Evaluation of phosphate insecticides and common herbicides: monitoring and risk assessment in water treatment plant, distribution networks, and underground water wells.

Despite the negative effects that the use of pesticides (such as herbicides and insecticides) have on human health and water resources, a significant portion of the world's agricultural production depends on them. The purpose of this study was to determine selected residual concentrations of pesticides (diazinon, ethion, malathion, alachlor, methyl-parathion, trifluralin, atrazine, chlorpyrifos, and azinphos-methyl) in samples from Shiraz potable water sources. For this purpose, water treatment plant, groundwater wells, treated surface water, and a mixture of groundwater and treated surface water were taken. In addition, statistical and risk analyses (carcinogenic and non-carcinogenic) were used. According to the results, chlorpyrifos with 84.4% had the highest removal efficiency and methyl-parathion with 10% had the lowest removal rate in the Shiraz water treatment plant process. The highest mean concentration was related to azinphos-methyl (1.5 µg/L) and chlorpyrifos (0.59 µg/L) in the groundwater samples. All measured compounds in water source samples were below standard levels, except for chlorpyrifos and azinphos-methyl, which were reported in groundwater above the limit recommended by the Environmental Protection Agency (EPA). The results showed that while the selected pesticides measured had a low non-carcinogenic risk for both adults and children, malathion and trifluralin posed a high carcinogenic risk for adults.

Best Practices of Hospitals in Management of Epidemic Conditions: A Scoping Review.

BACKGROUND: Many hospitals globally have valuable experiences in preparing for management and responding to infectious epidemics. Identifying and analyzing these experiences can provide comprehensive and practical data for decision-making and effective performance. This study aimed to conduct a scoping review and content analysis of the best practices of hospital (private or public) management in epidemic conditions. MATERIALS AND METHODS: This research is a scoping review and content analysis, conducted in 2021. Data was collected by searching different databases, including Pubmed, Scopus, Web of Sciences, ProQuest, websites, search engines, and public reports without time limits. Content analysis was performed for data analysis. RESULTS: We retrieved 8842 records from databases and other sources. Finally, 24 studies from 12 countries were selected for analysis. Most studies belonged to the United States (9 cases), and most subjects were on Coronavirus disease 2019 (Covid-19) (19 studies). We classified the results into two major categories of in-hospital executive readiness and logistic readiness. Executive readiness included 11 main categories (physical structure, resource management, exposure reduction, patients and caregivers' management, corpse management, disinfection, staff support, patient admission, instructions and guidelines, tele- communication, and education) and 26 sub-categories. Logistic readiness consisted of three major categories (leadership/team making, communication, and using capabilities) and five sub-categories. CONCLUSION: Healthcare managers can use the identified categories and dimensions of managerial readiness and responsiveness as an action plan during an infectious disease epidemic.

How public hospitals manage epidemic crises? Lessons from Iranian public hospitals.

BACKGROUND: The public hospital preparedness is essential for epidemic disaster like COVID-19 pandemic. This study was conducted to present a hospital management preparedness model of Iran's public hospitals for the epidemic. MATERIALS AND METHODS: The method of this study was an exploratory sequential mix method study (qualitative-quantitative). In this study, qualitative and quantitative methods were used in four stages. (1) Interviews with hospital managers to identify hospital management experiences during the COVID-19 epidemic and categorize the results in themes and subthemes, (2) assessing the performance of public hospitals in managing the coronavirus epidemic in a quantitative method, (3) present the initial hospital management model for a public hospital in epidemic conditions using an expert panel, and (4) validation of the model using the Delphi method. RESULTS: Experiences of hospital managers and specialists were categorized into eight themes: information gathering and environmental analysis, general and operational planning, provision of equipment and physical and financial resources, training and empowerment of human resources, a compilation of instructions and job descriptions, review and ensuring maximum readiness, monitoring and follow-up of service provision and existing problems, evaluation and feedback of performance problems and level of preparation and 51 sub-themes. The quantitative study indicated that all the investigated indicators had a significant decrease in the first month and an increase in the epidemic's continuation. The results were categorized in nine themes and 59 sub-themes, and finally, the model was validated in one round by the Delphi method. CONCLUSION: In Iran, managers have valuable experiences in COVID-19 epidemy management, but these experiences are scattered and not organized. In this study, by a qualitative-quantitative, a model was presented that contains essential points obtained from the experience of hospital managers and experts in actual disaster conditions and is appropriate and fits hospital structure and infrastructure of the health system in Iran.

Investigating the Rate and Affecting Factors of Unnecessary Cervical Collar Use in Trauma Patients.

Objective: This study aimed to investigate the necessity of cervical collars in patients with neck problems. Methods: This cross-sectional study was conducted on 114 patients who were admitted to the Haft Tir and Rasoul Akram Hospitals (Tehran, Iran) from August to September 2022. The Nexus protocol was used to select the patients with cervical collars. According to the protocol, a cervical collar was required for individuals who had at least one symptom. If none of these symptoms existed, the cervical collar was deemed unnecessary. The data were analyzed using the Chi-square test and Fisher's exact test. Results: Of the 114 trauma patients, the cervical collar was used unnecessarily by 49 (43%) patients. Tenderness was the most common complication in 62 patients (54.4%). The prevalence of unnecessary cervical collar use was 37.5% in female trauma patients and 43.88% in male trauma patients, which was not statistically significant (p=0.63). The prevalence of unnecessary cervical collar use in trauma patients with multiple trauma was 39.42% and 80% in patients without multiple trauma, which was statistically significant (p=0.018). Patients with a medical history had a higher rate of unnecessary use of the cervical collar (47.96%) than those without a history (12.5%), and this difference was statistically significant (p=0.008). Conclusion: The guidelines for using cervical collars need to be updated by the EMS. Due to the large number of trauma patients in Iran, cervical collars for necessary conditions can help to reduce the healthcare expenses and injuries caused by unnecessary cervical collars.

The Effect of Extracorporeal Shock Wave Therapy in the Treatment of Patients with Trigger Finger.

INTRODUCTION: Trigger finger disorder is a sudden release or locking of a finger during flexion or extension. Regarding the complications and disadvantages mentioned for the methods used in the treatment of trigger finger disorder, the aim of this study was to investigate the effect of extracorporeal shock wave therapy in the treatment of patients with trigger finger. METHODS: This study was an interventional study recruiting 19 patients with trigger finger disorder. Evaluation of pain severity, severity of triggering, and functional impact of triggering was carried out using the Visual Analogue Scale, Trigger Finger Score suggested by Quinnell, and Quick-Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, respectively, before intervention, immediately after intervention, and in 6 and 18 weeks after intervention. Each patient was treated with extracorporeal shock wave therapy in three sessions with a 1-week interval. Data were analyzed in Statistical Package for the Social Sciences (SPSS) software using ANOVA to monitor changes in pain severity, severity of triggering, and functional impact of triggering during follow-ups. RESULTS: There were statistically significant differences with regard to reduction of the pain severity, severity of triggering, and functional impact of triggering before intervention, immediately after intervention, and in 6 and 18weeks after intervention (P<0.01). However, the effect of extracorporeal shock wave therapy on reducing severity of triggering immediately after intervention did not yield a statistically significant difference compared to before intervention (P>0.01). CONCLUSION: It seems that extracorporeal shock wave therapy leads to a reduction in pain severity, severity of triggering, and functional impact of triggering. These effects persisted until the 18th week after the intervention. It is recommended to use extracorporeal shock wave therapy in terms of a non-invasive intervention with no significant complications for patients with trigger finger.

Cost Analysis of Accidents according to Demographic Factors in Iran.

BACKGROUND: The first cause of death and disability constituting to the burden of disease in Iran has been accident and injury incidents. Young people are more at risk, these accidents have a negative effect on the national gross domestic product (GDP), on the one hand, and they increase the costs of the health system on the other hand. Therefore, this study aimed to analyze the costs and epidemiological pattern of accidents. METHODS: The study variables in the first 8 months of 2016 included from Tehran Province, Iran; age, sex, how to transfer to the hospital, consequences of an accident, the injured area, and costs. Overall, 400 cases were investigated by referring to the patients' files and deriving the intended data. SPSS software used to analyze the data and statistical tests of t-test and ANOVA were applied. RESULTS: Most accidents have happened in summer months of Jun, Jul and Aug. Most of the files (48%) were related to the age group of 16-30. The mean cost was 9024.82 dollar. In total, 39% of the road accidents had occurred by motorcycle and 90.8% of the patients discharged from the hospital. CONCLUSION: Since about half of the traffic accidents were related to the age of 16 to 30 who were the active population of a community, therefore, any disability or death in these groups could cause an economic burden on the community and increase DALY. Thus, it appears essential to develop proper programs such as education for appropriate driving and strict rules for giving driving license to these ages.

A Survey of Current Practice of Informed Consent in Iranian Hospitals.

BACKGROUND: Informed consent is legal and ethical process which is considered as important issue in quality of patient's treatment. The aim of the current study was to assess current informed consent of patients admitted in Iranian selected Hospitals, 2016. MATERIALS AND METHODS: This cross-sectional study was conducted on 2150 patients admitted in 11 public Hospitals. Data was collected using a dichotomous questionnaire with 30 questions. Statistical analysis was done using SPSS software (version 18). RESULTS: The results shown that 46% of patients had medium perception about informed consent, 44% believed to get insufficient information and 66% claimed to have active participation in treatment process. The significant associations were found between some dimensions and important parameters: Understanding of information dimension and education level (p = 0.008), Participation (in decision-making) dimension and type of hospitalization (p = 0.01), and level of patients' information dimension with resident address (p = 0.027) and medical specialty (p < 0.001). CONCLUSION: In our study the current informed consent of patients wasn't in desirable condition. The Necessary measures are required to achieve a level that the patients' informed consent convert to informed choices. Hospital healthcare team need to take proper actions such as give proper information, patient training, sufficient information and etc.

Job Burnout, Stress, and Satisfaction among Emergency Nursing Staff after Health System Transformation Plan in Iran.

INTRODUCTION: Job burnout, stress, and satisfaction are linked to quality of care, patient outcomes and retention of staff. This study was conducted to determine the mentioned issues among emergency nurses. METHODS: This cross-sectional study was conducted on all nurses working in the emergency departments of 10 hospitals in Tehran, Iran, in 2017. Standard questionnaires were used for gathering the data of participants regarding job burnout, stress, and satisfaction. RESULTS: 709 (90%) participants returned the completed questionnaires (58.9% female). The mean age of the nurses was 33 (SD = 7) years. The level of job burnout was moderate in 76.1%, low in 22.5%, and high in 1.4% of the nurses. The level of burnout in the married nursing staff was lower than single nurses (3.78 ± 0.98 versus 4.14 ± 0.58, p = 0.049). The level of job satisfaction was moderate in 61.1%, low in 22.2%, and high in 16.7%. There was a significant correlation between age and job satisfaction (p = 0.027, r = 0.3). Job burnout was directly correlated with job stress (p ≤0.001, r = 0.57) and job burnout was negatively correlated with job satisfaction (p = 0.001, r = -0.41). CONCLUSION: More than 60% of the studied emergency nurses had moderate levels of job burnout, stress, and satisfaction. Job burnout had a direct correlation with job stress and indirect correlation with job satisfaction. Planning to reduce burnout of the emergency nursing staff seems to be necessary.

Muscle timing in injured and non-injured leg of athletes with chronic ankle instability in response to a visual stimulus during forward jumping.

OBJECTIVE: The aim of this study was to investigate premotor time, motor time and reaction time of the injured and non-injured leg muscles of athletes with chronic ankle instability in response to a visual stimulus during forward jumping. METHODS: Surface electromyography was performed on injured and non-injured leg of eight athletes with chronic ankle instability during forward jumping. RESULTS: Results showed that premotor time of the peroneus longus was significantly longer in non-injured leg compared with injured leg (489.37 ± 220.22 ms vs. 306.46 ± 142.92 ms, P = 0.031); on the contrary, motor time of the peroneus longus was significantly shorter in non-injured leg compared with injured leg (569.04 ± 318.62 ms vs. 715.12 ± 328.72 ms, P = 0.022). No significant difference was noted in the timing of other calf muscles (P > 0.05). CONCLUSION: According to the results of this study, rehabilitation protocols, regarding ankle instability, need to put greater emphasis on tasks that require proper timing of muscles and muscle re-education so that protocols could reduce residual symptoms after sprain and prevent recurrent sprains.

The effect of short-term aerobic exercise on depression and body image in Iranian women.

The purpose of this study was to determine the effect of short-term aerobic exercise on depression symptoms and body image attitudes among Iranian women. In this quasiexperimental study, 82 females were assigned to experimental group (aerobic exercise group, n = 41) or control group (waiting list, n = 41) and evaluated by Beck Depression Inventory-second edition (BDI-II) and Multidimensional Body Self-Relation Questionnaire (MBSRQ), respectively. The experimental group received four-week aerobic exercise program, and control group had been asked to wait for the next four weeks. Results of this study confirmed the significant decrease in depression symptoms at the experimental group compared to control group (P < 0.5). For the body image dependent variables, significant improvement was also found in appearance evaluation, appearance orientation, health orientation, and illness orientation in aerobic exercise group (P < 0.5).