Unveiling the performance of the prehospital Rapid Emergency Medicine Score (pREMS): How the predictive score impacts in-hospital outcomes in traumatic brain injury (TBI): A retrospective observational cohort study.

INTRODUCTION: This study aimed to evaluate the predictive accuracy of the prehospital rapid emergency medicine score (pREMS) for predicting the outcomes of hospitalized patients with traumatic brain injury (TBI) who died, were discharged, were admitted to the intensive care unit (ICU), or were admitted to the operating room (OR) within 72 h. METHODS: A retrospective cohort analysis was performed on a sample of 513 TBI patients admitted to the emergency department (ED) of Besat Hospital in 2023. Only patients of both sexes aged 18 years or older who were not pregnant and had adequate documentation of vital signs were included in the analysis. Patients who died during transport and patients who were transferred from other hospitals were excluded. The predictive power of the pREMS for each outcome was assessed by calculating the sensitivity and specificity curves and by analyzing the area under the receiver operating characteristic curve (AUROC). RESULTS: The mean pREMS scores for hospital discharge, death, ICU admission and OR admission were 11.97 ± 3.84, 6.32 ± 3.15, 8.24 ± 5.17 and 9.88 ± 2.02, respectively. pREMS accurately predicted hospital discharge and death (AOR = 1.62, P < 0.001) but was not a good predictor of ICU or OR admission (AOR = 1.085, P = 0.603). The AUROCs for the ability of the pREMS to predict outcomes in hospitalized TBI patients were 0.618 (optimal cutoff point = 7) for ICU admission and OR and 0.877 (optimal cutoff point = 9.5) for hospital discharge and death at 72 h. CONCLUSION: The results indicate that the pREMS, a new preclinical trauma score for traumatic brain injury, is a useful tool for prehospital risk stratification (RST) in TBI patients. The pREMS showed good discriminatory power for predicting in-hospital mortality within 72 h in patients with traumatic brain injury.

Navigating into the unknown: exploring the experience of exposure to prehospital emergency stressors: a sequential explanatory mixed-methods.

INTRODUCTION: The unpredictability of prehospital emergencies combined with constantly changing circumstances can lead to increased stress and mental health issues among Emergency Medical Technicians (EMTs). To accurately determine the stress-inducing factors in the prehospital environment, it is important to first identify the stressful events that occur in this environment. Therefore, this study strives to provide a thorough analysis of the stressors in the prehospital environment. METHODS: Sequential explanatory mixed methods were conducted in Hamadan prehospital emergency centers in 2022. The study included 251 EMTs, who were selected through a method in the quantitative phase. The quantitative part used a questionnaire consisting of basic information and the Posttraumatic Stress Questionnaire (PCL-5). In the qualitative phase, 17 with extensive experience in dealing with prehospital stressors were selected based on their PCL-5 scores (above 33). The qualitative phase analysis was carried out using the contractual content method using the Graneheim and Ladman's approach. Statistical analyzes for the quantitative and qualitative phases were performed using SPSS 21 and maxqda 10, respectively. RESULTS: The study revealed that the EMTs had an average PTSD score of 21. 60 ± 11. 45. Multivariate linear regression analysis showed that the number of shifts had a statistically significant relationship with PTSD scores (t = 26.38, P < 0.001). The qualitative phase of the study included 17 interviews, resulting in 14 subcategories, which consisted of four categories: "the overall impact of the stress crisis on technicians," "missing links in the communication network in incident management," "professional shortcomings in pre-hospital care," and "the complex and multifaceted context of stressful pre-hospital emergencies." Additionally, the study's theme was centered around "surveying the experiences of EMTs in stressful environments." CONCLUSION: As the number of shifts increased, the primary cause of the high prevalence of PTSD in EMTs was revealed. Prehospital emergency stress can be reduced and managed more skillfully by adjusting various factors such as shortening workdays, offering continuous training, augmenting workforce, supplying ambulance equipment insurance, refraining from hiring personnel devoid of clinical training, hiring psychologists, hiring midwives in an emergency, updating prehospital protocols and guidelines, encouraging cooperation between EMTs and other relief groups, and utilizing cutting-edge technologies.

The prevalence of intimate partner violence among Iranian pregnant women: a systematic review and meta-analysis.

BACKGROUND: Intimate partner violence against pregnant women is an important public health concern and human rights issue. According to the various findings of previous studies, this study was conducted to assess the pooled prevalence of intimate partner violence against Iranian women. METHODS: In this systematic review and meta-analysis, a literature search was conducted in databases such as PubMed, Scopus, Web of Science, MagIran, and Scientific Information Database without a time limit. Heterogeneity was assessed by Cochrane Q test statistics and the I2 test, and the results were incorporated into a random effects model to estimate the prevalence of intimate partner violence. Data analysis was performed using R software version 4.3.2. RESULTS: The overall prevalence of intimate partner violence was reported to be 51.5% (95% confidence interval (CI) 45.0-58.1), and the prevalence rate of physical, sexual, and psychological intimate partner violence was 18.0% (95% CI 15.1-20.9), 22.1% (95% CI 17.7-26.60) and 43.2% (95% CI 36.6-49.8), respectively. The lowest level of physical, sexual, and emotional intimate partner violence rate was observed in district 1 of Iran (includes Tehran, the capital of Iran and the surrounding provinces). The rate of physical and sexual intimate partner violence prevalence decreased with the increased mean age of the husband (P=0.005) and the mean age of the wife (P=0.035), respectively. CONCLUSIONS: Studies included in this review report that more than half of Iranian women experience violence during pregnancy. In order to prevent adverse maternal and neonatal consequences, it is necessary to identify these women and introduce them to support centres.

Prevalence and factors associated with COVID-19 vaccine acceptance among the general population in Asadabad, Iran: a cross-sectional study.

BACKGROUND: Vaccination can be an essential protective measure against Coronavirus disease 2019 (COVID-19) if well received by the public. Various factors affect the acceptance or refusal of vaccines. Several waves of COVID-19 caused much death in Iran. This study aimed to evaluate the acceptance of the COVID-19 vaccine in the general population of Asadabad in 2021. METHODS: In this cross-sectional study, 650 people from the general population of Asadabad with a mean age of 34.6 (SD = 15.1) years were selected and included. In addition to socio-economic and demographic data, data were collected using the COVID-19 fear scale. Univariate and multiple logistic regression models were used to investigate the relationship between the tendency to get the COVID-19 vaccine (the dependent variable) and other variables. RESULTS: About 42.3% of participants were reluctant to receive the available COVID-19 vaccines. After adjusting for several covariates, there was a significant relationship between willingness to get vaccinated and family history of COVID-19 infection (AOR = 1.86, 95% CI 1.06-3.27, p = 0.032), trust in healthcare workers (AOR = 2.07, 95% CI 1.13-3.79, p = 0.019), trust in existing vaccines (AOR = 3.94, 95% CI 2.15-7.23, p < 0.001), encouraging family members to get vaccinated (AOR = 7.6, 95% CI 4.12-14.01, p < 0.0001). Also, people infected with COVID-19 are less likely to accept vaccination (AOR = 0.55, 95% CI 0.33-0.93, p = 0.025). Also, a unit increase in the score of fear of getting the COVID-19 virus increased the odds of getting the COVID-19 vaccine by 6% (AOR = 1.06, 95% CI 1.02-1.10, p = 0.002). CONCLUSION: The culture and context of different societies can affect the acceptance or refusal of the COVID-19 vaccine. Based on these characteristics and providing extensive education to the people, the health authorities in each community should build trust and better communicate all health information to clear any fear and remove all obstacles to increase willingness to get COVID-19 vaccination.

Validation of the persian version of the COVID-19 prevention, recognition and home-management self-efficacy scale.

INTRODUCTION: Adopting preventive behaviors and following the guidelines for controlling the COVID-19 epidemic depend on people's self-efficacy in carrying out these behaviors and instructions. The aim of this study was to investigate the psychometric properties of the Persian version of the COVID-19 Self-Efficacy Scale (COVID-19 SES, Hernández-Padilla et al., 2020). MATERIAL AND METHODS: This cross-sectional study was performed in a group of 400 people who were residents of the city of Asadabad in western Iran from December 2020 to January 2021. The participants were selected using a convenience sampling method. Face and content validity was assessed qualitatively based on feedback from the participants and experts, and the necessary changes were applied to the final version of the questionnaire. For construct validity, exploratory factor analysis (n=200) and confirmatory factor analysis (n=200) were performed. Internal consistency was expressed as Cronbach's alpha coefficient. Relative stability was assessed using the intraclass correlation coefficient (ICC), and absolute stability was calculated through examination of standard error of measurement (SEM). RESULTS: In exploratory factor analysis, three factors of prevention, symptom recognition, and homemanagement of COVID-19 were extracted that together explained 71.35% of the total variance. The internal consistency of the whole instrument was 0.955 and its three dimensions were 0.894, 0.916 and 0.955, respectively. In addition, an ICC of 0.986 (95% CI: 0.975-0.993, p=0.001) was found. In the confirmatory factor analysis, comparative and parsimonious fit indices were excellent, and absolute fit indices were moderate. CONCLUSIONS: The Persian version of the COVID-19 SES has good validity and reliability and can be used to measure self-efficacy in prevention, symptoms recognition, and home-management of COVID-19.

Psychometric properties of the Farsi version of diabetes burnout scale in patients with type 1 diabetes.

OBJECTIVE: Diabetes burnout refers to the feeling of exhaustion and frustration in the management of diabetes, which can lead to treatment non-adherence, poor glycemic control, and a high prevalence of diabetes complications. Measuring diabetes burnout requires accurate and standard instruments. The aim of this study was to evaluate the psychometric properties of the Farsi version Diabetes Burnout Scale (F-DBS). METHODS: This cross-sectional study was performed on 550 patients with type 1 diabetes (262 men and 288 women) referred to diabetes centers in different cities of Hamedan province (Asadabad, Hamedan, Malayer, and Nahavand) in 2021. The mean age and duration of the disease in these patients were 35.58 (SD=14.32) and 15.02 (SD=10.60) years, respectively. Data were collected using the Diabetes Burnout Scale (DBS), Patient Health Questionnaire-9 and Kessler psychological distress scale. After forward-backward translation, face, content and convergent validity were performed. To evaluate the construct validity, convergent validity, exploratory and confirmatory factor analysis were performed. Internal consistency was examined with Cronbach's alpha coefficients. RESULTS: In the exploratory factor analysis, two factors of exhaustion (five items) and detachment (seven items) were extracted, which together explained 46.58% of the total variance. In confirmatory factor analysis, the fit indices were appropriate. There was a significant positive correlation between diabetes burnout and depression (r = 0.30, p < 0.001) and psychological distress (r = 0.36, p < 0.001). Cronbach's alpha coefficient of diabetes burnout, exhaustion and detachment were 0.813, 0.846 and 0.812, respectively. CONCLUSION: The Farsi version of the Diabetes Burnout scale has acceptable validity and reliability and can be used in various studies.

Prevalence of Cigarette Smoking and its Related Factors among Students in Iran: A Meta-Analysis.

Background: Smoking is a preventable cause of morbidity and mortality with an increasing prevalence in developing countries. The present systematic review and meta-analysis aimed to estimate the prevalence of smoking among college and high school students in Iran. Materials and Methods: Databases of Scopus, PubMed, Web of Science, Google Scholar, SID, and MagIran were searched with no time limitation. Observational studies published in Persian or English were included in the analysis. Time frame of the searches was from inception until 1 January 2021. The data was analyzed using random effects model, subgroup analysis, and meta-regression analysis. Heterogeneity among studies was examined using Cochran's Q test and I2 statistic. Results: A total of 63 articles with a sample size of 58742 were analyzed. The pooled smoking prevalence was found to be 13.56% (95% CI: 11.65-15.47). There was a significant increase in the prevalence of smoking among female students between 1998 and 2020. Regions 1 of Iran had the highest prevalence rates of smoking (Provinces of Alborz, Tehran, Qazvin, Mazandaran, Semnan, Golestan, and Qom). Smoking was more prevalent among college students (15.62%, 95% CI: 13.14-18.10) than in high school students (9.77%, 95% CI: 7.19-12.35). Conclusion: Given the relatively high prevalence of smoking among Iranian college and high school students, it is necessary to inform them about the harmful effects of smoking through training programs.

Examination of the psychometric properties of the persian version of the COVID-19-impact on Quality of Life Scale.

INTRODUCTION: As a result of high transmission and mortality rates, the Covid-19 pandemic has led to a worldwide health crisis, isolation, and widespread fear, therefore negatively influencing people's quality of life (QOL). The goal of the present study was to examine the psychometric properties (validity and reliability) of the Persian version of the COVID-19-Impact on Quality of Life (COV19-QoL) scale. METHODS: After translating the scale using the forward-backward method, face and content validly was qualitatively assessed. Then the scale was distributed to 488 individuals from the general population via online platforms. Construct validity was assessed using exploratory (EFA) and confirmatory (CFA) factor analysis. In addition, internal consistency was examined using Cronbach's alpha coefficient and McDonald's omega, relative stability was assessed using interclass correlation coefficient (ICC), and absolute stability was calculated through examination of standard error of measurement. RESULTS: The EFA revealed one factor that explained 55.96% of the total variance of the scale. Internal consistencies of 0.823 and 0.882 were found using Cronbach's alpha coefficient and McDonald's omega, respectively. In addition, an ICC of 0.837 (with a two-week interval) was found. Covid-19 had a greater impact on the QOL of healthy participants than that of those with underling conditions (p = 0.004), and also on the QOL of single participants than that of married ones (p = 0.032). CONCLUSION: The Persian version of the COV19-QoL is a valid and reliable instrument that can be used to examine the impact of Covid-19 on QOL.

Prevalence of needlestick and sharps injuries in the healthcare workers of Iranian hospitals: an updated meta-analysis.

BACKGROUND: Needlestick and sharps injuries (NSIs) are critical occupational risk among health care workers (HCWs), which is extremely worrying due to the potential risk of transmitting bloodborn pathogens (BBPs). This study was carried out to evaluate the prevalence of NSIs among Iranian HCWs. METHODS: In this systematic review and meta-analysis, the key terms percu* injur*, needle* stick injur*, needlestick* injur*, or sharp* injur* were searched in the Scientific Information Database (SID), MagIran, IranMedex, Google Scholar, Science Direct, PubMed, and Scopus. A prefabricated checklist, including variables: first author, publication year, study population, sample size, gender, total prevalence of needlestick in each gender, type of questionnaire, region, and type of hospitals, was used to extract data from the selected articles included which were published between 2003 and 2016. RESULTS: The analysis showed that the prevalence of NSIs in the Iranian HCWs was 42.5% (95% CI 37-48). Moreover, the prevalence of NSIs was more in women (47%; 95% CI 36-58) compared to men (42%; 95% CI 26-58). CONCLUSION: Given the high prevalence of NSIs, it is necessary to supply safe needles and instruments, hold training programs focused on new methods of using sharp objects safely, observe safety principles and standards, reinforce the practical skills of personnel, and pay more attention to reporting and improving occupational behaviors like avoiding needle recapping in order to reduce the prevalence of NSIs and consequently reduce potential risk of transmission of BBPs.