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Challenges and Barriers to the Participation of Non-Governmental Organizations (NGOs) in Flood Management: A Qualitative Study from Iran
No full textObjective: Floods are one of Iran's most important natural hazards, which cause a lot of damage every year. Various organizations, including non-governmental organizations (NGOs), participate in flood management. The present study aimed to explore the challenges and barriers of NGOs' participation in the management of the flooding in Iran based on stakeholders' experiences. Methods: This qualitative study is a case study that was conducted using the content analysis approach. Fifteen participants, including 3 national managers, 2 volunteers active in responding to recent floods, and 10 NGO managers/secretaries who had the knowledge or operational experience of participating in disaster management, were approached for interviews. Data were collected using a purposeful sampling method and continued until reaching data saturation. Results: Challenges and barriers to NGOs' participation in flood management were categorized into 4 main categories and 14 subcategories, including policy-making challenges, managerial challenges, executive challenges, and socio-cultural challenges. Conclusions: 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
COVID-19 Vaccination, Peltzman Effect and Possible Increase in Highrisk Behaviors: A Growing Concern Related to Risk Compensation and Reduced Compliance to Public Health Protective Measures after Vaccines Rollout
No full textThe world is still faced with widespread dissemination and many unanswered questions related to Coronavirus disease (COVID-19). Several candidate vaccines have been introduced against COVID-19, mostly requiring the injection of two doses and some with nearly 90-95 efficacy. All strategies against the spread of infection have focused on breaking the chain of virus transmission through protective public health measures and mass vaccination. The current situation emphasizes the global need for carefully designed policies to maximize vaccine access and uptake. The risk compensation theory (Peltzman Effect) states that the decrease in perceived risk through access to preventive measures may lead to increasing frequency of risky behaviors. The current pandemic has exposed people to the sense of risk compensation and behavior change in response to the perceived risk. Risk compensation phenomenon may significantly reverse the benefits of COVID-19 vaccination, especially if the vaccine is not sufficiently effective in real life or among high-risk populations. Recognition and awareness of Peltzman risk compensation are of high importance in counteracting and neutralizing the false complacency of the community, which also lends more weight to public health efforts. The public health messages and practices should be clearly expressed, straightforward, reliable and applicable. It is important to encourage mass vaccination of the population, and other NPIs must be re-established and implemented to ensure education to live with COVID-19 in parallel with daily activities and job tasks
The effects of a spiral model knowledge-based conversion cycle on improving knowledge-based organisations performance
No full textDue to an increasingly competitive environment, recognising the strategic value of knowledge is an important resource for maintaining a competitive advantage and improving organisational performance. The objective of this study included the effects of the conversion cycle of knowledge on a knowledge-based company performance. Four hypotheses based on knowledge socialisation, externalisation, internalisation and combination of Nonaka and Takeuchi model were tested. Fifty-nine questionnaires were completed by medical technology knowledge company members and statistical analysis was performed using SPSS software. The results showed a positive and significant correlation coefficient for the socialisation and externalisation and internalisation of knowledge variables and the stakeholders' aspect within organisational performance. Policy makers should focus on proposals that invest in the elite creative thinkers' ideas by creating a favourable environment for the flourishing of creativity, developing knowledge sharing within a company and in science and technology cities
Heavy Metals in Wheat Grain and Its Impact on Human Health: A mini-review
No full textHeavy metals (HMs) form a very varied group of elements that are very diverse in terms of chemical properties and biological functions. Heavy metal contamination in agricultural soil has become a serious environmental problem. These metals are toxic to soil, plants, aquatic life, and human and animal health. These toxic pollutants are caused by natural activities such as volcanoes and mining and smelting metals. These metals are stable in nature, therefore, they accumulate in the soil and agricultural products, and it is necessary to properly understand the relationship between the concentration of heavy metals in the soil and its accumulation in wheat. These metals also interfere with the level of antioxidants in plants and reduce the nutritional value of the product. Consumption of many heavy metals in the diet through the consumption of plants has long-term destructive effects on human health. In this review study, the most important heavy metals in agricultural products, especially wheat, on human health were reported. For this review study, keywords such as Crops, Heavy metal, Human health, Wheat flour were used. The databases searched for in those articles were Google Scholar, SID, Scopus, PubMed, Science Direct, and ISI search engines. Given that bread is the dominant force of the Iranian people, so the quality study of wheat in the country's consumer market in order to maintain the health of consumers seems necessary. Therefore, we need to inform people about this, so this review article explains the presence of HMs in bread and its disadvantages. © 2022, Islamic Azad University. All rights reserved
Comparison of Machine Learning Tools for the Prediction of ICU Admission in COVID-19 Hospitalized Patients
No full textBackground: The rapid coronavirus disease 2019 (COVID-19) outbreak has overwhelmed many healthcare systems worldwide and put them at the edge of collapsing. As the capacity of intensive care units (ICUs) is limited, deciding on the proper allocation of required resources is crucial. Objectives: This study aimed to create a machine learning (ML)-based predictive model of ICU admission among COVID-19 in-hospital patients at the initial presentation. Methods: This retrospective study was conducted on 1225 laboratory-confirmed COVID-19 hospitalized patients during January 9, 2020-January 20, 2021. The top clinical parameters contributing to COVID-19 ICU admission were identified based on a correlation coefficient at P-value < 0.05. Next, the predictive models were constructed using five ML algorithms. Finally, to evaluate the perfor-mances of models, the metrics derived from the confusion matrix, classification error, and receiver operating characteristic were calculated. Results: Following feature selection, a total of 11 parameters were selected as the top predictors to build the prediction models. The results showed that the best performance belonged to the random forest (RF) algorithm with the mean accuracy of 99.5, mean specificity of 99.7, mean sensitivity of 99.4, Kappa metric of 95.7, and root mean squared error of 0.015. Conclusions: The ML algorithms, particularly RF, enable a reasonable level of accuracy and certainty in predicting disease progres-sion and ICU admission for COVID-19 patients. The proposed models have the potential to inform frontline clinicians and health authorities with quantitative tools to assess illness severity and optimize resource allocation under time-sensitive and resource-constrained situations. © 2022, Author(s)
Molecular typing and antibiotic resistance patterns among clinical isolates of Acinetobacter baumannii recovered from burn patients in Tehran, Iran
No full textAcinetobacter baumannii (A. baumannii) is now considered a highly resistant pathogen to various types of antibiotics. Therefore, tracking the source of its prevalence and continuous control is crucial. This study aimed to determine antibiotic resistance and perform various molecular typing methods on clinical isolates of A. baumannii isolated from hospitalized burn patients in Shahid Motahari Burn Hospital, Tehran, Iran. Hospital isolates were confirmed by phenotypic and molecular methods. Then the sensitivity to different antibiotics was determined using the minimum inhibitory concentration (MIC) method. In order to perform molecular typing, three-locus dual assay multiplex polymerase chain reaction (PCR), multiple-locus variable-number tandem repeat analysis (MLVA), and multilocus sequence typing (MLST) methods were used. Among the 60 isolates collected, the frequencies of multidrug-resistant (MDR) and extensively drug-resistant (XDR) isolates were 90 and 10, respectively. The most effective antibiotics were colistin with 100 and tigecycline with 83.33 sensitivity. Isolates were 100 resistant to piperacillin/tazobactam and cephalosporins, and 68.3 were resistant to carbapenem. The results of multiplex PCR showed five groups that international clone I (IC I) and IC II were the most common. The MLVA method identified 34 MLVA types (MTs), 5 clusters, and 25 singletons. Multilocus sequence typing results for tigecycline-resistant isolates showed seven different sequence types (STs). Increasing antibiotic resistance in A. baumannii isolates requires careful management to control and prevent the occurrence of the pre-antibiotic era. The results of this study confirm that the population structure of A. baumannii isolates has a high diversity. More extensive studies are needed in Iran to better understand the epidemiology of A. baumannii
Comparison of Pain Score in Patients with Brain Disorders Using Care Pain Observation Tool (CPOT) and Nonverbal Pain Scale (NVPS)
No full textBackground: Traumatic brain injury (TBI) is one of the leading causes of death, which ranges from mild and irreversible to severe and life-threatening injuries.Objectives: This study aimed to compare the pain score in patients with brain disorders using Care Pain Observation Tool (CPOT) and Nonverbal Pain Scale (NVPS).Methods: A descriptive comparative study was performed in Ilam province, Iran, in a group of head trauma patients admitted to the intensive care unit who were intubated. One hundred twenty observations of nurses' practice were performed. A purposive sampling method was utilized. The CPOT and NVPS assessed the pain, and the Glasgow Coma Scale (GCS) assessed the state of con-sciousness. Data were analyzed by SPSS version 16 software.Results: Patients' mean +/- SD age was 38.45 +/- 4.2 years. The mean +/- SD pain score on the CPOT before the procedure was 0.39 +/- 0.49 in the facial expression dimension, 0.56 +/- 0.49 in activity, 0.54 +/- 0.50 in muscle tension, and 0.55 +/- 0.49 in compatibility with the ventilator. The mean +/- SD pain score on the NVPS before the procedure was 0.97 +/- 0.20 in facial expression dimension, 0.94 +/- 0.49 in activity, 0.95 +/- 0.31 in guarding, 0.64 +/- 0.49 in vital signs, and 0.92 +/- 0.53 in excitement.Conclusions: Both CPOT and NVPS were effective in diagnosing patients' pain, but the CPOT was more appropriate for diagnosing pain in intubated patients
Evaluation of the Total Antioxidant Capacity of Bitter and Sweet Varieties of Ferula assa-foetida and Bunium persicum
No full textBackground: Due to low information about total antioxidant capacity of three species of plants native to Ilam province which are used in the ethnobotanical knowledge of this region, This study was drafting to evaluation the antioxidant ability of bitter and sweet varieties of Ferula assa-foetida and Bunium persicum with therapeutic potential on gynecological diseases.Methods: The methanolic extracts of two different variants of F. assa-foetida and B. persicum gum-resin were prepared and then antioxidant effects were evaluated by ferric reducing-antioxidant power assay.Results: Our results showed that methanolic extracts of B. persicum gum-resin could significantly revealed antioxidant effect in comparison to two different variants of F. assa-foetida (P < 0.05). While antioxidant capacity between bitter and sweet varieties of F. assa-foetida were not statistically significant.Conclusion: Our results showed that both B. persicum and the bitter and sweet varieties of F. assa-foetida native to Ilam province, located in west of Iran, could have medicinal therapeutic effects relatively through direct oxidation prevention
Criteria for the selection of complementary private health insurance: the experience of a large organisation in Iran
No full textBackground Expenses related to employee's health benefit packages are rising. Hence, organisations are looking for complementary health financing arrangements to provide more financial protection for employees. This study aims to develop criteria to choose the most appropriate complementary health insurance company based on the experience of a large organisation in Iran. Methods This study was conducted in 2021 in Iran, in the Foundation of Martyrs and Veterans Affairs to find as many applicable criteria as possible. To develop a comprehensive list of criteria, we used triangulation in data sources, including review of relevant national and international documents, in-depth interviews of key informants, focus group discussion, and examining similar but unpublished checklists used by other organisations in Iran. The list of criteria was prioritised during focus group discussions. We used the best-worst method as a multi-criteria decision making method and a qualitative consensus among the key informants to value the importance of each of the finalised criteria. Findings Out of 85 criteria, we selected 28 criteria to choose an insurer for implementing complementary private health insurance. The finalised criteria were fell into six domains: (i) Previous experience of the applicants; (ii) Communication with clients; (iii) Financial status; (iv) Health care providers' network; (v) Technical infrastructure and workforce; (vi) and Process of reviewing claims and reimbursement. Conclusion We propose a quantitative decision-making checklist to choose the best complimentary private health insurance provider. We invite colleagues to utilise, adapt, modify, or develop these criteria to suit their organisational needs. This checklist can be applied in any low- and middle-income country where the industry of complementary health insurance is blooming
Risk Assessment of Arbaeen Mass Gathering in the Covid-19 Pandemic
No full textINTRODUCTION: Arbaeen is a religious ceremony held annually with the participation of a large number of pilgrims. During the pandemic of Covid-19, a mass gathering of Arbaeen pilgrims can strengthen the transmission of this disease and put more pressure on the health care system of countries. The aim of the study is to evaluate the risk of Arbaeen ceremony in the Covid-19 pandemic in 2021. MATERIALS AND METHODS: A mixed method was performed to perform the study using qualitative and quantitative methods. A national risk assessment tool was used that consisted of hazard identification and assessment, scenario development, exposure assessment, vulnerability assessment and risk estimation. The national risk assessment tool was completed through a focused group discussion and the opinions of 20 representatives of the health system and the level of risks were estimated. Data were collected, analyzed, and integrated by the research team. RESULTS: Based on the results of risk matrix analysis, factors such as the increase in the number of new cases of COVID-19, the probability of exposure to a new variant of COVID-19, the probability of arrival of a new variant of COVID-19 to the country, the probability of increasing referrals to healthcare facilities (score 16), the probability of getting respiratory diseases, and the environmental contamination (score 12) occupied the red area of the matrix and were found to have the highest risk (unbearable risk), that needs immediate action. CONCLUSION: Preparing for a mass gathering such as Arbaeen is very important in order to reduce the risk of communicable disease, and the first step in improving preparedness is risk assessment and its continuity in the various stages of the ceremony. Therefore, policy makers and planners of such events should conduct risk assessments with the participation of local and national public health authorities regularly