Prevalence and predictors of burnout among nurses during the COVID-19 pandemic: A survey in teaching hospitals.

BACKGROUND: Occupational burnout is one of the most important consequences of the coronavirus disease pandemic, associated with psychological well-being, quality of care, and intention to leave the nursing profession. This is a major health problem with serious adverse consequences not only for nurses but also for patients and healthcare systems. OBJECTIVE: To assess burnout and its associated factors in nurses who worked in teaching hospitals during the COVID-19 pandemic in Iran. METHODS: A cross-sectional study was conducted on nurses of two COVID-19 referral hospitals in Tehran, Iran. Data were collected using the sociodemographic form and Maslach burnout inventory-human service survey (MBI-HSS) questionnaire. Data were evaluated using SPSS software version 26. RESULTS: A total of 264 participants, 52.7% (n = 139) were males and the mean of them age was 34.41±9.71 years. Almost 50% of nurses experienced burnout, in each dimension. Emotional exhaustion was associated significantly with job retention intention (P = 0.01) and depersonalization was significantly associated with gender (P = 0.02), age (P = 0.01), educational level (P = 0.004), work shifts (P = 0.006), and job retention intention (P = 0.02). In addition, personal accomplishment score was significantly associated with age (P = 0.002), marital status (P = 0.03), educational level (P = 0.03), work shift (P = 0.04) and job retention intention (P = 0.01). CONCLUSION: The burnout rate in the COVID-19 era is high among nurses associated with improper care. Psychosocial support is needed to improve mental well-being among health care workers during unpredictable conditions like pandemics.

The Prevalence of Hypertension and Obesity in Iranian Professional Drivers.

Background: Professional driving is associated with overworking, lack of physical activity, and high stress, which are susceptible to cardiovascular diseases (CVDs). We aimed to determine the prevalence of hypertension and obesity in Iranian professional drivers. Methods: Overall, 132,452 drivers were included by census sampling methods and those who did not pass periodic examinations were excluded. Demographics and anthropometric data, including height and weight and the driver's blood pressure, were recorded. The criteria for hypertension assumed as the systolic blood pressure ≥ 130 mm and/or diastolic blood pressure ≥ 80 mm, and the criteria for prehypertension assumed as 120-129 systolic and < 80 mm Hg. In addition, body mass index (BMI) ≥ 25 is assumed as overweight, and BMI ≥ 30 is assumed as obesity. Results: Overall, 113,856 male drivers were included in the final analysis. The prevalence of HTN, pre-HTN, and abnormal blood pressure (HTN + pre-HTN) was calculated to be 14.2%, 57.4%, and 71.6%, respectively. Khuzestan, West Azerbaijan, and Yazd had the most prevalence of abnormal blood pressure. The prevalence of overweight, obesity, and abnormal weight (overweight + obesity) was calculated to be 50.9%, 22.6%, and 73.5%, respectively, and the northwest provinces had the highest prevalence of abnormal weight. Conclusion: Professional Iranian drivers have a high prevalence of abnormal blood pressure and weight associated with job-related risk factors. Preventive measures should be taken to confront a possible outbreak of CVDs in this population.

Health-promoting lifestyle and its determining factors among students of public and private universities in Iran.

BACKGROUND: Health-promoting lifestyle is one of the fundamental health-related components. The aim of this study was to determine the status of the health-promoting lifestyle and its determining factors among students of public and private medical universities. MATERIALS AND METHODS: In this cross-sectional study conducted in 2018, 1000 students from different public and private universities of medical sciences were selected by a multi-stage, stratified random sampling procedure and were studied using health-promoting lifestyle, self-efficacy, and well-being questionnaires. Data were analyzed using t-test, Chi-square, Pearson's correlation coefficient, and backward regression model. RESULTS: The health-promoting lifestyle was relatively acceptable in 775 people (77.5%); 649 (64.9%) had low self-efficacy, and 560 students (56%) had abnormal health conditions. The mean scores of health-promoting lifestyle, self-efficacy, and well-being in all students were 130.74 ± 22.14, 51.19 ± 12.66, and 15.22 ± 5.43, respectively. There were statistically significant differences between the mean scores of most aspects of health-promoting lifestyle, self-efficacy, and well-being in public and private universities. There was a statistically significant relationship between well-being (r = 0.08, P = 0.02) and self-efficacy (r = -0.19, P < 0.001) with health-promoting lifestyle. CONCLUSION: Students' well-being, self-efficacy, and physical activities of students were not at an acceptable level. Moreover, the health-promoting lifestyle of students was moderate. Implementing of health-related educational, developmental, and psycho-social programs for promotion and encouraging students to promote healthy behaviors is necessary.

The effects of functional foods mixture on inflammatory cytokines and biochemical findings in hospitalized patients with COVID-19: a randomized double-blind controlled trial.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has been shown to affect nutritional recommendations. Some functional foods have been demonstrated to be useful in the treatment of people with COVID-19. However, little is known about the impact of combining functional foods on disease control. This study aimed to investigate the effects of functional foods mixture on serum levels of inflammatory cytokines and biochemical findings in patients with COVID-19. METHODS: A randomized double-blind controlled trial was conducted in Baqiyatallah Al-Azam hospital in Tehran, Iran. Sixty patients were randomly assigned to receive either a soup containing functional foods (n = 30) or a usual soup (control group) (n = 30). Participants' sociodemographic information was gathered using a general questionnaire. Blood levels of inflammatory markers and biochemical findings were assessed using standard protocols. RESULTS: The results showed that soup containing functional foods was more effective in controlling serum levels of D-dimer, blood urea nitrogen, and creatinine than the control group (P < 0.05). Also, more significant improvement was found in the intervention group vs control group in terms of interleukin (IL)-1ß, IL-6, IL-17, IL-10, and tumor necrose factor-α (P < 0.05). In contrast, the control intervention more efficiently controlled potassium levels and reduced quantitative C-reactive protein than the intervention group (P < 0.05). CONCLUSIONS: This study indicates a soup containing functional foods could alleviate biomarkers of inflammation in patients with COVID-19. However, its effectiveness on biochemical findings remained inconclusive which warranted further research. TRIAL REGISTRATION: IRCT, IRCT20180201038585N11. Registered 23 August 2021, https://www.irct.ir/trial/57338.

An Intervention Program Using the Health Belief Model to Modify Lifestyle in Coronary Heart Disease: Randomized Controlled Trial.

BACKGROUND: Most effective interventions to control coronary heart disease (CHD) and prevent negative outcomes involve behavioral modification. This study examined how such modification based on the Health Belief Model (HBM) might improve lifestyle and clinical outcomes. METHODS: A total of 120 people with CHD seeking help at a general hospital in Iran were randomly assigned to either the intervention or control group. Information was collected using an HBM-specific questionnaire and the Health Promoting Lifestyle II (HPLP-II) scale. Clinical outcomes (blood pressure, body mass index, and fasting blood sugar) were also measured. The intervention group received a tailored education based on HBM principles plus routine care, while those in the control group received only routine care. Three months after the intervention, both groups were reassessed using Student's t test and analysis of covariance. RESULTS: All HBM subscale scores indicated significant improvements in the intervention group, in contrast to the control group, where scores worsened or stayed the same. Perceived severity and susceptibility were the dimensions that changed most. Total score on the HPLP-II improved significantly in the intervention group (p < 0.001, F = 747.5); however, subscale scores on spiritual growth and interpersonal relationships did not demonstrate significant between-group differences at follow-up. After adjustment for baseline scores, significant improvements in lifestyle subscales were also accompanied by significant improvements in clinical measures. CONCLUSIONS: This HBM-based behavior modification program improved both lifestyle and clinical measures in patients with CHD. Utilizing this program in patients with other cardiovascular diseases may in the future demonstrate similar results.

The effect of a topical formulation from Lawsonia inermis L. (henna) on pain intensity in patients with chronic sciatica: A randomized double-blind clinical trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Chronic sciatica (CS) is a common condition of disability and pain. Lawsonia inermis L. (henna) is a medicinal plant that is commonly recommended in traditional Persian medicine textbooks for pain relief in patients with sciatica, particularly in the form of oil. AIM OF THE STUDY: This research was designed to investigate the efficacy of a topical formulation from henna on pain intensity in patients with CS. METHODS AND MATERIALS: In a randomized, double-blind clinical study, 81 patients were randomly allocated to three groups to receive the topical henna formulation (aqueous extract of henna in sesame oil), sesame oil, or placebo, three times daily, for four weeks. The patients were assessed by visual analog scale (VAS), 36-item short form health survey (SF-36), and Oswestry disability index (ODI). RESULTS: There was a significant decrease in mean VAS in henna oil compared to sesame oil (p = 0.004) and placebo (p = 0.004). Significant improvements in total SF-36 scores were observed in henna oil and sesame oil compared to placebo (p = 0.011 and p = 0.025, respectively). Furthermore, ODI significantly decreased in henna oil compared to sesame oil (p < 0.001) and placebo (p = 0.005). CONCLUSION: Henna oil seems to be an effective treatment to reduce pain intensity in patients with CS. Moreover, it improves quality of life and functional ability. Further randomized controlled trials with longer intervention periods are recommended to confirm this efficacy.

Cell therapy procedure using anti-inflammatory macrophage M2 can potentially reduce Clinical Score in animals with Experimental Autoimmune Encephalomyelitis: A preclinical systematic review and meta-analysis study.

Macrophage M2 (MP2)-based cell therapy is a novel medicinal treatment for animals with Experimental Autoimmune Encephalomyelitis (EAE) as an experimental model of multiple sclerosis (MS). This systematic review and meta-analysis study was designed to assess the overall therapeutic effects of MP2 cell therapy on Clinical Score and motor impairment in EAE-induced animals. All experiments on MP2 cell therapy in animals with EAE were gathered (by October 2, 2022) from English (PubMed, Scopus, WoS, Science Direct, and ISC) and Persian (MagIran and SID) databases. The searching strategy was designed using "Experimental Autoimmune Encephalomyelitis," "Multiple Sclerosis," and "Macrophage M2" keywords. Following primary and secondary screenings, eligible papers were selected based on the PRISMA 2020 guideline, and the study quality was assessed using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) checklist. The difference in means of Clinical Score (score 0-5) as the effect size (ES) was analyzed based on the random effect model (CMA software, v.2). Subgrouping (EAE phases of Onset, Peak, and Recovery) was applied, and I2 index was used to assess the heterogeneity index. Publication bias and sensitivity indices were also evaluated. P < 0.05 was considered significant, and the confidence interval (CI) was determined 95%. Among 22 gathered papers, medium to high quality studies were selected for meta-analysis. Difference in means, P value, and I2 for Onset, Peak, and Recovery phases were 0.082 (CI95%: -0.323-0.159, P value: 0.504, I2 : 67.961%), -0.606 (CI95%: -1.518 to -0.305, P value: 0.192, I2 : 96.070%), and -1.103 (CI95%: -1.390 to -0.816, P value: 0.000, I2 : 30.880%), respectively and Overall Effect was found -0.509 (CI95%: -0.689 to -0.328, P value < 0.001). Also, P value (two-tailed) indices for publication bias were 0.366 and 0.583 for Egger's regression intercept and Begg rank correlation, respectively. The P value for sensitivity was detected 0.003. Cell therapy procedure using MP2 can potentially alleviate the Clinical Scores Index and correct the motor defects in Recovery phase of EAE animals. In healthy mice, the brain and myelin surrounding neurons are in a healthy and physiological state (1). To evaluate MS in humans, it is necessary to model this type of disease in animals using EAE procedure through subcutaneous injection of CFA, MOG35-55 , MT, and Pert. Thus, inflammation and autoimmunity occur, which finally lead to myelin destruction and motor symptoms (2). By aspiration of progenitor cells available in bone marrow, the MP2 can be isolated and cultured. By activation of these types of cells, a rich collection of MP2 can be prepared for the cell-therapy process (3). After injection through the tail vein or intra-peritoneal procedure, these cells can be located in CNS through crossing from the BBB. They begin their anti-inflammatory activities and help repair the damaged myelin (4). Eventually, the clinical symptoms can be modified considerably, and the animal motor function improves (5). CFA, complete Freund's adjuvant; MOG35-55 , myelin oligodendrocyte glycoprotein; MT, Mycobacterium tuberculosis; Pert, pertussis; EAE, Experimental Autoimmune Encephalomyelitis; BM, bone marrow; MP2, macrophage M2; and BBB, blood brain barrier.

Ionizing Radiation Promotes Epithelial-Mesenchymal Transition Phenotype and Stem Cell Marker in The Lung adenocarcinoma: In Vitro and Bioinformatic Studiesc.

OBJECTIVE: Ionizing radiation (IR) is one of the major therapeutic approaches in the non-small cell lung cancer (NSCLC); however, it can paradoxically result in cancer progression likely through promoting epithelial-mesenchymal transition (EMT) and the cancer stem cell phenotype. Therefore, we aimed to determine whether IR promote EMT/CSC and to investigate the clinical relevance of EMT/CSC hallmark genes. MATERIALS AND METHODS: In this experimental and bioinformatic study, A549 cell line was irradiated with a high dosage (6 Gy) or a fractionated regimen (2 Gy/day for 15 fractions). The EMT-related features, including cellular morphology, migratory and invasive capacities were evaluated using scratch assay and transwell migration/invasion assays. The mRNA levels of EMT-related genes (CDH1, CDH2, SNAI1 and TWIST1), stemness-related markers (CD44, PROM1, and ALDH1A1) and the CDH2/CDH1 ratio were evaluated via real-time polymerase chain reaction (PCR). The clinical significance of these genes was assessed in the lung adenocarcinoma (LUAD) samples using online databases. RESULTS: Irradiation resulted in a dramatic elongation of cell shape and enhanced invasion and migration capabilities. These EMT-like alterations were accompanied with enhanced levels of SNAI1, CDH2, TWIST1, CD44, PROM1, and ALDH1A1 as well as an enhanced CDH2/CDH1 ratio. TCGA analysis revealed that, TWIST1, CDH1, PROM1 and CDH2 were upregulated; whereas, CD44, SNAI1 and ALDH1A1 were downregulated. Additionally, correlations between SNAI1-TWIST1, CDH2- TWIST1, CDH2-SNAI1, and ALDH1A1-PROM1 was positive. Kaplan-Meier survival analysis identified lower expression of CDH1, PROM1 and ALDH1A1 and increased expression of CDH2, SNAI1, and TWIST1 as well as CDH2/CDH1 ratio predict overall survival. Additionally, downregulation of ALDH1A1 and upregulation of CDH2, SNAI1 and CTWIST1 could predict a shorter first progression. CONCLUSION: Altogether, these findings demonstrated that IR promotes EMT phenotype and stem cell markers in A549 cell line and these genes could function as diagnostic or prognostic indicators in LUAD samples.

Effectiveness of Family-Centered Empowerment Model on Psychological Improvement of Patients With Myocardial Infarction: A Bayesian Multivariate Approach.

Objective: There is a limited understanding of the impact of the family-centered empowerment model (FCEM) on the psychological symptoms in post-myocardial infarction (MI). This study aimed to evaluate the effectiveness of the FCEM on the psychological improvement of patients with MI. Methods: The present study was a randomized controlled trial (RCT) where patients experienced a standard home cardiac rehabilitation (CR) or CR utilizing the FCEM approach. The empowerment of patients was estimated during nine assessments, such as pre- and post-intervention. Factors, such as quality of life (QoL), state and trait anxiety, and perceived stress, were evaluated. A Bayesian multivariate mixed-effects model was used to simultaneously investigate the effect of the intervention group on study outcomes across the time. Results: Among all the participants in this study, 24 (34.3%) were women with a total mean ± standard deviation (SD) of 61.40 ± 12.83 and 24.87 ± 3.80 for age and body mass index (BMI). The participants who were in the FCEM group had a significantly higher mean level of perceived stress (ß = 28.80), state anxiety (ß = 16.20), trait anxiety (ß = 3.65), physical (ß = 38.54), and mental QoL (ß = 42.14). Moreover, the individuals in the FCEM group had a significantly higher mean level of general health (ß = 31.64) in the physical dimension of QoL, vitality (ß = 15.04), mental role limitation (ß = 21.84), and mental health (ß = 18.16) in the mental dimension of QoL. Conclusions: The FCEM can be a valuable treatment mechanism for patients with post-MI to improve their stress, anxiety, and QoL.

Epidemiological Study of Lung Cancer in Iran: A Systematic Review.

Background: There is no comprehensive study addressing all the epidemiological aspects of Lung cancer (LC) in Iran, therefore this systematic review investigated the epidemiological aspects of lung cancer in Iran. Methods: The search was performed until the Aug. 2020 on the in international databases based on PRISMA protocol by Pulmonary Neoplasms, Lung Neoplasm, Neoplasm, Lung, Lung Cancer, Cancer, Pulmonary Cancer, Cancer, Pulmonary, Cancers, Cancer of the Lung, Iran, incidence, death, risk factors keywords and different combinations of them. Articles that evaluated epidemiological aspects of lung cancer were included in the analysis. Results: Of 1420 articles, 82 cases were entered the analysis. Based on studies, in Iran, lung cancer has been the most common cancer and its prevalence is increasing. Squamous cell carcinoma and adenocarcinoma is the most common type of lung cancer in men and women, respectively. Cigarette smoking, human papilloma virus (HPV) infection, mustard gas, occupational risk factors and genetic factors considered as the major reported risk factors for lung cancer and vegetarian diet as a protective factor. Conclusion: In according to the increasing trend of incidence and mortality of lung cancer in Iran, elimination of the major risk factors can decrease this issue and national comprehensive planning should be considered in health promotion plans.

Association Between Dimensions of Professional Burnout and Turnover Intention Among Nurses Working in Hospitals During Coronavirus Disease (COVID-19) Pandemic in Iran Based on Structural Model.

Purpose: This study was done to assess the dimensions of professional burnout and turnover intention among nurses working in hospitals during the coronavirus disease 2019 (COVID-19) pandemic in Iran based on a structural model. Methods: This cross-sectional study was performed among 170 nurses working in two referral hospitals of COVID-19 in Tehran Province, Iran, from September to December 2020. Data were collected using the sociodemographic form, Maslach Burnout Inventory (MBI), and Turnover Intention Questionnaire. Data were analyzed with SPSS and Amos software version 22 using independent t-test, ANOVA, and structural equation model. Results: The mean scores for burnout in emotional fatigue, depersonalization, and personal accomplishment dimensions were 25.38 ± 7.55, 9.47 ± 4.40, and 34.94 ± 7.80, respectively, moreover for the turnover intention, the score was 6.51 ± 3.17. The reduced personal accomplishment was identified as a positive predictor of turnover intention (p = 0.01). Work position and interest in attending the organization were significantly correlated with the turnover intention (p < 0.05). Conclusions: There is an immediate need to prepare nurses to cope better with the COVID-19 outbreak. Work-related stressors during the COVID-19 pandemic have led to an increase in nurses' burnout and turnover intention. Identifying and managing the factors related to professional burnout will make it possible to prevent the nurses' turnover intention in such critical situations.

Spatial patterning of occupational stress and its related factors in Iranian critical care nurses using a hierarchical Bayesian technique.

BACKGROUND: In each community, health problems' patterns and geographical changes are of prime importance to determine high and low-risk areas. OBJECTIVES: This study aimed to investigate the Spatial patterning of occupational stress and its related factors in Iranian critical care nurses using a hierarchical Bayesian techniqueMETHODS:The current research was a cross-sectional descriptive-analytical study. The data includes the number of critical care unit nurses who show a high stress level based on a questionnaire. We used variables such as age, gender, collaboration status, working time, marital status, clinical experience, education, supervisor support, stress score, and working on holiday days for this study. The survey participants had to be at least 18 years old, a registered nurse, and working in the intensive care unit (ICU). OpenBUGS version 3.2.3 was used to implement the Bayesian hierarchical Poisson model and find partial patterning of occupational stress and its related factors. RESULTS: The final sample size was 17414 nurses. The overall prevalence of occupational stress in ICU nurses was estimated at 70%. The lowest and highest prevalence was 65.8% in the North Khorasan province and 75.2% in Golestan province. Occupational stress had a statistically significant association with collaboration status, but with demographic variables, shift work, supportive supervisor, and working on holidays had no statistically significant association. CONCLUSIONS: According to the findings, it is necessary to eliminate or reduce job stress and increase efficiency in Iranian nurses, encourage teamwork and collaboration as an essential element of a healthy workplace environment.

The effects of neck, core, and combined stabilization practices on pain, disability, and improvement of the neck range of motion in elderly with chronic non-specific neck pain.

BACKGROUND: Chronic non-specific neck pain is the most prevalent neck pain with notable impacts on the quality of life in the elderly. OBJECTIVE: The impacts of the neck, core, and combined stabilization practices on pain, disability, and improvement of the neck range of motion in the elderly with chronic non-specific neck pain were examined. METHOD: A quasi-experimental (open label) study was carried out through a cluster sampling in two phases in Tehran-Iran in 2017. Totally, 102 patients were randomly allocated to three groups of specific neck stabilization, specific core stabilization, and combined practices through envelope method. The intervention took 12 weeks. To measure the severity of pain and neck disability, the visual analog scale (VAS), neck disability index (NDI), and neck pain and disability scale (NPDS) was used. A goniometer was used to measure the range of the motion. To examine data, used SPSS (v.20). RESULT: The results, confirmed a significant decrease in pain over the time in the three therapeutic groups (p = 0.000). In addition, there was a significant difference between neck, core, and combined stabilization groups. Moreover, there was a significant increase in the angle of motion in all treatment groups with different treatment duration (P = 0.000). The highest increase in the angle of motion was after 12 weeks of practice in right lateral flexion (RLF) (p = 0.000). CONCLUSION: Twelve sessions of the neck, core, and combined stabilization practices can alleviate the pain and improve the strength in the elderly with chronic non-specific neck pain. In addition, compared to two other methods, the combined method was a more efficient way to improve the range of motion in patients.

Development of modified rapid entire body assessment (MOREBA) method for predicting the risk of musculoskeletal disorders in the workplaces.

BACKGROUND: Rapid Entire Body Assessment (REBA) technique is one of the tools developed for predicting the risk of musculoskeletal disorders based on the effective risk factors. This method has several limitations. The present study was aimed to develop the Modified Rapid Entire Body Assessment (MOREBA) method to more accurately predict the risk of musculoskeletal disorders. MATERIALS: This cross-sectional study was performed on 300 male workers of a steel factory with a variety of job tasks in Iran. Then, the information related to the various physical risk factors was extracted through observation of their duties and conversation with them. Also, the subjects were asked to complete the Persian version of Cornell musculoskeletal discomfort questionnaires (CMDQ). Then, a theoretical model was drawn in AMOS software. Computed coefficients were used to develop the MOREBA equation. In the end, the final scores were categorized by ROC curves, and the validation of the novel method was investigated using linear regression analysis. RESULTS: The parameters evaluated in the MOREBA method included contact stress, rapid and sudden movement, throwing motion, hand-arm vibration, whole-body vibration, temperature, and work-rest cycle in addition to the parameters of the REBA method, including awkward posture, coupling, force, load, static activity, and repetitive activity. The results showed that the strain produced by the physical risk factors with the total effect coefficient of 0.783 could significantly affect the musculoskeletal symptoms. The computed coefficients of the risk factors were applied to develop a novel index. The final score of the MOREBA method was categorized into four levels by optimal cut-off points of 12.37, 16.51, and 24.35. Based on the results, the MOREBA and REBA methods could justify 67 and 55% of the variations of musculoskeletal symptoms, respectively. CONCLUSIONS: The results revealed that modifications conducted in the REBA method were effective, and the MOREBA method can provide a more accurate prediction of the risk of musculoskeletal disorders.

The impact of education through nurse-led telephone follow-up (telenursing) on the quality of life of COVID-19 patients.

BACKGROUND: The widespread prevalence of COVID-19 has disrupted the social life, physical function, and daily activities of patients, leading to reduced quality of their lives. Because of the nature of this disease and its comprehensive impact on patients' lives, a follow-up based on the conditions of these patients is necessary. This study was conducted to determine the impact of nurse education and telephone follow-up (telenursing) on the quality of life of COVID-19 patients. METHODS: This quasi-experimental study included 120 COVID-19 patients discharged from 22nd-Bahman Hospital in Khaf city and was conducted over 6 months from July 20, 2020, to December 20, 2020. The participants were selected by convenience sampling method and were assigned into two matching groups. The training was delivered through telenursing based on the quality of life criteria for 1 month in the intervention group. The controls did not receive any intervention. Both groups completed the 36-item SF health survey before and 1 month after the intervention. RESULTS: The two groups were not significantly different regarding the quality of life mean scores at baseline (p = 0.61). However, after the intervention, the mean and standard deviation of the total life quality score was significantly different between the control and intervention groups (63.62 ± 3.93 versus 72.62 ± 3.51, p <0.001). CONCLUSIONS: Telenursing improves the life quality of COVID-19 patients. Through appropriate policies, health managers may put on the agenda the implementation of telenursing for COVID-19 patients.

Hyaluronic acid-based nanoplatforms for Doxorubicin: A review of stimuli-responsive carriers, co-delivery and resistance suppression.

An important motivation for the use of nanomaterials and nanoarchitectures in cancer therapy emanates from the widespread emergence of drug resistance. Although doxorubicin (DOX) induces cell cycle arrest and DNA damage by suppressing topoisomerase activity, resistance to DOX has severely restricted its anti-cancer potential. Hyaluronic acid (HA) has been extensively utilized for synthesizing nanoparticles as it interacts with CD44 expressed on the surface of cancer cells. Cancer cells can take up HA-modified nanoparticles through receptor-mediated endocytosis. Various types of nanostructures such as carbon nanomaterials, lipid nanoparticles and polymeric nanocarriers have been modified with HA to enhance the delivery of DOX to cancer cells. Hyaluronic acid-based advanced materials provide a platform for the co-delivery of genes and drugs along with DOX to enhance the efficacy of anti-cancer therapy and overcome chemoresistance. In the present review, the potential methods and application of HA-modified nanostructures for DOX delivery in anti-cancer therapy are discussed.

Training needs assessment of intensive care nurses in Zabol University of Medical Sciences' Hospitals.

BACKGROUND: The improvement of the knowledge, skill, and attitude of nurses working at the intensive care unit (ICU) through implementing training need assessment and holding continuous in-service training courses are of main requisites for providing better health services to the community. Based on this, in the present work, we are looking for the identification and prioritization of the training need of intensive care nurses in the Zabol University of Medical Sciences' hospitals. MATERIALS AND METHODS: As a cross-sectional, descriptive study, including two phases of identification and prioritization of training needs of ICU nurses, it was conducted by a close-ended researcher-made questionnaire for collecting the data on training needs from the viewpoint nursing officials, supervisors, and head nurses of the ICU wards in the first phase and a multiple-choice scientific test plus a checklist for measuring the knowledge and skill of the nurses in the ICU in the second phase. In both phases, census method was used for collecting the data. The validity and reliability of data-gathering tools, mentioned above, were tested and verified before gathering data. Data were analyzed with the descriptive statistics. RESULTS: The results indicated that ventilator setting according to arterial blood gas sampling and interpretation (77.81), cardiac monitoring, detecting dysrhythmia and taking immediate intervention (73.04), ventilator setting according to patient's respiratory status (68.61), airway management, oxygenation and intubation (64.39), and adults cardiopulmonary resuscitation (61.77) were the high-priority training needs of the nurses successively. CONCLUSION: To improve the quality of training programs and upgrading the knowledge, skill, and attitude of nurses working at ICU, the significance and the weight of each training titles should be determined according to the standards and the continuous in-service training plan along with nurses' training needs and duties.

The risk factors and related hospitalizations for cases with positive and negative COVID-19 tests: A case-control study.

BACKGROUND: The aim of this study was to evaluate the risk factors for hospitalizations of cases with positive and negative COVID-19 tests. METHODS: In this case-control study, the case and control groups consisted of 292 COVID-19 patients and 296 non-COVID-19 patients. Patients who referred to a reference laboratory in Tehran (Iran) in March 2020 were selected and interviewed. The patients were contacted by telephone and data were recorded through a questionnaire. RESULTS: The sample of this study consisted of 588 patients (349 [59%] females, 239 [41%] males) with a mean age of 42 ± 15. The results of this study showed that comorbidities like diabetes (OR = 7.42), hypertension (OR = 4.85), asthma and respiratory diseases (OR = 5.64) in addition to symptoms including fever (OR = 6.67), chills (OR = 11.2), anorexia (OR = 11.3), dyspnea (OR = 4.8), weakness and lethargy (OR = 5.7) were the most predictive variables for hospitalization of non-COVID-19 cases. Furthermore, demographical variables like male gender (OR = 3.71), high age (>50; OR = 3.12), BMI (>25; OR = 2.37), travel (OR = 2.79), comorbidities including diabetes (OR = 5.26), hypertension (OR = 3.7) and underlying immunosuppressant patients receiving corticosteroid therapy (OR = 3.62) in addition to symptoms like anorexia [OR = 2.55] and dyspnea (OR = 6.99) tend to increase the risk of hospital admission in COVID-19 patients, suggesting their predictive values for hospitalization of COVID-19 patients. CONCLUSION: Our results indicated that different factors tend to increase the odds of hospital admission in patients with positive and negative COVID-19 tests, suggesting their predictive values for hospitalization.

Therapeutic potential of AMPK signaling targeting in lung cancer: Advances, challenges and future prospects.

Lung cancer (LC) is a leading cause of death worldwide with high mortality and morbidity. A wide variety of risk factors are considered for LC development such as smoking, air pollution and family history. It appears that genetic and epigenetic factors are also potential players in LC development and progression. AMP-activated protein kinase (AMPK) is a signaling pathway with vital function in inducing energy balance and homeostasis. An increase in AMP:ATP and ADP:ATP ratio leads to activation of AMPK signaling by upstream mediators such as LKB1 and CamKK. Dysregulation of AMPK signaling is a common finding in different cancers, particularly LC. AMPK activation can significantly enhance LC metastasis via EMT induction. Upstream mediators such as PLAG1, IMPAD1, and TUFM can regulate AMPK-mediated metastasis. AMPK activation can promote proliferation and survival of LC cells via glycolysis induction. In suppressing LC progression, anti-tumor compounds including metformin, ginsenosides, casticin and duloxetine dually induce/inhibit AMPK signaling. This is due to double-edged sword role of AMPK signaling in LC cells. Furthermore, AMPK signaling can regulate response of LC cells to chemotherapy and radiotherapy that are discussed in the current review.

Analyses and anticipating the future trend of accidents in an electricity distribution company of Iran: A time series analysis.

BACKGROUND: Many work-related fatalities happen every year in electricity distribution companies. This study was conducted to model accidents using the time series analysis and survey descriptive factors of injuries in an electricity distribution company in Tehran, Iran. METHODS: Data related to 2010 to 2017 were collected from the database of the safety department. Time series and trend analysis were used for data analyzing and anticipating the accidents up to 2022. RESULT: Most of the accidents occurred in summer. Workers' negligence was the reason for 75% of deaths. Employment type and type of injuries had a significant relationship (p <  0.05). CONCLUSION: The anticipating model indicated occupational injuries are going to have an increase in the future. A high rate of accidents in summer maybe because of the warm weather or insufficient skills in temporary workers. Temporary workers have no chance to work in a year like permanent workers, therefore acquisition experiences may be less in them. Based on the estimating model, management should pay attention to those sectors of the company where most of the risky activities take place. Also, training programs and using personal protective equipment can help to protect workers in hazardous conditions.