Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Knowledge of Health Volunteers in the Damavand District on Food Safety: A Study Based on the World Health Organization Manual 1 12 FA M Ghfari Shahid Beheshti University of Medical Sciences N z Jafarian Shahid Beheshti University of Medical Sciences jafarian_zainab@ymail.com Y y Mehrabi Shahid Beheshti University of Medical Sciences N F Mohammadi-Nasrabadi Shahid Beheshti University of Medical Sciences N Introduction: Food borne illnesses are usually infectious or toxic in nature and caused by bacteria, viruses, parasites or chemical substances entering the body through contaminated food or water. Unsafe food causes more than 200 diseases - ranging from diarrhea to cancers. Food safety is a public health priority. The aim of present study was determine level of health communicators' knowledge about food safety in Damavand city that was performed according to the World Health Organization guide. Methods: This study is a descriptive analysis of the target a group of health Volunteers in Damavand depended to Shahid Beheshti University of Medical Sciences. 109 persons were enrolled with s awareness, scarification and consent of the census. Tools for data collection was a questionnaire consisting of 13 questions on demographic characteristics and 24 questions about food safety according to WHO’s guide. Data was analyzed with SPSS-18 software and statistical analysis includes one-way ANOVA, t-test and spearman correlation. Results: The mean age of participant was 44.75 ± 9.98 years. Average score of awareness of food safety was 35.87 ±6.22 and for awareness was 77 (71%). No significant relationships was observed between of awareness and marital status, age, education, occupation and education of wife was not significant relationships (p>0/05). Conclusion: In some safety food items the level of knowledge in some safety food items was good, in other one, such as food storage, transmission of microbes, cooking temperature for meat there was low awareness. In this respect, information, education programs to raise awareness of the health status for health volunteers is recommended Knowledge, Health Volunteers, Food safety, Damavand http://tbj.ssu.ac.ir/article-1-2266-en.html http://tbj.ssu.ac.ir/article-1-2266-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Comparison of Zinc Status between Patients with Phenylketonuria Undergoing Therapy Metabolic Formula and Healthy People 13 21 FA F Nazari Shahid Sadughi University of Medical Sciences N A Ghadiri Anari Shahid Sadughi University of Medical Sciences N M khoshbin Shahid Sadughi University of Medical Sciences N H Mozaffari-Khosravi Shahid Sadughi University of Medical Sciences N A ansari far bushehr University of Medical Sciences N A dehghani Shahid Sadughi N S firozbakht bushehr University of Medical Sciences N A najarzadeh Shahid Sadughi University of Medical Sciences azadehnajarzadeh@gmail.com Y Introduction:In patients with phenylketonuria protein rich-foods are restricted. Milk, dairy products, meat and fish are replaced by phenylalanine-free (phe-free) metabolic formula. Therefore patients with phenylketonuria may be at risk for protein deficiency and zinc deficiency. Aim of this study was to assess Plasma zinc status, and zinc intake in Patients with phenylketonuria Undergoing Therapy metabolic formula compared to healthy control. Methods: This study was case-control. 29 Patients with phenylketonuria and 29 healthy as control group took part in this study aged 0.5–42 years in Yazd and Bushehr provinces. Dietary intake data were collected by the 3-day food-record questionnaire. Plasma zinc levels were determinedby flame atomic absorption spectrophotometry. P value less than 0.05 was considered significant statistically. Results: Median Plasma zinc levels in the case group and the control group was 5.86 and 8.34 µmol/L (p=0/11).  Median Plasma zinc level was less than the normal range in two groups. Zinc intake in the case group was more than the control group significantly (p<0.001). Frequency of zinc deficiency was 82.8% in case group and 86.2% in control group. There was no significant difference about Frequency of zinc deficiency between control and case group (p=1). Conclusion: Despite of zinc intake in the case group was more than the control group significantly but Plasma zinc levels was not different in the case group and the control group significantly. Frequency of zinc deficiency was observed high rate in the case and the control group. Zinc intake,zinc status, PKU http://tbj.ssu.ac.ir/article-1-2268-en.html http://tbj.ssu.ac.ir/article-1-2268-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Assesment of the Relationship between Organizational Silence and Organizational Performance in Educational Hospitals Yazd University of Medical Sciences* (2014) 22 29 FA R Askari School of Public Health, Shahid Sadoughi University of Medical Science. Yazd, Iran. N F Sepaseh School of Public Health, Shahid Sadoughi University of Medical Science. Yazd, Iran. sepaseh_1001@yahoo.com Y Z Tavazoe School of Public Health, Shahid Sadoughi University of Medical Science. Yazd, Iran. N Abstract Introduction: One of the important tasks of human resource management; is Staff Performance appraisal that are influenced by several factors. This was one of the factors is lack of outdoor in organizations and prohibit employees to express their problems and ideas or organizational silence. The present study aimed to assesment of the relationship between organizational performance and organizational silence in educational hospitals Shahid Sadoughi University of Medical Sciences. Methods: This study was done cross-sectional analytical in 2014. The sample size is equal to 385 of the entire staff of educational hospitals Shahid Sadoughi University of Medical Sciences who were selected by stratified randomization. Also, in order to collect data were used from standardized questionnaire validity and reliability have already been demonstrated in previous studies. The software was used for data analysis SPSS.19 and data were analyzed by the Pearson correlation coefficient, t-test and Anova. Results: The aspects of organizational silence highest and lowest scores are related to the aspects of opportunity (2/98) and senior management (2/72). Also, among the aspects of organizational performance has been, highest and lowest scores were related to aspects of innovation (3/27) and quality (3/19). The Pearson correlation there was a significant relationship between the two components of organizational performance and organizational silence (p-value =0/000). Conclusion: As showed results there is a statistically significant relationship between the two components of organizational silence and organizational performance, in organizations that has more chance of their employees, their organizations where they feel safe and have job security, So committed to the organization And Will do their duties properly and to the satisfaction and motivation. Organizational performance, Organizational silence, Staff, Educational hospitals http://tbj.ssu.ac.ir/article-1-2269-en.html http://tbj.ssu.ac.ir/article-1-2269-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Factors associated with delaying birth of first child: A Case Study of 15- 49 years old married women lived in Meybod town 30 42 FA R Zare Mehrjardi Payam Noor University, Tehran ghazal59 _nima@yahoo.com Y T Mohamadinia Payam Noor University, Tehran N Gh Hosseini comprehensive management institute , Tehran N Introduction: The purpose of this paper is to examine the impact of demographic, social, economic and cultural factors on delaying the Birth of the first child in Meybod town. Spacing between marriage and the birth of the first child is a crucial factor in demographic planning. Methods: The survey was research method and Information collected by the structured questionnaire. The study population was married women 15 to 49 years old in the city Meybod, and the sample population included 379 such women were selected with using of multi stage cluster random sampling. Results: The results of the study show that there are a meaningful relationship between the variables of women’s tendency to pregnancy, kind of family, women’s age and duration of marriage, Education of women and their husbands, geographic origin of women, occupational status of women, and their type of marriage with the dependent variable the length of period from marriage to first child birth. Also, Results of multivariate regression shows that the Use of contraceptive, women’s marriage age, women’s geographic origin, Duration of marriage, Gender Equality and kind of family, Respectively, Have a major role in determining this spacing, and able to predict 34% of the variance in the dependent variable. Conclusion: The results of this study and previous studies shows that in recent years, the space between marriage and birth of first child has increased and from the intensity of fertility is reduced. Overall, from the findings can be concluded that impact of demographic, social and cultural Condition on increase in delaying of the first child birth, and therefore the fertility decline of society is far more than economic conditions. So, to reduce the space between marriage and the birth of first child in the planning, should pay more attention to demographic and social-cultural Factors. Delay in childbearing(Postponing Fertility), Age of marriage, Contraceptive methods, family type. http://tbj.ssu.ac.ir/article-1-2270-en.html http://tbj.ssu.ac.ir/article-1-2270-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 The Relationship between Cooperation of Employees and Sources of Manager, s Power in State Hospitals of Yazd 43 53 FA M Shahid Sadoughi University of Medical Sciences, Yazd, Iran. N F Heidari Shahid Sadoughi University of Medical Sciences, Yazd, Iran. N R Askari Shahid Sadoughi University of Medical Sciences, Yazd, Iran. N ME Eghbali zarch Shahid Sadoughi University of Medical Sciences, Yazd, Iran. N Shahid Sadoughi University of Medical Sciences, Yazd, Iran. m.soltani6988@gmail.com Y Abstract Introduction: The most important objective of an organization is increasing efficiency and performance of the firm. That is why organizations attempt to design systems and strategies to improve the job involvement levels. For it benefits both the organization and its employees at the same time. In the current research, we try to discover the relations between staff’s job involvement and manager’s power resources throughout the public hospitals of Yazd in 1392. Methods: This was an analytic-descriptive study. The sample size was 160 individuals. Power forcing and job involvement questionnaires used in the study. The data was analyzed with SPSS 16 using T-test and Spearman. Results: Among the power resources, the highest level of mean belongs to specialization power (5/09) from 8 score, the second rank is legal power, and the others are reference, obligation, and remuneration in respect. Job involvement’s mark is higher than average (%62/89). Age has direct relationship with the legal power, and a reverse relationship with the specialization power and job involvement. Official background has direct relationship with obligation power. Conclusion: It was found during the study that there is no relationship between the employees’ job involvement and the managers’ power resources. This reduction of efficiency is because of the lack of appropriate use of the resources by managers. Therefore, the managers must with to create responsibility, discipline, increased motion and motivation among the employees which ends in improving the efficiency of labor. Job Involvement, Power resource http://tbj.ssu.ac.ir/article-1-2272-en.html http://tbj.ssu.ac.ir/article-1-2272-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 The effect of education based on the theory of planned behavior on preventive behaviors of cutaneous Leishmaniasis in mothers living in endemic city of Natanz 54 66 FA MH Baghianimoghadam Shahid Sadoughi University Of Medical Sciences. N B Tavakoli Shahid Sadoughi University Of Medical Sciences. tavakoli.bfsh@gmail.com Y J Ayatollahi Shahid Sadoughi University Of Medical Sciences. N M Mirzaei Shahid Sadoughi University Of Medical Sciences. N Introduction: Due to the limited studies conducted on the educational interventions to change the preventive behaviors of cutaneous leishmaniasis(CL) as well as mothers' critical role in creating and maintaining these behaviors, this study aimed to determine the impact of education based on theory of planned behavior on preventive behaviors of CL in mothers living in endemic city of Natanz. Methods: In this case experimental study, two health care centers in endemic areas of CL were randomly assigned into two groups of experimental and control. Using list of mothers covered by each center, 80 patients were selected by simple random sampling, who were required to complete a questionnaire that has been designed based on the theory of planned behavior, and its reliability and validity had been confirmed in the previous studies. Then 4 sessions were held for the experimental group mothers and 2 training sessions were held for people who influenced them, whereas control group received no interventions. Two months after training intervention, the study data were collected again and were analyzed using the SPSS software (ver. 18) via independent statistical t-test, paired t-test, Chi-square and Mann Whitney tests. Results: Before the intervention, no significant differences were observed between the mean scores of different constructs of this theory in the two groups (p>0/005). Though after intervention, a significant increase was observed (p<0/005) in the mean score of knowledge, attitude, subjective norms, perceived behavioral control, intention and action of groups and in control group, only a significant increase was observed in the mean scores of knowledge and attitude (p<0/005). Conclusions: As the findings of the present study revealed, training based on theory of planned behavior can promote preventive behaviors of CL in mothers. Cutaneous leishmaniasis, Education, Mothers, Theory of planned behavior http://tbj.ssu.ac.ir/article-1-2271-en.html http://tbj.ssu.ac.ir/article-1-2271-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 The Relationship between Social Capital Dimensions and Perceived Health in Yazd Urban Society, 2013 67 77 FA MA Bahrami Shahid Sadoughi University of Medical Sciences N A Amiri Shahid Sadoughi University of Medical Sciences asma.amiri87@yahoo.com Y R Montazeralfaraj Shahid Sadoughi University of Medical Sciences N HR Dehghan Shahid Sadoughi University of Medical Sciences N Introduction: Health is the most fundamental parameter of society welfare and more than medical interferences is related to social factors. The concept of social capital, because of its nature and content, nearly is related to all under consideration subjects and topics in health, social and human areas. Social capital and social topics have a close connection with health. So the purpose of this research is the assessment of the social capital dimensions and perceived health in Yazd urban society. Methods: This research is analytic and temporary. The researched society includes all citizens of Yazd city. The number of sample volume equals 380 persons who have been chosen with random clustered sampling method. Data gathering tool was questionnaire including two questionnaires of social capital and perceived health. Results: Between dimensions of social capital; feeling of confidence and safety, the quality of family relationships, value of life, tolerance in the field of cultural variety and the quality of work relationships with perceived health there is a direct and meaningful connection but between participation in local society activities, proactivity in social context and the quality of relationships between neighbors with perceived health there is no meaningful connection. Conclusion: There is a direct and meaningful connection between social capital and it’s dimensions with perceived health. So, with increase in social capital the amount of perceived health increases too. Social capital, Perceived health, Citizens http://tbj.ssu.ac.ir/article-1-2273-en.html http://tbj.ssu.ac.ir/article-1-2273-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Stress and Predicting Factors of Psychological Well-being among Adolescents 78 91 FA N allahverdipourh@tbzmed.ac.ir Y N Abstract Introuduction: Stress is one of the major causes of many diseases. Adolescence is due to accompanied with puberty a period of stress and pressure and majority of them suffering of mental health problems. Methods: This study was performed among high school students in Tabriz during the 2013-2014. The sample of study consisted of 403 students in the all grades of 9-12. Four schools were randomly selected; then samples were randomly selected using cluster sampling with proportional allocation. GHQ-28, Oxford Happiness, General self-efficacy, Cohen’s perceived stress, Snyder’s Hopefulness and Diner life Satisfaction questionnaires were used to gather data. Results: Results indicated with an increase of stress scores odds of low psychological well-being increased by 27%. Also, 55% of girls and 46.3% of boys had high stress and stress was a predicting factor of psychological well-being and 62% had mental health problem. Conclusion: The current study demonstrated majority of students suffer from mental health problems and stress is one of the significant predicting factors of psychological well-being. Stress, psychological well-being, adolescents http://tbj.ssu.ac.ir/article-1-2275-en.html http://tbj.ssu.ac.ir/article-1-2275-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Survey of risk factors urinary tract infection 92 102 FA A Dehghani Shahid Sadoughi University of Medical Sciences, N M zahedi Shahid Sadoughi University of Medical Sciences, m_z0686@yahoo.com Y M moezzi Shahid Sadoughi University of Medical Sciences, N M dafei Shahid Sadoughi University of Medical Sciences, N H Falahzadeh Shahid Sadoughi University of Medical Sciences, N Introduction: Women are very susceptible to urinary tract infections and pregnancy raises the risk of urinary tract infection. In general, little information on the risk factors of urinary tract infection in pregnancy is underway. Urinary tract infection in pregnancy is an important risk factor for pregnancy dire consequences. The purpose of this study is to find risk factors associated with urinary tract infection in pregnant women. Methods: The study was observational and retrospective analysis was carried on in the winter of which 310 pregnant women participated in 11 health centers in Shahrekord. Of these 155 cases (patients) and 155 controls (healthy) that were matched for age Information required from the health records of pregnant women and complete Czech list of researcher whose validity was confirmed by experts were gathered. Information needed by pregnant women health records and complete list researcher was collected. Czech list contains a number of possible risk factors for illness and demographic characteristics of the study participants was Statistical analysis software spss version 16 by using chi square tests and logistic regression and t analysis was performed. Results: Among the variables vomiting (p = 0/00) a history of urinary tract infection in a previous pregnancy (P =.001, CI = 1.508-4.408, OR = 2.578) abortion own history (P =.014, CI = 1.165 -3.847, OR = 2.117), respectively, the most important risk factors for urinary tract infection in pregnant women were determined. Conclusion: Prevention and treatment of vomiting in pregnancy prevention of urinary tract infections during pregnancy. Prevention of abortion can play an important role in the prevention of urinary tract infection and its complications in pregnancy. The study also revealed a number of factors can have an impact on urinary tract infection in pregnancy that has not been enough attention and it is necessary that more attention be placed on health programs and prevention. urinary tract infection, pregnancy, risk factors http://tbj.ssu.ac.ir/article-1-2274-en.html http://tbj.ssu.ac.ir/article-1-2274-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Survey the Effect of Pistachio Waste Composting Process with Different Treatments on Concentration of Heavy Metals 103 114 FA M Jalili Shahid Sadoughi University of Medical Sciences, Yazd, Iran N A Ebrahimi Shahid Sadoughi University of Medical Sciences, Yazd, Iran N H Karimi Shahid Sadoughi University of Medical Sciences, Yazd, Iran N M Mokhtari Shahid Sadoughi University of Medical Sciences, Yazd, Iran mhimokhtari@gmail.com Y Abstract Introduction: Composting is one of the pistachio wastes management methods. In the appropriate compost production nutrients and heavy metals are determinant. The aim of this study is survey the effect of pistachio wastes composting process with different treatments on the concentration of heavy metals. Methods: In this study, during the 60-day pistachio wastes composting process with two treatments of dewatered sewage sludge and cow manure, pH, EC, carbon to nitrogen ratio, Heavy metals and nutrients indicators were studied. The results were compared with WHO and Iranian National standard. Drawing the diagrams by Excel software (Version 2007) and Statistical analysis was performed by Spss Software (version 20) at a significance level of 0.005.  Results: During the 60-day composting pH initially had downward trend and then increased. The Cu, Zn, Fe, Mn and C/N ratio had downward trend and the EC, Na, K had increasing trend. Eventually, Iron, zinc, copper and manganese were less than the standard, Sodium was in Standard range and potassium was more than specified standards in the produced compost from pistachios waste with both treatments.  Conclusion: The results showed that the concentration of heavy metals and nutrients in the produced compost with both treatments were in the acceptable range. Eventually quality of produced compost with cow manure treatment due to better decomposition and greater stability was better than processed compost with dewatered sewage sludge treatment. Composting process, pistachio processing waste, heavy metals http://tbj.ssu.ac.ir/article-1-2276-en.html http://tbj.ssu.ac.ir/article-1-2276-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 The assessment of Barriers to the Self-care Behaviors in Type 2 Diabetic Patients of Yazd Province in 2014 115 129 FA B Fallah Tafti Islamic Azad University, Tehran Medical Sciences Branch N AA Vaezi Shahid Sadoughi University of Medical Sciences, Yazd Vaeziali@yahoo.com Y Z Moshtagh Shahid Beheshti University of Medical Sciences N F Shamsi Shahid Sadoughi University of Medical Sciences, Yazd N Introduction: Patients with diabetes may have weakness in performing appropriate self-care behaviors and adherence to it. Therefore, the first step to the improvement of self-care behaviors is to identify the influential barriers to the self-care behaviors. This study aimed to determine the barriers of self-care behaviors in type 2 diabetic patients of Yazd province. Methods: This was a descriptive cross-sectional correlation study which was accomplished on 152 patients with type 2 diabetes who referred to Yazd Diabetes Research Center of Yazd by systematic sampling. The data were collected by a Self-made questionnaire. The validity and reliability of the questionnaire were assessed by the means of Cronbach's alpha at 0.8. The data were analyzed using SPSS version 16 and the Independent Samples t -test, ANOVA and Pearson correlation coefficient were applied. Results: The scores of the barriers to the self-care behaviors of diabetic patients was 52/03 from 100 which was at the level of moderate. The results suggest that the economic barriers were the most substantial factors among the self-care barriers (73 points), and the knowledge and attitude (63 points) were in the second row. The Effective barriers to the self-care behaviors based on age, sex, education, occupational status, income level, the duration of disease, having diabetic complications and the number of their referrals to the physicians were significantly different. Conclusion: Identifying the barriers to self-care behaviors is an important step in helping diabetic patients especially economically. Therefore, procedures such as monitoring of the blood glucose level for diabetic patients, providing supportive service and delivering self-monitoring and self-caring tools and equipments, self-monitoring will improve self-caring behaviors. barriers, self-care, type 2 diabetes http://tbj.ssu.ac.ir/article-1-2278-en.html http://tbj.ssu.ac.ir/article-1-2278-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Evaluate the Performance of Dual Media Filter to Improve Water Quality in Abadan Water Treatment Plant 130 143 FA I Baraee Islamic Azad University, Science and Research Branch, Tehran, Iran iran.baraee@yahoo.com Y S M Borghei Islamic Azad University, Science and Research Branch, Tehran, Iran N A Takdastan Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran N AH Hasani Science and Research Branch, Tehran, Iran N AH Javid Science and Research Branch, Tehran, Iran N Abstract Introduction: Nowadays, the greatest of process type used in treatment of beverage water is conventional treatment. That it cannot remove organic matter effectively. Filtration is one of the most important treatment processes used in water treatment plant.The one of approaches, modification of conventional rapid sand filters into dual or multimedia filters. Methods: This study was results from of pilot study that with the purpose of assessment performance was using of GAC and Anthracite in dual media filter filters in Abadan water treatment plant in removal of TOC, Fe, Mn, No3-and NH4+ in Drinking Water by GAC and Anthracite in dual - media filters in Abadan water treatment plant. All parameters were measured according to sections of Standard Methods APHA et al. The t-test and regression equations were calculated. Results: Samples were collected in summer from the inlet and outlet of each pilot filter and the outlet of the filtration unit. Turbidity, Total Organic Carbon (TOC), Fe, Mn, NO3- and NH4+ were measured in each sample for three different low, medium, and high filtration rates. Pilot No.2 had a maximum efficiency in the removal of the parameters that removal average of turbidity, TOC, Fe, Mn, NO3-, NH4+, respectively. So, the best performance of GAC-sand filter is in EBCT=20 min during loading rate of 35 l/d. Conclusion: In general, both pilot filters performed better at low surface loading rate. More specifically, pilot scale No. 2 showed better removal of parameters and longer empty bed contact time (EBCT) in that surface loading rate. dual media filter, water treatment, water quality, TOC, filtration, Abadan http://tbj.ssu.ac.ir/article-1-2280-en.html http://tbj.ssu.ac.ir/article-1-2280-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Prevalence of Food Supplements used in Patients with Rheumatoid Arthritis Referred to Government Hospitals in Yazd 144 154 FA A Noshi Shahid Sadoughi University of medical sciences N M Modares Mosadegh Shahid Sadoughi University of medical sciences Mo_modares@yahoo.com Y Sh Sadat Mirzania Shahid Sadoughi University of medical sciences N A Dehghan Shahid Sadoughi University of medical sciences N Introduction: Rheumatoid Arthritis (RA) is an autoimmune disease where immune system mistakenly assumes different elements of joints as exogenous and attacks it. Based on scientific findings, a wide range of complementary and alternative therapies (including herbal and food supplements) are useful for RA. Methods: This Cross-sectional study was carried out on 120 patients suffered from RA whom were referred to public health centers of Yazd in 2014. Using a questionnaire, demographic characteristics and the type and rate of supplementation were evaluated in these patients. Results: out of 120 patients, 118 individuals used at least one of the questioned supplements. Patients ranged from 19 to 76 years that 71.6 percent ≥ 40 years, 85% female, 92% married, 55% earned between 1 and 2 million Tomans per month and 51.7% had high school diploma or higher education. The most prevalent consumed supplement was calcium-Vitamin D (90.7%) and Folic acid (%80.5), vitamin D (%73.7), and omega-3 (%55.9) came afterward. Interestingly, majority of patients (96.5%) were taking supplements under the supervision of rheumatologist. Conclusion: Based on present data obtained in patients suffering from RA, most frequently used supplement was calcium-vitamin D. Most patients were satisfied of positive effects of these supplements. Rheumatoid Arthritis, Food Supplements, Yazd http://tbj.ssu.ac.ir/article-1-2281-en.html http://tbj.ssu.ac.ir/article-1-2281-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Prevalence of depression, anxiety and stress in Yazd (2013) 155 164 FA H Fallahzadeh School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. N M Momayyezi School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mahdieh_momayyezi@yahoo.com Y J Nikokaran School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. N Abstract Introduction: Depression and anxiety are the most common psychiatric disorders with a prevalence rate of 10-20% in the general population. Peace and avoidance of depression, anxiety and stress can increase the well-being. This study was conducted to determine the prevalence of depression, anxiety and stress in Yazd. Methods: A descriptive-analytic study was conducted on 400 people in Yazd through cluster sampling method. Yazd’s health centers were divided into 16 clusters and 25 families from each cluster. Data were collected by DASS-21 questionnaire. Statistical analyses included descriptive statistics and Mann-Whitney test, Kruskal-wallis test and logistic regression in SPSS/16 software. Results: The prevalence of depression, anxiety and stress prevalence were respectively 54.3%, 57.7% and 51%. Results of logistic regression analysis showed that history of chronic diseases and low income were predictor variables for depression. Also, gender, Low educational level, history of chronic diseases and low income were predictor variables for anxiety. Type of job, smoking and history of chronic diseases were predictor variables for stress. Conclusion: Results showed high levels of depression, anxiety and stress in population; also anxiety was more prevalent among them. Increase public awareness, Increase counseling centers, especially telephone counseling and improve the recreational facilities of parks is necessary to solve this issue and plan to improve conditions. depression, anxiety, stress, Yazd http://tbj.ssu.ac.ir/article-1-2284-en.html http://tbj.ssu.ac.ir/article-1-2284-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Effect of Heating Processes and Home Cooking Methods of Rice on Concentration of Aflatoxin B1 165 175 FA B Hajimohammadi Shahid Sadoughi University of Medical Sciences N M Kiani Shahid Sadoughi University of Medical Sciences mahdi_sarab@Yahoo.com Y MH Mosadegh Shahid Sadoughi University of Medical Sciences N J Biabani Shahid Sadoughi University of Medical Sciences N H Fallahzadeh Shahid Sadoughi University of Medical Sciences N MS Tabatabayi Shahid Sadoughi University of Medical Sciences N Introduction: Mycotoxin contamination of crops for human and animal health has been facing a serious concern. Aflatoxin B1 is the most toxic types of aflatoxins in foodssuch as rice. The aim of this study was to investigate the Effect of heating processes and home cooking methods of rice on concentration of aflatoxin B1. methods: The heating processes of 20 and 120 minutes and rinse in three types of roasted rice, boiled and water cooked was studied in naturally contaminated with aflatoxin  B1 and the amount by high performance liquid chromatography (HPLC) measured. Results: In the cases of 20 minutes and 120 minutes, the mean concentration of aflatoxin  B1 heats rice decreased as much as 16.6% and 81.7%. Although this reduction was not statistically significant heating at 20 minutes but at 120 minutes with heating was significant(P<0/05). The decrease in the average concentration of aflatoxin  B1in boiled, water cooked and roasted rice to order 60.2%, 85.5% and 87.6% indicated that this reduction was not statistically significant in the boiled cooking, but the cooking utensils and this reduction was not statistically with fried rice (P<0/05) was significant. Conclusion: The results show that the processes of heat and cook the rice variety could reduce the risks of aflatoxin  B1 in rice consumed by man. Rice, aflatoxin B1, high performance liquid chromatography (HPLC) http://tbj.ssu.ac.ir/article-1-2282-en.html http://tbj.ssu.ac.ir/article-1-2282-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 A Survey on Health Literacy of Referred Diabetic Patients to Yazd Diabetes Research Center 176 186 FA z Rezaee Esfahrood Shahid Sadoughi University of Medical Sciences, Yazd N A Haerian ardekani Shahid Sadoughi University of Medical Sciences, Yazd N M Rahmanian Shahid Sadoughi University of Medical Sciences, Yazd N M Ghaffari Targhi Shahid Sadoughi University of Medical Sciences, Yazd dr.m_ghaffari@yahoo.com Y Introduction:The ability to use skills such as reading, listening, analysis and decision making in health status depends on the degree to which individuals have the capacity to obtain, process, and understanding basic health information and services needed which is defined in term of health literacy. The purpose of this study was to determine the level of health literacy in referred patients to Yazd Diabetes Research Center. Methods: This cross-sectional study performed on 432 patients referred to Yazd Diabetes Research Center in 2014. Health literacy was measured by the Test of Functional Health Literacy in Adults (TOFHLA) and analyzed using the SPSS-17 software and analytical statistics (T-Test, Chi-Square, A-Nova and linear regression). Results: The mean age of studied population was 55.02 ± 6.32 years old and the mean duration of diabetes was 10.24 ± 7.13 years old. Increase age and decrease the Duration of diabetes, Increase health literacy scores. The average of Health literacy scores was significantly higher in men than women. Retired people, people living in the city, people with high educational level and good economic situation were more literate. (P-Value <0.001) Conclusion: The results showed that health literacy in 59.3 percent of patients was insufficient, in 18.5 percent was border and only 22.2 percent of patients had adequate health literacy that providing facilities and health literacy education seems to be necessary for them.   Health Literacy, Self-Care, Diabetes, Diabetes Research Center http://tbj.ssu.ac.ir/article-1-2283-en.html http://tbj.ssu.ac.ir/article-1-2283-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Antibiotic Resistance Patterns of Klebsiella pneumoniae Strains Isolated from Urine Samples Collected from Shahid Sadoughi University Hospitals, Yazd, Iran 187 197 FA A Dehghan Banadkouki Shahid Sadoughi University of Medical Sciences, Yazd, Iran N G Eslami Shahid Sadoughi University of Medical Sciences, Yazd, Iran N H Zandi Shahid Sadoughi University of Medical Sciences, Yazd, Iran hengameh_zandi@yahoo.com Y A Dehghan Banadkouki Shahid Sadoughi University of Medical Sciences, Yazd, Iran N A Mosadegh Shahid Sadoughi University of Medical Sciences, Yazd, Iran N A Amiri Shahid Sadoughi University of Medical Sciences, Yazd, Iran N Abstract Introduction: Klebsiella pneumoniae is an opportunistic pathogen that causes urinary tract Infection (UTI), intra-abdominal infection and pneumonia in patients with weakened immune systems or underlying diseases. Several studies have shown that the indiscriminate and irregular use of antibiotics can cause antibiotic resistance. Antimicrobial resistance has been introduced as one of the most important global health risks by the World Health Organization (WHO). Due to the increasing resistance of pathogens to antibiotics, antibiotic resistance patterns of Klebsiella pneumoniae strains isolated from urine samples have been investigated. Methods: In this descriptive-sectional study, 130 isolates of Klebsiella pneumoniae were collected from hospitalized patients with urinary tract infections and identified by biochemical tests. Antimicrobial susceptibility test was evaluated by standard disk diffusion method (Kirby-Bauer) that has been recommended by the CLSI. Results: From 130 strains of Klebsiella pneumoniae, 72 strains (55.4%) were isolated from female patients. The results showed that the highest rate of resistance was belonged to amoxicillin (100%) and cefotaxime (41.5%) respectively and the lowest rate of resistance was for meropenem (3.8%) and ertapenem (3.8%). Conclusion: The results of this study and other similar studies show that resistance to different antibiotics  have been acquired, so it is recommended that antimicrobial susceptibility tests should be performed before treatment and the results are reported to the clinicians and infection control committees.   Klebsiella pneumoniae, Urinary tract infection, Antibiotic resistance http://tbj.ssu.ac.ir/article-1-2286-en.html http://tbj.ssu.ac.ir/article-1-2286-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Effect of Communication Skills Training on Components of Burnout among Nurses Work in Tehran University of Medical Science Hospitals 198 208 FA SS Mazloomy Mahmoodabad Shahid Sadoughi University of Medical Sciences N M Safaeifar Shahid Sadoughi University of Medical Sciences safaeifar.m@gmail.com Y B Gharraee Shahid Sadoughi University of Medical Sciences N H Fallahzadeh Shahid Sadoughi University of Medical Sciences N Introduction: The aim of this study was to evaluate the impact of communication skills training on components of burnout among nurses working in hospitals affiliated to Tehran University of Medical Sciences. Methods: This was an interventional study on 107 nurses working in hospitals affiliated to Tehran University of Medical Science. Participants, who met the inclusion criteria, complete the two-part questionnaire for demographic variables and the Maslach burnout inventory (MBI). The interventional group participated in a two-day workshop communication skills training. Three months after the workshop, participants in the study were asked to complete MBI questionnaire again. Data were analyzed with Spss 18 software. Results: The results of the paired t-test in the experimental group before and after intervention showed statistically significant difference in the mean score on emotional exhaustion of the frequency scale (p< 0̸008) and intensity (p˂ 0̸001), and intensity scale of depersonalization (p˂ 0̸03). After the intervention, the mean score of the three components of burnout in both frequency and intensity scale, in two groups was significant (p˂ 0̸05), which implied that communication skills training have a favorable effect on burnout among hospital nurses. Conclusion: With knowledge of effect of communication skills training on nurses burnout, it is recommended to apply this training to prevention and health promotion programs for nurses. burnout, nurse, communication skills http://tbj.ssu.ac.ir/article-1-2285-en.html http://tbj.ssu.ac.ir/article-1-2285-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 Removal of 4-chlorophenol from synthetic wastewater by the granulated graphene oxide nano particles 209 220 FA A Eslami Shahid Beheshti University of Medical Science, Tehran, Iran. N A Moheb Isfahan University of Technology, Isfahan, Iran N M Mehralian Shahid Beheshti University of Medical Science, Tehran, Iran. mohammadmehralian@yahoo.com Y M Khashij Shahid Beheshti University of Medical Science, Tehran, Iran. N Abstract Introduction: 4-chlorophenols one of the most common pollutants in wastewater is generated from the chemical and petrochemical industries. It is due to the presence of chloride and benzene ring is resistant to biodegradation. In this study, the use of granulated graphene oxide nano particles as an adsorbent nanostructure with better properties than other adsorbents for Removal of 4- chlorophenol from aqueous solution were investigated Methods: This research was implemented during the year 2013-2014 where the Granules of Graphene oxide nanoparticles were prepared using sodium silicate and X-ray diffraction techniques and electron microscope were used to identify the morphology and structure of the adsorbent of.  Parameters  affecting the adsorption process such as initial concentration of  4-chlorophenol(5,10,15,20,25,30mg/L), amount of adsorbent(20,40,60,80% by weight), contact time (3,5,10,20,30 min) and pH(4,6,7,8,9) were investigated by changing one factor at a time. Finally, the data fitness with Langmuir and Freundlich isotherms were showed. Results: Adsorption process reached to equilibrium after 20 minutes. 2 g/L of graphene oxide granules at 3 minutes and 7 = pH could remove 5 mg/L 4-chlorophenol up to 58%. Freundlich isotherm have describing adsorption process and R2 =0.92. Conclusion: Absorbed process by the granules of Graphene oxide nanoparticles is low-cost high-efficiency and it could used to reduce and eliminate environmental pollutants particularly aqueous solutions.   Graphene oxide, nanostructure, 4-chlorophenol, absorption, sodium silicate http://tbj.ssu.ac.ir/article-1-2287-en.html http://tbj.ssu.ac.ir/article-1-2287-en.pdf

Shahid Sadoughi University of Medical Sciences, Yazd Tolooebehdasht 1728-5127 2538-1598 15 3 2016 9 1 New Technologys in Atrazine Removal from Environment with Emphasis on Biodegradation: A Review 221 246 FA Z Derakhshan Shahid Sadoughi University of Medical Sciences, Yazd, Iran N A Ebrahimi Shahid Sadoughi University of Medical Sciences, Yazd, Iran N M Faramarzian Shiraz University of Medical Science N S Sedighi Khavidak Ashkezar Branch, Islamic Azad University, Yazd, Iran sedighi.samaneh@yahoo.com Y MH Ehrampoush Shahid Sadoughi University of Medical Sciences, Yazd, Iran N Introduction:Considering the lack of agricultural lands and the loss of products by pests, utilization of pesticides like atrazine has increased. Due to low vapor pressure, high half-life, and high mobility, this herbicide results in pollution of different ecosystems. In regard with its toxicity, US Environmental Protection Agency has ranked atrazine in III class. Due to its potential capacity in polluting groundwater, it is highly significant. Methods: Many chemical and physical methods have been introduced to remove this herbicide from soil and water environments; however, these methods involve high expenses and cause the creation of other toxic products. Due to development of the science of interaction between man and nature, nowadays biological treatment is uniquely significant. Biological treatment is a process in which microorganisms are utilized to convert and decompose pollutants existing in the environment. Conclusion: Biodegradation is economically and environmentally the best approach to remove long-standing pollutants from the environment. Nowadays, genetic engineering extensively utilizes local or modified microorganisms in treating the environments polluted with pesticides. Finally, in order to further utilize this green technology, it is necessary to specify the soil properties and also conduct ecotoxicological studies in order to identify the capacity of local microorganisms of water and soil. Agricultural pesticides, Atrazine, Biodegradation, Persistant Pollutants, Environment http://tbj.ssu.ac.ir/article-1-2288-en.html http://tbj.ssu.ac.ir/article-1-2288-en.pdf