus was built and measured among experts on different aspects of a possible merger between the current Medical Care and Health Care Departments and the formation of a new Department of Health in TUMS. Forty-two experts from the Ministry of Health, TUMS, other medical universities in Tehran, the Management and Planning Organization and other research bodies were included in this study. Feedback from the aggregate responses of the panel was used to construct questionnaires employed in subsequent iterations of the Delphi. We used a Likert scale for assessment of opinions; consensus was defined as agreement or disagreement of at least two thirds of respondents on a particular subject. Consensus was attained in 27 out of the 36 items presented in the third round of the study. Consensus on the necessity and feasibility of the formation of the new department in TUMS was achieved after three rounds of the Delphi process. The panel converged to form a consensus on the need for a merger from different perspectives, including the overlapping responsibilities of the two departments, promoting a community-oriented approach, improving the quality of services and bringing the reforms in line with the policies of the Ministry of Health. The experts who participated in this study achieved consensus on the necessity and feasibility of formation of a new Department of Health in TUMS.

Obesity is a major health and nutrition problem all over the world. This was a cross-sectional study and the sampling method was of the component type (cluster and simple sampling). 2854 women who had children under 5 years of age participated in this study. The data were recorded by 20 trained interviewers using a questionnaire. Subjects were weighed on scales and had their height, waist circumference, and hip circumference measured by a meter. Pregnant women were not included in this study. Economic status was categorized based on possession of 10 consumer items considered necessary for modern-day life (Low >=3, Moderate = 4-6 and Good = 7-10). Three ethnic groups were compared in this study: Fars (native), Turkmen, and Sistani. The mean age was 28.2 y. Body Mass Index (BMI) in ranges of (25-29.9), (30-39.9) and (≥40) was observed in 28.3%, 15.9% and 0.5% of the subjects respectively. The frequency of BMI over 25 among Fars, Turkmen and Sistani mothers was 64.3%, 43.4%, and 32.9% respectively. The difference between the three groups was statistically significant (P<0.02). In 39.1% of these women, the Waist to Hip ratio (WHR) exceeded 0.8 and the index was higher in Turkmen women compared with other groups. The frequency in women with low, moderate and good economic status was 34.7%, 50.8% and 55.9% respectively, but these differences were not statistically significant. The prevalence of obesity in literate women is significantly higher than in illiterate women (p<0.04). On the whole, this study indicates that obesity is a common health problem among women in the rural areas of Gorgan. There is a relationship between the prevalence of obesity and higher economic status. Therefore, educating women on optimal nutrition and changing their food habits would be very important.

The purpose of this study was to determine toxoplasmosis seropositivity rates and to record ascending serologic titers in high-school girls. We also searched for possible risk factors. This descriptive-analytic study used 414 serum specimens collected from high school girls in six different regions of Esfahan city through cluster random sampling. The sera were taken from the tip of the finger by hematocrite microtubes. Samples were studied by the Indirect Immunofluorescent Assay Test(IFAT) for estimation of serum titers. Data were analyzed using chi-square (X²) and t tests. The overall seropositivity rate was 18.4% in 14-19 year-old girls and this rate increased with age. IFAT titers in 98% of the positive samples were at 1:100; the remaining 2% showed values above this threshold. For the latter group, we performed another titration test to determine exact titers. The supposed risk factors were age, place of residence, education level (parents and student), consumption of undercooked meat and raw liver, occupation and parent income, and exposure to contaminated material from cats and fowls. The highest positivity rates (27.5%) were recorded in District 1, while the lowest rates (14.5%) were seen in District 5. Significant relationships were found between seropositivity and exposure to cats and fowls.(P>0/05). No significant relationship was observed with the other factors. There was a low level of knowledge about toxoplasmosis and the relevant risk factors: only 2.4% of the subjects were relatively well-informed on this subject. There were not any acute cases. Toxoplasma infection is very important because of its socioeconomic implications, so control measures seem crucial. All seronegative women should be know about this infection and its transmission routes. Education is the most important element in prevention and must be promoted via the mass media, other education systems and the health managers. The studied group in this survey were girls at the usual age of marriage or younger, and it is recommended that health system managers continue to offer education on practices that help prevent infectious diseases in general and toxoplasmosis in particular.

Evaluation assures the success of each project, program or activity. It is one of the most important components of any management process. Because of its high importance, loss of an effective evaluation mechanism in a hospital not only increases costs, but also endangers community health. The current study tries to assess the perceptions and expectations of hospital managers and decision-making boards in Hamedan regarding the evaluation system and to determine gap between them. This is a cross-sectional study. Its target group in each hospital includes: head, manager, matron, emergency administrator, managers of medical records, laboratory, radiology, pharmacy sections plus the afternoon and night shift supervisors. The study took the form of a census, involving a total of about 400 subjects.The data were collected through a questionnaire and analyzed using the SPSS program. 1. The highest levels of target group expectation regarding evaluation indices were related to the “patient safisfaction” index. 2. The highest levels of target group perception of the evaluation indices were related to the “values and norms” index. 3. All the gaps detected between target group’s perception and expectation from evaluation indices were significant. 4.The highest percentage of difference between target group’s perception and expectation was related to the “staff satisfaction” index and the lowest one was related to the “values and norms” Index.

The aim of this study was to detect the level of the workers’ knowledge and their function regarding the care of lumbar spine. Some researchers have reported that increased knowledge of the workers, even when they have received specific training, does not cause any major changes in their back’s health and function. However, some research has shown a significant relationship between increased knowledge and improved worker function. Other research has shown that Back School instruction is effective in raising the level of knowledge in workers. This research was carried out using two questionnaires that assessed the level of knowledge and function of workers in a car company. The questions were designed in four groups relating to: (1) goods and load properties and methods of carrying and handling, (2) worker’s posture at work, (3) physical exertion, (4) tools and conditions of the workplace. Measures of outcome included the worker's function and the knowledge. We found that the worker's knowledge fell into one of 3 categories: low (%11), moderate (57%), and high (%32). We also found that %52 of workers had weak function, while %18 had moderate, and %2 had high function levels. Twenty-eight percent of workers showed function levels below that of the “low” category. In brief, our research showed that the level of the workers’ knowledge of the appropriate methods of work in relation to their back was in an acceptable range. However, this function level was associated with low knowledge levels. No significant relationship was found between the workers’ knowledge levels and their functional improvement.

Spatial autocorrelation statistics provide summary information about the spatial arrangement of data in a map. In fact, these statistics compare neighboring area values in order to assess the level of large scale clustering. Whenever a large number of neighboring areas have either relatively large or relatively small values, large scale clustering may be detected. Detecting such clustering is a very important issue because failure to take into account the spatial dependency of the data may bias the association between mortality and morbidity rates and their risk factors and erroneously suggest a direct relationship between them. The present article, therefore, explains the two most commonly used spatial autocorrelation statistics for continuous data including morbidity and mortality rates.

UV radiation is selected as the primary disinfection technology in numerous water and wastewater treatment plants of EU and North American countries having different ranges of capacities. It is expected that the method, often regarded as the best available technology, will replace chemical disinfection. As UV is claimed to be the only modality with no detrimental health effects for operators, consumers and the environment -even in high doses- it is important for directors of treatment plants to know how to apply new design criteria for UV to meet the different objectives of treatment. The recent guidelines are based on testing the UV system at various hydraulic loading rates (expressed in liters per minute per UV lamp). The rate that corresponds to the desired germicidal dose is used in the design of the system. Other design factors include water quality and characteristics of the lamp and quartz sleeves. According to this new approach, the lamp’s output is assumed to drop by 50% over its lifetime. Besides, sleeve fouling seems to reduce nominal UV light intensity by 20%. This article describes the types of data that must be collected through pilot testing on the site of treatment plant; it also shows how to use these data in the process of system design. The main advantage of this approach is that variability in the most important parameters is reflected in the design. In addition, it makes it possible to determine the number of lamps required in worst–case conditions and to meet the most stringent treatment standards.