شاپا: 2322-5130

Background and Aims: The increasing demand for groundwater in Iran, which is facing water shortages and lack of rainfall, is intensively ongoing. Consumption of water contaminated with heavy metals may result in adverse health effects in people. The present study aimed to determine the amount of arsenic,
cadmium and lead in groundwater resources of Shahrab and its surrounding areas having a lot of drinking and agricultural water uses.
Materials and Methods: A total of fourteen wells supplying rural drinking water in Shahrab area were sampled. Sampling was performed by standard methods. EC, pH and Eh were measured using a portable pH meter. Heavy metals concentration were also determined by ICP-MS. All stages of this research were conducted ethically.
Results: Cadmium concentrations were less than 3 μg/L in studied samples. However, lead concentrations were more than 10 μg/L, exceeding national drinking water standards in Iran. Furthermore, arsenic concentrations exceeded national standards (10 μg/L) in three sample.
Conclusion: A significant positive correlation was not observed between studied metals (arsenic and lead) and principal physicochemical parameters of water based on comparison between correlation coefficients. The concentration of heavy metals in groundwater resources is dependent on several factors, including the
type and amount of agricultural pesticides, the region’s climatic conditions, the level of groundwater, and geology of region. Further studies are needed to determine the exact source(s) of contamination.
Keywords: Drinking water, Heavy metals, Arsenic, Lead, Cadmium, Shahrab

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Background and Aim: The third phase of health reform plan in Iran came into force since the announcement of the book named value of the notification. Due to the influence of this book on hospitals performance,
this study aimed to determine and compare the selected statistical indicators of a teaching hospital before and after the implementation of the contents of this book.
Materials and Methods: The present cross-sectional descriptive-analytical study was conducted in 2015. Data (statistical indicators) were collected, with the permission and considering the confidentiality of information, through reports review and on-site visiting and analyzed using SPSS (version 17) software.
The comparison of selected indicators between paired samples were performed. Correlations were considered significant at α=0.05.
Results: Announcement of the value of the notification book resulted in a statistically significant increase in bed occupancy ratio, occupied bed day, average length of stay, and number of hospital death and also a significant decrease of bed turnover interval and rate. Furthermore, a significant increase of inpatients and
outpatients visits and significant decrease of emergency visits and caesarean were also observed.
Conclusion: Implementation of the aforementioned book significantly affected some statistical indicators (bed occupancy ratio, occupied bed day, and caesarian), but it has no significant effect on other statistical indicators (inpatients and outpatients visits, emergency visits and number of surgeries). However, extending
the results of this study to other hospitals requires more extensive studies.
Keywords: Health reform, statistical indicator, hospital, the relative value of health care, Iran

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Background and Aims: The municipality of Tehran has recently attempted to implement the integrated waste management system (IWMS) with the approach of minimizing environmental emissions, the lowest cost and the maximum utilization of existing potential. The present study set out with the aim of assessing
the fixed and variable investment costs along with estimating the cost functions of its subsystems.
Materials and Methods: Recorded data from September to October in 2014- 2015 were used, making arrangements well in advance. The annual waste input to each subsystems of IWMS was firstly divided into 0 to twice of input ratio. The amount of fixed and variable investment costs along with future costs were then determined considering experts’ opinions. Finally, MATLAB software version 7.1 was used in order to coding, estimating cost functions, and determining the correlation coefficient (R2) between the input and cost values.
Results: The results showed that transportation subsystem allocated the maximum amount of costs (43%). Processing (23%), anaerobic digestion (12%), aerobic digestion (9%), landfilling (7%), and incineration (6%) were ranked in the next positions, respectively. Furthermore, using actual cost data based on existing capacity as well as peer reviewed experts’ data with theoretical capacity indicated that all subsystems had economic scale with high correlation coefficients.
Conclusion: It is concluded that directing the waste flow from burial site to other waste processing technologies such as separation of recyclable materials, aerobic digestion, anaerobic digestion, and incineration would result in a significant reduction in the total amount of costs.
Keywords: Municipal solid waste, Waste management, Mathematical Functions, Operating cost, Unit cost

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Background and Aims: The establishment of green management to reduce the consumption of resources is now a high priority for the government. Organizational managers play a key role in the implementation of green management
plans. The present study was, therefore, aimed to assess the knowledge, attitude and practice of managers in Qom University of Medical Sciences towards green management.
Materials and Methods: According to the aim of study, the present research is considered as an applied crosssectional study. A questionnaire survey consisting of 50 managers of Qom University of Medical Sciences was performed to evaluate their knowledge, attitudes, and practices towards green management, as well as their
demographic factors. All stages of research were conducted ethically. Data were analyzed with independent t-test, ANOVA, and Pearson correlation coefficient using SPSS software.
Results: The results of this study showed that the managers mean scores on knowledge, attitude, and performance were 97.04 ±17.28, 32.60 ±7.70, and 29.86±50, respectively. The respective attributable maximum scores acquired
were 120, 40, and 40. The data analyzed suggests, therefore, that about 82% of managers had a good (positive) knowledge, and 70% positive attitude to take part in green management plans. However, only around 52% of respondents preferred to take practices about green management. Furthermore, there was no statistically significant relationship between the knowledge and demographic variables in this study.
Conclusion: This study found that managers had a relatively good knowledge, attitude and practice to green management. It should also be noted that besides a proper environmental knowledge and attitude, the implementation
of green management system requires the allocation of credit and funding, formation of green management committee, as well as training and cultural programs.
Keywords: Green management, Managers’ knowledge, attitude, and practice, Qom University of Medical Sciences

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Background and Aim: Identification and removal of the barriers of putting clinical governance into practice facilitate its successful implementation. This study aimed to identify the barriers of clinical governance implementation in Khozestan province hospitals in 2014.
Materials and Methods: A valid and reliable questionnaire was used for conducting this descriptive cross-sectional study. The questionnaire assessed five issues including managerial, cultural, human resource, procedural, and structural barriers of clinical governance. Questionnaires were completed by clinical governance officers in 40 hospitals of Khuzestan province. All statistical analyses (descriptive and analytical) were done using SPSS. Ethical issues such as informed consent, confidentiality of information and researchers’ objectivity were all considered.
Results: The mean score of clinical governance implementation barriers in studied hospitals was 2.92 out of 5. Structural and managerial barriers were respectively the most and least barriers of clinical governance implementation.
Lack of doctors’ involvement in clinical governance, insufficient financial resources for implementing clinical governance and the bureaucracy involved in clinical governance had created the greatest obstacle in implementing clinical governance.
Conclusion: Hospital managers should overcome the barriers of quality management techniques such as clinical governance before implementing these techniques. In addition, they have to create an appropriate structure and organizational culture in order to facilitate the successful implementation of clinical governance. Besides, health policy makers should develop an appropriate clinical governance model considering the structure and organizational culture of the hospitals.
Keywords: Clinical governance, Quality management, Barriers of clinical governance implementation, hospital

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Background and Aims: Besides toxic effects on human, animals and plants, aromatic hydrocarbons may also be effective in the formation of photochemical smog. The measurement of these hydrocarbons, therefore, play a
prominent part in evaluating their health and environmental impacts. The purpose of this study was to compare pump and adsorption sampling method with solid phase microextraction (SPME) to investigate changes in the
concentration of benzene, toluene, and xylene (BTX).
Materials and Methods: SPME samplers in sampling protective holders were placed in ambient air at a relatively high traffic routes for 5 days. Sampling was carried out in two seasons. Samples were analyzed at the end of sampling period. In addition, pump and adsorption sampling method was also used to measure the concentrations of benzene, toluene, and xylene. Ethical issues were all considered in conducting the study and citation.
Results: The obtained results in solid phase microextraction sampling method were compared with those obtained using the conventional pump and adsorbent method. Correlation coefficients (R2) between these methods were 0.98, 0.9 and 0.95 for benzene, toluene, and xylene, respectively. The results obtained with pump and adsorption method showed a higher values in general.
Conclusion: The comparison between obtained results with these methods indicates a relatively similar values. It may be concluded that SPME sampling method can also present reliable results for the measurement of benzene,
toluene and xylene concentrations in the ambient air.
Keywords: Passive sampling, SPME, Benzene, Toluene, Xylene

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