Hospitals In Tehran Research Articles

Cross‐cultural adaptation and validation of the Persian version of the Preparedness Assessment for the Transition Home After Stroke instrument: a methodological study

ABSTRACT Background The successful transition of stroke patients from hospital to home relies on the preparedness of caregivers. Assessing this preparedness is crucial, but existing tools need adaptation and validation for Iranian caregivers. Objectives This study aimed to translate, culturally adapt, and validate the Persian version of the “Preparedness Assessment for the Transition Home After Stroke” (PATH-s) for use among Iranian caregivers of stroke survivors. It also assessed the association of patient and caregivers’ characteristic association with the final PATH score. Methods The PATH-s was translated and culturally adapted using the Backward-Forward translation method and expert consultations. Face and content validity were ensured through input from both caregivers and experts. Participants were recruited from two referral hospitals in Tehran, Iran. The sample consisted of 386 caregivers, 74.4% female with a mean age of 47.18 years (SD = 12.2). Construct validity was assessed using Exploratory and Confirmatory Factor Analyses (EFA and CFA). Convergent validity was evaluated through the correlation with Zarit Burden Interview scores. Reliability was tested through internal consistency (Cronbach’s alpha) and test-retest reliability (Intraclass Correlation Coefficient, ICC). Results The factor analysis revealed a seven-factor structure with robust fit indices (CFI = 0.92, TLI = 0.90, RMSEA = 0.068, SRMR = 0.074). Convergent validity was supported by a significant negative correlation with the Zarit Burden Interview (r = -0.27, p < 0.001). Reliability analysis showed good internal consistency (Cronbach’s alpha = 0.84) and excellent test-retest reliability (ICC = 0.96). Conclusions The Persian version of PATH-s is a valid and reliable tool for assessing caregiver preparedness in Iran. Its use can improve patient outcomes and caregiver support during hospital-to-home transitions.

Assessing the relationship between low back pain and job stress on the work ability index among healthcare workers in an educational hospital in Tehran

Introduction: Considering that stress in the workplace for healthcare workers employees can adversely affect their work ability, diminish productivity, and lead to job dissatisfaction, burnout, as well as negative physical and mental outcomes, the present study was designed to assess the effect of low back pain and stress levels on the work ability index among healthcare workers in a tertiary hospital in Iran. Material and Methods: This cross-sectional study was conducted on healthcare professionals in one of the hospitals in Tehran City in 2022. The prevalence of musculoskeletal disorders among study participants was evaluated using the Nordic Musculoskeletal Questionnaire (NMQ). Additionally, the Work Ability Index (WAI) was employed to evaluate the participants' work ability, while the HSE Stress Questionnaire was used to measure their job stress levels. Results: A lower level of job stress among healthcare professionals was significantly associated with daily (P=0.02) and weekly (P=0.004) working hours. Moreover, healthcare professionals who did not experience low back pain in the past week were able to work more hours per day compared to others (P=0.01). In the linear regression model, the relationship between the Work Ability Index (WAI), job stress, and job position remained statistically significant (P&lt;0.05). Conclusion: Tackling job-related stress and enhancing employee well-being is essential to improve work productivity and overall health. Implementing specific interventions and conducting further research could effectively contribute to achieving these goals.

Predicting Gestational Diabetes Mellitus in the first trimester using machine learning algorithms: a cross-sectional study at a hospital fertility health center in Iran

BackgroundGestational Diabetes Mellitus (GDM) is a common complication during pregnancy. Late diagnosis can have significant implications for both the mother and the fetus. This research aims to create an early prediction model for GDM in the first trimester of pregnancy. This model will help obstetricians and gynecologists make appropriate decisions for treating and preventing GDM complications.MethodsThis applied descriptive study was conducted at the fertility health center of Vali-e-Asr Hospital in Tehran, Iran. The dataset was collected from the records of pregnant women registered in the hospital’s system from 2020 to 2022. Risk factors for designing predictive models were identified through literature review, expert opinions, and clinical specialists’ input. The extracted information underwent preprocessing, and six machine learning (ML) methods were developed and evaluated for GDM prediction in the first trimester of pregnancy: decision tree (DT), multilayer perceptron (MLP), k-nearest neighbors (KNN), Naïve Bayes (NB), random forest (RF), and extreme gradient boosting (XGBoost).ResultsModels were evaluated using accuracy, precision, sensitivity, and the area under the receiver operating characteristic curve (AUC). Based on the glucose tolerance test (GTT) results, the RF model achieved the best performance in GDM prediction, with 89% accuracy, 86% precision, 92% recall, and 94% AUC, using demographic variables, medical history, and clinical findings. In modeling based on insulin consumption, the RF model achieved the best results with 62% accuracy, 60% precision, 63% recall, and 63% AUC in predicting GDM using demographic variables and medical history.ConclusionThe results of this study demonstrate that ML algorithms, especially RF, have acceptable accuracy in the early prediction of GDM during the first trimester of pregnancy.

Why Do Nurses Fail to Implement Pain Assessment Instruments for Hospitalized Infants?

Background: Effective pain assessment in neonatal care is crucial for ensuring the well-being of newborns. However, barriers to its successful implementation persist. This study aims to identify the obstacles that hinder effective neonatal pain assessment by Neonatal Intensive Care Units (NICUs) nurses. Materials and Methods: This qualitative study was conducted using the method of conventional content analysis. Purposive sampling was employed from February to September 2023, selecting 14 female nurses working in NICUs of hospitals in Tehran and Karaj as participants. Indepth, semistructured interviews were conducted to collect the data. The software “MAXQDA” version 2016 was utilized for managing qualitative data. Results: Four main themes and eleven subthemes were identified: “Overtasked,” “Discordant atmosphere,” “Soulless care,” and “Lack of awareness.” Each of these main themes is further elaborated through the subsequent subthemes. Conclusions: This study found that the lack of knowledge and understanding of neonatal pain assessment tools, the busyness of nurses, lack of time, excessive documentation, and the inadequacy of staff relative to the number of newborns were the most significant obstacles to the assessment of newborn pain. Addressing these challenges is critical for optimal neonatal pain assessment and management, promoting the well-being of newborns.

Explainable artificial intelligence for stroke prediction through comparison of deep learning and machine learning models

Failure to predict stroke promptly may lead to delayed treatment, causing severe consequences like permanent neurological damage or death. Early detection using deep learning (DL) and machine learning (ML) models can enhance patient outcomes and mitigate the long-term effects of strokes. The aim of this study is to compare these models, exploring their efficacy in predicting stroke. This study analyzed a dataset comprising 663 records from patients hospitalized at Hazrat Rasool Akram Hospital in Tehran, Iran, including 401 healthy individuals and 262 stroke patients. A total of eight established ML (SVM, XGB, KNN, RF) and DL (DNN, FNN, LSTM, CNN) models were utilized to predict stroke. Techniques such as 10-fold cross-validation and hyperparameter tuning were implemented to prevent overfitting. The study also focused on interpretability through Shapley Additive Explanations (SHAP). The evaluation of model’s performance was based on accuracy, specificity, sensitivity, F1-score, and ROC curve metrics. Among DL models, LSTM showed superior sensitivity at 96.15%, while FNN exhibited better specificity (96.0%), accuracy (96.0%), F1-score (95.0%), and ROC (98.0%) among DL models. For ML models, RF displayed higher sensitivity (99.9%), accuracy (99.0%), specificity (100%), F1-score (99.0%), and ROC (99.9%). Overall, RF outperformed all models, while DL models surpassed ML models in most metrics except for RF. DL models (CNN, LSTM, DNN, FNN) achieved sensitivities from 93.0 to 96.15%, specificities from 80.0 to 96.0%, accuracies from 92.0 to 96.0%, F1-scores from 87.34 to 95.0%, and ROC scores from 95.0 to 98.0%. In contrast, ML models (KNN, XGB, SVM) showed sensitivities between 29.0% and 94.0%, specificities between 89.47% and 96.0%, accuracies between 71.0% and 95.0%, F1-scores between 44.0% and 95.0%, and ROC scores between 64.0% and 95.0%. This study demonstrates the efficacy of DL and ML models in predicting stroke, with the RF models outperforming all others in key metrics. While DL models generally surpassed ML models, RF’s exceptional performance highlights the potential of combining these technologies for early stroke detection, significantly improving patient outcomes by preventing severe consequences like permanent neurological damage or death.

The effect of mobile health application training based on micro-learning method on the level of resilience and happiness among intensive care nurses: a randomized controlled trial

BackgroundIncreasing the level of resilience and happiness of intensive care nurses can lead to an improvement in their psychological health. This study aimed to extract the possible effectiveness of mHealth application utilizing the micro-learning method on a mobile phone platform on the intensive care nurses’ resilience and happiness.Materials and methodsThis single-blind randomized controlled trial was conducted in 2022-24. Sixty nurses working in intensive care units at two hospitals in Tehran, Iran were recruited using purposive sampling and randomly assigned to either the intervention or control group. Techniques of resilience and increasing happiness were taught to the intervention group using the mHealth application based on the micro-learning method. No training was provided to the control group. For data collection, questionnaires of individual characteristics, Connor-Davidson Resilience, and Oxford Happiness were used.ResultsBefore the intervention, there was no significant difference between the mean of the subscales and the total score of resilience and happiness of the intervention and control groups (P < 0.05). However, after the intervention, there was a significant difference (P < 0.05). After using the mHealth application, the total resilience score of the intervention group increased from 67.30 ± 10.12 to 79.27 ± 5.87 (P < 0.0001), while the resilience of the control group changed from 68.80 ± 9.09 to 65.93 ± 8.44 (P = 0.548). Similarly, using the mHealth educational application based on micro-learning led to an increase in the happiness score of the intervention group from 38.50 ± 11.10 to 67.83 ± 8.84 (P < 0.0001), whereas the happiness score of the control group nurses after the intervention (38.93 ± 14.33) compared to the baseline (41.40 ± 14.51) did not change significantly (P = 0.388).ConclusionsThe use of the mHealth application based on the micro-learning method played an effective role in training resilience and happiness skills in nurses. It is recommended to conduct more studies using this new educational approach.Trial registrationThe study has been registered in the Iranian Registry of Clinical Trials (No. IRCT20221225056916N1, Date: 04/29/2023).

Lack of hospital resilience as the main challenge of hospital management during the COVID-19 pandemic: A grounded theory study.

Traditional hospital management responses during the coronavirus disease 2019 (COVID-19) pandemic proved ineffective, particularly considering the pre-existing challenges in healthcare systems. The study examines hospital management challenges during the COVID-19 pandemic, transforming their lived experiences into a conceptual approach to prevent repetition and benefit health planners and policymakers in future crises and normal times. This qualitative study utilized the grounded theory methodology, conducting in-depth interviews with 12 hospital administrators from seven major referral hospitals in Shiraz, Bushehr, and Tehran, focusing on COVID-19 patients' complex conditions. The participants had a mean age of 46.6 ± 8.8 years. Data analysis was conducted using the grounded theory (Straussian approach). A total of 98 subthemes and 25 themes were identified during the data analysis process. Using axial and selective coding, we found that in the presence of contextual and causal conditions, the lack of hospital resilience was recognized as the core theme in the final model. Intervening conditions, strategies to overcome the challenges of hospital management, and the outcomes were identified. Iranian hospital administrators dealing with COVID-19 recognize the lack of hospital resilience as their main management obstacle. Non-resilient hospitals' response to crises with new management strategies can fail due to insufficient documentation and information sharing, leading to persistent problems. Prioritizing evidence-based strategies and sharing successful approaches from other healthcare systems can improve resilience. Nationwide guidelines will ensure equitable patient treatment and reduce lawsuits against physicians for resource-efficient use. Hospital resilience implementation in real-world settings is widely sought for evidence.

Violence against infertile women in an Iranian setting

BackgroundInfertility as a distressing condition, is associated with numerous psychological and social consequences for couples. In addition, there is evidence to suggest that infertility may contribute to the occurrence of violence against women. The aim of the study is to determine the prevalence and factors associated with violence against Iranian women with infertility.MethodsA cross-sectional study was carried out in 2020, involving 310 infertile women who sought treatment at an infertility clinic in a referral women’s hospital in Tehran. The eligible participants were selected using the consecutive sampling method. The Infertile Women’s Exposure to Violence Determination Scale (IWEVDS) was used to collect data on violence. Data were analyzed using descriptive (Mean, frequency) and inferential statistics (Independent sample t-test, Chi-square, regression logistic) through the SPSS version 25.ResultsThe average score on the IWEVDS was found to be 43.89 ± 18.23, indicating a moderate level of violence. Out of the 310 participating infertile women, 84.2% reported experiencing violence. Among abused women, 67% experienced domestic violence, 76.2% encountered social pressure, 85.4% faced punishment, 88.9% were exposed to traditional practice, and 57.5% experienced exclusion. The main risk factors associated with violence were a low number of children, low economic status, and an increased duration of infertility.ConclusionsThis study’s findings underline a high rate of violence experienced by infertile women. Therefore, it is crucial to screen women with infertility for violence and provide them with adequate support.

Effects of trehalose on bone healing, physical function, and pain in patients with pertrochanteric fractures: a randomized controlled trial protocol

BackgroundAppropriate management of fractures is crucial for restoring natural bone function and preventing long-term complications. Previous research on animal models indicates that trehalose can improve bone fracture healing by inhibiting the inflammatory cascade. We hope that trehalose can accelerate bone fracture healing in humans, alleviate pain, and ultimately enhance the individual’s quality of life.MethodsThis randomized, double-blind clinical trial will be conducted at Taleghani Hospital in Tehran, Iran. Sixty-four patients admitted to the orthopedic ward will be enrolled based on eligibility criteria. The participants will be randomly allocated based on the permuted block randomization into two groups: those receiving trehalose (32 patients) or placebo (32 patients). The patients in the trehalose and placebo groups will receive 3.3 g of trehalose or placebo for 12 weeks, respectively. A consent form, general questionnaire, as well as the Visual Analog Scale (VAS), Harris Hip Score (HHS), and radiological analyses will be used to assess fracture healing quality. The intention-to-treat principle will form the basis of the statistical analysis.DiscussionThe trial results may provide a convenient and safe adjuvant treatment option for the Pertrochanteric Fractures population.Trial registrationIranian Registry of Clinical Trials. IRCT20240605062013N1. URL of the trial registry record: https://irct.behdasht.gov.ir/trial/77212. Registration date: 16 June 2024.

Factors associated with COVID-19 vaccine acceptance and hesitancy in children: a comprehensive survey

BackgroundThe COVID-19 pandemic has underscored the significance of immunizations, particularly among susceptible populations such as children. This study examines the factors that influence parents’ decision to accept or hesitate in vaccinating their children in an urban environment.MethodsA one-year cross-sectional study was carried out at a paediatric hospital in Tehran, Iran. The objective is to target a demographic of 226 children, aged 5 to 18, residing in metropolitan locations, over the period of June to August 2023. An extensive survey, built upon previous research, analyzed the variables that influence the reluctance and acceptance of vaccines. Data on demographics, vaccination status, and variables influencing hesitation or acceptance were collected.ResultsOut of the 226 participants, 22.1% of the children had received vaccinations. There was a correlation between parents getting vaccinated and greater rates of child vaccination (100% vs. 92.9%, p = 0.073). Significant relationships were seen between age, parental education, and past COVID-19 hospitalizations. The main motivations for vaccination were to guarantee safety (66%) and to avert serious illness (60%). The primary reasons for hesitancy were primarily attributed to worries regarding potential harmful effects (58%), lack of trust in the vaccine (19.9%), and uncertainties regarding its efficacy (15.9%).ConclusionsThe research emphasizes key factors that have a significant impact on the COVID-19 vaccination of children, such as age, previous hospitalization experiences, and parental attitudes. To boost vaccination rates in this demographic, it would be beneficial to address parental concerns regarding vaccine safety and enhance educational outreach regarding the advantages of vaccines. Public health programs should prioritize clear and open information and precise treatments to decrease vaccine reluctance.

Clinical Characteristics and Outcomes of COVID-19 in Pediatric Cancer Patients: A Retrospective Cohort Study

Background: The impact of COVID-19 on pediatric cancer patients remains a critical area of investigation. Objectives: This study aimed to compare the clinical characteristics and outcomes of COVID-19 in children with and without malignancies. Methods: A retrospective cohort study was conducted at Mofid Children's Hospital in Tehran, Iran, from July 2020 to December 2022. The study included 210 children with confirmed SARS-CoV-2 infection: 105 with malignancies (case group) and 105 without malignancies (control group). Clinical presentations, laboratory parameters, imaging findings, and outcomes were analyzed. Results: Children with malignancies exhibited lower rates of fever (P = 0.044), respiratory distress (P = 0.035), and nausea/vomiting (P = 0.002). Significant differences in laboratory findings were observed between the case and control groups, including WBC count (P = 0.007), hemoglobin levels (P &lt; 0.001), platelet count (P = 0.002), and ESR (P = 0.001). Ground-glass opacity on chest imaging was significantly associated with malignancy (P = 0.003). Although not statistically significant, the malignancy group showed a trend toward higher mortality (OR = 2.686, P = 0.105). Thrombotic events were rare in both groups. Conclusions: Pediatric cancer patients with COVID-19 exhibited more severe symptoms and distinct laboratory and imaging findings compared to non-cancer patients. While mortality rates were similar, the trend toward higher risk in the malignancy group highlights the need for specialized management strategies for this vulnerable population.

Comparison Between Continuous Non-invasive Arterial Pressure (CNAP) and Invasive Arterial Pressure Monitoring During Weaning from CPB in Patients Undergoing CABG Surgery: A Comparative Case Study

Background: Accurate and continuous measurement of arterial blood pressure is crucial in managing patients undergoing cardiac surgery to prevent complications and ensure better outcomes. Objectives: This study aimed to compare blood pressure monitoring using continuous non-invasive arterial pressure (CNAP) and invasive arterial pressure (IAP) methods after weaning from cardiopulmonary bypass (CPB). Methods: Blood pressure monitoring was conducted on 30 patients referred to Dr. Masih Daneshvari Hospital in Tehran for coronary artery bypass grafting (CABG) surgery. Measurements were taken every two minutes for 30 minutes after separation from CPB using both non-invasive CNAP and invasive IAP methods simultaneously. Data on systolic, diastolic, and mean arterial blood pressure (MAP) were collected and analyzed using SPSS statistical software. Results: The findings revealed no significant difference between the CNAP and IAP methods in monitoring MAP (P &gt; 0.05). However, systolic blood pressure (SBP) measured by the IAP method was significantly higher than that measured by the CNAP method starting 10 minutes after weaning from CPB (P &lt; 0.05). Conversely, diastolic blood pressure measured by the CNAP method was significantly higher than the IAP method at 2, 8, 10, 18, 20, and 22 minutes after CPB separation (P &lt; 0.05). Conclusions: Continuous non-invasive arterial pressure is a non-invasive and continuous blood pressure monitoring method that can be considered an alternative to the IAP method for measuring MAP in CABG surgery patients during weaning from CPB.

Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control study.

Latent tuberculosis (TB) can reactivate in immunocompromised individuals, such as cancer patients undergoing chemotherapy, leading to severe complications. Understanding the prevalence of latent TB in this high-risk group is crucial, especially in regions with moderate to high TB burdens. This study aims to determine the prevalence of latent tuberculosis in cancer patients before chemotherapy and immunotherapy to guide preventive interventions and reduce the risk of TB reactivation. This case-control study was conducted at Sina Hospital in Tehran, Iran, from 2012 to 2022. A total of 392, including 107 newly diagnosed cancer (case) and 285 non-cancer (control) patients, were enrolled in this study. All patients had received the Bacillus Calmette-Guérin (BCG) vaccine at the age of one. They underwent a thorough clinical examination and were screened using the tuberculin skin test (TST) to detect latent TB. Any active TB cases were identified through acid-fast smear tests. The data collected from the study participants was then analyzed. The results showed no significant difference in the size of TST between cancer and non-cancer patients (cases: median = 2mm, IQR: 1-12; controls: median = 2mm, IQR: 1-5; p = 0.09). The prevalence of latent TB was 27.1% in cancer patients and 20.7% in non-cancer patients, with no significant association identified between latent TB and malignancies (P-value = 0.176). Over a median follow-up of 4years, mortality was significantly higher in cancer patients compared to controls (42.1% vs 1.8%; P< 0.001, OR = 40.64). Additionally, deceased patients exhibited a greater prevalence of latent TB (44% vs 19.3% in survivors; P< 0.001, OR = 3.28), and increased size of TST was associated with higher mortality risk among cancer patients. In conclusion, this study emphasizes the need for vigilant latent TB screening in cancer patients, given the association between larger TST sizes and increased mortality risk. While no direct link between cancer type and latent TB was found, proactive TB management remains crucial, particularly for those undergoing immunosuppressive therapy.

The Impact of Disease-Modifying Therapies of Multiple Sclerosis on the Effectiveness of the BBIBP-CorV COVID-19 Vaccine

Background: It is well-known that disease-modifying therapies (DMTs) in patients with multiple sclerosis (PwMS) may reduce the immune response to COVID-19 vaccines. Objectives: The present study aimed to investigate the efficacy of the Sinopharm/BBIBP-CorV vaccine in Iranian PwMS treated with different DMTs. Methods: This quasi-experimental study was conducted between January 2021 and January 2022 at the MS clinics of Imam Hossein and Qaem Hospitals in Tehran and Mashhad, Iran. Based on inclusion and exclusion criteria, PwMS received two doses of the Sinopharm vaccine at an interval of 28 days. The humoral response to the vaccine was evaluated by measuring the IgG receptor-binding domain (RBD-IgG) against SARS-CoV-2 on three occasions: before vaccination, 28 days after the first dose, and 28 days after the second dose. Results: Of the 208 patients, 117 were eligible for analysis. The Sinopharm vaccine was generally safe among Iranian PwMS. The IgG antibody titer against the SARS-CoV-2 strain was significantly associated with the DMT class. Patients treated with fingolimod and rituximab developed the lowest humoral response to the Sinopharm vaccine (21.1% and 38.4%, respectively). Conclusions: The present study revealed that PwMS treated with fingolimod and rituximab are likely to have a suboptimal humoral response to the Sinopharm vaccine. This finding may help neurologists make informed decisions about DMT selection during the pandemic.

Psychometric properties of Farsi version of Demoralization Scale-II (DS-II) in Iranian cancer patients.

Demoralization, a prevalent form of psychological distress, significantly impacts patient care, particularly in terminally ill individuals, notably those diagnosed with cancer. This study aimed to assess psychometric properties of Farsi version of Demoralization Scale-II (DS-II) in Iranian cancer patients. This study was descriptive-analytical cross-sectional research. The statistical population was cancer patients who sought treatment at Imam Khomeini Hospital in Tehran throughout the 2021-2022. In the initial phase of the study, a preliminary sample comprising 200 patients was carefully selected through convenience sampling. After applying these criteria, 160 patients satisfactorily completed the questionnaires, forming the final study sample. They completed series of questionnaires that included sociodemographic information, DS-II, Scale of Happiness of the Memorial University of Newfoundland, and Beck Depression Inventory (BDI-II). The evaluation included exploratory factor analysis, confirmatory factor analysis (CFA), assessments of convergent validity, and internal consistency reliability. The CFA revealed a 2-factor model consistent with the original structure. The specific fit indices, including the Comparative Fit Index, Root Mean Square Error of Approximation, and Goodness-of-Fit Index, were 0.99, 0.051, and 0.86, respectively. Significant correlation coefficients (p < 0.05) were found between the DS-II and the Beck Depression and MUNSH Happiness scales. The internal consistency of the DS-II, as measured by Cronbach's alpha, yielded values of 0.91 for the meaning and purpose factor, 0.89 for the coping ability factor, and 0.92 for the total score. The Farsi version of DS-II has demonstrated reliability and validity in evaluating demoralization among cancer patients in Iran. This tool can offer valuable insights into the psychological problems of terminally ill patients. Further research opportunities may include conducting longitudinal studies to track demoralization over time and exploring the impact of demoralization on the overall well-being and care of terminally ill patients in Iranian society.

Comparison of the Parenting Education Effect with Multimedia and Social Media on Nurses' Parental Stress During the COVID-19 Pandemic

Background: The majority of female nurses have maternal responsibilities; therefore, psychological support, parenting education, and lifestyle modifications to reduce parental stress are particularly significant for this group. Objectives: This study aimed to compare the effects of parenting education delivered through multimedia and social media on nurses' parental stress during the COVID-19 pandemic. Methods: This quasi-experimental research was conducted in 2020 in selected hospitals in Tehran, where participants were randomly assigned to two experimental groups (social media and multimedia) and one control group (n = 20 per group). A total of 60 female nurses were recruited through convenience sampling. In the multimedia group, nurses received four DVDs, each containing five training sessions, over a period of four weeks. In the social media group, educational materials, including voice-narrated PowerPoint presentations, were delivered via Rubika and WhatsApp messengers in 20 sessions over four weeks. The control group received no intervention. The Parenting Stress Index was used for data collection both before the intervention and two weeks after its completion. Results: There was no significant difference in parental stress scores between the three groups before the intervention (P = 0.956); however, the difference after the intervention was significant (P &lt; 0.0001). Conclusions: Education delivered through social media had a greater impact on reducing nurses' parental stress compared to multimedia. This method is recommended for educating nurses to reduce stress and enhance their performance.

Development of a Conceptual Model to Identify and Rank Environmental and Health Costs of Work-Related Diseases Using Delphi Study and Analytic Network Process

Introduction: Improving health and the environment is one of the components of development, social welfare, and economic growth. Another influential factor in increasing health costs and reducing social welfare is work-related accidents and diseases, which impose high costs on individuals, industries, and the national economies of countries. Therefore, using multi-criteria decision-making methods, the present study provided a conceptual model to identify and rank work-related diseases’ environmental and health costs. Material and Methods: The present study was conducted in 2023. A classification model for the economic evaluation of environmental and health costs of occupational diseases was developed to achieve the study’s aim. In the current research, the Delphi method was used to identify health and environmental criteria, and the Analytic Network Process (ANP) was used to weight the sub-criteria. Finally, the cost of health and the environment was estimated based on the available information. Naft Tehran Hospital (NSHT) was also selected as a case study site. Results: The results showed that the drug and medical equipment cost factor, with a weight of 0.312 in the treatment sector, and the particular and infectious waste cost factor, with a weight of 0.085, were the most critical factors in the economic evaluation. Also, the parametric model results showed that 99.84% of the total costs are related to health costs, and 0.16% are related to environmental costs. In general, the results of this research showed that 61.3% of the costs of the health sector are related to the two sectors of medicine and medical equipment and the cost of service personnel, and 91.7% of the costs of the environmental sector are related to wastewater treatment and the cost of electricity consumption. Conclusion: This study presented a semi-quantitative model to estimate health and environmental costs caused by occupational diseases. The results can create a novel scientific insight into implementing control measures using the optimal point of cost-benefit parameters. Implementing this integrated model can be a practical and effective step in allocating resources and prioritizing interventions.

Evaluation of posttraumatic stress and posttraumatic growth in nurses working in neonatal wards of Tehran hospitals during the COVID-19 pandemic

Evaluation of posttraumatic stress and posttraumatic growth in nurses working in neonatal wards of Tehran hospitals during the COVID-19 pandemic

Can Underlying Co-Morbidities Affect Cerebral Oximetry in Cardiac Surgery Patients?

Today, there is a growing number of monitoring Equipment accessible. These equipments ranging invasive to non-invasive. Choosing suitable monitoring methods depends on their benefits, drawbacks, and expenses. Overall, non-invasive brain monitoring is growing in importance because of its precision in performance and increased stability in output. Like the assessment of regional brain oxygen levels and the assessment of anesthesia depth using the BIS device, whose specific role in guidelines remains undefined. Many patients who undergo heart surgeries including valvular, dissection and CABG have various comorbidities. To add details, according to literatures about CVA 28% of patients had (Cerebrovascular Accident), 74% IHD (Ischemic Heart Disease), 82% HTN (Hypertension), 52% DM (Diabetes Mellitus), 61% Smoking History, 36% CKD (Chronic Kidney Disease) and 42% CHF (Congestive Heart Failure). Current study delves into the correlation of short-term complications after cardiac operations with cerebral oximetry alterations and the space under the curve (duration of rSo2 drop) to take the best advantages of cerebral oximetry for heart surgery in the future. This prospective observational study was conducted among 101 patients undergoing cardiac surgery at Imam Khomeini Hospital in Tehran between 2019 and 2020. Following admission to the operating room, standard monitoring of vital signs, including non-invasive blood pressure (NIBP), electrocardiogram (ECG), central venous pressure (CVP), oxygen saturation (SpO2), and end-tidal carbon dioxide (ETCO2), was established. Prior to anesthesia induction, cerebral oxygen saturation (rSO2) was continuously monitored using the INVOS 5100c cerebral oximeter. Patients were followed for 7 days postoperatively, with documentation of intubation duration, intensive care unit (ICU) stay, and complications such as renal failure, cerebrovascular accident (CVA), and mortality. Data analysis was performed using SPSS 25.0 statistical software, with a P of less than 0.05 considered statistically significant. This study investigated rSO2 levels, as measured by a cerebral oximeter, in patients aged 19 to 79 undergoing cardiac surgery. Data were collected from both the right and left sides of the forehead during the operative period. Overall, these findings highlight the importance of rSO2 monitoring during cardiac surgery, particularly in patients with underlying cardiovascular conditions. Further research is needed to elucidate the specific mechanisms underlying these observations and to explore potential strategies for optimizing cerebral oxygenation in this vulnerable patient population.

A randomized, double-blind, placebo-controlled clinical trial to evaluate pregabalin efficacy in the treatment of behavioral and psychological symptoms of dementia in patients with Alzheimer's disease.

Behavioral and Psychological Symptoms of Dementia (BPSD) are common during Alzheimer's disease and cause severe problems for patients and their caregivers. To assess the therapeutic efficacy of Pregabalin in comparison with a placebo in treating BPSD in patients with Alzheimer's disease (AD) visiting the memory and cognition clinic of Roozbeh Psychiatric Hospital in Tehran, Iran. A 12-week double-blind, randomized comparison of Pregabalin and placebo treatments was conducted in 53 patients with DSM-V diagnosis of dementia of Alzheimer's type. They were randomly assigned to receive Pregabalin (doses: 50 titrated up to 300 mg/day) or a placebo. Clinical response was evaluated using the Neuropsychiatric Inventory (NPI), and the Behavioral Pathology in AD Rating Scale (BEHAVE-AD) scores compared with baseline. Side effects were also recorded carefully. Patients receiving Pregabalin had better outcomes in comparison with patients receiving a placebo regarding both NPI and BEHAVE-AD scores after 12 weeks (p-value = 0.009 for NPI and p-value = 0.003 for BEHAVE-AD). There was also a statistically significant decrease in the treatment group depression sub-score regarding NPI and BEHAVE-AD (respectively, p-value =0.000, 0.003). The caregiver burden sub-score of the NPI test was also lower in patients receiving pregabalin (p-value = 0.000). There was no statistically significant difference between the occurrence of adverse effects between the two groups (p-value = 1.00). Pregabalin at a dose of 300 mg/day was well tolerated and associated with reductions in the severity and frequency of behavioral symptoms in patients with AD. Pregabalin could be considered a favorable choice for treating BPSD in adults with mild to moderate stages of Alzheimer 's-type dementia, considering its befitting safety profile. https://www.irct.ir/trial/52750, identifier IRCT20201201049553N1.