Effectiveness of a social-emotional learning program on developmental assets and subjective well-being.

The present study was done to evaluate the effectiveness of a Social Emotional Learning (SEL) intervention designed based on social marketing on developmental assets and the well-being of female adolescents in Yazd, Iran. This mixed-method quasi-experimental study was conducted in 2018-2019. A total of 190 female students were selected by multi-stage sampling from the female middle and high schools in Yazd, Iran. A SEL intervention designed based on social marketing principles was implemented among the parents and students of the intervention group. The control group did not receive any intervention. Quantitative data were collected in three stages: pre-test, post-test after two months, and follow-up after six months via Developmental Assets Profile and EPOCH measure of wellbeing. A qualitative evaluation was also performed after the intervention. Results of the Repeated-Measures test indicated that the intervention significantly influenced social competence (p-value = .02). However results did not show improvement in the positive identity development of the participant girls. Qualitative findings suggested the effectiveness of the intervention on social competencies and positive identity. Based on the results of the present study, the SEL program might have a significant but small positive effect on the social competencies of the participating adolescents.

The challenges of strategic management of the wastage produced due to earthquake in Kermanshah and Varzaghan-Ahar: A qualitative study.

BACKGROUND: Strategic management of the wastage produced due to earthquakes has faced many challenges over the recent decade. Thus, the present study seeks to identify and explain the challenges in earthquake wastage strategic management. MATERIALS AND METHODS: The present qualitative study has been steered through a content analysis approach and conducted using semi-structured interviews and a purposive selection of 17 professors, experts, and managers experienced in the field of waste management in Kermanshah and Varzaghan-Ahar earthquakes over 2020-2021. Besides, the interviews were initially categorized using MAXQDA18 software. RESULTS: Analysis of the experiences and perception regarding the changes in strategic management of wastage produced due to Kermanshah and Varzaghan-Ahar earthquakes revealed 418 codes, 97 subcategories, 33 categories, and 8 main categories including management and leadership, organizational culture, planning, organizational learning, employee management, rules and regulations, resource management, and procedure management. CONCLUSION: Strategic waste management has not been implemented in a coherent, integrated, and well-planned manner in the cases of the Kermanshah and Varzaghan-Ahar earthquakes. The challenges of strategic waste management turned out to be due to various reasons which will result in many issues in achieving the goals and selecting the suitable method for resource and procedure management should they not be managed well. Hence, policymakers, managers, and executors in the field of crisis management and waste management in disasters -specifically earthquakes- must take the necessary measures to remove these barriers.

Responsibility-Evading Performance: The Experiences of Healthcare Staff about Triage in Emergency Departments: A Qualitative Study.

BACKGROUND: Correct triage is one of the most important issues in delivering proper healthcare in the emergency department. Despite the availability of various triage guidelines, triage is not still appropriately implemented. Therefore, this study was conducted to investigate the role of different underlying factors in triaging emergency patients through a qualitative approach. MATERIALS AND METHODS: This study was conducted by conventional content analysis. For this purpose, 30 interviews were conducted with 25 participants. The participants included triage nurses, emergency general physicians, emergency medicine specialists, and expert managers at different position rankings in hospitals and educational and administrative centers in Yazd, selected by purposeful sampling. Data were collected through in-depth and unstructured interviews from April 2017 to January 2018, and then analyzed by inductive content analysis. RESULTS: Four categories of profit triage, exhibitive triage, enigmatic, and tentative performance triage were drawn from the data, collectively comprising the main theme of responsibility-evading performance. CONCLUSIONS: The dominant approach to the triage in the emergency departments in a central city of Iran is responsibility evasion; however, the triage is performed tentatively, especially in critical cases. To achieve a better implementation of triage, consideration of the underlying factors and prevention of their involvement in triage decision-making is necessary.

The Feasibility of Increasing Hospital Surge Capacity in Disasters through Early Patient Discharge.

OBJECTIVE: Hospitals are expected to be able to provide quality services during disasters. However, hospital capacity is limited and most hospital beds are almost always occupied. The aim of this study was to determine the feasibility of increasing hospital surge capacity during disasters through identification of patients suitable for safe early discharge. METHODS: This cross-sectional study was conducted from May 2017 to February 2018 in two phases. In phase I, the Early Discharge Checklist was developed by a multidisciplinary panel of experts. Then in phase II, the checklist was used to assess the dischargeability of 396 in-patients in general wards of hospitals in Alborz province, Iran. Data were analyzed through the SPSS software (v. 22.0) and the results were presented by descriptive and analytical statics at a significance level of less than 0.05. RESULTS: Of 396 patients, (64.65%) were male, (68.9%) were married, and (38.6%) aged more than 54. Moreover, (34.6%) patients were dischargeable. Patients in cardiology wards were more dischargeable. At follow-up assessment, 33.3% of patients had been discharged after 48 hours. There was a significant relationship between patient dischargeability and 48-hour hospitalization status (p=0.001). Dischargeability had no significant relationships with patients' demographic characteristics (p>0.05). CONCLUSION: A considerable percentage of in-patients are dischargeable during disasters. The Early Discharge Assessment Checklist, developed in this study, is an appropriate tool to provide reliable data about early dischargeability in disasters.

Barriers and facilitators to provide continuity of care to dischargeable patients in disasters: A qualitative study.

OBJECTIVE: Early discharge of some in-patients is the effective measure to create hospital surge capacity in disasters. However, some of these patients may need to post-discharge continuity of care. The aim of the current study then is to explore the barriers of continuity of care, and to provide suitable solutions for potentially dischargeable patients during disasters. METHODS: This qualitative study was conducted in Iran in 2017. The data was collected via unstructured interviews with 24 disaster professionals; and analyzed by content analysis method. RESULTS: Identified barriers to the continuity of care were classified into seven categories, 'lack of disaster paradigm'; 'challenges of pre-hospital system'; 'insufficient coordination and cooperation'; 'inadequate hospital preparedness'; 'lack of using available resources and capacities'; 'poor patients' knowledge' and 'poor planning'. The suggested solutions for post-discharge continuity of care were: creation of registry and follow-up system; removing pre-hospital challenges; including disaster management courses in medical school curriculum; promoting hospital preparedness by All-Hazard Approach; and effective use of available resources. CONCLUSION: Understanding the barriers to continuity of care for discharged patients for adopting policies based on experiences of health care providers can help planners to design and implement effective programs, which will enhance patients' access to necessary care.

Effective factors on menstrual health among female students in Bam city: a qualitative study.

BACKGROUND: Menarche is an independent puberty event in a girl's life, and is associated with physical growth, ability in marriage and fertility. Therefore, poor menstrual health can be a major determinant of morbidity, as well as physical, mental and social problems in this age group. OBJECTIVE: The aim of this study was to explore the effective factors on menstrual health among female students in Bam city. METHODS: The qualitative study was conducted using content analysis approach in 2017. The participants were 32 individuals consisting of 13 students, 10 mothers of the same students, 9 school associates and health educators of 5 secondary schools in Bam city, who were selected based on an objective-oriented approach. The sampling was done until data saturation. Data collection methods were semi-structured and in-depth interview. Data analysis was performed using the steps suggested by Graneheim and Landman. RESULTS: There were two categories (easy interaction and inappropriate adaptation to changes in health behavior), 13 sub-categories and 52 initial codes. The positive factors included easy access to sanitary pads, appropriate school education, easy access to health and therapeutic services and school flexibility on menstrual issues, while the negative factors included inadequate facilities for sanitary pad disposal, lack of access to informed people about menstrual issues, insufficient attention to menstrual problems, feeling ashamed, the high cost of menstrual health, self-medication with traditional medicines, inadequate self-directed education, lack of awareness and trust in health center staff, and following family and teachers in menstrual problems. CONCLUSION: Overall, this study indicated that economic, social, cultural and educational factors affect menstrual health. Therefore, the identification of each of these factors helps planners to apply the most appropriate methods and strategies for menstrual health improvement.