Effectiveness of a social-emotional learning program on developmental assets and subjective well-being

The present study was done to evaluate the effectiveness of a Social Emotional Learning (SEL) intervention designed based on social marketing on developmental assets and the well-being of female adolescents in Yazd, Iran. This mixed-method quasi-experimental study was conducted in 2018-2019. A total of 190 female students were selected by multi-stage sampling from the female middle and high schools in Yazd, Iran. A SEL intervention designed based on social marketing principles was implemented among the parents and students of the intervention group. The control group did not receive any intervention. Quantitative data were collected in three stages: pre-test, post-test after two months, and follow-up after six months via Developmental Assets Profile and EPOCH measure of wellbeing. A qualitative evaluation was also performed after the intervention. Results of the Repeated-Measures test indicated that the intervention significantly influenced social competence (p-value = .02). However results did not show improvement in the positive identity development of the participant girls. Qualitative findings suggested the effectiveness of the intervention on social competencies and positive identity. Based on the results of the present study, the SEL program might have a significant but small positive effect on the social competencies of the participating adolescents.

The challenges of strategic management of the wastage produced due to earthquake in Kermanshah and Varzaghan-Ahar: A qualitative study

BACKGROUND

Strategic management of the wastage produced due to earthquakes has faced many challenges over the recent decade. Thus, the present study seeks to identify and explain the challenges in earthquake wastage strategic management.

MATERIALS AND METHODS

The present qualitative study has been steered through a content analysis approach and conducted using semi-structured interviews and a purposive selection of 17 professors, experts, and managers experienced in the field of waste management in Kermanshah and Varzaghan-Ahar earthquakes over 2020-2021. Besides, the interviews were initially categorized using MAXQDA18 software.

RESULTS

Analysis of the experiences and perception regarding the changes in strategic management of wastage produced due to Kermanshah and Varzaghan-Ahar earthquakes revealed 418 codes, 97 subcategories, 33 categories, and 8 main categories including management and leadership, organizational culture, planning, organizational learning, employee management, rules and regulations, resource management, and procedure management.

CONCLUSION

Strategic waste management has not been implemented in a coherent, integrated, and well-planned manner in the cases of the Kermanshah and Varzaghan-Ahar earthquakes. The challenges of strategic waste management turned out to be due to various reasons which will result in many issues in achieving the goals and selecting the suitable method for resource and procedure management should they not be managed well. Hence, policymakers, managers, and executors in the field of crisis management and waste management in disasters -specifically earthquakes- must take the necessary measures to remove these barriers.

Potent in vitro activity of curcumin and quercetin co-encapsulated in nanovesicles without hyaluronan against Aspergillus and Candida isolates

The rapid emergence of resistance to classical antifungals has increased the interest in novel antifungal compounds. Curcumin and quercetin are two natural plant-derived bioactive molecules shown to promote wound healing in injured tissues. In this study, we investigated the in vitro susceptibility of several Aspergillus and Candida isolates to curcumin and quercetin encapsulated in nanovesicles with and without hyaluronan and elucidated the efficacy of these nanovesicles as topical drug delivery systems. Antifungal susceptibility testing performed according to the CLSI guidelines indicated that curcumin-quercetin co-encapsulated in nanovesicles without hyaluronan (CUR-QUE-NV-WH) had stronger activity against Candida isolates than fluconazole. Furthermore, CUR-QUE-NV-WH showed efficacy against fluconazole-resistant Candida isolates as evidenced by MICs at least two times lower than those of fluconazole. Examination of skin permeation profiles using an in vitro Franz diffusion cell system revealed that curcumin and quercetin delivered by nanovesicles were released and accumulated in the skin; however, only quercetin could penetrate through the skin layers. Collectively, our results demonstrate that CUR-QUE-NV-WH has potent antifungal activity against Candida isolates and might be a topical treatment, which warrants its further investigation as a novel antifungal agent.

Assessment of University Students’ attitude towards Fast food consumption Based on the Prototype/Willingness model: A Qualitative Study in the East South of Iran, Rafsanjan

Background and Purpose: University students are young and are thus at a critical period of adopting healthy behaviors. Their life-style exposes them to a high rate of consuming fast food. In the long run, they are faced with higher chances of obesity and risk of affliction with diabetes and cardiovascular diseases. The present research aims to explore university students’ attitude towards fast food consumption based in the Prototype/Willingness model. Materials and methods: The present research followed a qualitative approach and a directed content analysis in 2018-19 among students affiliated with Rafsanjan universities. The participants were selected through purposeful sampling. A semi-structured interview was held with 20 students and it went on until data satiation occurred. The qualitative content analysis was done through Graneheim and Lundman method. Results: Analysis of university students’ experience of fast food consumption led to the extraction of 2 categories, 16 sub-categories and 65 final codes. The main theme was attitude for which the following subcategories were extracted: pleasure in consumption, fast preparation, inability to cook, lethargy, low cost, inadequate monitoring, Indulgence, bringing excuses, lack of knowledge, optimism in one’s health, consumeristic media, disorganized student life. For the negative attitude category, the following sub-categories were considered: attempts to provide healthy food, hated to fast food consumption, creation of a healthy supportive atmosphere by the family, bad experiences, perceived threat and perceived consequences. Conclusion: Knowledge of positive and negative attitudes would help program designers to contrive of the best preventive strategy focused on the adjustment of positive attitudes and reinforcement of negative attitudes to fast food consumption.

Elaborating Factors Affecting Maternal Nutritional Behavior; A Qualitative Approach

Introduction: Excessive consumption of confectionary can contribute to a high intake of sugar, fat and energy which lead to tooth decay, weight gain or obesity and related metabolic diseases. This study conducted to identify the effective factors on mothers’ nutrition behavior (reduction of confectionary consumption) on the basis of health action process approach. Methods: This qualitative research has been conducted through Directed Content Analysis. Data were collected through semi structured interviews. Participants were mothers who had at least one child over 6 months and consumed all sorts of confectionary. The collected data were analyzed according to Granheim and Landman's method. Results: The analysis of the interviews data resulted in 87 codes. The codes were organized into 6 categories and 26 subcategories and the 5 main themes are as follows: action planning, coping planning, action control, maintenance self-efficacy and social support Conclusion: Our study suggested that one of the community supports is media education and it should be considered in implementing community-based educational programs

Investigating the knowledge of the first degree relatives of patients regarding the risk factors and signs of colorectal cancer and colonoscopy screening test

Introduction: Colorectal Cancer (CRC) is the third most common cancer in the world. The risk of suffering from colorectal cancer in the first degree relatives is two to eight times higher than the ordinary people of the society. Therefore, the aim of this study is to evaluate the knowledge of the first degree relatives of the clients regarding the risk factors and signs of colorectal cancer and colonoscopy screening tests. Methodology: The present study was a descriptive cross-sectional study. In this study, 116 of the first degree relatives of patients were selected through simple random sampling. A researcher-made questionnaire was utilized to collect information about warning signs and risk factors. The reliability with Cronbach's alpha coefficient (α= 0.70) was calculated and then face and content validity were assessed by the professors. Data analysis was performed using SPSS software version 23 and using descriptive statistics (mean, and standard deviation) and inferential statistics (T-test and ANOVA). Results: The level of samples' knowledge about the risk signs of colorectal cancer was higher than the mean level (36.15 ± 8.46). The highest level of awareness about their (positive / negative) effects on colorectal cancer was related to consumption of vegetables, fruits (2.82 ± 0.65), and Aspirin consumption (1.34 ± 0.62). There wasn't a statistically significant difference between age, gender and education with the level of awareness of first degree of relatives but there was significant difference between the occupation of people and the level of awareness (P=0/005). The level of awareness of first degree of relatives about colonoscopy test was above the average level. (24.65 ± 4.57). The most knowledge about the nature of colonoscopy (2.78 ± 0.52) and the least awareness about the vitality of the operation were reported of the people above 50 (1.76 ± 0.74). There wasn't a statistically significant difference between the level of awareness of performing the colonoscopy and demographic characteristics of gender, age, education, and occupation. Conclusion: It is necessary to use new methods and strategies to maintain the available status and to raise the awareness of all people in the community regarding the signs and symptoms, especially the use of colorectal cancer screening to manage the initial programs of prevention and treatment.

The Feasibility of Increasing Hospital Surge Capacity in Disasters through Early Patient Discharge

Objective:

Hospitals are expected to be able to provide quality services during disasters. However, hospital capacity is limited and most hospital beds are almost always occupied. The aim of this study was to determine the feasibility of increasing hospital surge capacity during disasters through identification of patients suitable for safe early discharge.

Methods:

This cross-sectional study was conducted from May 2017 to February 2018 in two phases. In phase I, the Early Discharge Checklist was developed by a multidisciplinary panel of experts. Then in phase II, the checklist was used to assess the dischargeability of 396 in-patients in general wards of hospitals in Alborz province, Iran. Data were analyzed through the SPSS software (v. 22.0) and the results were presented by descriptive and analytical statics at a significance level of less than 0.05.

Results:

Of 396 patients, (64.65%) were male, (68.9%) were married, and (38.6%) aged more than 54. Moreover, (34.6%) patients were dischargeable. Patients in cardiology wards were more dischargeable. At follow-up assessment, 33.3% of patients had been discharged after 48 hours. There was a significant relationship between patient dischargeability and 48-hour hospitalization status (p=0.001). Dischargeability had no significant relationships with patients’ demographic characteristics (p>0.05).

Conclusion:

A considerable percentage of in-patients are dischargeable during disasters. The Early Discharge Assessment Checklist, developed in this study, is an appropriate tool to provide reliable data about early dischargeability in disasters.

Barriers and facilitators to provide continuity of care to dischargeable patients in disasters: A qualitative study

OBJECTIVE

Early discharge of some in-patients is the effective measure to create hospital surge capacity in disasters. However, some of these patients may need to post-discharge continuity of care. The aim of the current study then is to explore the barriers of continuity of care, and to provide suitable solutions for potentially dischargeable patients during disasters.

METHODS

This qualitative study was conducted in Iran in 2017. The data was collected via unstructured interviews with 24 disaster professionals; and analyzed by content analysis method.

RESULTS

Identified barriers to the continuity of care were classified into seven categories, 'lack of disaster paradigm'; 'challenges of pre-hospital system'; 'insufficient coordination and cooperation'; 'inadequate hospital preparedness'; 'lack of using available resources and capacities'; 'poor patients' knowledge' and 'poor planning'. The suggested solutions for post-discharge continuity of care were: creation of registry and follow-up system; removing pre-hospital challenges; including disaster management courses in medical school curriculum; promoting hospital preparedness by All-Hazard Approach; and effective use of available resources.

CONCLUSION

Understanding the barriers to continuity of care for discharged patients for adopting policies based on experiences of health care providers can help planners to design and implement effective programs, which will enhance patients' access to necessary care.

Responsibility-Evading Performance: The Experiences of Healthcare Staff about Triage in Emergency Departments: A Qualitative Study

Background:

Correct triage is one of the most important issues in delivering proper healthcare in the emergency department. Despite the availability of various triage guidelines, triage is not still appropriately implemented. Therefore, this study was conducted to investigate the role of different underlying factors in triaging emergency patients through a qualitative approach.

Materials and Methods:

This study was conducted by conventional content analysis. For this purpose, 30 interviews were conducted with 25 participants. The participants included triage nurses, emergency general physicians, emergency medicine specialists, and expert managers at different position rankings in hospitals and educational and administrative centers in Yazd, selected by purposeful sampling. Data were collected through in-depth and unstructured interviews from April 2017 to January 2018, and then analyzed by inductive content analysis.

Results:

Four categories of profit triage, exhibitive triage, enigmatic, and tentative performance triage were drawn from the data, collectively comprising the main theme of responsibility-evading performance.

Conclusions:

The dominant approach to the triage in the emergency departments in a central city of Iran is responsibility evasion; however, the triage is performed tentatively, especially in critical cases. To achieve a better implementation of triage, consideration of the underlying factors and prevention of their involvement in triage decision-making is necessary.

Molecular epidemiology of environmental Cryptococcus species isolates based on amplified fragment length polymorphism

OBJECTIVE

Cryptococcosis is a major opportunistic fungal infection caused by members of the genus Cryptococcus, mainly those belonging to the Cryptococcus neoformans/Cryptococcus gattii species complexes. Here, we report a comprehensive molecular epidemiological study of the environmental distribution of Cryptococcus isolates in Shiraz, Iran with review of litreature.

METHOD

A total of 406 samples were obtained from Eucalyptus trees and 139 samples from pigeon droppings. Cryptococcus species identification and genotyping were performed by amplified fragment length polymorphism (AFLP) fingerprinting sequencing and sequencing of the ITS rDNA region.

RESULTS

Majority of the isolates belonged to the Naganishia taxon (n=69) including N. albida (formerly C. albidus, n=62), N. globosa (formerly C. saitoi, n=4), N. adeliensis (formerly C. adeliensis, n=2), N. diffluens (formerly C. diffluens, n=1), and the identified C. neoformans isolates (n=25) belonged to genotype AFLP1/VNI (n=22) and AFLP1B/VNII (n=3).

CONCLUSION

More research efforts should be employed to isolate C. gattii species complex from environmental niches in Iran and provide additional evidence related to novel molecular types.

Effective factors on menstrual health among female students in Bam city: a qualitative study

Background

Menarche is an independent puberty event in a girl's life, and is associated with physical growth, ability in marriage and fertility. Therefore, poor menstrual health can be a major determinant of morbidity, as well as physical, mental and social problems in this age group.

Objective

The aim of this study was to explore the effective factors on menstrual health among female students in Bam city.

Methods

The qualitative study was conducted using content analysis approach in 2017. The participants were 32 individuals consisting of 13 students, 10 mothers of the same students, 9 school associates and health educators of 5 secondary schools in Bam city, who were selected based on an objective-oriented approach. The sampling was done until data saturation. Data collection methods were semi-structured and in-depth interview. Data analysis was performed using the steps suggested by Graneheim and Landman.

Results

There were two categories (easy interaction and inappropriate adaptation to changes in health behavior), 13 sub-categories and 52 initial codes. The positive factors included easy access to sanitary pads, appropriate school education, easy access to health and therapeutic services and school flexibility on menstrual issues, while the negative factors included inadequate facilities for sanitary pad disposal, lack of access to informed people about menstrual issues, insufficient attention to menstrual problems, feeling ashamed, the high cost of menstrual health, self-medication with traditional medicines, inadequate self-directed education, lack of awareness and trust in health center staff, and following family and teachers in menstrual problems.

Conclusion

Overall, this study indicated that economic, social, cultural and educational factors affect menstrual health. Therefore, the identification of each of these factors helps planners to apply the most appropriate methods and strategies for menstrual health improvement.

Epidemiological and mycological characteristics of candidemia in Iran: A systematic review and meta-analysis

To date, there has been no comprehensive review of the epidemiology, risk factors, species distribution, and outcomes of candidemia in Iran. This study aimed to perform a systematic review and meta-analysis of all reported candidemia cases in Iran until December 2015. The review process occurred in three steps, namely a literature search, data extraction and statistical analyses. After a comprehensive literature search, we identified 55 cases. The mean age of patients was 46.80±24.30 years (range 1-81 years). The main risk factors for candidemia were surgery and burns (23.6%), followed by malignancies (20%), use of broad-spectrum antibiotics (18.2%), and diabetes (7.3%). Candida parapsilosis (n=17, 30.8%) was the leading agent, followed by Candida albicans (n=15, 27.3%), Candida glabrata (n=10, 18.2%), and Candida tropicalis (n=8, 14.5%). The frequencies of candidemia cases due to C. glabrata, C. parapsilosis, and C. albicans were significantly higher among patients aged>60, 21-40, and 41-60 years, respectively. Comparison of risk factors for candidemia by multiple logistic regression showed that one of the most important risk factors was surgery (OR: 4.245; 95% CI: 1.141-15.789; P=0.031). The outcome was recorded in only 19 cases and 13 of those patients (68.4%) expired. This study confirms that knowledge of the local epidemiology is important when conducting surveillance studies to prevent and control candidemia and will be of interest for antifungal stewardship.

New objective and quantitative tests for gustatory sweating

Two newly developed tests for gustatory sweating, providing both quantitative and topographic information, are presented. In both tests a paper stencil shaped to fit the complex anatomy of the parotid region is used. The blotting paper technique uses the difference in weight before and after gustatory stimulation to measure the amount of sweating. The iodine-sublimated paper histogram (ISPH) uses iodine sublimated office paper that changes colour when wet. The paper stencil is than digitized and a histogram algorithm applied to measure the area of sweating. A calibration of these tests with known and appropriate quantities of saline is presented.