Comparison of barriers to effective nurse-patient communication in COVID-19 and non-COVID-19 wards

BACKGROUND

Communication is a basic need of humans. Identifying factors that prevent effective nurse-patient communication allows for the better implementation of necessary measures to modify barriers. This study aims to compare the barriers to effective nurse-patient communication from the perspectives of nurses and patients in COVID-19 and non-COVID-19 wards.

MATERIALS AND METHODS

This cross-sectional descriptive study was conducted in 2022. The participants included 200 nurses (by stratified sampling method) and 200 patients (by systematic random sampling) referred to two conveniently selected hospitals in Shahroud, Iran. The inclusion criteria for nurses were considered having at least a bachelor's degree and a minimum literacy level for patients to complete the questionnaires. Data were collected by the demographic information form and questionnaire with 30 and 15 questions for nurses and patients, which contained similar questions to those for nurses, based on a 5-point Likert scale. Data were analysis using descriptive indices and inferential statistics (Linear regression) in SPSS software version 18.

RESULTS

The high workload of nursing, excessive expectations of patients, and the difficulty of nursing work were identified by nurses as the main communication barriers. From the patients' viewpoints, the aggressiveness of nurses, the lack of facilities (welfare treatment), and the unsanitary conditions of their rooms were the main communication barriers. The regression model revealed that the mean score of barriers to communication among nurses would decrease to 0.48 for each unit of age increase. Additionally, the patient's residence explained 2.3% of the nurses' barriers to communication, meaning that native participants obtained a mean score of 2.83 units less than non-native nurses, and there was no statistically significant difference between the COVID and non-COVID wards.

CONCLUSION

In this study, the domain of job characteristics was identified by nurses as the major barrier, and patients emphasized factors that were in the domain of individual/social factors. There is a pressing need to pay attention to these barriers to eliminate them through necessary measures by nursing administrators.

Anisotropic plates with architected tendon network

We synthesize geometrically tailorable anisotropic plates by combining button shaped fish-scale like features on soft substrates, then lacing them with high-stiffness strings. This creates a new type of biomimetic architectured structure with multiple broken symmetries. First, the tendons and substrate together break the symmetry of the bending response between the concave and convex curvature. Next, the weave pattern of the tendons further breaks symmetry along the two directors of plates. The anisotropy is clearly evident in 3-point bending experiments. Motivated by these experiments and the need for design, we formulate an analytical energy-based model to quantify the anisotropic elasticity. The derived architecture-property relationships can be used to design architected tendon plates with desirable properties.

Relationship between resilience and self-efficacy among Iranian nurses: a cross-sectional study during the post-Corona era

BACKGROUND

Resilience and self-efficacy play an influential role in nurses' clinical performance, which are considered resources for improving adaptability and promoting work engagement. This study aimed to determine the relationship between resilience and self-efficacy among nurses at Shahroud University of Medical Sciences hospitals during the post-Corona era.

METHODS

This cross-sectional study was conducted on 280 nurses in all clinical departments. Nurses with a bachelor of science in nursing or higher degree and at least one year of full-time work experience were included in the study using a convenience sampling method. Participants completed a three-part tool, which included the demographic information form, the Connor-Davidson Resilience Scale, and the General Self-Efficacy Scale. The data were analyzed using descriptive statistics and inferential tests (multivariate linear regression using the backward method).

RESULTS

In this study, nurses reported low levels of resilience (63.64 ± 15.66) and high levels of self-efficacy (63.01 ± 9.57). Among the five resilience subscales, the highest mean item score was associated with "spiritual influences" (2.80 out of 4), while the lowest mean item score was associated with "trust in one's instincts and tolerance of negative affect" (2.36 out of 4). Furthermore, the multivariate linear regression model results indicated that self-efficacy accounted for 33.6% of the variance in resilience (P < 0.001 and β = 0.952).

CONCLUSION

According to the results of the present study, it is suggested that nurses' psychological capabilities, such as self-efficacy, should be increased to improve resilience and address the stressful conditions of the work environment.

Inhibitors and facilitators of compliance with professional ethics standards: nurses' perspective

INTRODUCTION

The clinical practices of nurses should be in accordance with the principles of professional ethics. Respecting professional ethics principles depends on several factors. The present study was conducted to investigate the effective inhibitors and facilitators in compliance with professional ethics and their importance from the nurses' perspective.

METHODS

During this cross-sectional descriptive study, 452 nurses were included by the census sampling method. The data were collected via the "inhibitors of compliance with professional ethics standards by the nurses' perspective" and "facilitators of compliance with professional ethics standards by the nurses' perspective" questionnaires. Additionally, by designing the "open-ended question" section, other inhibiting and facilitating factors of professional ethics standards from the nurses' perspective were investigated. The data were analyzed using descriptive and inferential statistics (Wilcoxon signed ranks test).

RESULTS

The individual care-related dimension as a facilitator had the highest mean score compared to the other dimensions (76.62 ± 4.92). Furthermore, seven items in the inhibitor section, 19 items in the facilitator section had higher scores. Among them, there were seven items in common. Strong or weak belief in compliance with ethical issues had the highest mean scores in the role of facilitator and inhibitor (90.54 ± 12.13 and 89.54 ± 14.88, respectively).

CONCLUSION

Strong or weak belief in compliance with ethical issues was the most important inhibitor and facilitator from the nurses' perspective, which makes it necessary to examine individual beliefs about ethical issues among applicants to enter the nursing profession.

The effect of increasing duration of family members' presence on sleep status in patients with acute coronary syndrome in cardiac care unit: A randomized controlled trial

AIM

To investigate the effect of increasing duration of family members' presence on sleep status in patients with acute coronary syndrome (ACS) admitted to the cardiac care unit.

DESIGN

Randomized controlled trial.

METHODS

Ninety patients with ACS randomly assigned into two groups. No intervention was performed in control group. In the intervention group, the time of family members presence was changed from 1 h per day to 2 h per day from the second to the fourth day. Then, ST Mary's Hospital Sleep Questionnaire was completed by the patients every day during the study.

RESULTS

The patients in the intervention group had statistically significantly better sleep status during the course of intervention compared to the control group.

PATIENT OR PUBLIC CONTRIBUTION

The increasing duration of family members' presence can improve the sleep quality and quantity of ACS patients.

Health Care Providers' Attitudes Toward Do-Not-Resuscitate Order in COVID-19 Patients: An Ethical Dilemma in Iran

This study aimed to investigate the health care providers' attitudes toward the Do-Not-Resuscitate order (DNR) in COVID-19 patients. This study was conducted on 332 health care providers (HCPs) at the COVID-19 referral hospital in Shahroud, Iran by convenience sampling method. The study tools included a demographic information form and the DNR attitude questionnaire. Significance level was considered 0.05 for all tests. The mean scores of attitudes toward DNR order, the procedure of DNR, some aspects of passive euthanasia, and religious and cultural factors were 25.27 ± 2.78, 40.61 ± 5.99, 11.26 ± 2.51, and 6.12 ± 1.27, respectively. The death of relatives due to COVID-19 and female gender were associated with high and low scores of attitudes toward DNR order, respectively. Extended working hours and more work experience were correlated with high scores of DNR procedure. The history of COVID-19 increased the mean score of attitudes toward some aspects of passive euthanasia. In addition, an increase in following COVID-19 news decreased the score of religious and cultural factors affecting DNR order. Despite the legal ban on implementation of the DNR in Iran, the attitude of Iranian HCPs toward this was positive in COVID-19 patients.

Psychometric evaluation of the Persian version of the Sense of Belonging in Nursing School (SBNS): a quantitative and cross-sectional design

BACKGROUND

This study aimed to evaluate the psychometric indicators of the Persian version of the Sense of Belonging in Nursing School scale (SBNS).

METHODS

The study conducted in Shahroud and Semnan schools of nursing and midwifery in Iran examined nursing students using a cross-sectional approach by convenience sampling method from 3/6/2023 to 24/8/2023. To assess the SBNS scale, the forward-backward procedure was used to translate it into Persian. Face and content validity were evaluated, and exploratory and confirmatory factor analyses were conducted with sample sizes of 200 and 182, respectively. Reliability was assessed using Cronbach's alpha coefficient, MacDonald's omega, and intra-class correlation coefficient.

RESULTS

The exploratory factor analysis resulted in the exclusion of four items, leaving a final selection of 15 items. These items were categorized into three factors: classmates, clinical staff, and inclusive educational environment, which accounted for 49.16% of the overall variance. The confirmatory factor analysis indicated that the model was a good fit for the observed data, and the subscales had high internal consistency (Cronbach's alpha coefficient was 0.752 to 0.880) and stability (intra-class correlation coefficient was 0.889 to 0.968).

CONCLUSION

According to the results, it can be concluded that the Persian version of the SBNS scale demonstrates sufficient validity and reliability in assessing students' sense of belonging to the nursing school.

Analyzing the influential factors of process safety culture by hybrid hidden content analysis and fuzzy DEMATEL

Due to the complex nature of safety culture and process industries, several factors influence process safety culture. This paper presents a novel framework that combines the hidden content analysis method with Decision Making Trial and Evaluation Laboratory (DEMATEL) and Fuzzy logic to achieve a comprehensive set of influential factors and their relationship. The proposed methodology consists of two primary stages. Firstly, combined methods of literature review and Delphi study were used to identifying influential factors of process safety culture. Secondly, the Fuzzy-DEMATEL approach is employed to quantify and determine the relationships between different influential factors. A diverse pool of experts' opinions is leveraged to assess the impact of each factor on others and process safety culture. In the first stage, 18 factors identified as influential factors on process safety. The findings of second stage revealed that eight variables were identified as causes, while ten variables were classified as effects. Also, the Organization management's commitment to safety factor had the greatest influence among all of the factors. As well as, the most significant interaction was associated with the risk assessment and management aspect. The integrated approach not only identified the influential factors, but also elucidates the cause-effect relationships among factors. By prioritizing factors and understanding their interconnections, organizations can implement targeted safety measures to improve process safety culture. Its effectiveness in quantifying qualitative data, identifying influential factors, and establishing cause-effect relationships make it a valuable tool for enhancing safety culture in process industries.

Relationship between academic success, distance education learning environments, and its related factors among medical sciences students: a cross-sectional study

BACKGROUND

Academic success is among the most important criteria for determining students' competence. Hence, one of the concerns of education system researchers has always been investigating its associated factors. Therefore, this study aimed to determine the relationship between academic success, distance education learning environments, and its related factors among Shahroud University of Medical Sciences students.

METHODS

This cross-sectional study was conducted on 208 medical sciences students who completed at least two online and two in-person academic semesters. Participants were selected through the convenience sampling method and filled out three questionnaires, including the demographic information form, the Academic Success Inventory for College Students, and the Distance Education Learning Environments Survey. Finally, the data were analyzed using descriptive statistics and inferential tests (t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression).

RESULTS

In this study, students reported moderate levels of academic success (107.81 ± 10.72). Moreover, they assessed their distance education learning environment as the positive points were more than the negative points (74.10 ± 14.89). Distance education learning environment (β = 0.233 and P < 0.001) and field satisfaction (β = 9.797 and P = 0.001) were also mentioned as factors related to students' academic success.

CONCLUSION

According to the present results, it is suggested to improve the learning environment of distance education and increase students' satisfaction to enhance their academic outcomes such as academic success.

Unexpected changes and associated factors of care burden among caregivers of cancer patients one year after COVID-19 outbreak

Purpose

The study aimed to evaluate the changes in the care burden and quality of life of caregivers of cancer patients and correlates of care burden during the COVID-19 pandemic.

Methods

This cross-sectional study used the census sampling technique with 260 cancer patients and their caregivers during January to March 2020 in northeast Iran. Data collection tools included the Novak and Guest Care Burden Scale, the SF-36 Quality of Life Questionnaire, and the Stress, Anxiety, and Depression Scale (DASS-21). Data were analyzed using descriptive and inferential statistics (independent t-test and multiple linear regression analysis).

Results

Baseline scores of care burden and quality of life in caregivers suggested mild to moderate care burden and a reasonable quality of life and moderate levels of stress, anxiety, and depression in patients. The post-outbreak mean scores of care burden and quality of life significantly decreased and increased, respectively (p < .001). Regression analysis showed that 39.3% of the changes in the care burden score during the pandemic could be predicted by studied variables. In exchange for increasing the quality-of-life score and daily care hours, the care burden score decreases and increases. The burden of care in caregivers was also related to the type of cancer. Care burden in the caregivers of patients with breast and neurological malignancies was lower than the caregivers of patients with gastrointestinal cancer (p < .05).

Conclusion

Despite the results obtained, supportive and educational interventions are needed to reduce the caregiver burden and improve the quality of life of caregivers and measure its impact on levels of psychological distress in their patients clinically.

Reasons for resistance to change in nursing: an integrative review

BACKGROUND

Change is a very complex and multifaceted phenomenon that is intertwined with the understanding of nursing practice, so, resistance to change in nursing can be considered as an important challenge. Knowing the reasons for this resistance can help in solving it in nursing. Therefore, the present study was conducted with the aim of investigating the reasons for resistance to change in nursing as an integrated review.

METHODS

This integrative review was conducted using the Whittemore & Knafl method in 5 stages, including problem identification, searching the literature, evaluating primary sources, analyzing data, and presenting the results. Databases like SID, Irandoc, Magiran, Google Scholar, Web of Science, PubMed, CINAHL, and Scopus were searched using the keywords; "Resistance", "Change", "Nursing", "Resistance to Change" and their Persian equivalents in the time range of 2000 to January 2023. After applying inclusion criteria and assessing the articles using Bowling's Quality Assessment Tool, finally, 15 papers were included from 2964.

RESULTS

After reviewing and critically appraisal of the qualified articles, the findings were placed in three main categories including; (1) individual factors, (2) interpersonal factors, and (3) organizational factors and six subcategories.

CONCLUSION

Undoubtedly, change is an integral component in nursing care, and resistance to it is the result of a set of individual, interpersonal and organizational factors that change managers should pay special attention to in order to make changes due to the reasons of this resistance, and the development process of developing changes in the clinical field is easily possible.

Comparison of the effect of pressure control and volume control ventilation on endotracheal tube cuff pressure in patients undergoing general anesthesia and mechanical ventilation: a parallel randomized clinical trial

BACKGROUND

Endotracheal intubation and mechanical ventilation are prevalent interventions in the operating room and intensive care unit. Recently, the complications of endotracheal tube cuff pressure have been a topic of interest. Therefore, this study compared the effect of pressure control and volume control ventilation modes on the endotracheal cuff pressure rate in patients undergoing general anesthesia and mechanical ventilation.

METHODS

In this triple-blinded randomized clinical trial, 50 patients undergoing open limb surgery and inguinal hernia were allocated to two groups of 25 based on inclusion criteria. After intubation, one group underwent ventilation on the pressure control ventilation mode, and the other underwent ventilation on the volume control ventilation mode. In both groups, using a manometer, the cuff's pressure was first adjusted in the range of 25-30 cm of water. Then, the cuff pressure was measured at 10, 20, and 30 min intervals. The data were statistically analyzed using independent t-test, and two-way repeated measures ANOVA.

RESULTS

The present study's findings showed that cuff pressure has significantly decreased over time in both study groups (F = 117.7, P < 0.001). However, a repeated measures ANOVA with a Greenhouse-Geisser correction showed no interaction between time and groups (F = 0.019, P = 0.98). The two groups had no significant difference in cuff pressure (F = 0.56, P = 0.458).

CONCLUSION

Since the cuff pressure has been significantly reduced in both groups over time, continuous monitoring of endotracheal tube cuff pressure in patients undergoing mechanical ventilation is essential. Therefore, it is suggested to keep the cuff pressure within the recommended range to prevent complications resulting from cuff pressure reduction, such as aspiration and ventilation decrease.

TRIAL REGISTRATION

The study was registered in the Iranian Registry of Clinical Trial on 23/02/2019 (trial registration number: IRCT20181018041376N1).

Recent advances in novel miRNA mediated approaches for targeting breast cancer

Breast cancer (BC) is considered one of the most frequent cancers among woman worldwide. While conventional therapy has been successful in treating many cases of breast cancer, drug resistance, heterogenicity, tumour features and recurrence, invasion, metastasis and the presence of breast cancer stem cells can hinder the effect of treatments, and can reduce the quality of life of patients. MicroRNAs (miRNAs) are short non-coding RNA molecules that play a crucial role in the development and progression of breast cancer. Several studies have reported that aberrant expression of specific miRNAs is associated with the pathogenesis of breast cancer. However, miRNAs are emerging as potential biomarkers and therapeutic targets for breast cancer. Understanding their role in breast cancer biology could help develop more effective treatments for this disease. The present study discusses the biogenesis and function of miRNAs, as well as miRNA therapy approaches for targeting and treating breast cancer cells.

Relationships Between Lifestyle, Quality of Life, Organizational Culture and Job Satisfaction Among Nurses Related to Health Promoting Hospital (HPH) Standards

Providing quality healthcare services through health promotion activities to patients, hospital-based professionals and the wider community is the goal of the health promoting hospital (HPH). There is, however, no formal structured pathway for "universally" providing health promotion services in hospitals. Accordingly, this study was conducted with the aim of presenting a model designed to promote and increase health-related satisfaction of hospital-professionals in health-promoting hospitals (HPHs) in Iran-as a potential tool to guide international HPH standards. Lifestyle, quality of life, organizational culture, and job satisfaction were measured using standardized questionnaires in specialized hospitals in Hamadan, Iran. A structural equation model (SEM) using partial least squares (PLS) software (version 2) was used to determine the validity and fit of the conceptual framework/model. The study revealed that several factors were identified as strong predictors of job satisfaction and wellbeing, including various dimensions of lifestyle such as spiritual health, physical activity, stress management, and interpersonal communication, dimensions of quality of life including physical and mental aspects, and organizational culture. The values of predictive relevance (Q2) for physical and psychological dimension of life quality, organizational culture, and job satisfaction were estimated to be 0.101, 0.250, and 0.040 and 0.251, respectively. Conclusively, the study found a goodness of fit (GOF) value of 0.415, indicating that the model had a high predictive power and fit well. Based on these results, it is suggested that implementing HPH interventions that focus on the outcomes of this model could lead to increased job satisfaction and wellbeing in hospitals. Additionally, the model could serve as a useful indicator of HPHs.

Spiritual Well-Being and Death Anxiety: A Cross-Sectional Study Among Iranian Patients With Acute Coronary Syndrome

Acute coronary syndrome (ACS) patients experience a tremendous psychological burden, typically in the form of death worry due to acute medical conditions and the possibility of mortality. The unfavourable conditions of ACS patients cause them to reconsider the meaning of life and their spiritual well-being. This study evaluated the association between death anxiety and spiritual well-being in a total of 241 ACS patients in Shahroud, northeast of Iran. The data were collected using the Templer Death Anxiety Scale, and the Spiritual Well-being Scale by convenience sampling method. All patients indicated a high degree of death anxiety, and roughly half reported a moderate level of spiritual well-being. There was a significant and direct correlation between death anxiety and spiritual well-being levels. Older age, single status, and non-smoking were other predictors of good spiritual well-being. A multidisciplinary health team should identify and implement approaches to promote spiritual well-being and reduce mental suffering.

Comparing the Effect of Local Application of Peppermint and Cold Compresses on the Severity of Pain from Venipuncture in Dialysis Patients: A Parallel Randomized Clinical Trial Study

Pain at the injection site is one of the most common complaints in the clinic and is the most important symptom affecting the quality of life of hemodialysis (HD) patients. The aim of this study was to determine the effect and compare the topical application of peppermint and cold compresses on the intensity of pain caused by the insertion of a needle into the fistula of HD patients. In this parallel randomized clinical trial, 99 HD patients were assigned to three groups receiving peppermint, a cold compress, or a control using six blocks. For the peppermint group, 20 min before the needle's insertion, a peppermint gel was used; for the cold compress group, an ice pack was used; and for the control group, the usual method was applied. The patients' pain was assessed with the Visual Analog Scale immediately after the needle's insertion. The results showed that after the intervention, the mean and standard deviation of the pain score in the intervention groups receiving peppermint (4.81 ± 1.13) or a cold compress (4.78 ± 1.13) were significantly less than those of the control group (8.42 ± 1.22) (P <0.001), but there was no statistically significant difference between the peppermint group and the cold compress group (P = 0.91). The use of peppermint, which is a cheap and uncomplicated herbal medicine, and a cold compress, which is easy to use and available, is recommended to reduce the severity of pain caused by venipuncture in HD patients.

Data driven of underground water level using artificial intelligence hybrid algorithms

As the population grows, industry and agriculture have also developed and water resources require quantitative and qualitative management. Currently, the management of water resources is essential in the exploitation and development of these resources. For this reason, it is important to study water level fluctuations to check the amount of underground water storage. It is vital to study the level of underground water in Khuzestan province with a dry climate. The methods which exist for predicting and managing water resources are used in studies according to their strengths and weaknesses and according to the conditions. In recent years, artificial intelligence has been used extensively for groundwater resources worldwide. Since artificial intelligence models have provided good results in water resources up to now, in this study, the hybrid model of three new recombined methods including FF-KNN, ABC-KNN and DL-FF-KNN-ABC-MLP has been used to predict the underground water level in Khuzestan province (Qale-Tol area). The novelty of this technique is that it first does classification by presenting the first block (combination of FF-DWKNN algorithm) and predicts with the second block (combination of ABC-MLP algorithm). The algorithm's ability to decrease data noise will be enabled by this feature. In order to predict this key and important parameter, a part of the data related to wells 1-5 has been used to build artificial intelligence hybrid models and also to test these models, and to check this model three wells 6-8 have been used for the development of these models. After checking the results, it is clear that the statistical RMSE values of this algorithm including test, train and total data are 0.0451, 0.0597 and 0.0701, respectively. According to the results presented in the table reports, the performance accuracy of DL-FF-KNN-ABC-MLP for predicting this key parameter is very high.

Prevalence of uncontrolled hypertension and its associated factors in 50-74 years old Iranian adults: a population-based study

BACKGROUND

By the lengthening of life span, the incidence of chronic diseases such as hypertension and uncontrolled hypertension has increased. This study aims to determine the prevalence of uncontrolled hypertension and its related factors in the age group of 50-74 years in Shahroud, northeast Iran.

METHODS

The data of the third phase of the Shahroud Eye Cohort Study were used in this study. This phase of the cohort study included 4394 participants aged 50 to 74 years from the previous phases. In addition to ophthalmological and optometric examinations, demographic characteristics, blood biochemistry tests, and blood pressure measurements were performed in this phase. Individuals with a blood pressure ≥ 140/90 mm/Hg (being treated or not treated with antihypertensive medicines) were defined as uncontrolled hypertension. In patients with diabetes and chronic kidney disease, blood pressure equal to or higher than 130/80 mm/Hg was considered uncontrolled hypertension. Descriptive statistics and multiple logistic regression were used to analyze the data.

FINDINGS

Overall, the prevalence of uncontrolled hypertension out of all the participants was 61.7% (95% CI: 60.3-63.2). Multiple regression results showed that the male gender (OR: 2.1, 95% CI: 1.5-2.9), patients with diabetes (OR:3.2, 95% CI: 2.4-4.3), and patients with chronic kidney disease (CKD) (OR: 3.2, 95% CI: 2.5-4.1) increased the risk of uncontrolled hypertension while in patients with cardiovascular disease (OR: 0.6, 95% CI: 0.4-0.8) and polypharmacy (OR: 0.2, 95% CI: 0.1-0.2) reduced the risk of uncontrolled hypertension.

CONCLUSION

The present study showed that uncontrolled hypertension has a high prevalence, and factors such as male gender, diabetes, and CKD are associated with this disorder. So, it is recommended to take the necessary measures to formulate and implement immediate actions to prevent or control hypertension.

Internalized Stigma and its Association with Hope, Self-Esteem, Self-Efficacy, and Treatment Adherence among Outpatients with Severe Mental Illness: A Cross-Sectional Survey

Background

This study investigated the association between internalized stigma and hope, self-esteem, self-efficacy, and treatment adherence and explored the most influential and predictive factor of internalized stigma among patients with severe mental disorders.

Materials and Methods

This correlational descriptive study was conducted on 257 outpatients diagnosed with severe mental illness according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) diagnostic criteria. The participants were seeking treatment at outpatient and affiliated clinics of Razi Hospital, Iran, from October 2018 to May 2019. We used a convenient sampling design. Internalized Stigma of Mental Illness scale, Dispositional Hope Scale, Rosenberg's Self-Esteem Scale, General Self-Efficacy Scale, and Drug Attitude Inventory were used to gather data. The data were analyzed using inferential statistics (Pearson correlation, coefficient logistic, and regression analyses) at a 0.05 significance level.

Results

The mean (standard deviation) score of internalized stigma was 1.57 (0.49), and 58% of the participants reported moderate to high internalized stigma. A negative significant relationship was found between internalized stigma and hope (r = -0.55, p < 0.05), self-esteem (r = -0.66, p < 0.05), and self-efficacy (r = -0.64, p < 0.05). Treatment adherence was not found to be significantly associated with the internalized stigma. In the final regression model, self-esteem and self-efficacy significantly predicted internalized stigma.

Conclusions

Given the crucial role of self-esteem and self-efficacy in predicting internalized stigma, nurses should devote special attention to these factors and use strategies to improve individuals' self-esteem and self-efficacy.

Effects of Increased Blood Flow Rate and Oral Activated Charcoal on the Severity of Uremic Pruritus: A Randomized Crossover Clinical Trial

The aim of this study was to compare the effect of increased blood flow rate and the administration of an activated charcoal suspension on the severity of uremic pruritus in hemodialysis patients in a crossover clinical trial. Each group (n = 20) received three 2-week interventions, including increased pumping speed, daily administration of a charcoal suspension (6 g), and the concurrent use of increased pumping speed and oral administration of the charcoal suspension. After each intervention, they had a 2-week washout period. The severity and quality of pruritus were measured using the Yosipovitch's pruritus questionnaire. The results showed that the mean severity, highest pruritus score, and lowest pruritus score decreased after all three interventions, but the highest decrease was related to the third intervention. Considering the results of this study, simultaneous use of increased pumping speed and oral administration of a charcoal suspension is recommended to reduce uremic pruritus in hemodialysis patients.

Decentralized prioritization of demand response programs in multi-area power grids based on the security considerations

The deregulation of electrical energy grids (EEGs) and surrogating the installation of bulk power plants with distributed generations such as wind energy sources, despite the score of advantages, bring new challenges for the secure operation of these EEGs for their operators. On the other hand, the deployment of demand response programs (DRPs) alongside the management of these multi-area EEGs (MEEGs) intensifies the complexity of the situation. In this paper, a method is proposed for the secure operation of MEEGs when DRPs are employed to incorporate the end-users in balancing the demand-supply chain. Moreover, the techno-economic impacts of fluctuating nature of wind energy sources are mitigated by coordinating them with energy storage systems (ESSs). To do so, a decentralized probabilistic DC-SCOPF model is developed for the operation of MEEGs with ESS-coordinated wind energy sources when several DRPs are deployed in their different areas. The decentralization of the model is performed based on the optimality condition decomposition (OCD) algorithm which results in a mixed-integer non-linear programming (MINLP) problem for each area of the MEEG. What is more; a priority list of DRPs in different areas of the MEEG is generated based on four criteria including the overall operational cost of the system, the number of critical contingencies as the security measure, the overall shed load, and the peak-to-valley ratio (PVR) of the daily demand curve. Numerical simulations are carried out on the New England 39-bus testbed and obtained results are discussed in depth.

Development of "The Safe Psychiatric Ward Battery"

This study reports the development process and psychometric testing of the safe environment in psychiatric wards instrument. In this mixed-methods study, the concept of a safe environment was explained with a qualitative study by performing semi-structured interviews with patients and staff and ward observation. Then, the items of the instrument were designed using qualitative data and a literature review. Content and construct validity, internal consistency, stability, and inter-rater agreement were evaluated. This study produced an instrument consisting of two sections. The first section was a scale (α = .920). Exploratory factor analysis of the scale identified two dimensions of "engagement" (α = .931) and "perception" of the physical environment (α = .760). The second section was a checklist with two dimensions, "accident-free living environment" and "staff empowerment." The intra-class correlation coefficients for the scale and checklist were .912 and .809, respectively. This study suggests that this instrument is a valid and reliable tool to assess safety in psychiatric wards.

Isolated systolic hypertension and its associated risk factors in Iranian middle age and older population: a population-based study

Background

Isolated systolic hypertension (ISH), is the most common form of hypertension in older adults. However, the ISH prevalence is not well known in many developing countries such as Iran. This study was conducted to determine the ISH prevalence and its related risk factors in an Iranian population.

Methods

Data were obtained from the second phase of the Shahroud eye cohort study (ShECS) in 2014. ShECS is a longitudinal population-based study which the first phase had been conducted in 2009 using the stratified multistage cluster sampling design on 5190 people aged 40 to 70 years. The ISH prevalence was determined based on the eighth Joint National Commission guidelines for different demographic variables. The associated risk factors were estimated by multiple logistic regression and a two-tailed p-value less than 0.05 was considered significant.

Results

The ISH prevalence was 15.89% (95% CI: 14.88–16.96). It was 15.68% (14.12–17.39) and 15.87% (14.54–17.29) for men and women, respectively. The prevalence of ISH increased significantly with increasing age. The 65–70 compared to 45–69 year age group (OR = 4.21), body mass index (OR = 1.03), diabetes (OR = 1.64), retirement, compared to practitioner job (OR = 1.53), and waist to hip ratio (WHR) (OR = 9.81) were significantly associated with ISH prevalence.

Conclusions

ISH is highly prevalent among the older adult population in Iran. Given the risk of cardiovascular disease associated with ISH, it is recommended to conduct education and public health interventions to improve the detection, prevention, and treatment of ISH.

Fish scale inspired structures-a review of materials, manufacturing and models

Fish scale inspired materials and structures can provide advanced mechanical properties and functionalities. These materials, inspired by fish scales, take the form of either composite materials or multi-material discrete exoskeleton type structures. Over the last decade they have been under intense scrutiny for generating tailorable and tunable stiffness, penetration and fracture resistance, buckling prevention, nonlinear damping, hydrodynamic and camouflaging functions. Such programmable behavior emerges from leveraging their unique morphology and structure-property relationships. Several advanced tools for characterization, manufacturing, modeling and computation have been employed to understand and discover their behavior. With the rapid proliferation of additive manufacturing techniques and advances in modeling and computational methods, this field is seeing renewed efforts to realize even more ambitious designs. In this paper we present a review and recapitulation of the state-of-the art of fish scale inspired materials.

Prevalence of hypertension and its associated factors among professional drivers: a population-based study

OBJECTIVE

Hypertension is one of the most important causes of cardiovascular disease. It has been found that professional drivers are at high risk of hypertension. This study has been performed to determine the prevalence of hypertension and its associated factors among professional drivers in Shahroud.

METHODS AND RESULTS

In this study, the prevalence of hypertension was determined according to the definition by the American Heart Association among 1461 professional drivers participating in the first cross-sectional phase of Shahroud drivers' prospective cohort study. The prevalence of elevated blood pressure and hypertension was examined based on the initial age, and gender presented, along with the factors affecting this disease based on multinomial logistic regression. The prevalence of elevated blood pressure, stage 1 and 2 hypertension was 46.9%, 6%, and 1.3%, respectively. In the multivariate multinomial logistic regression model, having diabetes, Body Mass Index ≥25, and driving years was associated with an increased chance of developing elevated blood pressure and hypertension.

CONCLUSIONS

Attention should be paid to high prevalence of elevated blood pressure and hypertension among professional drivers in Iran as a health priority for drivers. Plans should be made to reduce it as well as to prevent its complications.

Ability of older adults to recognize cognitive changes and its relationship with mental health: a cross-sectional study

INTRODUCTION

With rising age, the incidence of physical and mental problems increases. Physiological and social changes occur across the lifespan that can affect an individual's health and ability. The present study was aimed to determine older adult's ability to recognize cognitive changes and its relation with mental health status.

MATERIALS AND METHODS

A descriptive correlational design was used to recruit 423 older adults who were referred to health centers in Tabriz, Iran in 2019 to receive primary health care. A systematic random sampling method was used for selecting participants. Data collection tools included a demographic-social questionnaire, General Health Questionnaire for assessing mental health (with 4 subscales) and a questionnaire of ability to recognize cognitive changes (with 8 sub-scales). Data were analyzed using descriptive statistics and inferential statistics.

RESULTS

The mean score of mental health of the older adults was 56.35 (8.40) which shows moderately impaired mental health. The most impaired aspect of mental health detected was the social function dimension 13.20 (2.67). The average of the total ability score was 41.19 (4.78) and the physical strength dimension had the highest average of 9.08 (1.80) and the empowerment obligation dimension had the lowest average of 3.06 (1.08). There was significant relationship between dimensions of depression (r = 0.21, p < 0.001), anxiety (r = 0.1, p = 0.04) and social functioning (r = 0.17), p < 0.001) with the ability to recognize cognitive changes of the older adults.

CONCLUSION

Negative mood states and social functioning were associated with the ability to recognize cognitive changes in this population of older adults. This sample exhibited moderately impaired mental health status and relatively large burdens of untreated affective symptoms. Although causality cannot be determined with this cross-sectional design, use of social programs to keep older adults mentally active, as well as cognitive rehabilitation programs could be tested with longitudinal designs for their impact on cognitive change recognition.

One-year changes in the prevalence and positive psychological correlates of depressive symptoms during the COVID-19 pandemic among medical science students in northeast of Iran

Objectives

The COVID‐19 pandemic has imposed a significant psychological burden on many across society especially students studying medical sciences. This study intended to investigate the one‐year changes in the prevalence and correlates of depressive symptoms during the COVID‐19 pandemic among medical science students.

Methods

A cross‐sectional study in Shahroud, Iran administering a convenience sampling method (January to February 2021). Online self‐reported questionnaires included Rosenberg Self‐Esteem Scale, Paloutzian‐Ellison Spiritual Well‐Being Questionnaire, Diener's Satisfaction with Life Scale and the University Student Depression Inventory. Data analyzed using descriptive and inferential statistics (Independent t‐test and Multiple Regression Analysis).

Results

A total of 306 medical science students were investigated in this study. The mean scores 1 year after the outbreak of COVID‐19 were for depression (81.25 ± 26.04), spiritual well‐being (80.98 ± 18.06), self‐esteem (26.89 ± 2.20), and life satisfaction (19.68 ± 6.81). The results indicated that depression mean score was significantly higher in post outbreak assessment (71.92 ± 22.94 vs 81.25 ± 26.04) (P < .001). Fifty percentage of changes in depression can be predicted by studied variables. A high score of depression was directly associated with a higher level of self‐esteem. Moreover, increased interest in the field, scores of spiritual well‐being, and life satisfaction were inversely and significantly associated with depression.

Conclusions

Iran's education system has been significantly affected, with the addition to the COVID‐19 pandemic imposing a psychological burden such as depression, exacerbating this within medical science students compared to a year ago. Spiritual well‐being and life satisfaction as positive psychology constructs were recognized as protective factors against depression during the pandemic. Spiritual and social support should be integrated in psychological interventions within university settings for medical science students.

Effect of zinc supplement on sleep quality in older adults: A randomized clinical trial study

Introduction/Aim: The use of macronutrient and micronutrient foods is associated with the duration of sleep. This study aimed to determine the effect of zinc supplements on the sleep quality of older adults. Methods: The current parallel randomized clinical trial study was performed using a convenience sampling method. One hundred and fifty older adults who met the inclusion criteria were assigned to intervention and control group. The participants in the intervention group received a daily dose of 30 mg zinc supplementation pill for 70 days and the control group did not receive any supplement. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Serum zinc level in both groups was measured through the auto-analysis method. The questionnaire was completed and the serum level of zinc was measured twice, before the intervention and 70 days after the intervention. Results: Both groups were homogeneous in terms of demographic variables, sleep quality, and serum zinc level before the intervention. Of all, 73.3% of older adults in the intervention group and 74.7% of older adults in the control group had poor sleep quality. Sleep quality in the intervention group, as compared with the control group, significantly improved after the intervention. Furthermore, serum zinc levels in older adults in the intervention group, as compared with the control group, significantly increased after the intervention. Conclusion: Based on the results of this study, it is recommended to utilize zinc supplementation as a new therapeutic approach for improving sleep quality in older adults.

Prevalence of Restless Legs Syndrome and Its Relationship with Fatigue in Critical Care Nurses

Background

The critical care unit is inherently stressful due to its complexity, leading to fatigue and consequences such as restless legs syndrome (RLS). This study aimed to investigate the prevalence of RLS and its relationship with fatigue in critical care nurses.

Patients and methods

This cross-sectional study was performed with 200 nurses of critical care units of Shahroud hospitals in 2019 using the census sampling method. Data collection tools included the RLS questionnaire and the Multidimensional Fatigue Inventory. Data analysis was performed using descriptive and inferential statistics (multiple linear regression analysis).

Results

The results showed that 72% of the subjects had moderate to high RLS, and their mean fatigue was 55.31 ± 10.53. By increasing one point in the score of RLS and 1 year of critical care nursing experience, the fatigue score increases by 0.3 and 0.71.

Conclusions

Considering the relationship between fatigue and RLS in critical care nurses, supportive interventions seem necessary to reduce the effects of these two components.

How to cite this article

Ameri M, Mirhosseini S, Basirinezhad MH, Ebrahimi H. Prevalence of Restless Legs Syndrome and Its Relationship with Fatigue in Critical Care Nurses. Indian J Crit Care Med 2021;25(11):1275–1279.

Investigating the compliance of COVID-19 protocols in the workplaces of Ardabil, Iran

BACKGROUND

Workplaces are prone to the current outbreak- of COVID-19. Despite the production of the COVID-19 vaccine, due to some challenges in vaccinating all people worldwide, adherence to health protocols is still one of the ways to prevent infection.

OBJECTIVE

This study was conducted with the purpose of investigating the compliance of COVID-19 protocols in the workplaces of Ardabil, Iran.

METHODS

This was a cross-sectional research conducted on the workplaces affiliated to Ardabil University of Medical Sciences between August and September, 2020. A researcher-designed checklist was completed once in early August and once at the end of September for the workplaces. Accordingly, these workplaces were inspected for any compliance with the COVID-19 prevention protocols by health centers during August and September. In addition, the number of patients with COVID-19 was determined for each one of the workplaces.

RESULTS

The results showed that the highest increase was related to screening (57.8%) and the lowest change was related to personal hygiene (1.3%). The rates of increase in performance for small workshops, offices and industries were 35.4%, 33.1%and 12.4%, respectively. Moreover, a linear and inverse relationship was found between the incidence of COVID-19 and the level of observance of the OVID-19 prevention protocols.

CONCLUSIONS

Based on the results of this study, the inspection made by legal authorities led to the increased commitment of workplace managers to implement prevention programs, thereby increasing the observation level of these protocols in the workplace and reducing the incidence of COVID-19.

An introduction to the industrial town's safety management (ITSM) system

BACKGROUND

In industrial towns, the dangers of each industry also poses a threat to other industries due to the proximity of different industries to each other. So there is a need for a safety management system.

OBJECTIVE

This study was conducted to introduce a management system for managing the safety of industrial towns.

METHOD

This cross-sectional and qualitative study was conducted in three main phases: (1) Identify the elements of the safety management systems using literature review, (2) screening and determining useful elements using Delphi technique and (3) determining the structure of safety management system.

RESULTS

Participation of the industries and their compliance with the standards were considered as the system foundation. The networks of safety information of the industries, accident's database, safety training, contractors, emergency management and management of the changes were placed on the foundation as the system columns. The Industrial Town's Safety Management (ITSM) system as the system roof was placed on the columns. This structure was placed within a two-line framework including the trade secrets and program audit.

CONCLUSIONS

The ITSM system consists of a set of factors that can help manage the safety of the industrial towns. This system will increase the safety level of industrial towns by incorporating some safety principles. However, the safety management of an industrial town is very complex and requires a great deal of efforts.

The relationship between emotional intelligence, personality traits and safety behaviors in metal industries workers; confirmatory factor analysis

BACKGROUND

Human errors cause accidents in the workplace. Screening workers at employment can prevent future accidents from happening. Two important tools that can be helpful in screening are determining the emotional intelligence score and personality traits score of the workers.

OBJECTIVE

The purpose of this study was to evaluate the relationship between Emotional Intelligence, Personality Traits and safety behaviors in metal Industries workers.

METHODS

This is a cross-sectional survey. Confirmatory factor analysis was performed to determine the relationship between the components of emotional intelligence, unsafe behaviors, and personality. To collect data for this study, Five -factor Goldberg questionnaire, BAR-ON Emotional questionnaire and Safety behavior questionnaire were used. The collected data were entered into software (SPSS version22) and refined.

RESULTS

The results of this study showed that there was a significant positive correlation between personality traits, emotional intelligence and safe behaviors (P-Value = 0.000). The confirmatory factor analysis showed that personality traits influence safe behaviours. Also, studies have shown that emotional intelligence has a positive effect on safe behaviours. The amount indicators of goodness of fit (GFI), Comparative Fit Index (CFI), Tucker-Lewis index (TLI) and root mean square error approximation (RMSEA) were 0.944, 0.970, 0.965 and 0.061, respectively.

CONCLUSIONS

The results of this study suggest that personality traits and emotional intelligence influence safe behaviours in the workplace. Employers can use these two tools in the employment phase and prevent future human-related accidents.

Trend of ischemic heart disease mortality attributable to metabolic, behavioral, and environmental risk factors in the past two decades

Background

Ischemic heart diseases (IHD) is the leading cause of mortality, worldwide. Understanding of the status of risk factors contributing to IHD and mortality helps control this public health issue.

Purpose

This study aims to provide global, regional, and national estimates of the trend of IHD burden and deaths attributable to the modifiable risk factors, from 1990 to 2019.

Methods

Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 methodology, we evaluated the IHD incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). IHD deaths attributable to the different metabolic, behavioral and environmental risk factors were estimated based on risk exposure, relative risks, and the theoretical minimum risk exposure level input from 204 countries and territories, stratified by sex and Socio-demographic Index (SDI). Trends were estimated from 1990 to 2019, with an emphasis on 2010 to 2019.

Results

Globally, there were 21·2 million (95% uncertainty interval [UI] 18·8–23·7) new cases, 9·1 million (8.4–9·7) deaths, and 182·0 million (170·2–193·5) DALYs due to IHD, in 2019. From 1990 to 2019, IHD incident cases, deaths and DALYs increased globally by 29.1·9% (27.0–31·3), 32·4% (25.3–37·8), and 53.9% (42·7–64·3), respectively. Although high SDI regions succeeded to reduce DLAYs due to IHDs by −36.7% (−33.8 to −39.2), low SDI regions faced an increase in DALYs due to IHDs by +104.4% (+75.0 to +135.3). In 2019, the five leading risk factors of deaths due to IHDs were; high systolic blood pressure [2.2 million deaths (1.7–2.7)], high LDL cholesterol [1.7 million deaths (1.2–2.3)], high fasting plasma glucose [1.1 million deaths (0.6–1.8)], high body-mass index [0.8 million deaths (0.5–1.1)], and diet low in whole grains [0.6 million deaths (0.2–0.8)]. From 1990 to 2019, high SDI regions succeeded to reduce the age standardized death rate of IHDs attributable to metabolic risk factors by −60.1% (−61.9 to −57.7), behavioral risk factors by −61.2% (−62.8 to −59.2) and environmental risk factors by −65.8% (−71.4 to −59.3). During the same period, the age standardized IHD death rate attributable to environmental risk factors decreased by −16.0% (−30.4 to −1.6), while the age standardized IHD death rate attributable to metabolic and behavioral risk factors didn't change significantly, in low SDI regions.

Conclusions

During the past two decades despite steadily increase in incident cases of IHDs, the age standardized burden of IHDs has decreased in high SDI regions most probably due to control of attributable risk factors. However, burden of IHDs has increased dramatically in low SDI regions. Preventive measures such as “polypills” for high blood pressure control programs and life-style modification should be prioritized in these settings.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Bill & Melinda Gates Foundation Age-standardized DALY rates of IHD

Hypertensive heart disease burden attributable to high salt intake in the United States compared to the European Union and the global status: trends from 1990 to 2019

Background

Hypertensive heart disease (HHD) is a major cause of heart failure, cardiovascular related hospitalizations, and mortality. Diet high in salt is one of modifiable risk factors of HHD that can be controlled by appropriate policies.

Purpose

This study aims to provide the HHD burden attributable to diet high in sodium in the United States compared to European and the global trends from 1990 to 2019.

Methods

Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 methodology, we calculated the HHD, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Diet high in sodium was defined as a diet with more than 1,000 milligrams of sodium per day. HHD deaths attributable to the diet high in sodium was estimated based on risk exposure, relative risks, and the theoretical minimum risk exposure level Trends of HHD attributable to diet high in sodium was estimated from 1990 to 2019.

Results

Globally, there were 170·3 thousand (95% uncertainty interval [UI] 31.2 to 459.5) deaths, YLLs, YLDs, DALYs due to HHD attributable to diet high in sodium, in 2019. In the United States, 4525 deaths happened because of HHD caused by the diet high in sodium, with 208.4% rise from 1990. In the European Union, 18,143 deaths happened because of HHD caused by the diet high in sodium, with 78.0% rise from 1990. To address the impact of population aging and population growth, we estimated the age standardized values for burden of HHD attributable to the diet high in sodium. From 1990 to 2019, worldwide age standardized YLL, YLD, and DALY rates per 100,000 for HHD attributable to the diet high in sodium changed by −44.0% (−63.6 to −30.6), +3.7% (−14.3 to +13.6), and −41.8% (−61.3 to −28.8), respectively (Figure 1). In the European Union, age standardized YLL, YLD, and DALY rates per 100,000 for HHD attributable to the diet high in sodium changed by −14.8% (−44.6 to −0.2), −13.5% (−45.8 to −14.0), and −14.8% (−43.5 to −0.9), respectively. Compared to the European Union and the worldwide trends, United Sates had the opposite increasing trend of HHD caused by the diet high in sodium. In the United States, age standardized YLL, YLD, and DALY rates per 100,000 for HHD attributable to the diet high in sodium changed by +110.4% (+42.0 to +631.0), +44.2% (+106.4 to +300.5), and −14.8% (−43.5 to −0.9), respectively. As shown in figure 2, the United States' increasing trend of HHD attributable to the diet high in sodium was caused mainly by the increasing trend observed in men.

Conclusions

Despite worldwide success in the restriction of the diet high in sodium, HHD burden attributable to high consumption of sodium is rising in the United States. This warning results requires public health attention to taking actions such as advocating for healthy diet, restricting foods high in sodium such as fast foods, and increasing the access to low salt foods for working groups.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Bill & Melinda Gates Foundation Annual % DALY change of HHD due to saltTrend of HHD DALY in men vs women

The effect of workload on nurses' quality of life with moderating perceived social support during the COVID-19 pandemic

BACKGROUND

Due to the COVID-19 pandemic in Iran, the number of patients admitted to hospitals and the workload of nurses has increased. High workload can reduce efficiency and quality of life. In the meantime the percived social support may had a moderating role.

OBJECTIVE

The aim of the study was to investigate the effect of workload and perceived social support on quality of life in nurses who work in COVID-19 inpatient wards.

METHODS

This was a cross-sectional descriptive-analytic study. 336 nurses who worked in inpatient wards with COVID-19 patients were randomly selected and studied. NASA-TLX Workload Questionnaire, WHO Quality of Life Questionnaire and Multidimensional Social Support Perception Scale were used to data collection. Structural equation modelling in PLS software was used to modelling.

RESULTS

The results showed that the average score of workload, perceived social support and quality of life were 80.87±20.17, 56.23±11.46 and 55.87±13.74, respectively. A significant inverse relationship was observed between workload and quality of life (P < 0.05). Also, perceived social support had a moderator effect on relationship between workload and quality of life (P < 0.05).

CONCLUSIONS

High workload can upset the balance between work and life that leads to decrease the quality of life. Perceived social support as a moderator can reduce the negative impact of workload on quality of life. In the COVID-19 pandemic where nurses' workload have increased, by increasing the perceived social support can manage the negative effect of workload.

Validation of the Persian version of the comprehensive frailty assessment instrument plus in community-dwelling older adults

This study aimed to examine the validity and reliability of the Persian Version of the Comprehensive Frailty Assessment Instrument Plus (CFAI-Plus) among community-dwelling older adults. It was completed by 340 older adults ≥60 years. The content and face validity were confirmed based on the opinion of the target group and experts. In the exploratory factor analysis, seven factors were extracted, explaining 62.8% of the total variance. Confirmatory factor analysis showed acceptable fit indices (Root Mean Square Error of Approximation = 0.045; Comparative Fit Index = 0.93; Tucker-Lewis Index = 0.92). Internal consistency was adequate for factors (Cronbach's alpha: range 0.47 to 0.88), and the test-retest reliability was acceptable (intra-class correlation coefficient: range 0.76 to 0.92). A higher CFAI-Plus score were found in those who were older, female, less-educated, single, lived alone, and had inadequate income. This study supports the reliability and validity of the Persian CFAI-Plus in community-dwelling older adults.

Congenital renal arteriovenous fistula presenting with gross hematuria and its management

Renal arteriovenous fistula (AVF), an abnormal connection between artery and vein, results from development failure or following vascular injury. AVFs may cause various complications, i.e., secondary hypertension and hematuria. To manage AVF, it is recommended to bypass it from blood circulation surgically or by percutaneous embolization. The present study describes a woman with AVF, who primarily was managed percutaneously and then surgically.

Assessing the Virtual Social Networks Usage among Nursing Students: A Cross-Sectional Descriptive Study

BACKGROUND

Nowadays, virtual social networks are among the most essential communication tools in the exchange of science, knowledge, and technology and are very popular among different peoples of the society, especially nursing students. They can also influence academic success. The present study was aimed to investigate the use of social networks among nursing students of Tabriz University of Medical Sciences.

MATERIALS AND METHODS

This study adopts a descriptive cross-sectional design and employed 406 nursing students in 2018 by means of the convenience sampling method. For data collection, a researcher-made questionnaire consisting of demographic characteristics and social network usage was used. Descriptive and inferential statistics were used to analyze the data.

RESULTS

The mean (SD) of social networking usage was 116.81 (17.20) out of the achievable score range of 38 to 190, where the highest and lowest scores were related to dimensions of content sharing (73.56%) and unconventional issues (51.00%), respectively. There was a significant statistical relationship between total score of social networking usage which included the variables of grade point average (r = -0.17, p = 0.000), average daily study hours in non-exam periods (r = -0.10 and p < 0.04), family income (F_2,375 = 6.28, p < 0.001), number of siblings (F_4,350 = 4.98, p < 0.001), and academic semester (F_6,376 = 2.12, p < 0.05).

CONCLUSIONS

Given the high percentage of students enrolled and the aim of using these networks, proper planning for the management of cyberspace is necessary to take advantage of the benefits of social networks and reduce their disadvantages.

Internet gaming disorder and its relationship with behavioral disorder and mother's parenting styles in primary school students according to gender in Iran

BACKGROUND

The problem of students' gaming addiction has been related to the individual student's characteristics and the influence of family environment. Researchers aimed to investigate if and how internet gaming disorder (IGD) of the elementary school boys and girls is related to behavioral disorder and their mother's parenting style in Iran.

METHODS

This is a descriptive correlational study, involving 657 fifth and sixth-grade elementary school students in 2019. Researchers used a multistage stratified random sampling of students, their parents and their teachers. Data were collected using internet gaming disorder questionnaire (IGD 20), Rutter teacher behavioral disorder questionnaire and Baumrind Parenting Styles questionnaire (PSI). Obtained data were analyzed using SPSS version16 for descriptive statistics and Pearson correlation coefficient test.

RESULTS

Findings showed that IGD prevalence was 5.9% among primary school students with significant relationship between IGD and behavioral disorder among all participants (r = 0.23, p = 0.04); although it was insignificant among boys (r = 0.13, p = 0.11). Also the relationship between IGD and mother's parenting style was significant in the total sample (r = 0.12, p = 0.03), in particular for girls and their mothers (r = 0.2, p = 0.001).

CONCLUSIONS

The results of this study indicate the importance of family and parental involvement in prevention and management of IGD chiefly among girls. Healthcare professionals will benefit from knowing the problematic consequences of online gaming among school-age children and try to promote safe and healthy online behavior supported by a supervised family environment.

The effect of job security on safety behavior with the moderating role of salary: a structural equation model

This study aimed to model the relationship between job security and safety behavior with the moderating role of salary on the workers of the construction project of Qom (Iran) Subway. After determining the subjects of the study, the questionnaires on safety behavior and job security were completed by subjects. Also, the salary of the subjects was determined. Structural equation modeling used smart partial least squares software. The results revealed that job security had a direct and significant correlation with safety compliance, safety participation and safety behavior (p < 0.001). The salary as a moderator had a positive and significant effect on the relationship between job security and safety behavior (p < 0.05). Generally, it can be deduced that job security had a positive impact on safe behaviors, and the salary as a moderator enhanced this impact. To improve safety behavior in the workplace, employers should increase the job security of workers.

Prevention measures and risk factors for COVID-19 in Iranian workplaces

BACKGROUND

Exposure to the coronavirus (COVID-19) in industrial workplaces has caused concerns all over the world. Implementation of prevention measures is the best solution for protection of workers' health.

OBJECTIVE

The present study investigated prevention measures and risk factors for the COVID-19 infection in Iranian small, medium, and large industries.

METHODS

This study was conducted on 349 occupational health, safety, and environment professionals working in different industries. Data was collected using a checklist of prevention measures for COVID-19 and a questionnaire of risk factors for the infection.

RESULTS

The results demonstrated that 32.60% of industries reported positive cases of COVID-19. The mean of prevention measures in all the dimensions, except use of personal protective equipment (PPE), was in favorable status. Among prevention measures against COVID-19, the dimensions of education, engineering controls, use of PPE, use of hand washing soap and disinfectant, and physical distance were not significantly different among small, medium, and large industries. However, administrative controls were statistically lower in small and medium industries compared to the large industries. Moreover, screening was statistically lower in small industries than in large industries. The mean risk factors of ventilation, use of common tools and equipment, and physical distance as well as total risk factors were not statistically different among different industries.

CONCLUSION

Workers are at risk of COVID-19 infection. The risk factors of ventilation, sharing tools and equipment, and physical distance are critical in classification of risk of infection with COVID-19 in industrial settings.

Transition in Smoking Stages and Its Relationship with Family Psychological Function and Perceived Social Support in Adolescents of Tabriz, Iran

BACKGROUND

There is limited information on the relationship between family psychological functions and perceived social support with progress in cigarette smoking stages in adolescents. This study was aimed to determine the relationship between family psychological function and perceived social support through a transition in different stages of cigarette smoking in adolescents of Tabriz, Iran.

METHODS

In this study, 4,216 students (14-19 years old) from high schools were selected by multistage cluster sampling method. Initially, we used valid and reliable questionnaires for demographic characteristics, risk factors, Iranian family psychological function, and perceived social support. The smoking status questionnaire was administered twice, with an interval of 6 months. Data were analyzed using univariate and multivariate logistic regression analysis.

RESULTS

Overall, 3,968 students with the mean (standard deviation) age of 15.96 (0.75) years completed the questionnaire in the first phase of the study. The results showed that lower levels of family psychosocial function (P < 0.001) and perceived social support (P < 0.001) in the univariate state were significantly associated with progress in cigarette smoking stages. By controlling the potential confounding factors, the weak and moderate family psychological function compared to the strong function increased the chance of progress in the cigarette smoking stages by almost 11 and 4 times, respectively (P < 0.001). The low and moderate level of perceived social support compared to the high level increased the chance of progress in cigarette smoking stages by almost 7 and 2 times, respectively (P < 0.001).

CONCLUSIONS

It is suggested to perform an organized, precise, and operational planning for strengthening the family psychological functions and providing an appropriate social support condition among adolescents to prevent the tendency toward cigarette smoking and its more advanced phases.