Structural equation modeling may provide methodological opportunities in occupational health research with a potential to explain the complexity of interactions among risk factors. Prevention of work-related musculoskeletal disorders among nurses must account for physical and psychosocial conditions.

Objectives: Work-related musculoskeletal disorders are a significant occupational problem among employees and workers. This study attempted to explore the effect of stressors in the hospital environment on nurses' development of musculoskeletal disorders. Methods: We conducted a cross-sectional survey in a random sample of 123 hospital nurses from Semnan University of Medical Sciences. Data were collected during working days over 3 months starting from January 2014. Participants completed a standardized questionnaire for stresses and musculoskeletal disorders at work. Musculoskeletal disorders were used as the dependent variables, while demographic, physical, and psychosocial work factors were used as independent variables. Results: Our study revealed prevalence of low back ache, neck ache, shoulder ache, arm-elbow ache, and hand-wrist pain rated 48.3%, 39.5%, 33.1%, 31.3%, and 23.4%, respectively. The findings showed significant statistical association between musculoskeletal complaints in neck and upper extremity with exposed stress levels (P = 0.04). Musculoskeletal symptoms rates increased in employees experienced poor work posture (P = 0.01), fatigue (P = 0.04), and work-family conflict (P = 0.04). Conclusions:This study provides indication of the relationship between work environment stress levels and musculoskeletal disorders. Physical and psychosocial stressors should be considered for the development of preventive measures.

Objective: Cardiac complications are the major cause of morbidity and mortality in beta-thalassemia major. The aim of the study was to evaluate right (RV) and left (LV) ventricular systolic and diastolic functions using myocardial performance index in young, asymptomatic children suffering from thalassemia major, for early detection of cardiac function impairment, preventing further cardiac damage by modifying disease progression and treatment. Methods: A case-controlled, cross-sectional study involving 80 patients suffering from beta-thalassemia major and 80 children adjusted in terms of age and sex served as a control group were studied in Research Center for Children and Adolescent Health Zahedan. The relevant echocardiographic parameters were measured in both subject groups: myocardial performance index (MPI), isovolumic relaxation time (IRT), isovolumic contraction time (ICT), pre-ejection period (PEP), ejection time (ET), PEP/ET ratio, deceleration time (DT) and acceleration time (AT). Data were analyzed by unpaired Student t test. Results: The left ventricular mean IRT in the patient group was 114±21 and in the control group 94±10 msec (p<0.05). The mean MPI (LV) in the patient group was 0.58±0.18 and in the control group 0.41±0.08 (p<0.05). The mean ET (LV) in the patient group was 237±36 msec and in the control group 266±25 msec (p<0.05). The mean ET (RV) in the patient group was 237±39 msec and in the control group 261±36 msec (p<0.05). Conclusion: There is an early systolic and diastolic dysfunction in children younger than 10 years with beta-thalassemia major. Even in young asymptomatic children with beta-thalassemia major, serial echocardiography seems warranted in order to adjust cardioprotective therapy. (Anadolu Kardiyol Derg 2010; 10: 150-3) Key words: Beta-thalassemia major, systolic function, diastolic function, echocardiography, children ÖZET Amaç: Çalışmanın amacı, kalp fonksiyon bozukluğunu erkenden teşhis ederek, daha sonraki kalp hasarını önlemek için hastalığın seyrinde ve tedavisinde gerekli değişiklikleri yapmada talasemi majörlü genç ve asemptomatik çocuklarda miyokart indeksini kullanarak sağ ve sol ventrikülün sistolik ve diyastolik fonksiyonlarını değerlendirmekti. Yöntemler: Zahedan Çocuk ve Genç Sağlığı Araştırma Merkezinde yaş ve cinse göre uyumlu, 80 sağlıklı çocuk ve beta-talasemi majörlü 80 hastanın dahil olduğu olgu-kontrollü, enine-kesitsel bir çalışma yapıldı. Her iki grupta da ilgili ekokardiyografik parametreler ölçüldü: Miyokart performans indeksi (MPI), izovolümik relaksasyon zamanı (IRT), izovolümik kasılma zamanı (ICT), pre-ejeksiyon dönemi, PEP/ET oranı, deselerasyon zamanı (DT) ve akselerasyon zamanı (AT). Veriler eşleştirilmemiş Student t testi ile analiz edildi. Bulgular: Sol ventrikül ortalama IRT hasta grubunda 114±21 ve kontrol grubunda 94±10 msn (p<0.05) idi. Hasta grubunda ortalama MPI (LV) 0.58±0.18 ve kontrol grubunda 0.41±0.08 (p<0.05) oldu. Hasta grubunda ortalama ET (LV) 237±36'ydı ve kontrol grubunda 266±25 msn oldu (p<0.05). Hasta grubunda ortalama ET...

Incorporation of Project‐based Learning into an Occupational Health Course: Alireza DEHDASHTI, et al. Occupational Health Department, Faculty of Health, Research Center for Social Determinants of Health, Semnan University of Medical Sciences, Iran— Objective Use of an appropriate teaching approach is a major concern for faculty members who are involved in occupational health and safety academic education. The challenge is to explore teaching tools to equip students with knowledge and skills to prepare them for their practices, in which they will encounter occupational health and safety issues in various occupational settings. The current study presents the design and implementation of a team project‐based learning approach for undergraduate occupational health students to examine the appropriateness and perceptions of students and educators with regard to such a learning experience. Methodology: Steps were taken to guide the educators and students through the learning process based on projects completed in teams. The research tools for collecting data were a questionnaire and semi‐structured interviews with participants. Results The results illustrated that use of the proposed teaching approach as part of occupational health education may have the potential to motivate and enhance the active roles of educators and students in the learning process, and improve students' technical and social skills that are crucial for practice in the occupational health field. Conclusions The study findings showed that project‐based learning may provide a promising teaching strategy in the education and training of occupational health students. In addition, academic institutions should encourage educators to plan, introduce and evaluate the effectiveness of project‐based learning.

PurposeEvaluating educational programs can improve the quality of education. The present study evaluated the undergraduate occupational health program at the Semnan University of Medical Sciences in Semnan, Iran, with a focus on the associations between alumni perceptions of the learning environment and the outcomes of the occupational health program.MethodsA cross-sectional questionnaire survey was conducted among alumni of the undergraduate occupational health program. We asked alumni to rate their perceptions of the items using a 4-point Likert scale. The associations between alumni perceptions of the educational program and curriculum, faculty, institutional resources, and learning outcomes were modeled and described using structural equation modeling procedures.ResultsA descriptive analysis of alumni perceptions indicated low evaluations for the administrative system, practical and research-based courses, and the number of faculty members. We found that a structural model of the evaluation variables of curriculum, faculty qualifications, and institutional resources significantly predicted undergraduate educational outcomes. The curriculum had direct and indirect effects on learning outcomes, mediated by faculty.ConclusionThe findings of our study highlight the usefulness of the structural equation modeling approach for examining links between variables related to the learning process and learning outcomes. Surveys of alumni can provide data for reassessing the learning environment in the light of the professional competencies needed for occupational health graduates.

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Cardiorenal syndrome is a complex physiological, biochemical, and hormonal disorder of the heart and kidneys, whereby acute or chronic dysfunction in one organ may lead to acute or chronic dysfunction in the other, has been under focus for a long time. In this review we aim to define the interaction between the kidneys and the heart and different components to characterize the pathophysiological syndromes and discuss new approaches for the management of this entity.