A systematic review of the effect of lavender on cancer complications

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Effect of Consultation and Follow-up Phone Calls on Biochemical Indicators and Intradialytic Weight Gain in Patients Undergoing Hemodialysis

Objectives: We sought to determine the effect of consultation and follow-up phone calls on biochemical indicators and intradialytic weight gain (IWG) in patients undergoing hemodialysis. Methods: We conducted a double-blind, randomized clinical trial of 86 patients undergoing hemodialysis in Iran. Patients were grouped through convenience sampling and randomly allocated into two groups. The experimental group had face-to-face consultations, and each patient was given a monthly diet. Next, over 12 weeks, we conducted 28 follow-up phone calls. In both groups, biochemical indicators and IWG were measured at baseline, and in the fourth, eighth, and twelfth weeks of the study. Results: The results showed that calcium and IWG indices in the fourth, eighth, and twelfth week, and phosphorus and potassium and IWG indices in the eighth and twelfth weeks had statistically significant differences between the experimental and control groups (p < 0.050). Conclusions: In our study, consultation and follow-up phone calls in hemodialysis patients result in improved biochemical indicators. Therefore, in patients undergoing hemodialysis, consultation and follow-up phone calls are recommended to improve patient’s biochemical indicators

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Psychometric properties of the Persian version of the Second Victim Experience and Support Instrument

Abstract Aim This study was designed to characterize the psychometric properties of the Persian version of the Second Victim Experience and Support Instrument (P‐SVEST). Design This study was a methodological and cross‐sectional study. Methods The SVEST was back‐translated into Persian and 10 experts assessed its content validity. Construct validity was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with a total of 754 critical care and emergency nurses. Results The results of exploratory factor analysis showed that the P‐SVEST had four factors. These four factors accounted for 51.67% of the total variance. Also, these factors were confirmed by confirmatory factor analysis (root mean square error of approximation = (90%. confidence interval) = 0.058 [0.045, 0.071], goodness‐of‐fit index = 0.932, comparative fit index = 0.956, non‐normal fit index = 0.918, incremental fit index = 0.957 and Tucker–Lewis index = 0.944). Coefficients of Cronbach's alpha, McDonald's omega, composite reliability and maximum reliability for all of the factors were >0.7, demonstrating satisfied internal consistency

Nursing Challenges in Motivating Nursing Students through Clinical Education: A Grounded Theory Study

Nurses are the first role models for students in clinical settings. They can have a significant role on students’ motivation. The purpose of this study was to explore the understanding of nursing students and instructors concerning the role of nurses in motivating nursing students through clinical education. The sampling was first started purposefully and continued with theoretical sampling. The study collected qualitative data through semistructured and interactive interviews with 16 nursing students and 4 nursing instructors. All interviews were recorded, transcribed, and analyzed using grounded theory approach. One important pattern emerged in this study was the “concerns of becoming a nurse,” which itself consisted of three categories: “nurses clinical competency,” “nurses as full-scale mirror of the future,” and “Monitoring and modeling through clinical education” (as the core variable). The findings showed that the nurses’ manners of performance as well as the profession’s prospect have a fundamental role in the process of formation of motivation through clinical education. Students find an insight into the nursing profession by substituting themselves in the place of a nurse, and as result, are or are not motivated towards the clinical education

مقایسه ی صحت تریاژ پرستاران و پزشکان با استفاده از شاخص وخامت اورژانس و عوامل مرتبط با آن : Accuracy of triage by nurses and physicians

Introduction: The correct triage of patients based on the severity of their situation can reduce the crowding of patients in the emergency department and reduce complications and mortality among patients. One of the important tools to check the accuracy of triage by nurses and physicians is the emergency severity index. &nbsp;This study was conducted with the aim of determining the accuracy of triage by nurses and physicians, using Emergency Severity Index and factors related to it, in patients referring to trauma emergency unit in Zanjan, Iran. Methods: This descriptive cross-sectional study was conducted on 378 patients who referred to the emergency department of a teaching hospital in 2019. The data collection tool was a questionnaire that consisted of demographic information and the Emergency Severity Index triage evaluation form. The data were analyzed using SPSS version 16 statistical software and chi-square/Fisher's exact test, and analysis of variance test. A significance level of less than 0.05 was considered. Results: The present study showed that nurses did 84.4% correct triage and physicians did 90.5% correct triage. Most errors were in the form of under-triage, the rate of which was 10.3% and 7.4% among nurses and physicians, respectively. Nurses had 18.6% triage error cases and physicians had 9.5% triage error cases (P&lt;0.05). There was a statistically significant difference in the accuracy of nurses' triage based on their work experience, retraining period, and the patient's waiting time before assignment (P&lt;0.05). However, the accuracy of physicians' triage did not show a statistically significant difference based on the demographic characteristics of physicians and patients (P&gt;0.05). Conclusion: &nbsp;In this study, under-triage was the most common triage error made by nurses and physicians. Health care workers should know that under-triage can have irreparable consequences for patients. Therefore, it is recommended to periodically hold trainings to update the knowledge of health care professionals regarding triage.مقدمه: تریاژ صحیح بیماران براساس وخامت حال بیماران می تواند باعث کاهش ازدحام بیماران در اورژانس و کاهش عوارض و مرگ و میر بیماران شود. یکی از ابزارهای مهم برای بررسی صحت تریاژ پرستاران و پزشکان، شاخص وخامت اورژانس است. این مطالعه باهدف بررسی صحت تریاژ پرستاران و پزشکان با استفاده از شاخص وخامت اورژانس و عوامل مرتبط با آن در بیماران مراجعه کننده به اورژانس تروما &nbsp;در زنجان، ایران انجام شد. روش مطالعه: این مطالعه به‌صورت توصیفی- مقطعی بر روی 378 نفر از بیماران مراجعه کننده به بخش اورژانس یکی از بیمارستان های آموزشی در سال 1398 انجام شد. ابزار جمع‌آوری اطلاعات، پرسشنامه مربوط به اطلاعات جمعیت شناختی، فرم پایش و ارزیابی ترياژ Emergency Severity Index &nbsp;بود. داده‌ها با استفاده از نرم افزار آماری spss &nbsp;ورژن16 و با استفاده آزمون‌های آماری کای اسکوئر/ آزمون دقیق فیشر، آزمون آنالیز واریانس مورد تجزیه و تحلیل قرار گرفت. سطح معنی‌داری کمتر از۰۵/۰ در نظر گرفته شد. یافته ها: نتایج این مطالعه نشان داد که پرستاران 4/84% تریاژ صحیح و پزشکان 5/90% تریاژ صحیح انجام دادند. بیشترین خطای پرستاران و پزشکان به صورت تریاژ سبک بود که به ترتیب برابر با 3/10% و 4/7% بود. پرستاران 6/18% خطای تریاژ داشتند و پزشکان 5/9% خطای تریاژ داشتند (P&lt;0/05). صحت تریاژ پرستاران بر حسب سابقه ی کار و دوره بازآموزی و مدت زمان انتظار بیمار تا تعیین تکلیف اختلاف معنادار آماری داشت (P&lt;0/05). اما صحت تریاژ پزشکان برحسب مشخصات جمعیت شناختی پزشکان و بیماران اختلاف معنادار آماری نشان نداد (P&gt;0/05). نتیجه‌گیری: در این مطالعه، خطای تریاژ پرستاران و پزشکان به صورت تریاژ سبک بود. کارکنان مراقبت سلامتی بایستی بدانند تریاژ سبک می تواند تبعات جبران ناپذیری برای بیماران به همراه داشته باشد. لذا توصیه می شود به طور دوره ای آموزش هایی برای روزآمد شدن دانش کارکنان مراقبت سلامتی در خصوص تریاژ برگزار شود

The Effect of Patient Safety Educational Program on Nurses' Patient Safety Culture and Patient Safety Indicators

The need to improve patient’s safety is to change the patient’s safety culture. This study was conducted to determine the effect of the patient safety education program on nurses’ patient safety culture and patient safety indicators. This single-blind clinical trial was conducted in two cardiac medical wards that were randomly selected as research settings among the hospital teaching wards of the Zanjan city in Zanjan. Twenty-six nurses participated in this study under in the experimental and control groups. The experimental group received the educational program for two sessions, and the control group received a booklet about patient safety. The nurses’ patient safety culture was assessed using the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire before and 3 months after intervention. The patient safety indicators were assessed 1400 times before and 3 months after intervention using a standard checklist by direct observation of all indicators (N = 100 for each). The results revealed that the patient safety educational program could improve some safety indicators, and overall perception of patient safety composite from safety culture, positively (P = 0.034). The patient safety indicators in pharmacological considerations (P =0.001), personal information considerations (P =0.001), and proper implementation of procedure considerations (P = 0.001) were significantly improved in the experimental group compared to the control group. It seems that changing the patient’s safety culture using educational program requires more training courses

The Impact of a Training Program Based on Learning Needs on Self-Care Behaviors among Patients with Heart Failure

Abstract Background: Heart failure necessitates self-care; therefore, self-care training should be based on learning needs (LNs) of patients. Aim: This study aimed to determine the impact of a training program based on learning needs on self-care behaviors among patients with heart failure Method: This clinical trial was performed on 73 patients suffering from heart failure in Zanjan teaching hospitals in 2015. The subjects were randomly divided into three groups (based on having LNs assessment and family involvement). The intervention group received education based on LNs and family involvement.   Control group 1 (without LNs assessment with family involvement), and control group 2 (without LNs assessment, and family involvement). The groups received three sessions of face-to-face training (lasting 15-20 minutes) on medical symptoms, necessary measures for the disease, diet, and medication regimen. Self-care behaviors before and 90 days after the intervention were evaluated using a self-care of heart failure index. To analyze the data, analysis of variance (ANOVA) and Bonferroni post-hoc test were used in SPSS, version 11. Results: The mean age of the participants was 65.5±14.1 years. According to the results of ANOVA, the total self-care score before the intervention was not significantly different among the three study groups (

COVID-19 Risk Perception and its Related Factors and Outcomes in Vulnerable Groups: A Systematic Review

Background: The COVID-19 disease has worse outcomes in individuals with underlying diseases and elderly individuals. Therefore, identifying COVID-19 risk perception and its related factors and outcomes in vulnerable groups is essential for the health system. Objectives: This study aimed to determine COVID-19 risk perception, its related factors, and outcomes in vulnerable groups (individuals with underlying diseases, smokers, opioid addicts, the elderly, and pregnant women). Methods: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was carried out using the keywords “Risk perception” and “COVID-19” in PubMed, Scopus, Science Direct, SID, Proquest, and Magiran databases in the period from 2019 to July 3, 2021. The quality of selected studies was checked by two authors independently according to Newcastle-Ottawa Scale adapted for cross-sectional. Results: In the initial search, 640 articles were found, of which 56 remained in the screening phase. Then, the full text of 56 articles was studied. Eventually, based on the inclusion and exclusion criteria of the articles, 8 articles were reviewed. This systematic review showed that suffering from an underlying disease, more anxiety, younger age, and female gender are associated with higher COVID-19 risk perception. The outcomes of COVID-19 risk perception were higher COVID-19 risk perception, delayed treatment sessions, increased anxiety and fear, increased ineffective safety behaviors, and greater compliance with health protocols. Conclusion: Creating sensitivity and proper COVID-19 risk perception is necessary to follow health protocols, but high COVID-19 risk perception can endanger vulnerable groups’ mental and physical health. Besides, reducing the sensitivity of vulnerable groups toward COVID-19 can expose them to the diseas