Journal of Health Sciences and Surveillance System
Volume:2 Issue: 2, Apr 2014

Noise pollution has a particular importance in quiet environments such as hospitals. The main objective of this study was to evaluate the effects of noise exposure on the auditory system, blood pressure and precision, concentration and other psycho-neural components. This cross-sectional study was carried out in three large hospitals of Shiraz, during the period of 2012 to 2013. The study population consisted of 81 health care personnel (the exposed group) and 79 non-exposed individuals (the referent group). Day and night time sound levels were measured at different wards of the hospitals by a sound level meter (B&K 7110). Hearing status was assessed by pure tone audiometry of subjects by an Interacoustic AD27 audiometer. Blood pressure was measured with a mercury sphygmomanometer at resting time and psycho-neural components including sleep disturbances, headache, irritability and … were evaluated by a questionnaire devised and validated for this purpose. Data were analyzed by SPSS 16 software. Average sound pressure level for the exposed group (65.32±5.23 dB) was significantly higher than that of the referent group (53.26±2.46 dB) (P<0.05). Similarly, the mean values of permanent threshold shift (dB) as well as systolic and diastolic blood pressure were significantly higher in the exposed group than in their counterpart individuals (P<0.05). Likewise, symptoms such as headache and irritability were significantly more common among the exposed subjects. The findings suggest that exposure to sub-TLV levels of noise (recommended by ACGIH) in hospital environments is also associated with decreased hearing threshold, increased blood pressure, and prevalence of psycho-neural disorders.

Although enteral feeding solutions are used to reduce the morbidity and mortality in many malnourished and hospitalized patients, microbial contamination of these products may lead to severe infections, especially in immune suppressed ones. The aim of this study was to evaluate the microbiological quality of commercial enteral feedings in two hospital settings in Shiraz. Twenty commercial enteral feedings were collected immediately after preparation and then homogenized and serially diluted on the same day. MPN methods were used to evaluate the total viable count and Escherichia coli count. They were also tested for total coliform (pour plate method) and the presence of coagulase positive staphylococci. The results were compared with standard limits. All samples had a total viable count lower than 104 colony forming units (CFU) per g (the maximum recommended level of FDA standard).For all enteral feedings, coliform counts were not detectable (<10 CFU/g).Escherichia coli counts were also lower than those of Brazilian legislation (<3 CFU/g). Coagulase positive staphylococci were recovered just from one sample (5%). Freshly prepared commercial enteral feeding samples h ad a cceptable m icrobial q uality. S uch p roducts are considered to be more acceptable than hospital prepared ones. However, further steps involved in the preparation and administration of commercial feedings can be sources of microbial contamination. Thus implementation of hygienic practices and monitoring procedures during preparation and administration can be suggested.

Groundwater nitrate pollution is an important environmental problem in water resources management. In this regard, specific measures aiming at prevention of water pollution will be helpful to managers and decision-makers. Identification of aquifers’ vulnerable areas and determination of groundwater protection zones using most widely used models, such as DRASTIC and CD, are one of the most useful approaches in water resources’ hygiene. The present study aimed to assess the vulnerability of Shiraz plain’s unconfined aquifer using the above-mentioned models. The main hydro-geologic factors affecting the transmission of pollution, including depth to water table, net recharge, aquifer media, soil media, topography, impact of the vadose zone, aquifer hydraulic conductivity, and land use parameters were rated, weighted, and integrated using GIS 9.3. Finally, the maps of Shiraz plain’s unconfined aquifer vulnerability were prepared. The vulnerability maps based on these two indexes showed very similar results, identifying the southeastern part of the aquifer, around Maharlu Lake, as the vulnerable zone. The observed nitrate concentrations from the wells in the underlying aquifer were in accordance with these findings. The results of sensitivity analyses indicated the depth parameter as the most effective parameter in vulnerability assessment of Shiraz plain. As Shiraz plain has been covered with fine-grained sediments, except for some central and south-east regions which have moderate vulnerability and high nitrate concentration, its vulnerability is low. Given the intensive agricultural activities and also the rise in groundwater level in southeastern regions, more attention should be paid to these areas.

Evidence shows that job stress potentially has adverse effect on individuals’ health and organizational productivity. It has, therefore, become an important issue in the occupational health context. The aims of this study were to investigate job stress dimensions among nurses of Shiraz University of Medical Sciences (SUMS) hospitals and comparing the results with the findings of the previous studies conducted in other countries. In this cross-sectional study, 385 randomly selected nurses of SUMS participated. The Persian version of Job Content Questionnaire (P-JCQ) and demographic questionnaire were used for data collection. The linguistic validity and psychometric properties of P-JCQ have been assessed and approved in a previous study. One sample t-test was used to examine the differences between means of job stress dimension scores of the present and those of the previous studies carried out in other countries. The means (SD) of decision latitude, psychological job demands, social support, physical job demands and job insecurity were found to be 58.15 (6.50), 38.19 (5.14), 22.67 (3.67), 16.03 (2.58), and 7.74 (3.85), respectively. The results revealed that decision latitude and social support dimensions were in a low level among the study subjects. In contrast, psychological job demand, physical job demand, and job insecurity dimensions were shown to be in a high level. The SUMS hospital environment collectively imposes higher job stress on the nurses as compared to that of other countries. To prevent harmful effects of job stress on the nurses’ health and job performance, developing macro-ergonomic strategies in this working environment, such as enhancing job control, reducing job demands, and providing supportive climate, seem necessary.

Although sleeping problems are common among all age groups, the elderly suffer a higher prevalence of sleep disorders. The present study aimed to investigate the relationship between sleep quality, self-efficacy, and stages of change among the elderly. This descriptive-analytical study was conducted on 36 individuals aged 60-75 years selected through simple random sampling in 2013. The data were collected using Pittsburgh Sleep Quality Index (PSQI) and self-made structured questionnaires, including sleep self efficacy scale and stages of sleep behavior change scale. SPSS statistical software, version 19 was used to analyze the data and descriptive and inferential statistics such as independent samples t-test were used. The results of the present study revealed that the mean of sleep quality was 7.91 (SD=4.99). In addition, most of the subjects (69%) had poor sleep quality. Considering the stages of change, the participants were in different stages of sleep behavior change. Moreover, a significant relationship was found between self-efficacy and PSQI total score (P<0.001). Also, significant relationships were observed between self-efficacy and the variables of stages of change (P<0.05), except for the average night sleep. The results of this study showed that most of the elderly had poor sleep quality. Besides, they were in different stages of change in sleep problems. The results also indicated that self-efficacy affected the sleep quality in the elderly. Therefore, measures should be taken based on stages of change and increased self-efficacy to improve sleep quality among the elderly.

Many of health system services are done in clinical counseling. A patient’s expectation of clinical consultation and physician office visits is to obtain diagnostic-remedial results, while such an expectation can be fulfilled only through an active relationship between the doctor and the patient. The aim of this study is to evaluate the quality of doctor- patient interaction in an educational clinic in southern Iran. This is a conversation analysis based on critical approach. So, 33 clinical consultations were analyzed critically. Results showed that paternalistic model is the overall pattern in consultations. This leads to limitation of the patients’ opportunity to participate in their diagnosis and treatment. Powers’ asymmetrical relations lead to conditions in which physicians determine the clinical counseling process. Also, physicians determine the subject of consultation in the counseling period. In this situation, the patients’ concerns were ignored. This ignorance leads to the patients’ suppression in problematic situations. The main point is that the clinical counseling occurs in one general contract that is unwritten but has been known for the two sides of interaction. Clinical counseling can be an active consultation when it included the symmetrical distribution of power and the patient has an active participation in the consultation. Therefore, the new patient-centered approaches can be an appropriate model for access to a type of consultation based on symmetrical power distribution between physician and patient.