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Introduction: Hospitals are the first-line care providers in natural disasters. Nurses, as one of the critical health professional groups, require adequate peroration for responding to natural disasters. Due attention has to be paid to various teaching methods to improve the level of nurses’ preparedness. Objective: This study compared the effect of lecturing and lecturing-tabletop exercise methods on the level of nurses’ preparedness against natural disasters. Materials and Methods: In this quasi-experimental study, 74 nurses were randomly selected from different wards at a hospital in Yazd City, Iran, in 2017. Nurses’ preparedness level was measured with the 72-item Scale for Nurses’ Preparedness against Natural Disasters, including three areas of knowledge, attitude, and performance. The study participants were assigned into group A (lecturing method, n=37) and group B (lecturing-tabletop exercise method, n=37) using a simple random sampling technique. Nurses’ level of preparedness was measured three times (pre- and post-intervention, and follow-up) using the Preparedness for Disasters questionnaire. The obtained data were analyzed applying repeated measures Analysis of Variance (ANOVA) and Paired Samples t-test. Results: The mean scores of nurses’ knowledge, attitude, and performance were increased by 4.94, 7.38, and 5.59 in group A as well as 6.56, 11.43, and 6.08 in group B. Additionally, the total score of nurses’ preparedness in group B was significantly higher at Pre-test, post-test, and one-month follow-up (107.89±7.50) (P=0.0001). Conclusion: Education ( lecturing and lecturing-tabletop exercise methods) positively affected nurses’ preparedness. However, it was more effective through lecturing-tabletop exercise methods due to having a scenario and the better participation of nurses in the learning process. This finding emphasizes the positive effect of participants’ interactions in the tabletop exercise method on the quality of education, critical skill, and increased level of nurses’ preparedness against natural disasters.

Background: Restless legs syndrome is a neurological disorder in hemodialysis patients that causes disturbance and disability in rest, discomfort, sleep disturbance, fatigue, and stress. Objectives: This study was done to evaluate the effect of cold water bags on the severity of restless leg syndrome and sleep quality in hemodialysis patients. Methods: This is a quasi-experimental study (before and after) performed on patients referring to three hospitals in Yazd province. In this study, 40 patients with restless legs syndrome were selected from all patients who were referred to the hemodialysis ward by simple random sampling. The samples completed the Restless Legs Syndrome Symptoms Severity Questionnaire before and after using the cold water bag. Data were analyzed by SPSS 20 software and descriptive statistics and paired t-test at the significance level of < 0.05. Results: This study showed a significant difference between the mean score of restless leg syndrome and sleep quality before and after the interventions (P = 0.000). Furthermore, the mean scores of restless leg syndrome and sleep quality were different between the two intervention groups and statistically significant (P = 0.000). Conclusions: Based on the results, using a water bag reduces the symptoms of restless leg syndrome. Therefore, it is suggested that cold water bags should be used as an effective, safe, low-cost method.

The global and Iranian pandemic crisis of the coronavirus caused the health system to face the problem of lack of resources. Outpatient convalescence for coronavirus disease is one of the most effective ways to reduce hospital load and costs. In order to set up any position related to the issue of health, it is necessary to formulate the necessary laws and regulations and standards to be set up in which different levels of decision-making and implementation must play a role. Formulation of goals, laws, coordination, provision of equipment and space, manpower and cost coverage are among the things that should be considered in highlighting the role and function of convalescents by the authorities. In this study, our aim is to review the management strategies of coronavirus patients.

Objective: To identify and prioritize the key Components of prehospital emergency system to prevent mortality in road traffic injuries. Methods: A total of 25 emergency medicine practitioners, emergency ward nurses, and managers of prehospital emergency centers participated in this adjusted Delphi study in three rounds. After extracting the primary components through reviewing systematic studies and interviewing experts, the Delphi rounds were performed with the presence of experts. The data were analyzed with both qualitative content analysis and quantitative analysis using SPSS20 software. For the analysis and selection of the final priorities, the coefficient of agreement of over 70% was used. Results: After doing three Delphi rounds, in the final Delphi round, 10 superior components were selected respectively as follows: correct history taking of the victim, examining possible cervical injury, the time spent from the first call to arrival of technicians to the scene, the time spent from arriving at the scene to the time of hospital transport, passing of re-education courses by EMS technicians, coordination among the rescue organizations, police, the Red Crescent, fire station, and healthcare organizations, integrated commandership at scene, police attendance in the scene before EMS arrival at the scene, proper ambulance equipment with respect to the required equipment (A, B, C) on the basis of victim’s condition, and coordination with the target hospital for patient transport. Conclusion: This study determined the most applicable managerial methods of prehospital emergency components pertaining to preventable fatal road traffic injuries through empowerment of EMS systems in the fields of victim assessment, time management indices, personnel training, coordination between the involved organs, and the presence of the main commander in the scene.

Introduction: Due to the increasing mortality rate from trauma, determining the severity of injury has a very important role in the prognosis of the injured person. On the other hand, the quality of medical care provided to the casualties is evaluated using the Trauma Scoring System. Various scales were used to determine the trauma severity of injured. In this study, the most commonly used tools are investigated. Methods: This review was conducted by searching throughout the Persian data bases of Magiran, Barakat, SID and English databases of Scopus, Web of sciences, PubMed, and Google scholar. To conduct the search, the following keywords were used: "Severity of Trauma", "Trauma scoring", and "Trauma Scoring System" without considering any time intervals. Our early search resulted in 2125 articles. Finally, 17 articles were analyzed and different functions of traumatic assessment tools were compared and studied. Results: Traumatic assessment methods vary based on the anatomical and physiological parameters and composition of these two methods. In this study, the Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), and New Injury Severity Score (NISS) were considered as anatomical parameters; Revised Trauma Score (RTS) as physiological parameters; Trauma Score Injury Severity Score (TRISS) and A Severity Characterization of Trauma (ASCOST) were mentioned as a hybrid ranking system. Conclusion: Application of accurate scientific evaluations in trauma severity assessment methods and application of each method in its appropriate position would result in appropriate improvements in the development of trauma care. In addition, these systems can play an important role in providing care to patients with traumatic injuries in the present and future.

There are a variety of chemical reactions and absorption equipment in chemical production plants across the world. Appropriate modelling of chemical reactors and reactive absorption systems is important for simulation, optimization, and scale-up purposes in the process/chemical engineering discipline. In this study, a chemical reactor and a reactive absorption system are modelled through different mathematical methods. The first case includes two unsteady state first-order reactions in series, and the latter system incorporates a first-order reaction and a diffusive mass transfer phenomenon. The concentration distribution for these two different cases is attained using Homotopy Perturbation Method (HPM) and Enhanced Homotopy Perturbation Method (EHPM) as an efficient, straightforward, and precise technique to solve differential equations. The primary approximation is generally selected with some unknown constant parameters, which can be obtained through applying the initial and boundary conditions. The solution is eventually attained in the form of power series. The modelling results obtained from HPM and EHPM are compared to the outputs attained from the available analytical solutions. The comparison implies that EHPM has a higher capability to provide proper solutions for the governing equations of both reaction cases in this study with a reasonable accuracy. EHPM appears suitable in several cases to obtain approximate analytical solutions where the governing transport phenomena equations in various chemical engineering processes lead to complicated differential equations. This research work introduces a systematic and efficient modelling procedure to properly capture important aspects such as reaction progress, concentration distribution, and phase change in complex transport phenomena systems.

Introduction: Recognizing the factors affecting rail accidents plays a very important role in preventing its recurrence in the future. This study aimed to investigate the factors affecting the collision of two passenger trains near the "Haft Khan Station" between Semnan-Damghan in 2016. Methods: This case study was conducted to collect data from documentation and reports available at news sites and scientific associations, incident reports, and on scene observations of the staff. Results: After describing the accident and exploring the obvious causes of its occurrence, the underlying factors in the accident were identified in three groups: management, individual and environmental conditions. Conclusion: The results of the study showed that there are many factors involved in accidents and controlling effective factors can prevent the occurrence of these events.

Introduction: Arteriovenous fistula cannulation is one of the problems in hemodialysis patients. Reducing this pain improves their dialysis acceptance and life quality. This study investigated the effect of EMLA cream, Lidocaine spray, and ice pack on arteriovenous cannulation pain intensity in hemodialysis patients. Materials and Methods: A total of 40 hemodialysis patients with arteriovenous fistula participated in this quasi-experimental study in Shahid Rahnemoon Hospital in Yazd in 2015. In this study, pain intensity was measured in one group in four states of before intervention and after application of lidocaine spray, EMLA cream, and ice pack using pain intensity numerical scale. The data were analyzed with SPSS16 using ANOVA. Results: Our findings suggested that the mean pain score in the four stages of before intervention, and after application of lidocaine spray, ice pack, and EMLA cream were 7.45 ± 0.88, 4.22 ± 1.33, 5.38 ± 0.83, and 2.80 ± 0.70, respectively. The reduction in mean pain intensity was significantly greater with EMLA cream compared to lidocaine spray and ice pack (P

Introduction: The hemodialysis patients frequently experience the pain and anxiety induced by arteriovenous fistula (AVF) cannulation. This painful intervention, if repeated, imposes destructive psychosomatic effects on patients. Hence, the use of appropriate procedures to reduce pain in these patients is of utmost importance. Objectives: The present study aimed at investigate efficacy of lidocaine spray and topical eutectic mixture of local anesthetics (EMLA) cream in releiving pain induced by arteriovenous fistula cannulation in hemodialysis patients. Patients and Methods: This quasi-experimental study was conducted on 40 patients with arteriovenous fistula (AVF) selected on the basis of purposive sampling method in 2015 in hemodialysis ward of Shahid-Sadoughi hospital. Pain severity was measured at AVF cannulation using EMLA analgesic cream and lidocaine spray with the pain severity numerical scale. Repeated measures analysis of variance (ANOVA) was used in data analysis using SPSS 16. Results: Findings showed that the mean scores of the three methods of pain management, i.e., no pain control method, lidocaine spray, and EMLA analgesic cream, were 7.45±0.88, 4.22±1.33, and 2.8±0.70, respectively. There was a considerable reduction in pain severity using the lidocaine spray and EMLA analgesic cream compared to the conventional method (P

Liquid-Liquid equilibrium data for the (water + Lactic acid + 2-ethy-1-hexanol) ternary system in T=298.2K and P=1atm were determined and tie- lines related to equilibrium data has been drawn in the phases diagram . The reliability of the experimental tie-line data for this system was as confirmed by using the Hand and Othmer –Tobias correlations. The tie-line data were correlated by means of the UNIQUAC equation for this ternary system , The average root mean square deviation between the observed and calculated mass fractions was 0.66%. A comparison of the extracting capabilities of this solvent by 1-octanol was made with respect to distribution coefficients and separation factors bases. The results show that extraction of lactic acid from aqueous solutions by 2-Ethyl-1-hexanol is possible and 2-Ethyl-1-hexanol is more appropriate than the other octanol isomer.

Introduction: Hospitals have a very important role in responding to disasters. Since nurses are one of the largest group of the health team and play multi-roles in patient treatment, improvement of their knowledge and skills helps them to act better in disasters.The purpose of this study was to investigate the effect of a disaster management training program on the level of knowledge, attitude, and practice of nursing staffs. Methods: The present interventional study was conducted in Shahid Rahnemoon Hospital, Yazd, Iran in 2018. At first, 40 nurses were randomly selected and their level of knowledge, attitude, and practice was measured using the questionnaire of nurses’ preparedness in disasters. The questionnaire consisted of 72 items; The total attainable score was 132 in the questionnaire. Then, the disaster preparedness training program was implemented. The program was conducted in the form of a one-day workshop for eight hours. One month after the education program, the nurses' level of readiness, including their knowledge, attitude, and practice was re-evaluated using the same questionnaire. Data analysis was conducted by paired samples t-test using SPSS 22. Results: The results of the study showed that the mean score of nurses' knowledge increased from 14.23 to 21.30, the mean scores of their attitude increased from 62.20 to 71.67, and their performance mean score increased from 7.28 to 11.88. These differences were statistically significant (p

Context: The prehospital care system depends on many factors. If all factors contributing to prehospital care are handled correctly, many fatalities occurring in this phase will be prevented. Objectives: We aimed to identify root causes and factors contributing to preventable deaths in the prehospital phase of road traffic injuries. Data Sources: In this study, a systematic review was performed on the Web of Science, Scopus, and PubMed databases, as well as Google Scholar Search Engine, using keywords "preventable mortality/fatality", "road traffic injuries", "prehospital" and a combination of them to find papers published from May 10, 2018, to August 30, 2018. The quality of the finally retrieved papers was investigated by two researchers independently and in the case of any disparities, a third researcher explored the papers. The PRISMA checklist was used to analyze the quality of the papers. Study Selection: All documents and papers were included in the initial investigation regardless of the type of the paper. If a paper dealt with preventable fatalities of road traffic injuries in both prehospital and hospital phases, only were the prehospital phase results analyzed. Results: Based on the findings, 14 articles and records were included in the review. The precise assessment of the papers using content analysis resulted in the emergence of three themes, six subthemes, and 45 codes. The main themes including "systemic deficiencies, human errors, and patient’s clinical condition," and the subthemes including "educational deficiencies, managerial deficiencies, errors/delay in diagnosis, therapeutic deficiencies, technical deficiencies, and trauma types" were extracted. Conclusions: Various factors were rendered effective in preventable fatalities of road traffic injuries in the prehospital phase. The identification of these factors and resolving the identified problems can reduce the fatalities of road traffic injuries.

Introduction: The restless leg syndrome (RLS) is a neurologic disorder suffering the hemodialysis patients. Although the pathophysiology of this syndrome remains unknown yet, an investigation of the parameters pertinent to it may help to develop the related medical knowledge and to improve the therapeutic-care interventions in this regard. Objectives: The correlation between the RLSs on individual, clinical, and laboratory indices in patients undergoing hemodialysis. Patients and Methods: This descriptive-analytic study was conducted on 104 hemodialysis patients. Diagnosis of RLS was made using the International RLS Standard Questionnaire. The data on individual, clinical, and laboratory indices were obtained from patients’ recorded files and interviews. Results: Based on our findings, 28.8% of the patients undergoing hemodialysis were affected with mild RLS, 41.7% with moderate RLS, and 29.5% with severe RLS. There was a statistically significant correlation between affliction with RLS on the one hand, and age and gender, on the other (P < 0.05). However, there was no significant correlation between RLS and education level, occupation, length of hemodialysis, fasting blood sugar (FBS), hepatitis B and C, serum blood urea nitrogen (BUN), creatinine (Cr), iron, hemoglobin (Hb) level and also KT/Vor URR (P < 0.05). Conclusion: Regarding the high prevalence of RLS among the hemodialysis patients, there is the necessity for taking more care of these patients to reduce the somatic complications of the RLS especially among the elderly and female patients and to control the blood sugar of these patients at the normal level.

Background: Health-care personnel's familiarity with infection control methods and pathogen transmission channels play a determining role in reducing nosocomial infections. This study aimed at investigating the nurses' performance in observing hygienic principles and nosocomial infections control. Methods: This descriptive cross-sectional study was conducted on 34 nurses working at Afshar Hospital in Yazd, Iran in 2016. Nurses' performance on infections prevention was surveyed via a checklist using self-reporting by nurses. The gleaned data were analyzed using independent t-test and ANOVA. Results: Our findings suggested that 69.5% of nurses had moderate performance on nosocomial infections control with regard to themselves, 63.2% had it with regard to patients, and 71.5% had it with regard to hospital setting. Also, there was a significant correlation between performance quality and nurses' working experience (P=0.01), on the one hand, and participation in an orientation workshop (P=0.001), on the other hand. Conclusions: Based on our findings, it is rendered as mandatory for hospital authorities to provide the required conditions for improving nurses' awareness and performance with regard to observing the hygienic principles and nosocomial infections control.

Tarballs, which are lumps of oil weathered to solid sticky species, are mainly originated from offshore petroleum activities such as drilling, production, and maintenances. Removing them from water contaminated surfaces is not an easy separation process. Hence, it seems necessary to appropriately characterize them and to find an effective removal method to diminish their concentration in targeted beaches and oceans/seas. Besides the experimental work, a population balance model is developed to obtain the evolution of tarball aggregates size distribution in this study. The model predictions are compared to the experimental results, which are determined by an image analysis technique. The comparison shows a satisfactory agreement, implying the reliability and accuracy of the developed model. The model considers the fractal nature of the tarball aggregates so that the fractal dimension is calculated to be 1.9. The impact of poloxamine copolymer on the evolution of the size distribution of tarball aggregates is investigated. It is found that with increasing the concentration of poloxamine from 0 to 16.67 and 33.33 g/L, the average particle size increases from 90 to 99 and 155 μm, respectively. The number of the particles for an average diameter is determined through an experimental procedure. The average diameter increases with time before the steady state condition is achieved. It then lowers to become almost constant. This study can provide a systematic procedure to characterize tarballs, leading to finding an efficient technique for elimination of tarballs.

"survival rate of patients. Measurement of Alfa-Fetoprotein (AFP) in combination with iconography and liver biopsy are commonly used in the diagnosis of liver cancer as well as HCC. Despite the wide use of AFP in HCC diagnosis and introducing this tumor marker as the gold standard biomarker for HCC detection, the specificity and sensitivity of AFP used in screening for HCC is very controversial. In recent years, along with development of molecular biology and extensive research about ethnology of cancers and simultaneously advances in technology, researchers identified new tumor markers in this disease. In the latest researches various biomarkers including embryonic antigen, protein antigens, cytokines, enzymes and isoenzymes and related genes for effective early diagnosis and monitoring of hepatocellular carcinoma are introduced. In this review, a summary of the data of various studies that discuss new tumor markers involved in hepatocellular carcinoma and classification of these biomarkers was investigated Recently, use of different nanoparticle metal oxides for preventing the spread of microorganisms has reached to the expanding field of nanomaterial research. The objective of this study is to validate combined ultrasound and CuO or MgO noparticle treatments for inactivating Staphylococcus aureus and Pseudomonas aeruginosa. Results showed that nanoparticles of different materials vary in their effectiveness. Ultrasound increased the antibacterial effect of CuO nanoparticles more than the increased antibacterial effect of MgO. These results indicated that CuO or MgO nanoparticles exhibited antibacterial properties that could be additionally enhanced in the presence of ultrasound and, thus, should be further studied for a wide range of medical device anti-infection applications."

The preoperative, perioperative, and postoperative airway management by the anesthesiologist and the use of procedures and medicines that have the least interference with patients’ discharge from the hospital are of utmost importance. This can be achieved by the use of laryngeal mask airway and endotracheal tube. This study compared the postoperative complications of diagnostic laparoscopy between two groups of infertile women undergoing this procedure. This study was a double-blind clinical trial carried out on 120 patients undergoing gynecologic surgical laparoscopy. The patients were assigned into two equal groups of 60. The laryngeal classic mask, size 3-4, was applied for patients in group A and the cuffed endotracheal tube, size 7, was used for the patients in group B. All kinds of complications of anesthesia, consumption of anti-emetic drugs, analgesics, and also discomfort and pain in airways were recorded up to 24 hs. Our findings indicated that the relative frequencies of sore throat, voice hoarseness, and cough were statistically different between the two groups at 6 h and 12 h after anesthesia (P=0.001). At 24 h after anesthesia, there was only a significant difference between the two groups regarding sore throat frequency (P=0.003). Also, there was a significant difference between the two groups regarding heart rate (P=0.053) and mean arterial pressure (P=0.011).