Evaluation of the concentration and human health risk of nitrate and potentially toxic elements (PTEs) in melons from a southern region of Iran: Identification of pollution sources.

Decentralized agriculture, improper monitoring of cultivation conditions, and leaching of contaminants into lands led to the contamination of crops with various potentially toxic elements (PTEs). However, it is essential to know more about the profile level and associated risk of these contaminants and their origin, especially in high-water content crops. This study aimed to investigate the concentration of PTEs in melons of one of Iran's southern cities and follow that health risk assessment in the target population for the first time. Results of the present study confirmed that although the mean concentration of some metals was lower than the safety standard (Cr: 4.6 ± 2 mg/kg and Pb: 7.4 ± 4 mg/kg), their nutritional value was unfavorable regarding some micronutrients (Cu: 88.8 ± 27 mg/kg and Zn: 480 ± 275 mg/kg). The highest metal concentration in cantaloupe was iron (1706.47 mg/kg, p-value<0.05), and nitrate concentration in all melon types was 2.59-524.54 mg/kg (p-value<0.05). Principal component analysis (PCA) with K-means clustering and the Positive Matrix Factorization (PMF) model have shown that contaminants in melons originated from human activities. So, excessive use of agricultural fertilizers is a possible source of nitrates in melons, which have 93 % of factor loading values. The health risk assessment also showed that melons' carcinogenic and non-carcinogenic risk using the deterministic method was lower than the permissible limit (HQ < 1, ILCR 1 in the children group for the 95th percentile. Furthermore, the level of certainty in the carcinogenesis risk for children, women, and men was estimated at 86.48 %, 64.67 %, and 61.30 %, respectively. Also, the consumption rate was determined as the most important parameter in the sensitivity analysis. As a consequence, there is a potential health risk for Iranians after the consumption of melon due to PTEs and nitrate levels that also originated from anthropogenic sources.

The concentration of potentially toxic elements (PTEs) in drinking water from Shiraz, Iran: a health risk assessment of samples.

The existence of potentially toxic elements (PTEs) in water bodies has posed a menace to human health. Thus, water resources should be protected from PTEs, and their effect on the exposed population should be investigated. In the present investigation, the concentrations of PTEs such as lead (Pb), mercury (Hg), manganese (Mn), and iron(Fe) in the drinking water of Shiraz, Iran, were determined for the first time. In addition, hazard quotient, hazard index, cancer risk, and sensitivity analysis were applied to estimate the noncarcinogenic and carcinogenic impacts of Pb, Hg, Mn, and Fe on exposed children and adults through ingestion. The mean concentrations (µg/L) of Pb, Hg, Mn, and Fe were 0.36, 0.32, 2.28, and 8.72, respectively, in winter and 0.50, 0.20, 0.55, and 10.36, respectively, in summer. The results displayed that Fe concentration was more than the other PTEs. PTE concentrations were lower than the standard values of the Environment Protection Agency and World Health Organization. Values of the degree of contamination and heavy metal pollution index for lead, mercury, manganese, and iron were significantly low (< 1) and excellent (< 50), respectively. Based on the Spearman rank correlation analysis, positive and negative relationships were observed in the present study. The observations of the health risk assessment demonstrated that mercury, lead, iron, and manganese had an acceptable level of noncarcinogenic harmful health risk in exposed children and adults (hazard quotients < 1 and hazard index < 1). The carcinogenic risk of lead was low (< E - 06), which can be neglected. Monte Carlo simulation showed that water intake rate and mercury concentration were the most critical parameters in the hazard index for children and adults. Lead concentration was also the most crucial factor in the cancer risk analysis. The results of the present study proved that the drinking water of Shiraz is safe and healthy and can be confidently consumed by people.

The Development and Validation of Elder Self-Neglect Scale (ESNS) in Iranian Community-dwelling Older Population.

The aim of this study was to develop a valid and reliable elder self-neglect scale (ESNS) for field research on Iranian community-dwelling older adults. This mixed-method exploratory study was conducted in three stages: (1) item generation using literature review, (2) item reduction by expert panels, and (3) assessing the psychometric properties. In the third stage, the face, content, and construct validity (exploratory factor analysis) were performed on the first sample (n = 450), and the final 26-item scale was developed. After that, confirmatory factor analysis and reliability were assessed on the second sample (n = 250). Data were analyzed using IBM-SPSS v.23 and AMOS v.24. Exploratory factor analysis identified six factors with a total variance of 77.53%. The goodness of fit was indicated by Structural Equation Modeling. The Cronbach's alpha was estimated at 0.85. The optimal cutoff point was 73. This scale with 26 items seems to be an effective tool in screening elder self-neglect.

A Pilot Study on the Association of Lead, 8-Hydroxyguanine, and Malondialdehyde Levels in Opium Addicts' Blood Serum with Illicit Drug Use and Non-Addict Persons.

While a large body of literature has shown the health problems of illicit drug use, research is needed on how substance abuse impacts DNA damage and contaminants in blood, especially given Pb-contaminated opium. This pilot study aimed to evaluate the levels of lead (Pb), 8-hydroxy di-guanine (8-oxo-Gua), and malondialdehyde (MDA) in the blood serum of opium addicts and non-addict people. The current study is a case-control study with a cross-sectional design. A sample of 50 opium-addicted and non-addict adults were chosen for this study using convenience and random sampling methods. Participants were divided into two groups: addicts and non-addicts. The atomic absorption spectroscopy method was used to measure the quantity of Pb, and the Enzyme-Linked Immunosorbent Assay (ELISA) method was used to measure the amount of 8-oxo-Gua and MDA. The data were analyzed using an independent t-test. The results show that the amount of Pb in the blood serum of addicted women and men was higher than levels in non-addict men and women, for the study participants (p-value = 0.001). Blood levels were not significantly different between addicts and non-addicts for men or women for 8-oxo-Gua (p-value = 0.647 for women and p-value = 0.785 for men) and MDA (p-value = 0.867 for women and p-value = 0.995 for men). In general, addicts' blood Pb levels were found to be substantially higher than those of normal non-addict persons in this pilot study. As a result, testing for blood Pb levels in addicts may be informative in instances when symptoms are inconclusive.

Psychometric Validation of the Persian Version of Short Form Self-Regulation Questionnaire in Community-Dwelling Older Adults.

The aim of this study was to examine the validity and reliability of the Persian version of the Short Form Self-Regulation Questionnaire (SSRQ) among Iranian community-dwelling older adults and to determine its optimal cutoff point. In Shiraz, Iran, a cross-sectional study of 500 older adults ≥ 60 years was conducted in two steps. The forward-backward method was used for translation. Psychometric properties, such as the face and content validity, based on the point of view of experts, construct validity based on exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), convergent validity by assessing the relationship with the Generalized Self-Efficacy Scale (GSE-10), and reliability based on Cronbach's α were examined. A receiver operating characteristic curve (ROC) was plotted to confirm the cutoff point. Validity of both the face and the content was confirmed. The first stage of construct validity was performed using the kurtosis test and the EFA, and finally, only 20 items in four subscales were loaded with 76.34% of the total variance. The CFA indicated a good fit to the data (root mean square error of approximation (RMSEA) = 0.059; comparative fit index (CFI) = 0.92; and goodness of fit index (GFI) = 0.89). Cronbach's α coefficient of the SSRQ-20 increased to 0.87. A significant positive correlation was found between the SSRQ-20 and the GSE-10 (r = 0.44), indicating acceptable convergent validity. The optimal cutoff score for differentiating older adults in terms of self-regulation was 71. This study demonstrates that the Persian version of the SSRQ, which contains 20 items, is a valid and reliable tool for assessing self-regulation in Iranian community-dwelling older adults.

Which mother-headed households' parenting styles are related to children's behavior problems? A cross-sectional study.

Introduction: Parenting styles are considered as one of the main determinants of individual and social behaviors and the use of dysfunctional styles can create child behavioral problems. The aim of this study was to determine the relationship between mother-child relationship patterns in mother-headed households and children's behavioral problems. Methods: This is a descriptive-analytical cross-sectional study that was performed on 345 mother-headed households under the coverage of the Imam Khomeini Relief Committee in Shiraz, Iran. Mothers were selected by convenience sampling method and data were collected using several questionnaires including the mother-child relationship evaluation, the child behavior checklist, and social support appraisals scale. Data were analyzed using SPSS software version 21. Results: The overprotective parenting style, as one of the inefficient models has been used more than others by mother-headed households as well as the mothers with higher education levels used less from the child-rearing style " excessive ease ", and benefited more from the support of friends and others. In addition, children of divorced and low-income mothers are more prone to externalizing behavioral problems. The final result was also determined two parenting styles "excessive ease and overprotection" are effective on children's total behavioral problems. Conclusion: The findings highlight the need to plan and expand socio-economic and educational support services to improve living conditions and parenting skills in mother-headed households. Further research is also suggested to identify the determinants and types of interventions affecting mother-child relationships, children's behavioral problems, and finally quality of life among this low-income and vulnerable group.

The Effectiveness of Interventions in Improving Hand Hygiene Compliance: A Meta-Analysis and Logic Model.

BACKGROUND: Despite the availability of various guidelines, rules, and strategies, hand hygiene adherence rates among healthcare workers are reported significantly lower than expected. The aim of this meta-analysis is to determine the most effective interventions to improve hand hygiene and to develop a logic model based on the characteristics of the most effective interventions. METHODS: A literature search was conducted on PubMed, ProQuest, Web of Knowledge, Scopus, Cochrane Library, and ScienceDirect databases up to December 21, 2019, with no time limit. Randomized clinical trials which had designed interventions to improve hand hygiene were reviewed. Data were extracted independently by two authors. All statistical analyses were performed using Comprehensive Meta-Analysis (CMA) software (version 2.0). A random-effects model was used to estimate odds ratios. RESULTS: Although 14 studies were initially reviewed, only 12 studies entered the meta-analysis, since they had identified percentage rates of hand hygiene compliance. The most effective intervention (odds ratio 18.4, 95% CI (13.6-24.8)) was a multilevel strategy that influenced the determinants of hand hygiene behavior at individual, interpersonal, and organizational levels. Following this, a theory-driven logic model was mapped out to promote hand hygiene, based on situational analysis. CONCLUSION: This study suggests that designing integrated interventions based on a multilevel socioecological approach has the greatest potential to improve hand hygiene compliance in healthcare workers. The logical model proposed in this study can thus provide a useful guide for designing and conducting future experimental research.

The Social Consequences of the Novel Coronavirus Disease (COVID-19) Outbreak in Iran: Is Social Capital at Risk? A Qualitative Study.

As well as causing a global health crisis, the COVID-19 pandemic has also generated multilevel social changes by damaging psychosocial and economic resources across Iranian society. Therefore, this qualitative study was conducted to examine and explain these social consequences and their impact on the social capital of Iran during the COVID-19 outbreak. Using a content analysis approach, nine experts participated in semistructured, in-depth interviews. Interviews were recorded and transcribed verbatim and analyzed using Lundman and Graneheim's method. The social impacts of COVID-19 can be summarized into six categories and 32 subcategories. Three positive-negative categories emerged from the data analysis: "formation of new patterns of social communications; formation of new patterns of behavior; creation of economic changes." Three entirely negative categories included "creating a climate of distrust; disruption of cultural, social, and religious values; psychosocial disorders." Overall, most findings (27 out of 32 subcategories) indicated the destructive effects of the COVID-19 pandemic on social capital. Therefore, this raises concerns about social capital endangerment in Iran. However, positive social impacts can guide policies that strengthen social action and improve social capital.

Factors Affecting Panic Buying during COVID-19 Outbreak and Strategies: A Scoping Review.

Background: This study aimed to assess factors affecting panic buying and strategies to deal with them during COVID-19 with a scoping review. Method: The review was performed based on Arksey and O'Malley. PubMed, Embase, Scopus, ProQuest, and Science Direct databases were selected to search. All English language full-text articles from Jan 2020 to May 2021 were included. Initially, the titles and abstracts of the retrieved articles were read and screening was accomplished based on the research question. After that, the full text of eligible studies was examined. A third reviewer was resolved disagreements at any stage by a consensus meeting. A self-assessment form was designed for data extraction. The causes of panic buying were assessed as a descriptive study. Results: The search process returned 23 articles after deletion for complete data extraction and analysis. Through thematic analysis, the factors influencing panic buying were divided into six categories including cognitive, emotional, behavioral, social, and economic factors as well as government action, and finally, the recommended strategies were categorized in two categories included psychosocial and economic. Conclusion: A holistic view of panic buying's causes allows planners and decision-makers to design categorized strategies beyond the suggested strategies. Increasing customer awareness and monitoring the flow of information through social media and mass media, psychotherapy, counseling, and economic strategies are considered by planners to combat panic buying.

Effective Interventions on Improving Elderly's Independence in Activity of Daily Living: A Systematic Review and Logic Model.

This systematic review aimed to investigate the types and characteristics of effective interventions when improving the independence of the elderly during activities of daily living. After developing a search strategy, the various databases, including PubMed, Scopus, Cochrane Library, Science Direct, Proquest, and Embase, were searched up to October 16, 2019. The Review Manager 5.1 software was used to determine the risk of bias. The randomized clinical trials were reviewed to find if their interventions' main goal was to improve the elderly's independence in activities of daily living. Data were extracted independently by two authors. Eight randomized controlled trials were included in the final analysis. Three types of interventions were identified and categorized as cognitive training, physical exercises, and multicomponent interventions. All reviewed studies provided evidence of the effectiveness of interventions in improving older people's ability to perform the activities of daily living. However, the lack of uniform measurement indicators to identify and compare the most effective interventions forced us to develop a conceptual framework for designing future interventional research. This conceptual framework included designing tailored interventions, creating an age-friendly environment as well as financial, psychological, and social support. The proposed conceptual framework can also help develop future systematic reviews focusing on a particular intervention type.

Effectiveness of Positive Thinking Training Program on Nurses' Quality of Work Life through Smartphone Applications.

AIM: Job stress is a part of nurses' professional life that causes the decrease of the nurses' job satisfaction and quality of work life. This study aimed to determine the effect of positive thinking via social media applications on the nurses' quality of work life. METHODS: This was a pretest-posttest quasi-experimental study design with a control group. The samples were selected among the nurses in two hospitals in Fasa University of Medical Sciences and divided randomly into two interventional (n = 50) and control (n = 50) groups. Positive thinking training through telegrams was sent to the intervention group during a period of 3 months. Data were collected by using Brooks and Anderson's questionnaire of work life quality and analyzed by SPSS 18. RESULTS: The mean total scores of pretest and posttest in the intervention group improved noticeably and there were significant differences between mean scores of quality of work life in pretest and posttest scores in interventional groups (p < 0.001) and in dimensions of work life quality, home life (p < 0.001), work design (p < 0.001), work context (p < 0.001), and work world (p = 0.003). CONCLUSION: This study concluded that positive thinking training via social media application enhanced nurses' quality of work life. This study is necessary to carry out on a larger sample size for generalizing findings better.

Nursing MSc theses: a study of an Iranian College of Nursing and Midwifery in two decades (1990-2010).

AIM: A thesis is an important part of nursing graduate students' education, which is also their first systematic and scientific attempt to learn the ABCs of research. Articles derived from theses are important for the dissemination of science and the improvement of nursing as a field. Therefore, it is the goal of the present research is to analyze the different aspects of nursing MSc theses and the number of published articles derived from them. METHODS: This was a descriptive research carried out on 145 nursing MSc theses defended in Razi Faculty of Nursing and Midwifery in Kerman between 1990 and 2010. All of the extracted data were put into an Excel file (2007 version) followed by a data analysis. RESULTS: The results of this study were then presented via the use of descriptive statistics and figures. The research findings showed that most of the theses used a descriptive or analytical-descriptive method, and 42% of them had patients as their participants. They were usually delivered on the subject of health care, and only 58 articles were extracted from the whole 145 theses. CONCLUSION: The process of writing nursing MSc theses and thesis research articles is improving gradually. However, there is a growing need for empirical and semi-empirical research to bridge the gap between theory and practice, which is also a major concern among nurses.

Iranian Nurses' Attitudes and Perception towards Patient Advocacy.

Patient advocacy is an inherent component of professional nursing ethics; in other words, nurses' enough knowledge would be essential to gain a positive attitude towards nursing advocacy. Using a descriptive-analytic design, this study aimed to assess the correlation between nurses' perception and attitudes towards patient advocacy, amongst 385 nurses in Kerman, Iran; hence, a three-part questionnaire was applied: part I, a demographic data sheet, part II, attitude measuring instrument, and part III, perception measuring instrument in nursing advocacy. The results implied that fairly positive attitudes and perception were found amongst the participants, and nurses' attitudes, in general, were positively correlated to their perception toward nursing advocacy. This means that with an improvement in perception, the attitude would also improve. In addition to our findings, it seems that these nurses needed more advocacy educational programs and support from responsible employers.