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Introduction: The aim of this study was to investigate weight gain during pregnancy and birth weight in rural regions of Tabriz, a province in the northwest of Iran. Materials & Methods: A cross-sectional study was conducted using routinely collected data of pregnant mothers from rural health centers. Eight health centers were randomly selected in rural areas of Tabriz. Totally, 874 women aged 24.86±5.08 years with singleton term that regularly attended health centers for prenatal care and delivered between 2002 and 2007 entered the study. The data on pre-pregnancy weight, height, total weight gain during pregnancy, mother’s age, parity, newborn's birth weight, mother’s education and working status were extracted from the health records. The women were categorized based on their pre-pregnancy body mass index (BMI) as underweight, normal weight, overweight and obese. Pregnancy weight gain was compared with new (2009) and old (1990) recommendations of Institute of Medicine (IOM). Results: 86.1% of underweight and 77.7% of normal weight pregnant women gained weight during their pregnancy below the lower limits of recommended ranges. While weight gain in none of the underweight pregnant women was more than the new IOM recommendations, 1.1% of normal weight, 17.8% of overweight and 36.4% of obese women gained weight more than the upper limits of the new IOM recommendations. Conclusion: The results of this study indicate that according to IOM guidelines, most of Iranian rural pregnant women gain weight during pregnancy less than minimum recommendations.

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Introduction: Congenital hypothyroidism (CH) is one of the most common preventable causes of mental retardation. Its worldwide incidence is estimated to be one in 2500-5500 births. Assessment of thyroid gland in neonates is critical. The aims of this study were to demonstrate the incidence of CH in neonates born in Yazd province, Iran in 1389 (2010) and compare the results with other reported studies and investigate biochemical characteristics of affected infants. Materials & Methods: This is an analytical descriptive cross-sectional study. The study was conducted on all infants (13022 births) born in 1389 (March 2010-March 2011). Thyroid stimulating hormone (TSH) was measured using ELISA technique. Results: Forty five infants suffered from congenital hypothyroidism with an overall incidence of one in 289 live births. Twenty five of the diagnosed infants were males (incidence 1:261) and twenty were females (incidence 1:325). The incidence of CH in boys was more than girls (P-value = 0.295). The highest incidence of CH was observed in spring followed by summer and the lowest incidence was in autumn followed by winter (P-value=0.000. Conclusion: The CH incidence was 10.3 to 13.8 times more than other countries. The highest CH incidence was in spring followed by summer and the lowest incidence was in autumn followed by winter. It is important that a larger size of cases need to be screened and more information on the aetiology of the affected infants to be obtained

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Introduction: Depression as a disorder is relatively common in all societies several factors are involved in depression development, that shift work is one of these factors. This study compared the frequency of depression in different shifts of nurses in hospitals of Yazd University of medical sciences. Materials & Methods: This study is a descriptive analytical study. Based on statistical methods, 150 nurses participated in this study. The research tool was a questionnaire that included 15 personal questions and 21 questions related to Beck test. The results were analysed by SPSS software. Results: 13.3% of all subjects were males and 86.7% were females. Results showed that, there is no significant relationship between gender, education, type of job, employment status and satisfaction levels of income with depression. Marital status (P-Value = 0.009 and F = 6.93), shift work (day working and shift work) (P-Value = 0.032 and F = 1.11), job satisfaction (P-Value = 0.000 and F = 7.641) and the satisfaction of the employer (P-Value = 0.001 and F = 5.414) were significantly associated with depression. 3.49% of the nurses were in normal status, 7.26% had mild depression, 3.9% required consultation with the psychiatrist,% 7.8% suffered from moderate depression, 75.4% from severe depression and 3.1% from very severe depression. Conclusion: It seems that shift work can not cause depression alone, but depression is the result of the interaction of several factors.

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Introduction: Presence of mentally retarded children in every family affects on the structure and mental health of family specially parents. The purpose of this research is the comparison of the mean of psychological well-being, mental health and self-esteem between parents of normal and educable students. Materials & Methods: This was causal- comparative and retrospective study and the instruments were three questionnaire of self-esteem, public mental health GHQ and psychological well-being. Self-esteem questionnaire is including three scales of academic performance, social evaluation and external evaluation. The GHQ questionnaire is consisted of 28 items while psychological well-being questionnaire include 19 item for life satisfaction, 13 item for happiness and optimism, 8 item for growth and development, 8 item for positive relationship with others and 10 item for autonomy. The results were analysed by SPSS software. Results: This research showed that normal students parents have more psychological well-being than educable students’ parents, moreover two groups of educable and normal students parents are equal in mental health and self-esteem structure and there isn't significant difference between them. Conclusion: This research showed that psychological well-being in educable students’ parents is lower than normal students’ parents. Thus it is suggested that educational organization of exceptional children arrange courses for improving psychological well-being of educable students’ parents.

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Introduction: motivational interviewing techniques to manipulate and extract of patients' good behavior in order achieve to their better health behavior changes. Materials and Methods: The type of research used in this quasi-experimental, pre-test and post-test in done by control group. The statistics obtained from the population the population consists of all individuals associated with drug addiction treatment center in the city of Yazd, using purpose sampling methods were employed. . Therefore, 40 patients in methadone treatment were randomly assigned to two experimental and control groups, and the Barratt Impulsiveness Scale (2004) was used. Motivational interviewing program administered to experimental group for 6 sessions of 90 minutes. At the end of the training period, both groups were assessed again. Data were analyzed using SPSS statistical software. Results: T-test results showed that impulsivity is a significant difference between experimental and control groups. Conclusion: The results of this study can be concluded that group motivational interviewing in reducing drug addiction and impulsive highly effective drug-dependent individuals.

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Introduction: Industrial growth, development programs and infrastructure projects, in spite of all the advantages and benefits to humans, has been considered as the source of many hazards, risks and failures. Risk assessment is the organized and systematic method to identify hazards and risk estimation for decisions ranking, in order to reduce the risk to an acceptable extent. The aim of this study was the risk assessment of Ilam gas refinery with William fine procedure. Materials and methods: executive group consisting of managers of the gas refinery departments and agencies were formed in order to identify the risks. The risks of units using the form HSE-FO-001 (0) -90 were identified and the risk assessment of them was recorded. This technique is based on the calculation and assessment of risks that including the severity of the outcome, Occurrence probability and exposure. Results: 289 risks were found in this study which 5 risks (1.73%) had level of urgency (urgent need for corrective actions), 40Risk (13.84%) had abnormal levels (need of immediate attention) and 244 Risk (84.43%) had a normal risk level(should be deleted). Conclusion: According to information obtained from the risk assessment tables, the major risks that threaten employees of Ilam gas refinery including the risks associated with working at height, inhalation of gas containing H2S and exposure to excessive noise. Therefore, the engineering measures, in order to reduce the level of risk in the refinery units, must be conducted.

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Introduction- Pregnancy is a natural process that can lead to fatal accidents and serious injuries to the mother and fetus. When there is no possibility of vaginal delivery for the mother and There is a possible risk to the mother and children, Cesarean delivery is performed. In many cases there is no medical necessity for a cesarean delivery But ignorance, beliefs, behaviors and attitudes of non-false test has been determiner the method of delivery . Materials and methods-This was an experimental study that was done on pregnant women who were referee to health centers of Yazd city .The samples were 130 first pregnant mothers that were divided in two groups(65 case group and 65 control group). The samples were selected by random sampling. The data was collected by a researcher making questionnaire include 4 section. At first ,two groups completed the questionnaires , then the intervention was conducted for case group based on the Health Belief Model in given 45-minute sessions. about 2month after intervention , two groups completed the questionnaires twice. The data was analyzed with SPSS18 and describing Parameters the mean and the standard deviation . The relationship between structural and demographic variables were analyzed using Mann-Whitney, Kruskal-Wallis and Chi-square were analyzed. Results- In this study, the mean age of women was 24.36 ± 3.73 and the mean gestational age 31.53 ± 2.35, respectively.The results showed that there was significant difference between case and control groups after intervention in Perceived susceptibility(p=0.001),perceived threat(p=0.001),perceived benefit(p=0.01), perceived barrier(p=0.01) and knowledge(p=0.001).There was no significant difference between self efficacy (p=0.069)and methods of delivery between two group after intervention. Discussion- In this study educational intervention based on health belief model increased the awareness of pregnant women, However ,it has not been effective on their performance. Because many factors other than knowledge are involved in the choice of delivery method, It is proposed to enhance the efficiency of this model simultaneously different patterns that can be used effectively on other factors.

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Introduction: However human oral cavity consist a mass of microorganisms, some alteration such as application the complete removable denture with poor oral hygiene in edentulous patients may cause overgrowth of several opportunistic microorganisms resulted denture stomatitis. The aim of present study was to compare the dominant oral micro-flora between edentulous denture users with dentate elderly. Material and Method: In current analytical, cross-sectional study, 30 edentulous patients with complete removable denture and 30 dentate subjects, who admitted for non-prosthetic treatments, were randomly selected in Yazd dentistry department. Their oral cavity samples were obtained using sterile cotton-tip swabs, for direct smear analyzing and cultivation on the selective fungal as well as bacterial media. Isolated predominant bacteria and fungi were enumerated and identified by microbiological differential diagnosis tests. Data were analyzed with SPSS software with T test and differences were considered statistically significant when p<0.05. Results: The non-aureus staphylococcus and alpha-hemolytic streptococci showed the highest positive culture among the isolated microorganisms in both groups, whereas beta hemolytic streptococci showed the least percent of isolated microorganism in both groups. The higher density of non-aureus Staphylococci, α-hemolitic Streptococci, Gram negative cocobasillus, non-pathogenic Neisseria, Candida and Corynebacterium were recovered from oral samples of denture users in compare with dentate subjects (P= 0.0001). There was also seen a statistical significant correlation between the number of isolated microorganisms and the duration of denture utilization in denture users (P=0.013). Conclusion: Results of the present study showed that complete denture can be act as a predisposal factor in overgrowing of several oral micro-flora particularly Candida, non-aureus Staphylococci, α-hemolytic streptococci, gram negative cocobacillus, non-pathogenic Neisseria, and Corynebacterium, which emphasized the users denture hygine.

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Introduction: The vaginal flora is a dynamic ecosystem that can be easily altered. Although, there are four causes of vaginal discharges which cover almost 95% of vaginaitis. Candidal Vaginaitis is an infection of the vagina’s mucous membranes by Candida albicans (CA). Present study attempted to Candidal Vaginitis in women referred to health centers in Yazd and the role of innate & cell-mediated immunity against Candidal Vaginitis.
 Materials and Methods: A cross-sectional study conducted from September 2011 to September 2012 in Yazd city. A total of 360 women were recruited. The collection of material for diagnosis is ideally performed during a comprehensive pelvic examination using a speculum for diagnosis of CA with identify vaginal pH smear preparing and staining and culturing.
 Results: Finally all of 360 women that observed and tested, 120 (33.33%) of them have involved and 240 (66.67%) have not involved. from 120 infected women, 55paitents had Bacterial vaginosis (15.6%) 40 patients had Ca (10.8%) and 25 patients had Trichomonas vaginalis (5.9%). Despite the role for cell-mediated immunity in host protection against the majority of mucosal CA infections, studied has been in women with recurrent vaginitis, in HIV-infected women. Thus, current investigations have been focused specifically on innate and acquired immune responses against CA at the vaginal mucosa instead of Vulvovaginal Candidiasis being caused by defective or dysfunctional CD4+ T helper 1-type cell-mediated immune reactivity.
Conclusion: Strongly suggest that distinct vaginal lymphocyte subsets participate in the adaptive anti-Candida immunity at the vaginal level, with the vaginal CD4_ T cells probably playing a major role.

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Introduction: Aging priod is Special features and many problems in all dimensions of human life and cause increased supportive needs. During recent years the rapid increase in the senior population, their disabilities, reduced independence, and increased dependence have drawn more attention toward issues related to social support in this group. Social support impacts different dimensions of health of the elderly population. Therefore, The aim of this study was to determine the social support and activities of daily living of elderly is Yazd. Materials and Methods: This study was a cross-sectional study was conducted on 265 elderly people in the city of Yazd. A cluster sampling was random. The data are composed of items demographic and “Activities of daily living" questionnaire "social support Phillips”. then using the software SPSS 16 analysis were with statistical tests of Kruskal-Wallis, Mann-Whitney, Spearman correlation and crosstabs . Results: The results showed that the average total social support in the elderly (19/84±3/43) of the range acquisition score was (0-23). The results also indicate that between social support and age, type of housing, and activities of daily living, there was a statistically significant , negative direct solidarity between social support and age were observed , there was a statistically significant, positive direct solidarity between social support and activities of daily living were observed. Discussion & Conclusion: According to the results of this study, increased social support in performing activities of daily living and health promotion can be effective in elderly .Therefore enhance social support and protection needs of the elderly should expand their networks of support for elderly.

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Introduction: Increasing women's employment and economic activity increases social welfare, productivity and enhance the quality of life. The aim of this study was to investigate the role of women's employment and social health of families in Regions 1, 2, 19 and 20 in Tehran. Material &Methods: The study was applied research, descriptive and causal - comparative or retrospective The study sample included all households in Tehran who were 3000850 The sample was selected using a multistage cluster sampling and by helping formulation Cochran was 384. Standardized questionnaire (Keyes) was used to measure social health. For data analysis, descriptive statistical criteria (mean, median, mode and standard deviation) and inferential statistics such as (chi-square test, t, and analysis of variance) were used. Results: Findings showed a significant positive relationship between women's employment and social health of the family. There are significantly and positively relation between Component of social health (social acceptance, social adaptation, social prosperity) and women's employment. There isn’t relationship between Women's employment and social cohesion and social participation. Conclusions: Woman employment affects family social health. Managers must have attention to Woman employment in their strategic plan to creating healthy socia

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Background and Objective: Studies have shown that the presence of standard amount of fluoride in drinking water can prevent tooth decay. Meanwhile, higher concentration than permitted amount in drinking water causes bone disease and dental fluorosis. Given the importance of fluoride in drinking water and also GIS ability in spatial analysis of various factors in the groundwater, in this study the concentration of fluoride in the plain of Yazd-Ardakan has been investigated using two IDW (Inverse Distance Weighting) and Kriging models. Materials and Methods: In this study, the data on the water quality of underground water of Yazd Regional Water Company and the average annual fluoride in 2014 were used. The data were related to 76 rural wells and 107 urban wells in the studied area. The rate of fluoride in groundwater in rural and urban areas was compared to the standard amount in Iran and then was analyzed via Arc GIS software using IDW and Kriging interpolation methods. Results: The mean concentration of fluoride was 0.68 mg/l in rural areas and 0.7 mg/l in urban areas. With regard to the minimum and maximum concentrations of fluoride and standard deviation of 0.364, fluoride concentration fluctuations in rural areas were higher than urban areas. For both rural and urban areas Kriging interpolation method was more efficient than IDW method. Conclusion: The residents of southern districts of Yazd-Ardekan are more facing the shortage of fluoride in drinking water and the risk of tooth decay and necessary management should be done in these areas. Geo-statistical methods can greatly help understand environmental issues.

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Abstract:

Introduction: Natural disasters are considered as events that are beyond human control and usually result in death and different injuries; they also significantly affect public health. The lack of proper sanitation and communal life creates numerous problems. The aim of this study was to determine the knowledge, attitudes, and performance of nurses (since nurses work more than others in disasters) in disaster management.

Materials & Methods: This was a cross–sectional and descriptive study. The 220 participants of this study were selected by stratified random sampling method. Data was collected by questionnaire taken from similar studies in the field of nursing whose reliability was confirmed by the relevant specialists and its validity was confirmed by Cronbach's alpha (0.83). Data analyses included Spearman test, analysis of different levels of the independent variables (Mann-Whitney, Kruskal-Wallis test) or t- test, and comparing means as well as the related data (non-parametric).

Results: In this study, the average age of staff was 33.94±6.4 and years of their work experience was 10.5 ±7.14. The nurses' average level of knowledge about crisis management was 13.05±5.24 out of 22.  The mean grade scores of attitude to crisis management was 28.94±3.39 out of 33, further, their function in crisis management was 45.88±6.5 out of 57.

Discussion: Due to the increased frequency of occurrence and consequences of the disaster and the special role of health care services before, during, and after the occurrence of such incidents, the results were not suitable. Then, it was concluded that proper preparation is essential for nurses as the largest providers of information and health services to people, so their performance must be measured which is the objective of this study.

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Introduction: ADHD is one of the most common disorders among school children throughout the world. Parents of these children are faced with more conflicts than normal children's parents. The Purpose of his study was to evaluate and compare the mental health status of mothers having children with attention deficit / hyperactivity disorder versus mental health of mothers having normal primary school children, Yazd, Iran.

Materials and Methods: The sample consisted of 160 mothers of primary-school children who were selected through random cluster sampling; 80 of them had children with attention deficit / hyperactivity disorder and the remaining half had normal children. Also, for the diagnosis of children with attention deficit / hyperactivity disorder, the Conners test as well as test of General Mental Health (GHQ) were used to measure mothers' mental health. The data were then analyzed in two levels of descriptive and inferential statistics (T-test and analysis of variance)

Results: Comparison of mental health and its subscales indicated that mothers of children with ADHD disorder were lower in all aspects of mental health than mothers of normal children.

Conclution: According to the research results, mothers of children with attention deficit/hyperactive disorder have lower levels of mental health than mothers of normal children. So, it is recommended that education and health officials provide training courses for these parents to promote their mental health status and consequently their quality of family life.

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Introduction: reduction of possibility risk in hospitals is an important and vital issue for improving the quality of health care.
This research was conducted with the aim of identifying, analyzing and prioritizing risks using the failure mode and effects analysis (FMEA) method, providing solutions for reducing or controlling identified risks and examining the effective basics of risk management.
Methods: Hospital risk management team consists of 10 experts, during the one-year time period, the risks in different parts of the hospital's health care through inspection, observation and review of processes, non-conformities and documentation, as well as participation of experienced treatment staff These risks were identified in different classes and finally, the risk priority number (RPN) was calculated using the Excel software and the corresponding formula.
Results: Errors in nursing care were identified as the most important nursing work processes in the hospital. Of the number of identified risks, 22 were assigned RPNs above 150 that were in corrective proceedings priority. The highest RPN has been belonged to a failure to implement the blood injection guidelines (448) and then to medicate - missed dose process (336).
 
Conclusion: Major corrective proceedings include the formulation of educational programs, the adoption of policies and procedures, and the establishment of monitoring and evaluating programs to streamline risk management as well as reduction and control the risks in the hospital is considered as main part of the human resource management (HRM).
 
Keywords: Risk Management, Human Error, Hospital, FMEA, Human Resource
 
 

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Abstract
Introduction:
Respiratory disorders are common problems in farmers which have a high mortality rate in Yazd city. The aim of this study was to evaluate and compare respiratory parameters as well as the prevalence of respiratory symptoms in three age groups in farmers and non-farmers.
Methods:
This case-control study was conducted on 300 farmers and 300 non-farmers in Yazd. Questionnaires including cognitive knowledge and symptoms of respiratory diseases were completed for all participants and lung function tests were also performed. Data were analyzed using T-student, Chi square test or Fisher's exact test.
Results:
Spirometric results showed a significant reduction in respiratory capacity in the farmer group compared to non-farmer. In all three age groups, the prevalence of respiratory symptoms in farmers were higher than non-farmer groups and as the age increased, the prevalence of symptoms also increased. In the age group over 55, the risk of cough, phlegm, dyspnea and wheezing were 17,10/ 78,3/58 and 6/61 times more than non-farmers respectively which were statistically significant at 95% confidence interval P value < (0.05). Among the symptoms of respiratory, cough had the highest and shortness of breath had the lowest prevalence.
Discussion and conclusion:
Regarding the prevention of high prevalence of respiratory disorders in farmers, the mechanization of agricultural practices, the promotion of health awareness of farmers by health professionals, appropriate implementation of training programs by the health department and assistance of Jihad-e-Agriculture are necessary
 

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Introduction: Iranian students of health need to bone up on their academic English to be able to read the English sources of health as a factor contributing to community health promotion. In the Iranian academia, students are placed in Basic and General English courses not on the basis of proficiency levels, but on the basis of their academic majors with the same protocol, teaching materials, and methodology used for these heterogeneous classrooms leading to failure and dissatisfaction in the use of academic English as a vehicle for increasing their knowledge of community health. This study investigated the effect of English proficiency homogenization on linguistic proficiency of Iranian students of health as a means of health enhancement via reading English sources.
Methods: In this quasi-experimental study conducted in 2018, the Cambridge Placement Test was given to 71 students of three health majors at Shahid Sadoughi University of Medical Sciences selected with convenient sampling method. The students were divided into three language ability groups using placement test percentiles and taught with two different protocols which were used till the midterm exam. The midterm exam was given and the data were collected and analyzed with SPSS20 using descriptive statistics, i.e., frequency, percentiles, mean, and standard deviation and also inferential statistics, i.e., one-way ANOVA, Levene statistic, Tukey HSD, and independent T-test.
Results: A significant difference was found between the three groups on the placement test (p=0.015); there was no significant difference among the three different academic majors with regard to Criterion-referenced Test (CRT) scores (p=0.05); there was no significant difference among the three Norm-referenced Test (NRT) forms (Forms A, B, & C) (p=0.05); also, there was a significant difference among the two CRT forms (Forms A, B) (p=0.05). Regarding the placement test, the significance indices demonstrated a significant difference between group A, on the one hand, and groups B and C, on the other with no significant difference between groups B and C (p=0.05). The findings of the second part of the post hoc test showed a significant difference for the midterm exam between Group A, on the one hand, and Group B and Group C (p=0.05), on the other, with no significant difference between groups B and C (p=0.05), indicating the success of the present study.
Conclusion: The students of health should be grouped in Basic English and EGP courses, not based on their academic majors, but based on their English proficiency levels for a successful English pedagogy leading to successful use of English texts of health as a means of promoting health community.

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Background:Despite the commitment of governments to improving health outcomes such as "life expectancy", "maternal mortality reduction", there are significant differences in the health status of different social groups within and between communities that can be prevented by appropriate interventions.In IRAN an  important activity to move towards reducing health inequality was the establishment of a social deputy at the Ministry of Health and Medical Sciences Universities in 2016 which three years of activity, this department was dissolved. This study aimed to investigate the status of health socialization and its strategies and pillars in the current structure of the country in the field of health socialization and to examine the relationship between these pillars.
Methods: This paper is a qualitative study conducted through documentation analysis and two in-depth semi-structured interviews with social deputies of two medical universities of Iran. Data were analyzed using content analysis method.
Result: The study revealed that Iran has three strategies for socialization of health, and eight elements have been designated for their implementation. Currently, the implementation of the strategies has been distributed to various departments of the Ministry of Health and universities. They don’t have clear coordination and communication process.
Conclusion: for achieving equity in socialization of  health goals, it is better to clarify socialization of health stewardship  in the whole country.

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Introduction: With regard to the importance of the environment in sustainable development along with environmental literacy among citizens, the present study aimed to assess the levels of environmental literacy among citizens residing in the city of Yazd, Iran.
 Methods: In this descriptive--analytical study, the sample size was determined based on the Cochran formula of 410 individuals. The data selection tool was also a researcher-made questionnaire comprised of items on demographic characteristics information as well as levels of awareness, attitudes, and practices concerning the environment such as air pollution, waste management, etc. Face validity verified by 10 qualified individuals as the faculty members and Reliability was confirmed by Cronbach’s alpha coefficient of 0.93. The collected data was analyzed using the SPSS 22. In this study, significance level was considered as 0.05.
Results: awareness score was statistically significant in terms of age, level of education, and employment status (p<0.05). However, attitudes were only in a significant relationship with employment status (p=0.004). The relationship between practice score was also statistically significant with regard to age, marital status, and area of residence (p<0.05). A significant relationship was further observed between age and level of income and level of awareness, but there was no significant relationship considering attitudes (p>0.05). Moreover, a positive correlation was found between awareness, attitude, and practice scores (0.323≥ r ≥0.28, p<0.001).
Conclusion: Although awareness among Yazd citizens on some environmental issues was at low levels, in general, their awareness specifically regarding health issues stemming from air pollution was proper. In view of the importance of environmental factors, it is necessary to conduct various research studies to identify and control these factors and find proper solutions.