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Objectives: This study aimed to assess the impact of nurses' training on the implementation of preventive measures for falls in hospitalized elderly individuals.Methods: A quasi-experimental study was conducted, involving 64 nurses employed at Ganjavian Hospital in Dezful, Iran. Convenience sampling was used to select the participants between April 15th and July 15th, 2020. The nurses were then randomly assigned to either the intervention or control group. Initially, a checklist was utilized to assess both groups' fall prevention activities for older patients. Subsequently, the intervention group received workshop training, while no specific intervention was provided to the control group. After a two-week period, the fall prevention behaviors were reassessed in both groups. Data analysis was performed using SPSS software version 16, employing independent t-tests, paired t-tests, chi-square tests, and analysis of covariance.Results: Prior to training, the mean score for nurses' fall prevention behaviors was 12.31±4.12. Following the training, the mean score significantly increased to 26.78±3.41 (p

Introduction and Objective In most cases, due to the failure of nonsurgical methods in the treatment of diseases related to the colon, it is necessary to perform colostomy as the main treatment method. However, this surgery can cause a wide range of physical, social, and psychological problems in patients. Therefore, in order to prevent and treat the complications of colostomy, it is necessary to adopt measures in the field of self-care and continuous education for patients to control the complications of the disease, seek treatment, and experience improvements in their quality of life . Additionally, considering the role of mobile health (mHealth) applications in facilitating continuous and effective training, and improving self-care for these patients, the aim of the present study was to design and evaluate an mHealth application for self-care of colostomy patients.

Introduction: Post-traumatic stress disorder (PTSD) is a prevalent and highly debilitating mental disorder that often occurs following accidents and natural disasters. This study aimed to assess the prevalence of PTSD among flood victims in Lorestan, Iran and examine its relationship with coping strategies. Methods: This descriptive-analytical study included 470 flood victims in Lorestan, Iran within the first year after the flood in 2019. Participants were selected through simple random sampling. The research utilized the PTSD checklist and coping strategies questionnaire as data collection instruments. Data analysis involved independent t-tests, one-way analysis of variance, and the Pearson correlation coefficient, with a significance level of 0.05, using SPSS software version 22. Results: The prevalence of PTSD among flood victims in Lorestan, Iran was found to be 12.8 %. Women, individuals over 35 years old, those with an education level below high school, married individuals, and people with low income exhibited higher PTSD prevalence and average total coping strategies scores. Passive coping strategies (r = 0.267, p < 0.001), social coping strategies (r = 0.148, p = 0.004), and the overall coping score (r = 0.153, p = 0.003) demonstrated a direct and significant correlation with the average PTSD score. Conclusion: This study highlights the prevalence of post-traumatic stress disorder (PTSD) among flood survivors, especially among vulnerable groups such as the elderly, women, and those with low socio-economic status. To enhance post-disaster adaptation, support organizations should implement various strategies including resilience-building, mental health awareness campaigns, and improved access to healthcare services. Effective screening and promoting positive coping strategies are crucial for supporting survivors' psychological well-being.

Background: Hepatitis C is one of the most challenging viral infections worldwide. Patients with hepatitis C may experience some disease-related stigma. Objectives: The aim of this study was to evaluate perceived stigma and its role in predicting anxiety, depression, and quality of life among patients with hepatitis C. Materials & Methods: This cross-sectional analytic study was conducted in behavioral counseling centers of three cities, i.e., Khorramabad, Boroujerd and Noorabad, located in the western part of Iran, from May to August 2019. Stratified multistage sampling was used to select 144 patients diagnosed with hepatitis C. The WHOQOL-BREF Scale, Stigma Impact Scale (SIS), Beck Depression Inventory, Second Edition (BDI-II), and Beck Anxiety Inventory, Second Edition (BAI) were used to collect the data. Univariate and multivariate linear regression models were used to estimate the association of covariates on stigma and quality of life. The Stata 16 software was used to analyze the data at the significance level of 0.05. Results: The mean perceived stigma was 66.805 ± 1.291 with social rejection and social isolation achieving the highest scores (23.409 ± 0.551, 20.208 ± 0.437). In the multivariate regression model, depression (B=0.7, 95%; CI: 0.5, 0.89) and anxiety (B=0.21, 95%; CI: 0.02, 0.41) had direct significant associations with stigma independent of age, sex, marital status, and occupation. Depression (B=-0.27, 95%; CI:-0.47, -0.07), anxiety (B=-0.33, 95%; CI: -0.5, -0.16), and stigma (B=-0.41, 95%; CI: -0.56, -0.26) were inversely associated with patients’ quality of life. Conclusion: This study found a high perceived stigma score among HCV patients. Depression and anxiety were significantly associated with stigma. The quality of life of HCV patients were inversely associated with depression, anxiety, and stigma scores.

Abstract Background Transition from a clinical expert nurse to a part time clinical nursing instructor (PTCNI) poses several challenges. Designing a professional development curriculum to facilitate the transition from a clinical expert nurse to a PTCNI is critical to effective education. A comprehensive competency-based curriculum was developed and implemented with structured mentoring to prepare clinical expert nurses as PTCNIs. Methods A mixed-methods study with a sequential-exploratory approach was conducted in Iran in 2019. In the qualitative phase, Saylor et al.’s (1981) seven-step model was used, consisting of (1) collecting evidence from a systematic review, (2) conducting interviews with learners, (3) setting goals and objectives, (4) design, (5) implementation, (6) evaluation, and (7) feedback. In the quantitative phase, curriculum domains were evaluated. Additionally, the effective professional communication skills module was implemented using a quasi-experimental study with a pre-test post-test single-group design for 5 PTCNIs in a pilot study. Results After integrating the findings of the literature review and field interviews in the analysis stage, a curriculum was developed with a total of 150 h, six modules, and 24 topics. Results of the pilot study showed a significant improvement in the confidence of PTCNIs as a result of the implementation of the effective communication skills module using the mentoring method (t = − 16.554, p = 0.0005). Conclusions This competency-based curriculum was based on the evidence and needs of PTCNIs and provides a complete coverage of their clinical education competencies. It is suggested that managers of educational institutes that offer nursing programs use this curriculum to prepare them in continuing education programs. Further studies are needed to thoroughly evaluate the learning outcomes for students.

Background: technology-based concept mapping is a subset of e-learning and is considered a selective strategy for providing information and educational skills. The aim of this study was to investigate the effectiveness of concept mapping instruction in mobile phones on the creativity of nursing students. Methods: This study was a pretest posttest randomized controlled trial. Sixty eight senior nursing students were selected using the whole enumeration. They were divided equally into the experimental (n=34) and control groups (n=34) by stratified block randomization. In the experimental group, concept mapping instruction was carried out using mobile phones; however, the routine method was used in the control group. Students' creativity was measured by Abedi’s Creativity Test before and after the intervention. Data were analyzed with SPSS software using the paired t-test and multivariate analysis of covariance. Results: There was no significant difference between the two groups in terms of demographic characteristics (p > 0.999).The mean total creativity score and the mean scores on all the subscales decreased in both groups in comparison to the pre-intervention scores. The changes in the scores of elaboration (p= 0.046), originality (p= 0.022), and total creativity (p= 0.036) showed a significant difference between the control and experimental groups, but there was not any significant difference between two groups in term of fluency (p = 0.08) and flexibility (p=0.143). Conclusion: Although the easy access of learners to mobile phones made the use of this approach seem useful in students' education, further studies are recommended with higher sample sizes and other creativity assessment instruments.

Abstract Background Self-medication by older adults has been always a public health concern. The present study aimed to modify the psychological constructs of Health Belief Model (HBM) in relation to self-medication behaviors using Freire’s Adult Education Model (FAEM) among older adults in Khorramabad, Iran, from 2017 to 2018. Methods The mean age of the older adults was 66.28 ± 7.18 years. This was a randomized controlled trial study conducted on 132 individuals older than 60 who were referred from different health care centers. The participants were selected using multistage sampling method and randomly divided into two groups of intervention and control. The data collection instruments included a questionnaire which was designed based on both HBM and self-medication behaviors questionnaire. The phase of adult education model (AEM) was used to modify the psychological constructs of HBM and self-medication behaviors. Data were analyzed using SPSS software version 20 with a significant level of 0.05. Descriptive statistical tests, chi-squared test, paired t-test, independent t-test, and univariate modeling were employed for the purpose of analyzing data. Results There was no significant difference between groups in terms of self-medication. Unawareness of the effects of medicine were the most important reason for self-medication (p = 0.50). The two groups were not significantly different in terms of knowledge, HBM constructs, and self-medication behaviors (p > 0.05). However, they came up to be considerably different for the above variables after the intervention was implemented (p

Objectives: Apart from the functional problems that disability creates for the disabled, it has negative effects on parents as well. Thus, identifying these problems plays a decisive role in the health of the family. In this regard, the present study aimed to determine the psychosocial problems of the parents of intellectually disabled children (IDC) receiving services from the Iranian State Welfare Organization in Khorramabad. Materials and Methods: Participants consisted of the parents of IDC receiving services from the State Welfare Organization of Iran, in Khorramabad during 2015. The data collection instrument was a questionnaire including demographic items and items related to psychological and social problems. The parents of 144 IDC participated in the study and completed the questionnaire via interviews at home. Results: All parents suffered from psychosocial difficulties although, on average, mothers had more problems due to their different roles in families. Finally, a significant relationship was found between parents’ education and the gender of the IDC (P < 0.05). Conclusions: The impact of disability on parents depends on the severity of the disability and parents’ coping skills, abilities, and capabilities.

Cancer is an important public health issue worldwide and is the main cause of death in the developed countries and the second cause of death in the developing countries. There are several treatments for cancer such as photodynamic therapy, surgery, chemotherapy, hormonal therapy, radiotherapy and immunotherapy. Current cancer treatments have various side effects, including the gradual resistance of cancer cells to treatment. The era of targeted cancer therapy has brought about new clinical approaches such as antibodies, small molecules, antiangiogenics, and antivirals. Yet even these strategies remain limited in their ability to accumulate in tumors and tumor penetration, which are the main obstacles in the treatment of cancer. Historic efforts to harness living organisms to fight cancer have recently been revived in the field of synthetic biology. Certain circulating bacteria can intrinsically home in on tumors, and can be engineered to controllably induce local cytotoxicity while remaining unobtrusive to the host system. Due to the ineffectiveness of conventional treatments such as chemotherapy and radiation therapy in advanced tumor stages, resistance to treatment and non-specificity of these treatments, with the advancement of studies in this field, it is hoped that bacterial therapy will add a new dimension to cancer treatment.

Background: Awareness of the experiences of students and educators in the educational process plays an important role in facilitating and improving this process. This study aimed to explain and investigate the experiences of nursing educators and students about the presence of students with practical nursing diplomas in the process of undergraduate education. Materials and Methods: In this qualitative study conducted from 2016 to 2018, which adopted a content analysis approach, 24 nursing students and educators of Lorestan University of Medical Sciences were selected using the purposive sampling method and were interviewed in depth. The data were manually recorded and analyzed using the Graneheim and Lundman method. Results: The three main themes of “from contrast to alignment with professional competence,” “peaceful coexistence in the educational process,” and “reflection of the perceived reality of the clinical environment,” along with six categories and 30 subcategories were extracted from the interviews. Conclusions: It seems that monitoring and managing undergraduate courses more thoroughly, as well as raising the awareness of educators about the positive and negative dimensions of the presence of nursing students with practical nursing diplomas in undergraduate nursing courses can make it possible to optimize and improve students' learning process.

Background: Considering the position of home health care in the current world, the objective of thisstudy was to design an applied model of providing home care services in Iran.Methods: The mixed methods approach was employed in three stages in Iran from Feb 2015 to Sep2016. During the first phase, the qualitative method of content analysis was used. Data were collected by conducting 26 individual interviews and holding one focus group session involving 7 people. Dataanalysis was based on Graneheim and Lundman’s approach to content analysis.In the second phase of the study, a literature review was carried out and at the end of this stage, apreliminary model was designed. The model was standardized in the third phase using the Delphimethod with 23 participants in two rounds.Results: In the first and second stages of the study, various categories emerged including patientreferral, agreement, determination of the needed level of care, care plans designing, provision ofcomprehensive services, documentation, service monitoring, inter-professional cooperation, issuanceof death certificates at home, ethical considerations, and the evaluation of services. Then, in the Delphi phase, 20 (95.2%) of the experts confirmed the structure and content of the model and its applicability.Conclusion: The designed model can be helpful in organizing the provision of integrated andcomprehensive health services to clients at home, which can be effective in improving the clients’health and enhancing their self-care and autonomy.

Abstract Background Human instinctively desire to have offspring. Infertility can cause painful emotional experiences throughout the life mainly known as quality of life impairment. This study aimed to investigate the impact of infertility on a woman’s quality of life. Methods A number of 180 infertile and 540 fertile women participated in this matched case-control study. The cases were selected through a combination of multistage stratified and cluster sampling methods. For each infertile woman three fertile women were randomly selected. The data gathering instrument consisted of demographic variables and the WHOQOL-BREF questionnaire. Data collection was conducted through interview with participants. The multivariate marginal model and SPSS software 21 were used for data analyses with a significance level of 0.05. Results The results of the multivariate modeling show infertility can potentially affect various aspects of women’s quality of life such as physical health (p

Abstract Background According to the World Health Organization, palliative care is one of the main components of healthcare. As the incidence of cancer is increasing in the world, home-based palliative care can be beneficial for many patients. This study was designed to explore health care providers’ perceptions about home-based palliative care in terminally ill cancer patients. Methods This qualitative study was carried out using the conventional content analysis from October 2016 to September 2018 in Iran. Participants were home care providers who were selected using purposive sampling. The data were collected through 18 individual interviews, and a focus group meeting. Data were analyzed based on the method proposed by Lundman and Graneheim. Results from the data analysis, 511 initial codes were extracted, which were categorized into the two main categories of challenges and opportunities for home-based palliative care and 10 subcategories. The subcategories of challenges included deficiencies in inter-sectoral and inter-professional cooperation, lack of infrastructures for end-of-life care, challenges related to the management of death, challenges of transferring patients to home, providing non-academic palliative care, lack of political commitment of the government and Spiritual vacuum. The category of opportunities included subcategories of cost-effectiveness, moving towards socializing health, and structure of the health system. Conclusions Home-based palliative care requires government and health system support. Structural and process modification in the healthcare can provide conditions in which terminally ill cancer patients receive appropriate care in home and experience death with dignity through support of family, friends and healthcare.

Abstract Background The self-efficacy of educators plays a crucial role in their professional competence and subsequent provision of care. The present study aims to explain the main sources contributing to the development of self-efficacy beliefs among healthcare providers in delivering health education. Methods This qualitative study was conducted from 2015 to 2016 in various settings of Isfahan such as hospitals, doctor’s offices, and healthcare centers. Twenty three health educators with an average of 10-year work experience in healthcare participated in the study. Data were collected using semi-structured in-depth individual interviews and were analyzed through conventional content analysis. Prolonged engagement with the participants, maximum variation in the participants’ characteristics, sampling, and member check were among the factors enriching the research. Results The six main categories extracted during data analysis included: 1) Quantity and quality of their experience; 2) Encountering unexpected events; 3) Client trust; 4) Self-concept; 5) Professional knowledge and skill; 6) Vicarious experiences. Conclusions The study results show two new findings, including “encountering unexpected events” and “client trust”, affecting professional self-efficacy beliefs among healthcare providers in the delivery of health education. The other main findings were extremely similar to Bandura’s theory. These results can be used as a basis in planning and implementing health development educational models for human resources.

Background: The present research is a case-control study to analyze the influence of pre-miRNA-146a rs2910164 and pre‑miRNA-499 rs3746444 polymorphisms as candidate susceptibility factors for both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Methods: Polymorphism in miR146 and miR499 using ARMS-PCR was genotyped on 139 autoimmune disease (AD) patients (89 RA and 50 SLE) referred to Educational Hospitals of Khorramabad, Lorestan Province, west of Iran in 2018–2019 and 237 healthy control subjects. Results: A significant increase in the likelihood of carrying the GC vs. GG of pre-miR146-rs2910164 and T vs C allele of pre-miR499- rs3746444 in patients with RA was found. On the contrary, patients with RA were less likely to carry the TC + CC vs TT genotype and the C vs T allele of pre-miR499- rs374644. In females with the GC vs GG and GC+ CC vs GG genotypes, a significant association was found with the increased risk of RA. Interestingly, the genotypic combination of TC of the pre-miR499-rs374644 with GG of pre-miR146-rs2910164 more strongly decreased the risk of RA. In patients with SLE, no notable associations were found between both pre-miRNA-146a rs2910164 and pre‑miRNA-499 rs3746444 with risk of disease. Conclusion: Genetic polymorphisms of miR146 rs2910164 is associated with RA susceptibility especially in females. Interestingly, there is a potential in miR499 to reduce the risk with the protective effect of gene-gene interactions on miR146 in RA disease.

Background: Jaundice is a physiological phenomenon and common disorder in the neonatal period. Jaundice occurs in the first month of life in 60% of term and 80% of preterm neonates, leading to hospitalization. The present study aimed to determine the effect of oral zinc sulfate on serum bilirubin levels in the neonates undergoing phototherapy. Methods: This randomized clinical trial was conducted on 90 normal term neonates aged more than 24 hours with the total serum bilirubin of 14-19 mg/dc, who were admitted to the neonatal ward of Shahid Madani Hospital in Khorramabad, Iran for uncomplicated jaundice. Based on the inclusion criteria, these infants were divided into two groups of experimental (n=45) and control (n=45) via block random allocation. Infants in the control group only received phototherapy, and the experimental group received oral sulfate zinc (5 mg b.i.d.) in addition to phototherapy. Total serum bilirubin levels were measured upon admission and 24 and 48 hours after admission. Results: No significant differences were observed between the experimental and control groups in terms of age, gender, birth weight, hemoglobin level, reticulocyte percentage, and total serum bilirubin at the beginning of the study (P>0.05). Comparison of the bilirubin levels using repeated measures ANOVA at different times indicated significant differences in the neonatal serum values and blood cell counts between the study groups (time effect) (F=598.078; P

It is estimated that up to 20% of all types of human cancers worldwide are attributed to viruses. The genome of oncogenic viruses carries genes that have protein products that act as oncoproteins in cell proliferation and transformation. The modulation of cell cycle control mechanisms, cellular regulatory and signaling pathways by oncogenic viruses, plays an important role in viral carcinogenesis. Different signaling pathways play a part in the carcinogenesis that occurs in a cell. Among these pathways, the Wnt signaling pathway plays a predominant role in carcinogenesis and is known as a central cellular pathway in the development of tumors. There are three Wnt signaling pathways that are well identified, including the canonical or Wnt/β-catenin dependent pathway, the noncanonical or β-catenin-independent planar cell polarity (PCP) pathway, and the noncanonical Wnt/Ca2+ pathway. Most of the oncogenic viruses modulate the canonical Wnt signaling pathway. This review discusses the interaction between proteins of several human oncogenic viruses with the Wnt signaling pathway.

Introduction: Oral and dental health is one of the most important parts of public health. The purpose of this study was to assess the factors influencing oral and dental health among the pregnant mothers referring to urban health centers in Khorramabad, Iran, based on the Health Belief Model (HBM) in 2016. Methods: In this cross-sectional study, 340 pregnant mothers living in Khorramabad, Iran were selected from health centers using multi-stage random sampling. The decayed, missing, filled teeth (DMFT) index, the Oral Health Index – Simplified (OHIS), the health belief model (HBM) scale, and performance regarding oral and dental health care were measured and the data were analyzed. The obtained data were analyzed using the SPSS 20 software and descriptive statistical tests, Pearson correlation coefficient, and linear regression. Results: The mean DMFT score was 7.8 ± 3.27 and the mean OHIS score was 2.74 ± 1.65. Pearson correlation coefficient showed a direct and significant relationship between the constructs of the health belief model and performance (p< 0.05). Among the constructs of the health belief model, self-efficacy (22.2 %) had the highest predictive power. In addition, there was a positive correlation between the DMFT and OHIS scores. Conclusion: The present study showed that cognitive barriers are associated with oral and dental health behaviors and they should receive attention from the oral and dental health professionals. On the other hand, the most important predictor variable of oral health care among pregnant mothers is self-efficacy. Therefore, the self-efficacy of pregnant women should be boosted for them to practice good oral and dental health care.

Introduction: Self-medication is one of the problems in the treatment cycle of patients. Aging is associated with increased drug use and adverse effects. The purpose of this study was to assess the factors influencing self-medication among the elderly referring to urban health centers in Khorramabad, Iran, based on the Health Belief Model (HBM) in 2016-2017. Methods: This cross-sectional study was conducted on 137 elderly individuals over 60 in Khorramabad. The participants were selected using the multistage sampling method. Data collection instruments included a questionnaire designed based on the HBM and a self-medication checklist. The data were analyzed using the SPSS software, descriptive statistical tests, Pearson correlation coefficient, and linear regression. Results: Among the constructs of the HBM, perceived severity alone could predict 31 percent of the self-medication behaviors, and perceived severity plus barriers could predict 40 percent of the self-medication behaviors. The overall prevalence of self-medication among the elderly was 39.4%. The most common reason for self-medication was previous experiences with self-medications (59.8%). Additionally, there were significant relationships among the constructs of HBM with the favorable practice of the elderly regarding self-medication (p < 0.001). Conclusion: The results indicated that perceived severity and barriers play a more crucial role in the development of self-care behaviors regarding self-medication among the elderly.

Background and aim: Oral health is crucial for high-risk pregnant women in order to preserve their health and the health of their infants. Therefore, this study aimed to determine the impact of training programs on the behavior of pregnant mothers concerning oral health in Khorramabad, Iran. Methods: This is an educational experimental study carried out in 2015 on 164 pregnant women referring to health centers in the city of Khorramabad who were randomly divided into two groups (each n=82). The instruments for data collection included a questionnaire based on the Health Belief Model regarding oral health and two checklists of oral health indexes (OHIS and DMFT). Data were analyzed using SPSS 20 via paired- samples t-test, independent-samples t-test and Chi-square. Results: The mean score of knowledge and performance, and the variables of the components of the Health Belief Model including the perceived susceptibility, severity, benefits, barriers and self-efficacy regarding the oral health care, significantly increased in the intervention group following the training intervention (p

Background and purpose: The World Health Organization (WHO) has specified the tolerance limit of fluoride content of drinking water to be 1.5 mg/L, since excessive intake of fluoride leads to various detrimental diseases. The present study assessed the adsorption effectiveness of HCl-modified eucalyptus leaves in fluoride removal from synthetic solutions. Materials and Methods: In this experimental study, pseudo-first and pseudo-second order kinetics, Langmuir and Freundlich isotherm models, as well as pH (2-12), initial concentration (5-30 mg/L), adsorbent dose (0.1-1 g/L), and temperature (25-45 0C) were investigated on defluoridation. Results: The results with the maximum removal efficiency of 90% was obtained in pH = 10, initial concentration = 5 mg/L, and adsorbent dose = 0.1 g/L. In the investigation of the effect of temperature on removal rates, the maximum removal of fluoride was observed to be in 45 0C. The removal efficiency also decreased while the adsorbent dose increased, the initial concentration of fluoride increased, and the temperature in the studied ranges decreased. It was also found that the adsorption equilibrium and kinetic data were in good agreement with Langmuir Model (R2=0.994) with qmax= 61.35 mg/g and pseudo-second order reaction (R2=0.999). Conclusion: On the basis of the obtained results, HCl-modified eucalyptus leaves were found to be able to remove fluoride from aqueous environments with good removal efficiency and adsorption capacity.

Background: Ethical care is a core value in nursing. Pediatric nurses are in direct and continuous contact with children and their parents. They manage their lives and health. As part of the pediatric nurses' daily work, ethical issues play an important role in making decisions, are important to make decisions, and this capability is only achieved by ethical practice. This study aimed to explore the factors facilitating the learning of ethical practice among Iranian pediatric nurses. Materials and Methods: This study is a conventional qualitative content analysis based on the Graneheim and Lundman method. It was conducted through semi-structured interviews with two focus groups, incorporating 28 nurses working in pediatric wards. Unstructured observation and field notes were other methods of data collection. Purposive sampling continued until data saturation was ensured. All interviews were tape recorded and transcribed in verbatim. Results: Three main categories and 12 subcategories emerged from this study. The facilitating factors include (1) individual competencies (knowledge, experience, emotional intelligence, and loving children), (2) ethical imprinting (responsibility, reflection, empathy, and ethical beliefs), and (3) an environment that nurtures moral values (organizational, spiritual, family, and cultural environments) as facilitating factors. Conclusions: The promotion of nurses' competencies, ethical virtues, and imprinting, as well as improvement of the quality of nursing care must be the top priority of the health team. Undoubtedly, the success of the health care system is not possible without ensuring that pediatric nurses learn ethical practices.

Human error is one of the most important factors contributing to accidents. Unfortunately, in many reported accidents, a human error such as Bhopal, Three Mile Island, and Chernobyl played a significant role. The purpose of this research was to identify and evaluate the human errors that happened by the butene-1 unit’s control room operators in a petrochemical industry using Human Error Assessment and Reduction Technique (HEART) and Technique for the Retrospective and Predictive Analysis of Cognitive Errors (TRACEr) methods. In this study, 9 control room operators in a petrochemical industry unit based on the three-shift work schedule was investigated in 2016. The census sampling method was used to select sample size through all operators. The data were collected using observation methods, interview with control room’s operator, and shift controller as well as by previous incidents assessment. The research included three major parts. In the first part, all functions of control room operators were analyzed and a Hierarchical Task Analysis (HTA) was conducted. In the second part of this research, the types and reasons of human errors in each task were identified by the TRACEr method. Finally, in the third part, HEART method was applied regarding each job to review tasks, human error pre-condition impact factors, and determine the risk of error. In the current study, 2273 External Error Modes (EEM’s), 1768 Internal Error Modes (IEM’s), 1401 Performance Shaping Factors (PFS’s), 1185 Psychological Error Mechanism (PEM’s) were identified in the petrochemical plant’s control rooms. According to the results obtained from the TRACEr technique, the most influential factors affecting the occurrence of human errors happened by the control room operators were alertness, concentration, fatigue, improper use of communication devices, and the quality of communication. Based on the findings, the most effective performance shaping factors for control room operators were alertness, concentration, and fatigue, respectively. Since, control room operators had to repeat tasks in a seated posture and in front of a monitor which may cause to decrease their alertness, concentration, and increase fatigue. So it is recommended to use smart ergonomic chairs for control room operators to prevent loss of consciousness.

Pericardial tuberculosis (TB) is rare, but has particularly severe complications and a high mortality rate when not treated. Prompt treatment of pericardial TB is important and can be life-saving. We report a 13-year-old girl with massive pericardial effusion and negative workup for TB, who was empirically treated with an excellent response.

Brucellosis is a disease that is transmitted from animals to humans mainly via the consumption of unpasteurized dairy products, and it can involve any organ all over the body. Here, we report a significant rare case of brucellosis with cutaneous manifestations in a 52-year-old male patient whose disease was diagnosed via a serology test. The patient received standard antibiotic treatment, and his cutaneous lesions healed quickly. Although the cutaneous manifestations of brucellosis are exceedingly rare, in case of encountering ulcerative lesions and other cutaneous findings, particularly in endemic areas, infection with brucellosis should be kept in mind as an important differential diagnosis.

Phenol and its derivatives are pollutant compounds that are present in the wastewater of many industries. The objective of this study was to investigate the photocatalytic degradation of phenol in water containing various concentrations of sodium chloride. A laboratory study was conducted to evaluate the performance of UV/ZnO process on the efficiency of phenol removal from saline water with ZnO nanoparticles fixed on glass using UVC radiation. The effects of pH, contact time, sodium chloride concentrations, and the initial concentration of phenol on the photocatalytic removal of phenol were studied. The photocatalytic degradation of phenol showed suitable efficiency under the absence of sodium chloride (100% phenol removal at a concentration of 5 mg/l and during 120 minutes). However, the removal efficiency decreased in the presence of a concentration of 30 g/l of sodium chloride (92.4%). Additionally, phenol photocatalytic degradation efficiency decreased as a result of an increase in the initial concentration of phenol and the efficiency increased as a result of a decrease in pH (pH = 3). The results obtained from this study indicated that ZnO nanoparticles or ultraviolet rays alone cannot remove phenol fully and have a much lower efficiency in comparison with the photocatalytic degradation of phenol. Thus, the photocatalytic degradation process (UV/ZnO) is an effective method of removing phenol from saline water solutions.

Background: The objective of the present study is to investigate the relationship between the familial history of digestive system cancers and development of gastric cancer. Methods: In this case-control study conducted in 2012, 84 patients with a definite diagnosis of gastric cancer, diagnosed using endoscopy and pathological study of biopsies, were compared with 84 people with the same age and sex as the control group. The control group consisted of outpatients referring to the dermatology and ophthalmology clinics. All patients having a chronic condition were excluded from the control group. All patients filled out a questionnaire to determine whether they had any first-degree relatives with upper or lower digestive tract cancers. Data were analyzed using the Fisher’s exact and logistic regression tests. Results: The mean age of the patients was 65.4±10.7 and 64.3 percent of the patients were male. A statistically significant relationship between a background of gastric or colon cancer among first-degree relatives and the development of gastric cancer was observed An estimation of the odds ratio of the development of gastric cancer among patients with first-degree relatives who had developed gastric or colon cancers to the control group was 4.5 (95% CI=2.21-8.16) and 5.5 (95% CI=2.11-10.71), respectively. No significant relationship was found between a background of esophageal cancer among first-degree relatives and the development of gastric cancer among the participants (P_value = 0.24). Conclusion: The presence of relationships between the development of gastric cancer and a familial background of digestive tract cancers need to be studied in further research and with larger samples.