ali ardalan

Demographic characteristics are among the factors that can contribute to flood-related deaths. Investigating the relationship between these factors and flood-related deaths, as well as measuring their impact on the prevention, reduction, and elimination of such deaths, is essential.

This study was conducted as a case-control study in all flood-affected areas of Iran that experienced flood-related deaths from 2002-2018. The sample size of the study was 369 (123 cases and 246 controls) from 12 provinces and 30 counties. The study measured the impact of demographic characteristics on flood-related deaths using a valid and reliable tool.

The findings of this study revealed that individuals under the age of 15 face a 31.974 times higher risk of flood-related death compared to individuals over 65. The young population, specifically those aged 15 to 29 in Iran, have a 1.475 times higher risk. Drivers face a 13.874 times higher risk, while individuals involved in agriculture, shepherding, and livestock farming have a 0.947 times higher risk compared to homeowners.

Among the demographic characteristics, children, young adults, and engaging in certain high-risk occupations such as driving or agriculture increase the risk of flood-related deaths. Therefore, it is recommended to prioritize protection, education, and vulnerability reduction measures for these individuals, especially in flood-prone areas.

We aimed to identify indicators affecting firefighters’ resilience through a systematic review.

International electronic databases, including Web of Science, Medline through PubMed, Scopus, Cochrane Library, and Google Scholar, were searched on Dec 23, 2018. The search strategy was developed using main words, including firefighter, resilience, and indicators. Then, the indicators related to firefighters’ resilience were extracted and analyzed using a qualitative synthesis method.

Overall, 7178 unique documents were identified by searching different databases. Then, by screening the title and abstract, 7104 articles were excluded, and only 74 full text papers were critically studied. Finally, 31 full text articles were selected for the analysis. Quality appraisal of included studies done by modified STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) tool. Moreover, 186 indicators and criteria were extracted from the included studies and classified into 6 domains and 15 categories.

This study suggests six main domains, including physical health, physical fitness, mental health, life style, job-related competencies, and demographic status, to categorize different indicators of firefighters’ resilience. Building resilience in firefighters requires all these domains to be considered in the assessment, planning, and evaluation processes.

Various studies indicate that in many cases, fire has broken out in hospitals. This study aims to assess fire protection in the selected units of Imam Khomeini hospital located in Tehran, Iran in 2020. In this descriptive-analytic study, first, a researcher-made checklist was developed for the data collection by valid scientific resources (CVI = 0.90 and CVR > 0.62). After revising and the final confirmation of reliability, the checklist was separately completed by two members of the risk management committee in 22 units of Imam Khomeini Hospital, Tehran, Iran. Cronbach’s weighted Kappa statistical test was calculated. The domain of Ability and Capability of Fire Prevention was 66.1%; the domain of Responsiveness was 65.1%, and the domain of Urgent Evacuation Ability was 27.3%. In the domain of Responsiveness, the highest scores were relevant to accessing fire extinguishers cylinder in the units (95.5%) and holding fire extinguishing practice courses, and doing seasonal practices with that region’s fire station (90.9% for both). The highest scores in the domain of Urgent Evacuation Ability were assigned to accessing adequate ambulances to evacuate patients (90.9%) and mapping the units as well as determining patient evacuation routes when a fire breaks out (72.7%). The essential protection measures should be taken in order to improve the hospitals’ fire protection by better access to the exits, increasing the number of the exits and standardizing the emergency exits, enhancing the due fire extinguishing practices and hospital evacuation as well as training the staff.

Floods are kinds of natural disasters that directly threaten human life. To save lives and reduce the number of injured people in floods, it is crucial to determine the underlying factors of flood deaths. This study was conducted to find the causal factors which influence flood deaths in Iran.

The present research was conducted in four separate phases. In the first phase, a systematic review was conducted to determine the risk factors influencing flood death based on the available documents in the globe. In the second phase, using a qualitative study with content analysis method, the underlying factors that might cause flood deaths in different groups of Iranians were identified. In the next phase, a validated tool was developed based on the psychometry method. In the last phase, through a retrospective study using the validated tool, the risk factors affecting flood deaths were identified.

The systematic review identified 114 risk factors which were categorized into five groups of vulnerability factors. The results of the qualitative study indicated that a large number of underlying factors lead to flood deaths including the categories of hazard-related features, cultural, economic, social, demographic, management, and physical factors. The results of regression analysis in a retrospective study showed that by increasing some risk factors, the likelihood of flood deaths decreases. While other groups of risk factors increase the risk of flood deaths.

Based on the findings of this study, comprehensive and appropriate strategies and interventions can be implemented to reduce and eliminate the impact of flood risk mortality and ultimately to reduce flood deaths. These include planning, training, promotion of awareness and culture of prevention, promotion of risk perception, protection of vulnerable groups, flood risk assessment and flood risk reduction, observance of urban and construction safety principles, improving urban flood management by responsible organizations, and involvement of people in all stage s of death-flood risk management.

Hospitals usually are at risk of potential hazards, which may necessitate emergency hospital evacuation (EHE). Deciding about hospital evacuation is of the critical task and is affected by numerous factors.

The aim of this study then was to explore the factors behind the decision for EHE in disasters. Setting and Design: This is a qualitative study that was conducted from May 2014 to February 2015, employing conventional content analysis.

This is a qualitative study (conventional content analysis). Data were collected through in-depth semi-structured interviews with 25 key participants, who were selected using purposeful sampling. Data were analyzed using conventional content analysis according to the technique described by Graneheim and Lundman. Statistical Analysis Used: No statistical methods were used in this study.

Factors behind the decision for EHE in disasters merged into three main categories, including risk assessment and estimation, the possibility of continuing service provision, and the necessary prerequisites for evacuation. The seven subcategories of these three main categories were hospital population density, hospital characteristics, accident characteristics, vulnerability of the hospital, potential capabilities of the hospital, administrative adjustments, and the possibility of safe patient transfer.

Many different factors can contribute to the decision for EHE. The findings of this study can help hospital administrators to develop plans for making better evacuation-related decisions.

Road traffic injuries (RTIs) pose a disproportionate public health burden in the low and middle-income countries (LMICs) like Uganda, with 85% of all the fatalities and 90% of all disability-adjusted life years lost reported worldwide. Of all RTIs which are recorded in Uganda, 50% of cases happen in Kampala —the capital city of Uganda and the nearby cities. Identifying the RTI prone-areas and their associated risk factors can help to inform road safety and prevention measures aimed at reducing RTIs, particularly in emerging cities such as Kampala.

This study was based on a retrospective cross-sectional design to analyze a five year (2011 – 2015) traffic crash data of the Uganda Police Force.

Accordingly, 60 RTI prone-areas were identified to exist across the Kampala. They were ranked as low and high risk areas; 41 and 19, respectively and with the majority of the latter based in the main city center. The bivariate analysis showed a significant association between identified prone-areas and population flow (OR: 4.89, P–value: 0.01) and traffic flow time (OR: 9.06, P–value: 0.01). On the other hand, the multivariate regression analysis only showed traffic flow time as the significant predictor (OR: 6.27, P–value: 0.02) at identified RTI prone-areas.

The measures devised to mitigate RTI in an emerging city like Kampala should study thoroughly the patterns of traffic and population flow to help to optimize the use of available resources for effective road safety planning, injury prevention and sustainable transport systems.

In the aftermath of mass casualty incidents (MCIs), many decisions need to be made in a fast and influential manner in a high pressure environment to distribute the limited resources among the numerous demands. This study was planned to rank the criteria influencing distribution of casualties following trauma- related MCI.

This study utilized a modified Delphi methodology, concentrating on extracted criteria attained from preceding systematic literature reviews. The 114 extracted criteria were classified into eight sec- tions including space, staff, equipment, system and structures, triage, treatment, transport, and uncategorized criteria and were imported into an online survey tool. In the first round, experts were asked to rank each crite- rion on a five-point Likert scale. The second round incorporated feedbacks from the first round, stating percent and median scores from the panel as a whole. Experts were then called upon to reassess their initial opinions regarding uncertain remarks from the first round, and once again prioritize the presented criteria.

Fifty- seven criteria were regarded as relevant to the following sections: space: 70% (7/10); staff: 44% (4/9); system / structure: 80% (4/5); equipment: 39.1% (9/23); treatment; 66.7% (6/9); triage: 73.7% (14/19); transport: 38.7% (12/31) and other sections: 12.5% (1/8). The ï ˇn ̨Arst round achieved nearly 98% (n=48) response rate. Of the 114 criteria given to the experts, 68 (almost 60%) were approved. The highest percentage of approval belonged to the system and structures sections (4/5=80%). The response rate for the second round was about 86% (n=42). A consensus could be reached about nearly 84% (57) of the 68 criteria presented to experts.

"Casu- alty Level of Triage on the Scene" and "Number of Available Ambulances" were the two criteria that obtained the highest level of consensus. On the other hand, "gender of casualty", "Number of Non-Medical staff in each Hos- pital" and "Desire to transport family members together" got lowest level of consensus. This sorted list could be used as a catalogue for developing a decision support system or tool for distribution of victims following mass casualty incidents.

To examine all aspects affecting the functioning of the system and the most important factors in its assessment through a systematic review during 1990 to 2017.

This systematic review of the current literature study was conducted during July 2017, and all articles, books, guidelines, manuals and dissertations pertaining to the Incident Command System were analyzed. A total of articles and relevant documents were identified and finally these articles, which we found, were analyzed based on the specified indicators.

In this research 992 articles and relevant documents were identified and eventually, 48 articles were included and analyzed. The results were categorized into 6 main groups including 65 subgroups and 221 variables: features  of hospital incident command system (14 subgroups and 53 variables), strengths of the system (15 subgroups and 70 variables), weaknesses of the system (10 subgroups and 15 variables), factors influencing the system's performance improvement (12 subgroups and 42 variables), factors that reduce the  effectiveness of system  include 11 subgroups (10 internal factors and 1 external factor) and 22 variables and important factors in assessing system performance (2 sub-groups and 19 variables).

According to the results, Evaluating the effectiveness of a hospital accident command system (HICS) in a valid method can improve the efficiency of this system. In this appraisal, hospital managers and health decision-makers should consider principles, characteristics, strengths and weakness of it.

Humanitarian logistics aims to reduce the suffering of disaster victims by fulfilling their immediate needs. A key component of humanitarian logistics is the prepositioning of relief items (such as water and food) for effective emergency response.

This study aimed to explore factors affecting the prepositioning of relief items for natural disasters.
Data Sources: This was a systematic review. Relevant articles were retrieved from Google Scholar, PubMed, Web of Science, and Scopus databases. We also assessed other gray literature.
Data Extraction: Data were summarized and analyzed through thematic content analysis. Overall, 22 final articles were included in the study. Articles that referred to the prepositioning of relief items were included in the study.

Factors affecting the prepositioning of relief items were categorized into four main categories and eight sub-categories. These categories included site selection, preparation, and management of warehouse (with two sub-categories of warehouse site selection, warehouse workforce); risk management studies (with two sub-categories of uncertainty, and demand estimation); infrastructures (with two sub-categories of transportation infrastructures, and other infrastructures); and financial and sociopolitical factors (with two sub-categories of financial problems and limitations sociopolitical factors).

Appropriate identification of factors that affect relief-item prepositioning can help decision-makers design appropriate models for prepositioning.

Constructions in informal settlements not respected any applying rules, regulations of urban planning, and building codes with high population density, are the municipality challenge. We aimed to identify level of buildings seismic vulnerability and population at risk in Tehran’s Farahzad informal settlement in 2017.

In this observational cross-sectional study, residential buildings were assessed for seismic performance of constructions. We screened 160 buildings according to Iranian national guidelines by Rapid Seismic Visual Screening Method as a tool to calculate and determine Level of Retrofitting (LR) scores of buildings. We also interviewed residents of the buildings to collect data regarding socio-demographic data, individual disability status, Disaster Assessment of Readiness and Training (DART) regarding household disaster preparedness, and time occupancy in the buildings.

Overall, 160 buildings with 209 households and 957 individuals were surveyed. 97.5% of buildings were formed of heavy construction materials. None of them were categorized as engineered buildings and LR of residential buildings ranged from 82.4% to 163.8% with a mean 117.9%. LR scores of more than 100% were capped as 100%. Vulnerable groups of the sample population include under-five years old (8.7%), 60 yr old and above (6.7%), and 9.1% of households had at least one disabled member. 16.7% of households were living in homes with dense area. The DART score for 94.3% of surveyed households was zero.

Disaster managers in Tehran municipality must design and implement a comprehensive risk reduction plan in poor urban areas as vulnerable regions for earthquake hazard.

Dear Editor, We appreciate the interest of the authors in our article entitled “A productive proposed search syntax for health disaster preparedness research”. They have rightly emphasized on the standard reporting of systematic reviews. However, as it is clear from the title and objective of the published article, we did not report results of a systematic review, our article instead aimed to present a syntax validation process which guide with creating a proper search strategy for systematic reviews on disaster preparedness [1-4].

Since society is the first respondent to every disaster, it is essential that the community’s ability to cope with such a situation increase. Given the importance of the role of society in the current approach to disaster risk management, the choice of the primary society is important in order to achieve greater success and acceptance in other societies. This study aimed to determine the importance of community selection criteria in community-based disaster risk management interventions.

Using the qualitative technique with the nominal group technique, community-based selection criteria for implementing a people-centered disaster management intervention from the viewpoint of the 12 different organizations in Kerman, which have been involved with risk management, have been developed through four stages of idea creation, idea registration, idea clarification, and prioritization, which was investigated.

In this study, 38 criteria for choosing a community were outlined in the idea of registration. At the stage of defining ideas, the four criteria were combined due to non-relevancy and five criteria due to similarities with other criteria. The remaining criteria are classified into four main categories: hazard and risk, organizational capacities, social capacities, and social indicators.

Due to resource constraints and the impossibility of implementing the program in all societies, it is necessary to define the criteria for selecting communities (as one of the stages of implementing a people-centered disaster management plan), by the matrix system, by rating the best locations from the target communities carefully, and according to the views society itself.

Physical rehabilitation, as one of the rehabilitation disciplines, can play a great role in humanitarian reliefs. The effectiveness of physical rehabilitation services is completely dependent on time of intervention, the importance of good timing in providing services during disasters is not well understood. The objective of this study was to systematically review the physical rehabilitation services provided in disasters and emergencies. An electronic search of PubMed, Scopus, Cochrane, and PEDro (Physiotherapy Evidence Database) was undertaken from Jan 2000 to Sep 2017. All English studies reporting physical rehabilitation services in natural and man-made disasters were selected regardless of study design. The included studies were analyzed by descriptive and analytical method. Thirteen studies were included after reviewing by title, abstract and full text in this study. Most of the physical rehabilitation studies come back to recent years. Most of the disaster physical rehabilitation services were physiotherapy and occupational therapy. The physical rehabilitation experts have been attended in the affected area from the few first hours until several months after disasters in order to provide the required services to the affected population. There are few studies about physical rehabilitation services provided in the disaster-affected areas and this study showed that the services were limited and at different times. Physical rehabilitation services post disasters should have a comprehensive service model, like other health services. Therefore, it is necessary to conduct further studies to achieve this aim.

Internationally, inclusion of physical rehabilitation services during early disaster response is relatively new. The aim of the study was to gain an understanding of disaster relief physical rehabilitation in Iran. A qualitative study design was employed and sixteen semi-structured interviews were conducted for data collection. Content analysis was used for data analysis. The participants in this study were purposively selected among people who experienced the Bam (2003) and Varzaghan (2012) earthquakes. Three main themes were explored including: indispensable intervention, barriers to continuous intervention and opportunities for intervention. Almost all participants reiterated the importance of effective physical rehabilitation services during disasters. Some participants mentioned significant barriers for delivering such services in the context of Iran. The lack of an effective responsible body, weak disaster-related competencies and under-prioritization by government were among other barriers. On a more positive note, some interviewees talked about national programs that could facilitate service delivery. Providing disaster relief physical rehabilitation has faced many barriers in Iran. However, there are some facilitators in the country that could help provide these services. Finally, the feasibility of post-disaster physical rehabilitation services delivery completely depends on the current national rehabilitation system.

Every year, a large number of people lose their lives or become injured seriously as a result of fires. Fires in buildings pose a great threat to resident safety. The aim of this systematic review is to identify preventive measures for fire-related injuries in residential buildings, taking into account associated risk factors. In this study, a systematic review was performed of all studies conducted in the field of residential building fires, influencing factors and available safety procedures. From the earliest record up to 7 July 2017, databases of PubMed, Web of Science/Knowledge, and Scopus were searched and selected articles included in the study. A total of 5,613 published articles were examined, of which 30 were finally found to meet the inclusion criteria. The findings of the study were included in two main groups of preventive measures and risk factors for residential building fires and related injuries. Regarding preventive measures, the factors to reduce the risk of fire-related injuries raised in the studies under review included rule amendments, changes and modification of the environment, behavior change such as emergency evacuation during fire occurrence, improvements to emergency medical services, and awareness-raising. Also, many of the studies showed that areas with a large number of young children, older people, people with physical and mental disabilities, alcohol and drug addicts, smokers, single-family households and low-income families were particularly at risk of fire-related injuries and deaths. There are features in residential buildings and attributes among residents that can be related to fire hazard and fire-related injuries and deaths. The most important point of this study is to focus on preventive strategies including environmental modification, promotion of safety rules and changes in risk behavior among residents. Policy makers should pay more attention to these important issues in order to promote safety and injury prevention in relation to building fires.

To find a proper search strategy to do a systematic review related to preparedness for disasters. MeSH and Emtree terms were searched to detect synonyms for two main search terms “disaster” and “preparedness”. Expert opinion on the synonyms was examined applying a Google form. The adopted syntax was searched in PubMed and results were sifted. Hand searching in two top key journals was done and sensitivity was calculated. Out of 1120 articles, 122 were included. In PDM journal, 10 articles were included by hand searching, out of which 5 were not spotted in PubMed search with the proposed syntax. In DMPHP journal, 13 publications were included, with 5 not found in PubMed search. Because of human error in hand searching 2 articles were added. The proposed syntax in this study achieves a sensitivity of search of 0.6 in PubMed which could be quite applicable for researchers. Moreover, in case only MeSH or Emtree terms were applied in search strategy or where hand searching was not performed, there were a number of articles missed.

Disasters are medically defined as events in which the demands for patients’ care far exceed the available resources. In such situations, triage and rationing of limited resources are inevitable. A decision regarding triage needs not only scientific guidelines but also an ethical framework and supporting policies. This study aims to provide a comprehensive review of the criteria for ethical decision-making in disasters triage. Medline (Via pubMed.com), Scopus, Web of Science, and ProQuest databases will be searched from 1990 to July 2017 using a defined search strategy. Other search resources include Google Scholar, World Health Library, Global Ethics Library, Gray Literature Report website, and World Health Organization (WHO), which will be searched using a modified search strategy. The manual search will be conducted in two journals with the highest number of retrieved titles in the Scopus search and the reference list of selected articles. Study selection, quality assessment, and data extraction will be done by the first author, and the second reviewer will check the results, and probable disagreements will be resolved through discussion and review by a third reviewer.  This systematic review will identify all factors a triage officer should be considered when he or she would like to make an ethical decision. Transparency and consistency are two main procedural ethical values of disaster triage. The result of this review could be used to make a consistent decision in disaster triage.

The massive un-exploded landmines in Iran every year take many victims among the citizens of the landmine areas. The aim of this study was to investigate the health-related consequences of landmine explosions in Kurdistan province. This cross-sectional study was conducted in 2016 - 2017. An active sampling approach was carried out in urban and rural areas of Kurdistan province. Data were collected by a researcher-made questionnaire. Reliability and validity of the questionnaire were calculated. Overall, 410 cases were recruited. Data analysis was performed using SPSS V. 22 software. 32.4% of the victims were immediately killed after landmine explosions and 67.6% of the survivors were living with injuries and various disabilities. The most prevalent injury was the amputation of at least one upper or lower limb with the rate of 63.5%. The prevalence rates of complete blindness and deafness were 9.8% and 1.5%, respectively. In order to prevent and mitigate the consequences, it is recommended to detect, enclose, and clear the landmine contaminated areas and implement educational programs for people and communities at risk of landmine explosions. It is also necessary for provincial planners and policymakers to implement rehabilitation and treatment programs for landmine survivors in Kurdistan.
Keywords: Landmine; Explosion; Health Impacts; Kurdistan
Please cite this article as follows:Fathollahi S, Fatemi F, Ardalan A, Bidarpoor F, Esmaeilnasab N.Yari Arezoo Assessing health-related consequences of land mine explosions in Kurdistan province during the last 37 years: 1980-2017. Hakim Health Sys Res 2018; 21(3): 200- 210.

This study aimed to assess satisfaction of emergency medicine residents and specialists.

This was a cross-sectional survey conducted in Tehran, Iran. All emergency medicine specialists and residents in Iran at the time of study were eligible and included. A modified questionnaire, originally developed by Lloyd et al. was used. The final statistical analysis was done on the questionnaires.

A total of, 210 questionnaires from 143 residents and 67 emergency medicine specialists were collected. The overall satisfaction in specialists and residents was 50% and 42%, respectively (P < 0.05). The status of specialists’ recruitment, managerial aspects, available facilities, current lifestyle, and challenges related to the job, showed significant differences.

Based on the findings of this study, although both residents and specialist satisfaction rates were at a moderate level, however, specialists were more satisfied with their job in comparison to residents.

Climate change and air pollution are linked. Both of them are expected to impact human health. Climate can increase health risks from poor air quality and lead to emergencies. Forecasting health consequences of air pollution episodes is a matter of great concern.
The current study mainly aimed at simulating the climate change impact on emergency medical services (EMS) clients caused by air pollution to estimate the future trend of EMS clients with cardiovascular and respiratory symptoms by 2050.
Future climate pattern was projected using general circulation model outputs under the scenario of two representative concentration pathways (RCP2.6 and RCP8.5). Statistical downscaling was performed by LARS weather generator to produce high-resolution synthetic time series weather dataset. Simulation was performed using an artificial neural network (ANN). Observed climate and air pollutant variables were tagged as predictors in ANN, and EMS clients were considered as the target. Projected future (2020 - 2050) climate and air pollution were applied to estimate the future trend of EMS clients.
The climate pattern was predicted to become warmer and wetter in the study area (Tehran, Iran). Annual trend of EMS clients with cardiovascular and respiratory symptoms increases under both RCP scenarios. Further increase is under RCP8.5 for EMS clients with cardiovascular symptoms, and the least increase is under RCP2.6 for those with respiratory symptoms. Annual and monthly trends of EMS clients with cardiovascular and respiratory problems are more sensitive to different groups of climate and air pollution variables.
ANN is an executive tool to simulate the impact of climate change and air pollution on public health to estimate the future trend of related morbidity and forecast short-term cases across the world.

Resilience has received increased attention among both practitioners and scholars in recent years. Child resilience has received notable attention in disaster risk reduction (DRR) during the creation of the Sendai Framework 2015–2030 to improve child protection in the event of disasters. As resilience is a subjective concept with a variety of defnitions, this study evaluates its different factors and determinates in the existing research to clarify the path for the near future and objective research. A systematic literature review was conducted by searching and selecting the peer‑reviewed papers published in four main international electronic databases including PubMed, SCOPUS, WEB OF SCIENCE, and PsycINFO to answer the research question: “What are the criteria, factors or indicators for child resilience in the context of a natural disaster?” The process was based on PRISMA guidelines. In total, 28 papers out of 1838 were selected and evaluated using thematic analysis. The results are shown in two separate tables: one descriptive and the other analytical. Two main themes and fve subthemes for criteria for child resilience in a disaster have been found. The factors found cover the following areas: mental health, spiritual health, physical, social behavior, and ecological, and as well as environmental. The majority of the included studies mentioned the scattered criteria about children resilience without any organized category. Although this concept is multifactorial, additional research is needed to develop this study and also observe other kinds of disasters such as human‑made disasters.

Context: Disasters are increasing worldwide, with more devastating effects than ever before. Hospitals must maintain their normal functions or have an evacuation plan due to the rate of damages at the time of a sudden disaster. The present study was conducted to determine the effective determinants and components in hospital evacuation decision- making.
Evidence Acquisition: In this systematic review study, which was conducted in 2016, bibliographies, citation databases, and other available records such as international guidelines, documents and reports of organizations and academic dissertations were used to find an answer to the following question: What are the effective components in hospital evacuation decision- making? Finally, 34 articles were included in this systematic review. This systematic review article was checked with PRISMA checklist.
The common factors affecting hospital emergency evacuation decision-making were classified into 4 general categories and 40 subcategories, which have been explored during thematic analysis. These 4 categories included hospital infrastructure consequences, threat, internal factors, and external factors. Level of risk was the most important component of threat category and it was mentioned in most of the reviewed literature. Loss of electricity and water, communication and transportation, resources such as staff, and removing patient devices were the most mentioned factors in hospital infrastructure consequences, external factors, and internal factors, respectively.
Different variables affect the process of hospital emergency evacuation decision-making. Thus, further studies are needed to develop a decision-making tool for hospital emergency evacuations in Iran.

Emergency physicians should secure Endotracheal tubes (ETT) properly in order to prevent unplanned extubation (UE) and its complications. Despite various available endotracheal tube holders, using bandages or tape are still the most common methods used in this regards.
This study aimed to compare adhesive tape (AT) versus fixing bandage (FB) method in terms of properly securing ETT.
This was an observational longitudinal trial. All patients older than 15-years-old admitted to the ED who had indication for ETT insertion were eligible. Patients were randomly assigned to one of the two groups in which AT or FB was applied. All patients were observed thoroughly in the first 24 hours after intubation. Using a pre-prepared checklist, encountered UE rate and other data were recorded.
Seventy-two patients with the mean age of 55.98 ± 18.39 years were finally evaluated of which 38 cases (52.8%) were male. In total, 12% of patients in our study experienced unplanned extubation. Less than 12% of the patients experienced complete UE; there was no statistically significant difference between the two groups (p = 0.24). Comparison of UE with age showed no significant difference (p = 0.89). Male patients experienced more UE, but this was not statistically significant (p = 0.44).
It is likely that whether the AT method or FB was applied for securing the ETT in emergency departments, there was no significant difference in rates of unplanned extubation.

Hospitals need volunteers to help the injured people during disasters. Thus, it is necessary to prepare some criteria for selecting volunteers. The purpose of this study was to determine and prioritize individual and social criteria for selection of local volunteers in hospitals before disasters, the volunteers who provide health services for victims in disasters.
This was an analytical descriptive study in which a researcher-made questionnaire was used to collect the data in 2015. The statistical population consisted of emergency and health managers and experts in hospitals affiliated to Tehran University of Medical Sciences. The sample were selected using Cochrane methodology and calculated as 180 subjects. The data were analyzed through calculating mean, standard deviation, 1-sample t-test, and Friedman test using SPSS.
Based on the results, most personal and social criteria were significant (P≤0.05) and important in volunteers’ selection. The results showed that the most important personal criteria were physical ability and fitness, practical expertise, and voluntary attendance experience with the mean ranks of 4.03, 3.94, and 3.77, respectively. Also among social criteria, prompt response with the mean rank of 7.26, responsibility with 6.25, and conscience with 6.06 have been determined as important factors in the selection of volunteers for health services of hospitals in disasters.
Hospitals could select volunteers based on the determined criteria. Personal criteria of physical fitness and practical expertise along with social criteria of prompt response and responsibility were reliable norms that based on them, the best volunteers could be chosen to perform health duties and decrease injuries in relief and health services.

Climate Change affects the agricultural sectors of different countries differently and several studies confirm climate change’s negative impact on food security. Ethiopia has experienced repeated famine for a century.
The rationale of this paper is to analyze, report, and discuss the results of a critical appraisal of a systematic review looking at climate change intervention and adaptation in Ethiopia.
This paper systematically appraises methodological aspects of literature reviews examining the relationship between climate change and adaptation published in peer reviewed journal between 2000 to 2016.Systematically, twenty-five relevant articles were examined.
The overall effect of response and adaptation was aware the key informants and participant’s awareness creation on Ethiopians climatic change facilitation availability and improves climate change adaptation.

This systematic review reveals that the role of climate change adaptation is crucial for food security in Ethiopia. Thus, sustaining climate change is so important to attain food security in Ethiopia.