ali sahebi

Healthcare workers are at the forefront of the fight against COVID-19 and are exposed to numerous risks and health consequences, including sleep disturbance. The present study aimed to investigate the prevalence of sleep disorders among HCWs during the COVID-19 pandemic using an umbrella review of meta-analyses.

Methods & Materials: 

Based on the guidance of PRISMA, literature was searched on the Web of Science, PubMed, Embase, Science Direct, Scopus, and Google Scholar (from the beginning of January 2020 to the end of March 2022). The random effects model was used for meta-analysis, and the I2 index was employed to ascertain heterogeneity among studies. Publication bias was investigated using the Begg test. Data were analyzed using STATA software version 14.

Initially, 561 studies were found after the primary literature search in the data resources, of which 27 eligible studies were selected for quality assessment and data extraction. The results showed that the prevalence of sleep disorders among HCWs during the COVID-19 pandemic was 38.27% (95% CI: 35.20- 41.01, I2= 74.2%, P= 0.008).

Based on the results of this review, the prevalence of sleep disorders among HCWs during the COVID-19 pandemic was relatively high. Therefore, these individuals should undergo routine screening for sleep quality and other mental health disorders.

Celiac disease is an autoimmune disorder of food intolerance that leads to difficulties in the digestion and absorption of nutrients. This disease can have destructive effects on oral and dental health. This study attempted to investigate the association of dmft index with oral health related quality of Life in (OHRQoL) children with celiac disease.

This cross-sectional study was conducted including 49 children, with celiac, and 49 healthy children, aged 3-6 years. To determine the dmft index, World Health Organization criteria were used and the early childhood oral health impact scale (ECOHIS) was applied to define OHRQoL. The data were analyzed by the statistical software, SPSS 20, at a significance level of P < 0. 05.

The mean dmft for the case group was 2.46±2.75 and significantly less than the control group with a mean of 3. 77±2. 86 (P=0. 009). The mean score of OHRQoL was 14.08±3.23 and 17.02±15.88 for the case and control groups, respectively. This difference was not statistically significant (P=0.567). There was a significantly positive correlation between the OHRQoL score and dmft index for both case and control groups (p<0/001).

Despite the lower mean dmft index in children with Celiac disease, oral health related quality of life was similar for both groups.

Vaccination is the most efficient strategy to tackle the COVID-19 epidemic, and it is important in many ways. Additionally, healthcare workers represent an important vaccine information source for the general population. This systematic review and meta-analysis aimed to evaluate the COVID-19 vaccine acceptance rate among healthcare workers.

Methods & Materials:

 This study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and the protocol of this study was registered in PROSPERO with the registration number CRD42023402082. Searches were conducted up to 20 October 2023 in data resources, including PubMed, Scopus, Web of Science, and Google Scholar. The random-effects model was used for meta-analysis, and the I2 index was used to evaluate heterogeneity among studies. The STATA software (version 14) was used for data analysis.

During the initial search, 6132 articles were selected. After the screening, study selection, and quality assessment, 93 studies entered the meta-analysis process, and a total of 196235 healthcare workers were examined. The overall vaccine acceptance rate among healthcare workers was reported as 68.56% (95% confidence interval (CI) =18.7-99.7; I2 = 99.750%; p< 0.001).

The overall acceptance rate of the COVID-19 vaccine in healthcare workers was lower than expected. Also, some determining factors were identified. The analysis of the vaccine acceptance rate and the factors affecting it can help healthcare officials and policymakers with proper healthcare planning.

Irritable bowel syndrome is the most common digestive system disorder. Despite the long period of study in the treatment of irritable bowel syndrome, only a small number of treatments have proven effective. The current study aimed to compare the effectiveness of reality therapy and compassion-focused therapy in the reduction of depression, anxiety, stress, and physical symptoms in patients with irritable bowel syndrome.

The present study was conducted on 45 patients with irritable bowel syndrome (diagnosed by a gastroenterologist applying the Rome III criteria) who were assigned to two experimental groups: reality therapy (n=15) and compassion-focused therapy (n=15), as well as the control group (n=15). The experimental groups received eight sessions of reality therapy and compassion-focused therapy. All three groups responded to the Severity of Symptoms of Irritable Bowel Syndrome (IBS-SI) and Depression-Anxiety-Stress Scale(DASS-42)  as pre-post and follow-up tests.

The results of the repeated measures ANOVA demonstrated a significantly lower mean score in depression, anxiety, stress, and physical symptoms among the experimental group in the post-test. The follow-up test administered eight weeks after the post-test did not show any change in the results.

The obtained results supported the effectiveness of reality therapy and compassion-focused therapy in the reduction of depression, anxiety, stress, and physical symptoms in patients with irritable bowel syndrome. There was also no significant difference in the efficacy of these two treatments.

 Multiple sclerosis (MS) is the most common neurocognitive disorder among middle–aged individuals and a chronic, progressive disease of the central nervous system that negatively affects various aspects of relationships, including sexual relationships. Constandinidis et al. (2019) found a relationship between MS, marital conflicts, and sexual dysfunction. Marital conflict refers to physical and verbal/psychological aggression between spouses. Reality therapy and choice theory are popular options for couple therapy, aiming to increase sexual satisfaction and reduce sexual conflicts. Another potentially effective treatment for marital conflicts is acceptance and commitment therapy, which helps individuals by increasing psychological flexibility and mindfulness, clarifying values, breaking free from unhelpful thoughts, and engaging in intelligent actions. According to some studies, positive behavior therapy, which Seligman and colleagues developed, is another treatment that has been effective in reducing some components of marital conflict. The present study was conducted to evaluate and compare the effectiveness of reality therapy, acceptance and commitment therapy, and positivist approach in a group manner on marital conflicts in female patients with multiple sclerosis living in Hamadan City, Iran.

 The current quasi–experimental research employed a pretest–posttest design with a control group. The study's statistical population included all women with multiple sclerosis living in Hamadan in 2020. Of these, 63 were selected using available sampling and randomly assigned to three experimental groups (reality therapy with 16 people, acceptance and commitment therapy with 15 people, and positivist approach with 15 people) and a control group with 17 people. The therapy program consisted of one 90–minute weekly session in 8 sessions for three experimental groups (one therapeutic intervention for each group). In the case of the control group, there was no intervention at that time. In addition, the present study used the Marital Conflict Questionnaire (Sanayi Zaker et al., 1992) to collect information. The questionnaire has 54 questions scored on a 5–point scale from 1 to 5. The reliability and validity of the questionnaire were confirmed by calculating the Cronbach alpha equal to 0.96. Analysis of the research data was done using the analysis of the covariance using SPSS–25 software.

 Univariate analysis of covariance after adjusting pretest score showed significant differences between MS women participating in reality therapy, acceptance and commitment therapy, and positive approach regarding the average posttest scores of marital conflicts (p<0.001) with the effect size of 0.526. Based on the Bonferroni post hoc test results, the average posttest scores of marital conflicts in the reality therapy group (p<0.001), acceptance and commitment therapy group (p<0.001), and positive approach group (p<0.001) were significantly lower than the control group. Also, the average scores of marital conflicts in the reality therapy group (p<0.031) and acceptance and commitment therapy group (p<0.001) were significantly lower than those in the positive approach group (p<0.001). However, there was no significant difference between the reality therapy group and the acceptance and commitment therapy group. All three interventions of reality therapy, acceptance and commitment, and positive approach therapies were significantly effective in reducing the marital conflicts of MS women. In addition, no difference was observed between the effectiveness of reality therapy and acceptance and commitment therapy.

 Comparing the efficacy of three intervention approaches showed that all three treatment methods effectively reduced marital conflicts. However, acceptance and commitment therapy was more effective than the other two interventions. Therefore, we suggest that all three methods of reality therapy, acceptance and commitment therapy, and the positivist approach can be used to reduce marital conflicts. Of course, based on the results of the present study, it is better to use acceptance and commitment therapy as the first choice of therapists.

Maternal and fetal morbidity and mortality depend on identifying of pregnancy risks and risk management. There is a dearth of information about the experiences of high-risk pregnant mothers in self-mitigation of the risk in the socio-cultural setting of Iran. This research was conducted to explore the risk management experiences of high-risk pregnant mothers. This Qualitative study was conducted in educational hospitals in Mashhad, Iran, from July 2018 to December 2020. The purposive sampling method was used to recruit the participants based on medical or obstetric high-risk conditions in pregnancy. Qualitative data were obtained from in-depth and semi-structured 29 interviews. Mothers’ experiences of pregnancy in a risky condition were asked, and the interview continued until data saturation. Data were analyzed using the MAXQDA 10 software and the Elo and Kyngäs method. Maternal experiences for risk management in pregnancy were formed by nine sub-categories and three categories: the excitement of emotion including: “feeling worry and despair”, “gladness in the shadow of hope and optimism”, “momentary shocking and excitement”, and “inactivity and helplessness”; self-contemplation including: “active analysis of the ways of moderating the risk”, “cognitive denial”, and “ignoring the risk”; and witnessed action including: “problem-focused and rational actions”, and “avoidance and inefficient engagements”. Risk management experiences of pregnant women with high-risk pregnancies include a wide range of positive and negative feelings, effective and ineffective thoughts, and behaviors. Mutual collaboration between mothers and midwives/obstetricians by providing high-quality risk management counseling can lead to choosing effective risk management strategies.

Among musculoskeletal disorders, low back pain causes the most common complaints among emergency medical services personnel worldwide. This study aimed to investigate the prevalence of low back pain among emergency medical services personnel.

We used the PRISMA guideline in the present systematic review and meta-analysis. The search was conducted in PubMed, Scopus, Web of Science, Cochrane, ProQuest, Science Direct, Google Scholar, and Embase using English keywords and SID, Irandoc, and Magiran data resources with equivalent Persian keywords. Studies were selected based on inclusion and exclusion criteria. The data were gathered without a time limit until the end of June 2021. The quality evaluation of the selected studies was performed using the Appraisal tool for Cross-Sectional Studies (AXIS) tool. The random-effects model was used for meta-analysis, applying the I2 index as a measure to estimate heterogeneity among studies.

In the present study, a total of 1038 articles were identified in the primary search, of which ten studies entered the final evaluation phase and meta-analysis after initial screening and removing duplicates. In these studies, 7499 emergency medical services personnel were examined; the prevalence of low back pain was 50.30% (95% CI: 37.98-62.62, I2= 99.1%).

Our results indicated a considerable prevalence of low back pain among emergency medical services personnel. Also, the heterogeneity between studies was very high. It is recommended to teach the correct methods of lifting the stretcher and equipment as well as redefining the duties of the staff with low back pain.

Irritable bowel syndrome (IBS) is the most common disorder of the digestive system. Despite the long period of study on the treatment of IBS, only a small number of treatments have proven effective.

The current study aimed to determine the efficacy of compassion-focused therapy (CFT) in depression, anxiety, stress, and physical symptoms in patients with IBS.

This was a quasi-experimental study with a pretest, posttest, follow-up, and control group. The present study was carried out on a total of 30 patients with IBS (diagnosed by a gastroenterologist applying the Rome III criteria) selected and divided into CFT (n=15) and control (n=15) groups. The experimental group received eight sessions of CFT. All groups responded to the Severity of Symptoms of Irritable Bowel Syndrome, and Depression Anxiety Stress Scale-42 was administered as pre-post and follow-up tests.

The results showed significantly lower mean scores in depression, anxiety, stress, and physical symptoms in the experimental group in the posttest. The follow-up test given 8 weeks after the posttest did not show any change in the results.

The obtained findings support the efficacy of CFT in depression, anxiety, stress, and physical symptoms in patients with IBS.

Taking exercise in health sector is one of the important steps to implement the disaster risk management programs, especially preparedness phase. The present study aimed to identify indexes and factors affecting successful evaluation of disasters preparedness exercises in hot wash stage.

This study was a qualitative content analysis. Data were collected by purposeful sampling through in‑depth and semi‑structured individual interviews with 25 health professionals in the field of disasters. The data were analyzed using directed content analysis method by which the initial codes were extracted after transcribing the recorded interviews and immersing them in the data analysis. The initial codes were reviewed, classified, and subdivided into several stages to determine the main classes.

The data analysis resulted in the production of 24 initial codes, 5 subcategories, 2 main categories of “evaluation and exercise debriefing” and “modification of programs and promotion of exercise operational functions” under the original theme of “exercise immediate feedback.”

This study can be considered a suitable standard guide for health care organizations to evaluate successfully disasters exercises in hot wash stage, maintain and promote their preparedness, and properly respond to disasters.

This research was aimed to study the effectiveness of group new reality therapy (based on choice theory) on couples’ conflict and its dimensions. The research was a semi-experimental design with pre-post and follow-up test with control group. The data were analyzed using univariate and multivariate covariance analysis test . The statistical population included the Saman Bank employees and their spouses. The sampling method was convenient. Twenty couples from Saman Bank were volunteered and were randomly replaced in two experimental and control groups. The tool used in this research was Marital Conflict Questionnaire (MCQ) developed by Barati and Sanaie. The intervention consisted of eight three-hours group new reality therapy sessions based on principles of William Glasser institute. The findings revealed that no significant difference between the two mentioned groups in marital conflict in post test stage. However there was a significant difference in two sub-scales: decreased sexual relationship and decreased family relations with their spouse’s relatives and friends. Moreover, in follow up stage there was significant diference between experimental and control in marital conflict and its subscales of decreased marital cooperation, decreased sexual relationship, increased emotional reactions and decreased family relations with their spouse’s relatives and friends. Based on the limitations and findings of this research, it is recommended that number of samples and length of interventions increase significantly. This fact helps the efficiency to be promoted as the time factor showed its vital role in learning and persistency which was revealed in follow-up stage. It is also recomended to use this approach for pre-marital training and counseling.

Patient safety is one of the most important parameters of quality health care. The role of health care workers in providing safe care is essential, and their positive attitudes towards this issue will positively affect patient safety. This review aimed to investigate the attitudes of health care workers towards patient safety in Iran.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guideline was used to conduct the present review. Data resources including SID, Magiran, Scopus, PubMed, ISC, Web of science, and Google Scholar were chosen to conduct the literature search both in Persian and English without any time limit until the end of January 2021. Inclusion criteria included all English or Persian language studies in which the Safety Attitude Questionnaire (SAQ) was used to assess the attitude of Iranian health care workers towards patient safety.

In the primary search, 342 studies were obtained, finally 11 of which were reviewed. Among these, 10 studies had cross-sectional designs, and one study was a quasi-experimental research. Overall, 2162 health care workers were analyzed. The results of the present study showed that most health care workers in Iran had unfavorable attitudes towards patient safety. 

As upgrading health care workers’ attitudes seems necessary to improve patients’ safety, it is recommended that health organizations provide regular patients’ safety training, both at employment time and during service to the health care workers who are in direct and indirect contact with patients.

Occupational accidents cause death and disabilities among millions of workers around the world. The mining industry is among the riskiest occupations in this respect. This study aims to investigate interventions made and challenges faced by the health system in response to the Zemestan-Yurt Mine explosion in the Golestan Province, Iran, 2017.

In this article, being a field report, data were collected through direct observations and interviews with first responders involved in the response process, and by checking national and local reports from other organizations.

On Wednesday, May 4, 2017, at 11:58 AM, an explosion occurred in the Yurt coal mine, Golestan Province, in which 126 people were affected directly or indirectly. In fact, 43 workers were killed immediately after the explosion of a coal wagon, 55 were dispatched to hospitals, and 28 received outpatient health services. In this incident, more than 100 teams from various organizations, including the health system, arrived at the scene and carried out relief and rescue operations.

The results of the current study indicate that the health system does not have specific instructions, training plans, as well as well-trained and prepared personnel for managing mine-related accidents. Besides, interactions are not integrated and coordinated among disaster management response teams. Therefore, developing preparedness instructions for responding to disasters, forming rapid response teams and training them for industrial accidents, as well as performing joint exercises and drills with responsible organizations can be effective in improving responses to such accidents.

The aim of this study was to study the effectiveness of teaching choice theory on the basic needs satisfaction and level of violence among high school girls in Hamadan.The research method was-experiment in the form of a pre-test, post-test design. The study participants in this study are all female students of the second grade of high school in Hamadan, who was studying in the academic year 1396-97. The model includes 30  female students of the first and second grades of high school who were nominated by a random multi-cluster sampling method. Finally, by simple random sampling method, they were allocated into experiment and control groups. For data gathering, the Bass and Perry Aggression Questionnaire (1992) and 70-item Glasser Basic Needs Questionnaire were used. To analyze the data, multivariate analysis of covariance test with SPSS_25 software was used. The results show that the teaching choice theory is effective in reducing physical aggression, verbal aggression, anger and hate, and absence of satisfaction of the need for existence, power, love, fun, freedom of students (p <0.05).In this study, the highest effectiveness is the satisfaction of the absence of need for freedom and the least effectiveness is the satisfaction of the absence of need for love and belonging. Thus, it can be concluded that teaching choice theory to female students can be a useful and effective method to reduce the scopes of aggression and the lack of satisfaction with their needs. This data can be used in the direction of treatment arrangement and scientific interventions to decrease aggression in female high school students.

Although the hospital is known as a safe place for treating patients, due to various reasons, it is prone to several internal hazards, including fire. This study aimed to identify the factors affecting hospital emergency evacuation during fire.

This was a systematic review conducted according to the PRISMA guideline. Thematic Content analysis was utilized to analyze and extract results. We found the studies investigating the factors affecting hospital emergency evacuation during fire through a comprehensive search in various data resources (MEDLINE, Web of Science, Google Scholar, Embase, ProQuest, Scopus, IRANMEDEX, SID, ISC, and Magiran) and other sources from the beginning of January 2000 to the end of December 2019. Thematic Content analysis was also employed to analyze.

At first and based on the initial search, 4484 studies were identified, and 48 articles were finally included in the study. Based on the results; five main themes along with 10 sub‑themes were identified. The themes included the incident’s characteristics, response measures, hospital preparedness, hospital residents, and hospital building, and the sub‑themes were emergency evacuation features, fire characteristics, command, operation, patients’ and staff’s characteristics, planning, logistics, and structure and design hospital.

Based on the results of the present study, hospital preparedness as one of the most important factors can reduce the hospital evacuation time. Therefore, hospitals can ensure a timely and more effective response in emergency evacuation during fire by improving their preparedness.

Suicide is not an uninvited guest entering unannounced rather it always occurs following a previous background. Suicide is interpreted as an action in order to accredit life or give up everything. Suicide happens because of determinism or full anxiety and depression. The present study aimed to investigate the effect of Choice Theory training on the suicidal tendency of first high school male students in Sonqor County, Kermanshah Province, Iran.

This quasi-experimental study was conducted using a pretest-posttest design with a control group. The statistical population of the study consisted of all boys of the first high school in Sonqor County, Kermanshah Province, Iran, in the academic year of 2017-18. According to available statistics, about 500 students were studying at six male high schools from which one high school was selected randomly. After implementing the Multiple Attitude Questionnaire of suicidal tendency in adolescents, 30 students were divided into two groups (15 cases per group) randomly. The obtained data were then analyzed through single-variable and multivariate analysis of covariance.

The results of this study showed that the implementation of the Choice Theory Education to first high school male students influenced their suicidal tendency (P<0.01), and suicidal tendency decreased in the students of the experimental group. Furthermore, the results from the comparison of the attraction to death at posttest in two groups by controlling the pretest effect indicated no significant difference between the two groups in terms of the attraction to death scores (F=0.175; P<0.01).

Considering the findings, this intervention is a suitable method to modify the behavior and improve adaptation in male students.

 Suicidal behavior in children under 10 years of age is a warning and a matter of concern. It can be an important indicator for evaluating the mental health of individuals in the community. 

This study reported an 8-year-old boy who had three failed suicide attempts by hanging. The psychiatric assessment revealed that he had major depressive disorder which had not been diagnosed.

 Evaluation of his behavior by using the Child Behavior Checklist completed by his parents showed that he had the highest scores in aggressive behavior, attention problems, rule-breaking behavior, and anxious/depressed subscales. Lack of parental attention to meeting the needs and creating a supportive environment may have led to behavioral-emotional disorders and risky behaviors such as suicide in the boy.

Fire is one of the most important threatening factors for hospitals and needs special attention. The present study was conducted to explain the factors affecting hospital emergency evacuation following fire based on hospital administrators’ experiences.

This was a qualitative study conducted employing the content analysis approach. Participants included 22 hospital administrators in Tehran, Lorestan, Kurdistan, and Ilam provinces. The participants were purposefully selected and included until reaching principle of data saturation. Data were collected through in‑depth semi‑structured interviews from November 2019 to August 2020 and analyzed by the content analysis method.

Factors affecting hospital emergency evacuation during fire were categorized into five main categories and 17 subcategories including response to incident (five subcategories of fire nature, emergency evacuation, service provision, coordination and communication; and collaboration and companionship), human factors (two subcategories of individual characteristics and competencies), hospital preparedness (three subcategories of planning, safety and security; and information management system), environmental factors (two subcategories of hospital design and infrastructure; and weather condition), and finally ethical values (five subcategories of human dignity, trust, altruism, responsibility and accountability; and empathy).

The results of this study indicated that during fire in Iranian hospitals, several factors in addition to available standard guidelines affect the emergency evacuation process that need to be considered. Hospital emergency evacuation during fire is a complex process and necessitates a full and high‑level hospital preparedness, so using the results of this study can be used to develop and practice evacuation plans and improve the hospital preparedness.

Patient safety is an important and mandatory component of quality health services. Insecure health services, in addition to inflicting pain and suffering to patients, impose a high financial burden on the health system of every society. The present study was conducted to evaluate the critical standards of patient safety based on the Patient Safety Friendly Hospital Initiative (PSFHI) checklist in Iran.

The present systematic review and meta‑analysis were performed based on the PRISMA guideline. For this purpose, articles related to the critical standards of patient safety based on the PSFHI checklist were obtained by searching valid Persian and English keywords in SID, Magiran, PubMed, Scopus, Web of Science, and Google scholar data resource through the end of 2019. The studies were analyzed using the STATA (version 14) software.

In the initial search, 533 articles were extracted among which 7 were eligible and entered into the meta‑analysis process. Overall, 55 hospitals were surveyed, and the results of the meta‑analysis showed that the average critical standards of patient safety were 69.52% (95%, CI = 57.09–81.95, I2 = 69%, P = 0.004).

The results showed that a moderate level of critical standards of patient safety in hospitals in Iran. Since meta‑regression analysis revealed a decreasing trend in compliance rate, hospital managers should implement principals designated by the World Health Organization to achieve the required standards that are the basis and pillar of a patient‑friendly hospital. With proper management, hospitals should set goals and take steps based on a strategic plan toward achieving these goals.

Risk perception in high‑risk pregnancies influences the mothers’ adherence to medical treatments and recommendations. Because of the lack of information about the women’s perception of risk, the aim of this study was to explain perception of risk in high‑risk pregnancies. 

This qualitative study was conducted on 25 women with a high‑risk pregnancy in educational hospitals of Mashhad, Iran, from August 2017 to August 2018. Data were collected through semi‑structured interviews and data saturation was reached after 29 interviews. Data collection and analysis were simultaneously carried out using the qualitative content analysis method adopted by Elo and Kyngäs in MAXQDA software.

Data analysis resulted in the four main categories of perception of risk control ability (risk controlling through experience, risk tolerance through relying on a higher power, and risk tolerance to reach family goals), wrong estimation of risk (wrong calculation of possible risks based on wrong beliefs and knowledge, and incorrect risk estimation caused by misunderstanding), possibility of mutual vulnerability of pregnancy and risk condition (possibility of vulnerability of the fetus to risk factors, and possibility of the mother’s vulnerability to risk factors), and induced risk (risk induced by negative experiences, induced threat of unknown pregnancy outcome, and fear of ambiguous medical terms).

The results of this study promoted our understanding of risk perception in women with high‑risk pregnancies. Therefore, it will help to establish a‎ better link between women with a high‑risk pregnancy and the health team, enhance and improve maternal and fetal care.

Occupational burnout, as a reaction to persistent work pressures, reduces efficiency, wastes manpower, and causes physical and psychological complications. The aim of this study was to determine the frequency and intensity of occupational burnout among pre-hospital emergency staff in Iran.

This study was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data resources included Scientific Information Database (SID), Magiran, Islamic World Science Citation Center (ISC), Irandoc, PubMed, Scopus, Web of Science, and Google Scholar.

Initially, 178 articles were extracted, and then 13 articles were finally analyzed. Overall, 2034 pre-hospital emergency personnel were examined. Mean of occupational burnout in term of frequency, respectively for emotional exhaustion (16.78, 95% CI = 8.89-24.67, I 2 = 62.30%, p = 0.004), depersonalization (11.57, 95% CI = 6.97-16.18, I2 = 68.50%, p = 0.001) and the lack of personal accomplishment (16.11, 95% CI = 8.60 -23.62, I2 = 74.70%, p = 0 <001) were determined. Also, in term of intensity, respectively for emotional exhaustion (17.90, 95% CI = 8.24-27.57, I2 = 64.80, p = 0.004), depersonalization (11.20, 95% CI = 6.80-16.22, I2 = 49.60%, p = 0.044) and the lack of personal accomplishment (23.45, 95% CI = 13.41 -33.49, I 2 = 84.80%, p = 0 <001) were determined.

According to findings, depersonalization and lack of personal accomplishment had moderate and high-level, respectively. Therefore, it is necessary health policymakers pay special attention to identifying and resolving the causes of occupational burnout in this population.

Cardiovascular emergencies have a high prevalence and are important among other pre-hospital emergencies. In such emergency situations, making decisions to provide the best care and transport to the hospital are brought with many challenges. The current study reports paramedics’ on-scene decision-making challenges in relation to a patient with the acute coronary syndrome. The case was an old woman who complained of sudden dizziness and weakness. The patient’s vital signs included a blood pressure of 100/70 mm Hg, heart rate of 58 beats per minute, respiratory rate of 17 breaths per minute, O2 sat of 96% and blood sugar of 145 mg/dL. The past medical history of the patient indicated that she had no previous disease or use of medications. In the hospital emergency unit, electrocardiography was recorded and ST-segment elevation myocardial infarction was observed. Paramedics face many challenges in on-scene decision making, which affect the time, process, and consequences of their decisions. In low and middle-income countries, due to resource limitations, all ambulances are not equipped with diagnostic equipment including portable sonograph and electrocardiograms. In such contexts, decision-making protocols need to be designed and used at the emergency scenes to guide the paramedic and ensure their optimal performance.

Postpartum depression (PPD) is a mood disorder that can affect women after childbirth and this disorder can strike fathers as well as mothers.  The study reports a 28-year-old man who attempted suicide three times following his wife delivery and newborn baby boy. Psychiatric assessment showed that the man revealed major depression following childbirth. So effective mental disorders screening and health care services must be provided for fathers as well as mothers and children.

Disasters have many health consequences such as suicide ideation as one of the relatively common psychological consequences after natural disasters, especially earthquakes. This study aimed to determine the prevalence of post-earthquake suicidal ideation in affected people.

Related keywords of this systematic review and meta-analysis in English and their Persian equivalents were searched in the data resources including Google Scholar, SID, Magiran, Scopus, PubMed, and Web of Science from Jan 2014 to May 2019. The STROBE checklist was used to evaluate the quality of the articles. The I2 index was used to determine the heterogeneity and the random-effects model was used in meta-analysis. Statistical analysis was conducted in the STATA software version 14.

Overall, 14347 subjects including 6662 males and 7715 females with the mean age of 23.88 ± 15.81yr old were assessed. The prevalence of post-earthquake suicidal ideation was 20.34% (95% CI: 13.60-27.08, P<0.001, I2=99.1). The prevalence of suicidal ideation showed a decreasing trend based on the year of the study and the duration of post-earthquake follow-up.

Although the prevalence of post-earthquake suicidal ideation showed a decreasing trend, the probability of incidence of these thoughts in the long-term is still noticeable. Therefore, implementing a surveillance system is recommended to monitor the mental health status of earthquakes survivors for the possibility of suicidal thoughts in the short and long term recovery phase.

Adherence of emergency medical technicians (EMTs) to a professional code of ethics is one of the most important aspects of their occupation. The purpose of this study was to determine the degree of adherence to the professional code of ethics from the perspective of EMTs and their patients. This was a cross-sectional study. The inclusion criteria for patients were age between 18-65 years, willingness to participate in the study, normal mental status, being medically stable and absence of any chronic mental or psychiatric disorder. The inclusion criteria for EMTs were willingness to participate in the study, having an associate or bachelor’s degree in the medical emergency, working at medical emergency departments and management centers. The exclusion criteria were refusal to continue the study and the necessity of therapeutic intervention while completing the questionnaire. The patients were recruited by cluster sampling. For this reason, first, two hospitals were randomly selected among six hospitals in Arak, Markazi province (Arak, Iran). Then, the list of missions at each shift was extracted by referring to the emergency departments of these hospitals. Afterward, one of the missions in each shift was randomly selected. In this study, a two-part questionnaire was used for data gathering. In this first part, the demographic information of the participants was collected. In the second part, a professional code of ethics for EMTs' questionnaire, including 26 statements in 5 dimensions was used. Finally, the questionnaires were given and completed by the pre-hospital emergency personnel and the transferred patients. A total of 105 EMTs and 109 patients were randomly selected as they transported patients to the studied hospitals. From the viewpoint of patients, adherence to the professional code of ethics was rated 2% as highly desirable, 39% as desirable, 58% as moderate, and 1% as undesirable. On the other hand, the EMTs rated themselves as 59.8% highly desirable, 37.1% as desirable, and 3.1% as moderate. There was a statistically significant difference between the average score of adherence to a professional code of ethics from the viewpoint of patients versus that of the EMTs (p <0.001). There was a statistically significant difference between the degrees of adherence to the professional code of ethics by EMTs from their own viewpoint versus that of the patients.