Aims: During the past decade, the application of engineering and managerial techniques for designing a variety of qualitative and quantitative risk assessment methods and modeling the consequences of accidents have had a great contribution to the promotion of safety in the industrial systems. The present study was conducted to identify and prioritize safety risks in one of the automotive industries. Risk management of the operation of transferring waste thinner from the paint shop represents a critical issue owing to special safety. Materials and Methods: One of the most important theories for the modeling of events is the bowtie analyzing method. Bowtie is a qualitative analyzing method which incorporates managerial system techniques and provides a highly accurate analysis in the form of fault and event trees. In the present study, the process of risk identification and management was carried out using the Bowtie analyzing method and the obtained results were applied to the structure of a bowtie graph and the consequence was modeled using ALOHA software. Results: In the study, the operation of transferring waste thinner from the paint shop of an automotive industry was examined. Possible safety risks that may happen during the loading and unloading operations of the waste thinners were detected using bowtie analyzing method and the modeling of fire at chemical tanker carrying thinner and also the modeling of BLEVE phenomenon was conducted. The results represent that the area, in which employees are stationed is at very high risk that in the event of a possible fire, the personnel will be quickly caught in fireballs caused by the burning of thinner. Conclusion: According to the results, it was found that one of the administrative units is positioned inappropriately and incorrectly in the vicinity of thinner loading station that in the case of nondisplacement of the mentioned unit and the incident of fire or explosion in the place of loading and unloading of thinner, undoubtedly there would be fire at the mentioned administrative unit.

Aims: The tourism industry is one of the world's top three industries with an annual growth of 4%. This research was conducted with the aim of determining the environmental health indicators of hotels and lodging houses in the city of Kashan in the winter of 2015 and the spring of 2016. Materials and Methods: This research is a descriptive study carried out on all hotels and guesthouses in Kashan city. The information was collected through direct referral and health visit with the environmental health expert of the health centers of Kashan. Information was gathered by in the form of completion of Article 13 of the Code of Conduct and then analyzed using descriptive statistics. Results: Having a medical examination card by all the staff, improvement the walls of the building at 14.3%, and improvement the ceiling in 28.6% of the hotels, the use of a depreciated bed in a hotel and a guesthouse, the lack of an appropriate ventilation in 50% of the guesthouses, the lack of attention to the provision of health cards by drivers of food-carrying vehicles was observed in more than 50% of the places. Conclusion: The health status of the hotels and inns (lodging house) of the city of Kashan is in a relatively favorable situation. Considering the many tourism attractions in Kashan and the presence of tourists, it is important to pay attention to the safety and improvement of buildings of residential centers to maintain the health and comfort of tourists and also to prevent earthquake hazards.

Aims: The trend of withdrawal from groundwater resources in Kashan plain has been increased during the recent 40 years. For example, the number of deep wells has been increased from 67 in 1965 to 927 in 2003. As a result, the well discharges and water quality have been diminishing. Hence, this research was aimed to study the salinity variation modeling in Kashan plain groundwater resource. Materials and Methods: This descriptive research was done based on recorded data for some wells in Kashan plain. First, the data from 112 wells were considered then, 16 wells with more complete data were selected for analysis. Total dissolved solids (TDSs) were considered as the salinity index. Results: The results showed that, in Kashan plain, the mean of salinity has been increased from 1190 mg/L to more than 1400 mg/L during 7 years. Although the salinity has been somewhat less after each annual precipitation, the trend is upward. Minimum and maximum of TDS were identified taken samples from wells number 27 and 47, respectively. Maximum rate of salinity was found in wells number 53 and 55, while the minimum was related to well number 54. Conclusions: The groundwater salinity in Kashan plain has an upward trend. The groundwater salinity can be related to some major factors such as distance from Salt Lake, less annual precipitation, and more withdrawal from the aquifer in the recent decades. Since the later can be managed withdrawal, especially for agricultural activities have to be minimized as the most effective way for prevention of the groundwater quality degradation.

Aims: Cutaneous leishmaniasis (CL) is a skin infection that causes various forms of ulcers and also remains scars even after treatment. This disease is prevalent in many countries of Middle East including Iran. Since determining the species of the parasite is important for prevention and control programs, this study was conducted to identify Leishmania species in Aran and Bidgol, Isfahan province, center of Iran. Materials and Methods: This cross-sectional study was carried out on 112 CL suspected patients who referred to health centers of Aran and Bidgol. Serosity of the wound was collected, and amastigote form was detected by microscopic method. After extraction of DNA from serosity, kDNA-polymerase chain reaction (PCR) was used to identify Leishmania species. Results: Fifty-four of all suspected CL samples (48.2%) were positive microscopically, while 55 (49.1%) were positive using kDNA-PCR. The results of PCR revealed that 51 isolates (92.7%) were Leishmania major and 4 (7.3%) Leishmania tropica, respectively. The most lesion form caused by L. major was papular or volcanic-like, while all of wounds caused by L. tropica were papular/nodular forms. Conclusion: The results of the study indicated that the predominant species was L. major and zoonotic CL is more prevalent in this region.

Context: Emotional disturbances are caused by various factors that include two general biological and cognitive components. Understanding the factors affecting emotional disturbances is important in improving the quality of life of individuals. Aims: This study was aimed to determine the mediation role of acceptance and mindfulness in relation between behavioral inhibition/activation system sensitivity and emotional distress of Islamic Azad University, Tabriz branch. Settings and Design: The research method of the study was descriptive form type of correlational. Subjects and Methods: The statistical population of the study included all students of the Islamic Azad University, Tabriz branch. Among them, 380 participants (190 females and 190 males) were selected through cluster random sampling. To collect the data, Carver and White's (1994) behavioral inhibition and behavioral activation scales, Bond et al. 's (2007) second version of the Acceptance and Action Questionnaire-II, and Bauer et al.'s (2006) five-facet mindfulness questionnaire and depression, anxiety, and stress scale, were used. Statistical Analysis Used: To analyze the data, the Pearson correlation coefficient and multiple regression were used. Results: The findings indicated that behavioral inhibition/activation systems, acceptance, and mindfulness could significantly predict about 45% of depression variance, 53% of anxiety variance, and 41% of stress variance of emotional distress. Conclusions: According to the findings, it could be concluded that stress, anxiety, and depression as emotional distress are the result of the behavioral inhibition/activation systems that they are the result of the acceptance and mindfulness effect. In fact, the acceptance and mindfulness have the mediation role in relation between behavioral inhibition/activation system sensitivity and emotional distress. In order to regulate emotions, it should be pay attention to behavioral inhibition/activation systems, acceptance, and mindfulness.

Aims: High prevalence of sick building syndrome (SBS) owing to the work is one of the popular discomforts. High prevalence of sick building syndrome (SBS) owing to the work is one of the popular discomforts and Work-related absenteeism between office workers. The aims of this study were to assess the association of indoor carbon dioxide (CO₂) concentrations with SBS prevalence among employees in two office buildings of Petroleum Industry Health Organization in Tehran city. Materials and Methods: In this analytical-descriptive study, 170 employees of the two office buildings of Petroleum Industry Health Organization in Tehran city have been selected. HSE questionnaire was combined with Skov's questionnaire as data collection tools. Questionnaire data analysis has also carried out using SPSS and Chi-square independent sample t-test. CO₂concentrations were measured using calibrated instruments. Results: The results suggested that the CO₂concentration in both buildings is higher than the threshold limit. CO₂concentration was significantly associated with some symptoms such as dry throat (P = 0.028), shortness of breath (P = 0.028), nasal irritation (P = 0.008), dizziness (P = 0.0312), headache (P = 0.0315), nausea (P = 0.049), and sickness (P = 0.023). Conclusion: The prevalence of syndrome symptoms in women was higher than men. Some of SBS symptoms were exacerbated by increasing CO₂concentrations among the employee.

Aims: The present study was conducted to identify and prioritize Health, Safety, and Environment (HSE) risk in Loghman hospital. Risk management of hospitals represents a critical issue owing to special safety, health, biological and infection risks, and hospital wastes. Materials and Methods: This study is, in terms of the purpose, an applied research. Statistical population includes 68 managers and experts of risk management in Loghman hospital of Iran. A targeted sampling method was used for sampling. Five points were selected to identify and evaluate the risks at which field visits were made and the checklists were completed. The identified risks were extracted from the checklists and worksheets for identification and evaluation of the risks were completed based on failure mode and effect analysis (FMEA) method. Priority of risks obtained by analytical hierarchy process technique was quiet close to that achieved by FMEA approach. Results: Occurrence probability, severity, and detectability of HSE risks were identified using FMEA technique. According to the results, lack of emergency exit with normal weight of 0.143 has the highest priority, followed by lack of building strength (normal weight of 0.114), electricity (0.113), and biological contamination (0.107). Inconsistency rate was estimated close to zero (<0.1), suggesting reliability of the results. Conclusion: According to the results, Loghman hospital lacks emergency exit due to old nature of the building which causes a serious threat for both hospital and people. An emergency exit gate can be constructed for each floor that can be used in emergency events and hence, minimize the estimated risk. Considering low strength of the building due to its old nature, the hospital can be reconstructed through a sophisticated engineering plan. At first, this proposal may not be suitable owing to high cost; however, much higher cost will be imposed if a disaster occurs.

Aims: Regarding the low level of physical activity (PA) in schizophrenia and bipolar disorder (BD), our aim was to compare the level of PA between the two groups. Methods: In this cross-sectional study, 100 patients with schizophrenia and 100 patients with BD were selected through convenience sampling in 2017. The level of PA was assessed using International Physical Activity Questionnaire. Chi-square, extended Fisher's exact, Student's t, and Mann–Whitney tests were applied to analyze the data. Results: Prevalence of low PA in schizophrenic patients and BD was 36.7% and 30.3%, respectively. The frequency of moderate PA was less in schizophrenic patients than that in the BD patients (56.1% and 65.7%, respectively) and vigorous PA was more frequent in schizophrenic patients than the BD individuals (7.1% and 4%, respectively) (P = 0.334). Schizophrenic patients had significantly fewer minutes of PA than that of the BD patients (P = 0.027). Minutes of vigorous PA were higher in schizophrenic patients, while BD patients had more minutes of moderate PA, but these differences were not statistically significant (P > 0.05). BD patients had significantly more walking minutes than that of the schizophrenic patients (P = 0.05). Conclusion: The prevalence of inactivity was higher in schizophrenic patients than BD patients. This rate was high in both groups due to hospitalization, factors associated with the disease, or even lack of attention to these patients. Therefore, more attention should be paid to the physical health of these patients; also, psychiatric centers should take preventive and interventional measures in this regard.

Background and Aim: Renal transplantation is one of the main treatments of chronic renal disease that creates a more optimal condition and reduces the risk of fatality. The most common reason behind the functional problems of transplanted kidney in its initial postoperation phase is acute renal transplant rejection, the timely diagnosis of which would help the doctors, begin the required treatments immediately to maintain renal functionality, and prevent further irrecoverable damages. Therefore, identifying the variables which are accurate and reliable predictors of renal transplant rejection can be hugely beneficial. Materials and Methods: In this historical cohort study, 87 nondiabetic patients with renal failure who had received treatments at Kidney Transplantation Department of Imam Reza and Ghaem Hospitals of Mashhad, Iran, were selected and their demographic and clinical characteristics were collected. Among these data, creatinine, fasting blood sugar (FBS) and serum insulin, thyroid-stimulating hormone (TSH), and T3 and T4 hormones were measured four times after the transplant operation. Data were analyzed using SAS 9.3 and MedCalc 13 software. First, the missing data were imputed with appropriate imputation methods, and then using logistic regression and area under receiver operating characteristic (ROC) curve, the most important detectors of acute renal transplant rejection were determined. Significance level (α) was set at 0.01. Results: Using logistic regression analysis and drawing ROC curves for average value of four measurements, the effect of serum creatinine and T4 hormone was found statistically significant (P < 0.01). Conclusion: Results showed that among six variables that were studied (creatinine, FBS, insulin, TSH, T3, and T4), serum creatinine and T4 hormone were statistically significant and also were the most important of acute renal transplant rejection.

Aims: Nursing and midwifery students experience multiple stressors in the clinical setting that can affect their proper functioning. Therefore, the objective of this research was the effective stressors in clinical education among nursing and midwifery students of Islamic Azad University, Mahabad in 2016. Materials and Methods: This study was a cross-sectional study of applied type. The statistical population was nursing and midwifery students of the Azad University of Mahabad in 2016. The sample size was selected in clinical setting to be 300 person. The data gathering tool was a researcher-made questionnaire consisting of two sections of demographic information and a section of the stressful factors of clinical education in eight domains and 106 items. The validity of this questionnaire was determined by content validity. Hence, the reliability of this tool was confirmed by a test–retest method with a correlation of 0.89. The partial least square (PLS) method, independent t-test, and Friedman test were used for data analysis. Results: The results showed that there is a positive and significant relationship between the interpersonal communication, environmental factors, educational planning, personal–social factors, university education factors, unpleasant experiences, and clinical experiences with stress (P = 0.000). However, there was not a statistically significant relationship between the humiliating experiences and the feeling of tension in students (P ≤ 0.218). Furthermore, Friedman test showed that the most important stressor on students' perception of their stress in the clinical environment is environmental factors. Conclusion: The results of stressful factors in clinical education indicated lack of significance in all areas except for humiliating experiences area. Therefore, the authorities should take necessary steps to control and manage stress in students and increase the quality of education by holding workshops and the formation of the committee or the community to examine these factors, given all the stressful areas in the clinical education setting, especially environmental factors.