نشریه طلوع بهداشت
سال یازدهم شماره 1 (پیاپی 34، بهار 1391)

The primary coolant is an essential cooling medium used to control heat in a nuclear power plant. During the oxidation process، Nickel may be released in the primary coolant which increases its contamination. The operational problems and high cost of treatment necessitate the research for some newer methods. The aim of this research is investigation of nickel removal from synthetic nuclear-power-plant by using iron oxide nanoparticles and the effective parameters. In this research، zerovalent iron nanoparticles was converted to Iron oxide nanoparticles and its efficiency for Ni (II) ion removal in synthetic coolant water batch system was studied. Also the impact of effective parameters including iron oxide nanoparticles concentration، solution pH، and agitation time were investigated and absorption isotherm and kinetic model reaction were determined. STM images indicate that the particles size is lass than 40 nm. The complete removal was in primary pH of the solution، t=4h، and C=40g/l. In alkaline pH، t=4h، C=1g/l were obtained with maximum removal. Ni (II) absorption at absorbent C= 35g/L and pH = 2. 71 obeys Langmuir isotherm and the kinetic reaction is peso-second-order. The results of the study show that increasing pH in alkaline condition، hightens removal efficiency. The reason is that when the pH of the solution is above the isoelectric point، the oxide surface becomes negatively charged and can form surface complexes with cations (e. g.، metal ions). In optimal condition، iron oxide nanoparticles have the potential of purifying coolant water.

Vitamin D plays a known role in a wide range of diseases such as osteoporosis، cancer، cardiovascular diseases، and diabetes. Recently، the role of vitamin D in cognitive function and mental health has been reported as well. Vitamin D concentrations have been demonstrated to be low in patients suffering from mood disorders and have been associated with cognitive function. The aim of the present study was to determine concentration level of serum 25-Hydroxyvitamin D in depressed people in Yazd. In this cross-sectional study، 211 depressed patients with Beck Depression Inventory)BDI (score above 17 were studied. The data were collected by questionnaires and blood sampling was performed to measure serum 25(OH) vitamin D. Vitamin D deficiency was determined at the level of 25 (OH) D< 35 nmol/L. Resulst: Out of 211 participates، 33. 2% were men and 66. 8% were women. The mean of age was 33. 4. Median concentration of 25-OH vitamin D levels in all the patients، men and women، were 26. 4، 36 and 22. 6 nmol/L respectively. The results showed that 34. 3 % of subjects were in a normal status but 65. 7 % had vitamin D deficiency. Totally 39. 5% and 7. 6 % of the patients suffered from moderate and severe deficiency respectively. No correlation was detected between vitamin D level and BDI score in this study. We observed a high prevalence of vitamin D deficiency among depressed subjects like other groups of people in Yazd، therefore requiring immediate attention to detect its reasons and finding the effect of vitamin D deficiency elimination on depression status.

Rabies is one of the fatal diseases in human and other mammals. With regard to lack of full control of the disease in wild and domesticated animals، There is stillt the possibility of incidence of the disease in our country. The aim of this study was to determine the epidemiology and causes of delays in getting treatment for rabies and animal bites in the city of Tabas during 2005-2010.

The present research is a descriptive cross-sectional study in which، the existing information for 480 bitten subjects referring to Tabas rabies units during 2005-2010 was used. Patient-related factors، factors related to location، factor related to the time of being bitten، the wound status as well as bite status were studied. The descriptive statistics، including descriptive indicator was used to analyze the data، and the logistic regression analysis was used to measure the effect of considered variables on delay in receiving preventive treatment of rabies. The analysis was performed using SPSS version 18.

Out of 480 bitten persons، 413 individuals (86%) were male and others 67 (14%) were female. Totally 54. 6% (262 cases) of animal-bite incidents were in the city and 45. 4% (218) had experienced it in the rural areas. The cases were mostly related to dog bites (63. 1%) and cat bites (27. 3%) respectively. Most bites had occured for 107 students (22. 3%) and 98 (20. 4%) for others. Mean and standard deviation of delay time in receiving the anti-rabies vaccines was 6. 5±1. 5 hours. The most offective factors in delaying or notdelaying were age (OR = 0. 98، CI: 0. 74-0. 99)، time of accident (OR = 1. 06، 1. 01-1. 12)، bite of the lower extremities (OR = 5. 31، CI: 3. 8-6. 33)، history of vaccination (OR = 0. 39، CI: 0. 21-0. 68)، having primary care recommended for the injury (OR = 6. 75، CI: 4. 4-8. 8) and animal type (OR = 4. 17، CI: 3. 34-6. 5).

Regarding the relatively high incidence of animal bites in this county، the necessity of controlling animals such as dogs and cats through training vulnerable individuals such as adolescents as well as animal owners and intersectional coordination to eliminate the straying animals should be more considered. Because of the imposed cost sustained by health system care for any bite، the preventive measure should be considered as priority.

One of the most important factors for increasing clients '' satisfaction is the relationship between health care providers '' capability in communicating appropriately with their clients. To this aim، we decided to compare the effect of communication skills training of health staff، either written or lecture، on clients'' satisfaction in Shiraz health centers. Totally 25 health care workers of six health centers of Shiraz and about 1000 clients participated in this study. The data on the relationship of health workers to their clients was collected by a questionnaire before and after the intervention. After the first phase، the participants were divided into two groups. One group was trained by speech and the other by written skills. After a six- week intervention، the data for second phase were collected by the same tool. Data were then analyzed by SPSS software and some tests such as chi-square and regression. There was a significant difference between the mean scores of satisfaction of speech groups before and after the intervention (p<0. 0001). The mean score of satisfaction of speech group was 37. 47 before intervention which increased to 44. 86 after the intervention. In the written group however it raised from 39 to 40. 5 (P=0. 016). The full satisfaction with speech group was29. 8%before intervention which raised to 81. 3% after the intervention. The results of this study showed that the education intervention had a positive role on clients'' and health care workers'' satisfaction. The effect of training through speech was more than the written one. It is therefore proposed that there should be an education intervention for health care workers on communication skills.

ICT has had a profound influence on human life. Perhaps its most important and profound influence is on learning and education Moreover، Higher education system considered as the main custodian in education and research sectors acts in specializing efficient personnel and enhancing public knowledge and professional skills in all levels of the country. This descriptive cross-sectional study was performed on 406 students of Yazd University who were selected by stratified random sampling method. Data collection tool was a questionnaire its validity of which was confirmed by relevant experts and its Cronbach alpha reliability was also calculated (P<82. 7). After data collection using spss software، the frequency، percentage، mean، standard deviation، one-way anova، chi-square and Pearson correlation tests were used to analyze data. Data analysis revealed that 39. 2% of students watch TV less than an hour daily، but 60. 8% watch more than an hour; also 58. 7% of students use internet less than an hour but 41. 3% use more than an hour. Internet، mobile، satellite، television، books، and radio were mentioned as the most appealed to by the students respectively. Use of FCT had significant relationship with students'' improvement (P<0. 001). There was no significant relationship between ICT and demographic variables: age، sex، marital status، occupation of parents، place and educational group. In this study، ICT and media education were found to have high effect on social relations in society as well as increase probability of independent learning. ICT which was formerly used to collect and store data، nowadays has made a change in its role and is used as a tool for data production thus facilitating learning and teaching process.

To control the spread of pathogens in hospital environments، good hygienic routines are required to disinfect surfaces contaminated with biological materials. Chemicals have traditionally been used to disinfect surfaces during final room disinfection. However، chemical disinfection is both time- and labor-consuming، and it might be harmful for staff and the environment. The search for more environmentally friendly and healthier methods has therefore been under way for many years. UVC light (200-280 nm) has germicidal effect on microorganisms in water، on surface، and in air. However، its lethal dose for various microbes is different. In this study، the dose of UVC lamps (wavelength 254 nm) in hospital operating rooms of Shahid Sadughi Burn Center were measured and its disinfectant strength was compared with a standard chemical disinfectants (Cornex). In this cross-sectional descriptive study at first the UVC irradiance levels were measured after 14 houres light exposure at the outset. The distance between the measurement locations was 50 Cm and the radiometer was put on the 80 Cm height of the floor. In addition the UVC irradiance levels were measured in 15 other sites including surfaces on the table، bed، door handle، inside the rack etc. Microbial samples were obtained from surfaces in isolated units before and after standard hospital environmental cleaning، irradiation with UVC and cornex disinfection. Samples were collected using standard contact plates and were compared together. The results of this study showed that the UVC detected dose was 0-37951 j/m2. Also the results showed that UVC markedly reduced the number of bacteria on surfaces in operating rooms، from a mean of 64. 80 cfu per sample to 41. 67 cfu per sample after UVC disinfection and to 16. 53 cfu per sample after additional cornex disinfection. So the use of UVC and of cornex disinfection alone or in different combinations significantly reduced the amount of surface contamination (P<. 001 for both) According to the results obtained، the detected dose in about half part of the locations was almost 0 j/m2، while in the places near to the lamps the detected dose was higher than the required dose for resistant virus inactivation due to long time exposure. Therefore it is concluded that the number، locations of the UVC lamps، and also the exposure time should be changed according to the standard dose for all parts of the room. On the other hand، UVC is not suitable and efficient disinfectant for the sites that are in shadow. There fore،these places must be disinfected by a combination of UVC and chemical disinfectants.

Lack of nutritional knowledge and subsequently inadequate practice causes health problems such as malnutrition and communicable diseases. Few studies have compared the effect of educational methods on knowledge، attitude and nutritional indices of women. This study there fore was carried out with the aim of comparing the effect of peer education and education by health personnel on knowledge، attitude and nutritional indices of women. In this quasi-experimental study، 108 women who had referred to Orumieh health care centers were investigated. Out of all health care centers of Orumieh، 4 were selected randomly two of which were assigned for peer education and the two others for by-personnel education. In each health care centers، 27 women aged 18-35 were entered in the study randomly. A valid and reliable questionnaire was used for data collection. First a pretest was conducted for both groups. In peer education group، two of the participants who obtained the highest scores were selected as peer educators. Both groups received 4 two-hour-education sessions. Six weeks after education sessions،a post test was performed. Data were analyzed using independent T-test and paired T-test. Before intervention، the mean score of knowledge، attitude، GDI، FCI، and MCI، was 25. 48، 6. 68، 7. 77، 5. 38 and 2. 11 in personnel education group and 30. 38، 8. 20، 7. 78، 5. 75 and 2. 33 in peer education group respectively. After education these scores were، 31. 83، 8. 88، 7. 25، 4. 9 and 2 in personnel education group and 34. 4، 15. 4، 5. 33، 3. 62 and. 85 in peer education group respectively. There was a significant difference in mean scores of knowledge، attitude and nutritional indices in both groups. The mean score of knowledge was increased significantly higher in personnel education group but، the other variables proved significantly higher in peer education group. The higher increase of knowledge score in personnel group indicates the weakness of peers in presenting scientific and theory subjects، but they are more sufficient in increasing attitude and practices، so applying this method in nutrition education is recommended.

Organizations’ performance، particularly in the case of health and treatment، is considered as the basis of qualitative and quantitative improvement of each country; if organizations never perform a survey research for evaluation of their knowledge assets، organizational management will never lead to performance development and organizational improvement. This study evaluates the effect of strategic knowledge management on organizational innovation and performance of community health centers.

This study is practical from the objective aspect، and descriptive-survey from data collection method aspect. The population of this study is out of the health centers of north part of Fars province. In this study، 30 times more than the study variables، that is، 120 people were selected as the sample. We used a questionnaire comprising 20 closed questions in order to test the assumption of this study. In order to assess construct validity، Lizrel software confirmatory factor analysis was used and for analyzing the results، we applied the structural equation testing.

variables relation was evaluated to measure the effect of knowledge encoding and knowledge individualizing on innovation and performance. T values corresponding to the standard value model of the final way indicate that innovation variables and organizational management are directly related to encoding with 99 percent reliability. In addition، organizational innovation and performance are directly related to knowledge individualizing with 99 percent reliability. Besides، T values corresponding to standard values indicate that innovation is directly related to organizational performance with 99 percent reliability.

Results show that knowledge individualizing and encoding have a positive effect on innovation and organizational performance. Also these variables have a positive effect on organizational performance through innovation. More over there is a positive and significant relationship between innovation and organizational performance.

Work-related musculoskeletal disorders (WMSDs) mainly caused by awkward postures، manual lifting and carrying the load، repetitive movements and lack of appropriate work station design. To identify the prevalence rate of work-related musculoskeletal disorders in auto parts-manufacturing plants’ workers، this study was conducted. In a cross-sectional study، we calculated the prevalence rate of WMSDs in 1383 workers of two largest auto parts-manufacturing plants، using Nordic questionnaire in Iran. According to the results، 81. 2% of the workers mentioned that they have experienced musculoskeletal disorders at least in one of their nine body regions during last year. The most common body regions affected were lower back (61. 8%)، hand and wrist (59. 2%) and elbow (48. 7%)، respectively. Results of this study show that the prevalence rate of WMSDs is very high in workers studied. Therefore، for improving working conditions، it is necessary to set ergonomics preventive programs and workplaces design.

Waste is a permanent part of human life. Urban development، increasing use of irresolvable materials and many other achievements of machine life have com to raise one of the main concerns of urban environmental management، that is waste disposal. Waste management in different qualities and quantities is the most important environmental problem. The aim of the current study was to determine the Shiraz environmental landfill waste by using hierarchical analysis، fuzzy logic and Geographic Information Systems (GIS) techniques using Expert Choice software. At First، important factors in site selection for solid waste were identified. Then، nineteen layers were digitized and weighted on the basis of the existing standards. The Last ratio that has to be calculated is CR (Consistency Ratio). Generally، if CR is less than 0. 1، the judgments are consistent، so the derived weights can be used. In this study، using data such as the legal limits of the city، distance from roads، land airport، land use، land capability، artifact effects (rural، urban facilities and equipment، mining، …)، fault، the physical development of the city، surface water، wind direction، population density، soil type، Hypsometric (height floor)، slope، vegetation coverage، land types، geology،by different models and maps based on fuzzy logic were used to combine these data. After georefrencing the data and models with satellite images a region with 272 hectares in the north of shiraz (19 km away) with capacity of receiving waste more than 1000 ton per day for 15 yeare، was selected as waste disposal site.

Moral hazard is referred to behavior change of service-provider (physician) and service-consumer (patient) as the result of insurance. It is a serious concern for health insurance and insurance policies market in the health system reforms. Moral hazard usually leads to such unpleasant consequences as welfare loss، increasing health expenditures، decrease of insurance coverage، unnecessary use of resources، decrease of risk pooling benefits، as well as decrease in allocation and technical efficiency. There fore، in this review article، we want to describe the appropriate policy interventions to prevent moral hazard of consumers and healthcare providers. This is a review article. The related articles were taken from sound sites and reliable published texts. The databases such as Medline،Web of Science، Science Direct، Google Scholar، and Springer were explored based on appropriate key words used in current methods for moral hazard control in supply side and demand side. Demand policies only affect service demand on the part of patient، and do not impede extra service delivering on the part of service provider. So، more effort is needed from supply policies to monitor the use of extra services. In terms of demand aspect، such methods such as franchise، co-payment، waiting list، and encouragement for non-utilization are being used، while in terms of supply aspct، strategies like financial incentive and payment methods (fee-for-service، global payment)، reform of source-providing system structures and behavior interventions (exclusive referring and gate-keeping، use of clinical-guidelines)، and prospective supervision on use rate are being basically employed. Different methods used to control moral hazards may prevent source waste، unnecessary services delivering، and misallocation of resources through preventing low-value consumptions. As a result، efficiency can be promoted and health expenditures can also be controlled.