Clinical Epidemiology
Hossein Rafiei
Abstract
The occurrence of pressure ulcers can be problematic for patients and health care systems. A medical device-related pressure ulcer (MDRPU) is considered as one of the important indicators of patient safety assessment as well as the quality of care provided to the patient. This case report concerns a ...
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The occurrence of pressure ulcers can be problematic for patients and health care systems. A medical device-related pressure ulcer (MDRPU) is considered as one of the important indicators of patient safety assessment as well as the quality of care provided to the patient. This case report concerns a 54-year-old male patient, who was admitted to the cardiac unit of a hospital. The patient developed stage II pressure ulcers due to the connection of a nonstandard probe of the electrocardiogram to its chest. Nurses had not taken any action to treat the patient’s ulcers. To improve this matter, necessary measures such as training courses should be considered by the officials and healthcare planners. Apart from this, to prevent the development of MDRPUs in the future, it is of great importance to pay special attention to the probes that are being used for the recording of an ECG.
Molecular Epidemiology
Farshad Kakian; Mohammad hoseein Rezaei; Masoud Amiri; saeid janabadi; behnam zamanzad; Abolfazle gholipour; Kourosh Naderi
Abstract
Background and aim: Klebsiella is an opportunistic organism that is the cause of many nosocomial infections. The present study was designed to investigate the molecular epidemiology of Verona integron-encoded metallo-β-lactamase (VIM) and Imipenemase (IMP)-producing Klebsiella isolates in ...
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Background and aim: Klebsiella is an opportunistic organism that is the cause of many nosocomial infections. The present study was designed to investigate the molecular epidemiology of Verona integron-encoded metallo-β-lactamase (VIM) and Imipenemase (IMP)-producing Klebsiella isolates in patients with urinary tract infection (UTI) in an educational hospitalin Shahrekord, in the center of Iran. Methods: In a cross-sectional study, from 234 urine samples, 80 isolates of Klebsiella were identified with biochemical tests. In order to determine the production of Metallo-β-lactamases (MBLs), Modified Hodge Test (MHT), EDTA Disc Synergy (EDS) test and AmpC disc test were performed. The frequency of VIM and IMP genes was determined after DNA-amplification with PCR by electrophoresis technique. Thereby, 16SrRNA was considered as an internal control in PCR.Results: Phenotypic tests showed that out of the 80 isolates, 18 (22. 5%), 18 (22. 5%) and 10 (12.5%) isolates were positive for MHT, EDS and AmpC disc test, respectively. Following DNA amplification by PCR, the genes of interest were analyzed by electrophoresis technique. The findings were as follows: 22 isolates (27.5%) carried the VIM gene, but the IMP gene was not found in any of the isolates. Conclusions: Expansion of Klebsiella strains that produce MBLs is a severe threat to health centers and public health. The findings of this study showed that Klebsiella may produce MBLs. These enzymes can in turn degrade carbapenem antibiotics, which are considered as a last resort in the treatment of multidrug-resistant (MDR) infections.
Nursing
Parisa Fathizadeh; Haydeh Heidari; Reza Masoudi; Morteza Sedehi; Feridoun Khajeali
Abstract
Introduction: Tele-nursing is a modern way of promoting quality of nursing care, treatment outcome, reducing medical costs and the need for visits, patient and family involvement in decision making, and careful patient monitoring by using all kinds of technologies. The aim of this article was to determine ...
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Introduction: Tele-nursing is a modern way of promoting quality of nursing care, treatment outcome, reducing medical costs and the need for visits, patient and family involvement in decision making, and careful patient monitoring by using all kinds of technologies. The aim of this article was to determine the most popular methods and related reasons for their common use in Iran.Methods: In this narrative literature review, PubMed, Science Direct, Google Scholar, SID, and Nindex were searched for full texts of Iranian studies published in English or Persian by using the descriptors of Tele-nursing, MHealth, nursing care, Telecare, and follow-up with phone calls between 2010 and 2020. The search found 472 articles and after considering the eligibility of articles, 56 articles were included.Results: The review found that 74% of papers reported the telephone as the first common method for tele-nursing. The second popular method was short message service (SMS) followed by internet and smartphone software.Conclusion: Tele-nursing includes many methods that nurses can use for distance nursing care which is not limited to telephone or SMS. In Iran, about 68 million people have a smartphone and have access to the internet. Nurses can use this potential capacity to improve nursing care.
Pharmacoepidemiology
Kourosh Zali
Abstract
The randomized controlled trial (RCT) is considered the best interventional design to assess issues related to treatment and prevention. The RCTs can have different designs including superiority, equivalence, or non-inferiority design. A superiority trial aims to detect the potential superiority of new ...
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The randomized controlled trial (RCT) is considered the best interventional design to assess issues related to treatment and prevention. The RCTs can have different designs including superiority, equivalence, or non-inferiority design. A superiority trial aims to detect the potential superiority of new therapy compared to an active comparator or a placebo, an equivalence trial tends to demonstrate that a new therapy is an equivalent (within margins) to its active comparator, and a non-inferiority trial (NIT) is going to show that the new therapy is not worse than the comparator, as a typical active drug. Increasingly, major trials are conducted to see if the efficacy of a new treatment is as good as a standard treatment. The new treatment usually has some other advantages (e.g., fewer side effects, ease of administration, lower cost), making it worthwhile to demonstrate non-inferiority in respect to efficacy. Thus, NIT is going to determine whether a new treatment is not worse than a reference treatment by more than an acceptable amount. Among the challenges of NITs compared with superiority, trials are the choices of the non-inferiority margin (NIM), the primary population for analysis, and the comparator treatment considering several choices for the comparator arm in an NIT. This article is going to review the current knowledge about NIM.
Behavioral Health
Mojtaba Senmar; Mohammad Reza Mostafaei; Ali Razaghpoor; Fateme Yousefi; Razie Alipour; Hossein Rafiei
Abstract
Background: Euthanasia and its related factors are addressed as an important ethical issue in end-of-life care nursing. It's an illegal issue in Iran. This study aimed to examine the attitude towards euthanasia in nursing students, and its relationship with their personal beliefs’ level.Methods: ...
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Background: Euthanasia and its related factors are addressed as an important ethical issue in end-of-life care nursing. It's an illegal issue in Iran. This study aimed to examine the attitude towards euthanasia in nursing students, and its relationship with their personal beliefs’ level.Methods: The current cross-sectional study was conducted in Qazvin during the education year of 2017-2018. The samples of this study consisted of 121 nursing students who were studying at the Qazvin University of Medical Sciences for more than two semesters. The Euthanasia Attitude Scale and Palutzian and Ellison Spiritual Wellbeing Scale were used for the data collection.Results: The response rate was 73.3% (121 of 165 nursing students). All of nursing students in the present study were Muslim. The mean overall scores of attitudes towards euthanasia and spiritual wellbeing were 60.24±9.82 and 75.73±7.48, respectively. No significant relationship was found between attitude towards euthanasia and personal beliefs among them (p=0.204).Conclusion: Iranian nursing students reported a relatively neutral attitude towards euthanasia which is mainly related to its legal issue in Iran. Also, no significant relationship was observed between attitude towards euthanasia and personal beliefs among the participants. Further studies are needed in this regard.
Occupational Epidemiology
Amanuel Godana Arero; Godana Arero; Shimels Hussien Mohammed; Sahar Eftekhari
Abstract
Background and objective: Low back pain (LBP), as a musculoskeletal disorder, remains a common health problem and is one of the most prevalent occupational injuries affecting adults living in both developed and developing countries. To increase the power and improve the prevalence estimates of LBP among ...
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Background and objective: Low back pain (LBP), as a musculoskeletal disorder, remains a common health problem and is one of the most prevalent occupational injuries affecting adults living in both developed and developing countries. To increase the power and improve the prevalence estimates of LBP among the working Ethiopian population, a comprehensive meta-analysis was carried out. Methods: A comprehensive systematic literature search was conducted through multiple international electronic bibliographic databases such as Web of Science, Pub Med, EMBASE, Scopus, and Google Scholar. Population-based studies with the prevalence of LBP among the working population living in Ethiopia were included. Meta-analyses, meta-regression, and sensitivity analysis was conducted. Funnel plot symmetry visualization followed by Begg’s rank correlation, and Egger’s regression asymmetry test methods were performed to detect the existence of publication bias. Heterogeneity between studies was assessed by using the Cochrane Q and I2 statistics. Results: Overall, 719 articles were identified and 13 articles with 6513 participants met the inclusion criteria for meta-analyses. The pooled point and twelve-month prevalence of LBP among the working Ethiopian population was 49% (95% CI: 40-58) and 56% (95% CI: 49-62), respectively. Conclusion: The results showed a high prevalence of LBP among the working Ethiopian population, especially among teachers. We believe that prevention strategies addressing the early onset of LBP among the working population would most likely be the answer to the burden of LBP on future economies in Ethiopia.
Clinical Epidemiology
Farshad Kakian; Mohammad Ghasemi Palangi; Nahal Hadi
Abstract
Background: Urinary stones are one of the major health problems worldwide and a significant part of referrals to physicians. Also, growing antibiotics resistance is an important concern. The purpose of this study was to evaluate the prevalence of urinary stones and bacterial strains with antibiotic resistance ...
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Background: Urinary stones are one of the major health problems worldwide and a significant part of referrals to physicians. Also, growing antibiotics resistance is an important concern. The purpose of this study was to evaluate the prevalence of urinary stones and bacterial strains with antibiotic resistance in women admitted to shiraz, southwest of Iran, from 2014 to 2019. Methods: In this period, all women admitted to the Zeinabieh Hospital were evaluated. The frequency of urinary stones and bacterial strains and antibiogram patterns of bacterial isolates were investigated from 2014 to 2019.Antibacterial susceptibility testing was done by disk diffusion method, fulfilling the standard criteria of “Clinical and Laboratory Standards Institute (CLSI) Performance Standards for Antimicrobial Susceptibility”. Results: Out of 101 isolates, the identified gram-negative bacteria were E. coli (68.3%), Klebsiella (6.9%), Enterobacter (6.9%), Pseudomonas (5%), Proteus (1%), and Acinetobacter (1%). Of gram-positive strains, Coagulase-positive Staphylococci (5.9%), coagulase-negative Staphylococcus (CONS) (3%) and Non-Hemolytic Streptococci (2%) were identified. Also, the frequency of urinary tract stones was about 5%. Four cases of kidney stones were associated with E. coli and one case with Klebsiella. All isolates had the highest resistance to co-trimoxazole (62.5%), Ampicillin and Nalidixic acid.Conclusion: In this study, no association was found between the type of bacteria and urinary stone. From the variable bacteria isolated, the highest rate of E. coli (as an important pathogen) was confirmed. Also, most of the bacterial isolates were resistant to multiple antibiotics, although Amikacin and nitrofurantoin (as the empirical therapy in our hospital) were dominated.
Behavioral Health
Mojtaba Senmar; Ali Razaghpoor; Faezeh Safarali; Faeze Ramezani; Neda Fallah; Saeideh Hosseini; Hossein Rafiei
Abstract
Background: While evidence-based practice (EBP) should be considered by all of midwifery and nursing groups, it is more important to midwives and nurses working with neonates and infants. Due to the limited number of available studies in this area, the objective of this study was to examine the knowledge, ...
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Background: While evidence-based practice (EBP) should be considered by all of midwifery and nursing groups, it is more important to midwives and nurses working with neonates and infants. Due to the limited number of available studies in this area, the objective of this study was to examine the knowledge, attitude, and intention of midwives and nurses of pediatrics and neonatal units regarding EBP.Methods: This study was taking place in 2019 in Iran. A descriptive analytical study was carried out with 125 midwives and nurses working in pediatrics and neonatal units. The knowledge, attitude, and intention were assessed through a 34-item Rubin and Parrish questionnaire. Of these 34 items, 10, 14, and 10 items could assess the knowledge, attitude, and intention of the participants, respectively.Results: The total average knowledge score was 36.7 with a standard deviation of 5.6. The overall average of attitude score was 45.4 with a standard deviation of 4.7. The overall average of intention score was 38.1 with a standard deviation of 5.4. Two factors of “participating in EBP workshops” and “participating in research projects and having published articles” were the two factors that resulted in an increase in the level of knowledge, positive attitude, and a rise in the level of intention regarding EBP (p <0.05). Moreover, higher education has significantly increased the intention to use EBP (p <0.05).Conclusion: Participants in this study had a moderate level of knowledge, moderate intention, and a relatively positive attitude toward EBP. It is recommended that this situation be improved by providing training courses and workshops on EBP and involving clinical nurses and midwives in research projects.
COVID-19
Jose Luis Turabian
Abstract
BackgroundMost people with COVID-19 receive care at home, increasing the likelihood of exposure for household members.ObjectiveTo study the prevalence and characteristics of secondary cases in families after the appearance of a primary caseMethodologyAn observational and retrospective study of families ...
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BackgroundMost people with COVID-19 receive care at home, increasing the likelihood of exposure for household members.ObjectiveTo study the prevalence and characteristics of secondary cases in families after the appearance of a primary caseMethodologyAn observational and retrospective study of families with at least one polymerase chain reaction (PCR) confirmed COVID-19 primary case was conducted from March 15 to December 25, 2020, in a general medicine office in Toledo, Spain. Socio-demographic and clinical variables were compared between primary and secondary cases in the families. The outcome of interest was secondary attack rate of SARS-CoV-2 within the family.Results39 families with a primary case (average size 3.4 members) with a total of 132 cohabitants were included. There were 22 cohabitants with negative PCR (22/92 = 24%), 70 secondary cases with positive PCR (Secondary attack rate 76%), of which 25 were asymptomatic (25/70 = 36%), and a cohabiting new-born. A high frequency of people from ethnic minorities, low household income and complex families was found, both in primary and secondary cases. The secondary cases with respect to the primary ones were more women, younger, students and with a lower socio-occupational level, with more asymptomatic cases, and milder symptomatic cases.ConclusionsIn this context, the prevalence of secondary domestic contacts is very high, and it occur in young women, being asymptomatic or mild. The high secondary attack rate suggests the importance of the pre-symptomatic or early symptomatic period of COVID-19, as well as the possible failure to comply with isolation measures.
Health Practice
Shima Heidary; Haydeh Heidari; Roya Choopani
Abstract
Introduction: Mothers of preterm infants, as the primary caregiver, need to learn more about their infants and the complex environment of neonatal intensive care. This study aimed to develop and evaluate the educational module for the mothers of premature infants admitted to the neonatal intensive care ...
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Introduction: Mothers of preterm infants, as the primary caregiver, need to learn more about their infants and the complex environment of neonatal intensive care. This study aimed to develop and evaluate the educational module for the mothers of premature infants admitted to the neonatal intensive care unit (NICU) in Iran.Method: The online databases (SID, Magiran, Google Scholar, ScienceDirect, PubMed, Elsevier, and Scopus) were accessed from 2009 to 2019, using the keywords ‘mother’, ‘neonatal intensive care’, ‘program’, ‘intervention education,’ and ‘empowerment’. In general, 275 articles were retrieved and a total of 12 studies was retained for appraisal, after screening the titles, abstracts, and full-text reviews. Finally, the qualitative module validity and face validity were determined, using the opinions of 11 experts and 10 mothers of premature infants, respectively.Results: Eight themes were identified based on thematic analysis, including orientation with the NICU, characteristics of premature infants, premature infants’ problems, needs of premature infants, preparation of premature infant’s environment, behavioral symptoms of premature infants, the positioning of premature infants, and preparation for discharge and measures were developed after the discharge of the premature infant. Considering all acquired interventions for all items, a content validity ratio of 0.59 and content validity index of 0.79 based on the opinions of experts at two levels of specialists and mothers.Conclusion: Due to the lack of enough nursing staff and a high workload in the NICU, this review offers nurses to spend less time educating mothers and focusing more on premature infants. Moreover, supporting mothers can help to provide better care. The educational module can help nurses and mothers have more effective care for premature infants.
Pharmacoepidemiology
Kourosh Zali
Abstract
The presence of a placebo arm is certainly a substantial element in randomized control trials (RCTs) because the effectiveness or efficacy of a new therapy can be evaluated through a direct comparison between the test treatment and the placebo arm. Conducting a placebo-controlled RCT is often very difficult ...
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The presence of a placebo arm is certainly a substantial element in randomized control trials (RCTs) because the effectiveness or efficacy of a new therapy can be evaluated through a direct comparison between the test treatment and the placebo arm. Conducting a placebo-controlled RCT is often very difficult or even impossible. To solve this problem, the availability of standard treatments and ethical concerns have led scientists to consider an active or positive control treatment as a comparator to assess the treatment effect without a placebo arm. Such an assessment is often made under a so-called “non-inferiority trial” (NIT) design. Non-inferiority margin (NIM) is the most important part of an NIT. Because there is no well-established method to determine the NIM, it is very important that this margin be pre-specified and the criteria for how it was established well defined prior to conducting the study. All methods of determination of NIM rely upon subjective judgment with unverifiable assumptions. This article demonstrates six simple methods to calculate NIM.
COVID-19
Fazlollah Keshavarzi; Berry Wei Qi Ting; Betty Zhi Xin Tang; Kai Xin Chang; Fei San Chee; Kar Mey Chen
Abstract
Background. The worldwide economic impact of the COVID-19 pandemic is comparable with the largest disastrous events of modern human history, such as the first and second world wars. This study investigated the nationwide impact of the pandemic on the local Malaysian firms.Methods. A cross-sectional, ...
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Background. The worldwide economic impact of the COVID-19 pandemic is comparable with the largest disastrous events of modern human history, such as the first and second world wars. This study investigated the nationwide impact of the pandemic on the local Malaysian firms.Methods. A cross-sectional, online survey was carried out in East and West Malaysia by inviting the Malaysian firms’ executives to fill in a questionnaire that was adopted from previous similar studies in other countries. The final questionnaire included 16 questions distributed in three categories. The executives of firms were contacted through email and social media. SSPS was used to analyse the collected data.Results. A total of 379 responses were received. Nearly 42% of firms reported a small impact with some difficulties in business operations but overall stability. Approximately 32% of businesses were severely impacted, and operations were barely maintained. Six percent of the firms had no significant difficulties and 5.3% reported that the pandemic provided new opportunities for development.Conclusion. Almost one-third of the Malaysian firms are affected significantly by the COVID-19 pandemic. The business operation of half of the Malaysian firms is also affected to some extent. Supportive policies are needed to reduce the companies’ manufacturing costs and assist them in surviving and eventually returning to normal business operations.
COVID-19
Samira Zouhri; Mohcine El Baroudi
Abstract
A woman in her sixties with a normal medical history was admitted to a general medical floor with Neuropathic pain symptoms such as a burning sensation throughout her body (head, back, spine, throat, and tongue with dry mouth, chest, abdomen, kidneys, thighs, toes), inability to eat, urinary incontinence, ...
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A woman in her sixties with a normal medical history was admitted to a general medical floor with Neuropathic pain symptoms such as a burning sensation throughout her body (head, back, spine, throat, and tongue with dry mouth, chest, abdomen, kidneys, thighs, toes), inability to eat, urinary incontinence, difficulty wearing clothing, and difficulty leaning on the back. There was a difficulty and delay in diagnosing the patient's condition, which was confirmed to have severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with no respiratory symptoms. The patient's pain did not respond to the covid-19's first-line medications, but it did respond to neuropathic medication with Pregabalin and Alprazolam. Our study shows that Pregabalin could be helpful in relieving the patient’s pain and very effective for treating neuropathic pain with a safe profile, unlike Alprazolam, which interferes with the same stages of sleep, which made her sleep condition worse.
Epidemiology
Itse Olaoye; Akinola Ayoola Fatiregun; Stephen Fagbemi; Famokun Gboyega; Rosemary Onyibe
Abstract
Background: Acute gastroenteritis, a very common disease in humans affecting both children and adults, remains a major public health concern worldwide. Several groups of viruses have been reported as the causative agents of acute gastroenteritis. An outbreak of acute gastroenteritis with a high fatality ...
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Background: Acute gastroenteritis, a very common disease in humans affecting both children and adults, remains a major public health concern worldwide. Several groups of viruses have been reported as the causative agents of acute gastroenteritis. An outbreak of acute gastroenteritis with a high fatality rate was reported in Ondo State, Southwest, Nigeria, in September 2020. Methods: To provide a descriptive epidemiology of the outbreak, a field investigation was carried out in affected communities in September 2020. Results: Four Local Government Areas (LGA) were affected, with Odigbo LGA having the highest attack rate of 14.9 per 100,000 population. The epidemic curve was propagated in nature. 50 cases were reported with 21 deaths (42%). The outbreak primarily affected 15-year-olds (94%, n=47) and more males (58%, n=29). Conclusion: Poor sanitation, food, and water hygiene conditions in communities of the LGA visited were observed. The spread of the outbreak was probably facilitated by water sellers.
COVID-19
Virendra Mane; Poorva Bhalerao
Abstract
Background: The COVID-19 pandemic was expected to affect India severely; cases rose exponentially from May-June 2020, but around mid-September reached their peak and started declining. It showed a sign of the wave’s completion by the end of January 2021. This decline was not predicted by any models ...
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Background: The COVID-19 pandemic was expected to affect India severely; cases rose exponentially from May-June 2020, but around mid-September reached their peak and started declining. It showed a sign of the wave’s completion by the end of January 2021. This decline was not predicted by any models and the authors have not come across any explanation. Winter seasonality of influenza and similar viruses is well known and observed fact and that it has a direct correlation to the colder temperatures as well as lower humidity. Similarly, in low humidity, viruses are most viable, and they become ineffective as the humidity increases and reaches its maximum extent. This article hypothesizes and tries to explain the cause behind the first major decline and shows the subsequent rise of the second wave, and one short low humidity period followed by a high humidity period between the first and second waves. Methods: The humidity cycles in India were studied to find high and low relative humidity periods, which then corresponded to the daily cases in the country (macro-level), region (mid-level), and smaller regions (micro-level). Results: A definite correlation was observed between Monsoon-induced humidity and the incidence rate decline. This happens in 8 to 10 weeks. Incidence rates start declining about 4 weeks after the peak humidity is reached in a particular region. A decrease in humidity below 65% or 55% or lower causes an increase in the case increase/uptrend in about 3-4 weeks. Conclusion: COVID-19 has a seasonal peak in India, peaking in the middle of the monsoon season around mid-September and reaching its lowest levels in January-February. As humidity drops from February to June/July, a trend reversal and sharp rise are expected. The subsequent wave/case peak would be expected to be seen around mid-September 2021.
Patient Care
Razieh Akbari; Shayesteh Salehi; Nasrollah Alimohammadi
Abstract
Background: Most survivors of traumatic head injury, due to functional disorders, are dependent on their family members. In fact, these families are at the forefront of many challenges and stresses. The aim of the present study was to investigate the effectiveness of a family-centered empowerment program ...
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Background: Most survivors of traumatic head injury, due to functional disorders, are dependent on their family members. In fact, these families are at the forefront of many challenges and stresses. The aim of the present study was to investigate the effectiveness of a family-centered empowerment program on the care needs of the families of patients with traumatic head injuries discharged from Al-Zahra Hospital in Isfahan in 2019.Methods: The present study was a clinical trial conducted among 56 family members of patients with traumatic head injury. The samples were randomly allocated to two groups: experiment and control. The experimental group received an empowerment program based on the "family-centered empowerment model" through 3-5 sessions of 45-60 minutes, while the control group received routine education during discharge. Data was collected using a checklist for demographic information as well as the standardized Family Need Questionnaire (FNQ).Results: Based on the findings of the present study, the level that the care needs have been met regarding health information, emotional support, instrumental support, and professional support was statistically significant higher in the experimental group compared to the control group (p < 0.001). The average care needs related to health information, emotional care, and instrumental support were statistically significant lower in the experimental group compared to the control group (p < 0.05). While considering community support network, the average care needs were statistically significant lower in the control group compared to the experimental group (p < 0.05); however, about involvement in care, no statistically significant difference was found between the two groups of experiment and control (p > 0.05).Conclusion: To meet the care needs of the families of patients with traumatic head injuries discharged from medical centers, implementation of the family-centered empowerment program is effective, and it results in improvement and continuous providing of services at home and meeting families’ care needs. Therefore, the application of such programs is recommended for healthcare planners.
Psychoepidemiology
Hossein Tavangar; Farzan Madadizadeh; Zohre Kalani; Razie Beygi Rizi; Zakieh Tavakoli; Mostafa Shokati Ahmad Abad
Abstract
Background: The presence of pain and anxiety in a patient affects the results and, therefore, the process of healing, as well as the postoperative complications. Therefore, this study was performed to gauge the effect of individual education-supported needs assessment on anxiety among elderly patients ...
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Background: The presence of pain and anxiety in a patient affects the results and, therefore, the process of healing, as well as the postoperative complications. Therefore, this study was performed to gauge the effect of individual education-supported needs assessment on anxiety among elderly patients who were candidates for open-heart surgery.Method: This quasi-experimental study was carried out in Iran in 2019. Sixty-one patients, who were candidates for open-heart surgery and aged 60 years or older, were divided into two groups: experiment and control. The patients within the control group received routine care, and therefore, the patients with the intervention received education-supported needs assessment in addition to routine care. The State-Trait Anxiety Inventory was used to assess the patients’ anxiety levels. All analysis was performed in SPSS v19 with a significance level of 0.05.Results: The demographic variables were similar in both groups (p <0.05). The mean scores of both the state and the trait anxiety among the patients in the intervention group decreased significantly after the intervention (p <0.05). The mean scores of both the state and the trait anxiety among the patients in the control group were similar before and after the intervention (p>0.05).Conclusion: Individual education based on needs assessment among elderly patients is an effective strategy for reducing their anxiety before open-heart surgery.
WHO
Semeeh Akinwale Omoleke; Yolanda V. Bayugo; Ukam Ebe Oyene; Jonathan Abrahams; Nina Gobat; Suvajee Good; Mary Manandhar; Samar Elfeky; Ana Gerlin Hernandez Bonilla; Nicole Valentine; Jackeline Alger; Qudsia Huda; Saqif Mustafa; Maria Isabel Echavarria; Ankur Rakesh; Taylor Warren; Jostacio Moreno Lapitan; Jana Deborah Mier-Alpano; Dayo Spencer-Walters; Meredith Del Pilar Labarda; Mihai Mihut; Aphaluck Bhatiasevi; Obinna I. Ekwunife
Abstract
Community Engagement (CE) plays a crucial role in successful public health actions, achieving universal health coverage, and the realization of the United Nations Sustainable Development Goals. It has emerged as an effective strategy across different settings through prevention, preparedness, readiness ...
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Community Engagement (CE) plays a crucial role in successful public health actions, achieving universal health coverage, and the realization of the United Nations Sustainable Development Goals. It has emerged as an effective strategy across different settings through prevention, preparedness, readiness and response, and recovery towards attaining community resilience, Primary Health Care (PHC) strengthening and universal health coverage (UHC), health security, and sustainable development. We reviewed the existing literature and various data sources and found that several CE training packages are available from international partners, focusing on the principles, theories, general questions, and CE techniques. However, there are still challenges because they are often fragmented, with little or no systematic procedures to guide the CE processes in different settings.In this light, WHO initiated a discourse on the CE Package (CEP) development in consultation with some selected international partners. The CEP Project will focus on developing a database, learning, and workshop packages based on curation of CE experiences in different settings using defined criteria. The CEP would harmonize CE processes and facilitate the reinforcement of the CE integration into public health. Further, the CEP Project serves as a collection of selected best practices for pre-service and in-service training packages for health professionals. Also, there is an anticipated inclusion into curricula of health training institutions and WHO staff capacity development. Finally, the database for compiling best practices is designed such that it can be periodically updated and becomes a compendium of CE for learning, research, and informing practice.
Patient Care
Fatemeh Ghapanvari; Seyedehzahra Hosseinigolafshani
Abstract
Background: Recent studies on hemodialysis patients have focused more on the suffering caused by physical and psychological problems in them, and they have paid less attention to their caregivers. Since the caregivers of these patients are intensively affected by the physical and psychological problems ...
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Background: Recent studies on hemodialysis patients have focused more on the suffering caused by physical and psychological problems in them, and they have paid less attention to their caregivers. Since the caregivers of these patients are intensively affected by the physical and psychological problems caused by this method of treatment, it is necessary to pay more attention to the challenges as well as the problems that exist among them. This study aimed to describe the lived experiences of caregivers in caring for hemodialysis patients. Methods: The present study is a qualitative study with a phenomenological design. Sampling was first done through a purposive sampling method, and the snowball sampling method was then applied in order to select 21 caregivers for the hemodialysis patients from three hemodialysis centers in Qazvin, Iran. An audio recorder were used to collect the data of in-depth face-to-face semi-structured interviews. The interviews were analyzed using Colaizzi's approach. The criteria of Lincoln and Guba was followed for trustworthiness. Results: Analysis of the interviews in response to the main question revealed 108 initial codes, 18 subcategories, and 3 main themes, including 1. Care: Growth experience, 2. Care: Living in solitary confinement, and 3. In silence: Seeking help. Conclusion: In situations where the caregivers of hemodialysis patients felt they did not have sufficient material and spiritual support from those around them, they reported two different and conflicted experiences. Some people experienced progress and excellence, while others felt stuck and had to make ideal sacrifices. More in-depth research is required to discover the factors that influence such diverse insights.
Clinical Epidemiology
M.A. Bashir; A.I. Yahaya; Mukhtar Muhammad; Ashiru Hassan Yusuf
Abstract
Prehypertension is a borderline blood pressure status associated with both higher incidence of cardiovascular disease as well as higher risk of progression to hypertension. The rising burden of hypertension and prehyperension globally is a serious concern to all and sundry. This study aims to estimate ...
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Prehypertension is a borderline blood pressure status associated with both higher incidence of cardiovascular disease as well as higher risk of progression to hypertension. The rising burden of hypertension and prehyperension globally is a serious concern to all and sundry. This study aims to estimate the burden of prehypertension in Nigeria. Online searches of Google Scholar, PubMed and African Index Medicus were conducted and studies selected based on predefined criteria. 21 studies consisting of 25839 individuals conducted between 2011 and 2021 were included in the meta-analysis. The pooled prevalence of prehypertension in Nigeria was found to be 34%(95% CI: 30%-40%) translating to 41.4 million adult Nigerians. Males have higher prehypertension prevalence of 39.1% (95% CI: 30.9%-47.6%) than females with prevalence of 28.5% (95% CI: 21.2%-36.4%). Differences between sexes are not statistically significant. The region with the lowest prehypertension prevalence is North-East at 18%. The region with the highest prevalence of prehypertension is North-West at 43%. Differences between the regions are statistically significant. The pooled prevalence in rural settlements is 32% whereas the pooled prevalence for urban settlements is 37%. Differences rural and urban settlements were not statistically significant. In conclusion, the burden of prehypertension in Nigeria is high and represents a future burden of hypertension and other cardiovascular diseases
Clinical Epidemiology
F. Aliakbari; F. Safei; F. Deriss; S. Salehitali
Abstract
Introduction: Patients with chronic renal disease are at risk for dyspnea, which can have a negative impact on their quality of life. The current study aims to investigate the influence of breathing exercise on respiratory parameters in hemodialysis patients due to a lack of agreement on the efficacy ...
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Introduction: Patients with chronic renal disease are at risk for dyspnea, which can have a negative impact on their quality of life. The current study aims to investigate the influence of breathing exercise on respiratory parameters in hemodialysis patients due to a lack of agreement on the efficacy of breathing exercise in the respiratory status of hemodialysis patients.Method: Participants were randomly assigned to one of two groups in this single-blind clinical investigation (intervention and control). Under the supervision of a nurse, the intervention group practiced breathing interventions (deep and slow breathing) for eight sessions over the course of a month. Data was collected using two questionnaires (demographic and respiratory parameter checklist).Results: There was a significant change (P=0.000) between the pre- and post-scores of the respiratory score in the intervention and control groups.Conclusion: Because breathing intervention is beneficial in lowering dyspnea and improving respiratory parameters, nurses should consider using it as an appropriate therapy for these patients due to its simplicity and low cost.
Behavioral Health
Kian Nourozi Tabrizi; Maedeh Mortezanasab; Farahnaz Mohammadi-Shahboulaghi; Mostafa Shokati Ahmad Abad; Mahdi Noroozi
Abstract
Background: Medical students must have sufficient expertise to provide health services to the old as the global population of the elderly grows. Few research, however, have looked into this issue among medical, health, and nursing students. As a result, the purpose of this study was to look into the ...
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Background: Medical students must have sufficient expertise to provide health services to the old as the global population of the elderly grows. Few research, however, have looked into this issue among medical, health, and nursing students. As a result, the purpose of this study was to look into the knowledge of medical, health, and nursing students on aging and related variables.Methods: In the year 2020, a cross-sectional study was done in Yazd, Iran. The research community was founded by Yazd University of Medical Sciences students. A total of 105 students from medical, health, and nursing were needed for the study. Two tools were used to collect data. a) A list of demographic characteristics Age, gender, level of education, and b) The Facts on Aging Quiz are among the items on this checklist (FAQI). FAQI is made up of 25 things in four dimensions, each of which can be answered with one of three options: "correct," "don't know," or "false." A higher score suggests a better position and a greater understanding of aging facts.Results: Students were 29 years old on average. Women made up almost 75% of those who took part. Only over a quarter of the attendees went to conferences and seminars on senior health. The majority of students in all three areas (medicine, health, and nursing) had never volunteered with the elderly before. Medical, nursing, and health students scored 11.093.4, 8.83.1, and 11.82.8 out of a possible 25 points on their understanding of aging facts, respectively. Only the area of study was statistically associated to the mean score of facts of aging among the demographic variables, indicating that the knowledge score of medicine and nursing students was lower than that of health students.Conclusion: The students that took part in this study lacked appropriate awareness of the facts of aging. Students' understanding in this area must be increased through the implementation of relevant educational programs.
Epidemiology
Itse Olaoye; Akinola Ayoola Fatiregun; Ekun Opeyemi; David Adeleke; Tsemaye Jacdonmi; Stephen Fagbemi; Famokun Gboyega; Abiona Samuel; Adefesoye Victor Akinpelumi; Onyibe Ifeoma Rosemary
Abstract
Background: The last case of the indigenous Wild Polio Virus in Ondo state was in 2008, and the last Polio compatible infection was in 2010. Poliovirus transmission was stopped thanks to the World Health Organization's (WHO) standards, which included acute flaccid paralysis (AFP) surveillance. We wanted ...
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Background: The last case of the indigenous Wild Polio Virus in Ondo state was in 2008, and the last Polio compatible infection was in 2010. Poliovirus transmission was stopped thanks to the World Health Organization's (WHO) standards, which included acute flaccid paralysis (AFP) surveillance. We wanted to describe the state's polio surveillance performance during the last five years, from 2016 to 2020, using WHO-recommended measures and find areas where it could improve.Methods: Between January 2016 and December 2020, AFP case-based surveillance data was used to undertake a retrospective examination of records. Microsoft Excel was used for data processing, and Quantum Geographic Information System was used for mapping (GIS).Results: From 2016 to 2020, a total of 1,096 AFP instances were recorded, none of which were confirmed as Poliomyelitis. The bulk of the cases (77.2 percent) were found in children under the age of five. Males made up more than half of the cases (53.4%). More than 89 percent of reported cases received three or more OPV doses. Between 2016 and 2020, there was a 79 percent decline in reported incidents. Between 2016 and 2020, the average Non-Polio AFP rate was 11.2 per 100,000, with a stool adequacy of 98.4%.Conclusion: AFP surveillance in Ondo state met the minimum WHO targets during the study period, according to the findings. However, because of the possibility of poliovirus being imported from endemic countries, which might threaten Nigeria's polio-free status, all surveillance actors' sensitization and active case search should be strengthened, particularly in underperforming local government areas (LGAs).
COVID-19
Hooman Angoorani; Soheila Masoudi; Molood Jafari Fesharaki; Bita Zoghalchi; Paniz Jahani; Marzieh Urumieh
Abstract
Background: Following the resumption of football training and competitions during the coronavirus disease 2019 (COVID-19) pandemic, it was necessary to tighten up the hygiene protocol and impose restrictions such as prohibiting spectators from entering stadiums and the detection of positive disease cases, ...
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Background: Following the resumption of football training and competitions during the coronavirus disease 2019 (COVID-19) pandemic, it was necessary to tighten up the hygiene protocol and impose restrictions such as prohibiting spectators from entering stadiums and the detection of positive disease cases, particularly among sub clinically infected players. The purpose of our study was to find out how common COVID-19 is among professional football players and to see if regular PCR testing and symptom recording are adequate screening methods in football.Study design: A cross-sectional retrospective study was used as the study design.Method: Periodic polymerase chain reaction (PCR) testing are used to evaluate athletes and other involved people for breaks in the transmission chain and to preserve their health. From March to November 2020, 784 players from Iran's prime and second division leagues participated in this study. The symptoms of the participants, as well as the results of the PCR testing, were recorded.Results: The results showed that 107 cases (13.6%) had positive PCR tests, with 52 Premier League players (10.4%) and 55 second-tier League players among them (19.3 percent). 41.1 percent of individuals who had positive PCR testing were symptom-free, while 17.5 percent of those who tested negative experienced at least one symptom. Myalgia was the most commonly reported symptom among symptomatic participants (7%).Conclusion: Due to the large number of asymptomatic patients, we advocate combining a periodic PCR test with serologic tests for the diagnosis of COVID-19 in football players to improve diagnostic accuracy.
HIV/AIDS
Ayouba A. Fofana; Nimetcan Mehmet
Abstract
Background: In Africa, HIV is one of the most serious public health issues. The purpose of this study was to look into the prevalence and incidence rates of HIV/AIDS in West Africa across all age ranges and population groups.Methods: This is a comprehensive study of published and unpublished studies ...
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Background: In Africa, HIV is one of the most serious public health issues. The purpose of this study was to look into the prevalence and incidence rates of HIV/AIDS in West Africa across all age ranges and population groups.Methods: This is a comprehensive study of published and unpublished studies on HIV/AIDS prevalence and incidence in West Africa. All publications published between 2010 and 2020 that were retrieved from databases, as well as other records containing information on the topic under consideration, were examined.Results: The comprehensive assessment of the literature generated 13 papers with data on the prevalence and incidence of HIV after applying the inclusion, exclusion, and quality criteria. These items came from nine different countries in West Africa. The prevalence rate of HIV in a specific group ranged from 1.4 percent to 54.9 percent in this article review.Conclusions: The review found that HIV prevalence in important demographics in West African nations was high. It also revealed that women are the ones who are most affected. HIV prevalence and incidence differ from country to country. In comparison to other nations, HIV prevalence in important populations was greater in Nigeria and lower in Benin.