Climate Change and Occupational Heat Strain Among Women Workers: A Systematic Review.

Climate change increases heat stress exposure and occupational heat strain in tropical and subtropical regions with generally hot-humid climate conditions. The present systematic review was conducted to assess the effect of climate change on occupational heat strain among women workers. In this study, three main databases (PubMed, Scopus, and Web of Science) were searched to find relevant literature on climate change and its effects using subject headings and appropriate MeSh terms. This article has been written according to the PRISMA checklist. A total of 6,176 studies were identified for screening and 13 studies were eligible for data extraction. Scientific evidence reveals that there is an imprecise but positive relationship between climate change and occupational heat strain regarding women workers. Some complications associated with occupational heat strain among women workers include fatigue, discomfort, dehydration, reduced brain function, and loss of concentration. Climate change can lead to an increase in the occurrence of heat-related illnesses and the levels of injury risk. In addition, its adverse health effects on women workers are mentioned. This systematic study identifies key priorities for action to better characterize and understand how occupational heat strain among women workers may be associated with climate change events. Strong evidence indicates that climate change will continue to cause occupational heat strain among women workers. It is essential to implement preventive measures considering multidisciplinary strategies to reduce the adverse effects of climate change on women workers health in hot weather settings. This can limit the health risks and negative effects of climate change.

Exploring the relationships among safety leadership, safety climate, psychological contract of safety, risk perception, safety compliance, and safety outcomes.

Background: Recently, two types of safety compliance behaviors including deep compliance and surface compliance were differentiated. The current study aimed to investigate the relationships among safety leadership, safety climate, psychological contract of safety (PCS), risk perception, and deep compliance and surface compliance behavior of workers. In addition, the effects of both deep and surface compliance on safety outcomes were considered. Methods: Workers' perceptions in terms of safety leadership, safety climate, PCS, risk perception, deep compliance, and surface compliance were measured by appropriate questionnaires. Three questions were asked to measure undesired safety outcomes. Structural equation modeling and correlation analysis were applied to examine the research model and relationships among variables. Results and discussion: The results of the current study showed that deep compliance was positively predicted by safety leadership, safety climate, and PCS and negatively predicted by risk perception. Surface compliance was positively predicted by safety leadership and safety climate and negatively predicted by risk perception. Surface compliance is not significantly predicted by PCS. With regard to the adverse safety outcomes, the results showed that both deep and surface compliance were negatively associated with adverse safety outcomes, however, deep compliance had a stronger negative correlation with adverse safety outcomes than surface compliance.

The effect of cooling vests on physiological and perceptual responses: a systematic review.

Humans in hot environments are exposed to health risks and thermal discomfort which seriously affect their physical, physiological and mental workload. This study aimed to assess the effects of using cooling vests (CVs) on physiological and perceptual responses in the workplace. Three main databases were searched using subject headings and appropriate Mesh terms. The article has been written according to the preferred reporting items for systematic reviews checklist. A total of 23,837 studies were identified for screening and 63 studies were eligible for data extraction. A statistically significant difference was observed in body temperature among hybrid cooling garments (HBCGs), phase-change materials (PCMs) and air-cooled garments (ACGs) at 31.56-37 °C (60% relative humidity), evaporative cooling garments at 25.8-28.1 °C and liquid cooling garments at 35 °C (49% relative humidity) compared to without CVs (p < 0.001). HBCGs (PCMs and ACGs) are effective means in hot, moderate, humid or dry environments.

Traffic climate, driver behaviour and dangerous driving among taxi drivers.

Traffic accidents are considered a major public health problem in many countries. The aim of this study was to explore the relationships between traffic climate factors (i.e., external affective demands, functionality and internal requirements), driver behaviours, dangerous driving behaviours and traffic accident involvement among taxi drivers. A total of 450 male taxi drivers participated in the study. The traffic climate scale (TCS), the driver behaviour questionnaire (DBQ), the positive driver behaviours scale (PDBS) and the Dula dangerous driving index (DDDI) were used to measure driving behaviours and traffic conditions. The results showed that there was a significant negative correlation between functionality (of the TCS) and the number of accident involvement. Further analysis demonstrated that the effect of risky driving (of the DDDI) on accident involvement was significant. Taken together, these findings suggest that functional traffic systems and driving environments play important roles in traffic accident involvement.

An investigation of pain intensity patterns and psychosomatic symptoms among the cardiac patients admitted to an Iranian hospital.

BACKGROUND: Heart diseases are the main reasons of death in the developed countries. This study was conducted with the aim of investigating the patterns of pain intensity and psychosomatic symptoms among cardiac patients. METHODS: This is a descriptive study and the statistical population included all the cardiac patients who were admitted to an Iranian Hospital (Kermanshah-Imam Ali Hospital) during 2018 (From July to November) 250 people were selected out of the population using convenience sampling and 180 patients answered pain intensity assessment tools, the patient health questionnaire (PHQ-15) and the patient demographic information form. RESULTS: The results of this study indicated moderate (52.2%), low (36.1%) and high (11.7%) levels of pain intensity plus mild (4.4%), moderate (28.3%) and severe (67.2%) psychosomatic symptoms with the most common psychosomatic symptoms being chest pain (52.8%), fatigue (52.8%), shortness of breath (49.4%), heart palpitation (47.8%).The results of chi-square test showed a no significant relationship between psychosomatic symptoms and variables of age, marital status, drug abuse and pain intensity (p> 0.05), however, significant relationship was found between psychosomatic symptoms and gender (p< 0.001). Moreover, there was no significant relationship between pain intensity and age, gender, marital status and drug abuse at the level of (p>0.05). CONCLUSION: Psychosomatic symptoms and pain intensity are associated with certain functional disorders and health care, therefore, identifying psychosomatic symptoms and pain intensity is very useful in assessing the effectiveness of clinical approaches on cardiac patients.

Planar tunable graphene based low-pass filter in the terahertz band.

In this paper, design and analysis of planar graphene-based low-pass filters in the terahertz band are proposed. Using the proposed approach, it is possible to design plasmonic low-pass filters with the desired properties in the form of open stubs. The transfer matrix method is used based on the transmission line model for analyzing filters. The propagation constant and characteristic impedance required for this method are obtained according to the electrostatic scaling law and power-current approach, respectively. A typical fifth-degree low-pass filter is designed and analyzed according to the mentioned process. The frequency response of the low-pass filter indicates insertion loss of less than 2 dB, roll-off rate of 17 dB/THz, return loss higher than 10 dB, and constant group delay of 0.3 ps. The results of the full-wave simulation confirm the analytical ones. Also, the theory of graphene equivalent circuit variation to the different chemical potentials is expressed so the filter frequency response can be explicitly predicted for any bias value. These filters, due to their compact structure and integrated electrical and physical shape, are the suitable choice for use in full-integrated planar circuits of terahertz systems.

Accuracy of pulse oximetry in detection of oxygen saturation in patients admitted to the intensive care unit of heart surgery: comparison of finger, toe, forehead and earlobe probes.

BACKGROUND: Heart surgery patients are more at risk of poor peripheral perfusion, and peripheral capillary oxygen saturation (SpO2) measurement is regular care for continuous analysis of blood oxygen saturation in these patients. With regard to controversial studies on accuracy of the current pulse oximetry probes and lack of data related to patients undergoing heart surgery, the present study was conducted to determine accuracy of pulse oximetry probes of finger, toe, forehead and earlobe in detection of oxygen saturation in patients admitted to intensive care units for coronary artery bypass surgery. METHODS: In this clinical trial, 67 patients were recruited based on convenience sampling method among those admitted to intensive care units for coronary artery bypass surgery. The SpO2 value was measured using finger, toe, forehead and earlobe probes and then compared with the standard value of arterial oxygen saturation (SaO2). Data were entered into STATA-11 software and analyzed using descriptive, inferential and Bland-Altman statistical analyses. RESULTS: Highest and lowest correlational mean values of SpO2 and SaO2 were related to finger and earlobe probes, respectively. The highest and lowest agreement of SpO2 and SaO2 were related to forehead and earlobe probes. CONCLUSION: The SpO2 of earlobe probes due to lesser mean difference, more limited confidence level and higher agreement ration with SaO2 resulted by arterial blood gas (ABG) analysis had higher accuracy. Thus, it is suggested to use earlobe probes in patients admitted to the intensive care unit for coronary artery bypass surgery. TRIAL REGISTRATION: Registration of this trial protocol has been approved in Iranian Registry of Clinical Trials at 2018-03-19 with reference IRCT20100913004736N22. "Retrospectively registered."

Agreement and Correlation between Arterial and Central Venous Blood Gas Following Coronary Artery Bypass Graft Surgery.

INTRODUCTION: Arterial blood sampling, used to assess patients in acute conditions, may result in complications such as thrombosis and embolism. However, it can be replaced by venous blood sampling, but there is a dearth of information on this. AIM: To assess the correlation and agreement between the arterial and central venous blood gases analyses in patients undergoing elective Coronary Artery Bypass Graft (CABG) surgery. MATERIALS AND METHODS: In this cross-sectional study, 100 ICU patients undergoing elective CABG surgery were recruited. 2 mm arterial and a 2 mm venous blood samples were obtained from each patient's arterial and central venous lines, respectively. To predict Arterial Blood Gas (ABG) values based on central Venous Blood Gas (VBG) values, the linear regression analysis was used and for evaluating their agreement Bland-Altman method was used. RESULTS: In total of 200 samples were obtained. The mean and Standard Deviation (SD) of age was 58.9±9.1 years and 51% of the participants were female. There was a strong correlation between ABG and central VBG values regarding pH, partial Pressure of Carbon Dioxide (PCO2), Bicarbonate (HCO3) and Base Excess (BE) (r= 0.73, r=0.74, r=0.67 and r=0.71, respectively; p<0.001); however, the correlation between the arterial and venous Partial Pressure of Oxygen (PO2) and Oxygen Saturation (SO2) was moderate (r=0.29, p=0.005 and r=0.27, p=0.006, respectively). The Bland-Altman analysis showed an excellent agreement between all the variables (p<0.001). CONCLUSION: Central VBG analysis cannot replace ABG analysis in measuring exact PO2 status, necessitating arterial sampling in some matters, but with respect to the accuracy of pulse oximetry measurements in determining the exact PO2 status, for the rest of the indices a central VBG rather than an ABG can be utilised for determining patient's acid-base status. Particularly in patients who are hospitalised for a long time and have a central venous catheter in place like patients who have undergone CABG, thus reducing the risk and need for invasive arterial sampling.

Accuracy and precision of four common peripheral temperature measurement methods in intensive care patients.

INTRODUCTION: An accurate determination of body temperature in critically ill patients is a fundamental requirement for initiating the proper process of diagnosis, and also therapeutic actions; therefore, the aim of the study was to assess the accuracy and precision of four noninvasive peripheral methods of temperature measurement compared to the central nasopharyngeal measurement. METHODS: In this observational prospective study, 237 patients were recruited from the intensive care unit of Imam Ali Hospital of Kermanshah. The patients' body temperatures were measured by four peripheral methods; oral, axillary, tympanic, and forehead along with a standard central nasopharyngeal measurement. After data collection, the results were analyzed by paired t-test, kappa coefficient, receiver operating characteristic curve, and using Statistical Package for the Social Sciences, version 19, software. RESULTS: There was a significant meaningful correlation between all the peripheral methods when compared with the central measurement (P<0.001). Kappa coefficients showed good agreement between the temperatures of right and left tympanic membranes and the standard central nasopharyngeal measurement (88%). Paired t-test demonstrated an acceptable precision with forehead (P=0.132), left (P=0.18) and right (P=0.318) tympanic membranes, oral (P=1.00), and axillary (P=1.00) methods. Sensitivity and specificity of both the left and right tympanic membranes were more than for other methods. CONCLUSION: The tympanic and forehead methods had the highest and lowest accuracy for measuring body temperature, respectively. It is recommended to use the tympanic method (right and left) for assessing a patient's body temperature in the intensive care units because of high accuracy and acceptable precision.

Open and Closed Endotracheal Suctioning and Arterial Blood Gas Values: A Single-Blind Crossover Randomized Clinical Trial.

Aim. This study was aimed at comparing the effects of the open and closed suctioning techniques on the arterial blood gas values in patients undergoing open-heart surgery. Methods. In a clinical trial, we recruited 42 patients after open-heart surgery in an educational hospital. Each patient randomly underwent both open and closed suctioning. ABGs, PaO2, SaO2, PaCO2, were analyzed before and one, five, and fifteen minutes after each suctioning episode. Results. At first the pressure of oxygen in arterial blood increased; however, this increase in the open technique was greater than that of the closed system (P < 0.001). The pressure of oxygen decreased five and fifteen minutes after both suctioning techniques (P < 0.05). The trends of carbon dioxide variations after the open and closed techniques were upward and downward, respectively. Moreover, the decrease in the level of oxygen saturation five and fifteen minutes after the open suctioning was greater than that of the closed suctioning technique (P < 0.05). Conclusion. Arterial blood gas disturbances in the closed suctioning technique were less than those of the open technique. Therefore, to eliminate the unwanted effects of endotracheal suctioning on the arterial blood gases, the closed suctioning technique is recommended.

Reducing Irrational Beliefs and Pain Severity in Patients Suffering from Non-Cardiac Chest Pain (NCCP): A Comparison of Relaxation Training and Metaphor Therapy.

BACKGROUND: Patients suffering from non-cardiac chest pain (NCCP) can interpret their chest pain wrongly despite having received a correct diagnosis. The objective of this study was to compare the efficacy of the relaxation method with metaphor therapy for reducing irrational beliefs and pain severity in patients with NCCP. METHODS: Using a randomized controlled trial, 33 participants were randomly divided into a relaxation training group (n= 13), a metaphor therapy group (n = 10), and a control group (n = 10), and were studied for 4 weeks. The two tools used in this research were the Brief Pain Inventory (BPI) index for determining the degree of pain and the short version of the Jones Irrational Belief Test. Metaphor therapy and a relaxation technique based on Öst's treatment were used as the interventions. The collected data were analyzed with a multivariate analysis of covariance (MANCOVA), a Chi-square test, and the Bonferroni procedure of post-hoc analysis. RESULTS: The relaxation training method was significantly more effective than both metaphor therapy and the lack of treatment in reducing the patients' beliefs of hopelessness in the face of changes and emotional irresponsibility, as well as the pain severity. Metaphor therapy was not effective on any of these factors. In fact, the results did not support the effectiveness of metaphor therapy. CONCLUSIONS: Regarding the effectiveness of the relaxation method as compared with metaphor therapy and the lack of treatment in the control group, this study suggests that relaxation should be paid greater attention as a method for improving the status of patients. In addition, more studies are needed to determine the effectiveness of metaphor therapy in this area.

Anesthetic Management in Complex Arch Surgery: Debranching of Innominate and Left Common Carotid Arteries in Extensive Aortic Dissection without Cardiopulmonary Bypass.

Aortic dissection begins with the formation of a tear in the aortic intima, and it directly exposes an underlying diseased medial layer to the driving force of the intraluminal blood. This blood penetrates the diseased medial layer and cleaves the media longitudinally, thereby dissecting the aortic wall. Herein, we report the case of a 38-year-old woman, who presented with chest pain and dyspnea. After physical examination, laboratory evaluation, echocardiography, and CT-angiography, extensive aortic dissection was diagnosed involving the innominate and left common carotid arteries. Accordingly, the debranching of the aortic arch arteries was performed. During the procedure, the patient was monitored with bilateral regional cerebral tissue oximetry. The patient did not show any signs of complications either in the postoperative period or at postoperative three-month weekly follow-up or at subsequent monthly follow-up for the past year.

Off-pump coronary bypass grafting causing stunned myocardium.

The term "stunned myocardium" refers to abnormalities in the myocardial function following reperfusion and is common in on-pump coronary artery bypass grafting (CABG) and is exceedingly rare in off- pump CABG. A 53-year-old man presented with unstable angina due to the severe stenosis of the left anterior descending coronary artery (LAD) and the obtuse marginal. Laboratory findings and Chest X-ray revealed nothing abnormal. The intraoperative course was uneventful. The patient left the operating room without any inotropic support. Six hours later, however, he developed low cardiac output. At exploration, cardiac tamponade was excluded and flowmetry showed that the graft had adequate function. Cardiac enzymes were normal. High-dose adrenalin and Dobutamine were administrated and an intra-aortic balloon pump was used. After hemodynamic stabilization, the patient left the Intensive Care Unit without an intra-aortic balloon pump and inotropic support. On the fifth postoperative day, coronary angiography showed patent grafts and correct anastomotic sites. On the seventh postoperative day, the akinetic lateral wall of the left ventricle changed to dyskinesia. Finally after hospital discharge on the thirtieth postoperative day, an echocardiogram showed normal left ventricular function without regional wall motion abnormalities.