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Background: A decade after the implementation of the Urban Family Physician Program (UFFP) in Fars province, southern Iran, we aimed to reveal people’s opinions regarding the strengths and challenges of this program, which help policymakers for evidence‑based improvement of this program. Methods: In this thematic content analysis qualitative study, which was performed in 2023, one adult individual of each family under the coverage of UFPP was selected using a purposeful sampling method. Then, an in‑depth and semi‑structured phone interview was conducted with each participant. Interviews were continued until the achievement of data saturation. The trustworthiness of data was checked according to Guba and Lincoln criteria. Data analysis was accomplished using MAXQDA software version 10. Results: A total of 25 participants with a mean age of 41 ± 12 years old were interviewed. Extracted strengths points of UFPP consisted of 390 meaning units, 41 open codes, 16 subcategories, 9 categories, and 3 themes, of which the main themes consisted of proper governance, adequate service provision, and promoting community health. In contrast, the challenges of this program comprised 127 meaning units, 54 open codes, 17 subcategories, 7 categories, and 3 themes, the main themes of which included weak governance, inefficient service provision, and limitation of resources. Conclusions: After a decade of implementation, people demonstrated contradictory opinions about many aspects of UFPP. Strength points should encourage policymakers to advocate more for this program and extend it to the other provinces of Iran, whereas weak points should be used for its revisions and improvement. [ABSTRACT FROM AUTHOR]

Background: Brain drain is an issue of concern in developing countries. Many factors are involved in this issue, and their identification can be a good guide for decision-makers at different management levels. Therefore, the present study was carried out to identify the factors affecting brain drain and solutions to reduce it in Iran's health system. Methods: The data for this qualitative study was collected in 2023 through 15 semi-structured interviews with Iranian health experts and emigrant elites. Interviews were collected both face-to-face and virtually (on Skype and Google Meet) and analyzed using the thematic content analysis method. Results: Data analysis of the factors affecting brain drain in Iran's health system yielded seven main categories and 45 subcategories. The main categories were "individual factors," "economic factors," "social and cultural factors," "organizational and administrative factors," "political factors," "attraction factors for destination countries," and "attraction factors of destination countries for elites." Also, the solutions were divided into four categories of "economic," "social," "organizational and scientific," and "political" factors and 19 subcategories. Conclusion: Due to the increase in brain drain in recent years, it is necessary to make a serious decision in dealing with this issue. Solutions such as creating stable economic conditions, creating an atmosphere of hope, increasing respect and dignity for elite students by politicians, using the elites in macro-decisions, and creating the job rank for honorary professors can lead to reducing brain drain and decreasing the costs of the health system. [ABSTRACT FROM AUTHOR]

Objective: Hospitals play a vital role in disaster management and their function must be maintained during crises. Isfahan province is susceptible to major crises and disasters at any time of the year. The study aimed to investigate the hospital safety index (HSI) in hospitals in Isfahan province. Methods: This cross-sectional study was conducted using the HSI questionnaire of the world health organization. The safety of all 55 hospitals in Isfahan province was evaluated with the Persian version of the questionnaire from 2017 to 2022. In this study, all hospitals were evaluated by a group of experts from the emergency operations center (EOC) of Isfahan University of Medical Sciences, and the checklists were completed with the cooperation of the hospital disaster committee, visiting the hospitals, and interviewing the personnel. Results: The safety level of hospitals has improved from 2017 to 2022 so in 2022, 38 hospitals (69.09%) had a high safety level, and 17 hospitals (30.91%) had a medium safety level. This increase in safety has happened in all three components of safety (functional, non-structural, and structural safety). There was no significant difference in the overall hospital safety score between academic-educational, non-academic governmental, social security and military, and private and charity hospitals (P<0.05). Conclusion: Although the safety in the hospitals of Isfahan province has improved due to the continuous disaster prevention and preparedness activities, hospitals still need to improve to achieve higher levels of safety. The HSI shows how well a hospital can maintain its organization and performance during disasters. This index will be useful for decision-making and policy-making to prioritize administrative and civil interventions. [ABSTRACT FROM AUTHOR]

Healthcare workers are leading the way in treating patients with coronavirus disease 2019 (COVID-19). Due to the high levels of psychological stress, this group is more likely to experience psychological issues. These psychological problems in healthcare providers include depression, anxiety, insomnia, stress and post-traumatic stress disorder (PTSD). The goal of this systematic review and meta-analysis was to find out how common these problems were in the face of COVID-19. On 20 February 2022, systematic searches were conducted in the PubMed, Cochrane Library, Scopus, EMBASE, Science Direct, Web of Science and ProQuest databases. Two authors selected articles based on search keywords. As a last step, articles about the prevalence of psychological problems among healthcare workers in the face of COVID-19 were looked at and analysed for five different outcomes. The initial search yielded 18,609 articles. After reviewing the titles, abstracts and full texts of the articles, 44 were chosen for the final analysis and 29 were subjected to a meta-analysis. Insomnia, anxiety, depression, PTSD and stress are among the psychological issues faced by healthcare workers. Furthermore, the highest pooled prevalence of depression, anxiety, insomnia, PTSD and stress was 36% (95% confidence interval (CI) 24–50%), 47% (95% CI 22–74%), 49% (95% CI 28–70%), 37% (95% CI 19–59%) and 27% (95% CI 6–69%). In this meta-analysis, insomnia was found to be the most common mental health problem, followed by anxiety, PTSD, depression and stress in healthcare workers in the face of the COVID-19 pandemic. Generally, the pooled prevalence of these mental health problems was higher among physicians, nurses and older staff in the subgroup analysis. As a result, health policymakers and managers of the health care system should think about effective interventions to promote mental health, paying particular attention to these two groups. Studies conducted in China reported more mental problems than in other countries. Health policymakers and health system managers should hold training programs to promote healthcare workers' mental health with a particular focus on more vulnerable groups. The prevalence of PTSD, stress, anxiety, depression and insomnia were higher among physicians, nurses and older staff. Health systems at both national and local levels have to take older physicians, nurses and healthcare providers into consideration while designing interventions. [ABSTRACT FROM AUTHOR]

COVID-19 has recently become a pandemic. Early diagnosis and the transmission chain cutting off are critical keys to controlling this disease and stopping its spread. In this case report, the significance of proper and on-time diagnosis is discussed. Misdiagnosis of COVID-19 may lead to delay in early diagnosis of the disease. A 78-year-old man with the chief complaint of dark stool and constipation was admitted. Based on the preliminary complaints of the patient, the emergency medical specialist transferred him to the internal caregiving service, but according to radiological findings and his positive Real-time PCR test, COVID-19 was the final diagnosis. Healthcare planners and policymakers should prepare precise clinical guidelines that are compatible with domestic conditions of the country to improve the ability of healthcare providers to diagnose patients with COVID-19 to promote controlling this condition. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to evaluate the surge capability of Shahid Rajaee Trauma Hospital in Shiraz City, Iran, in response to a mass causality incident. Materials and Methods: This descriptive study was conducted in Shahid Rajaee Hospital in Shiraz in 2017. The Delphi technique was used in this study. Three checklists were used for the Emergency Department, Operating Room, and Intensive Care Unit. The surge capacity was calculated for each unit based on the formulas derived from different studies. Results: The surge capacities of the Emergency Department, Intensive Care Unit, and Operating Room were obtained 36%, 20%, and 17.5%, respectively. Shahid Rajaee Hospital of Shiraz can quickly increase its capacity by 27% based on the scenario defined in this study. However, if an accident leads to more causalities, it will likely face several limiting factors for increasing the surge capacity. Conclusion: Due to the critical role of hospitals in the crisis, it seems that the studied hospital should look for ways to increase its surge capacity to cope with unexpected accidents as soon as possible. [ABSTRACT FROM AUTHOR]

Background: Iran is a disaster-prone country, which in recent years has been affected by heavy rainfall and consequent flooding. In March 26, 2019, heavy rainfall in northern parts of Iran resulted in flooding. The situation became more critical when central and western provinces were affected, finally causing significant damages in 25 provinces. The most affected areas were Golestan, and Khuzestan provinces with significant damages to their infrastructure, killing 76 people. Materials and Methods: This qualitative study aims to describe the findings and results of field visits in flood-hit provinces of Lorestan, Khuzestan and Golestan. All interviews were held with experts in late April 2019. Results: Golestan province was in recovery phase and Lorestan and Khuzestan provinces were in response phase. Due to the acute conditions of these two mentioned areas, it was not possible to visit all areas. In Lorestan Province Treatment and Emergency Situations; In Golestan Province Health Status and in Khuzestan Province Pre-hospital Care and Rescue Support were visited and evaluated. The field visited results indicate the presence of government forces and people in the field and provide comprehensive assistance to the flood-affected areas. Conclusion: There are numerous hazards each year, but few documented lessons are available for researchers. Due to the importance of applying lessons for community development it is imperative that special attention be paid to the discussion of emergency and disaster research and the presence of specialized researchers to record lessons learned. Although organizations make significant efforts during disasters, the specialized research force for recording these achievements in disasters remains neglected. Therefore, it is valuable to document and apply appropriate documentation to promote interventions and responses to possible future events. [ABSTRACT FROM AUTHOR]

Background: There has been a significant increase in the number of train crashes worldwide, mainly due to the extension of the rail network and the use of the most sophisticated and cutting-edge technology. Incident Report: The Tehran-Zahedan train had 260 passengers on board and left for Tehran City at 14:50 local time on Wednesday, September 25, 2019. The accident happened at 16:20 local time at 100 km distance from Zahedan City. Results: Five train cars derailed 2 km from Shorou Station, where four people died, and 157 were injured. According to the investigations, the accident occurred due to the unscrewing of some bolts and spring washers. There were 170-180 screws and spring washers removed along 50-60 m, which resulted in the creation of a dangerous point and derailment of the train. This study examined the challenges, strengths, and learned lessons of the incident. Conclusion: Concerning standard and vast rail networks in Iran and the latest train crashes that mainly occurred just outside the cities, accessibility to the accident scene should be considered one of the most important physical vulnerability indexes. As a result, accessibility to special firefighting and rail rescue train car at some stations in crowded routes effectively decreases the consequences of such accidents. [ABSTRACT FROM AUTHOR]

Factor VII deficiency is a rare congenital coagulopathy disorder. In most cases, this disorder is diagnosed in childhood. Common symptoms of congenital factor VII deficiency are different and consist of cutaneous, mucosal hemorrhage, gastrointestinal bleeding, and joint bleeding. CNS hemorrhage is a fatal and severe complication of congenital factor VII deficiency. The incidence of gross hematuria is a rare symptom of factor VII deficiency. Isolated presentation of hematuria is rarer and usually is accompanied by bleeding in other sites. The patient reported here is a 6-month-old girl who was diagnosed with congenital Factor VII deficiency following episodes of isolated gross hematuria. We decided to report this case to demonstrate if there is no other organic cause in the investigation of a child with recurrent hematuria, we should also consider a coagulation factors deficiency. Since isolated hematuria is a rare symptom in the coagulation factors deficiency, the coagulation tests may be of less interest. [ABSTRACT FROM AUTHOR]

Due to the increasing elderly population and the subsequent increase in their need for medication and more referrals to the pharmacy, this study was conducted to investigate the Iranian hospital pharmacies in terms of age-friendliness criteria. This was a cross-sectional study conducted in 2017. The study population included 3 metropolitan hospital pharmacies selected through clustered sampling, and all their 67 pharmacies were included by census. Data collection tool was a reliable researcher-made checklist (t = 0.85, α = 0.9) Data analysis was performed using Kruskal-Wallis test and Mann-Whitney test through SPSS version 24. The results in these three cities showed that only two pharmacies were in a high level of age-friendly. The relationship between type of pharmacy and the final score of age-friendly situation in these cities showed no significant relationship. There was no significant relationship among the average of the final score of the age-friendly situation in three studied cities. Due to the increasing elderly population and the aging society, readiness of Iranian hospital pharmacies to provide services to the elderly will be one of the most challenging issues in the long term. With proper legislation and policies on health-care systems, especially pharmacies, physical and psychological problems in elderly can be reduced in the future. Furthermore, with advancing toward age-friendly pharmacies, the community can be empower and become ready encountering elderly problems. [ABSTRACT FROM AUTHOR]

Background: The skill of delivering bad news to the patient and their family is one of the most complicated communication skills with a profound and considerable impact on the satisfaction and life quality of the patient and their family as well as the success in the continuation of the treatment process. In this regard, this study was carried out to investigate the effect of virtual education on delivering lousy news methods between Nurses of Dr. Jalil Hospital. Objective: Evaluation of virtual education effect on delivering bad news skills between nurses. Material and Methods: This Field experiment study was performed with a pre-test and post-test pattern, control group, and statistical population of 20 individuals from the CPR team and Convenience Sampling in 2021-2022. Samples were randomly divided into two experimental groups and researcher-made questionnaires with the content validity and reliability conformation Cronbach's alpha coefficient %85. Utilize to gather data primarily, a pre-test was performed in two groups then the experimental group spent two weeks virtual education course.The post-test was carried out after 3 weeks as the questionnaires were filled in by individuals online. The Spss23 and descriptive-analytical tests were used for data analysis. Results: Depending on analysis, the results revealed that teaching communication skills to individuals has a statistically meaningful promotive effect on the delivering bad news capability of the experimental group (P<0.001). Conclusion: Considering the results defining organized programs for delivering bad news skill virtual education. Manner seems to be necessary for medical university. [ABSTRACT FROM AUTHOR]

Background: Minimizing the impact of disasters is essential in today's society, so education is a top priority to make this happen. Disaster preparedness training requires innovative training methods to be more effective compared to traditional approaches. Objective: This study was conducted with the aim of reviewing the application of simulation technologies in disaster management in 2023. Material and Methods: This study was conducted as a systematic review in the period from 2018 to 2022 in PubMed, Google Scholar, Embis and Cochrane databases. Keywords used for the search included simulation, disaster, and technology. The different stages of the search were done by two researchers and the articles were screened in terms of the title, abstract and text of the article, and finally the remaining articles were selected for the final analysis. Results: After searching the databases, 15 articles were extracted, of which 5 articles were related completely to the purpose of the study. Using simulation for training is very effective both in terms of cost and flexibility for various applications, such as creating situational awareness and creating scenarios for training domains. With regard to technical and non-technical skills, simulation-based training plays an important role in emergency surgery. In addition to focusing on skill acquisition, it is also important to ensure that surgeons are able to perform a variety of tasks in unique and challenging situations. Conclusion: Simulation-based training can be a valuable training method in this situation, as it provides opportunities to practice and prepare for high-risk, often low-frequency events. [ABSTRACT FROM AUTHOR]

Background: Mother's mental health affects the health of parents and the development of children. There are many mental health mobile apps available that have the potential to improve health and enhance the pregnancy experience. However, therapists and women know little about them. Therefore, this study was conducted with the aim of investigating the use of mobile applications in the mental health of pregnancy in 2022. Objective: The purpose of this systematic review is the use of mobile phone applications in mental health during pregnancy. Material and Methods: PubMed, Scopus, and Web of Science databases were searched from 2015 to September1, 2022 to identify English studies related to the purpose of the study the included studies were evaluated for quality and risk of bias using the CASP criteria by two authors. All non-English studies, non-original studies and studies that were not related to our purpose were excluded. Results: Out of 4000 retrieved articles, 10 met the inclusion criteria. Pregnancy mental health mobile applications included: Bright Self, Baby Buddy, IHypnobirth, and Music for Pregnancy Relaxation, and Pregnancy Yoga Exercises, which have been used for diagnosis, prevention, screening, and treatment of prenatal anxiety and depression, relaxation training, and mood management. Conclusion: App developers and obstetricians should seek advice from women who experience mental disorders in pregnancy to optimize apps. Future studies should include psychological treatment, perinatal continuity of care, and clinical sustainability to realize the potential of mobile applications. [ABSTRACT FROM AUTHOR]

Background: Telenursing refers to the use of telehealth technology in the nursing profession, which is consistent with the basic philosophy of health care. The goal of telenursing is to provide clinical support, overcome geographical barriers and increase the efficiency of people's health. Objective: The purpose of this study is to provide suitable solutions for using remote nursing technology for disaster management to reduce the amount Injuries and help to rehabilitate the victims, which was done in 2022. Material and Methods: In this research, a review method was used among numerous articles in Google Scholar, SID, Magiran and Pubmed databases. Searched keywords included nursing, remote, disasters, Telenursing and Telehealth. The search period was from 2010 to 2022, and all searching and screening steps were performed by two people. Results: In period of disasters, the tasks that should be prioritized include: lifesaving measures, care and decision-making in stressful situations (triage), handling trauma victims, technical skills, handling patients with special needs, and psychological and emotional support. Cost-effective health care technologies in low and middle income countries can range from smartphone apps (to improve pre-hospital care) to electronic data collection and analysis (to improve quality), telemedicine., drones/robots (supporting remote areas and optimizing resources during day-to-day care and disasters), flexible medical and surgical facilities using mobile (such as battery-powered CT scanners). Conclusion: Empowering nurses to use consulting applications and providing telenursing services during sudden disasters like Corona can help in providing clinical care to patients. [ABSTRACT FROM AUTHOR]