Southeastern Iran Research Articles

Canine leishmaniasis caused by Leishmania Tropica in southeastern Iran: a case series study

Dogs are the primary reservoirs of Leishmania infantum (L. infantum), but Leishmania tropica (L. tropica) infection is also possible in dogs and can transmitted to humans. The southeast of Iran experiences a high prevalence of canine leishmaniasis (CanL), and veterinarians frequently encounter symptomatic cases. Therefore, from December 2017 to November 2022, the present case series was designed to assess the prevalence of CanL in owned dogs with cutaneous manifestations resembling CanL. A total of 500 owned dogs with dermal lesions from two endemic cities, Zabol and Kerman, were enrolled. Impression smears from skin lesions and popliteal lymph nodes were prepared from all cases, whereas blood samples were gathered from amastigote-positive dogs for serological and molecular surveys. Commercial ELISA was done on sera samples, and two-step nested PCR was used on extracted DNA to amplify variable fragments of the Leishmania species’ kinetoplast DNA (kDNA). Leishman bodies were microscopically detected in 7.2% (36/500) of dermal smears. Of the 360 owned dogs from Zabol, 2 have been diagnosed with L. tropica, and 10 have been diagnosed with L. infantum. Out of 140 owned dogs from Kerman, 8 were identified with L. tropica infection, and 16 were infected with L. infantum. Molecular results revealed the presence of 750 full dual-band bases related to the L. tropica species in 10/36 (27.7%) cases, which showed a considerable increase in canine cutaneous leishmaniosis compared with previous studies in southeastern Iran. The noticeable prevalence of L. tropica in owned dogs indicated that the dog’s role in cutaneous leishmaniosis should be re-evaluated as a possible animal reservoir in endemic areas.

Modeling PM2.5 and SO2 levels and identifying factors impacting them in Kerman city, southeastern Iran

Modeling PM2.5 and SO2 levels and identifying factors impacting them in Kerman city, southeastern Iran

Biogeography of the Iranian snakes.

The events of the Cenozoic era such as mountain formation caused Iran to become one of the most amazing biodiversity hotspots in the world today. This pioneering study on Iranian snake biogeography integrates historical and ecological analyses. A phylogeographic review traces speciation and dispersal, while cluster analysis with a new snake checklist assesses faunistic similarities within Iran and its surroundings. Jaccard and Sorenson indices generate similarity dendrograms, Indicator Species Analysis pinpoints regional key species, and Endemism index calculates regional endemism rates, enriching our knowledge of Iran's species diversity. Phylogeographic analyses identify four biogeographical corridors for snake ingress into Iran: the Arabian region through southwestern Iran, the Western Asian mountainous transition zone via northwestern Iran, the Turanian region into northeastern Iran, and the Indus River Valley into southeastern and eastern Iran. Dendrogram analysis divides snake fauna into three groups. The first group associates western Zagros and Khuzestan fauna with the Sahara and Arabian regions. The second group links Kopet Dagh and Turkmen Steppe fauna with the Turanian region, and Central Plateau and Baluchistan fauna with the Iranian region. The third group connects northwest highlands, Alborz and Zagros mountains, and Caspian Sea coasts with the Western Asian Mountain transition zone. The study validates broad biogeographic patterns via ecoregional associations and indicator species analysis, providing finer resolution. Species like Platyceps najadum in Caspian Hyrcanian mixed forests exemplify ecoregional alignment, while Zagros and Alborz mountains exhibit unique faunal indicators, indicating species-level divergence. Shared indicators among widespread ecoregions reflect habitat continuity; exclusive indicators emphasize regional distinctiveness. Despite endemic species prevalence, they seldom act as significant indicators due to various factors. Our research confirms the Zagros Mountains, Khuzestan Plain, Alborz Mountains, and Persian Gulf coasts as snake diversity hotspots, marked by higher species richness compared to other Iranian regions.

The Psychometric Properties of the Persian Version of the Relaxation, Meditation, and Mindfulness Experiences Questionnaire Utilized Among Patients with Cancer: A Cross-Sectional Study in Iran.

Mindfulness is increasingly recognized as an effective strategy for managing chronic illnesses and improving mental well-being in cancer patients. This study sought to adapt and validate a Persian version of Relaxation, Meditation, and Mindfulness Experiences Tracker Questionnaire trait month 3.1″ (P-RMMtm 3.1) for use with Iranian cancer patients. This cross-sectional study was conducted in several hospitals affiliated with Kerman University of Medical Sciences in southeastern Iran. Validity and reliability tests were administered between March and December 2023. Results showed strong psychometric properties, with a six-factor solution explaining 72.387% of the variance. The identified factors were mindful transcendence, mindful relaxation, mindful emotion, mindful focus/awareness, mindful quiet, and mindful action. Confirmatory factor analysis indices were generally satisfactory (χ2/d.f. = 2.253, RMSEA = 0.079, GFI = 0.833, CFI = 0.923, and IFI = 0.924). Cronbach's alpha values for the RMMtm 3.1 factors ranged from 0.802 to 0.89. In conclusion, the Persian version of RMMtm 3.1 is a reliable instrument for assessing relaxation, meditation, and mindfulness experiences in Iranian cancer patients. Its concise format makes it suitable for future research with this population.

Drought risk assessment based on hazard, vulnerability, and coping capacity concepts for hot and dry climate regions of Iran

Due to the complex and multi-dimensional nature of droughts, it is not possible to assess drought-induced damage and its consequences for various social, economic, and environmental aspects of societies by relying only on a univariate index such as precipitation-based drought indices. The present study aimed to develop a practical and scientific framework based on hazard, vulnerability (social, economic, and environmental), and coping capacity to generate a drought risk map for the hot and dry climate regions of Iran. Accordingly, the Drought Hazard Index (DHI), Drought Vulnerability Index (DVI), and Drought Coping Capacity Index (DCCI) were derived from “the Standardized Precipitation Evapotranspiration Index (SPEI)”, “16 social, economic and environmental variables” and “three social, economic variables”, respectively. The layers of all variables of the three indices in the GIS were provided, and they were combined in the form of an equation to produce a drought hazard map of central and southeastern Iran. The results indicate that the counties most and least vulnerable to drought were located in the southeast and west of the case study area, respectively. A number of large households, long distances from provincial centers, and soil erosion were the most important social, economic, and environmental factors making the southeast of the case study (including south of Sistan and Baluchestan and south of Kerman provinces) most vulnerable to drought. Due to their high drought coping capacity, counties located in the west of the case study (west of Kerman and south of Yazd provinces) were least vulnerable to drought. Extended support for low-income households by charitable organizations, tertiary education, and most importantly, a variety of jobs and career opportunities were the most important factors in reducing vulnerability in this part of Iran. Furthermore, our methodology by taking social, economic, and environmental dimensions into account as risk, vulnerability, and coping capacity indices can be far more efficient than the methods considering only risk and vulnerability factors.

Predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients

BackgroundEnd-stage renal disease (ESRD) causes numerous physical and psychological problems in patients, so that they must adhere to their treatment regimen to recover their disease, alleviate these problems, and increase their lifespan. The present study aimed to determine the predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients.MethodsThis correlational cross-sectional study investigated some variables related to treatment adherence in 184 patients undergoing hemodialysis referred to two dialysis centers in Kerman, southeastern Iran. A census method was used to select the participants and data were collected using socio-demographic characteristics questionnaire, Adherence to Treatment Questionnaire (ATQ), Conner-Davidson Resilience Scale, Reef Psychological well-being Questionnaire, and Spiritual Well-Being Scale (SWBS).ResultsThe overall treatment adherence score was 155.42 ± 27.98 and we found a positive significant correlation between spiritual health, resilience, psychological well-being, and treatment adherence (p < 0.001). The mean scores of resilience, spiritual health and psychological well-being were 70.59 ± 17.02, 90.09 ± 12.01, and 77.88 ± 11.72, respectively. Spiritual health, psychological well-being, resilience, gender and marital status predicted 54% of the variance of treatment adherence, with psychological well-being being the best predictor (p < 0.001).ConclusionsSpiritual health, psychological well-being, and resilience are factors that influence treatment adherence of the patients undergoing hemodialysis, with psychological well-being having the greatest contribution to improving patient’s treatment adherence. Interventions effective in improving psychological well-being, spiritual health and resilience can improve treatment adherence of patients undergoing hemodialysis. Healthcare workers must pay more attention to the factors affecting treatment adherence of patients undergoing hemodialysis.

Effectiveness of Interventions on Habits among University Staff in Southeastern Iran

Background: Health-promoting environments are a key focus of the Ottawa Strategic Charter, which aims to enhance health in the workplace and reduce unhealthy behaviors among employees. Objectives: This study aimed to evaluate the effectiveness of health-promoting interventions on the habits of university staff in Southeastern Iran. Methods: This semi-experimental study was conducted from 2020 to 2021 in Zahedan, Southeastern Iran. A total of 254 administrative staff from the University of Medical Sciences and Sistan &amp; Balochistan University were selected using available randomized methods and divided into control and intervention groups. The study instrument was a researcher-designed questionnaire, which demonstrated a content validity ratio (CVR) of 0.8, a Content Validity Index (CVI) ranging from 0.83 to 0.97, and an internal consistency with a Cronbach's alpha of 0.85. The questionnaire was distributed online via the Porsline platform. For the intervention, training sessions were conducted online, and the session files and training booklet were made available to intervention group staff through the university's education system. A post-test was administered one month after the pretest. Data were analyzed using SPSS 21 software, with pretest results adjusted using chi-square and ANCOVA statistical tests. Results: The study found that the mean age of participants was 40.5 ± 7.4 years. Scores for employee knowledge, attitude, and behavior were 80.0 ± 16.4, 86.6 ± 22.8, and 80.8 ± 17.6, respectively. The most significant factors influencing attitudes were education (P &lt; 0.001) and health status (P = 0.001). Type of employment (P = 0.025), work experience (P = 0.017), and health status (P = 0.037) were also significantly associated with behavior. After adjusting for pretest results, there were significant differences between the intervention and control groups in terms of scores for knowledge, attitude, and behavior (P &lt; 0.001). Conclusions: The study concluded that employees with correct attitudes and healthy behaviors reported better health outcomes. Additionally, educational interventions effectively improved staff knowledge, attitudes, and behavior. To enhance health status, reduce employee disability, decrease absenteeism, and increase organizational productivity, it is recommended to plan and implement workplace health promotion programs focused on employees.

Experiences of family caregivers of nurses infected with COVID-19: a qualitative study

BackgroundNurses, as the main healthcare workers during the COVID-19 pandemic, were at high risk of contracting the disease. Family caregivers played a vital role in the support and recovery of patients with COVID-19. The experiences of family caregivers of nurses are very important due to the nature of their job. However, little information is available in this field. To this end, the present study aimed to explore the experiences of family caregivers of nurses who recovered from COVID-19.MethodsThis descriptive qualitative study was conducted in one of the hospitals in southeastern Iran in 2022. The participants were 12 family caregivers of nurses who recovered from COVID-19 and were selected through purposive sampling. The data were collected through semi-structured interviews and analyzed using conventional content analysis. The Consolidated Criteria for Reporting Qualitative research checklist was used to report the findings.ResultsThe analysis of the data revealed psychosocial consequences as main theme, three categories and nine subcategories including negative emotions and attitudes (fear of deterioration/death, fear of frequent infection, fear of transmitting infection to others, despair of recovery, Changing attitudes toward the nursing profession), caregiver burden (role conflict, economic pressure) and lack of support, ineffective interactions and isolation (Lack of support from nursing managers and colleagues, ineffective interactions and isolation).ConclusionLike other caregivers, family caregivers of nurses recovered from COVID-19 experienced psychosocial consequences and a heavy burden of responsibility. However, what differentiates our findings from the results reported in previous studies is the change in caregivers’ attitudes toward nursing and regret for their family members being nurses. The lack of support from medical staff and managers for nurses, the condition of nurses frequently contracting COVID-19 due to the nature of their profession, and the fear of transmitting the infection to others due to contact with COVID-19 patients in the workplace expose these caregivers to additional stress and many risks. Thus, these caregivers need more attention and support in similar situations; an issue that seems to have been neglected during the COVID-19 pandemic.

Hybrid machine learning approach integrating GMDH and SVR for heavy metal concentration prediction in dust samples.

In agricultural regions prone to dust storms, heavy metal contamination of soil and crops from airborne particulates poses significant risks to food safety and public health. This study has assessed the potential of machine learning models for predicting concentrations of toxic heavy metals like arsenic, chromium, and lead in dust from the agricultural Sistan region of southeastern Iran. This region experiences frequent dust storms mobilizing particulates from local dried lakes onto agricultural lands. The metals including nickel, copper, magnesium, cobalt, zinc, chromium, arsenic, and lead were measured in summer dust samples during 2012-2018 across 15 stations. Two hybrid models were developed combining group method of data handling (GMDH) and support vector regression (SVR) machine learning with harmony search optimization (H) so as to predict toxic metals arsenic, chromium, and lead using nickel, copper, magnesium, cobalt, and zinc inputs. Standard error maps were uncertainty higher in southern and western areas, and they are most impacted by dust storms. Results demonstrated that the hybrid GMDH + H and SVR + H models improved the accuracy of individual GMDH and SVR models in predicting heavy metals. The GMDH + H model performed the best for the lead with an agreement index (d-index) of 0.98, root mean square error (RMSE) of 2.87ppm, normalized RMSE (NRMSE) of 0.12, and coefficient of determination (RR) of 0.96. The SVR + H model showed the highest accuracy for arsenic and chromium, obtaining d-index 0.96, RMSE 0.47ppm, NRMSE 0.09, and RR 0.92 for arsenic, and d-index 0.96, RMSE 11.24ppm, NRMSE 0.16, and RR 0.93 for chromium. Taylor's diagram and heatmap analysis confirmed the superiority of the hybrid techniques. This work demonstrates the utility of state-of-the-art computing for addressing complex environmental health challenges.

A Village in the Southeastern Region of Iran Harboring the c.716T>A (p.Val239Asp) Mutation in SLC26A4.

After GJB2, SLC26A4 is the second most common contributor to autosomal recessive nonsyndromic hearing loss (ARNSHL) worldwide. In this study, we used Exome Sequencing (ES) to present a village with 31 individuals affected by hereditary hearing loss (HHL) in southeastern Iran near the border of Pakistan. The village harbored the known pathogenic missense SLC26A4 (NM_000441.2):c.716T>A (p.Val239Asp) mutation, which has a founder effect attributed to Pakistan, Iran's southeastern neighbor. Our findings, in addition to unraveling the molecular cause of non-syndromic hearing loss in these patients and further confirming the common ancestry and migration story between the people of this region and Pakistan, provide further insight into the genetic background of this region and highlight the importance of understanding the mutation spectrum of GJB2 and SLC26A4 in different regions to choose cost-effective strategies for molecular genetic testing.

Occurrence and Environmental Factors Associated with Cryptosporidium in South-Eastern Iran.

The Article Abstract is not available.

Comparative Assessment of Antimicrobial Activity of Methanolic Extracts of Five Species of Astragalus (Fabaceae) Collected from Southeast of Iran, Kerman

Background: The antimicrobial properties of certain plants against five microorganisms have been investigated and compared. Objectives: In this research, we collected, dried, and identified five perennial (chamaephyte) species of Astragalus (Fabaceae) from a mountainous region (Takht-e-Sartashtak) with an average elevation of 3600 meters in southeastern Iran. The species include Astragalus cemerinus, Astragalus dactylocarpus, Astragalus glaucacanthus, Astragalus rhodosemius, and Astragalus siliquosus. Methods: The methanolic extracts of these plant species were tested to evaluate their antimicrobial activity against five pathogenic microorganisms, including one fungus (Candida albicans), two gram-negative bacteria (Pseudomonas aeruginosa and Escherichia coli), and two gram-positive bacteria (Bacillus cereus and Staphylococcus aureus). The tests were conducted using Mueller Hinton Agar culture media and the agar-well diffusion method. Results: The antimicrobial activity of these five species was compared. It was found that the plant species displayed different antimicrobial activities. Astragalus glaucacanthus was active against four of the five microorganisms and was the only plant active against Escherichia coli. Astragalus siliquosus showed no activity against any of the microorganisms. Conclusions: Most of the antimicrobial activity was observed with Astragalus rhodosemius against Staphylococcus aureus. The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and minimum fungicidal concentration (MFC) of the plant extracts were almost similar.

The Prevalence of Chronic Hepatitis B Infection and Associated Factors Among Pregnant Women in Southeast of Iran

Background: Hepatitis B virus (HBV) infection is a significant global public health issue. Although infant immunoprophylaxis effectively reduces viral transmission, mother-to-child transmission during pregnancy, often associated with intrauterine infection, remains a major route of HBV infection. Objectives: The aim of this study was to determine the prevalence of maternal HBV infection, identify its associated factors, and measure viral load in Hepatitis B surface antigen (HBsAg)-positive pregnant women in Zahedan, Iran. Methods: This cross-sectional study included data from pregnant women who were referred to the Central Laboratory of Zahedan, Iran, for routine pregnancy tests between August and December 2019. Data were collected during the first prenatal visit along with HBsAg testing. Hepatitis B surface antigen testing was repeated for HBsAg-positive women at 24 - 28 weeks of gestation. If the patient remained HBsAg-positive, serum viral load was determined. Factors associated with HBV infection were identified using multiple logistic regression models. Results: A total of 1,474 pregnant women participated in this study. Among them, 24 (1.6%, 95% CI: 0.9% - 2.2%) were HBsAg-positive, with 17 (71%) of these patients being unaware of their infection. The mean viral load in infected women was (11.1 ± 3.2) × 107 IU/mL. Only 13.3% of pregnant women were vaccinated against HBV. Maternal tobacco use, family history of HBV infection, previous history of HBV infection, and history of nonalcoholic fatty liver disease were significantly associated with HBV infection (P &lt; 0.05). Conclusions: The prevalence of HBV infection remains high among pregnant women, and vertical transmission poses a major challenge in the elimination of HBV infection in southeastern Iran. In addition to active-passive immunoprophylaxis, universal screening of all pregnant women for HBV infection and the use of peripartum antiviral therapy in HBsAg-positive pregnant women with high viral loads are warranted.

Environmental contamination with feces of free-roaming dogs and the risk of transmission of Echinococcus and Taenia species in urban regions of southeastern Iran

BackgroundDogs are the most important definitive hosts of zoonotic taeniid helminths worldwide. Different Echinococcus and Taenia species of domestic and wild carnivores pose a potential risk to human population. High populations of free-roaming dogs (FRDs) in urban areas of Iran and widespread contamination of the environment with dog feces is a potential source of infecting people living in the urban regions with cystic echinococcosis (CE). Our knowledge on the risk of CE transmission in the urban settings in the endemic regions is limited. The present study surveyed the species and genotypes of E. granulosus sensu lato and other taeniids by examining feces of free-roaming dogs in the urban areas in the city of Kerman, southeastern Iran.MethodsThe city was divided into 100 consecutive blocks of which 25 blocks were randomly selected. Fecal samples of FRDs were counted, mapped and fresh samples were collected. Then Zinc chloride flotation, and sequential sieving was performed, and the samples were examined under an inverted microscope. Single individual taeniid eggs were isolated, partial nad1 gene was amplified and sequenced to identify species and genotypes.ResultsIn total 5607 fecal samples of dogs were mapped and 83 fresh samples were collected. Taeniid eggs were detected in nine fecal samples (10.8%) from seven out of the 25 city blocks (28.0%). Echinococcus eggs were found in four samples (4.8%) from three city blocks, two samples containing E. granulosus sensu stricto (2.4%), two samples containing E. canadensis G6/7 (2.4%). In addition, three samples contained eggs of Taenia hydatigena (3.6%), and one sample of Taenia serialis (1.2%).ConclusionsThis study documented the potential risk of CE transmission to humans resulting from the feces of dogs roaming freely in urban areas.Graphical

Knowledge, attitudes, and practices of healthcare professionals regarding dengue fever in high-risk regions of southeastern Iran

BackgroundDengue fever (DF) is one of the most prevalent arboviral infections worldwide. In Iran, the dengue-positive serological cases as well as the presence of the dengue vector Aedes aegypti have raised health concerns, highlighting the need to enhance the dengue surveillance system. This study aims to assess the knowledge, attitudes, and practices (KAP) of healthcare professionals (HCPs) regarding dengue fever in a large and high-risk region of southeastern Iran.MethodsA total of 492 HCPs were recruited using a multi-stage sampling method from May 2022 to July 2023. Data were collected using a self-administered questionnaire. Data analysis was done using independent t-tests, one-way analysis of variance (ANOVA), one-factor and multi-factor general linear models, and simple and multiple regression models.ResultsAbout two-thirds (71%) of the participants did not receive any training on DF. A small percentage of participants were familiar with ovitrap (32.6%) and only 21.7% knew that destroying larval breeding sites could not eliminate the dengue vector. The knowledge of disease symptoms among HCPs was found to be lower in border areas compared to non-border areas (P = 0.018). However, the practice situation in HCPs working in border areas was better than in non-borders (P = 0.003). According to the multiple regression model, the most influential factors associated with knowledge, attitude, and practice were the type of healthcare facility and passing the DF training course. Additionally, education level, work experience, and gender were identified as other factors associated with it, respectively. Significant correlations were found between knowledge and practice (P < 0.001), indicating that higher knowledge led to better practice. Similarly, a positive attitude was significantly linked to better practice (P < 0.001).ConclusionRegular, targeted, and continuous training courses are necessary to improve the knowledge level of HCPs, particularly those with lower education levels working in low-level health centers. Utilizing comprehensive dengue KAP studies to evaluate the status and impact of health education programs and identify gaps between knowledge and practice should be a research priority.

Archaeological Studies and Statistical Analysis of Sasanian Coins (Drachm) from Tis Village in Southeast of Iran

In 2002 AD, a hoard comprising of 183 coins was discovered by workers during the construction of a road near a village within the environs of Tis near Chabahar in Southeastern Iran. From this cache of 183 coins, 157 are currently preserved in the Museum of Zahedan and are used in this study. To date, no research has been conducted on any of the coins, which are arranged in albums with only a small number displaying details of their various properties. Initial research involved identifying the coins, identifying and recording their exact location, and developing a typology. This study identifies the precise location as determined via analysis of the king, the mint, and the date and in consideration and comparison of the listing of the coins by Stephen Albums, in which the qualitative measurement of the quantity of coins and quantitative measurement of coin’s mints have been studied. Studies show that the coins are attributed to the Sasanian period, Peroz I and are classified into four groups of typological type, and in 15 different mints, including Mazda Artaxerxes, Estakhri, and Darabgerd. Using the relative frequency graph, the highest quantity of coins, according to typology, is attributed to the second type at 35.02 % and the lowest attributed to the first and third types jointly at 11.46 % of the total. The highest quantity of coins is attributed to the mint of Estakhr at 13.37 % and the lowest to the mint of Gorgan at 0.64 % of the total. Due to an absence of determinable typological features, 10.88 % of the coins could not be attributed to any type. In addition, 26.74 % of the coins could not be attributed to any specific mints.

Calcite e-twins as a tectonic indicator, paleo stress pattern and structural evolution of the Zagros hinterland, SE Iran

Through the examination of calcite twins, this research outlines the tectonic development and paleo stress patterns of the Paleozoic Routshon complex situated in the southeastern segment of the Sanandaj–Sirjan zone, a hinterland region of the Zagros orogeny in southeastern Iran. The study of orogenic phase indicates that the deformation event affecting the southern sector of the Sanandaj-Sirjan zone aligns with the Cimmerian orogenic phase of the Late Triassic period. A variety of structural features at both map and outcrop scales highlight the importance of slip partitioning in the structural evolution of this region, driven by inclined transpression. Observations suggest that the deformation related to contractional components includes steeply to moderately plunging folds, dip-slip domain deformation primarily involving thrusts, and ongoing deformation by strike-slip component motion, which results in thrust-related ductile shear zones. The analysis of calcite c-axis fabrics from mylonite samples obtained from these shear zones indicates a low-temperature monoclinic pattern of non-coaxial deformation. This deformation type underscores the impact of the strike-slip component in the development of progressive simple shear within thrust-related shear zones in this segment of the Sanandaj-Sirjan zone. Dynamic analysis of c-axis fabric data reveals a NE-SW orientation for the principal compressive axes (σ1) in this area. This direction, corroborated by additional data such as fault surface, GPS, and earthquake focal mechanism data, confirms that the orientation of the compressive axes (σ1) has remained consistent from the Late Triassic to the present.

Local Site Effects on the Damage Distribution during the 2003 Bam Earthquake (Southeastern Iran) and Its Implementation in Preparation of Earthquake Design Spectra for the City of Bam

Local Site Effects on the Damage Distribution during the 2003 Bam Earthquake (Southeastern Iran) and Its Implementation in Preparation of Earthquake Design Spectra for the City of Bam

Nursing educators' experiences of cultural competence in the nursing education program: A qualitative descriptive study

BackgroundTo meet the population's increasing diversity and the health system's needs, it is necessary to prepare nursing schools to produce culturally qualified students. PurposeThis study aimed to extract the experiences of nursing educators about the cultural competence of nursing students. MethodIn this qualitative descriptive study, data were collected through in-depth, semi-structured interviews with 15 nursing educators affiliated with three medical sciences universities in southeastern Iran. Purposive data sampling and analysis were performed using Graneheim and Lundman's conventional content analysis methods. ResultsOne main theme, 5 categories, and 18 subcategories were extracted. The main theme was “cultural equality, the essence of care and education”. Categories included “Toward culturally-based caring and education”, “Charter of cultural rights”, “The need for cultural competence facilitators”, “Cultural exposure”, and “Modifying the curriculum policies”. ConclusionThis study shows that nursing educators strive to take into account students' cultural competence, even though cultural competence is not explicitly integrated into nursing curricula. The acquisition of cultural competence requires multifaceted changes in education, in clinical centers, and in the creation of cultural infrastructure.

COVID-19 Vaccine Effectiveness on the Severity of Disease: A Case-control Study in Southeastern Iran

Background: Considering the importance of the effectiveness of vaccination in terms of reducing the severity of COVID-19 and mortality, knowledge of the effect of the vaccine on the severity of COVID-19 in communities is essential. Therefore, the purpose of this study was to evaluate the effect of the COVID-19 vaccine on the severity of COVID-19 in southeastern Iran (Bam region). Methods: A case-control study of a total of 2,082 adults aged &gt;18 years was conducted to evaluate the association between hospitalization due to COVID-19 and previous vaccination with existing vaccines (including Sinopharm, AstraZeneca, and CovIran Barkat) in the country. Multinomial logistic regression was used, and relative risk (RR) and 95% confidence intervals (CIs) were calculated Results: After controlling for potential confounders, multinomial logistic regression revealed that COVID-19 vaccination reduced the likelihood of hospitalization for males and females in temporary wards (RRmen=0.22 vs. RRwomen=0.34), general wards (RRmen=0.25 vs RRwomen=0.31), and intensive care units (RRmen=0.47 vs RRwomen=0.77) (p &lt; 0.001). The relative risk of hospitalization in all wards decreased for men and women who received Sinopharm or AstraZeneca and for women who received the Barkat vaccine, but only a significant difference was detected in the reduction in patients who received the Sinopharm vaccine (p &lt; 0.001). Conclusion: The results showed that vaccination is related to reducing the severity of the disease in the hospital. Therefore, efforts to increase the vaccinated population can reduce the severity of COVID-19 and might reduce the need for intensive care in hospitals.