Effectiveness of interventions to promote pesticide safety and reduce pesticide exposure in agricultural health studies: A systematic review.

ObjectiveThere is a relationship between pesticide exposure and farmworkers' health. Well-conducted evaluations can provide an insight into how to develop and implement more effective interventions to prevent farmers and farmworkers' exposure to pesticides. This review aimed to summarize the literature on the effectiveness of interventions to promote pesticide safety and reduce pesticide exposure among farmers and farmworkers.MethodsA comprehensive search on PubMed, Embase, ISI Web of Science, Scopus, Science Direct, Agricola, NIOSHTIC, and Agris databases was performed to identify relevant studies published from 2000 to 2019. Randomized controlled trials (RCTs) and quasi-experimental studies assessing the effectiveness of interventions on a variety of outcomes related to pesticide exposure were considered. The searches were restricted to articles written in English. The methodological quality of included reviews was appraised using the Effective Public Health Practice Project quality assessment tool (EPHPP).ResultsThe initial search led to 47912 records, 31 studies of which including nine RCTs and twenty-two quasi-experimental studies met the criteria. The majority of the included studies focused on the educational/ behavioral approach. The studies that applied this approach were effective in improving the participants' knowledge and attitude; however, these interventions were less effective in terms of making changes in participants' behaviors and their risk of exposure to toxic pesticides. Multifaceted interventions were moderately effective in terms of improving farmers' and farmworkers' behaviors and reduction in exposure to toxic pesticides. We did not find any studies that had evaluated the effectiveness of engineering/technological, and legislation/enforcement interventions.ConclusionsAlthough the majority of studies were based on an educational/behavioral approach and did not assess the effect of interventions on objective measures, the results of this review highlight the significant effectiveness of educational programs and some potential key elements of these interventions. These findings may inform policymakers to develop interventions to reduce pesticide exposure among farmers and farmworkers

The comparison of the therapeutic effect of ischemic compression on upper trapezius trigger points in neutral and passive stretched positions in computer's operators

Introduction: Myofascial pain syndrome (MPS) is thought by some authors to be the main cause of neck and shoulder pain. MPS is characterized by myofascial trigger points (MTrPs). The aim of this study was to compare effects of ischemic compression (IC) in stretched & neutral position on the trigger points of trapezius muscle. Materials & Methods: Sixty computer’s operators with upper trapezius MTrP participated in this study. Subjects were divided randomly in two groups. Group1 that was treated with the IC in stretched position and group 2 that was treated with IC in neutral position of upper trapezius muscle. The local pain intensity , degree of active cervical lateral flexion ROM  and pain pressure threshold (PPT) were measured before intervention. Outcome measures were repeated within 5min and 3days after treatment. Statistical methods were kolmogorov-smirnov test, repeated measures ANOVA, independent T-test and Chi-square test. Results: The results showed a significant improvement in PPT, active cervical lateral flexion ROM and a significant decrease in the local pain intensity within each group. There was no significant difference between two groups. Conclusion: IC technique in stretched & neutral position was shown to be effective in increasing active cervical lateral flexion ROM, PPT and reducing pain intensity. IC technique in stretched position was more effective but difference between groups was not significant statistically. Key words: ischemic compression, stretching, trigger point, upper trapezius muscl

The effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick’s model

Background: Clinical experience associated with the fear and anxiety of nursing students in the psychiatric unit. Mental health nursing instructors find it challenging to teach nursing students to deal with patients with mental disorders in an environment where they need to provide patient teaching and clinical decision-making based on evidence and new technology. Objective: To measure the effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick’s model evaluation in the psychiatry unit of Imam Reza Hospital, Bojnurd, Iran. Methods: This cross-sectional study was carried out from 2011 to 2016 on 76 nursing students from a university as part of a clinical mental health course in two semesters. The students were selected by a non-probable convenient sampling method. After completing their clinical education, each student responded to checklist questions based on the four-level Kirkpatrick’s model evaluation and open questions relating to clinical supervision. Finally, all data was analyzed using the SPSS version 16. Results: The students have evaluated clinical supervision as a useful approach, and appreciated the instructor’s supportive behavior during teaching and imparting clinical skills. This has made them feel relaxed at the end of the clinical teaching course. In addition, in the evaluation through Kirkpatrick’s model, more than 70% of the students have been satisfied with the method of conducting the teaching and average score of nursing students’ attitude toward mental health students: Their mean self-confidence score was 18.33±1.69, and the mean score of their performance in the study was evaluated to be 93.74±5.3 from 100 points. Conclusion: The results of clinical mental health teaching through clinical supervision and Kirkpatrick’s model evaluation show that the satisfaction, self-esteem, attitude, and skill of nursing students are excellent, thereby portraying the effectiveness of clinical teaching. But this program still needs to be reformed. To establish longterm goals and obtain knowledge and clinical skills of nursing, it is recommended to develop a curriculum and evaluate it appropriately

Factors influencing the behavior of pregnant women towards using prenatal care services in Iranian healthcare centers

Background & aim: Care provision is one of the most important factors in preventing and reducing mortality among pregnant mothers. Despite availability, the uptake of health services in health centers is undesirable. This study aimed to investigate the factors influencing the behavior of pregnant women towards using prenatal care services based on health belief model in healthcare centers of Tuyserkan, Hamadan Province, Iran. Methods: In this descriptive, analytical, cross-sectional study, 165 mothers visiting the health care centers of Tuyserkan, Hamadan Province, Iran, 1-15 days postpartum were chosen using the convenient sampling method during 2015. A self-structured questionnaire comprising items on demographics, knowledge, and health belief model constructs was employed for data collection. The data were analyzed using Pearson correlation coefficient, independent t-test, and logistic regression. Results: The study revealed that 72.1% of the pregnant women had regular visits, while 27.9% had irregular visits. Logistic regression reflected that knowledge (OR=0.929) and self-efficacy (OR= 0.976) were effective variables on regular prenatal visits. Conclusion: Considering pregnant women's physiological and anatomical conditions, prenatal care and regular visits are essential; thus, effective interventions in this area should be planned and implemented

Comparison between the Impact of Video Instructions and Traditional Training on FBS Control in Type 2 Diabetics, Hamadan: A model based intervention

Background: Diabetes is a chronic progressive disorder that imposes negative effects on various aspects of an individual's life. This study was conducted to compare the effect of video instructions in comparison with traditional training on glucose control in type 2 diabetic patients of Hamadan. Methods: In this experimental study, 120 patients with type 2 diabetes who referred to diabetes center of Hamadan were divided into two groups: intervention and control. Data collection tool was a questionnaire based on health belief model completed by interviewing before, immediately after, and three months after the intervention. In addition, the serum levels of HbA1c were measured before and three months after the study. Intervention was conducted on three groups of 20 participants using video playback as well as question and answer sessions. Data were analyzed by SPSS21 using Friedman, Wilcoxon and Mann-Whitney tests. Results: This study revealed a significant difference in the median of knowledge, perceived threat, perceived benefits, and barriers in the intervention group immediately and three months after the intervention. HbA1c levels decreased after the intervention but this change was not significant. Three months after the intervention, in the intervention group both physicians and video were the most effective cues to action. Conclusion: Instructional videos for diabetes education can have a positive impact on healthy lifestyle in Patients with type 2 diabetes. It was concluded that decrease in HbA1c level needs longer intervention period; more than three months