شیوع اختلالات اسکلتی‌عضلانی و عوامل مرتبط با آن در کارکنان بخش اداری مراکز بهداشتی درمانی شهر میناب با تکنیک ROSA با تکنیک ROSA Prevalence of musculoskeletal disorders and its related factors in office workers of Minab Health centers by ROSA Technique 1 1 مقدمه: مشاغل اداری از جمله مشاغلی هستند که شیوع اختلالات اسکلتی- عضلانی در آنها بالا میباشد. یکی از مهمترین ریسک فاکتورهای این اختلالات، پوسـچر نامناسـب کارکنان و شرایط محیطی نامطلوب میباشد. پژوهش حاضر با هدف بررسی شیوع اختلالات اسکلتی-عضلانی و ریسک فاکتورهای مرتبط با آن در کارکنان اداری مراکز بهداشتی درمانی شهرستان میناب در سال 1397 انجام پذیرفت. روش بررسی: مطالعه حاضر از نوع توصیفی- تحلیلی و به روش مقطعی بر روی 104 نفر از کارکنان اداری مراکز بهداشتی درمانی شهرستان میناب در سال 1397 انجـام شـد. جهت تعیین شیوع اختلالات اسکلتی-عضلانی پرسشنامه نوردیک و برای ارزیابی سطوح مواجهه با ریسک فاکتورها از روش ROSA استفاده گردید. داده‌ها با استفاده از آماره‌های توصیفی و آزمون آماری کای دو (Chi-Squre) و نرم افزارSpss تجزیه و تحلیل شدند . از نرم افزار Excel جهت رسم نمودار داده‌ها استفاده گردیده است. نتایج: نتایج مطالعه نشان داد که نواحی کمر (5/63 درصد)، گردن (9/51 درصد) و قسمت فوقانی پشت (50 درصد) دارای بیشترین میزان فراوانی اختلالات اسکلتی-عضلانی در بین کارکنان اداری مورد مطالعه بوده است. ارتباط معناداری بین وجود اختلال اسکلتی-عضلانی با سن، جنس و BMI مشاهده نشد (05/0 ˃P) اما با سابقه کاری ارتباط معناداری (05/0 ˂P) را نشان داد. 6/36 درصد از کارکنان در اولویت اول اقدامات اصلاحی (یعنی لزوم هر چه سریعتر اقدامات ارگونومیکی) قرار گرفتند. ارتباط معناداری بین پوسچر نامناسب و وجود درد در گردن مشاهده گردید (05/0 ˂P). نتیجه‌گیری: فراوانی اختلالات اسکلتی عضلانی در کارکنان اداری مراکز بهداشتی درمانی بالا بود و درد گردن با پوسچر نامناسب فرد ارتباط داشت. 2 Introduction: Prevalence of musculoskeletal disorders (MSDs) is high among office workers. One of the most important risk factors of these disorders is awkward posture and inappropriate environmental conditions. So, this study was carried out to determine frequency of MSDS and its related risk factors among the office workers of Minab city healthcare centers in 2018. Materials and Methods: This cross-sectional study was conducted on 104 staff in Minab city health care centers. Nordic musculoskeletal disorders questionnaire was applied to determine the prevalence of MSDs and Rapid Office Strain Assessment (ROSA) method was used for posture analysis. The data were analyzed by SPSS version 21 using descriptive statistics and chi-square test. Excel software was used to plot the graph. Results: The highest prevalence rates of MSDs were reported in low back (63.5%), neck (51.9%) and upper back (50%). There was no significant difference between MSDs and age, sex and BMI (P˃0.05) but there was a significant relationship with work experience (P˂0.05). Totally, 36.6% of employees were placed in the first priority of corrective actions (i.e. the need for ergonomic interventions as soon as possible). There was a significant correlation between awkward posture and neck pain (P <0.05). Conclusion: The frequency of MSDS in health center office workers was high and neck pain was related to awkward posture. 1 12 2018/09/20 1397/6/29 2020/01/12 1398/10/22 مریم هاشمی maryam hashemi دانشگاه علوم پزشکی یزد ایران maryam.h98@yahoo.com غلامحسین حلوانی Gholam Hossein Halvani دانشگاه علوم پزشکی یزد ایران halvanig[at]ssu.ac.ir محسن عسکری شاهی Mohsen Askari Shahi دانشگاه علوم پزشکی یزد ایران m.askari@ssu.ac.ir عبدالحمید تاجور Abdulhamid Tajvar دانشگاه علوم پزشکی شیراز ایران omid.tajvar@gmail.com سیده فاطمه وحدانی Sayyid Fatemeh Vahdani دانشگاه علوم پزشکی هرمزگان ایران fvahdani078@gmail.com امیر هوشنگ مهرپرور Amir Houshang Mehrparvar دانشگاه علوم پزشکی یزد ایران maryam.h98@yahoo.com Office workers Ergonomic risk factors Musculoskeletal disorders ROSA Technique شیوع اختلالات اسکلتی- عضلانی ROSA عوامل خطرارگونومی کارکنان اداری اداری منابع##1. Choobineh A. Posture Assessment Methods in Occupational Ergonomics. 3, editor. 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شناسایی و رتبه‌بندی ریسک‌های ایمنی در پروژه‌های ساختمانی با رویکرد ترکیبی FMEA و TOPSIS فازی Safety risk assessment and ranking of the construction projects with combined approach of FMEA and fuzzy TOPSIS 1 1 مقدمه: یکی از بخش‌های مهم اقتصاد کشور که ظرفیت بالائی در ایجـاد فرصت‌های شغلی دارد، پروژه‌های ساختمانی می‌باشد. پروژه‌های ساختمانی به‌عنوان جزئی از مجموعه عظیم و استراتژیک پروژه‌های عمرانی بوده که متأسفانه به دلیل بی‌توجهی به مقوله ایمنی، سهم عمده‌ای از حوادث ناشی از کار را به خود اختصاص داده است. یکی از مهم‌ترین مسائلی که می‌تواند در ایجاد این حوادث در پروژه‌های ساختمانی دخیل باشد؛ ضعف یا فقدان مدیریت ارزیابی ریسک به‌صورت جامع و کارآمد می‌باشد. هدف از پژوهش حاضر، شناسایی و رتبه‌بندی ریسک‌های ایمنی در پروژه‌های ساختمانی با رویکرد ترکیبی FUZZY FMEA و FUZZY TOPSIS می‌باشد. روش بررسی: پژوهش از نوع توصیفی- پیمایشی و از نظر هدف کاربردی محسوب می‌گردد. مطالعه بهصورت موردی روی پروژه احداث شهرک قصردریا واقع در شهرستان محمودآباد در سال 1394 پرداخته شده است. جمع‌آوری داده‌ها از طریق میدانی روی جامعه آماری شامل مدیران پروژه، مهندسان ناظر و مجری و متخصصان در زمینه ایمنی ساختمان انجام گردید. سپس دادهها در نرم‌افزارهای MATLAB, EXCEL محاسبه شده و خروجی دو روش FUZZY FMEA و FUZZY TOPSIS مورد تجزیه و تحلیل قرار گرفتند. نتایج: ریسک‌های شناسایی‌شده، طی پرسشنامه در اختیار متخصصان و خبرگان در زمینهی ایمنی ساختمان قرار گرفت. مهم‌ترین ریسک‌هایی که از روش FUZZY TOPSIS استخراج‌شده مربوط به برخورد بازوی جرثقیل با ساختمان و لغزیدن و سقوط افراد از روی رمپ راه‌پله می‌باشد. در روش FUZZY FMEA ریسک‌های مربوط به سقوط افراد از لبه گودبرداری، لغزیدن و سقوط از روی رمپ راه‌پله و سقوط از روی داربست و جایگاههای کار دارای بالاترین رتبه می‌باشند. نتیجه‌گیری: مهمترین ریسک‌های شناسایی‌شده صنعت ساختمان از دو روش، شامل سقوط افراد از لبه گودبرداری، لغزیدن و سقوط از روی رمپ راه‌پله و سقوط از روی داربست، جایگاه‌های کار، برخورد بازوی جرثقیل با ساختمان و لغزیدن و سقوط افراد از روی رمپ راه‌پله می‌باشد. 2 Introduction: Construction projects are one of the most important sectors of the economy of the country, which has a high capacity for job creation. Construction projects as part of a huge and strategic set of construction projects that unfortunately have a large share of work-related accidents due to the lack of attention to safety. One of the most important issues that can contribute to these events in construction projects is the weakness or lack of comprehensive and efficient risk management. The purpose of the present study was to identify and rank safety risks in construction projects with the combined approach of FUZZY FMEA and FUZZY TOPSIS Materials and Methods: This study is descriptive-survey research in terms of purpose and terms of data collection The research was conducted by case study in the case of Qasrdaria town project in Mahmudabad city in 2015. Data collection was through a field study on the statistical population, including project managers, supervising and executive engineers, and building safety experts. The data were calculated in MATLAB and EXCEL software and the output of FUZZY FMEA and FUZZY TOPSIS methods were analyzed. This method for subsequent stages of risk assessment and risk control based on their priority, as well as cost savings. Results: The identified risks were given to the building safety specialists in the form of a questionnaire. The most important risks extracted from the FUZZY T.O.P.S.I.S method were related to the colliding crane arm with the building and then slipping and falling off the people from the stair ramp. In the FUZZY F.M.E.A method, the risks associated with falling from the edge of the pit, slipping and falling off the stair ramp, as well as falling from the scaffolding and workstations are the highest. Conclusion: The most important identified risks in the construction industry based on these two ways are as follows: falling off the edge of a pit, slipping and falling from a stair ramp falling from a scaffold, workstations, colliding of crane arm with the building and slipping and falling people from the stair ramp 13 23 2018/09/202017/06/5 1396/3/15 2020/01/122020/06/30 1399/4/10 سعید امامقلی زاده saeid emamgholizadeh دانشگاه شمال ایران gholizadehsaeid@gmail.com سید امیر حسینی seyed Amir Hoseini دانشگاه شمال ایران hoseini5559@yahoo.com Construction projects Fuzzy logic FUZZY FMEA FUZZY TOPSIS Safety risk ریسک ایمنی پروژه‌های ساختمانی منطق فازی FUZZY FMEA FUZZY TOPSIS 1. Enshassi A, Mayer PE, Mohamed S, El-Masri F. Perception of construction managers towards safety in Palestine. International Journal of Construction Management. 2007; 7(2):41-51.##2. Pinto A, Nunes IL, Ribeiro RA. Occupational risk assessment in construction industry–Overview and reflection. 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تعیین مدل بهینه ارزیابی ریسک در پروژه‌های عمرانی مطالعه موردی پروژه احداث کارخانه فولاد Determining optimal risk assessment model in construction projects (Case study: steel plant construction project 1 1 مقدمه: بدون تردید شناسایی مخاطرات شغلی و مدیریت ریسک‌های ایمنی و بهداشت، مهم‌ترین مأموریت و مسئولیت نظام مدیریت ایمنی و بهداشت در سازمان‌ها بوده است و اتخاذ برنامه‌های مدون جهت تحقق این مهم، کلید بهبود مستمر این نظام و ارتقای آن می‌باشد. روش بررسی: این مقاله توصیفی– تحلیلی، به‌منظور تعیین روش بهینه ارزیابی ریسک در پروژه‌های عمرانی به رشته تحریر درآمده است. در این پژوهش با استفاده از مطالعات تحقیقات پیشین و جمع‌آوری نظرات خبرگان و پس‌ازآن با استفاده از 3 تکنیک پرکاربرد، یک فعالیت مهم در صنعت ساخت فولاد بررسی و ارزیابی ریسک ‌گردید. سپس ماتریس تصمیم بر اساس نقاط قوت و ضعف مدل‌ها تشکیل شد و در انتها اولویت‌بندی این 3 روش با استفاده از روش تصمیم‌گیری تحلیل سلسله مراتبی صورت پذیرفته است. نتایج: در این مطالعه 5 عامل کلیدی، میزان کاربرد در شناسایی خطرات، قابلیت استفاده در مراحل مختلف ارزیابی ریسک، قابلیت راستی آزمایی، سهولت کاربرد و نیاز آموزشی آن و هزینه، به‌عنوان مهم‌ترین معیارهای انتخاب یک تکنیک ارزیابی ریسک مشخص‌شده و روش FMEA به‌عنوان روش برتر ارزیابی ریسک عنوان گردیده است. نتیجه‌گیری: روش FMEA با توجه به قابلیت‌هایی که دارد به‌عنوان روش بهینه ارزیابی ریسک پروژه‌های عمرانی معرفی شده است. 2 Introduction: Identifying occupational hazards and managing occupational safety and health risks has been the most important mission and responsibility of the health and safety management system in organizations and adopting coded plans to achieve this is the key to continuously improving this system and promoting it. The aim of the present study was to determine the optimal risk assessment methodology in development projects. Materials and Methods: This was a descriptive-analytic research In this research, using previous research studies and collecting expert opinions, the most important criteria for selecting a specific risk assessment methodology, and then using one of the three most-used techniques is an important activity in the steel making industry and risk assessment. Then, the decision matrix is based on the strengths and weaknesses of the models. The prioritization of these three methods is done using the hierarchical analysis decision method. Results: In this paper, five key factors, the degree of application in identifying hazards, usability in different stages of risk assessment, reliability, ease of use, and training needs and costs, are identified as the most important criteria for choosing a risk assessment technique and the FMEA method was considered as the best Risk Assessment Method. Conclusion: FMEA methodhas been introduced with regard to its capabilities as an optimal risk assessment method for contruction projects. 24 33 2018/09/202017/06/52018/08/8 1397/5/17 ساغر سلاجقه SAGHAR SALAJEGHEH ایران Saghars2001@yahoo.com آفرین اخوان Afarin Akhavan دانشگاه علم و هنر ایران akhavan@sau.ac.ir علیرضا حاجی حسینی َAlireza Hajihosseini شرکت برق منطقه‌ای یزد ایران safetyarh@gmail.com Risk assessment Construction projects Hazard FMEA JSA AHP ارزیابی ریسک پروژه ساختمانی FMEA FTA JSA AHP 1. Pinto A. 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بررسی دوز مؤثر سالیانه پرتوکاران بخش آنژیوگرافی قلب (Cath Lab) بیمارستان افشار یزد و ارائه راهکارهای حفاظت پرتوی جهت مدیریت بهتر دوز دریافتی پرسنل Investigating the effective annual dose of radiation angiography department of Afshar Hospital in Yazd and providing radiation protection strategies to better manage the dose received by staff 1 1 مقدمه: با توجه به استفاده روزافزون از روش‌های آنژیوگرافی و احتمال ابتلا به خطرات قطعی و تصادفی برای پرتوکاران این بخش نسبت به سایر روش‌های رادیولوژیکی، حفاظت پرتوی این پرتوکاران از اهمیت بالایی برخوردار است. این مطالعه بر آن است تا دوز موثر پرسنل بخش آنژیوگرافی را بدست آورده و با حد دوز استاندارد مقایسه گردد و راه‌کارهای کاهش دوز شغلی آنژیوگرافی بیان گردد. روش بررسی: در این پژوهش گزارش فیلم بج افراد پرتوکار در اتاق آنژیوگرافی از 1394 تا 1397 بررسی گردید و دوز موثر دوره‌ای و سالیانه 34 پرتوکار بهدست آمد. همچنین ارتباط بین دوز موثر و شاخص توده بدنی، سابقه پرتوکار و جنس و سن پرتوکار نیز مورد ارزیابی قرار گرفت. نتایج: نتایج نشان داد که متوسط دوز موثر پزشکان، پرستاران و رادیوتکنولوژیست بخش آنژیوگرافی در مدت 2 ماه در هر دوره 2/0 میلی سیورت و متوسط دوز موثر سالیانه آن‌ها به ترتیب 6/1، 2/1 و 2/1 بوده است. همچنین ارتباط معناداری بین دوز موثر و سابقه، سن، جنس و شاخص توده بدنی یا BMI پرتوکاران مشاهده نشده است. نتیجه‌گیری: دوز موثر پرتوکاران این مطالعه کمتر از حد دوز سالیانه می‌باشد. پایین بودن دوز موثر موجب نمی‌شود تا حفاظت پرتوی آن‌ها کم‌اهمیت باشد زیرا این کاهش می‌تواند به دلیل رعایت حفاظت پرتوی توسط پرسنل بخش باشد؛ بنابراین تا حد ممکن باید اقدامات حفاظتی جهت کاهش پرتوگیری پرتوکاران آنژیوگرافی صورت گیرد. در این پرتوکاران حفاظت از تیروئید، چشم، گنادها و اندام‌هایی که معمولاً خارج از روپوش سربی قرار دارند از اهمیت بالایی برخوردار است. 2 Introduction: Due to the increasing use of angiography procedures and the higher risk of deterministic and stochastic effects for radiation workers of these sections than other radiological procedures, radiation safety is very important among angiography staff. Therefore, this study aimed to obtain the effective dose of angiography staff, compare them with the standard dose limit, and finally outline the strategies for occupational dose reduction in angiography. Methods: In this study, the report of film dosimetry of angiography staff was studied and the effective periodic and annual doses of 34 radiographs were reported from the year 2015 to 2018. The relationship between effective dose and body mass index, work experience, gender and age of staff was also evaluated. Results: The results showed that the average effective dose of the physicians, nurses and radiographers in 2 months period were 0.2 mSv and their average annual effective dose were 1.6, 1.2 and 1.2, respectively. In addition, there were no significant relationship between effective dose and work experience, age, sex and BMI of the radiation workers. Conclusion: The effective dose of radiation in this study is less than the annual dose.. Low effective doses do not make their radiation protection less important because this reduction can be due to radiation protection by personnel in this ward. Therefore, as far as possible, radiation protection measures should be taken to reduce the radiation exposure of catheterization lab staff. 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ارتباط شناختی رنگ وسایل نقلیه با نوع تصادفات منجر به فوت و جرح رانندگان Investigating the Cognitive Relationship between the Color of Vehicles and the Type of Accidents Leading to Death and Injury of Drivers 1 1 مقدمه: سالانه در دنیا افراد زیادی در اثر سوانح جاده‌ای جان خود را از دست می‌دهند و یا دچار صدمات جبران‌ناپذیری میشوند. یکی از علل تصادفات عوامل شناختی رانندگان می‌باشد که رنگ وسیله‌ی نقلیه از جمله مواردی است که بر عملکرد شناختی رانندگان تأثیر دارد. لذا این پژوهش با هدف بررسی رابطهی رنگ وسیلهی نقلیه با نوع تصادفات منجر به فوت و جرح است. روش بررسی: این مطالعه‌ توصیفی و به روش مقطعی بر روی 300 مورد از تصادفات انتخاب شده به روش تصادفی ساده در کرمان انجام شد. اطلاعاتی شامل نحوهی تصادف، نام و رنگ وسیلهی نقلیه، محل، علت، ساعت، حوزه استحفاظی، ایام هفته، فصل و نوع حادثه از آمار پلیس‌راه و ادارهی راهنمایی و رانندگی جمع‌آوری شده و با استفاده از نرم‌افزار SPSS تجزیه و تحلیل شد. نتایج: نتایج مطالعه نشان داد که حوادث در روز (ساعات روشن) بیشتر رخ‌داده است. موتورسیکلت، وسایل نقلیه با رنگ مشکی و سفید بیشترین و وسایل نقلیه با رنگ زرد و بژ کمترین فراوانی تصادفات را داشتند. تفاوت معنیداری میان رنگ وسیلهی نقلیه (تیره و روشن) و سایر متغیرها با نوع تصادفات منجر به فوت و جرح رانندگان مشاهده نشد. نتیجه‌گیری: با توجه به نتایج این بررسی رابطهی معنیداری میان متغیر رنگ وسایل نقلیه (تیره و روشن) با نوع تصادفات منجر به فوت و جرح رانندگان مشاهده نشد. به نظر میرسد یکی از دلایل آن تفاوت روشهای تجزیه و تحلیل آماری میباشد. برای بررسی ارتباط نوع تصادفات و رنگ وسیلهی نقلیه نیاز به مطالعات بیشتری میباشد. 2 Introduction: Annually, many people die or suffer from irreparable injuries in road accidents worldwide. One of the causes of accidents is drivers, cognitive factors and the vehicle color is one of the factors that affect the cognitive performance of the drivers. Therefore, this study aimed to investigate the relationship between vehicle color and type of accidents leading to death and injury. Materials and Methods: This descriptive cross-sectional study was performed on 300 randomly selected cases of accidents in Kerman. Information including the manner of accident, name and color of vehicle, location, cause, time, area of protection, weekday, season and type of accident were collected from traffic police and traffic department statistics and analyzed by using SPSS software. Results: The results of the study showed that most of the accidents occurred during daylight hours. Motorcycle, black and white vehicles had the highest and yellow and beige vehicles had the least frequency. There was no significant difference between vehicle color (dark and light) and other variables with the type of accidents leading to the driver's death and injury. Conclusion: According to the results of this study, no significant relationship was observed between vehicle color (dark and light) and the type of accidents leading to death and injury on. One of the reasons seems to be the difference between the methods of statistical analysis. Further studies are needed to investigate the relationship between the type of accidents and vehicle color. 45 54 2018/09/202017/06/52018/08/82019/10/222020/01/16 1398/10/26 سمیه مرادی بن توت somayeh moradi bontoot دانشگاه علوم پزشکی شهید صدوقی یزد،ایران ایران somimoradi66@gmail.com غلامحسین حلوانی Gholam Hossein halvani دانشگاه علوم پزشکی شهید صدوقی یزد،ایران ایران halvani39@gmail.com ناصر صدرا ابرقویی naser sadra abarghouei دانشگاه جامع علمی- کاربردی، یزد، ایران ایران Nasersadra@yahoo.com سارا جام برسنگ sara Jambarsang دانشگاه علوم پزشکی شهید صدوقی یزد،ایران ایران s.jambarsang@gmail.com حسین فلاح Hossein fallah دانشگاه علوم پزشکی وخدمات بهداشتی درمانی تبریز،تبریز، ایران ایران fallah_hossein@yahoo.com ویداسادات انوشه vida sadat anoosheh دانشگاه علوم پزشکی شهید صدوقی یزد،ایران ایران anooshehvida@gmail.com بابک صمصامی babak samsami دانشگاه ارومیه، ایران ایران samsami.b@gmail.com Accidents Drivers Cognitive ergonomics Vehicle تصادفات رانندگان ارگونومی شناختی وسیله‌ی نقلیه W.H.O. 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Epidemiology. 2002;13(6):721-4.##9. Newman MC, Willis FN. Bright cars and speeding tickets. Journal of Applied Social Psychology. 1993;23(1):79-83.##10. Wang H, Zhang N, editors. The analysis on vehicle color evoked EEG based on ERP method. 2010 4th International Conference on Bioinformatics and Biomedical Engineering; 2010: IEEE.##11. Erfanpour S, Hashemi Nazari SS, Ghadirzadeh MR. Epidemiological study of traffic accidents leading to death in Khorasan Razavi province in 2012. Mashhad University of Medical Sciences Journal. 2016;59(4):261-8.##12. Kazemian M, Movahhedi M, Movahhed F. Facial Fracture Types in Motorcyclists with and without Helmet in Southeast of Iran. Journal of Mashhad Dental School. 2019;43(3):295-303.##13. Lucas EC, Mendes-Da-Silva W, Lyons AC. Gender Differences and Automobile Insurance Acquisition. Individual Behaviors and Technologies for Financial Innovations: Springer. 2019; p. 25-45.##14. Gholamalie B, Khazaei S, Jamourpour S, Mohammadian Hafshjani A. Epidemiological study of traffic accidents in motorcyclists across the country, 2013 [Persian]##15. Deme D. Review on Factors Causes Road Traffic Accident in Africa. American International Journal of Sciences and Engineering Research. 2020;3(1):14-21.##16. Sajjadi SM, Medghalchi A, Beheshti SAH, Aghakhani MR. Analysis of Vehicle Reversal Accidents (A Case Study of Zanjan Province in 2006). 2009. [Persian]##17. Derefeldt G, Swartling T, Berggrund U, Bodrogi P. Cognitive color. Color Research & Application: Endorsed by Inter‐Society Color Council, The Colour Group (Great Britain), Canadian Society for Color, Color Science Association of Japan, Dutch Society for the Study of Color, The Swedish Colour Centre Foundation, Colour Society of Australia, Centre Français de la Couleur. 2004;29(1):7-19.##Laughery KR. Safety communications: warnings. Applied ergonomics. 2006;37(4):467-78.##18. Shin S-y, Lee S. Correlation between Car Accident and Car Color for Intelligent Service. 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بررسی سطح بهزیستی و ویژگی‌های روانسنجی مقیاس بهزیستی پرستاران در محیط کار Survey the level of well-being and Psychometric characteristics of hospital nurses’ well-being at work scale 1 1 مقدمه: مشکلات سلامت روانی در بین پرستاران متداول است چراکه می‌بایست با تنیدگی‌های محل کار خود نظیر مشکلات چرخه استراحت-کار، مسئولیت‌پذیری بیش از حد، مشکلات مالی، فقدان اوقات تعطیلی، تنش‌های کاری، چارچوب‌های ارتباط با بیمار و مشاهده تجربیات رنج آور بیماران مواجه شوند. این عوامل می‌تواند سبب کاهش بهزیستی آنها شود، با این حال، در حال حاضر مقیاس مختصر و کاربردی برای ارزیابی توانمندی‌های پرستاران وجود ندارد. بنابراین، هدف مطالعه حاضر ارزیابی ویژگیهای روانسنجی مقیاس بهزیستی پرستاران در محیط کار بود. روش بررسی: در این مطالعه مقطعی، 194 پرستار مقیاس بهزیستی پرستاران در محیط کار را تکمیل کردند. مقیاس بهزیستی پرستاران در محیط کاراز 67 سوال متشکل است و ویژگیهای روانسنجی از طریق روایی صوری، روایی محتوایی، روایی همزمان، روایی سازه بررسی شد. تحلیل داده ها از طریق نرم افزار SPSS انجام شد. نتایج: روایی صوری و محتوایی توسط پنج روانشناس مورد تایید قرار گرفت. شاخص KMO و کرویت بارتلت نشان دادند که ماتریس همبستگی به منظور انجام تحلیل عاملی اکتشافی مناسب است. تحلیل عامل با تحلیل مولفه اصلی یک عامل را با میزان تبیین 066/67 درصد واریانس کل استخراج کرد. همسانی درونی از طریق آلفای کرونباخ 957/0 بدست آمد. بر اساس یافته‌های پژوهش حاضر، 1/2 درصد از پرستاران بهزیستی خیلی کم، 7/6 درصد بهزیستی کم، 6/66 درصد بهزیستی متوسط و 7/22 درصد بهزیستی زیاد تجربه کردند. نتیجه گیری: این پژوهش نشان داد که مقیاس بهزیستی پرستاران در محیط کار ویژگی‌های روانسنجی مناسبی دارد و شاخص غربالگری روا و پایایی در سنجش بهزیستی پرستاران است. این شاخص می‌تواند ارزیابی بهزیستی را به روشی مختصر و کاربردی در پرستاران تسهیل کند. بعلاوه بررسی و بهبود بهزیستی پرستاران در محیط کار می‌بایست مورد توجه جدی قرار گیرد. 2 Introduction: Mental health problems is common among nurses, because they have to deal with to workplace stresses such as work-rest cycle problems, overload responsibility, financial problems, lack of vacation time, pressures of work, patient communication frameworks and painful experiences of patients. These factors can decrease their wellbeing, but there is not brief and practical scale to assess psychological resiliency among nurses. Therefore, the aim of the present study was to evaluate the psychometric properties of the hospital nurses’ well-being at work scale. Materials and Methods: This cross-sectional study was conducted on 194 nurses. The hospital nurses’ well-being at work was administered. The hospital nurses’ well-being at work is composed of 67 items and psychometric properties were examined through the Face validity, Content Validity, Concurrent validity, Construct validity. The data were analyzes by SPSS software. Results: Face and content validity were approved by five psychologists. The KMO index and Bartlett's Cruity Index indicated that correlation matrix was suitable for performing exploratory factor analysis. Factor analysis with Principal Component Analysis extracted one factor with 67.06% total variance. Internal consistency was confirmed by a Cronbach’s alpha of 0.957. According to the findings of the present study, 2.1% of nurses experienced very low well-being, 6.7% experienced low, 66.6% experienced moderate and 22.7% experienced high one. Conclusion: This study showed that the hospital nurses’ well-being at workplace had appropriate psychometric properties and is a valid and reliable screening index to measure well-being of nurses. This index could facilitate the assessing Well-Being in brief and practical way among nurses. 55 68 2018/09/202017/06/52018/08/82019/10/222020/01/162019/01/26 1397/11/6 رضا سلطانی شال Reza Soltani Shal دانشگاه گیلان ایران soltani.psy@gmail.com فاطمه سعادت بین جواهری Fatemeh Saadatbin Javaheri دانشگاه گیلان ایران fatemeh.sadatbin@gmail.com عذرا زبردست Azra Zebardast دانشگاه گیلان ایران zebardast@yahoo.com Hospital Nursing Staff Psychometrics Well-Being کارکنان پرستار بیمارستان روانسنجی بهزیستی 1. 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مقایسه و بررسی تأثیر مواجهه تنفسی کارگران با آلاینده BTEX بر شاخص‌های اسپیرومتری در دو سال متوالی در کارگران سکوهای بارگیری فرآورده‌های نفتی Effect of respiratory exposure to benzene, toluene, xylene and ethyl benzene on the spirometric indices in two consecutive years among the petroleum products loading workers 1 1 مقدمه: بنزن، تولوئن، زایلن و اتیل بنزن BTEX از جمله مهمترین ترکیبات هیدروکربنی آروماتیک در فرآوردههای نفتی می باشند. ترکیبات BTEX به علت داشتن فشار بخار بالا به‌راحتی به‌صورت گاز و بخار درآمده و با هوای محیط ترکیب میشوند. کارگران شاغل در سکوهای بارگیری با استنشاق ترکیبات BTEX در معرض مواجهه با این ترکیبات میباشند. هدف از این مطالعه، بررسی تأثیر مواجهه تنفسی با ترکیبات BTEX بر روی شاخصهای عملکردی ریه بود. روش بررسی: در یک مطالعه توصیفی- مقطعی که در بازه زمانی سال 1394 تا 1395 بر روی کارگران سکوهای بارگیری فرآوردههای نفتی انجام گرفت. تعداد 18 نمونه هوا از منطقه تنفسی فرد برای تعیین میزان مواجهه کارگران به آلاینده های بنزن، تولوئن، زایلن و اتیل بنزن تهیه شد. نمونه برداری با استفاده از جاذب زغال فعال انجام گردید. جهت تعیین و ارزیابی شاخصهای عملکردی ریه از تست اسپیرومتری طبق دستورالعمل سازمان ایمنی و بهداشت شغلی آمریکا OSHAاستفاده شد. نتایج: نتایج حاصل از آنالیز نمونههای اخذ شده نشان داد که میانگین میزان مواجهه کارگران با بنزن بالاتر از حد مجاز مواجهه شغلی و میانگین مواجهه با اتیل بنزن، تولوئن و زایلن پایینتر از حد مجاز مواجهه شغلی بوده است. همچنین نتایج حاصل از آزمون اسپیرومتری افت در شاخصهای عملکردی ریه شامل ظرفیت حیاتی سریع FVC، ظرفیت حیاتی سریع در ثانیه اول FEV1، نسبت ظرفیت حیاتی در ثانیه اول به ظرفیت حیاتی سریع (FEV1/FVC) را نشان داد. نتیجهگیری: نتایج این تحقیق نشان داد مواجهه با ترکیبات BTEX میتواند بر شاخصهای عملکردی ریه اثر گذاشته و باعث کاهش آنها شود. 2 Introduction: Benzene, toluene, xylene and ethylbenzene (BTEX) are the most important aromatic compounds in petroleum products. Due to high vapor pressure, BTEX compounds easily change to gas form and mixed with ambient air. Petroleum products loading workers are exposed to these compounds by the inhalation of BTEX compounds. The aim of this study was to evaluate the effects of respiratory BTEX exposure on lung function indicators . Materials and Methods: A cross sectional study was conducted on petroleum products loading workers in 2015 until 2016. there were process of inclusion and exclusion in working tasks. 32 people participated in this study consciously. Eighteen samples of air was gotten in the breathing zone of workers. Sampling was performed by indivial sampling pump 222-4 model by use of activated charcoal were taken to determine the workers' exposure to benzene, toluene, xylene and ethyl benzene. Method of sampling was 1501 NIOSH.To determine and evaluate the lung function, spirometry tests were performed according to OSHA protocols. Results: The results of analysis of samples showed that the average exposure to benzene was above the occupational exposure limit and the average exposure to ethyl benzene, toluene and xylene were below the occupational exposure limit. Lung functions indices, including FVC, FEV1, FEV1 / FVC were reduced. Conclusion: The results showed that exposure to BTEX compounds could affect lung function indices, and reduced Lung functions indices. 69 75 2018/09/202017/06/52018/08/82019/10/222020/01/162019/01/262016/05/30 1395/3/10 2020/01/122020/06/302020/07/3 1399/4/13 احمد ذوالفقاری Ahmad Zolfaghari بهداشت و درمان صنعت نفت اصفهان ایران ahmad_mui@yahoo.com عبدالرضا زارعی Abdoreza Zarei بهداشت و درمان دانشگاه علوم پزشکی قم ایران مهرداد مستغاثی Mehrdad Mostaghaci دانشگاه علوم پزشکی یزد ایران Mehrdadmostaghaci@gmail.com حمیده میهن پور Hamide Mihanpour دانشگاه علوم پزشکی یزد ایران H.MIHANPOUR@GMAIL.COM محمدجواد زارع سخویدی Mohammad javad zare sakhvidi دانشگاه علوم پزشکی یزد ایران mjzs63@gmail.com Benzene Toluene Xylene Ethyl Benzene Inhalation exposure Spirometry بنزن تولوئن زایلن اتیل بنزن مواجهه تنفسی اسپیرومتری ## ##

بومی سازی راهنمای بالینی تست MWT Adaptation of a clinical practice guideline for Maintenance of Wakefulness Test (MWT) 1 1 مقدمه: خواب آلودگی بیش از حد با عوارض قابل توجه و افزایش خطر مرگ و میر در خود فرد و دیگران همراه است. تستMWT جهت سنجش پاسخ به درمان این اختلال با ارزیابی توانایی بیدار ماندن افراد در شرایط استاندارد تست، طراحی شده است. با توجه به وجود روشهای مختلف جهت انجام و تفسیر تست MWT و اهمیت یکسان سازی روش انجام و تفسیر این تست در کشور، بومی سازی راهنمای استفاده بالینی تست MWT مد نظر قرار گرفت. روش بررسی: در ابتدا راهنماهای بالینی موجود در زمینه تست MWT بررسی شد و یک راهنما به عنوان راهنمای اصلی انتخاب و توصیه های سایر راهنماها نیز مد نظر قرار گرفت. سپس به منظور استاندارد سازی خدمات بالینی ارایه شده به بیماران، با توجه به شرایط و امکانات موجود در کشور، بومی سازی راهنمای استفاده بالینی تست MWT انجام شد. نتایج: این راهنما شامل توصیه‌های استاندارد جهت انجام تست MWT و تفسیر آن است. برای هر یک از توصیه‌ها "سطح شواهد موجود" نیز مشخص شده است که شامل سطوح standard، guideline و option می‌باشد. نتیجه‌گیری: با توجه به شیوع خواب آلودگی و اهمیت آن در ایمنی، حوادث شغلی و سوانح جاده ای و نقش تست MWT در ارزیابی آن، امید است که با ارائه هزینه-اثربخش ترین روش تشخیصی در این راهنما، گامی در جهت تخصیص بهتر منابع سلامت در کشور صورت گیرد. 2 Introduction: Excessive daytime sleepiness is related to significant morbidity and mortality in either the patients or others. Maintenance of Wakefulness Test (MWT) is designed to evaluate the ability to maintenance of wakefulness in standard conditions of the test. Due to the existence of different methods for performing and interpreting the MWT test and the importance of unifying the method of performing and interpreting this test in Iran, the localization of the clinical use guide of the MWT test was considered. Materials and Methods: Initially, it was studied the available guidelines, and one of them was chosen as the main guideline. Then, to standardize the clinical services provided to patients, according to the conditions and facilities in Iran, the localization of the clinical guideline of MWTtest was performed. .Results: This guideline contained recommendations for implementation and interpretation of MWT. For each recommendation, the level of evidence including “standard”, “guideline” and “option” was specified. Conclusion: Given the prevalence of drowsiness and its importance in safety, occupational accidents and road accidents and the role of MWT testing in its evaluation, it is hoped that by providing the most cost-effective diagnostic method in this guide, a step will be taken to better allocate health resources in the country. 87 97 2018/09/202017/06/52018/08/82019/10/222020/01/162019/01/262016/05/302018/09/30 1397/7/8 2020/01/122020/06/302020/07/32019/07/7 1398/4/16 خسرو صادق نیت حقیقی Khosro Sadeghniiat-Haghighi دانشگاه علوم پزشکی تهران ایران سحر افتخاری Sahar Eftekhari دانشگاه علوم پزشکی تهران ایران فرزانه میرزاآقایی Farzaneh Mirzaaghaee دانشگاه علوم پزشکی تهران ایران زهرا بنفشه آل محمد Zahra Banafsheh Alemohammad دانشگاه علوم پزشکی تهران ایران Sleepiness MWT Clinical Guideline Safety Sensitive Jobs خواب آلودگی MWT راهنمای بالینی مشاغل حساس 1. Arand D, Bonnet M, Hurwitz T, Mitler M, Rosa R, Sangal RB. The clinical use of the MSLT and MWT. Sleep. 2005;28(1):123-44.##2. Kryger M. Principles and Practice of SLEEP MEDICINE. 6th ed: Elsevier; 2017.##3. Schreier DR, Roth C, Mathis J. Subjective perception of sleepiness in a driving simulator is different from that in the Maintenance of Wakefulness Test. Sleep medicine. 2015;16(8):994-8.##4. Sadeghniiat K. Sleepiness among Iranian Lorry Drivers. Acta Medica Iranica. 2006;45(2):149-52.##5. Banks S, Catcheside P, Lack LC, Grunstein RR, McEvoy RD. The maintenance of wakefulness test and driving simulator performance. Sleep. 2005;28(11):1381-5.##6. Sadeghniiat-Haghighi K, Eftekhari S, Mirzaaghaee F, Aminian O. Adaptation of clinical practice guidelines for manual titration of CPAP and BPAP in patients with obstructive sleep apnea. tkj 2016;8(2):37-50 (In Persian)##7. Wise MS. Objective measures of sleepiness and wakefulness: application to the real world? Journal of clinical neurophysiology. 2006;23(1):39-49.##8. 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J Clin Sleep Med. 2005;1(4):386-90.##13. Bonnet MH, Arand DL. Level of arousal and the ability to maintain wakefulness. Journal of Sleep Research. 1999;8(4):247-54.##14. Schweitzer PK, Randazzo AC, Stone K, Erman M, Walsh JK. Laboratory and field studies of naps and caffeine as practical countermeasures for sleep-wake problems associated with night work. Sleep. 2006;29(1):39-50.##15. Valent F, Sincig E, Gigli GL, Dolso P. Maintenance of Wakefulness and Occupational Injuries among Workers of an Italian Teaching Hospital. Saf Health Work. 2016;7(2):120-3.##16. Carskadon MA, Acebo C. Regulation of sleepiness in adolescents: update, insights, and speculation. Sleep. 2002;25(6):606-14.##17. Arzi L, Shreter R, El-Ad B, Peled R, Pillar G. Forty- versus 20-minute trials of the maintenance of wakefulness test regimen for licensing of drivers. J Clin Sleep Med. 2009;5(1):57-62.##18. Shreter R, Peled R, Pillar G. 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