مجله دانشکده بهداشت و انستیتو تحقیقات بهداشتی
سال نهم شماره 3 (پیاپی 35، پاییز 1390)

Coronary artery disease (CAD) and its complications at a low age are more serious and more progressive than at higher age. Because of this difference in the natural history of the disease as a function of age, this study was conducted to compare CAD risk factors between two age groups, namely people below and above 45 years old. Two groups of 200 hospitalized CAD patients each, one below, and one above, 45 years old were selected by simple random sampling between 2005 and 2007. Two groups were similar with regard to dates and duration of hospitalization. The following data were collected from the patient's hospital files and analyzed using SPSS/Win: age, sex and marital status; area of residence; a history of smoking, diabetes, and hypertension; a family history of early-onset cardiovascular disease (CVD); weight and height; and lipid profile. The logistic regression test was used to compare the variables between the two groups. The following variables were found to be positively associated with CAD in the under-45 year group: smoking history (OR=2.54 p=0.009), a history of early-onset CVD (OR=3.15 p=0.009), low high- density lipoprotein cholesterol (HDLc) (OR=5.53 p<0.001), and high blood cholesterol (OR=3.96 p<0.006). The most important coronary heart disease risk factors at a lower age are smoking, a history of early-onset CVD, low blood HDLc, and high total blood cholesterol.

Breast and cervical cancer screening is considered a health promotion behavior, influenced by complex factors. The theory of planned behavior provides a useful framework for predicting and understanding the health behavior and designing appropriate educational interventions. Integrating this theory with self-efficacy will increase its predictive value. The objective of this qualitative research project was to understand the factors influencing the behavior of breast and cervical cancer screening of female-workers as a base for future educational planning.

This was a qualitative approach research based on the Integrated Model of Planned Behavior and Self-Efficacy. Seventy 20-45 year-old women working in industrial plants in Abbasabad, Pakdasht, selected by purposeful sampling with maximum diversity participated, in 10 groups of 7 each, in focus-group discussions, in which they discussed their experience regarding factors influencing the behavior of breast and cervical cancer screening. Data were collected and their validity, conformability, transferability and dependability confirmed. For data analysis the conventional method of content analysis was used.

The female workers had a low knowledge and attitude concerning the behavior of breast and cervical cancer screening. Attaching importance to comments given by the family members, especially the husband, and preference of treatment to prevention of disease in the society at large were the subjective norms of the female workers. The most important barriers to participating in screening programs were lack of knowledge, depression, fatigue, embarrassment and fear of examinations, fear of being sick, poor quality of services and lack of attention to privacy in health centers, limited access to health centers, and costs of tests. The female workers had a low self-efficacy for planning and overcoming barriers. Most of them had not had screening tests and had no intention of doing their screening tests in the following three month.

The following measures are recommended: designing and implementing specific educational programs in workplaces for female-workers aiming at increasing their awareness and positive attitudes towards breast and cervical cancer screening; designing and implementing educational/training programs for families, employers and planners to increase their knowledge and attitude; and facilitating women's access to health centers in industrial estates.

The aim of this study was to assess the adherence to anti-retroviral prophylaxis after occupational and non-occupational exposure to human immunodeficiency virus (HIV) in patients consulting the Voluntary Counseling and Testing Center (VCT) of Imam Khomeini Hospital, Tehran during the period 2008 to 2009. In this prospective study, patients were selected, the required information about them was recorded, and adherence to anti-retroviral drugs (including Ziduvudin, Lamivudin and Efavirens) was determined based on self-report by the patients. Eighty-nine exposed patients were followed monthly for 4 months, and in the case of low-adherence (less than 95%) they were asked for the reason(s) for noncompliance. Of the 89 patients, 55 were men (61.8%) and 34 (38/2%) were women with a mean age of 30.16± 8.39 years; 47 participants (52.8%) were single and 42 (47.1%) married; 27 subjects (30.3%) were physicians, 35 (39.3%) nurses and 27 (30.3%) had occupations outside the healthcare system. From among the 36 subjects (40.5%) who stopped the treatment, 24 (27.0%) stopped it correctly (that is, when the serological test proved to be negative), while 12 (13.4%) did not stop it on a sound basis. Fifty-three subjects (59.6%) completed the prophylaxis. Adherence was found to be significantly associated with age and marital status (p<0.05). The main reason for stopping the prophylaxis (a negative serological test result of the resource patient) was more pronounced than previous studies, which indicates the higher availability of the resource patient.

There is evidence showing that increased inflammatory mediators and reduced serum levels of polyunsaturated fatty acids may be present in patients with neurodevelopment and psychiatric disorders, e.g. attention-deficit/ hyperactivity disorder. (ADHD). The objective of this study was to determine the effects of dietary omega-3 fatty acid supplementation on hyperactivity, attention deficit, and serum inflammatory mediators in children with ADHD This was an 8-week randomized double-blind clinical trial. The participants were 103 6 to12-year old children with ADHD receiving effective maintenance therapy, who were assigned randomly to receive either a daily omega-3 supplement (635 mg eicosapentaenoic acid and 195 mg docosahexaenoic acid (intervention group) or a placebo visually similar to the omega-3 capsules (placebo group). The serum levels of C-reactive protein (CRP) and interleukin-6 (IL-6) were determined at baseline and at the end of the period. In addition, the abbreviated 10-item Conners parent rating scale (CPRS) was completed for each child before and after the intervention. The intervention brought about statistically significant reductions in the levels of CRP and IL-6 and a significant improvement in the CPRS score in the omega-3 group. The findings indicate that dietary omega-3 fatty acid supplementation can have desirable effects on hyperactivity, attention deficit and inflammatory mediators in children with ADHD.

Child growth disorders are a result of nutritional ignorance and lack of appropriate care and growth monitoring. This study was conducted to assess the effects of mother's educational program based on the precede model on the prevention of growth retardation in 6 to12-month old children in the health centers of Shiraz city, Fars Province, Iran.

This quasi-experimental study included 120 mothers (60 cases and 60 controls) with a single exclusively-breastfed child under the coverage of health centers in Shiraz city, Fars province, Iran. A questionnaire was used to collect data on demographic characteristics and the precede model components (knowledge, attitude, enabling and reinforcing factors and maternal behavior). In addition, the children were weighed and their weights recorded. The mother's educational intervention consisted of six 55 to 60-minute sessions. The questionnaire was completed by the case mothers before and 4 months after the intervention.

The interventional educational program brought about statistically significant increases in the mean scores of knowledge (p<0.001) and attitude (p<0.001). Further analysis of the data also showed that the enabling (training sessions and using references) and reinforcing factors, as well as practice score of the mothers and the mean weight of the children in the case group improved significantly as compared to the control group (p<0.001).

The results of this study indicate that an interventional educational program for mothers based on the precede pattern had a positive effect in the prevention of growth retardation in the study population.

Fleas are the most important ectoparasites of humans and domestic animals. Their bites are painful, usually accompanied with itching; in addition, they transmit diseases such as plague, tularemia, and endemic typhus. The aim of this study was to identify species of fleas in the rural areas and animal farms in Boyerahmad This study, conducted for 6 months, from April to September 2007, included 30 villages of the Boyerahmad District (30 ° 9'-31 ° 32 'N: 49 ° 57'- 50 ° 42'). To collect fleas, the common catch methods, such as fly paper, light trap, etc. were District, Kohgiloye-and-Boyerahmad Province, Iran.used. The samples collected were kept in 70%-ethanol, and then, after clarifying and dehydration, were identified in the laboratory using valid keys. A total of 2435 fleas (54% males and 46% females) belonging to two families (Placida and Ceratophylidae), 4 genera and 7 species were collected. The most common species was Xenopsylla buxtoni (24.7%), followed by the dog flea, Ctenocephalides canis (21.4%), the cat flea, Ctenocephalides felis (18.5%), Xenopsylla astia (14.5%), Xenopsylla nuttalli (7.6%), Pulex irritans (7.2%), and N. fasciatus (6.1%). The fleas abundance (mean ± SE) in human and animal habitats was found to be 0.7±0.06 and 3.4± 0.2, respectively. On the whole, the flea species are quite diverse and abundant in the rural areas of Boyerahmad District in human and, particularly, animal habitats. This is a serious problem. Measures should be taken to control the fleas, particularly in rural areas.

Omega-3 fatty acids can reduce inflammation in diabetic patients via special mechanisms. The objective the current study was to investigate the effects dietary omega-3 fatty acid supplementation on the serum levels of C-reactive protein (CRP), interleukin-2 (IL-2), and tumor necrosis factor-alpha (TNF-α) in type 2 diabetes patients. This randomized double-blind placebo-controlled clinical trial was conducted on 57 subjects with type-2 diabetes. The participants were randomly assigned to one of 2 groups receiving either an omega-3 fatty acid supplement (containing 1584 mg eicosapentaenoic acid, 828 mg docosahexaenoic acid, and 338 mg other omega-3 fatty acids) or a placebo tablet (containing 2100 mg sunflower oil) for a period of 8 weeks. The serum TNF-α and IL-2 concentrations decreased significantly in the omega-3 fatty acid group in comparison with the placebo group (in both cases, p<0.01). The intervention did not bring about any statistically significant changes in the serum CRP concentrations. Considering the beneficial effects of omega-3 dietary fatty acid supplements on the 2 inflammatory biomarkers, namely TNF-α and IL-2, type-2 diabetes patients are recommended to consume such supplements or foodstuffs rich in omega-3 fatty acids, e.g., fish