The Effect of the COVID-19 Pandemic on Environmental Health (Two Sides of the Same Coin): A Systematic Review.

BACKGROUND: The outbreak of the COVID-19 pandemic in late 2019 has led to many changes such as reduced human activities and effects on the environment. There is no big picture of the effects of pandemics on the environment using related evidence. OBJECTIVES: This study was conducted to investigate the effect of the COVID-19 pandemic on environmental health. METHODS: A systematic search of English language studies was performed in major electronic databases; Web of Science, PubMed, Scopus, and Google scholar web search engine from December 2019 to February 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard guidelines were used to follow up the review process. finally 58 articles entered the review procedure. RESULTS: The results of indicate a significant reduction of air pollutants and improved air quality. It improved the water quality of some rivers, canals, and seas during the lockdown of the COVID-19 pandemic. The effects of this disease on the environment cannot be fully described yet. CONCLUSION: In the short term, the amount of air, water, and coastal pollution has been reduced. few studies have examined the effects of pandemics on the environment in the long run, which paves the way for more researches.

Experiences and challenges of nursing education in response to the COVID-19 pandemic: A qualitative study in Iran.

BACKGROUND: The preparedness of nurses in the COVID-19 pandemic, will be of great importance when it comes to the unknown future of the pandemic and other similar ones. Identifying their problems can lead to better planning, preparation, and management. This study aims to explore Iranian nurses' experience of their preparedness challenges to give an effective response to the pandemic. MATERIALS AND METHODS: A qualitative content analysis approach using semi-structured interviews was employed to explore nurses' preparedness experiences. 28 nurses were interviewed, after transcription of the interviews, a content analysis using constant comparison was performed for data analysis based on Graneheim and Lundman approach. RESULTS: The results of the study can be summarized in 6 main categories and 14 subcategories, such as the necessity of continuing educational workshops, the necessity of holding exercises in the same environment, the importance of familiarity with the pandemic, the importance of educating all those involved in providing services in the pandemic, the need for providing immersive education for the pandemic and the need for planning and practice concerning the pandemic. CONCLUSION: When nurses receive more support, they can have their best performance. up-to-date training can prepare nurses more effectively, which will, in turn, make prepared nurses available, maximize their efficiency, and minimize their adverse mental consequences. Nurse managers may support nurses and increase hospital resilience in such emergencies. Nurses indicated some issues including managers' support, workplace culture, education, physical space, access to PPE, and willingness to provide the best care. These findings can be helpful in the management of the pandemic and preparing nurses as a large group of healthcare workers. Necessary training, along with the provision of adequate resources, should be programmed to support this effective group of health providers.

Challenges to manage pandemic of coronavirus disease (COVID-19) in Iran with a special situation: a qualitative multi-method study.

BACKGROUND: With the unprecedented expansion of COVID-19 in the world since December 2019, Iran's health system, like other countries, faced various challenges in managing the disease, which led to numerous experiences and lessons learned. This study was conducted to identify these challenges regarding unique political, economic, and cultural issues, which could help other countries with similar situations. METHODS: The present study was performed using a qualitative multi-method approach with a content analysis method. The data were collected through in-depth and semi-structured interviews and focused group discussions with 60 key persons who were selected purposefully, including policymakers, health care workers, and affected people by the disease, and the review of all available national reports between February 21, 2020, and March 22, 2021. The data collection and analysis were done simultaneously. RESULTS: Identified critical challenges for the management of COVID-19 in the health system were limited evidence and scientific controversies, poor social prevention and social inequalities, burnout and sustained workload among healthcare workers, improper management of resources and equipment, the lack of a guideline for contact tracing, and patient flow management, and mental health problems in the community. CONCLUSIONS: According to our results, measures should be taken to conduct a continuous comprehensive risk assessment and develop a national response plan with an emphasis on precise contact tracing, active screening, patient flow, paying attention to the psychological and social dimensions of the disease, and also transparency of social inequalities in the face of risk factors of the COVID-19. Also, the social protection programs should become a vital tool for policymakers and supporting the vulnerable groups using the capacity of the community and international cooperation to develop a vaccine, which is difficult to procure due to the sanctions.

Coronavirus disease-2019 risk management using strengths, weaknesses, opportunities, threats analysis approach in the health system: A qualitative multimethod study.

BACKGROUND: Utilizing the successful experiences of countries and local regions can be useful in the management and control of coronavirus disease-2019 (COVID-19), so the research team aims to determine and extract the strengths, weaknesses, opportunities, and threats of the health system in the risk management of COVID-19 using strengths, weaknesses, opportunities, threats (SWOT) analytical approach. MATERIALS AND METHODS: This study was performed by a qualitative multimethod approach. In addition to reviewing the minutes of meetings and approvals of the Provincial Anti-Corona Headquarters, focused group meetings and in-depth semi-structured individual interviews were conducted. The results were extracted based on the SWOT analytical approach in the form of strengths, weaknesses, opportunities, and threats of the health system and then based on the SWOT matrix, the necessary strategies were identified. RESULTS: In the necessary strategies, based on SWOT matrix in SO strategies: SO1, formation of regional health assessment teams; SO2, promotion of preparedness, resilience, and effective response; SO3, activation of research and training centers; SO4, integrated management, supervision, and coordination; in WO strategies: WO1, analysis and COVID-19 risk monitoring; WO2, communication and risk information management; WO3, people-based management; and WO4, activation of local economic institutions and manufacturing centers; in ST: ST1, comprehensive care system strategies; and ST2, enhancing social trust with a transparency approach; and finally in WT strategies; WT1, stress management; and WT2, specific financial system design for disaster management were identified. CONCLUSION: Now, for the prevention and control of this disease, the need of empathy and participation of all human societies is felt more than anything else. These experience and analysis are based on the SWOT approach for the health system to be able to provide solutions and practical points that can be used by stakeholders.

Hospital Disaster Preparedness in Iran: A Systematic Review and Meta-Analysis.

BACKGROUND: Disasters are increasing all over the world. Iran, is one of the high-risk countries in this regard; so it is unavoidable to prepare hospitals as vital centers when disasters happen. This study aimed to evaluation the hospital preparedness based on previous studies in Iran. METHODS: A systematic review and meta-analysis by browsing through all articles published since 2006 to 2017, in English and Persian both languages were designed. Databases that we searched to, include Google Scholar, PubMed, Web of Science, Scopus, Medlib, Cochrane Library, Science Direct, Internationally and SID, Irandoc and Magiran, domestically. Two expert researchers investigated separately. Researchers used random and fixed effect models in the meta-analysis. Moreover, random and fixed effects model and meta-regression tests were applied by using STATA ver. 11. The P<0.05 was considered statistically significant. RESULTS: Twenty-five studies with a sample size of 181 hospitals were introduced to the process of meta-analysis. Iranian hospital preparedness is 53%, totally, that is moderate. Preparedness in different categories is as follows: emergency services 62%, communication 57%, security 54%, education 57%, logistic 65%, human resources 52%, Management and command 64%, reception 43%, transfer and evacuation 44%, traffic 47%, non-structural safety 57%, and structural safety 49%. CONCLUSION: Hospital preparedness is moderate in Iran. Optimal management of existing resources and the use of Update technologies in the field of hospital services be directed towards improving the preparedness of hospitals for disasters.

The association between air pollution and cancers: controversial evidence of a systematic review.

There are inconsistent reports on the association between air pollution and cancers. This systematic review was, therefore, conducted to ascertain the relationship between air pollution and some cancers. This is a systematic review study, which all articles published in this area were extracted from January 1, 1950 to December 31, 2018 from Web of Science, PubMed, Scopus, Cochrane Library, MEDLINE, EMBASE, Science Direct, Google scholar. Searching was performed independently by two search-method experts. The required data were extracted from the articles by an author-made questionnaire. Forty-eight articles were investigated. Evidence linking air pollution to some cancers is limited. Leukemia had the highest association with exposure to various air pollutants and bladder cancer had the lowest association. It is noteworthy that the specific type of pollutants in all studies was not specified. Based on the findings, the results are contradictory, and the role of air pollution in some cancers cannot be supported. Accordingly, studies are recommended to be performed at the individual level or multifactorial studies to specifically investigate the relationship between air pollution and these types of cancers. In this way, the role of air pollution in the incidence of these cancers can be determined more accurately.

The simultaneous effects of thermal stress and air pollution on body temperature of Tehran traffic officers.

PURPOSE: Global warming and air pollution are among the most important problems all over the world. Considering the key role of traffic officers who saliently deal with traffic management and are in full, constant and direct exposure to thermal stress and air pollution index, this study aims to investigate the simultaneous effects of these factors on the body temperature of traffic officers in the main squares of Tehran. METHODS: This study was conducted among 119 traffic officers who were working in 29 squares of Tehran, located near the active pollutant's stations during 2017. Samples were selected by the census method. Environmental parameters such as air temperature (dry and wet), radiation temperature, the level of air pollution in the main squares and characteristics of officers such as body temperature and the Wet-Bulb-Globe-Temperature (WBGT) index were evaluated. Data were analyzed through independent samples t-test and factorial ANOVA with a p value of p ≤ 0.05 in SPSS software. RESULTS: There was no significant relationship between air pollution and ear temperature, but there was a statistically significant difference between the wet-bulb temperature and the ear temperature (t = 26.4, P < 0.001). The interaction effect of air pollution and wet-bulb temperature on the ear temperature was also significant (F = 3.98, P = 0.048). CONCLUSION: Exposure to heat and air pollution affects body temperature, with its greatest impact on the temperature of the ear. More studies are recommended to be conducted in these field and other factors such as demographic and environmental factors at different times of the year should be investigated. Accordingly, some interventions should be implemented to reduce the vulnerability of officers based on the findings of the research.

Comparing the effects of two different educational methods on clinical skills of emergency intermediate technician: A quasi-experimental research.

BACKGROUND: Assessing the clinical skills of prehospital Intermediate technician is considered to be one of the priorities in dealing with diseases, which may provide an appropriate reflection of the training programs. The purpose of this study was to compare the two methods of clinical skills training of emergency intermediate technician. METHODS: This quasi-experiment was carried out on Kerman's emergency medical technicians in 2017. Operational and clinical skills, such as cardiopulmonary resuscitation (CPR), triage, familiarity with the equipment, and proper patient transportation methods, were taught in both electronic and traditional methods on two groups, each consisting of 30 intermediate technicians. Finally, the personnel's satisfaction level with the two teaching methods was compared and analyzed using IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. RESULTS: There was no significant difference between the theoretical test scores in both the electronic and traditional methods in all the participants (triage, pulmonary resuscitation, familiarity with equipment, and patient transportation). Furthermore, there were significant differences between the practical test scores in both the electronic and traditional methods, in all the participants except triage. There was a significant difference between learners' satisfaction in both electronic and traditional methods in two areas of teaching and course difficulty in CPR, equipment usage, and methods of transportation. CONCLUSION: According to the results obtained by the present study, the electronic educational systems due to their inclusive and interactive nature are recommended to be employed in courses that have more theoretical aspects such as triage. The traditional method is suggested in teaching practical courses such as CPR that need more practical and clinical skills.

A comprehensive evaluation of the association between ambient air pollution and adverse health outcomes of major organ systems: a systematic review with a worldwide approach.

Ambient air pollution is nowadays one of the most crucial contributors to deteriorating health status worldwide. The components of air pollution include PM2.5 and PM10, NO2, SO2, CO, O3, and organic compounds. They are attributed to several health outcomes, for instance, cardiovascular diseases (CVD), respiratory diseases, birth outcomes, neurologic diseases, and psychiatric diseases. The objective of this study is to evaluate the association between different ambient air pollutants and the above-mentioned health outcomes. In this systematic review, a total of 76 articles was ultimately selected from 2653 articles, through multiple screening steps by the aid of a set of exclusion criteria as non-English articles, indoor air pollution assessment, work-related, occupational and home-attributed pollution, animal studies, tobacco smoking effects, letters to editors, commentaries, animal experiments, reviews, case reports and case series, out of 19,862 published articles through a systematic search in PubMed, Web of Science, and Scopus. Then, the associations between air pollution and different health outcomes were measured as relative risks and odds ratios. The association between air pollutants, PM2.5 and PM10, NO2, SO2, CO, O3, and VOC with major organ systems health was investigated through the gathered studies. Relative risks and/or odds ratios attributed to each air pollutant/outcome were ultimately reported. In this study, a thorough and comprehensive discussion of all aspects of the contribution of ambient air pollutants in health outcomes was proposed. To our knowledge up to now, there is no such comprehensive outlook on this issue. Growing concerns in concert with air pollution-induced health risks impose a great danger on the life of billions of people worldwide. Should we propose ideas and schemes to reduce ambient air pollutant, there will be dramatic reductions in the prevalence and occurrence of health-threatening conditions.

Behavioral, Normative and Control Beliefs about Earthquake Preparedness: A Deductive Content Analysis Study.

INTRODUCTION: Despite efforts to increase earthquake preparedness (EP), the level of earthquake preparedness in Tehran is low, even when people acknowledge the risk they face. This problem has its roots in the beliefs of Tehran inhabitants about EP. This study is aimed to elicit the salient beliefs about earthquake preparedness among Tehran citizens. METHOD: This is a deductive content analysis research. The theory of planned behavior (TPB) has been applied as the theoretical framework of the study. 132 semi-structured interviews have been conducted with Tehran heads of households and the obtained data have been analyzed. RESULTS: The interviews showed that the belief in the usefulness of the EP and the belief that "the EP can cause anxiety among family members" were the salient behavioral beliefs (the ones influencing the attitude towards a behavior). The main normative belief (which influences the subjective norms), was "my family doesn't disagree with the EP" although most of the interviewees did not know about their families' views. Finally, the main control belief (which is the basis of perceived behavioral control), was that "education can facitilates EP". CONCLUSION:  Tehran inhabitants preparedness behaviors can be influenced by their behavioral, normative and control beliefs about preparedness. Recognition of these beliefs may assist policy makers and executives to develop a better understanding of the origins of the preparedness behaviors. Any interventions to change these behaviors should be made based on such knowledge. Key words: Earthquake; preparedness; salient beliefs; theory of planned behavior.

Nurse in limbo: A qualitative study of nursing in disasters in Iranian context.

BACKGROUND: An understanding of nurses' experiences in disasters can help to identify their problems in this area. These can be overcome with better planning and preparation. The aim of this study was to explore the experiences and perceptions of disaster nurses regarding their provision of disaster health care services. METHODS: This was a qualitative study using an inductive qualitative content analysis. Participants included 15 Iranian nurses who had experiences of health care delivery in disasters. A purposeful sampling was applied until data saturation was reached. Data were collected using semi-structured interviews and then analyzed based on the principle of inductive content analysis. RESULTS: Five main categories emerged from the experiences and perceptions of nurses who were involved in providing health care services in disasters: afraid of probability of recurrence, necessity of providing healthcare services for an unknown period of time, challenge of what to prioritize, nurses' own conflicting emotions, and their concern for their own families. DISCUSSION: There are several factors affecting the delivery of healthcare in disasters. Nurses, who feel better prepared and have some understanding of the ethical implications of working under different standards of care, may be more comfortable with care giving in disasters. Appropriately, training and preparing nurses for disasters is important for optimizing the safe functioning and minimizing emotional and psychological damage.

Nursing in disasters: A review of existing models.

BACKGROUND: Since nurses play an important role in responding to disasters, evaluating their knowledge on common patterns of disasters is a necessity. This study examined researches conducted using disaster nursing as well as the models adopted. It provides a critical analysis of the models available for disaster nursing. METHODS: International electronic databases including Scopus, PubMed, ISI Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health (CINAHL), and Google Scholar were investigated with no limitation on type of articles, between 1st January 1980 and 31st January 2016. The search terms and strategy were as follows: (Disaster∗ OR Emergenc∗) AND (Model OR Theory OR Package OR Pattern) AND (Nursing OR Nurse∗). They were applied for titles, abstracts and key words. This resulted in the generation of disaster nursing models. RESULTS: Out of the 1983 publications initially identified, the final analysis was conducted on 8 full text articles. These studies presented seven models. These evinced a diverse set of models with regard to the domains and the target population. CONCLUSIONS: Although, disaster nursing models will inform disaster risk reduction strategies, attempts to systematically do so are in preliminary phases. Further investigation is needed to develop a domestic nursing model in the event of disasters.