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Effects of Empowerment Programs on Nurses’ Competence in Disaster Response
No full textBackground: It is necessary to prepare nurses for their important and accountable roles in disaster response teams. Given the lack of in-service training courses, nurses’ knowledge and skills in responding to disasters are lower than the desired level. This status can lead to nurses’ poor performance in caring for victims of disasters. This study aims to determine the effects of empowerment programs on nurses’ competence in disaster response. Materials and Methods: A total of 70 nurses working in Ardal and Naghan hospitals in Chaharmahal and Bakhtiari Province, Iran, in 2020 were selected via a sampling method. One hospital was randomly selected as the intervention and the other as the control. The members of the intervention group were divided into 5 groups. Educational sessions were held in four 2-h sessions in one month. In addition, the intervention consisted of a 2-day workshop, hanging posters, and pamphlets that covered topics of competencies in disaster nursing. Results: The results showed that the mean score of nurses’ competence score significantly increased in the intervention group (P=0.001); however, no significant difference was observed in the control group (P>0.05). Additionally, significant improvements were observed in all dimensions of competencies in the experimental group. The Mean±SD scores of the increase in different domains of nurses’ competencies were as follows: management, 16±4.6; ethical competency, 12±2.8; personal competency, 18±8.6; and technical competency, 30±9.3. Conclusion: According to other study results with the same scale in Iran, nurses’ competencies in disaster response are not desirable; therefore, it is recommended that nurses, administrators, and other members of the healthcare system use these results to improve nurses’ competencies through in-service training
Determining the effect of selected mental factors on turnover intention through two modulators - stress and resilience over COVID-19 period
No full textIntroduction: Turnover intention among nurses has risen in an alarming rate since the onset of the pandemic. There are various underlying factors to turnover intention. The present study aims to determine the effect of a number of mental factors on nurses’ professional-turnover intention through two modulators of stress and resilience over COVID-19 period. Methods: The current cross-sectional study was conducted at three hospitals in Khuzestan Province, southern Iran, during the winter of 2021. To collect the data, given the restrictions in place during COVID-19 period, the web link of electronic self-reported questionnaires (including general health, mental workload, work-family conflict, resilience, job stress, corona fear, and turnover intention) were sent to 350 nurses through e-mail and other social media (WhatsApp and Telegram). Accordingly, they were asked to complete the questionnaire during rest periods within two weeks. Totally, 300 people (85% participation) filled out the questionnaires. Finally, a model was constructed in the Amos software. Results: The results showed that the four independent parameters of decreasing general health, increasing mental workload, increasing WFCs and fear of COVID-19 can indirectly increase nurses’ turnover intention by increasing job stress. Among these variables, the highest indirect effect coefficient on turnover intention was related to the general health parameter (-0.141). The results also demonstrated a negative correlation between job stress and resilience, with lower resilience raising job stress and, consequently, increasing intention to quit the job. Conclusion: Mental factors affecting turnover intension were identified in this study through path analysis. Therefore, it is recommended that the required resilience-enhancing measures to be taken by hospitals and nursing administrations to reduce psychological pressures caused by mentioned variables with the aim of minimizing job-related stress and fostering nurse retentio
MiR‐548 K regulatory effect on the ABCG2 gene expression in MDR breast cancer cells
No full textBackground: multidrug resistance (MDR) is One of the foremost challenges in overcoming breast cancer. Various molecular processes are involved in the development of MDR in breast cancer cells, including over expression of ABC transporters such as ABCG2 (BCRP), increase breast cancer stem cells drug resistance, and epithelial mesenchymal transition. Aims: In the present study, we used bioinformatics and experimental analysis to investigate the role of miR-548 K, in the modulating of ABCG2, in MDR breast cancer cells. Methods and Results: In silico inspections introduce 14 microRNAs targeting 3′-UTR region of ABCG2 transcripts, which are probably involved in breast cancer drug resistance. An association was highlighted between miR-548 k with ABC transporter family. The expression level of ABCG2 gene in MCF7-MX cell lines was significantly more than MCF7 cell lines. On the other hand, we increased the expression of miR-548 K in MCF7-MX and MCF7 cell lines through its transfection, which dramatically coincided with decreasion in the ABCG2 transcripts level. Additional studies on patient samples revealed that the expression of ABCG2 showed an increase in ABCG2 level in neoadjuvant chemotherapy drugs resistance (NCDR) patients compared to primary pre-operative chemotherapy drugs response (PCDR) patients. Also, a reduction in the expression of miR-548 K in NCDR patients was revealed. Conclusion: The results of our study suggest that miR-548 K may be involved in modulating the expression of ABCG2 in MDR breast cancer cells
Obesity and the Risk of Developing Kidney Stones: A Systematic Review and Meta-analysis
No full textObesity is a growing problem that causes various metabolic disorders and organ dysfunction. The present systematic review and meta-analysis examined the impact of obesity on the risk of kidney stones. This meta-analysis was designed according to PRISMA guidelines. This extensive search was conducted on June 6, 2022, using relevant keywords in databases including PubMed, Web of Science, EMBASE, and Scopus. The data collected from observational studies were recorded in a datasheet. Odds Ratio (OR) and their 95 confidence intervals (CI) evaluated the overall effect size. The Cochran Q test and the statistic I2 were used to evaluate the heterogeneity of studies. Egger’s and Begg’s tests assessed potential publication bias. We included 15 observational studies published between 2005 to 2022 in this analysis. Compared to non-obese individuals, the OR for developing kidney stones in obese participants was 1.35 (95 CI: 1.20 to 1.52, P < .001). Considering geographical location, the OR for the risk of developing kidney stones in obese individuals was 1.51 (95 CI: 1.11 to 2.05, P = .009) in North America, 1.33 (95 CI: 1.16 to 1.51, P < .001) in Europe, and 1.18 (95 CI: 1.08 to 1.29, P < .001) in Asia. Begg’s test results (P = .625) demonstrated no publication bias. However, Egger’s test results (P = .005) indicated publication bias. Based on the results, obesity increases the risk of kidney stone development. Therefore, community health programs should be implemented to reduce the incidence of obesity and lower the risk of kidney stones
Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026
No full textBackground: The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods: In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings: In 2019, at the onset of the COVID-19 pandemic, US7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the 43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, 37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation: There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained. Funding: Bill & Melinda Gates Foundation
The psychological symptoms and behavioral problems of children with mothers working as medical staff in the crisis of Covid-19 outbreak in Hamadan, Iran
No full textBackground and objectives: The purpose of this study was to investigate the psychological symptoms and behavioral problems of children with mothers working as medical staff in the crisis of Covid-19 disease in Hamadan. Methods: This descriptive causal-comparative study was conducted on all mothers with children aged 6 to 12 years in Hamadan from September 2 to November 29, 2020. In this study, eligible individuals were selected using random sampling and were assigned to two groups of mothers working as the medical staff and the control group. The research instruments included the Child Behavior Checklist (Achenbach) and the Child Symptom Inventory-4 (CSI-4). Results: The results showed that the mean scores of psychological and behavioral symptoms of children in terms of group membership (group of mothers working in the medical staff and control group) had a significant difference. There was a significant difference between the mean scores of depression and aggression in children of the staff group and the control group meaning that for depression and aggression scores of children of the staff group are higher than children of the control group (p < 0.05). There was no significant difference between the mean anxiety scores and there was almost a significant difference between the attention scores of the staff group and the control group (p < 0.05). Conclusion: Children whose mothers worked as medical staff during Covid-19 show more depression, attention, and aggression problems than children whose mothers do not work as medical staf
Psychosocial comorbidities of diabetes during the COVID-19 pandemic in Iran
No full textBACKGROUND: The psychosocial impacts of the COVID-19 pandemic are mainly focused on the general population, while pandemics do not impact the mental health of the entire population uniformly, especially vulnerable populations with underlying health conditions. This study aimed to investigate diabetes psychosocial comorbidities among Iranians with type 1 diabetes (T1D) during the COVID-19 pandemic. MATERIALS AND METHODS: This was a cross-sectional study of 212 adults with T1D in different cities in Iran. Study participants completed an online survey in April-June 2020. The survey collected self-reported data on diabetes psychosocial comorbidities (i.e. diabetes burnout, diabetes distress, and depressive symptoms). Demographic and COVID-19 data before and during the pandemic were also collected. Responses were analyzed using ordinary least squares and logistic regression methods. RESULTS: Around 17.5% reported being tested for COVID-19 virus, 8% were diagnosed positive, 10.8% were hospitalized, and 92.9% followed precaution recommendations during the pandemic. Participants had high levels of diabetes distress (57.1%), depressive symptoms (60.8%), and diabetes burnout (mean score = 3.1 out of 5). During the pandemic, trouble paying for the very basic needs was a consistent factor increasing the risk of diabetes distress, diabetes burnout, and depressive symptoms. Lack of access to diabetes care was only associated with diabetes burnout, while diabetes hospitalization/emergency department (ED) visit was associated with diabetes distress. Existing diabetes disparities before the pandemic were also associated with higher scores of diabetes psychosocial comorbidities [accessing diabetes supplies and medications (P < 0.0001) and places for physical exercise (P < 0.0333)]. CONCLUSION: The negative impact of the COVID-19-related changes on individuals with diabetes, as one of the most vulnerable populations, must be recognized alongside the physical, financial, and societal impact on all those affected. Psychological interventions should be implemented urgently in Iran, especially for those with such characteristics
Factors affecting the resilience of hospital medical staff during the COVID-19 pandemic
No full textBackground. During the coronavirus disease 2019 (COVID-19) pandemic, most hospitals have faced a heavy load of pa-tients. In this situation, it is very important to consider the resilience and endurance of medical staff, as well as to identify and investi-gate the relevant factors which can increase their resilience. Objectives. The aim of this study was to identify the factors affecting the resilience of hospital medical staff during the COVID-19 pan-demic. Material and methods. The present study is a qualitative study using a semi-structured interview. Participants included doctors, nurs-es, clinicians and managers working in tertiary referral hospitals during the COVID-19 pandemic. Interviews were conducted as needed until data saturation was reached using the purposive sampling method. A total number of 20 people, including 6 physicians, 2 hospital managers, 7 nurses, 1 radiologist, 3 laboratory technicians and 1 clinical psychologist, were interviewed in 7 educational hospitals of the Kerman Province. Results. After data analysis and coding, 127 initial codes were identified. By reviewing the codes, 127 initial codes were merged by the research team, and 23 codes in 6 main categories, including Personal Factors (7 codes), Family-Related Factors (2 codes), Community-Related Factors (2 codes), Virus-Related Factors (2 codes), Organisational Factors (7 codes) and Economical Factors (3 codes) were extracted. Conclusions. Paying attention to the identified factors on the maintenance of medical human resources in the form of the “Surge Capacity Programme” can increase the resilience of medical staff. Such measures pave the way for a better response to other threats similar to the COVID-19 pandemic
Cancer recurrence or aggravation following COVID-19 vaccination
No full textCOVID-19 infection has been a global health issue in the past recent years and numerous topics are studied in order to discover its pathophysiology and potential side effects. The potential for disease recurrence following the administration of the COVID-19 vaccine is one of the issues that has recently attracted attention. Several studies have revealed that the COVID-19 vaccines, like other vaccines, may have side effects and, in some cases, they may even deteriorate the underlying illnesses, such as rheumatic diseases, autoimmune diseases, and cancers. The effectiveness and safety of the COVID-19 vaccine for patients with malignancies are one of the factors that are considered regarding this vaccine. Lymph node involvement, disease recurrence, and potential paraclinical changes after receiving the COVID-19 vaccine are some of the concerns of patients with malignancy. In this mini-review, we attempted to investigate cases of cancer recurrence or recovery as well as lymphadenopathy following vaccination
Novel insight into the ectodermal dysplasia 11A: Splicing variant of the EDARADD gene in a family with clinical variability and literature review
No full textPathogenic variants in the EDARADD gene result in autosomal recessive and autosomal dominant ectodermal dysplasia. This article reports on the fourth family in the world with ectodermal dysplasia 11A (ECTD11A) cause from a novel splicing variant in the EDARADD gene, identified by whole exome sequencing and confirmed by Sanger sequencing. The proband and his mother were heterozygous for the detected variant (NM_145861.4:c.161-2A>T). The proband manifests unusual symptoms including hyperkeratotic plaques, slow-growing hair, recurrent infection, and pectus excavatum. His mother presents hypohidrosis, extensive tooth decay, fragile nails, and sparse hair. Further studies on ECTD11A patients could be useful to characterizing the phenotype features more precisely