Suicide Death Rate after Disasters: A Meta-Analysis Study

Background Disasters have undesirable effects on health among individuals such as psychosocial disorders which may lead lead to suicide in some cases. Thus, the present study aimed to measure the rate of suicide death after disasters all over the world. Methods In the present meta-analysis study, all of the articles published in English until the end of 2019 were probed in electronic databases such as Web of Science, PubMed, Cochrane Library, Science Direct, PsycINFO, PsycARTICLES, and Google Scholar. Then, the data were imported to STATA ver.13 software and analyzed through fixed- and random-effects models, meta-regression, and Cochrane statistical tests. Results A total of 11 studies including a sample size of 65495867 were considered. Suicide death rates before and after the disasters were calculated as 13.61 (CI95: 11.59-15.77) vs. 16.68 (CI95: 14.5-19:0) among the whole population, 28.36 (CI 95:11.29-45.43) vs. 32.17 (CI95: 17.71-46.62) among men, and 12.71 (CI95: 5.98-19.44) vs 12.69 (CI95: 5.17-20.21) among women. The rate of suicide death significantly increased in the whole population and men, while no significant difference was reported among women. Conclusion Suicide death rate increases after disasters indicating the destructive impact of this phenomenon on peoples' health. Therefore, implementing supportive and interventional measures is highly suggested after disasters in order to prevent suicide death among the affected people

Decision-Making Challenges of Paramedics in Prehospital Emergency Care

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, O-2 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 electrocardiogram. 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

The challenges of health volunteers management in COVID19 pandemic in Iran

Purpose The use of volunteers is one of the approaches to capacity building, preparedness and the response of the health system in disasters. Appropriate management of volunteers during disasters and emergencies is essential. This study aimed to explain the challenges of volunteer management in the Pandemic COVID-19 in Iran. Design/methodology/approach Qualitative research was conducted using the content analysis based on the Graneheim method. The participants' selection was done based on purposeful sampling and theoretical sampling until data saturation. Direct field observation and 26 interviews were applied to collect data. Findings Four categories and 15 sub-categories emerged to describe the challenges of volunteer management during the COVID-19 crisis including policymaking barriers (including legal barriers, insurance and support coverage and risk governance), managerial barriers (including planning, coordinating and organizing, training and awareness, command and leadership and information management and documentation), socio-cultural barriers (personal safety attitude and culture, attitudes and expectations of the community and perspectives on volunteers) and executive-operational barriers (monitoring and evaluation, cost and needs assessment). Originality/value It is essential to increase managers', officials' and volunteers' perceptions of COVID19 risk through education and information. Preparing a database for volunteers' information, including non-governmental organization and governmental organization volunteers, planning for needs assessment, establishing a mechanism for recruiting volunteers and using their capacities and appropriate organizing, tracking and monitoring of volunteers can be among effective strategies

Challenges facing the health system in responding to mining accidents: The case of the zemestan-yurt mine explosion in iran (2017)

Background: 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. Materials and Methods: 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. Result: 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. Conclusions: 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 Author(s) 2021; All rights reserved. Published by Rafsanjan University of Medical Sciences Press

The prevalence of sexual violence during pregnancy in Iran and the world: a systematic review and meta-analysis

BACKGROUND: Domestic violence during pregnancy is a public health crisis, because it affects both mother and fetus simultaneously, resulting in irreversible consequences for mothers and their newborns. This study was performed to determine the prevalence of sexual violence during pregnancy in the world and Iran as meta-analysis. METHODS: This study is a meta-analysis on the prevalence of sexual violence during pregnancy in the world and Iran that was conductedon Persian and English published articles up to 2015. To this end, through searching the information by key words and their compounds at SID, Medlib, Irandoc, Google scholar, Pubmid, ISI, Iranmedex, Scopus and Magiran, all related articles were extracted independently by two trained researchers. The results of studies analyzed using the STATA and Spss 16 software. RESULTS: In the initial searching of 167 articles, 33 articles related to Iran, 40 articles related to other parts of the world and totally 73 articles met inclusion criteria for study. The prevalence of sexual violence during pregnancy were estimated in the world 17 (CI 95: 15 -18) and in Iran 28 (CI 95: 23-32). The prevalence of sexual violence during pregnancy in Iran is 11 percent more than the world. CONCLUSIONS: According to the present meta-analysis results, the prevalence of sexual violence during pregnancy in Iran is high. Given that sexual violence during pregnancy causes damage to the mother and infant, it is recommended that the relevant authorities with the implementation of intervention and educational programs reduce the prevalence of sexual violence during pregnancy

Challenges facing the health system in responding to mining accidents: The case of the zemestan-yurt mine explosion in iran (2017)

Background: 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. Materials and Methods: 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. Result: 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. Conclusions: 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 Author(s) 2021; All rights reserved. Published by Rafsanjan University of Medical Sciences Press