مجله دانشکده بهداشت و انستیتو تحقیقات بهداشتی
سال هفتم شماره 2 (پیاپی 26، تابستان 1388)

Factors determining the health care-seeking behaviors of an individual are social, cultural, and economic (treatment costs). Utilization of a health care system by a person will, on the whole, depend mainly on the socio-economic and demographic factors, cultural beliefs and practices, gender discrimination and women's status, the economic and political systems, environment, patterns of illness, and the health care system itself. The main objective of the present study was to examine current patterns of health care-seeking behavior in residents of Tehran, Iran in 2007. Methods and Materials: In a cross-sectional study a two-stage cluster sampling method was used to select neighborhoods at the first stage and households at the second. The sample included a total of 1882 individuals over 18 years old in the households. The data were collected using a questionnaire. For analysis of the data the exact fisher test, X2, and multivariate logistic regression were used; the software used was SPAA.3 About 22/9% (431 persons) of the participants reported 1-2 illnesses during the previous month. Multivariate logistic regression indicated that age, sex, perceived severity of the illness, educational level, and marital status were all statistically associated with an attempt to seeking care, whether self-treatment or consulting a health center. The effects of different variables on decisions related to seeking care from a health care center versus self-care were also examined. The data showed that age, sex, perceived severity of the illness, income, educational level, household size, and method of payment were statistically the most significant variables affecting seeking care from a health center. Based on these findings, it may be concluded that increasing social awareness about side effects of medicines, potential dangers of self-treatment, continuous education and training of physicians and pharmacists, improving health insurance systems and universal insurance coverage will be appropriate strategies for better utilization of health care services by the people.

Thalassemia is one of the most common worldwide single-gene diseases. On the molecular level, it is a heterogeneous disease. So far, beside large deletions, more than fifty point mutations have been identified for this disease around the world. Four to ten percent of Iranians are carriers of thalassemia-affected genes. In this study we determined the relationship between the value of MCV/MCH and the type and severity of mutations in alpha thalassemia carriers.Methods and Materials: The major abnormality in alpha thalassemia carriers is decreased values of MCV and MCH. A total of 104 adult alpha thalassemia heterozygotes, 20-40 years old, including 33 persons from Khoozestan Province and 71 from Khorasan Province, were included in the study. Two hundred and eight chromosomes were isolated from peripheral blood leukocytes using standard procedures. DNA samples were amplified by Gap-PCR. Only one mutation (MED) was found in 2.9% of the population. The carriers of this mutation had virtually identical ranges of MCV and MCH. In contrast, + mutations were associated with significant differences in mean MCV and MCH values. The various mean MCV/MCH ratios of carriers were statistically significantly lower than those of + heterozygote. The results indicated that the degree of reduction in MCV and MCH is directly related to the severity of the mutations. Deviations, in cases, were associated with lower numbers of the carriers. Only one mutation (MED) was found in 2.9% of the population. The carriers of this mutation had virtually identical ranges of MCV and MCH. In contrast, + mutations were associated with significant differences in mean MCV and MCH values. The various mean MCV/MCH ratios of carriers were statistically significantly lower than those of + heterozygote. The results indicated that the degree of reduction in MCV and MCH is directly related to the severity of the mutations. Deviations, in cases, were associated with lower numbers of the carriers.

Adolescence is the transition period between childhood and adulthood, a period in life that begins at puberty. It is one of the fastest growth periods in a person's life. During this time, physical changes affect the body's nutritional needs, while changes in one's lifestyle may affect eating habits and food choices. Nutritional health during adolescence is important for supporting the growing body and for preventing future health problems. In Iran, the prevalence of anemia, obesity, and other chronic nutritional diseases has increased in recent years due to undesirable eating habits. This survey was conducted to determine consumption of the four major food groups (vegetables, fruits, milk products, and meat) among a group of high school students in Zanjan Province, Iran.Methods and Materials: A descriptive, cross-sectional study was carried out on 1500 students, selected by random cluster sampling, in Zanjan high schools, Iran in 2005. The daily intakes of the 4 food groups during the previous week were determined using a food frequency questionnaire. The potential determinants of the pattern of food consumption were also determined. The proportions of the students not having consumed fruits, vegetables, and meat during the weak were 16%, 6.8%, and 10%, respectively. More than 95% of the students said that they had consumed milk/milk products at least once a day. Only 8.7% consumed fruits and 27% consumed vegetables 3 times or more daily. The consumption of the 4 food groups of large proportions of Zanjan Province adolescents is below the current recommendations. Health and nutrition educational programs would be a valuable tool to correct erroneous food habits of the adolescents leading to improvements in their nutritional status.

By providing the greatest amount of direct service to patients, nurses play an extremely valuable and unmatched role in the quality and efficiency of care and curative services. Workplace violence is regarded as one of the factors which can reduce job satisfaction and the quality of working life of nurses and their interaction with patients, as well as the work efficiency of nurses and hospitals. In this study, after translating and validating tools of violence measurement in the health sector, the exposure of nurses to psychological violence was measured in a large teaching hospital in TehranMethods and Materials: A descriptive-cross sectional design was used in this study in summer of 2009 (1387). The study population included all the nurses (n=413) working in a large teaching hospital in Tehran. The questionnaire used for collecting data was adopted from a standardized questionnaire designed jointly in 2003 by the International Labor Office, the World Health Organization, the International Council of Nurses, and the Public Services International. Analysis of the data was made using the descriptive statistical methods and the Chi square- and t-tests. Sixty-nine percent of the nurses had experienced workplace violence. The most common forms of violence were verbal abuse (%64) and bullying-mobbing (%29). On the whole, 26% of the nurses had experienced both forms of violence in the previous year, while 335 had not faced any form of violence in their workplace. Nurses working in outpatient clinics and emergency wards experienced the highest number of encounters with verbal abuse. Encounters with bullying and mobbing were more common among female nurses than the male ones. Overall most of the violent behaviors were committed by patients and their relatives. Exposure of nurses to psychological violence is considerable and comparable to that reported by previous investigators in other countries. Thus it is highly crucial to adopt appropriate management policies aiming, particularly, at educating the medical personnel in ways of preventing and reporting violent behaviors.

In the initial preparation stage, before feeding worms with organic wastes, the wastes are pre-composted for some time. This was done so that the thermophilic phase of organic wastes degradation is passed, no harm is done to the worms which are sensitive to high temperatures, production of fertilizer faster is quicker, and biological contamination is reduced. The length of this preparation time is important with regard to the quality of the compost obtained, the vermicomposting process, and space and facilities needed. The purpose of this study was to determine the effect of preparation time of food wastes on the vermicomposting process without any preliminary action or continuous aeration. The Eisenia Foetida species was used for vermicomposting. Food waste preparation times of 0,6,12 and 18 days were attempted, and factors such as pH, C%, N%, C/N ratio, and the process rate were monitored during the process. The lowest and highest final C/N ratios were seen on days 6 and 18 of preparation, respectively. The data also showed that the highest reduction (64.93) in this ratio was observed on 6 day and the lowest (36.56) on day18. On the basis of these findings it can be concluded that there is a significant difference among various food waste preparation times with regard to C/N ratio (p-value<0.05), the preparation time is effective on the C/N ratio, and the most appropriate length of time for preparation is 6-12 days.