Components of hospital personnel preparedness to evacuate patients in disasters: a systematic review.

BACKGROUND: During natural catastrophes, hospital staff members' readiness for crisis management-particularly concerning patient evacuation and improving their safety-becomes paramount. This study aimed to identify the components contributing to hospital staff members' preparedness to evacuate patients in an emergency. METHOD: A systematic review was conducted by searching databases such as Scopus, Web of Science, PubMed, ProQuest, and grey literature through May 2023. Studies that offered unique qualitative or quantitative data regarding hospital personnel readiness to evacuate patients in an emergency were included. Thematic analysis and descriptive statistics were used to examine the extracted data points. RESULTS: In total, there were 274 scientific articles. The total number of unique studies decreased to 181 after removing duplicate articles. 28 papers that were deemed appropriate for additional study were found based on the titles and abstracts of these articles. Eighteen papers that met the inclusion criteria were selected for the systematic review after their entire texts were finally assessed. Hospital staff preparedness for patient evacuation was divided into four primary topics and nineteen sub-themes. The four primary themes that emerged were management, communication, individual issues, and training on the evacuation process. CONCLUSION: The implementation of proper disaster evacuation training programs can be achieved by elevating the perceived sensitivity and protective motive of personnel and considering the personnel's stages of change. Training hospital staff to properly evacuate patients during disasters is also significantly impacted by other factors, such as effective administration, leadership and prompt and efficient communication.

A comparative investigation of machine learning algorithms for predicting safety signs comprehension based on socio-demographic factors and cognitive sign features.

This study examines whether the socio-demographic factors and cognitive sign features can be used for envisaging safety signs comprehensibility using predictive machine learning (ML) techniques. This study will determine the role of different machine learning components such as feature selection and classification to determine suitable factors for safety construction signs comprehensibility. A total of 2310 participants were requested to guess the meaning of 20 construction safety signs (four items for each of the mandatory, prohibition, emergency, warning, and firefighting signs) using the open-ended method. Moreover, the participants were asked to rate the cognitive design features of each sign in terms of familiarity, concreteness, simplicity, meaningfulness, and semantic closeness on a 0-100 rating scale. Subsequently, all eight features (age, experience, education level, familiarity, concreteness, meaningfulness, semantic closeness, and simplicity) were used for classification. Furthermore, the 14 most popular supervised classifiers were implemented and evaluated for safety sign comprehensibility prediction using these eight features. Also, filter and wrapper methods were used as feature selection techniques. Results of feature selection techniques indicate that among the eight features considered in this study, familiarity, simplicity, and meaningfulness are found to be the most relevant and effective components in predicting the comprehensibility of selected safety signs. Further, when these three features are used for classification, the K-NN classifier achieves the highest classification accuracy of 94.369% followed by medium Gaussian SVM which achieves a classification accuracy of 76.075% under hold-out data division protocol. The machine learning (ML) technique was adopted as a promising approach to addressing the issue of comprehensibility, especially in terms of determining factors affecting the safety signs' comprehension. The cognitive sign features of familiarity, simplicity, and meaningfulness can provide useful information in terms of designing user-friendly safety signs.

Neuroprotective potential of trimetazidine against tramadol-induced neurotoxicity: role of PI3K/Akt/mTOR signaling pathways.

Tramadol (TRA) causes neurotoxicity whereas trimetazidine (TMZ) is neuroprotective. The potential involvement of the PI3K/Akt/mTOR signaling pathway in the neuroprotection of TMZ against TRA-induced neurotoxicity was evaluated. Seventy male Wistar rats were divided into groups. Groups 1 and 2 received saline or TRA (50 mg/kg). Groups 3, 4, and 5 received TRA (50 mg/kg) and TMZ (40, 80, or 160 mg/kg) for 14 days. Group 6 received TMZ (160 mg/kg). Hippocampal neurodegenerative, mitochondrial quadruple complex enzymes, phosphatidylinositol-3-kinases (PI3Ks)/protein kinase B levels, oxidative stress, inflammatory, apoptosis, autophagy, and histopathology were evaluated. TMZ decreased anxiety and depressive-like behavior induced by TRA. TMZ in tramadol-treated animals inhibited lipid peroxidation, GSSG, TNF-α, and IL-1ß while increasing GSH, SOD, GPx, GR, and mitochondrial quadruple complex enzymes in the hippocampus. TRA inhibited Glial fibrillary acidic protein expression and increased pyruvate dehydrogenase levels. TMZ reduced these changes. TRA decreased the level of JNK and increased Beclin-1 and Bax. TMZ decreased phosphorylated Bcl-2 while increasing the unphosphorylated form in tramadol-treated rats. TMZ activated phosphorylated PI3Ks, Akt, and mTOR proteins. TMZ inhibited tramadol-induced neurotoxicity by modulating the PI3K/Akt/mTOR signaling pathways and its downstream inflammatory, apoptosis, and autophagy-related cascades.

A survey on road hazardous material transportation accidents in Iran.

Hazardous material road transportation is one of the most challenging procedures performed by large trucks and trailers. In this study, after examining and analyzing road hazardous material transportation accidents, occurred over 5 years in Iran, the contributing factors of road hazardous material transportation accidents were determined. Subsequently, the introduced factors were prioritized using fault tree analysis and the Dempster-Shafer evidence theory. The results revealed that the frequency of accidents has significantly increased in recent years. It is shown that the three pivotal factors in road hazardous material transportation accidents were transport vehicle, packaging and loading of hazardous materials, and human factors. These findings provide an empirically supported theoretical basis for transportation corporations to take corrective and preventative measures to reduce the accident risks. A novel technique has been introduced for analyzing the causes of road hazardous material transportation accidents. Finally, the absence of hazardous material transportation companies in Iran is introduced as a critical reason for the higher frequency of such accidents in Iran compared to other countries.

Effects of traffic sign design and personal characteristics on the usability of traffic signs.

BACKGROUND: Previous researchers examined the effects of either drivers' personal characteristics or traffic sign design features on the usability of traffic signs. Their research indicated a connection existed between personal characteristics and usability and between design features and usability. OBJECTIVES: The focus of this study was to investigate which personal characteristics of drivers and which features of traffic sign design affect traffic sign usability the most. METHODS: The study was conducted in three stages. In the first stage, the participants filled out a questionnaire designed to record each driver's personal characteristics. In the second stage, a System Usability Scale (SUS) was used to evaluate the subjective usability of traffic signs. The SUS had 10 statements that participants (N = 386) scored on a 5-point Likert-type scale from strongly agree to strongly disagree. In the third stage, these participants assigned from 0 to 100 points to 20 signs based on participant perception of the five design features of familiarity, concreteness, simplicity, meaningfulness, and semantic distance. RESULTS: The results showed that four of the five personal characteristics studied (age, education level, possession of a driving license, and formal driving experience) correlated significantly with traffic sign usability. The exception was gender, which did not correlate significantly. Additionally, it was found that the five traffic sign design features correlated in varying degrees of significance with each other and with specific traffic signs. CONCLUSIONS: Traffic sign usability depends mostly both on driver education level and age group and on the design feature of meaningfulness. These findings have implications for how drivers should be trained and how signs should be designed.

Traffic climate, driver behaviour and dangerous driving among taxi drivers.

Traffic accidents are considered a major public health problem in many countries. The aim of this study was to explore the relationships between traffic climate factors (i.e., external affective demands, functionality and internal requirements), driver behaviours, dangerous driving behaviours and traffic accident involvement among taxi drivers. A total of 450 male taxi drivers participated in the study. The traffic climate scale (TCS), the driver behaviour questionnaire (DBQ), the positive driver behaviours scale (PDBS) and the Dula dangerous driving index (DDDI) were used to measure driving behaviours and traffic conditions. The results showed that there was a significant negative correlation between functionality (of the TCS) and the number of accident involvement. Further analysis demonstrated that the effect of risky driving (of the DDDI) on accident involvement was significant. Taken together, these findings suggest that functional traffic systems and driving environments play important roles in traffic accident involvement.

Curcumin Can be Acts as Effective agent for Prevent or Treatment of Alcohol-induced Toxicity in Hepatocytes: An Illustrated Mechanistic Review.

Previous studies have shown that alcohol abuse can cause serious liver damage and cirrhosis. The main pathway for these types of hepatocellular cell neurodegeneration is mitochondrial dysfunction, which causes lipid peroxidation and dysfunction of the glutathione ring and the defect of antioxidant enzymes in alcoholic hepatic cells. Alcohol can also initiate malicious inflammatory pathways and trigger the initiation and activation of intestinal and extrinsic apoptosis pathways in hepatocellular tissues that lead to cirrhosis. Previous studies have shown that curcumin may inhibit lipid peroxidation, glutathione dysfunction and restore antioxidant enzymes. Curcumin also modulates inflammation and the production of alcohol-induced biomarkers. Curcumin has been shown to play a critical role in the survival of alcoholic hepatocellular tissue. It has been shown that curcumin can induce and trigger mitochondrial biogenesis and, by this mechanism, prevent the occurrence of both intrinsic and extrinsic apoptosis pathways in liver cells that have been impaired by alcohol. According to this mechanism, curcumin may protect hepatocellular tissue from alcohol-induced cell degeneration and may therefore survive alcoholic hepatocellular tissue. . Based on these mechanisms, the protective functions of curcumin against alcohol-induced cell degeneration due to oxidative stress, inflammation, and apoptosis events in hepatocellular tissue have been recorded. Hence, in this research, we have attempted to evaluate and analyze the main contribution mechanism of curcumin cell defense properties against alcohol-induced hepatocellular damage, according to previous experimental and clinical studies, and in this way we report findings from major studies.

Analysis of hand-forearm anthropometric components in assessing handgrip and pinch strengths of school-aged children and adolescents: a partial least squares (PLS) approach.

BACKGROUND: The purpose of this study was to examine the influence of hand-forearm anthropometric dimensions on handgrip and pinch strengths among 7-18 years children and adolescents and to investigate the extent to which these variables can be used to predict hand strength. METHODS: Four types of hand strengths including handgrip, tip to tip, key, and three-jaw chuck pinches were measured in 2637 healthy children and adolescents (1391 boys and 1246 girls) aged 7-18 years using standard adjustable Jamar hydraulic hand dynamometer and pinch gauge. A set of 17 hand-forearm anthropometric dimensions were also measured with an accurate digital caliper and tape measure. RESULTS: No significant differences were found between the hand strengths of boys and girls up to the age of 10 years. Gender related differences in handgrip and pinches were observed from the age of 11 years onwards, with boys always being stronger. The dominant hand was stronger than the non-dominant hand (8% for handgrip and by about 10% for all three types of pinches). The strongest correlations were found between the hand length and hand strengths (r > 0.83 for handgrip and three all pinches; p < 0.001, 2-tailed). Based on the partial least squares (PLS) analysis, 8 out of 17 anthropometric indices including hand length, hand circumference, thumb length, index finger length, middle finger length, and forearm length had considerable loadings in the PLS analysis, which together accounted for 46% of the total variance. CONCLUSIONS: These results may be used by health professionals in clinical settings as well as by designers to create ergonomic hand tools.

Neuroprotective and neuro-survival properties of safinamide against methamphetamine-induced neurodegeneration: Hypothetic possible role of BDNF/TrkB/PGC-1α signaling pathway and mitochondrial uncoupling protein -2(UCP-2).

Methamphetamine is a behavioral psychostimulant that has a high potential for misuse and induction of neurotoxicity. Safinamide is a novel inhibitor of monoamine oxidase B (MAOB) with neuroprotective properties. Methamphetamine abuse causes dysfunction in the respiratory chain of the mitochondria, but the specific signaling mechanism and role of the uncoupling protein-2(UCP-2) remain unclear. As we know, some indirect evidence indicates that neurodegeneration can be caused by inhibition of the brain-derived neurotrophic factor (BDNF) receptor, TrkB and its downstream signaling pathway, such as the PGC-1α protein. Neuroprotective strategies and approaches to the management, treatment or prevention of methamphetamine-induced neurodegeneration by modulating BDNF / TrkB / PGC-1α-UCP-2 can be considered as novel therapeutic approaches to these psychostimulant neurochemical and neurobehavioral approaches. Previous studies have shown that safinamide, a monoamine oxidase-B (MAOB) inhibitor, can function as a neuroprotective agent and inhibit the neurodegenerative process especially in Parkinson's disease but its impact on other neurodegenerative processes and drug-induced neurotoxicity remain unclear. Although there is some evidence that BDNF / TrkB / PGC-1α-UCP-2 signaling pathway and mitochondrial UCP-2 mediated safinamide induced neuroprotection but it's exact and precise mechanism of action and neuroprotective effects in neurodegenerative disorder and the protective properties against methamphetamine induced neurodegeneration and the role of BDNF / TrkB / PGC-1α signaling pathway and role of mitochondrial UCP-2 in this process have not yet been clarified. Therefore, in subjects addicted to methamphetamine, we hypothesized that safinamide will provide neuroprotection against methamphetamine-prompted neurodegeneration, and it appears that BDNF / TrkB / PGC-1α signaling pathway and mitochondrial UCP-2 are likely to play a critical role.

Development of a national conceptual framework and measuring tool for Organisational Social Responsibility and Accountability for Health (OSRAH).

Organisations can have a significant impact (positive or negative) on society through their actions and decisions. Given this reality, it is important that they are held responsible and accountable for the consequences of their actions. This concept is often referred to as 'social responsibility'. However, 'social responsibility', as currently conceived in the literature, neglects a specific focus on health as a social goal. Additionally, there are no practical tools to capture this concept in a holistic way to facilitate implementation and monitoring of organisational improvement. This paper reports on the process of developing a more holistic conceptual framework and tool for assessing organisational social responsibility and accountability for health (OSRAH). We conducted a review of the published and grey literature and engaged in expert consultation and focus group discussions. The initial OSRAH framework and the self-assessment tool were finalised for implementation and used by 95 organisations at a national event in Iran in February 2017. The results of the assessment data collected at the event showed organisations scored lowest in the domain of community health and highest in the domain of employee health. The OSRAH framework and assessment tool represents a new understanding of health and its determinants in organisations outside the health sector. It integrates health within the existing Corporate Social Responsibility (CSR) culture of organisations. The process of creating the tool and implementing it at the national festival of OSRAH in Iran created momentum for intersectoral action. This experience can inspire researchers and practitioners in other countries, especially in developing countries, to develop their own local definition and practical assessment framework for responsibility and accountability.

Health needs assessment of workers in Kaveh industrial city.

Background: Health needs assessment (HNA) is essential for allocation of limited resources to the most prioritized problems. HNA in work places has gained increasing importance. Kaveh industrial city is the largest and oldest industrial city in Iran, with a wide range of different industries, making it an exemplary industrial city in Iran. This study was done to conduct health needs assessment of workers in Kaveh industrial city. Methods: In this study, intensive HNA approach and qualitative method were used. In-depth interviews and Focus Group Discussions (FGDs) were conducted to collect information related to health risk factors, and Delphi method was used to prioritize these risk factors. A total of 74 key informants participated in this study, which constituted more than 80% of the total related experts of Kaveh industrial city. Results: The main identified health challenge was inefficiency of the existing Health, Safety and Environment (HSE) control and monitoring system. The most important physical health risk factors were smoking and obesity and the most prioritized psychosocial risk factors were stress and lack of appropriate management and organizational culture. Ergonomic issues and noise pollution were the prioritized work environmental factors and inappropriate placement of pollutant industries in the industrial city was the most prioritized bioenvironmental risk factor. Unsafe road to industrial zone and poor safety devices used by workers were the most prioritized occupational injuries risk factors. Conclusion: Addressing the identified health needs of workers in Kaveh industrial city is of high importance. Also, redefining the HSE control and monitoring system should be prioritized.

Cannabinoids Δ9-tetrahydrocannabinol and cannabidiol may be effective against methamphetamine induced mitochondrial dysfunction and inflammation by modulation of Toll-like type-4(Toll-like 4) receptors and NF-κB signaling.

The neurodegeneration, neuro-inflammation and mitochondrial dysfunction which occur by methamphetamine (METH) abuse or administration are serious and motivation therapeutic approaches for inhibition of these types of neurodegeneration. As we know, METH through Toll-like receptors (TLRs), specially type 4, and NF-κB signaling pathway causes neuro-inflammation and mitochondrial dysfunction. Neuroprotective approach for management of METH-induced neurodegeneration, inflammation and mitochondrial dysfunction, through a novel neuroprotective agent is continuously being superior to any kind of other therapeutic strategy. Therefore, the clarification, introduction and development of efficacious novel neuroprotective agent are demanded. During recent years, using new neuroprotective agent with therapeutic probability for treatment of METH-induced neuro-inflammation and mitochondrial dysfunction has been astoundingly increased. Previous studies have stated the neuroprotective and anti-inflammatory roles ofcannabinoid derivate such as cannabidiol (CBD) and delta-9-tetrahydrocannabinol (Δ9-THC) in multiple neurodegenerative events and diseases. According to literature cannabinoid derivate, by inhibition of TLR4 and activation of NF-κB signaling pathway, exerts their anti-inflammatory and neuroprotective effects and cause mitochondrial biogenesis. Thus we hypothesized that by using cannabinoids in METH dependent subject it would provide neuroprotection against METH-induced neurodegeneration, neuro-inflammation and mitochondrial dysfunction and probably can manage sequels of METH-induced neurochemical abuses via modulation of TLR4/NF-κB signaling pathway. In this article, we tried to discuss our hypothesis regarding the possible role of CBD and Δ9-THC, as a potent neuroprotective and anti-inflammatory agents, in inhibition or treatment of METH-induced neurodegeneration, neuro-inflammation and mitochondrial dysfunction through its effects on TLR4/NF-κB signaling pathway.

Granular chain escape from a pore in a wall in the presence of particles on one side: a comparison to polymer translocation.

Escape of a granular chain from a pore in a wall in the presence of diffusing granular particles on one side of the wall is studied experimentally. The escape time shows power-law behavior as a function of the chain length (τ ∝ Nα). A Langevin dynamics simulation of a polymer chain in a similar geometry is also performed and similar results to those for a granular system are obtained. A simple scaling argument and an energetic argument (based on the Onsager principle) are introduced which explain our results very well. Experiments (simulations) show that by increasing the number of particles on one side of the wall from zero, the exponent α decreases from 2.6 ± 0.1 (3.1 ± 0.1) to about 2. Both scaling and the Onsager principle argument predict α = 2 at high particle concentration, in agreement with the experiments and simulations. In the absence of particles, the scaling predicts τ = N2.5 (in agreement with the experimental result for the granular chain) and the Onsager principle predictsτ = N3 ln N, supporting the simulation result for the polymer chain. Experiments, simulations, scaling, and the Onsager principle confirm an inverse relation between τ and the density of particles on one side of the wall.

Safety Evaluation of the Lighting at the Entrance of a Very Long Road Tunnel: A Case Study in Ilam.

BACKGROUND: At the entrance of a tunnel, reflection of sunlight from the surrounding environment and a lack of adequate lighting usually cause some vision problems. The purpose of this study was to perform a safety evaluation of lighting on a very long road in Ilam, Iran. METHODS: The average luminance was measured using a luminance meter (model S3; Hagner, Solna, Sweden). A camera (model 108, 35-mm single-lens reflex; Yashica, Nagano, Japan) was used to take photographs of the safe stopping distance from the tunnel entrance. Equivalent luminance was determined according to the Holliday polar diagram. RESULTS: Considering the average luminance at the tunnel entrance (116.7 cd/m2) and using Adrian's equation, the safe level of lighting at the entrance of the tunnel was determined to be 0.7. CONCLUSION: A comparison between the results of the safe levels of lighting at the entrance of the tunnel and the De Boer scale showed that the phenomenon of black holes is created at the tunnel entrance. This may lead to a misadaptation of the drivers' eyes to the change in luminance level at the entrance of the tunnel, thereby increasing the risk of road accidents in this zone.

Validating the Heat Stress Indices for Using In Heavy Work Activities in Hot and Dry Climates.

BACKGROUND: Necessity of evaluating heat stress in the workplace, require validation of indices and selection optimal index. The present study aimed to assess the precision and validity of some heat stress indices and select the optimum index for using in heavy work activities in hot and dry climates. METHODS: It carried out on 184 workers from 40 brick kilns workshops in the city of Qom, central Iran (as representative hot and dry climates). After reviewing the working process and evaluation the activity of workers and the type of work, environmental and physiological parameters according to standards recommended by International Organization for Standardization (ISO) including ISO 7243 and ISO 9886 were measured and indices were calculated. RESULTS: Workers engaged in indoor kiln experienced the highest values of natural wet temperature, dry temperature, globe temperature and relative humidity among studied sections (P<0.05). Indoor workplaces had the higher levels of all environmental parameters than outdoors (P=0.0001), except for air velocity. The wet-bulb globe temperature (WBGT) and heat stress index (HSI) indices had the highest correlation with other physiological parameters among the other heat stress indices. Relationship between WBGT index and carotid artery temperature (r=0.49), skin temperature (r=0.319), and oral temperature (r=0.203) was statistically significant (P=0.006). CONCLUSIONS: Since WBGT index, as the most applicable index for evaluating heat stress in workplaces is approved by ISO, and due to the positive features of WBGT such as ease of measurement and calculation, and with respect to some limitation in application of HSI; WBGT can be introduced as the most valid empirical index of heat stress in the brick workshops.