Analysis of trace elements in processed products of grapes and potential health risk assessment.

Raisins and grape pekmez are consumed commonly by human all over the globe. Consumption of contaminated foods may be the likely pathway of heavy metal exposure. Therefore, the objectives of the present research were to quantify trace elements concentration in raisins and grape pekmez produced from locally grown grapes in Gonabad and to assess non-carcinogenic (HQ and HI) and carcinogenic (total cancer risk, CRt) health risks caused by trace elements exposure via oral intake of these products for children, teenagers, and adults. For this purpose, a totally 30 (15 raisins and 15 grape pekmez) samples were purchased from the vineyard gardeners and examined for ten trace elements including As, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, and Zn. The HI values signaled that the studied population consuming these products is at risk. The HQ, HI, and CRt values of the elements were in order of children > teenagers > adults. The highest cancer risk contribution was attributed to As and Ni for all the studied age groups in both raisins and grape pekmez samples. However, it is recommended that the concentration of trace elements in the soil and crops of the study area and its related health risks be regularly monitored to avoid significant health risks in the future.

Determination of Concentration of Metals in Grapes Grown in Gonabad Vineyards and Assessment of Associated Health Risks.

Metals are considered major public health hazards, and they are known to accumulate in fruits, which are consumed by humans because of their unique sweet taste and potential health benefits. Therefore, the aims of this study were to determine the concentration of ten metals, namely arsenic (As), cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), lead (Pb), and zinc (Zn) in red grape samples grown in Gonabad vineyards and to estimate the associated health risks of metals in terms of chronic daily intake (CDI), carcinogenic and non-carcinogenic risks by hazard quotient (HQ), hazard index (HI), and cancer risk (CR) for children, teenagers, and adults. The overall concentrations of the metals in red grapes were in the range 0.07-0.5 (mean 0.14), 0.08-0.13 (mean 0.10), 0.07-0.13 (mean 0.09), 0.06-1.49 (mean 0.29), 0.52-4.12 (mean 1.65), 6.43-42.17 (mean 19.01), 0.89-4.04 (mean 1.89), 0.07-9.23 (mean 0.71), 0.07-0.37 (mean 0.18), and 0.40-4.13 (mean 1.05) mg/kg dry weight for As, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, and Zn, respectively. Based on the results, As in 11.76% and Zn in 5.88% of the samples exceeded the FAO/WHO permissible limits. The estimated non-carcinogenic and carcinogenic risk indices for children, teenagers, and adults showed that the results were lower than the critical value (1) and were in acceptable range. Therefore, red grape is safe for consumption with no impact on the human health. However, red grape consumption was just one part of fruit consumption, and the potential health hazards for inhabitants might actually be higher than in this research when other routes of heavy metal intake and also other fruits are considered.

Socio-Environmental Determinants and Human Health Exposures in Arid and Semi-Arid Zones of Iran-Narrative Review.

Lifestyle is different in arid and semi-arid zones. However, where people are born and live have a lasting influence on their social and environmental exposure. This review focuses on the, various dimensions of environmental health imbalance inequality especially in significant environmental sources such as (ie, air, water, soil) among provinces that creates a big health gap in the center, East and the Southeast of Iran. Thus, the population of the arid and semi-arid zones of Iran is facing respiratory, cardiovascular, cancer and infection diseases linked to environmental problems such as chemical and microbial pollution due to air pollution and unsafe water sources, respectively. The prevalence of certain types of cancer such as skin, stomach, bladder, prostate and colorectal cancer together with some respiratory and cardiovascular diseases in arid and semiarid zones such as Kerman, Yazd, etc., has been reported in comparison with other provinces frequently. These impacts have effects on multiple levels of health security in those zones. Based on these concerns, we propose key questions that should guide research in the context of the socio environmental science to support science-based management actions in Iran and other similar semi-arid areas worldwide.

Improving Hand Hygiene Compliance of Intensive Care Unit by Using Pender's Model.

BACKGROUND: Hand hygiene (HH) compliance is an effective behavior in controlling hospital-acquired infection because the hand is the main means of transmitting infections in patient-medical staff communication as well as the inanimate environment. This study aimed to explore the effect of applying Pender's Health Promotion Model on the HH compliance of intensive care unit staff. METHODS: This quasi-experimental study with a single research group was conducted from January to July in 2019. The required data were collected from 90 staff of the intensive care units of Imam Reza Hospital in Mashhad, Iran through 1796 and 2343 opportunity of monitoring before and after the intervention. The data collection instruments were a standard HH observation form and a researcher-made HH questionnaire in the light of Pender's health promotion model. The data were statistically analyzed in SPSS using Paired-samples T-test and Chi-squared test. RESULTS: The mean age of the 90 included participants was 35.92 (± 6.5) years and the mean length of their work experience was 10 (±1.5). The hand hygiene index rose from 23% before the intervention to 41.4% after the intervention (p=0.001). Moreover, statistically significant differences were found in moments after touching surroundings (p=0.001), before and after touching a patient (p=0.001), and also in perceived barriers (p=0.015), interpersonal influences (p=0.008) and situational influences (p<0.001). CONCLUSION: Pender's model showed to have improved the staff's HH compliance as a professional behavior.

Investigating the status of marital burnout and related factors in married women referred to health centers.

BACKGROUND: Marital burnout is an important issue in marriage and many factors play an important role in this phenomenon. The aim of this study was to determine the status of marital burnout and the factors affecting married women who were referred to health centers because of it. METHODS: In this study, 936 women were selected by multistage sampling and data collection was performed using questionnaires of demographic and couple burnout. Data analysis was performed using SPSS software version 24. RESULTS: The mean (± SD) of marital burnout, in this study, was 55.46 (± 18.03) (out of 147 score). There was a significant relationship between the level of women's education with total marital burnout, and the subscales of somatic and emotional burnout (P < 0.05). A significant relationship was also observed between mandatory marriage and total marital burnout, as well as subscales of somatic, emotional, and psychological burnout (P < 0.05). A significant relationship was detected and observed between women's participation in training courses of communication skills and total marital burnout, inclusive of the subscales regarding psychological burnout (P < 0.05). The results of linear regression showed a significant relationship between mandatory in marriage, marital satisfaction, marriage duration, and husband's level of education with women's marital burnout. The variables were finally able to predict 12% of marital burnout variance. It should be noted that marital satisfaction had a higher effect on predicting marital burnout (P < 0.001). CONCLUSIONS: Marital satisfaction was one of the effective factors in predicting marital burnout, so it can be concluded that it is necessary to pay more attention to this issue. Educational programs and examining the factors that enhance marital satisfaction are needed to prevent and reduce marital burnout in married couples.

Epidemiology of Suicide/Suicide Attempt and Its Association with Individual, Family, and Social Factors in Eastern Part of Iran: A Historical Cohort Study.

BACKGROUND: Suicide/suicide attempt, as a major public health problem, has been included among anti-social behaviors. We aimed to investigate the epidemiology of suicide and some associated individual, family, and social factors. METHODS: A historical cohort study was conducted among all cases (748 persons) reports related to suicide/suicide attempt that register in hospital reporting system and health care center in Gonabad and Bajestan, Iran, from 2009 to 2014. The required data were extracted through a checklist. Descriptive (mean and standard deviation) and analytic statistics (t-test, Chi-square, and logistic regression) applied to analyzed data. All data were analyzed using SPSS software. RESULTS: Of the 748 reported suicide attempters, 17 cases (2.3%) had completed suicide. The annual average incidence rate of suicide was 110.03 per 100,000 populations. The mean age of suicide attempt had significantly decreased during the time (P=0.007). Furthermore, a significant association was observed between outcome of suicide and place of residence (P=0.019), history of physical illnesses (P=0.002), and method of suicide (P=0.001). CONCLUSION: Due to trend of age among suicide attempters, considering intervention programs of suicide prevention for school pupils and university students especially individuals residing in rural areas, as well as individuals suffering from physical illness would be effective to reduce the rate of suicide.

Obesity and its socioeconomic determinants in Iran.

OBJECTIVE: To investigate the socioeconomic inequality of obesity and its determinants in Iran. METHODS: Data was from Iran's surveillance system for risk factors of non-communicable diseases which was conducted on 89,400 individuals aged 15-64 years in 2005. Principal component analysis was used to create a new variable for defining socioeconomic status of participants. We assessed inequality by calculating a slop index of inequality and concentration index for obesity. Oaxaca-Blinder decomposition analysis was used to determine the determinants of inequality. RESULTS: The slop index of inequality and concentration index for obesity was -13.1 (95% Confidence Intervals [CI]: -16.3 to -9.8) percentage points and -0.123, respectively. The level of inequality varied widely between different provinces in Iran and was more severe in women and urban population. Obesity persisted in 20.2% (95% CI: 19.4-20.9) of the low-socioeconomic group and 11.0% (95% CI: 10.5-11.6) of the high-socioeconomic group. More than 90% of this gap was due to differences of independent variables (mainly age, gender and marital status) in two socioeconomic status groups. CONCLUSIONS: A pro-rich inequality existed in the obesity in Iran. Older age, female gender and rural residency contributed most to the economic inequality of obesity.

Comparing the Effects of Objective Structured Assessment of Technical Skills (OSATS) and Traditional Method on Learning of Students.

BACKGROUND: Despite the benefits of the objective structured assessment of technical skills (OSATS) and it appropriateness for evaluating clinical abilities of nursing students , few studies are available on the application of this method in nursing education. OBJECTIVES: The purpose of this study was to compare the effect of using OSATS and traditional methods on the students' learning. We also aimed to signify students' views about these two methods and their views about the scores they received in these methods in a medical emergency course. PATIENTS AND METHODS: A quasi-experimental study was performed on 45 first semester students in nursing and medical emergencies passing a course on fundamentals of practice. The students were selected by a census method and evaluated by both the OSATS and traditional methods. Data collection was performed using checklists prepared based on the 'text book of nursing procedures checklists' published by Iranian nursing organization and a questionnaire containing learning rate and students' estimation of their received scores. Descriptive statistics as well as paired t-test and independent samples t-test were used in data analysis. RESULTS: The mean of students' score in OSATS was significantly higher than their mean score in traditional method (P = 0.01). Moreover, the mean of self-evaluation score after the traditional method was relatively the same as the score the students received in the exam. However, the mean of self-evaluation score after the OSATS was relatively lower than the scores the students received in the OSATS exam. Most students believed that OSATS can evaluate a wide range of students' knowledge and skills compared to traditional method. CONCLUSIONS: Results of this study indicated the better effect of OSATS on learning and its relative superiority in precise assessment of clinical skills compared with the traditional evaluation method. Therefore, we recommend using this method in evaluation of students in practical courses.

Students' Aggression and Its Relevance to Personal, Family, and Social Factors.

BACKGROUND: Aggression is defined as behaviors intended to hurt, harm, or injure another person. Aggression is by no means a new concern in human society, especially in youth. Universities are among the institutions in which most of the members are young people and because of facing with various personal and social stressors, the students usually experience high level of stress. OBJECTIVES: This study aimed to determine aggression among university students and its association with their personal, family, and social characteristics. MATERIALS AND METHODS: This cross-sectional, analytic study was conducted on a representative sample (n = 809) of university students (1 state university and 2 private universities) locating in Gonabad, Iran in 2012. Using proportional to size stratified sampling, we selected the respondents and gathered the required data using a valid and reliable questionnaire. The data were entered into SPSS (version 20) and analyzed through t test, ANOVA, and regression model. RESULTS: A total of 381 (47.2%) male and 428 (52.8%) female students participated in the study. Mean (SD) age of the respondents was 21.79 (2.86) years. Overall mean aggression score (SD) in the students was 72.45 (15.49) and this score for in dorm and out of dorm students was 74.31 (15.59) and 70.93 (15.23), respectively. There were significant associations between the mean aggression score of dormitory students and sex (P = 0.004), age (P = 0.044), and type of the university (P = 0.039). On the other hand, there was no significant association between all independent factors and mean aggression score of students living out of dorm. CONCLUSIONS: Regarding the control of aggressive behaviors, paying attention to male, young students living in dormitory, especially in non-governmental universities has the highest priority.

Socioeconomic inequality in hypertension in Iran.

OBJECTIVE: Hypertension covers a large portion of burden of diseases, especially in the developing countries. The unequal distribution of hypertension in the population may affect 'health for all' goal. This study aimed to investigate the socioeconomic inequality of hypertension in Iran and to identify its influencing factors. METHODS: We used data from Iran's surveillance system for risk factors of noncommunicable diseases which was conducted on 89 400 individuals aged 15-64 years in 2005. To determine the socioeconomic status of participants, a new variable was created using a principal component analysis. We examined hypertension at different levels of this new variable and calculated slop index of inequality (SII) and concentration index (C) for hypertension. We then applied Oaxaca-Blinder decomposition analysis to determine the causes of inequality. RESULTS: The SII and C for hypertension were -32.3 and -0.170, respectively. The concentration indices varied widely between different provinces in Iran and was lower (more unequal) in women than in men. There was significant socioeconomic inequality in hypertension. The results of decomposition indicated that 40.5% of the low-socioeconomic group (n = 18190) and 16.4% of the high-socioeconomic group (n = 16335) had hypertension. Age, education level, sex and residency location were the main associated factors of the difference among groups. CONCLUSION: According to our results, there was an inequality in hypertension in Iran, so that individuals with low socioeconomic status had a higher prevalence of hypertension. Age was the most contributed factor in this inequality and women in low-socioeconomic group were the most vulnerable people for hypertension.

A community assessment model appropriate for the Iranian community.

BACKGROUND: Community assessment is one of the core competencies for public health professionals; mainly because it gives them a better understanding of the strengths and drawbacks of their jurisdictions. We planned to recognize an appropriate model that provides a conceptual framework for the Iranian community. METHODS: This study was conducted in Tehran, during 2009-2010 and consisted of two parts: a review of the literature and qualitative interview with selected experts as well as focus group discussion with health field staff. These steps were done to develop a conceptual framework: planning for a steering committee, forming a working committee, re-viewing community assessment models and projects, preparing the proposed model draft, in-depth interview and focused group discussions with national experts, finalizing the draft, and preparing the final model. RESULTS: Three different models published and applied routinely in different contexts. The 2008 North Carolina Community Assessment model was used as a reference. Ten national and 18 international projects were compared to the reference and one and six projects were completely compatible with this model, respectively. CONCLUSION: Our final proposed model takes communities through eight steps to complete a collaborative community assessment: form a community assessment team, solicit community participation and gain inter-sectoral collaboration, establish a working committee, empower the community, collect and analyze community's primary and secondary statistics, solicit community input to select health priorities, evaluate the community assessment and develop the community assessment document, an develop the community action plans.

Knowledge translation in Iranian universities: need for serious interventions.

BACKGROUND: The aim of this study was to assess the status of knowledge translation (KT) in Iranian medical science universities in order to assess the strengths and weaknesses of the most important organizations responsible for producing knowledge in the country. METHODS: The KT activities were assessed qualitatively and quantitatively in nine universities using the Self-Assessment Tool for Research Institutes. RESULTS: The strengths and weaknesses of universities were determined using seven main themes: priority setting; research quality and timeliness; researchers' KT capacities; interaction with research users; the facilities and prerequisites of KT; the processes and regulations supporting KT; and promoting and evaluating the use of evidence.The quantitative and qualitative results showed that the Iranian universities did not have an appropriate context for KT. There were significant shortcomings in supportive regulations, facilities for KT activities, and the level of interaction between the researchers and research users. CONCLUSIONS: The shortcomings in KT were mostly in the area of stewardship and policymaking (macro level), followed by planning and implementation at the universities. In order to strengthen KT in Iran, it should occupy a prominent and focused role in the strategies of the country's health research system.