فهرست مطالب

Journal of Health Sciences and Surveillance System
Volume:10 Issue: 3, Jul 2022

  • تاریخ انتشار: 1401/05/02
  • تعداد عناوین: 20
|
  • Hosein Eslami, Amir Hooman Sadr Haghighi, Hossein Hosseinifard, Fatemeh Salehnia, Elaheh Fakhri, Farzaneh Afshari * Pages 238-249
    Background

    New antimicrobial procedures are of significant importance to emerging species of bacteria and viruses. The objective of this systematic review study was to identify the efficacy, safety, and application of UV light in the disinfection of dental environments, instruments, and materials.

    Methods

    In this systematic review article, the authors performed an electronic search of Google Scholar, Pubmed, and SCOPUS databases to retrieve related English language articles published between the years 1990 and 2020. At first, the selected articles were reviewed by screening their titles and abstracts and ultimately by full text.

    Results

    35 articles were considered relevant and included in this study. Fifteen studies were related to the antibacterial efficacy of UV radiation on various bacterial, fungal, and viral species. Two studies applied UV irradiation for the disinfection of titanium implants. Sixteen articles suggested the application of UV radiation for disinfection of dental impressions, toothbrushes, N95 masks, removable prostheses, acrylic resins, and surfaces. Furthermore, one study strongly suggested using eye protection appliances while working with UV radiation, and one study claimed that UVB radiation led to oral and skin cancer while this risk is higher for oral cancer.

    Conclusion

    UV radiation with a specific dose and a duration effectively kills viruses, bacteria, and fungi for disinfection in dental procedures, which includes dental tools and materials such as toothbrushes, dental implants, impression materials, removable dentures, and dental environment. However, the principles of protection are emphasized to reduce its harmful effects on the eyes and skin.

    Keywords: Dental Equipment, Dental instrument, Dental office, Disinfection, Ultraviolet rays
  • Mohebat Vali, Alireza Mirahmadizadeh, Zahra Maleki, Sima Afrashteh, Arefe Abedinzade, Farzaneh Kasraei, Haleh Ghaem * Pages 250-256
    Background

    Coronavirus is among the pathogens that primarily target the respiratory system. Given the importance of Health Care Workers (HCWs) in the fight against COVID-19, their infection with the virus and death can cause irreparable damage to public health. The present systematic review and meta-analysis aimed to investigate the physical and psychological implications of COVID-19 among HCWs.

    Methods

    In this systematic review and meta-analysis, some well-known databases were searched for the studies published before 26 June 2020 using the following search strategy: “Novel coronavirus pneumonia”, “Nurses”, “Physicians”, “Medical Staff, Hospital”, “Health Personnel”, and “Community Health Workers”. Finally, 101 out of the 2234 primary screened articles were assessed.

    Results

    Of the total studies included, 54 were related to Physical problems, and 47 were related to Psychosocial Stress. Skin damage (54.48%), Nasal bridge (58.79%), and Dryness tightness (58.57%) were the most common Physical Problems, and Insomnia (32.03%) and Distress (29.34%) were the most common psychosocial problems among HCWs.

    Conclusion

    Training and awareness of the treatment staff about the unwanted side effects of these diseases should be considered in educational programs in different countries because patient care depends on their availability.

    Keywords: COVID-19, Health Personnel, Physical problems, Psychosocial stress, Systematic review
  • Jalal Mohammadi, Mohsen Kalantari, Zahra Nasiri, Davood Mehrabani, Hamzeh Alipour, Mohammad Djafar Moemenbellah-Fard, Kourosh Azizi * Pages 257-265
    Background

    Visceral leishmaniasis (VL) is still widespread in tropical and subtropical regions worldwide. The vector of the disease is a sandfly, when infected with Leishmania parasite, can transmit the parasite from humans to other vertebrates. As knowledge about causative agents, vectors, and reservoirs of VL in Iran is necessary to control the disease, the present review study has focused on the disease elimination status from a health perspective in the country.

    Methods

    In a recent review, various databases, such as Web of Science, PubMed, Scopus, Cochrane Library, Science Direct, Google Scholar, MEDLIB, Irandoc, Magiran, and SID were searched using the keywords “visceral leishmaniasis”, “VL”, “kala-azar”, “causative agent”, “parasite”, “vector”, “reservoir”, and “Iran”, and the retrieved data were extracted and reviewed independently during 2001-2019.

    Results

    475 published studies were recorded about VL in Iran from 2001 to 2021. 68 articles were later excluded from the study due to duplication after the initial review. Leishmania infantum and L. tropica were the causative agents, and dogs and humans were the reservoirs. The most common vectors were Phlebotomus major, P. kandelakii, P. keshishiani, P. alexandri, P. perfiliewi, and P. tobbi in different country regions.

    Conclusion

    The prospect of eliminating VL in Iran is inadequate. Based on the findings, L. infantum and L. tropica were the causative agents, and humans and the Caninae subfamily were the VL reservoirs in the country. These findings can be added to the literature when health policymakers target preventive measures for VL in Iran.

    Keywords: Disease reservoirs, Iran, Leishmaniasis, Vector-borne diseases
  • MohammadMehdi Golbini Mofrad, Mika Sillanpää, Iman Parseh, Afshin Ebrahimi *, MohammadMehdi Amin Pages 266-275
    Background

    Treating working fluid wastewater (WFW) by having several organic/inorganic pollutants is not an easy task. There are many hurdles to adopt an appropriate treatment strategy through biological, physical, chemical, and electrochemical approaches.

    Methods

    The treatment methods of WFW are reviewed in this work through a critical literature survey. Therefore, databases such as Google scholar, science direct, and PubMed were considered to find literature. Altogether, about 49 articles were finally found relevant to the topic to extract and interpret findings.

    Results

    The best solution to treat WFW could be an integrated approach by designing various AOPs for the pre-treatment and post-treatment of main units. For this reason, and to meet discharge standards, measuring intermediates and the toxicity of reaction solution and final effluent by bioassay could be a complementary tool. Additionally, if the used AOP is a photocatalytic one, applying catalysts with a low energy bandgap and designing reactors to utilize the highest amount of energy is crucial to make a process cost-effective. Furthermore, using aeration could increase the number of radicals by supplying oxygen and removing contaminants from the reaction medium. Finally, if AOPs are the pretreatment unit, removing halogens should be done to predict floc breakage in the next step.

    Conclusion

    Hybrid treatment approaches with at least 80% efficiency in degrading and removing micropollutants could be reliable methods to dispose of working fluid wastewater. However, further research on them in the future is essential because of discharging a considerable volume of them annually worldwide.

    Keywords: Advanced oxidation process, Environmental pollutants, Fluid waste disposal, Industrial wastes, Rankine cycle
  • Swathy Moorthy, Teena Koshy, Mahesh Kumar K, Jasmine Chandra A, Emmanuel Bhaskar, Santhi Silambanan * Pages 276-283
    Background
    Patients with COVID-19 (coronavirus disease 2019) present varying disease severity; with such heterogeneity in clinical presentations, it can be challenging to assess the severity and progression of the disease. In addition, no specific markers have been identified that would indicate the diagnosis or prognosis of the disease. Therefore, this study was aimed to determine whether a panel of hematological and inflammatory biomarkers were indicative of disease severity in the assessment and the prognosis of COVID-19.
    Methods
    The retrospective cross sectional study was carried out in a university hospital in South India between May 2020 and September 2020. The participants were 997 patients with COVID-19, confirmed by real-time reverse transcriptasepolymerase chain reaction (RT-PCR). Information regarding demographics and laboratory tests was obtained from medical records. Association analysis was conducted using SPSS, version 16, and a P-value <0.05 was considered statistically significant.
    Results
    Inflammatory markers such as C-reactive protein (CRP) and D-dimer, calculated inflammatory ratios, and hemoglobin were significantly increased in cases of severe COVID-19. Leucocytosis with increased absolute neutrophil count and decreased absolute lymphocyte count were observed.
    Conclusion
    Haematological and inflammatory markers mayindicate the severity of the disease. The severity of COVID-19 was indicated by elevated total white cells, increased neutrophillymphocyte, and platelet–lymphocyte ratios. Increasing levels of CRP indicated a severe prognosis of the disease. D-dimer elevations may indicate the incidence of thromboembolic episodes. Therefore, hematological indices were considered applicable in assessing the progression of the disease and for the risk stratification of the disease.
    Keywords: COVID-19, Hematological markers, Inflammatory Markers, Radiological findings, SARS-CoV-2 Infection
  • Mohsen Poursadeqiyan, Nayyereh Kasiri, Behzad Khedri, Zahra Ghalichi Zaveh, Amin Babaei Pouya, Somayeh Barzanouni, Milad Abbasi, Maryam Feiz Arefi, Farahnaz Khajehnasiri, Naser Dehghan Pages 284-292
    Background

    People’s participation in more efficient control of the disease and public awareness about the risk of COVID-19 affect their preventive behavior. This study examines the level of fear of COVID-19 infection in Iranian society after returning to social activities and business reopening.

    Methods

    This Cross-Sectional study consisted of urban dwellers in Iran, and the data gathering tool was a researcher-designed questionnaire. To design the instrument, the authors interviewed experts and ordinary people to determine the key questions . Then, the questions were modified and finalized based on the experts’ feedback and a reexamination by the experts after two weeks. An online version of the questionnaire was disseminated using social networks. 168 people were included in the study by the available sampling method. Data were analyzed through descriptive statistics methods. Quantitative data as mean and standard deviation were reported, and the qualitative data were reported as numbers. Chi-square test and Spearman correlation coefficient were used to examine the relationship between questions related to COVID-19 infection fear and demographic variables. Data analyses were done in SPSS 20.

    Results

    The study was carried out on 168 participants, and 78 of them were employees of different offices. The participants believed that among the ways of spreading the disease, kissing and hugging (n=142, 84.5%), shaking hands (n=127, 75.6%), contact with the saliva of an infected person (n=116, 69.0%), and spread through the air (n=60, 35.7%) had the highest frequencies.

    Conclusion

    Fear of COVID-19 infection in the participants was at moderate and above moderate levels. The participants also hoped that the vaccine would be found and made available to the public. Policy-makers in the health sector can use the results.

    Keywords: Anxiety, COVID-19, Distress, Prevention, Risk, Stress
  • Aliasghar Masihi Nezhad *, Amena Barikani, Maryam Javadi Pages 293-300
    Background
    Probiotics are non-pathogen microorganisms that confer a health benefit on the gut system. The Health personnel are responsible for treating the patients, which is a sensitive role; therefore, their knowledge, attitude, and consumption of probiotics are important.
    Methods
    A cross-sectional study was planned to evaluate personnel. Random sampling was conducted to select 136 persons as study samples from 275 personnel willing to participate in the study. Data collected using a self-made questionnaire consisted of demographic data, awareness, attitude, and behavioral items. Descriptive, correlation, and regression statistics were performed using SPSS ver. 22.
    Results
    Total awareness score of personnel about probiotics was medium. No significant associations were found between total awareness score and gender, education, and field of education (P>0.050) except for age (P=0.008) and acquaintance (P=0.003). The younger group and experienced participants were more aware of probiotics than others. Most of the personnel had positive attitudes about probiotics. The study showed no correlation between attitude and variables, including genus (P=0.150), education (P=0.507), field of study (P=0.756), and acquaintance of personnel (P=0.259). The personnel’s overall behavior score did not correlate with genus (P=0.841), age (P=0.955), education level (P=o.527), field of study (P=0.955), and acquaintance (P=0.832). Logistic regression indicated that total awareness predicts personnel’s behavior.
    Conclusion
    Shiraz health centers Personnel had no considerable awareness about probiotics. Personnel’s attitudes toward probiotics were positive, but lack of knowledge, high price, and limited access to probiotic products resulted in low consumption.
    Keywords: Attitude, Awareness, Health Personnel, Probiotics
  • Mohamadali Ghodratollahifard *, Sajad Aminimanesh, Mahbobeh Chinaveh Pages 301-307
    Background
    This study evaluated the mediating role of anxiety tolerance and cognitive emotion regulation concerning childhood harms and the occurrence of symptoms of avoidant personality disorder in nurses at Shiraz University of Medical Sciences.
    Methods
    291 nurses at Shiraz University of Medical Sciences participated in this descriptive correlational cross-sectional study in 2020.They were selected by simple cluster sampling. The instruments used in the present study included the Childhood Injury Questionnaire, the Cognitive Emotion Regulation Questionnaire (CERQ), the Millon-3 Clinical Multi-Axis Questionnaire (MCMI-III), and the DTS Distress Tolerance Questionnaire. To analyze the statistical data, the Pearson correlation coefficient method was used by SPSS software version 16, and to determine the fit of the studied model, the structural equation model in AMOS-22 software was used to analyze the path of observable variables.
    Results
    The present study’s findings showed that the childhood physical abuse in the final model indirectly affected nurses’ APD through the adaptive/maladaptive styles of cognitive emotion regulation. Thus, with increased childhood physical abuse, the rate of adaptive cognitive emotion regulation styles of nurses decreased and the rate of maladaptive cognitive emotion regulation styles increased; as a result, their avoidant personality disorder increased.
    Conclusion
    The present study results showed that nurses who were abused or mistreated during childhood were more likely to display signs of APD in their adulthood.
    Keywords: Avoidant personality disorder, Child abuse, Distress Tolerance, Emotion regulation, Personality Disorder
  • Tooba Kazemi, Bita Bijari *, MohammadReza Abedini, Hamid Azadmehr Pages 308-313
    Background

    Obesity is one of the most public health challenges in the 21st century, which has increased in most countries during the last decade. This study aimed to determine factors affecting the prevalence of obesity, overweight, and central obesity among urban adults referred to Birjand health centers in 2017.

    Methods

    In this cross-sectional study, we investigated the data of all individuals who were registered in the Integrated health application system of Birjand (SIB) from April 2016 until March 2017 by census method. A checklist was designed to include the participants’ demographic characteristics, weight, height, and waist circumference. After coordinating with the health department of Birjand University of Medical Sciences, the authors logged in to the SIB system, collected and entered the data into the checklist. Then, the authors analyzed data using chi-square, independent sample T-test, and ANOVA tests by SPSS-22 software.

    Results

    In the present study, 10,000 people participated. Their average age was of 44.3±11.8 years. The majority were females 7190 (71.9%) out of which 4827 (48.3%)were in the age group of 30 to 40 years old. The prevalence of overweight, obesity, and central obesity in urban adults who registered in the SIB system in Birjand was 3539 (35.4%), 1968 (19.7%), and 4847 (48.5%), respectively. These features for women were significantly higher than men in all age groups.

    Conclusion

    These findings revealed that obesity and abdominal obesity were high in urban adults in Birjand, which requires immediate intervention to improve the obesity status.

    Keywords: Abdominal obesity, adult, Obesity, Overweight
  • Ahmad Baleshzar, Zeinab Rasouli Kahaki *, Zahra Rojhani Pages 314-321
    Background
    Productivity plays a fundamental role in the global economy. Human resources are the most important factor, causing an increase or decrease in the productivity of an organization. Ergonomics is the scientific theory that studies the relationship between individuals and other elements of a system and the profession applies theories, principles, evidence, and methods to design to optimize human well-being and productivity of the organization. This study aims to investigate the effects of ergonomic features and anxiety on the productivity of office workers.
    Methods
    In this descriptive-analytical cross-sectional study, 176 office workers (133 female and 43 male) of a university with three years of work experience were randomly selected. Data collection tools included demographic surveys, an inspection checklist, Rapid Upper Limb Assessment (RULA) checklist, the productivity measurement questionnaire, and Beck anxiety inventory.
    Results
    The study results showed that 70% of workstations need to be changed through ergonomic interventions and changes. According to the results obtained from the linear regression model between productivity and working posture, anxiety, and work environmental factors, there is a positive relationship between working environment conditions and productivity (P=0.002).
    Conclusion
    The main contribution of this research is that productivity should receive attention through changing working environment. The chairs are a vital element of an ergonomic and productive work office
    Keywords: Anxiety, Ergonomics, Office workers, Posture, Productivity
  • Mehdi Ahmadian, Mohsen Ebrahimi * Pages 322-327
    Background
    Several studies have investigated supplement and drug use prevalence among elite athletes. However, nonelite athletes who exercise in gyms to improve their health and appearance have received less attention. The present study aimed to evaluate the prevalence of supplement use in recreational athletes in Fars, Iran.
    Methods
    In this cross-sectional study, 256 recreational athletes (165 men and 91 women, mean age 28.67±7.28) completed the questionnaire (researcher-made), and the differential validity was estimated by the comparison of novice and elite athletes using the Kruskal-Wallis test. Moreover, the reliability of the instrument was confirmed based on internal consistency (Cronbach’s alpha) and stability (repeatability) using test-retest (correlationcoefficient of the test scores). Data analysis was performed using descriptive statistics.
    Results
    In this study, 84% of the participants used various supplements, and 54% consumed performance-enhancing and occasional drugs. The most common supplements were multivitamins (77.7%), protein powders (69.1%), fish oil (47.9%), and vitamin D (39.9%). According to the findings, 46.8% of the subjects consumed supplements to improve their physical appearance, while 21.8% used these substances to enhance their health. Meanwhile, 62.2% of the athletes considered themselves fit (not obese/lean), while 31.1% and 33.3% tended to lose weight and slightly gain weight, respectively.
    Conclusion
    According to the results, the rate of consuming supplements, weight loss drugs, occasional drugs, and performance-enhancing drugs was high in the recreational athletes in Fars province, which indicated the necessity of more control and attention to the prevention of excess supplement use and raising awareness in this regard.
    Keywords: Recreational drug use, prevalence, Doping in sports, Drug, Supplementation
  • Masoud Sayadi Shahraki, Bahareh Sadat Abtahi Naeen, Amin Asefi, Mahdi Rafie, Shima Sefiddashti, Milad Nazari Sabet * Pages 328-333
    Background
    Hand dermatitis is a group of diseases that result in inflammation of the skin in the area of the hand. The prevalence of latex allergies has been increasing in recent years, one of the reasons being the use of latex gloves to maintain safety. This study aimed to evaluate the effect of wearing cotton-polyester gloves under surgical latex gloves to improve the symptoms.
    Methods
    This study is a randomized controlled clinical trial performed in Alzahra and Ayatollah Kashani hospitals in Isfahan. The statistical population consisted of the staff of the surgery room. Sampling was done by the census from October 2018 to March 2019. Cotton-polyester gloves (weight between 5–10 grams, 50% cotton and 50% polyester) are soft and flexible and easily absorb the sweat- under latex gloves. Also, it can be re-sterilized with ethylene oxide. In rupture of surgical gloves due to strong and integrated stitching, the cotton-polyester gloves prevent hand burns with electrocautery or damage by sharp objects. These gloves were distributed and used among the samples for 6 months.
    Results
    Data were analyzed based on symptoms of erythema, appearance, economic burden, and disruption in daily life; there was a significant relationship between lack of using cottonpolyester gloves under the surgical gloves compared to when using them (P<0.01). However, there was no significant relationship between pain and disorder in social relations (P>0.01).
    Conclusion
    Using cotton-polyester gloves under surgical latex gloves can improve the symptoms of dermatitis. On the other hand, the use of these gloves will not interfere with the function of the hands.
    Keywords: Dermatitis, LaTex, Gloves, Cotton-polyester
  • MohammadHassan Minooeianhaghighi, Alireza Mohammadzadeh, Fatemeh Khani, Roya Peirovi-Minaee *, Milad Mokhtarzade, Javad Bagheri Pages 334-341
    Background

    Mosques are known as a gathering place and a center of worship for Muslims. The present study aimed to investigate the environmental health status and fungal and bacterial contamination of mosques in Gonabad, Iran.

    Methods

    This analytic-cross sectional study assessed the environmental health status of mosques using the relevant regulations. The sterile carpet sampling method and the sterile swap were used to take the samples of the surfaces. Standard methods were used to determine fungal and bacterial contamination. Overall, 67 samples were taken from the surfaces of doors, windows, and carpets. Data were analyzed at a significance level of 0.05.

    Results

    Data analysis indicated that the environmental health status of mosques was acceptable. None of the dermatophyte fungal colonies grew on the plates which contained Sabouraud agar with cycloheximide and chloramphenicol (SCC) during incubation of primary culture media. Aspergillus niger was detected in all mosques and on all surfaces. Frequency and percentage of Aspergillus niger were 18 (48.67%) and 6 (16.23) for Mucor. In the case of bacterial contamination, Coagulasenegative staphylococci with the highest percentage (38.46%) and Staphylococcus aureus, Klebsiella, and Escherichia coli, each with 3.84%, were the lowest types of detected bacteria, respectively. The most fungal and bacterial contamination was detected in the carpets.

    Conclusion

    According to the results, it is essential to pay attention to the environmental health of the mosques and personal hygiene that requires the implementation of new programs and rules to increase the health awareness of worshipers and mosque servants to prevent the spread of fungal and bacterial infections.

    Keywords: Bacterial Contamination, Fungal count, Health, Surfaces
  • Rita Rezaee, Sahar Zare, Fatemeh Niknam, Ali Akbari, Mohammad Shirdeli *, Farshad Falahati, Saeed Aghajani Pages 342-350
    Background
    A variety of clinical and administrative employees form a complicated communication network which makes various conflicts and contradictions possible in hospitals. This highlights the significant impact of internal communication in directing healthcare centers as one of the manager’s duties. Although improving hospital management is key to improvement of the healthcare delivery, few studies have been conducted to address internal communication as one of the main management tasks in hospitals. The current study aimed to determine the contributing factors influencing internal communication based on hospital managers and healthcare personnel’s points of view.
    Methods
    A qualitative study utilizing a content analysis approach was performed. A purposive sampling method was recruited and twenty hospital managers and healthcare staff in Shiraz University of Medical Sciences participated in the study. Semi-structured interviews with open-ended questions were conducted. Data were analyzed using thematic analysis by MAXQDA version 10.
    Results
    Eight managers and twelve healthcare staff including eleven male and nine female subjects participated in the study. Three main themes were discerned: namely “personal factors”, “technical factors”, and “organizational and structural factors”. The participants placed the most emphasis on leadership and new technologies as the influential subthemes.
    Conclusion
    Many factors can affect internal communication, some of which depend mostly on managers to be applied effectively in the hospitals and some on healthcare staff. The identified factors help the managers and staff to recognize how their internal communication can be impressed by these factors and how they can create effective internal communications.
    Keywords: Communication, Health Personnel, leadership, Hospitals, Qualitative research
  • Maryam Nikbina *, Zahra Pajohideh Pages 351-357
    Background
    Overall, women make up a third of the world’s workforce. With the heavy increase in the number of working women, marital dissatisfaction will also increase. While the strength of the marital relationship without having satisfactory sex is in jeopardy, paying attention to sexual satisfaction is an essential part of healthcare standards; it is also part of sexual health in women. The present study aimed to determine the relationship between the of job and sexual function and satisfaction in Ahwaz city.
    Methods
    The is a descriptive-analytic cross-sectional study. The sampling was done through random-convenience method on 685 women who referred to the health centers and hospital in Ahwaz (137 housewives and 548 employees in educational, health, medical, and administrative and service sectors) and had the inclusion criteria. A three-part questionnaire was used which included questions on a) personal characteristics including age, occupation type, years past from marriage, the number of children, age of youngest child, age of spouse and preventing pregnancy, b) Female Sexual Function Index (FSFI), and c) Larson Sexual Satisfaction Questionnaire.
    Results
    There was a significant relationship between the type of job with lubrication, satisfaction, intercourse pain, total sexual function, and sexual satisfaction scores.
    Conclusion
    According to the results of the study, it seems that there is an relationship between the type of job with lubrication, satisfaction, intercourse pain, total sexual function and sexual satisfaction scores (P=0.4); due to increase in the number of employed women, the detecting and solving of sexual dysfunctions have a significant effect on improving the quality of marital relationships, which is an important step in order to prevent family disputes and its consequences.
    Keywords: Sexual activity, Sexual Satisfaction, Job type
  • Reza Tavakkol, Ashkan Karimi, Armin Fereidouni, Azadeh Amiri *, Ebrahim Nazari Far Pages 358-364
    Background
    Coping strategies depend to a large extent on stressors, individual experiences, severity, and characteristics of the stressors. In general, it seems that the risk of physical and mental health problems in stressful situations increases if people do not use coping mechanisms.
    Methods
    This is an observational cross-sectional study of analytical and descriptive type performed on 192 operating room staff at 7 hospitals affiliated to Shiraz University of Medical Sciences. The data were collected through "Ways of Coping Questionnaire (Folkman and Lazarus)", "General Health", and "Lifestyle" questionnaires. SPSS software version 20 was then used to analyze the data.
    Results
    The analysis of the results revealed that the total mean scores of lifestyle and mental health were reported to be 333±42.91 and 39.24±39.24, respectively. Also, the mean total scores of the emotion-focused problem-focused style were equal to 100.16±13.90 and 104.38±14.89, respectively. There was a significant relationship between gender and work experience in the emotion-focused coping style (P<0.05). There was also a direct relationship between lifestyle and coping strategies in the operating room staff, and that the relationship was significant (P<0.05).
    Conclusion
    Due to the high level of stress among the operating room staff and also the relationship between coping strategies and gender, it seems quintessential that operating room staff should take measures to avert and reduce staff stress. Furthermore, given the use of various coping strategies in stressful situations by operating room staff, it appears necessary to train the people living in that specific society to use effective coping techniques.
    Keywords: Health, Mental health, Operating room nursing, Coping strategies, Nurse
  • Zahra Jorjoran Shushtari, Marzieh Shirazikhah, Sina Ahmadi, Yahya Salimi, Akbar Biglarian, Ali Almasi, Toktam Paykani * Pages 365-375
    Background
    Iran, after China, emerged as one of the first COVID-19 epidemic countries. Despite all efforts to interrupt new transmission chains, the virus continued to quickly spread across the country. WHO has highlighted a crucial role for social factors and intersectoral collaboration to tackle COVID-19. This study aimed to identify challenges related to the upstream determinants and downstream risk factors of COVID-19 infection in Iran as perceived by health professionals at different levels of service administration.
    Methods
    We conducted a qualitative study in October 2020. A directed qualitative content analysis was done to explore the views of health professionals and administrators toward determinants of COVID-19 infection in Iran. Using a deductive approach, we tested the implications of the WHO Commission on the Social Determinants of Health (CSDH) framework regarding COVID-19.
    Results
    The determinants of COVID-19 infection in Iran are referred to as: 1) upstream social determinants, including political considerations in dealing with COVID-19, conflicting authority structures between and within organizations and sectors, poor intersectoral collaboration, unstable macroeconomic environment, pandemic crisis management, poor governance in the health system, cultural and societal values, trust and social capital, and individuals’ socioeconomic status; and 2) downstream risk factors, including poor health literacy, poor compliance with COVID-19 prevention guidelines, secrecy related to the infection, individual’s health status, lifestyle, and virus characteristics.
    Conclusion
    It is essential to motivate people to practice preventive COVID-19 infection behaviors. To change the behavior at the population level, a complex fusion of policy and practice, and dealing with the complexity of structural determinants and downstream risk factors are needed.
    Keywords: COVID-19, Iran, Intersectoral collaboration, Social Determinants of Health, Health professionals
  • Mohammad Khammarnia *, Seyed Mohammad Hashemi-Shahri, Alireza Ansari-Moghaddam, Seyed Mehdi Tabatabaei, Ali Naghizadeh, Mohammadhadi Abbasi, Seyed Mohammad Nasiruddin Tabatabaei, Fatemeh Setoodehzadeh, Mehdi Zangane Bayegi, Majid Sartipi Pages 376-379
    Background

    COVID-19 has become a global problem. In this case study, the experiences gained from disease control in rural areas are reported.

    Methods

    An observational study was done in 2020 in Sistan and Balochestan, the largest province with most rural areas in the southeast of Iran.

    Results

    After identification of the first patient of Covid-19 in a rural area, three measures were taken including: 1. Diagnosis, screening and treatment of the disease (Incident command post was established and the village was completely quarantined, etc.; 2. Intersectoral coordination for epidemiological management (limiting traffic for people and any gathering); and 3. Identification of any Covid-19 positive cases. The results of these measures showed that after quarantining the village and performing the mentioned actions, the number of patients decreased, and the disease was controlled.

    Conclusion

    Quarantine of the contaminated rural area and people’s traffic routes is one of the most important measures in controlling Covid-19.

    Keywords: Rural health, COVID-19, Quarantine, Intersectoral collaboration
  • Alireza Nematollahi, Shadi Zamansaraei *, Farima Safari, Parvin Bahrami Pages 380-387
    Background

    Ebstein’s anomaly (EA) is a congenital heart defect that causes cyanosis and arrhythmia. The treating physician has difficulty when it comes to pregnant women since patients frequently reach reproductive age. How to manage these patients during pregnancy or approach patients who are planning to become pregnant is an important issue. The aim of this study was to evaluate previous and current literature reviews, as well as case studies, to better understand how to treat Ebstein’s abnormality in pregnancy.

    Methods

    This study is a literature review with case report. Here, we review the literature on this subject to discuss how to manage Ebstein’s anomaly in pregnancy. We analyzed the literature from different perspectives. We also focused on three of Ebstein’s anomaly-affected women’s pregnancies.

    Results

    Three women had four pregnancies, all of which were delivered vaginally or through cesarean section. There were no preterm births. 2.540.88 kg was the average birth weight. There were no cardiac abnormalities in any of the three infants. One patient had Ebstein’s abnormality and congenitally corrected transposition of the great arteries (ccTGA).

    Conclusion

    In Ebstein’s abnormality, pregnancy is often well tolerated. However, the maternal risks of pregnancy correlated with the severity of anatomical malformations and the presence of cyanosis or simultaneous other cardiac anomalies.

    Keywords: Ebstein’s anomaly, Pregnancy, Congenital heart defect, Cardiovascular abnormality, Cardiovascular disease
  • EhsanAllah Kalteh, Abdurrahman Charkazi, Golshirin Yatimparvar, Mousa Ghelichi-Ghojogh, Abdolaziz Ghezel Pages 388-389