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Background & Objectives: Infants are more sensitive than adults in pain staining due to disformation of descending control system. Since, non-pharmacological methods are recommended for infants’ pain control, this study aimed to determine combined effect of breastfeeding and maternal-infant skin to skin contact on pain of first injection in healthy term infants. Methods: This clinical trial study was conducted on case and control groups in delivery room of Alavi Hospital for a period of 8 months in 1389. 200 infants were randomly selected and divided in four groups group1: Control, group2: breast-feeding, Group 3: skin to skin contact of mother and infant, and group4: breast-feeding and skin to skin contact of mother and infants. Researchers observed all the DAN scale factors and completed observation paper from the moment of injection until 45 seconds later. Data were analyzed by chi- sq square and t test using SPSS software. Results: Average pain severity was 5.34 for group 1, 3.70 for group 2, 4.16 for group 3, and 3.48 for group 4, based on DAN scale criteria. Statistically significant difference was observed between group 1(no intervention) and group 4 (breastfeeding with skin to skin contact) (p=0.04). Conclusion: Since pain severity is decreased during breastfeeding and maternal- infants skin to skin contact, these two methods may be used to prevent mental and emotional consequences of intramuscular injection pain.

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Background & Objectives: Road traffic fatality is in critical situation in our country nowadays and about 28000 individuals die from road traffic accidents annually. The aim of the current study was to investigate road traffic accidents in patients admitted in emergency department of Alejalil hospital in Aq-Qala city. Methods: An analytical study conducted from July 2009 to July 2010. Data (E.g. selected demographic and other related variables to the study objectives) were recorded through interview either with patients or accompanies using census method. The questionnaire was validated by content validity analysis. ANOVA was applied for data analysis with the alpha level set at p<0.05. Results: Average age of 833 subjects was 24.67(SD=13.96) years. 33.8% of the patients were in 20-29 years age group. Sex ratio (male to female) was 5.7. 74.5% of injuries occurred for motorcyclists and 10.9% for pedestrians. 96% have not used either helmet or seat belt at the accident occurrence time. 41.6% of the accident occurred between 12 to 18 o’clock and 19.3 in Thursday. Thirty eight point five percent was occurred in summer. Significant relationships were observed between accident occurrence and season and day of the week (p<0.05). Conclusion: Majority of the road traffic accidents were in young motorcyclists’ who don’t wear helmet.

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Background & Objectives:�Turbidity and colloidal factors are good shelters for growth and transmission of biological parameters as well as the factors affecting water usage from aesthetic point of view. Coagulating agents such as metal hydroxides are produced by the process of electrolysis. The coagulating agent combines with the pollutants to form large size flocs. This study aimed to investigate the efficiency of electrocoagulation-electrofloatation in removal of turbidity from aquatic environments.

Methods: In a laboratory-scale fundamental-applicable study a plexiglass electrocoagulation reactor (24 ×17 ×18 cm) was made.  4 iron/aluminum plates (electrode) with a dimension of 15 ×16 cm and thickness of 1mm were placed in parallel and 1.5 cm apart in the tank. A DC power supply with adjustable voltage (0-60 v) and amperage (0-6 amps) was used.

Results: : The results showed that the highest turbidity removal from solution was obtained by aluminum electrode (97.60 %) at pH of 7, potential difference of 50 volts, and contact time of 30 minutes. The maximum rate of turbidity removal from aqueous solution by using iron electrodes (89.92%) was achieved at pH=7, potential difference of 50 volts, and contact time of 30 minutes.

Conclusion: based on experiments' results, using electrocoagulation-electrofloatation has an appropriate efficiency in turbidity removal. It can also be concluded that the efficiency of Al electrode to remove turbidity from solution is higher than that of Fe electrode.

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Background & Objectives: Increasing population growth increases the demand for agricultural products and food. Nowadays, number of accidental or intentional poisoning among pesticide users is high due to lack of adequate familiarity with agricultural pest control and pesticide storage principles. The aim of this study was epidemiologic evaluation of poisoning due to pesticides in patients referred to Ardabil city hospitals in 2011. Methods: This descriptive study has been conducted on 245 patients hospitalized in Ardabil city hospitals. Information on age, gender, residence place, job, marriage status, pesticide type, cause of poisoning, poisoning season, mental and physical diseases history, and clinical symptoms was collected through a checklist and analyzed by descriptive statistical methods such as table, graph and mean±SD using SPSS.16. Results: 162 patients (66.1%) were female with the rest being male. The mean age of cases was 30.52 years and the most prevalent age group was 20-30 years with 89 cases (36.3%). The highest number of patients was admitted in summer season with 112 cases (39.7%) and the poisoning in 91 cases (77.95%) was intentional. 29. 4, 42, 51.8, 86.9, 29, and 7.8% of cases were admitted with respiratory, neurological, ocular, gastrointestinal, cardiovascular, and renal symptoms. Aluminium phosphide with 86 cases (35.1%) was the dominant type of pesticide. Conclusion: Regarding to pesticide poisoning mortality, financial burden, and morality it is necessary to take educational measures to protect people against poisoning.

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Background & Objective: Heavy metals are among the significant pollutants of water sources. Unlike organic contaminants, they are not biodegradable and tend to accumulate in living organisms. The objective of the present work was to investigate efficiency of glass beads modified with APTES ligand (3-aminopropyltriethoxysilane) on copper ion removal from aqueous solution Methods: Methodology of the research was experimental, basic and applicable based on the nature of the study and experimental data. Response surface methodology based on Box-Behnken design was used to assess the effect of independent variables including flow rate, solution pH, initial concentrations and size of glass beads on the response function (removal efficiency of copper ion). Results: The optimum conditions to remove copper ion from aqueous solution was achieved at pH≥6, flow rate of 30 ml min−1, and a glass beads size of 38-63µ. Absorption results indicated that Cu2+ adsorption from aqueous solutions to fit with Langmuir isotherm and follow pseudo-second-order kinetic model. Conclusion: All the results demonstrated that modified glass beads successfully absorb copper ion from aqueous solution.

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Background & Objectives: Several methods are available for cleaning ammonia gas from the air stream. It seems that acid scrubbing by packed column is more successful than other methods. In this study, the possibility of removal of ammonia gas with sulfuric acid scrubbing liquid by a packed column was investigated. Methods: A packed column with 20 cm diameter was randomly packed in 30 cm with ceramic raschig rings. Acidic scrubbing liquid in three liquid flow rates and three pH of scrubbing liquid including 5, 6, and 7 were used to scrub the gas with three concentrations as well as three air flow rates. The pH values of scrubbing liquid were controlled by using sulfuric acid and monitored with a pH meter. Ammonia gas was measured by using a direct reading sampler. All measuring instruments were calibrated by the researcher or local manufactures representative. The results were analyzed by SPSS version 16 software package. Results: The findings of this study showed that with decreasing the pH of scrubbing liquid from 7 to 6theremoval efficiency of column increased but it was not significant. Also with decreasing the pH of scrubbing liquid from 6 to 5theremoval efficiency of column increased but it was not significant. However, the removal efficiency of column increased significantly (p<0.01) as the pH of scrubbing liquid was reduced from 7 to 5. Conclusion: Chemical absorption was increased the removal efficiency of ammonia gas significantly. Gas removal efficiency was increased with the decreasing of scrubbing liquid pH values.

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Background & objectives: Mismatching between human resources with capacity of the facilities and failure of capacity building of human resources is the main reason behind lack of efficiency in hospitals. The purpose of this study is to evaluate the allocation of human resources in general university hospitals that located in the cities of East Azerbaijani province. In order to inform health care managers of Status of Man power Distribution.

Methods: This Retrospective cross-sectional study�has compared the situation Of Distribution of human resources in general University hospitals in the cities of East Azerbaijan province with the standard criteria. The data collected by data collection form and analyzed by SPSS software.

Results: Ratio of staff to active beds in all reviewed hospitals is 1/7 that Correspond with ministerial standard but the allocation and distribution of resources in the reviewed groups are in disarray.

Conclusion: Manpower distribution in Reviewed hospitals is unfair and unreasonable. Providing an updated and efficient information system to deal with problems and shortcomings of the existing human resources helps university administrators optimize allocation and distribution of resources based on the standards and the actual needs of hospitals (evidence based and data) and also preventing the Accumulation of human capital in some units and severe shortage of human capital in others.

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Background & objectives: An important part of patient satisfaction in health care centers, is the concern to protect their rights from health care providers. By observing the Patient Bill Rights,they  can effectively take care of patients. This study aimed to assess the inpatients awareness from  patients  rights and their satisfaction from observance of that rights.

Methods: This cross-sectional study was conducted in three hospitals affiliated to Tehran University of Medical Sciences. The estimated sample size was 306 patients and with regard to the assessment of patient's awareness and also, total of questionnaires were 612. The data analyzed by using T Test and ANOVA  in SPSS.18 software.

Results: Average of patient's awareness from patient rights obtained 83.4% and average of patient's satisfaction from observance of that rights were 68.9%. The highest average of awareness was related to the first axis, lowest level of awareness related to the third axis, the greatest satisfaction related to the fourth axis and the lowest level of satisfaction is also related to third axis of the patient bill rights.

Conclusion: Regarding to the lowest average in the awareness and satisfaction of the patient's was related to the third axis of  patient bill rights, it seems that hospital managers for increasing patient satisfaction, must pay further attention both to training of this axis to patient, and Also to The observance of this axis from health care providers.

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Background & objectives: Iron is one of the key elements need for physical growth of the body. Iron deficiency anemia is the most common type of anemia and children under 2 years old are the most vulnerable group. The present study is aimed at surveying the use of supplementary iron drops in 6-24months infants in Ardabil district.

Methods: An analytical-descriptive study was carried out as a cross-sectional work on 200 infants aged 6-24months. The subjects were selected through cluster sampling and a questionnaire was used for data gathering. Data analysis was done by variance and correlation analysis using SPSS19 with the significant level set at p=0.05.

Result: In general, 53.1% of the mothers used iron drops on regular bases, 36.2% on irregular bases, and 10.7% did not use the drops. Only 13.5% of the mothers had adequate information and 5% had acceptable performance with respect to using iron drops. There were significant relationships between consumption of iron drops and performance, awareness, and place of supplying the drops. The main causes for not using the drops were infant vomiting and mothers’ forgetfulness.

Conclusion: Not using Iron drops and using the drop on irregular bases and low knowledge and practice of mothers on drop consumption implies the necessity for planning to screen infants with anemia and holding training courses for the mothers with low literacy.

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Background & Objectives: Rapid sand filter backwashing water typically consists of 2-5% of the total treated water and it has high turbidity. Therefore, effluent treatment of rapid sand filter backwashing is essential. This research aimed to survey turbidity removal from filtration effluent of Tehranpars water treatment plant using Electrocoagulation (EC)/Electroflotation (EF) process.

Methods: This practical study was done in a continuous system at laboratory scale. An electrocoagulation tank with the dimensions of 24×17×18 cm and volume of 7.35 l from plexiglass was used in this work. Inside the tank 4 Al or Fe plates (15×22×0.1cm) were used as cathode and anode. Each electrode was immersed up to 16 cm in effluent of electrocoagulation tank. 126 samples with turbidities of 320, 350, and 400 NTU were taken from effluent of rapid sand filter backwashing and the removal efficiency was tested at current densities of 4.16, 5.83, 7.5, 10, 11.66, and 13.33 mA cm^-2 in detention times ranging from10 to 30 min. The space of electrodes is fixed at 1.5cm and pH at 8.2.  Data analyzed by excel software.

Results: The optimum pH of 8.2 was determined for this process. The optimum current density and detention time for both electrodes were the same and equal to 13.33 mA cm^-2 and 30 min, respectively. At optimum conditions the respective highest turbidity removal by Al and Fe electrodes were 95.13 and 4.87%.

Conclusion: Regarding the results, using electro coagulation-electro floatation processes has an appropriate efficiency in turbidity removal. One can say that aluminum electrode has higher efficiency than iron electrode to remove turbidity.

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Background & objectives: Achievement on improving nursing care quality has always been considered by administrators. "Improving the productivity of clinical staffs’ law" has been adopted to address nurses' problems and providing better services to the patients. This study aimed to investigate the situation of this law enforcement.

Methods: The study population is all the administrators and clinical staffs employed in 4 hospitals affiliated to Ardabil University of Medical Sciences. The subjects were selected by both census (for administrators; n=52) and simple random sampling (for clinical staffs: n=300) methods. Data were collection using a researcher made questionnaire. Data collection tools reliability and validity were evaluated through content validity and test–re-test method, respectively. Data analysis was done using descriptive statistics and spearman, Mann-Whitney & Kruskal-Wallis tests.

Results: Mean attitude scores among administrators and clinical staffs were 3.27±0.70 and 3.35±0.64, respectively. Among the factors affecting attitude, improving working conditions (3.48±1.00) in perspective of managers and increasing the quality of services (3.45±0.87) in perspective of clinical staffs were the most important factors on creating a positive attitude. The most important weakness of the law enforcement in perspective of both staffs and administrators was shortage of clinical staffs. Clinical staffs’ age, sex, marital status, employment history, education level, and type of employment had significant relationships with the attitude and satisfaction scores (p< 0.05).

Conclusion: Enforcement of "improving productivity of clinical staffs’ law" has had advantages for the majority of clinical staffs and it can resolve many of their concerns subject to modification made in employment system, improving work conditions based on the needs, and implementing incentive programs. It can also be effective on improving productivity of nurses and thereby improves the health system.

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Background & objectives: Dyes are one of the most important existing pollutants of textile industry wastewater. They are often toxic, carcinogenic, teratogenic, and non-biodegredable. This study was conducted to evaluate efficiency of Steel/Pb/PbO₂ electrode in the removal of Reactive Blue 29 and Reactive Red 198 Azo dyes from aqueous solutions using Electrochmical Process.
Methods: Concentration of colors was measured before and after Electrochemical Process. Moreover, the intensity of the electric current, the reaction time, the pH, and the initial dye concentration were measured on the efficiency of the removal process and the amount of electrical energy consumed.
Results: The results of the experiments showed that the process efficiency increased by increasing reaction time and electrical current intensity. It was also decreased by increasing pH and initial concentration of color. Under constant operating conditions (pH=4, electric current intensity of 0.5 mA cm2, reaction time of 60 minutes and color concentration of 150 mg/l), the efficiency of this process were 94% and 88% in the removal of Reactive Red 198 and Reactive Blue 29, respectively.
Conclusion: According to our findings, the Electrochemical Process with Steel/Pb/PbO₂ was very efficient and economic process in removing color from wastewater.

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Background & objectives: The Internet is used for different activities by many on a daily basis. The problematic internet use (PIU) is related to poor academic and job performances and also sleep problems. The purpose of this study was to investigate the prevalence of problematic internet use and its relationship with daytime sleepiness (DS).
Methods: A descriptive cross-sectional study was conducted on 280 medical students of the Ardabil University of Medical Sciences. Medical students were entered into the study using the convenience sampling method and were interviewed using the PIU and Epworth questionnaire. The statistical analysis was done by SPSS Version 23 using the chi-square test, Student’s t-test and Pearson’s correlation. Univariate linear regression analysis was applied to find the relation between PIU and DS.
Results: The mean age of participants in the study was 23.93 years with an SD of 2.25. Most of the participants were 23-25 years old. The obtained results showed that 33.6% of the participants had normal scores followed by 44.8% mild disorder, 18.4% moderate disorder, and 2.3% severe disorder. The daily prevalence of daytime sleepiness was 11.6%. There was a positive correlation between the improper use of the Internet and daytime sleepiness.
Conclusion: PIU associated strongly with daytime sleepiness. Students should be educated and informed about the problematic internet use.

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Background & objectives: The significance of optimal breastfeeding of infants for their survival, growth, and development has been recognized and accepted as an important public health issue over the past decades. This study aimed to determine the factors affecting the breastfeeding intention behavior of mothers referring to health centers in rural area of Baiza, south of Fars province, on exclusive breastfeeding, based on theory of planned behavior during the first six months after birth in 2018.
Methods: This is a cross-sectional descriptive-analytical study. A questionnaire was administered to 116 mothers who were selected by simple random sampling among whom referred to the health centers in Beyza. Mothers completed the demographic information and the theory of planned behavior questionnaire including attitudinal structure, subjective norms, perceived behavioral control, and intention through self-report method. The data were analyzed by SPSS 19 software using Pearson's correlation coefficient and linear regression.
Results: The mean age of mothers was 26.60±4.87. In regression analysis, attitude (B=0.24, p<0.001) and subjective norms (B=0.23, p<0.001) significantly predicted breastfeeding intention, but perceived behavioral control was not a significant predictor of intention (B=0.24, p>0.05).
Conclusion: In order to improve exclusive breastfeeding, it is necessary to consider the necessary interventions which can improve awareness, subjective norms, attitude and behavioral control of mothers.
 

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Background & objectives: Considering the rewards, intrinsic motivation and trusting the goodwill can provide a situation for employee creativity that is vital to the survival of the organization. Therefore, considering the important role of creative employees in organizations, the goal of present research was to investigate the relationship between reward systems and staff creativity of Pars Abad health network
Methods: The present study is descriptive-survey in terms of method and applied in terms of purpose. Data were collected using the Standard Employee Creativity Scale by Torrance (1963) and the Kabura Reward Systems Questionnaire (2009). 238 people were selected as the sample by Cochran's formula and simple random sampling method. The obtained data were tested by Pearson correlation and multivariate regression analysis.
Results: The results showed that there were relationships between reward systems with stretch dimension (ß=0.173, p=0.007), with initiative dimension (ß=0.170, p=0.008) and with flexibility dimension (ß=144, p=0.026), but there was no significant relationship between reward systems with fluid dimension.
Conclusion: Considering the relationship between reward systems and the creativity of the officials and employees of the health network of the studied city, it is suggested that the managers of the organization provide a suitable environment for creativity through methods such as timely reward in proportion to employees' performance. The implementation of the reward system and the program of job privileges and the granting of related benefits should be based on the results of the employee performance evaluation process.
 

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Background & objectives: Breast cancer is the second leading cause of cancer mortality for women, behind lung cancer in Iran. Given the high prevalence of breast cancer, it is crucial to determine the reproductive risk factors of breast cancer. 
Methods: A total of 139 female patients with breast cancer (the case group) and 279 healthy females (the control group) that were age-matched participated in the study from March 2018 to March 2019. Demographic and reproductive variables, including the number of pregnancies, breastfeeding, history of oral contraceptive use, abortion, age at first menstruation, and age at first childbirth, were all collected using a questionnaire. Conditional Logistic regression was utilized to calculate OR (CI: 95%), and the classification tree model was used to classify the patients. 
Results: The mean age of breast cancer patients was 50.8 ± 8.3. Positive first-degree family history, intake of oral contraceptive use, and delaying first pregnancy increased the chance of breast cancer. In contrast, breastfeeding and menstruation after age 14 played a protective role in the development of breast cancer. 
Conclusion: The findings of this study reveal that the age at first birth, use of oral contraceptives, first-degree family history, and lack of breastfeeding has a significant relationship with breast cancer. Thus, women who have experienced such factors are susceptible to breast cancer and must be prioritized for preventive treatments and screening. 
 

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Background & objectives: The emergence of COVID-19 has precipitated a global health crisis, profoundly affecting various dimensions of human life, including social, academic, cultural, economic, and political spheres. This study aims to compare the management strategies employed by South Korea, Japan, and Iran in response to the pandemic, highlighting the effectiveness of their approaches and the resultant outcomes.
Methods: This research employs a comprehensive literature review of articles from scientific databases, including Scopus, Elsevier, Science Direct, PubMed, and ISI. It analyzes the strategies each country implemented to curb the spread of COVID-19, highlighting both successes and challenges encountered during the pandemic.
Results: The findings indicate that countries with prior experience in managing epidemics, such as South Korea and Japan, were better equipped to handle the COVID-19 crisis. South Korea’s rapid response included widespread testing, contact tracing, and the use of technology to monitor the virus's spread. Japan, leveraging its geographical proximity to China and existing health infrastructure, also implemented effective measures, including travel restrictions and public health campaigns. In contrast, Iran faced significant challenges in managing the pandemic. The rapid spread of COVID-19 overwhelmed its healthcare system, exacerbated by pre-existing economic sanctions and health infrastructure deficiencies. Despite various strategies implemented by the Iranian government and the Ministry of Health, including public awareness campaigns and temporary lockdowns, the outcomes were less favorable compared to South Korea and Japan. Inadequate responses to the health crisis resulted in serious social and psychological consequences, worsening the situation.
Conclusion: Countries that effectively managed the new coronavirus pandemic had prior experience with epidemics. Their swift actions and recognition of the critical situation contributed to minimizing human and financial losses.