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Introduction: Selection and employment of clerks and managers is a crucial factor in modern organization and, recruiters try to select the best candidates in all organizational levels. One challenge which has been harmful for management stability is Similar-to-me (STM) effect. This effect explains that people usually tend to select a person with whom they have common demographic and attitudinal characteristics. Determination of all factors and challenges related to STM was the main objective of the present study. Method: This is a descriptive, cross-sectional study performed on all managers of Shiraz University of Medical Sciences (SUMS). A four-dimension questionnaire was applied with more than 0.7 α Chronbach coefficient for all dimensions. Moreover, its content validity was approved by experts' perspectives. SPSS 18 and Person correlation were used in to analyze the data. Results: According to the results obtained with the participation of 60 mangers of Shiraz University of Medical Sciences, narcissism had a significant correlation with STM effect (0.805). Also a positive correlation was observed between STM and groupthinking (0.875). Another result of the current research was the negative impact of functional conflict on STM (-0.685) Conclusion: Findings of the study revealed that the destructive consequences of similar-to-me effect through narcissism, groupthinking and functional conflict avoidance can affect the performance of SUMS managers negatively. These behaviors should be studied and prevented in order to achieve the goals of this system in the future. [ABSTRACT FROM AUTHOR]

Background: The co-occurrence of deep vein thrombosis with vascular aneurysms, whether venous or arterial, seems to be uncommon. This case report details a patient who experienced an isolated rupture of the right common iliac aneurysm 1 year after a deep vein thrombosis episode., Case Presentation: A 20-year-old Iranian female with a history of deep vein thrombosis DVT was treated with rivaroxaban but later presented with a ruptured right common iliac aneurysm. Surgical intervention was successful, but she developed persistent abdominal pain, small bowel obstruction, and a large pancreatic pseudocyst requiring drainage. Despite continued anticoagulant therapy, a thrombosed graft was observed, although the patient remains asymptomatic for organ ischemia or blood supply disorders., Conclusion: The association of deep vein thrombosis with vascular aneurysms is a rare occurrence. It is important to consider aneurysm-related flow disturbances and compression effects on veins when evaluating patients with concurrent deep vein thrombosis and aneurysms. Behçet's disease, Hughes-Stovin syndrome, chronic traumatic arteriovenous fistula, and recurrent nontyphoidal Salmonella bacteremia can also contribute to this association., Competing Interests: Declarations. Ethics approval and consent to participate: This research is under review by the Biomedical Research Ethics Committee of Shiraz University of Medical Sciences and the patient has filled out the consent form to participate and publish the article. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests: The authors declare that they have no competing interests., (© 2024. The Author(s).)

Background: Every year, natural disasters in many countries lead to the destruction of infrastructure, loss of assets, and harm to the physical, mental, social, and spiritual health of people. The attention of policymakers and the media is mostly focused on the reconstruction of damaged buildings and the physical rehabilitation and recovery of the injured, while the spiritual rehabilitation of the people affected is often neglected. This study aims to identify the factors influencing the spiritual rehabilitation of people affected by natural disasters., Methods: This study was conducted using a systematic literature review following the PRISMA guidelines. Relevant studies were extracted from data sources, including MEDLINE (PubMed), Web of Science, Google Scholar, Embase, ProQuest, PsycInfo, Scopus, IranMedex, SID, and ISC. Systematic review studies, key journals, and conference proceedings related to the factors affecting the spiritual rehabilitation of individuals after natural disasters from January 1, 2020 to March 31, 2022 were included. Thematic analysis was used to analyze the obtained data., Results: Initially, 1,753 studies were identified based on the initial search, and eventually, 22 final studies were included in the study. Based on the thematic analysis results, the factors influencing the spiritual rehabilitation of people affected by natural disasters were classified into four main themes and eleven sub-themes. The main themes included communication with God, strengthening religious beliefs, social participation, and meaning-making. The sub-themes included praying, using supplication, reading the holy book, praising God, believing in the afterlife, understanding the position and characteristics of the world, understanding the divine, participating in religious ceremonies, membership in supportive groups, the meaning of suffering and adversity, and the meaning of death., Conclusions: The results of this study demonstrate that the connection with the divine (God), strengthening religious beliefs, social participation, and meaning-making are influential factors in the spiritual rehabilitation of affected people after natural disasters. Incorporating these factors in the spiritual counseling and care of the affected people can improve their spiritual health after encountering the destructive effects of natural disasters. These findings can provide valuable insights for managing natural disasters through a holistic approach to the health of affected people, and can guide caregivers in implementing spiritual rehabilitation interventions.

Introduction: Drought, a prevalent consequence of climate change, significantly impacts mental health among farmers. Enhancing psychological resilience is crucial to mitigating these effects. This study aims to explore the concept and factors affecting the psychological resilience of farmers living in drought-affected regions in Iran., Method: This study utilized a conventional qualitative content analysis method. Twenty-six participants, divided into two groups of experts and farmers, were selected through purposive sampling. Data collection was conducted via in-depth semi-structured interviews. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist and was carried out between June 2023 and February 2024., Results: The factors affecting the psychological resilience of farmers living in drought-affected regions were categorized into two main categories with nine subcategories. The first category, environmental factors, included economic factors, socio-cultural factors, drought adaptation methods, government policies, and infrastructural factors. The second category, intra-individual factors, comprised personal characteristics, health factors, psychological factors, and perception and knowledge., Conclusion: The study revealed that both environmental and intra-individual factors influence the psychological resilience of farmers during droughts. It is recommended to implement intervention strategies, such as providing training and education on drought adaptation methods and managing agricultural and healthcare expenses. Further research is needed to expand this concept to various disasters and occupational groups in future studies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tahernejad, Sohrabizadeh and Mashhadi.)

Background: Air pollution poses a significant threat to global public health, contributing to high rates of mortality and morbidity. India, home to the world's largest population of children, is particularly affected. This study aims to identify effective strategies to mitigate the adverse health impacts of air pollution on this vulnerable group., Material and Methods: The study utilized directed content analysis using a deductive approach and purposeful sampling to carry out in-depth interviews with researchers, academicians, paediatricians, public health experts, and climate change experts from different organizations in India. In total, 17 interviews were conducted over two months in March and April 2024 until data saturation was reached., Results:  A total of 29 subcategories were extracted. The main sub-categories include strategies for reducing indoor emissions and multisectoral emission reduction, strategies to reduce exposure at home, schools and transit, strategies for public awareness, effective communication, health sector communication and awareness, and raising awareness by frontline workers and educational institutions, strategies for capacity building of health sector and frontline stakeholders, strategies for building research and knowledge translation, strategies for vertical and horizontal collaboration, strategies for child-centric policies, school closure policies, fiscal policies, comprehensive policymaking, sectoral policymaking, advocacy in policymaking, strategies for monitoring, and strategies for mother and child health., Conclusions: The results of this study indicate that mitigating the adverse health impacts of pollution for children would entail a multi-pronged approach encompassing effective communication and education strategies and awareness raising of important stakeholders such as health professionals, community, grassroots-level workers, parents, teachers and children. Such strategies could be useful to trigger the desired change in behaviour of all concerned. Also, there is a need for collaboration and partnership between various stakeholders and ministries as policy-making bodies. There is a need to build on the research and strengthen the monitoring and surveillance., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Shahid Beheshti University of Medical Sciences issued approval IR.SBMU.PHNS.REC.1402.047. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Chhabra et al.)

Background: The use of respiratory masks has been one of the most important measures to prevent the spread of COVID-19 among health care workers during the COVID-19 pandemic. Therefore, correct and safe use of breathing masks is vital. The purpose of this study was to exploring factors affecting the unsafe behavior of health care workers' in using respiratory masks during the COVID-19 pandemic in Iran., Methods: This study was carried out using the conventional qualitative content analysis. Participants were the number of 26 health care workers selected by purposive sampling method. Data collection was conducted through in-depth semi-structured interviews. Data analysis was done using the content analysis approach of Graneheim and Lundman. This study aligns with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist and was conducted between December 2021 and April 2022., Results: The factors affecting the unsafe behavior of health care workers while using respiratory masks were divided into 3 main categories and 8 sub-categories. Categories included discomfort and pain (four sub-categories of headache and dizziness, skin discomfort, respiratory discomfort, feeling hot and thirsty), negative effect on performance (four sub-categories of effect on physical function, effect on cognitive function, system function vision, and hearing), and a negative effect on the mental state (two subcategories of anxiety and depression)., Conclusion: The findings can help identify and analyze possible scenarios to reduce unsafe behaviors at the time of using breathing masks. The necessary therapeutic and preventive interventions regarding the complications of using masks, as well as planning to train personnel for the correct use of masks with minimal health effects are suggested., (© 2024. The Author(s).)

Introduction: Migration and mobility of population have been reported as a common reaction to drought. There is historical evidence to suggest the health effects of droughts and human migration linkage in Iran. This study aimed to map the drought and migration patterns in Iran in 2011 and 2016 and explore their possible health impacts., Methods: This sequential explanatory mixed-method study was done in two stages of spatial analysis and qualitative study. Data mapping was conducted through the equal interval classification and using drought, migration, and agriculture occupation data based on provincial divisions in Iran in 2011 and 2016. This qualitative study was conducted using the content analysis approach., Results: The in-migration rate was higher in 2011 rather than 2016. Migration to cities was much higher than migration to villages in both years. The frequency of male migrants was higher than females in all provinces in 2011 and 2016. Physical and mental diseases as well as economic, sociocultural, education, and environment effects on health were extracted from the qualitative data., Conclusion: A holistic picture of droughts and migration issues in Iran and their health consequences were achieved by the present research. Further research is needed to explore the determinants of health impacts of climate change in vulnerable groups. Public health problems can be prevented by adaptive and preventive policy-making and planning. This can improve the coping capacity of the population facing droughts and enforced migration.

Background: Economic evaluation approaches are needed to establish useful interventions for saving lives, preventing economic damage, and saving recovery costs at the time of disasters. Thus, the present study is aimed to identify the studies that applied economic evaluation approaches/methods for evaluating the economic costs of disasters., Methods: A scoping review was conducted to find the eligible studies and perform a comprehensive data analysis., Results: Based on the findings, cost-effectiveness analysis, economic loss assessment, modeling, or mapping, as well as behavioral economic analysis were used as the economic evaluation approaches/methods., Conclusions: Applying economic evaluation approaches to illustrate the economic costs of disasters is highly recommended. Managing competing priorities and optimizing resources allocations to the most cost-effective interventions can be achieved by cost-effectiveness analysis. The results of economic loss assessment can be used as the basis of disaster preparedness and response planning. Economic modeling can be applied to compare different interventions and anticipate socio-economic effects of disasters. A behavioral economic approach can be effective for decision-making in the field of disaster health management. Further research is needed to identify the advantages and limitations of each economic evaluation method/approach in the field of health in disasters. Such research can preferably be designed as the systematic review and meta-analysis.

Background: Knowledge about the spiritual rehabilitation of affected people after disasters is scare. The objective of the present study is to identify the factors affecting the spiritual rehabilitation of affected people after natural disasters employing a systematic review study., Methods: The protocol of this review has been registered in the International Prospective Register of Systematic Review (PROSPERO) with the code CRD42021228552. Using MEDLIN (PubMed), Web of Science, Google Scholar, Embase, ProQuest, Scopus and ISC database as well as studies related to the research topic till the end of 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was used to find articles related to the research objective. Thematic content analysis then was used for concepts extraction., Results: This systematic review identifies factors affecting the spiritual rehabilitation of affected people after natural disasters., Conclusions: Both systematic review as well as qualitative study are essential in order to explore spiritual rehabilitation of affected people after natural disasters, while the current study was employed systematic review. It is expected that planners and policy-makers can use the extracted factors for improving the spiritual rehabilitation of people affected by natural disasters.

Introduction: Process industries may have different hazards that can cause serious injury to humans, the environment, and the economy. Considering the importance of man-made risks in process industries, Experts' Points of View should be considered to apply risk reduction strategies Hence, the present study was performed to explain the views of experts regarding the types and importance of man-made hazards in process industries., Materials and Methods: This study was conducted using a qualitative method of directed content analysis with a deductive approach. The participants included 22 experts in the field of process industries. The selection of samples started purposeful and continued until data saturation. Data collection was done through semi-structured interviews., Results: Based on experts' points of view, 5 man-made hazards in process industries were classified into 14 subcategories. The man category was divided into three subcategories: human error, technical knowledge error, and management error, the Material category was divided into 3 sub-categories of leakage and rupture, chemical properties, physical properties, Medium category was divided into two sub-categories of incorrect location selection and placement and harmful environmental factors, Machines category was divided into three sub-categories of failure in design, failure in Preventive Maintenance (PM), failure in Safety Instrumented System (SIS), and the Methods category was classified into three sub-categories: defects in inspection, defects in information, defects in executive instructions., Conclusion: Technical training to reduce personnel errors, conducting risk-based inspections to control leaks and possible ruptures, careful design and site selection in the initial phase of the project, is recommended. The use of engineering methods and artificial intelligence to obtain the risk number and control methods to reduce the harmful effects of risks can be helpful., Competing Interests: The authors declare no competing interests., (© 2023 The Authors.)

Background: Drought is one of the most frequent natural hazards in Iran. Gender analysis can highlight the different needs and capacities of men and women to manage drought hazards. Thus, the present study aimed to map drought and the gender gap in drought data based on the provincial zones in 2011 and 2016. Methods: This cross-sectional study was conducted in 2 stages establishing a database and spatial analysis. Data mapping was done based on provincial divisions, sex-disaggregated distribution of literacy, and employment rate as well as drought patterns in Iran in 2011 and 2016 using ArcGIS software. Descriptive statistics were applied to analyze and report the sex-disaggregated literacy and employment data. Results: About 80.73% and 75.27% of women and 80.89% and 74.74% of men experienced severe and very severe droughts in 2011 and 2016, respectively. Gender inequality in the aspects of literacy and employment in drought-affected regions was found in 2011 and 2016. Conclusion: Community-based planning and management in regions exposed to climate change are suggested for reducing the consequences of climatic disasters such as droughts. Women need to be empowered and trained for innovative livelihood activities in rural and urban areas in Iran and other developing countries affected by long-term droughts., (© 2022 Iran University of Medical Sciences.)

Objective: Educated midwives have a range of abilities to use their skills in normal situations. Given that working under normal situations is different from critical conditions, the recognition of skills and competencies required for midwifery practice is important. The purpose of this study was to explore specific professional competencies that midwives need to have for the provision of reproductive health services during disasters., Methods: This was a qualitative study using a content analysis method. Subjects were 19 midwives with the work experience of practice in disaster situations. Data were collected using semi-structured interviews and analysis was based on the approach suggested by Graneheim and Lundman., Results: Six major categories developed in this study were "safe pregnancy," "safe childbirth," "women's health care," "contraception," "violence and sexually transmitted infections," and "infant care.", Conclusions: Midwives can play a very important role in the provision of reproductive health services. Therefore, they must have special capabilities and capacities. Policies and curriculum development are recommended in accordance with the needs of reproductive health in disaster-affected communities.

Background: Many accidents caused by vehicles are the result of improper driving behavior. Use the vehicle in an antisocial form has led to a phenomenon called driving violence. Antisocial behavior while driving has a potential risk to other road users. This study aims to explain the conceptual framework of the formation of unsafe antisocial behaviors in the road traffic field., Methods: This qualitative grounded theory study was conducted with exploratory methods. 31 participants were included in this study. Purposeful and theoretical sampling was used in this study. The data collection process was semi-structured interviews. Codes, subcategories, and categories were extracted by the inductive process and analyzed by Corbin and Strauss approach. Trustworthiness criteria were used to assure the quality of the results. The data analysis process continued until there were no new concepts., Results: A conceptual model was developed to explain the different relationships between the main categories extracted from the study. 10 main categories with 44 subcategories were extracted. Categories include cultural factors, educational factors, rules, economic factors, psychological factors, infrastructure weakness, poor socialization of individuals, violent driving, reduced social welfare and reduced traffic safety., Conclusions: The people's socialization weakness in society was considered as the core concept in the process of formation of these behaviors. The conceptual model obtained from this study can be used in developing prevention programs and identifying the required interventions Considering the negative consequences caused by this type of behavior, its prevention should be the focus of road traffic policy makers.

Spiritual health is one important dimension of human health. Natural disasters, however, can adversely affect human spiritual health. One of the undeniable requirements of disaster management is the spiritual rehabilitation of victims to help them recover to their pre-disaster health conditions. This study aimed to explore the factors challenging the spiritual rehabilitation of Iranian men suffering from natural disasters based on the experiences of key informants. The participants were 19 spiritual health experts in post-disaster spiritual rehabilitation. Participants were selected using a purposive sampling method until data saturation was reached. The data were collected through semi-structured interviews and analyzed using Granheim and Lundman (2004) content analysis method. The factors challenging men's spiritual rehabilitation were classified into 6 main categories and 16 subcategories. The extracted categories included (i) correcting victims' perspectives, (ii) describing God's characteristics, (iii) seeking help from God, (iv) strengthening spiritual beliefs, (v) psychological factors, and (vi) tranquility factors. Our findings identified the important factors challenging the spiritual rehabilitation of the men victimized by natural disasters, which needed to be considered by responsible organizations and health sectors. Particularly, the organizations in charge of disaster management should take necessary measures and plans during the post-disaster phase to restore people's spiritual health. Spiritual health, currently a neglected dimension of health, should be considered people's in parallel with physical, psychological, and social health dimensions. Our results can be helpful in developing action plans for delivering a comprehensive spiritual rehabilitation service, which would help to lead to the full rehabilitation of victims after natural disasters., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: Floods are one of Iran's most important natural hazards, which cause a lot of damage every year. Various organizations, including non-governmental organizations (NGOs), participate in flood management. The present study aimed to explore the challenges and barriers of NGOs' participation in the management of the flooding in Iran based on stakeholders' experiences., Methods: This qualitative study is a case study that was conducted using the content analysis approach. Fifteen participants, including 3 national managers, 2 volunteers active in responding to recent floods, and 10 NGO managers/secretaries who had the knowledge or operational experience of participating in disaster management, were approached for interviews. Data were collected using a purposeful sampling method and continued until reaching data saturation., Results: Challenges and barriers to NGOs' participation in flood management were categorized into 4 main categories and 14 subcategories, including policy-making challenges, managerial challenges, executive challenges, and socio-cultural challenges., Conclusions: As multiple NGOs take part in responding to disasters and performing relief operations, establishing a unified command and supervision system for effective coordination and collaborations among NGOs and other stakeholders is highly suggested. Further research is needed to develop a measurement tool for assessing the effectiveness of NGOs' activities during disasters.

Objective: To analyze the consequences of the Natech scenario of H 2 S toxic gas release from an oil refinery near Tehran and its effects on surrounding residential areas following an earthquake., Methods: This research was an applied study. The Natech risk map and the end-point distance of gas release were determined using the Rapid-n software and the Worst-Case Scenario of RMP, respectively., Results: Regarding the high seismic vulnerability of the structures affected by the Natech risk, all residents of this area were simultaneously affected by earthquake and the toxic gas inhalation. In comparison to earthquake, response capacities were poor for Natech events, due to insufficient resources, limited accessibility, lack of planning, and unsafe evacuation places in exposed regions. Unlike earthquake, few studies have been conducted on Natech risk assessment and related consequences in Iran. Our study not only covered this gap but also revealed some dimensions of consequences of human, structural, and response capacities., Conclusions: It is recommended to have plans for implementing short-term such as identifying vulnerable industries and areas, public awareness and long-term such as land use planning measures to reduce Natech risk and resilience improvement.

Objective: Volunteers need considerable resiliency to cope with formidable challenges during their operations in disaster scenes. The present study was conducted to identify factors affecting the different aspects of resiliency among volunteers in disasters., Material and Methods: The databases of Web of Science, Scopus, PubMed, ProQuest, Google Scholar, World Health Organization Library, International Committee of the Red Cross (ICRC) Library, PsycArticles, and SafetyLit were searched until September 29, 2018. The main search terms were resiliency, disaster, humanitarian aid worker, and volunteer., Results: A total of 548 documents were obtained and screened based on the inclusion and exclusion criteria. A number of 8 documents was selected for the final analysis. The main factors contributing to the resilience of volunteers at the 3 stages of pre-, during, and post-disasters were classified into 3 groups of individual, environmental, and organizational. Important factors affecting resilience of volunteers in disasters included previous disaster response experience and disaster-related training., Conclusion: Resiliency should be deemed integral to relief operations. Considering the main factors affecting volunteers' resiliency, it is highly suggested that organizations active in humanitarian endeavors explore the factors impacting on resilience among their volunteers via various research methods and seek to select those with higher degrees of resilience in order to avert untoward consequences in their missions.

Background: Collaboration, as a key factor in disaster risk management, is a mechanism that prevents the loss of time, investment, and resources. The variety of units in the health sector has made collaboration a major challenge. The present study aimed at developing a tool for assessing collaboration in the health sector during disasters., Methods: In this mixed-methods study, a questionnaire was developed by integrating the findings of a systematic literature review and a qualitative study. Face and content validation were performed. The reliability of the tool was tested through a 15-day interval test-retest by Cronbach's alpha and intraclass correlation coefficient (ICC) with 30 participants. Confirmatory factor analysis was done to test the validity and reliability of instrument using SmartPLS in a case study with 450 health sector staff., Results: The factors affecting intraorganizational collaboration of the health sector were identified in six categories and 19 subcategories by searching 46 articles in the systematic review and content analysis of 16 semistructured interviews with health sector staff. The results of content validity ratio (=0.81), content validity index (=0.92), Cronbach's alpha (=0.975), and ICC (=0.970) confirmed the validity and reliability of the tool. Convergent validity, discriminant validity, and reliability were approved by AVE (average variance extracted) >0.5, Fornell and Larcker matrix, and CR (composite reliability) >0.7. According to the positive result of R 2 , Q 2 , and goodness-of-fit (GOF) criteria, the model fit was confirmed., Conclusion: The results of validity and reliability measurements approved the proposed tool. The use of this tool is recommended for developing collaboration in the health sectors of different countries., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 International Journal of Preventive Medicine.)

Background: In recent decades, earthquakes, as natural hazards that caused direct effects both on communities and the chemical industry, produced many Natech events. Natech term is utilizing to describe the technological disasters caused by natural hazards. This study was conducted on the emergency evacuation challenges of residential areas adjacent to a refinery near Tehran based on H2S toxic gas release following a possible earthquake scenario., Methods: This Research was an applied study at two phases in 2020. In the first phase, a review study was conducted to identify the community's previous experiences on emergency evacuation following Natech events. In the second phase, the challenges of emergency evacuation were analyzed based on the scenario of a possible earthquake and gas release from the refinery., Results: Due to the high seismic vulnerability of structures in the area affected Natech risk, the total Resident population in this area would be affected simultaneously by an earthquake and H2S gas release in concentration 30 ppm as the result of the earthquake impact on chemical facilities. Emergency evacuation would be inevitable. The existing evacuation places are very unsafe and dangerous due to having open spaces. The nearest suitable evacuation places were found in the north direction for more than 38 % of the exposed population and in the east, west, and south direction for more than 61% of them., Conclusions: The emergency evacuation challenges were discussed in 4 viewpoints, disrupted or interrupted rescue and firefighting operation, unnecessary evacuation, frequent evacuation, and evacuation behavior. The measures such as revising and updating emergency evacuation maps; public informing, training, preparedness; providing protocols and training for operational and therapeutic response teams; and coordination improvement can help resilience increasing to such disasters.

Background: Disasters have undesirable effects on health among individuals such as psychosocial disorders which may lead lead to suicide in some cases. Thus, the present study aimed to measure the rate of suicide death after disasters all over the world., Methods: In the present meta-analysis study, all of the articles published in English until the end of 2019 were probed in electronic databases such as Web of Science, PubMed, Cochrane Library, Science Direct, PsycINFO, PsycARTICLES, and Google Scholar. Then, the data were imported to STATA ver.13 software and analyzed through fixed- and random-effects models, meta-regression, and Cochrane statistical tests., Results: A total of 11 studies including a sample size of 65495867 were considered. Suicide death rates before and after the disasters were calculated as 13.61 (CI95%: 11.59-15.77) vs. 16.68 (CI95%: 14.5-19:0) among the whole population, 28.36 (CI 95%:11.29-45.43) vs. 32.17 (CI95%: 17.71-46.62) among men, and 12.71 (CI95%: 5.98-19.44) vs 12.69 (CI95%: 5.17-20.21) among women. The rate of suicide death significantly increased in the whole population and men, while no significant difference was reported among women., Conclusion: Suicide death rate increases after disasters indicating the destructive impact of this phenomenon on peoples' health. Therefore, implementing supportive and interventional measures is highly suggested after disasters in order to prevent suicide death among the affected people.

Nowadays, air ambulances have been developed as part of advanced emergency medicine services with many countries employing these services for transferring patients in usual and emergency conditions. However, there are challenges concerning the optimal development of air ambulance base. The present research aimed to identify factors affecting the development of air ambulance bases to provide the opportunity of planning to improve the quality of emergency medical services. In this systematic literature review, the peer-reviewed papers in fiv electronic databases, including Medline through PubMed, Scopus, Web of Science, ScienceDirect, and ProQuest, as well as available gray literature, were searched and selected. Two combinations of groups were used as keywords: the Health Planning and development factor, air ambulance base. The focus was on the PRISMA checklist, with no time limitations until from 1990 to January 2020. Finally, through 5156 related citations, 20 articles were included. Descriptive and thematic content analyses were evaluated. The factors affecting the development of the air ambulance base were classified in fiv categories and 14 subcategories as follows: navigation criteria, process indications and standards, sociopolitical factors, and current situation of the area. There are few studies on factors affecting the development of air ambulance bases. It is necessary to apply multidimensional models to consider various factors for development. The development of high populated cities, events and ceremonies with a crowd of participants, and increase of human-made disasters are making these services increasingly indispensable., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Objectives: Women and men are assigned roles and responsibilities based on their gender in all contexts. Measuring gender-based differences through gender analysis can help understand who will be at greater risk in disasters. Thus, the present study is aimed to develop a valid and reliable gender analysis tool to collect accurate and necessary gender-disaggregated information in disaster-affected regions., Methods: A mix method approach using qualitative and quantitative studies was applied for conducting this study. A total of 20 people affected by the earthquakes and floods and 10 key informants were interviewed in the qualitative stage. The validity and reliability of the tool were measured using the experts as well as women and men living in the destroyed villages of Razavi Khorasan province during the quantitative stage. The Graneheim approach and SPSS software were used to analyze the data collected in both stages., Results: At the first stage, 7 categories were extracted from the data, namely, livelihood status, social status, health, household/family management, reconstruction, welfare and educational facilities, and disaster prevention. The results of content validity ratio (0.69) and content validity index (0.88) confirmed that the tool is valid. The amount of Cronbach's alpha (0.75) and test-retest (0.83) examination indicated that the tool was also reliable. The results of content validity and reliability measurements approved that the gender analysis tool can be applied for postdisaster gender analysis surveys., Conclusions: It is highly suggested to use the information provided by the gender analysis tool for future disaster management plans, programs, and policies in health systems.

Background: In December 2019, the Chinese city of Wuhan reported a novel pneumonia caused by COVID-19. While the COVID-19 pandemic has been increasingly affecting the world, the occurrence of disasters resulted in complex emergencies. The present review is aimed to identify the literature focused on health system response to coincidence of COVID-19 and disasters as well as describing their finding, implications and lessons-learned., Methods: This study was conducted and reported based on PRISMA guideline. The databases of Web of Sciences, PubMed, Scopus, Google Scholar and World Health Organization Library were searched. The inclusion criteria were all forms of published articles which investigated the coincidence of disasters and COVID-19 pandemic. Using the title and abstract screening, the selections of studies were performed by two researchers. Once, the relevant papers were finalized, the analysis was done in two parts of descriptive analysis and implications for health systems., Results: Out of 1245 studies generated by initial search, a number of 13 articles was selected for final analysis. Earthquake was the most frequent disaster which its coincidence with COVID-19 was studied by researchers (31%). The implications of researchers for healthcare system were explained in three sections of climatic events, earthquakes and all hazard approach in relation to COVID-19., Conclusion: Extracting the lessons learned from the regions affected by disasters at the time of COVID-19 pandemic can be helpful for healthcare professionals and policy-makers to improve their preparedness and response during disasters and a serious pandemic such as COVID-19. Further research is needed to identify the factors which strengthen the preparedness of health system for the dual risk of natural hazards and pandemics.

Objective: To explore the factors affecting unsafe antisocial behaviors of drivers in the context of Iran., Methods: The interviews were conducted from June to November 2019. A number of 19 participants were selected using purposive sampling method. The data were collected using face to face in-depth semi-structured interviews. Content analysis using Granheim's approach was applied for data analysis., Results: Seven categories and 14 sub-categories were extracted from the data . The categories included cultural factors, educational and training factors, laws, imitating, substance abuse, awareness and attitude, and psychological problems., Conclusion: Based on the findings, various cultural, legal, educational, individual and psychological factors affect the unsafe antisocial behavior in driving. Seemingly, such behaviors could increase the chance of death or injury caused by road traffic crashes among the road users and affect social welfare of the citizens and road user's safety., (Journal compilation © 2021 Trauma Research Center, Shiraz University of Medical Sciences.)

Background: The Islamic Republic of Iran is at high risk of natural disasters. Households are the basic unit of society and they need to be prepared for disasters., Aims: This study assessed disaster preparedness among Iranian households in 2015., Methods: Using multistage cluster sampling, 2968 households in the catchment area of 53 public health departments in all 30 provinces of the Islamic Republic of Iran were surveyed on the disaster preparedness measures they had taken in the past year. The data collection questionnaire included 15 disaster preparedness measures. The mean preparedness score was calculated and its association with residence (urban versus rural), house ownership (owner versus renter) and education level of the head of the household (illiterate, elementary school, middle school, high school, university) was evaluated., Results: The mean score for household disaster preparedness was 9.3 out of 100 (95% confidence interval: 8.3-10.3). Multivariate analysis showed higher preparedness among rural than urban households (P = 0.02). Higher education level was positively associated with a higher preparedness score (P < 0.001), as was house ownership (P < 0.001)., Conclusion: The level of household disaster preparedness in the Islamic Republic of Iran in 2015 was low. In line with the first priority for action of the Sendai Framework for Disaster Risk Reduction, the current study provides an overall picture of household disaster preparedness in the Islamic Republic of Iran. This estimation can be used as a baseline value for policy-making, planning, and evaluation of public awareness of disasters in the country., (Copyright © World Health Organization (WHO) 2020. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Background: Humanitarian aid workers experience various challenges in disasters, which affects their wellbeing. Being resilience can help volunteers to adapt to them. This study was conducted to develop and validate a resiliency questionnaire to evaluate the resilience of humanitarian aid workers in disasters. Methods: This study was conducted in 2 phases between Dec 2017 and Oct 2018. In the first phase for item generation, we used qualitative content analysis. Face-to-face semi-structured interviews with 18 humanitarian aid workers were used for data collection. In the second phase, by conducting a quantitative study, the psychometric properties of the scale including face, content and construct validities as well as internal and external reliabilities, were determined. Data analysis was performed using SPSS 19 and the significance level was set at less than 0.05. Results: Six main subjects were extracted from the first-stage data using content analysis. The final questionnaire included six factors and 31 items after validity and reliability criteria analysis. These six factors including organizational supports, individual factors, organizational planning, social support, teamwork and challenges of disaster scene included 52.19% of the variance. The internal consistency was confirmed as well (Cronbach's alpha = 0.814). Conclusion: This specific self-assessment questionnaire can be used for scoring the resilience of humanitarian aid workers in disasters. In the case of low resilience score of volunteers, managers should avoid sending them on missions and try to improve their resilience through educational programs., (© 2019 Iran University of Medical Sciences.)

Objective: Workplace violence is one type of occupational hazards that is increasingly growing worldwide. In the health system, one of the important groups subject to workplace violence is emergency medical services (EMS) personnel, who provide emergency services for patients and casualties as the first responders. The aim of this study was to determine the prevalence of workplace violence and its different types among Iranian EMS personnel. Method : This study was conducted based on PRISMA guideline for systematic review and meta-analysis. The data were extracted from Scopus, PubMed, Web of Science, Google Scholar, SID and MagIran databases using Persian and English keywords. The search was conducted up to December 2018 without any limitation in publication year. The qualities of selected papers were assessed by STROBE checklist. I 2 index was used to evaluate heterogeneity, and random effects model was used in meta-analysis. Data were analyzed using Stata14. Results: A total of 9 studies entered the meta-analysis. The total sample size was 1257 Iranian EMS personnel, with an average age of 32.21 ± 2.01 years. The prevalence of physical, verbal, and cultural workplace violence among EMS personnel was 36.39% (CI 95%:27.29-45.50, P<0.001, I 2 = 90.8%), 73.13% (95% CI=68.64-77.62, P=0.013, I 2 = 62.7%), and 16.51% (95% CI =3.49- 29.53, p<0.001. I 2 = 94.7%), respectively. Conclusion: Considering the high prevalence of workplace violence among EMS personnel in Iran, more studies should be conducted to determine the underlying causes of EMS staff workplace violence in Iran. Training violence prevention methods as well as assigning national protective rules are highly suggested. Insufficient studies on Workplace violence among EMS personnel in Iran and high heterogeneity were the limitations of this study., (Copyright © Psychiatry & Psychology Research Center, Tehran University of Medical Sciences.)

Background: In Iran, Road Traffic Injuries (RTIs) with mass casualties occur repeatedly. Since Road Traffic Accidents (RTAs) occur far from health facilities, EMSs play an important role in reducing the disability and mortality resulting from RTIs. Thus, the study aimed to report Iraqi pilgrims' bus which rolled over in the Malayer town., Case Presentation: A mass casualty event occurred on 7 September 2017 when a bus full of Iraqi pilgrims rolled over on a road 4-km outside of Malayer, Iran. A large team of responders were dispatched including 5 ambulances with 10 EMTs along with 6 police officers serving in the area. The accident resulted in 35 injured patients (21 female and 14 male) as well as 11 deaths ranging in age from 2 to 65 years. Twenty-one of the injured were transported to the hospital and 14 patients refused transport and 12 patients sustained multiple trauma. The case has been described four phases of dispatch, on-scene, hospital and post-mission. Frequent calls made by laypeople were considered as the main challenge of dispatch phase. The response on scene was hampered by large numbers of lay bystanders. The over-crowding around the emergency units disrupted the medical care procedures in hospital phase., Conclusion: This case highlights over-crowding and laypeople interference at the scene disrupts the relief and rescue. To solve these challenges, the public education and police monitoring and control is recommended. Establishing a unified command post at the scene can facilitate effective coordination among relief and rescue organizations.

IntroductionNatural disasters have many effects on vulnerable groups, especially infants and children. Protecting breastfeeding in disasters is important, because artificial feeding puts a lot of risk to the child. In disasters, artificial nutrition is dangerous to children and its supplementation requires special equipment. There is little information on the nutritional status of infants after disasters in Iran.ProblemThe purpose of this study was to explore the barriers to appropriate lactation after disasters in Iran., Method: This was a qualitative study using a content analysis method. A total of 19 midwives with disaster-relief experiences were approached for interview. Data were collected using semi-structured interviews. Data analysis was performed using the Graneheim's approach., Results: The categories of maternal factors, neonatal factors, management factors, and context-base factors were extracted from the data., Conclusion: The challenges of social support, mothers' self-efficacy, educated staff for disasters, and privacy for breastfeeding can be considered as important barriers to breastfeeding in disasters. Training programs, as well as health system support, can help overcome the breastfeeding barriers in disasters. MirMohamadaliIeM, Khani JazaniR, SohrabizadehS, Nikbakht NasrabadiA. Barriers to breastfeeding in disasters in the context of Iran. Prehosp Disaster Med. 2019;34(1):20-24.

While religiosity is emerging as one of the more important subjects in disaster management, identifying gender differences in using religion as a coping method has attracted very little attention. The aim of this study was to explore the effects of religiosity on disaster-affected women and men in the setting of Iran. A field-based investigation using a qualitative approach was carried out to achieve the study's purpose. Data were collected using in-depth unstructured interviews with 25 participants who had been damaged by recent disasters. Two themes, negative and positive effects of religiosity, and five categories were extracted from the data. Women may be influenced by religion more than men, and thus, they can play key roles in strengthening the positive effects of religiosity.

Background: Natural disasters represent critical threats to the health, safety, and well-being of a community-including reproductive health, which has been neglected in disaster-stricken regions. The current study was undertaken to explore administrative issues related to post-disaster reproductive health systems in Iran., Methods: A qualitative approach using in-depth unstructured interviews was applied to explore the administrative issues of reproductive health systems in the affected regions. A total of 22 participants were interviewed using the purposeful sampling method. Data were collected in three provinces: East Azerbaijan, Bushehr, and Mazandaran. Transcribed interviews were analyzed using the conventional content analysis., Results: Six categories of management issues of reproductive health in disasters were extracted from data. These categories were: ignoring cultural factors, lack of planning, lack of training, insufficient data collection, ignoring male reproductive health, and lack of monitoring systems., Conclusion: Different challenges to reproductive health management that emerged from the research should be considered and included in reproductive health plans and policies in disaster-affected regions in Iran. Involving community in all processes of providing reproductive health services, from planning to monitoring, is highly suggested.

Although international agreements have achieved significant milestones in the improvement of women's status, experiences from the fields show a discrepancy between words and actions. The aim of this brief communication was to identify the gap between experts' perceptions and the findings of a large qualitative field survey on women's status in the recent natural disasters of Iran. A total of 10 experts were asked to fill a checklist, which consisted of the concepts extracted from field data. The range of agreement between experts' perceptions and field data was between 40 and 100 percent. In conclusion, although literature review and international research papers can provide appropriate information for both experts and managers, meeting the various needs of women living in the affected regions requires field-based surveys.

Introduction : The twin earthquakes of eastern Azerbaijan induced considerable devastations of many villages and cities. About 70% of all victims were women and children. The present case report was aimed at describing the lessons learnt from both capabilities and challenges of girls and women after the twin earthquakes of eastern Azerbaijan. Methods : A qualitative approach using in-depth unstructured interviews was used for this study. A total of 13 participants (two men and 11 women), affected by the quakes, were interviewed applying the purposeful sampling method. A manifest content analysis was performed for analyzing the transcribed interviews Case presentation : Two categories of women's capabilities and challenges and four subcategories of women's participation in community reconstruction, livelihood efforts, aggravated poverty and violence were extracted from the data which were gathered in the destroyed fields of eastern Azerbaijan. Lessons learnt : Women can play an important role in post-disaster recovery. Consequently, ignoring the challenges and capabilities of women may impede post-disaster development processes, which would adversely affect the whole community.

Disasters do not affect people equally; the impact of disasters on the lives of women is different from other groups of a community. Women's fundamental rights to health and safety are violated after disasters. The authors of this study aimed to explore various factors of women's health with reference to previous natural disasters in Iran. A qualitative approach using in-depth unstructured interviews and field observations was employed to explore women's health factors in the affected regions. A total of 22 participants affected by disasters, as well as key informants, were interviewed applying the purposeful sampling method. Data were collected in 2014 in three provinces, including East Azerbaijan, Bushehr, and Mazandaran. A content analysis using the Graneheim approach was performed for analyzing the transcribed interviews. Two themes and four categories were extracted from the data. The themes that emerged included psycho-physical effects and women's health status. Physical and psycho-emotional effects and reproductive and environmental health effects were the four emergent categories. The findings implied that managing women's health challenges may result in reducing the distressing effects of disaster. These findings support identification and application of the mechanisms by which women's well-being in physical, mental, reproductive, and environmental aspects can be protected after disasters.

Unlabelled: Introduction Violence against women (VAW) is one of the most widespread violations of human rights and a major barrier to achieving gender equality. Violence against women is increased in disaster-stricken communities. Violence experiences, cases, and lessons-learned concerning Iran's disasters have not been investigated, documented, or shared so far. To fill this knowledge gap, this qualitative study aimed to explore types of VAW and girls after the recent quakes and floods in Iran. Problem The objective for this study was exploring the manifestations of VAW after the natural disasters in Iran., Methods: A qualitative approach was used for this study. Data were collected by in-depth, unstructured interviews and field observations in three affected regions of Iran, including East Azerbaijan, Bushehr, and Mazandaran. A total of 15 participants, eight damaged women as well as seven key informants, were interviewed. A content analysis using Graneheim approach was performed for analyzing transcribed interviews., Results: Two main themes were extracted from data, including domestic violence and violence within community. The first theme included three categories: physical, psychological, and sexual violence. Psychological violence and sexual harassment were two categories of violence within the community concept., Conclusion: Different types of violence emerged from the present research that can be anticipated and integrated into future disaster medicine plans, public health reforms, and national rules of Iran. Improving women's knowledge on their rights to have a life without violence, and participation of both women and men in violence reduction projects, can be considered in all disaster management phases. Sohrabizadeh S . A qualitative study of violence against women after the recent disasters of Iran. Prehosp Disaster Med. 2016;31(4):407-412.

Introduction: Iran is placed among countries suffering from the highest number of earthquake casualties. Household preparedness, as one component of risk reduction efforts, is often supported in quake-prone areas. In Iran, lack of a valid and reliable household preparedness tool was reported by previous disaster studies. This study is aimed to fill this gap by developing a valid and reliable tool for assessing household preparedness in the event of an earthquake., Methods:  This survey was conducted through three phases including literature review and focus group discussions with the participation of eight key informants, validity measurements and reliability measurements. Field investigation was completed with the participation of 450 households within three provinces of Iran. Content validity, construct validity, the use of factor analysis; internal consistency using Cronbach's alpha coefficient, and test-retest reliability were carried out to develop the tool., Results:  Based on the CVIs, ranging from 0.80 to 0.100, and exploratory factor analysis with factor loading of more than 0.5, all items were valid. The amount of Cronbach's alpha (0.7) and test-retest examination by Spearman correlations indicated that the scale was also reliable. The final instrument consisted of six categories and 18 questions including actions at the time of earthquakes, nonstructural safety, structural safety, hazard map, communications, drill, and safety skills., Conclusion:  Using a Persian-version tool that is adjusted to the socio-cultural determinants and native language may result in more trustful information on earthquake preparedness. It is suggested that disaster managers and researchers apply this tool in their future household preparedness projects. Further research is needed to make effective policies and plans for transforming preparedness knowledge into behavior.

Background: Engaged nurses have high levels of energy and are enthusiastic about their work which impacts quality of health care services. However, in the context of Iran, due to observed burnout, work engagement among nurses necessitates immediate exploration., Objectives: This investigation aimed to identify a suitable work engagement model in nursing profession in hospitals according to the hypothesized model and to determine antecedents and consequences related to work engagement among nurses., Patients and Methods: In this cross-sectional study, a questionnaire was given to 279 randomly-selected nurses working in two general teaching hospitals of Shiraz University of Medical Sciences (Shiraz, Iran) to measure antecedents and consequences of work engagement using the Saks's (2005) model. Structural Equation Modeling was used to examine the model fitness., Results: Two paths were added using LISREL software. The resulting model showed good fitness indices (χ(2) = 23.62, AGFI = 0.93, CFI = 0.97, RMSEA = 0.07) and all the coefficients of the paths were significant (t ≥ 2, t ≤ -2). A significant correlation was found between work engagement and model variables., Conclusions: Paying adequate attention to the antecedents of work engagement can enhance the quality of performance among nurses. Additionally, rewards, organizational and supervisory supports, and job characteristics should be taken into consideration to establish work engagement among nurses. Further researches are required to identify other probable antecedents and consequences of nursing work engagement, which might be related to specific cultural settings.

Background: Although natural disasters have caused considerable damages around the world, and gender analysis can improve community disaster preparedness or mitigation, there is little research about the gendered analytical tools and methods in communities exposed to natural disasters and hazards. These tools evaluate gender vulnerability and capacity in pre-disaster and post-disaster phases of the disaster management cycle., Objectives: Identifying the analytical gender tools and the strengths and limitations of them as well as determining gender analysis studies which had emphasized on the importance of using gender analysis in disasters., Methods: The literature search was conducted in June 2013 using PubMed, Web of Sciences, ProQuest Research Library, World Health Organization Library, Gender and Disaster Network (GDN) archive. All articles, guidelines, fact sheets and other materials that provided an analytical framework for a gender analysis approach in disasters were included and the non-English documents as well as gender studies of non-disasters area were excluded. Analysis of the included studies was done separately by descriptive and thematic analyses., Results: A total of 207 documents were retrieved, of which only nine references were included. Of these, 45% were in form of checklist, 33% case study report, and the remaining 22% were article. All selected papers were published within the period 1994-2012., Conclusions: A focus on women's vulnerability in the related research and the lack of valid and reliable gender analysis tools were considerable issues identified by the literature review. Although non-English literatures with English abstract were included in the study, the possible exclusion of non-English ones was found as the limitation of this study.