Lived experiences of Iranian prehospital emergency technicians in facing women's emergencies: a phenomenological study.

INTRODUCTION: This study aimed to investigate the work problems and challenges of male prehospital emergency technicians when faced with female medical emergencies. Given that qualitative research has not been done in this field, planning to find the weak points and improve the quality of prehospital emergency as the first line of treatment for female emergency patients, which is considered an important part of the health care system, is considered important and valuable. Therefore, this phenomenological study was conducted in 2023. METHODS: This study was conducted using a qualitative method of phenomenology in 2023. The environment of the research was urban and road prehospital emergency centers in Iran and the data were collected through interviews with EMS technicians. The collected data were analyzed using Smith's approach to explain the lived experiences of EMS technicians facing female emergencies or women's emergencies in Iran. RESULTS: All the 15 participants were men. Their mean age was 35 years, with a range of 25 to 45 years, and with a mean work experience of 10.54 years with a range of 4 to 20 years. The lived experiences of 115 emergency technicians in facing women's emergencies in Iran were placed in four main themes cultural-social factors, organizational factors, human resources-related factors, and administrative-legal factors. CONCLUSION: EMS personnel face various obstacles in carrying out missions related to women's emergencies, Considering the critical nature of women's emergencies, it is recommended that policymakers and clinical educators improve the level of community culture, communication skills, theoretical and practical training, respecting privacy, hiring female personnel, adding specialized equipment, amending and changing laws, removing road-traffic obstacles and to support personnel, patients and their families psychologically to optimize performance in women's emergencies.

Terrorist attacks in Iran: A counter-terrorism medicine analysis.

INTRODUCTION: Terrorism is a combined phenomenon, the concept of which is strongly affected by the spatial and temporal situation. Terrorist attacks can affect the demand for and delivery of healthcare services and often put a unique burden on the first responders, hospitals, and health systems. This study provides an epidemiological description of all -terrorist-related attacks in Iran from 1979 to 2020. METHODS: Data were collected using a retrospective search through Global Terrorism Database (GTD). GTD was searched using internal database search functions for all incidents that occurred in Iran from January 1, 1979, to December 31, 2020. The target type, attack type, primary weapon type, perpetrator group, country where the incident occurred, and the number of fatalities and injuries were collected, and the results were analyzed. RESULTS: In total, 543 terrorist attacks were identified in the study period, which resulted in the fatality of 1,150 people and the injury of 3,792 people. It indicates 2.12 fatalities and 7,009 injuries per incident. Explosives were used in 301 attacks (55.63 percent), followed by incendiary weapons in 177 attacks (32.71 percent). The most significant types of attacks are bombings in 290 attacks (52.3 percent), followed by assassination in 99 attacks (17.9 percent), and armed assaults in 81 attacks (14.6 percent). CONCLUSION: Due to a decreasing trend of terrorist incidents in Iran, we can state that national security and stability have improved in Iran. However, the development of security promotion policies and passive defense approaches can help prevent the occurrence of such incidents.

Care in emergencies and disasters: Can it be person-centered?

OBJECTIVES: While person-/patient-centered care aims to influence policymakers' rules and regulations to improve the care of individuals worldwide, exploration of the concept in the context of disaster and public health emergencies as an alternative ethical approach is lacking. This study aims to provide a nuanced understanding of the advantages and challenges of diverse ethical approaches in emergencies, to improve patient care. METHODS: A survey, created after several rounds of Delphi methodology, with 22 statements, was applied to 39 participants from nine different countries. The questionnaire's results, including participants' comments, were analyzed. RESULTS: The results show that practitioners chose to use a combination of diverse ethical approaches in managing victims of disasters and public health emergencies. CONCLUSION: The selection of an approach is context- and situation-dependent and seems to primarily respond to the nature of underlying etiology, creating a possibility to use diverse approaches to offer individualized care on a later occasion and when a flexible surge capacity is available. PRACTICE IMPLICATIONS: The outcomes of this study will enhance the future ethical discussion in person/patient-centered care during situations with limited resources and help to develop necessary ethical and educational guidelines.

Factors affecting the preparedness of Helicopter Emergency Medical Services (HEMS) in disasters: a systematic review.

BACKGROUND: One of the most significant advantages of Helicopter Emergency Medical Service (HEMS) in disaster relief efforts is their ability to reach inaccessible or remote areas quickly. This is especially important in the aftermath of natural disasters such as earthquakes, floods, or hurricanes, where roads may be blocked or damaged, and conventional ground transportation may not be available. There are many factors can affect the performance of Helicopter Emergency Medical Service (HEMS) in disasters. This study aims to investigate the factors affecting the Helicopter Emergency Medical Service (HEMS) in disasters. METHODS: The systematic search in Cochran Library, PubMed, Scopus, Science Direct, Web of Science, ProQuest, and Google Scholar databases between the first of January in 1975 and the thirty-first of May in 2023. The articles were selected based on the keywords of the authors. At last, the criteria were extracted from the selected ones. RESULTS: The primary search included 839 articles. After studying their title, abstract, and full context, only nine articles, including two qualitative and seven quantitative ones, were chosen for analysis. After analysis and extracting data from the final studies, the preparation factors were categorized into 6 general classes of human resources: training and practicing, management, instructions and standards, equipment, and structure. Among these, the role of training is highlighted by holding practice and maneuvers to improve and prepare the personnel and manage disasters and incidents. CONCLUSION: The results obtained from this systematic review provide a total view of the factors affecting the preparation of the air ambulance during disasters and incidents. It is recommended that senior managers and policy makers use the findings of the present study to identify the factors which affect preparedness of HEMS in disasters and take the necessary measures to eliminate to obstacles.

Preparedness of Iranian nurses against COVID-19: An analytical study.

Background and Aims: The reasons for the unfavorable performance of hospitals in providing care to Coronavirus Disease 2019 (COVID-19) patients include the lack of preparation, knowledge, and relevant skills, making it necessary to evaluate the preparedness of nurses to respond to COVID-19. Therefore, the present study aimed to investigate the preparedness of hospitals affiliated with Shahrekord University of Medical Sciences during the COVID-19 pandemic in 2022. Methods: In this analytical study, data were collected from 350 randomly selected nurses who worked in three hospitals affiliated with Shahrekord University of Medical Sciences; demographic information tools and the preparation of nurses for COVID-19 patients were used to collect the data. We analyzed the data using SPSS software version 26. Results: The mean and standard deviation of the total preparation score was 118.85 ± 0.98. The lowest (6.80 ± 0.18) and highest (23.35 ± 0.19) average values belonged to risk assessment and management and COVID-19, respectively. The score of nurses' preparedness to deal with COVID-19 was not statistically correlated with age, work experience, and so on. The average preparation score was significantly different in different treatment departments (operating room and COVID-19). Conclusion: The preparation of nurses was low in dealing with COVID-19. Thus, managers of nursing services should design and implement educational programs to strengthen the nurses' weaknesses and ultimately increase their awareness and skills in dealing with disasters.

A comparative study of interagency communications and information exchange in disaster response among selected countries.

BACKGROUND: Effective communications and secure information exchange platforms during disasters and emergencies are among the significant factors in inclusive disaster management and can radically contribute to better preparedness, efficient and timely responsiveness, and, finally, maximal reduction of damages and fatalities. The present study was to compare communications and information exchange among disaster response organizations in selected countries. MATERIALS AND METHOD: This applied research, carried out in 2022, was a qualitative descriptive-comparative study pursuing a content analysis approach. Australia, Turkey, India, America, Japan, and Iran constituted the statistical population of the study. The sampling was based on the countries' disaster histories and response experiences. The note-taking tool was used to extract and collect data during the review of texts, documents, and articles, and the qualitative content analysis method was employed for data analysis. RESULTS: The outcomes of the descriptive-comparative analysis fell into four main comparative axes of the selected countries, including comparing reference, authority, and coordinator organizations in the response phase, comparing planning records and histories in disaster and emergency management comparing the contribution or non-contribution of government, military institutions, and non-governmental organizations to disaster and emergency management, the commonalities of the selected countries' disaster and emergency management and dependence on government. CONCLUSION: The results revealed that all selected countries depended on the government in managing disasters and emergencies, and the four communication platforms, i.e., landline telephone, mobile phone, radio communications systems, and couriers, were the common communication and information acquisition sources.

Identifying the components and effective factors in disaster education to improve adolescents' resilience: A thematic analysis.

BACKGROUND: Education is considered one of the critical elements of behavioral changes in societies with a high risk of disasters. Meanwhile, the role of adolescents, as the key and the largest group of stakeholders in planning for disaster preparedness and response, has often been neglected. The current study aimed to extract the components and effective factors in disaster education to increase adolescents' resilience in disasters in Iran. MATERIALS AND METHODS: This qualitative study was done by inductive approach through in-depth semi-structured interviews conducted with 21 key informants and 11 adolescents selected through purposive sampling. To extract the components and factors affecting education to increase adolescents' resilience in disasters, the data were analyzed by thematic analysis. RESULTS: The effective factors in increasing adolescents' disaster resilience were classified into four categories, namely, social participation, need-based education, scope of influence, and governance perspectives, and 19 subcategories. CONCLUSION: This study provided an overview and a comprehensive understanding of disaster education to increase adolescents' resilience. Recognizing these factors can help effectively in developing disaster education programs to improve adolescents' resilience against disasters. By encouraging natural hazard habits in this age group, it can also potentially increase the society's resilience in future.

Exploring senior managers' experiences preparedness to respond to COVID-19: a qualitative study in Iran.

BACKGROUND: Epidemics caused by emerging respiratory viruses are challenging for the health system of most societies, and preparedness of the health system in responding to such epidemics is important. Therefore, the aim of this study was identifying different fields and key issues of the senior managers' experiences preparedness to respond to the COVID-19 epidemic from the Iranian senior managers' point of view. METHODS: This is a qualitative descriptive study. Eighteen in-depth and semi-structured individual interviews were conducted for data collection. For this purpose, 18 senior managers with work experience in managing the COVID-19 crisis were enrolled in the study using purposive sampling. The collected data were analyzed according to Graneheim and Lundman's approach. RESULTS: Analysis of the data resulted in the emergence of five themes and twelve sub-themes. The main themes and sub-themes included: (1) capacity improvement consisting of performance improvement and logistic improvement; (2) resource and infrastructure management including supply and support of human resources, infrastructure improvement, and supply of equipment; (3) an increase in epidemiology capacity including epidemiology improvement and emerging disease surveillance; (4) application of the principles of disaster and emergency management including intra- and extra-organizational interaction management, disaster risk management, and data management; and (5) society resilience increase including improving adaptation skill and maintaining health and social participation. CONCLUSION: The results of this study present the key issues for the management of future emergency situations. Health system managers and policymakers in Iran and other countries should be aware of these key issues and apply them in practice to prepare the health systems to respond to next outbreaks. Indeed, the study results can help policymakers and health system managers to plan to achieve acceptable preparedness for the management of such outbreaks.

Artificial Intelligence Functionalities During the COVID-19 Pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has led us to use virtual solutions and emerging technologies such as artificial intelligence (AI). Recent studies have clearly demonstrated the role of AI in health care and medical practice; however, a comprehensive review can identify potential yet not fulfilled functionalities of such technologies in pandemics. Therefore, this scoping review study aims at assessing AI functionalities in the COVID-19 pandemic in 2022. METHODS: A systematic search was carried out in PubMed, Cochran Library, Scopus, Science Direct, ProQuest, and Web of Science from 2019 to May 9, 2022. Researchers selected the articles according to the search keywords. Finally, the articles mentioning the functionalities of AI in the COVID-19 pandemic were evaluated. Two investigators performed this process. RESULTS: Initial search resulted in 9123 articles. After reviewing the title, abstract, and full text of these articles, and applying the inclusion and exclusion criteria, 4 articles were selectd for the final analysis. All 4 were cross-sectional studies. Two studies (50%) were performed in the United States, 1 (25%) in Israel, and 1 (25%) in Saudi Arabia. They covered the functionalities of AI in the prediction, detection, and diagnosis of COVID-19. CONCLUSIONS: To the extent of the researchers' knowledge, this study is the first scoping review that assesses the AI functionalities in the COVID-19 pandemic. Health-care organizations need decision support technologies and evidence-based apparatuses that can perceive, think, and reason not dissimilar to human beings. Potential functionalities of such technologies can be used to predict mortality, detect, screen, and trace current and former patients, analyze health data, prioritize high-risk patients, and better allocate hospital resources in pandemics, and generally in health-care settings.

The necessity revealed by COVID-19 pandemic: Paradigm shift of Iran's healthcare system.

Background: COVID-19 pandemic has resulted in drastic changes around the world, revealing vulnerable aspects of healthcare systems. This study aimed to explore how Iranian healthcare system experienced the paradigm shift during the pandemic and determine the aspects that need improvement during the pandemic era. Method: This qualitative study was conducted in 2021. A framework analysis approach was used to analyze the content of the 19 semi-structured interviews with the healthcare system experts from Shiraz University of Medical Sciences (SUMS). The interviews' audio files changed into transcript after each session and data was saturated at the 19 interview. To increase the trustworthiness of the study, Guba and Lincoln's criteria including credibility, transferability, dependability, and confirmability were used. Goldsmith's five-step framework analysis was used applying MAX QDA version 10 software. Result: Eight main themes and 20 subthemes were explored. The main themes included "strengthening the electronic health infrastructure," "research for evidence-based decision making," "dedicated financing to the pandemic," "prevention of disruption in the effective provision of services and medicines," "enriching the authority of the Ministry of Health by focusing on interactions," "recruiting, managing and empowering health human resources with attention to financial and non-financial incentives," "reforming educational approaches in training students in medical universities," as well as "lessons learned from neglected aspects." Conclusion: To be ready to respond to a possible future pandemic and for a paradigm shift, bold steps must be taken to make fundamental changes in various aspects of the healthcare system including e-health development, evidence-based decision making, dedicated budgets for pandemics, reinforcement of interactions at the national and international level, as well as sufficient attention to healthcare workers from all financial, non-financial and educational aspects.

Virtual reality applications for rehabilitation of COVID-19 patients: A systematic review.

Background and Aims: The COVID-19 pandemic has changed people's lifestyles as well as the way healthcare services are delivered. Undoubtedly, the difficulties associated with COVID-19 infection and rehabilitation and those associated with quarantine and viral preventive efforts may exacerbate the need for virtual reality to be used as a part of a complete rehabilitation strategy for these individuals. Thus, the present research aimed to evaluate the potential uses of virtual reality for the rehabilitation of individuals suffering from COVID-19. Methods: From 2019 to March 1, 2022, a systematic search was conducted in PubMed, Cochran Library, Scopus, Science Direct, ProQuest, and Web of Science databases. The papers were selected based on search terms and those that discussed the use of virtual reality in the rehabilitation of COVID-19 patients were reviewed. Each step of the study was reviewed by two authors. Results: A total of 699 papers were found during the first search. Three papers were chosen for further investigation after a thorough evaluation of the publications' titles, abstracts, and full texts. Cross-sectional studies, randomized controlled clinical trials, and case reports comprised 33%, 33%, and 33% of the publications, respectively. Based on the results, people suffering from COVID-19 were the focus of two papers (66%) that employed immersion virtual reality for cognitive rehabilitation, whereas one study (33%) used non-immersive virtual reality for physical rehabilitation. In two papers (66%), virtual reality was also offered to patients in the form of a game. Conclusion: According to the results of the present research, virtual reality games may enhance functional and cognitive consequences, contentment levels among patients, and their ability to take charge of their own health care. In light of the obstacles faced by COVID-19 patients, alterations in the delivery of healthcare, and the significance of rehabilitation in this group during quarantine, new techniques have been considered for these patients to maintain treatment, return to regular life, and enhance their standard of life.

Investigating the Effect of Perceived Social Support on the Promotion of Earthquake-Related Awareness in Iranian High School Students.

INTRODUCTION AND OBJECTIVE: Students are one of the groups in society that are always exposed to earthquake-related hazards. Perceived social support plays a major role in students' self-efficacy to respond appropriately to earthquakes. Social support affects students' beliefs about their abilities and enhances their performance during earthquakes. Thus, the present study aimed to investigate the effect of perceived social support on the promotion of earthquake-related awareness amongst high school students. METHODS: The present educational intervention with a randomized control group was conducted on 64 high school students in Lordegan, Iran. The participants were randomly divided into an intervention and a control group. Earthquake-related awareness index and perceived social support were completed by the two groups before, immediately after, and two months after the intervention. The intervention group received 120-minute educational intervention sessions once a week for four weeks. The data were entered into the SPSS 20 software and were analyzed using descriptive and inferential statistical methods. RESULTS: According to the results, educational intervention was effective in improving the perceived social support. The results also showed that increasing the perceived social support significantly improved the earthquake-related awareness among the high school students in the intervention group compared to the control group after the intervention (P <.001). CONCLUSION: The findings revealed that perceived social support played a major role in promoting earthquake-related awareness in the high school students. Due to the accuracy of the study, these results can be considered in future investigations.

Application of Telerehabilitation for Older Adults During the COVID-19 Pandemic: A Systematic Review.

INTRODUCTION: The use of telerehabilitation in different disciplines, particularly in the rehabilitation of older adults, has grown significantly across the world. In the wake of the coronavirus disease 2919 (COVID-19) outbreak, a chance has arisen to improve the user experience and to draw attention to the advantages of using this service. The current research aimed to evaluate the investigations that used telerehabilitation to assist elderly people during the COVID-19 pandemic. METHODS: Systematic searches of papers published between September 1, 2019, and December 1, 2021, were conducted in PubMed, Cochrane Library, Web of Science, Scopus, Science Direct, and ProQuest databases. The author narrowed down the list of articles by using search terms. Ultimately, publications from the COVID-19 period were studied for their perspectives on the use of telerehabilitation among the elderly population. The whole process was supervised by 2 investigators at the same time. RESULTS: In total, 2529 articles were included in the first search. Five articles were chosen for further assessment based on the careful consideration of their titles, abstracts, and full texts. Cross-sectional, feasibility, case, and interventional studies comprised 20%, 20%, 20%, and 40% of the papers, respectively. The studies were carried out in Brazil, the United States, Germany, Japan, and South Korea and involved using telerehabilitation for elderly individuals, identification of crucial manifestations and impairments, improving physical function in this population, and ensuring their happiness. CONCLUSIONS: Using a digital strategy for rehabilitation should be regarded as a means of overcoming the field's obstacles. As a result, legislators and rehabilitation groups should consider the use of telerehabilitation for the elderly population during the COVID-19 pandemic.

Alternative Water Resources Selection to Supply Drinking Water in Flood Disasters by Multicriteria Decision-Making Techniques (DANP and VIKOR).

Background: Emergency is generally caused by natural disaster and infectious disease outbreaks, or it is man-made. Floods are natural phenomena that generally appear in multiple parts of the world. Flooding is one of the most destructive naturally occurring environmental hazards and can cause public, infrastructural, and environmental damage. The purpose of this study is to select alternative water resources for supplying Bandar Abbas in flood disasters by multicriteria decision-making techniques. Methods: Information required includes possible water resources alternative for flood, quantitative and qualitative characteristics of the water resources, climatic circumstances, and demographic information used in organizations data and previous studies. After selecting and proposing water resources alternative for Bandar Abbas in flood, the subcriteria were weighed applying DANP (DEMATEL-ANP) techniques and water resources were prioritized with the VIKOR technique. According to the network structure and internal and external dependence of the criteria and subcriteria, the advantages of DANP in calculating weights have been used to adapt to more real-world problems. The VIKOR technique was developed for multicriteria optimization of complex systems. Results: After reviewing and extracting the criteria from various studies, 9 main criteria and 44 subcriteria were defined to select water resources in disasters and emergencies. According to field studies and related organizations' information, the proposed water resources for Bandar Abbas to use in flood disasters include humidity, sea (Persian Gulf), Sarkhoon plain, and wastewater treatment plant of Bandar Abbas. Conclusion: Results showed that the optimal water resources for Bandar Abbas in flood disasters are the sea and wastewater treatment plant effluent (after advanced treatment). The study proposed appropriate model to select optimal water resources for various natural disasters in different geographical areas. This model can help officials and decision-makers to plan for drinking water supply from disaster-prone areas before disasters occur.

Investigating the Preparedness of Iranian Families in the Face of Disasters.

OBJECTIVE: Preparedness in different sections of a society can improve the reactions of individuals at the time of disasters and strengthen the cooperation and coordination between people and organizations. The present study aimed to investigate the preparedness of households in Ardabil Province of Iran in the face of disasters in 2020. METHODS: This descriptive, cross-sectional study was conducted in Ardabil Province in Iran in 2020. The target population included the households living in Ardabil Province. The study was conducted on 10 502 participants. The data were collected using a questionnaire completed by trained questioners by referring to the participants' houses. It should be noted that the questionnaires were completed by one of the household parents. The questionnaire contained 15 questions related to taking and not taking disaster preparedness measures at specific times. EXCEL 2016 (Microsoft, Redmond, WA) and SPSS 23 software (IBM Corp, Armonk, NY) were used for data analysis. RESULTS: Considering the score of 1 for each action, the mean score of households' disaster preparedness in Ardabil Province was 31.09%. The preparedness level of 51.4%, 42.31%, and 6.29% of the households in the province against disasters was at low, moderate, and good levels, respectively. Among the items of preparedness in the face of disasters, the highest value was related to the familiarity of family members with the initial warnings of significant hazards (5162 households, 49.15%) followed by planning for coping with disasters (43.12%) and assessing the non-structural vulnerability (38.93%). Furthermore, the results showed that the level of household preparedness was higher in the center of the province compared to other cities. CONCLUSION: Evaluating the level of preparedness of different societies in the face of disasters can be very useful in identifying the challenges to improve preparedness and, consequently, achieving sustainable development. This assessment can be considered a resource for provincial policy-making and planning to achieve the priorities set out in the Sendai framework. However, such assessments should be performed periodically, for example, annually, to reflect the effectiveness of the interventional measures in improving preparedness. Considering the low level of households' preparedness in the present study, there is a gap between what people know and what they do, and comprehensive studies are needed on various factors that encourage people to take preparedness measures.

Explaining factors affecting the participation of nongovernmental organizations (NGOs) in disaster management: A systematic review.

BACKGROUND AND OBJECTIVE: Numerous disasters have occurred over the recent years. Moreover, there has been a considerable rise in the number of victims, injured people, and damages caused by disasters worldwide. Governments cannot meet needs alone due to the complicated nature of crises and accidents. Therefore, nongovernmental organizations (NGOs) and communities must assist the states during disasters. The present study aimed to derive the factors affecting the participation of NGOs in disaster management using a systematic review in 2022. DESIGN: This systematic review was done using ISI, Science Direct, Scopus, PubMed/MEDLINE, ProQuest, and Cochran Library based on the preferred reporting items for systematic reviews (PRISMA) standard from January 1, 2000 to December 31, 2021. The articles were selected based on the search keywords (population, intervention, comparison, outcome (PICO)). After studying the titles, abstracts, and full texts of the articles, the factors affecting the participation of NGOs in disaster management were derived. RESULTS: The final assessment was done on 13 articles. Cooperation and coordination with other organizations, education, communication between NGOs, social empowerment, access to adequate references, and flexibility were the criteria with the highest frequency. CONCLUSION: As multiple NGOs take part in responding to disasters and performing relief operations, establishing a unified command and supervision system for effective coordination and collaborations among NGOs and other stakeholders is highly suggested. Further research is needed to develop a -measurement tool for assessing the effectiveness of NGOs' activities during disasters.