Effects of Work-Related Stress on Work Ability Index among Iranian Workers

AbstractBackgroundWork Ability Index (WAI) is a well-known and valid self-report tool that has been widely used in various studies to identify and avoid early retirement and work-related disability. Nevertheless, very few studies have been carried out to evaluate work ability in Iran. We aimed to investigate the WAI and the effect of work-related stress on it among Iranian workers.MethodsA cross-sectional, descriptive and analytic study was carried out among 449 workers from five working sectors in three big cities of Iran. Work ability and work-related stress were measured using the Persian version of WAI and the Persian version of Health and Safety Executive Stress Indicator Tool.ResultsMore than a third of the workers surveyed (34.70%) did not have an appropriate level of work ability (WAI < 37). There was a significant correlation between subscales of work-related stress and the mean score of WAI. Furthermore, the variables of body mass index, sleep quality, exercise activity, job tenure, and three subscales of work-related stress including demands, supervisor support, and role were significant predictors of WAI.ConclusionAccording to the results of this study, the interventional programs must be focused on improving supervisors support, eliminating ambiguity and conflicts in the role of workers in their job and organization, reducing job demands, improving sleep quality, and increasing exercise activity

Necessary Indicators for Developing a Hazmat Response Team of the Iranian Health System

Introduction: Although some countries have set up predetermined programs and specialized teams to deal with hazardous materials (Hazmat) induced events, in other countries including Iran there are many weaknesses in this regard.&nbsp;Objective: We aimed to develop the necessary indicators for the formation of teams to deal with Hazmat accidents in the health system based on existing standards and resources as well as the indigenous conditions of Iran.&nbsp;Methods: This cross-sectional study was carried out in two stages from 2018 to 2020.&nbsp; In the first stage, the literature review was performed and the current guidelines, standards, and models presented in other countries were reviewed and related items were extracted. In the second stage, semi-structured and purposeful interviews by managers and physicians specialized in Hazmat incidents working in Iran, were conducted. The interviews were recorded and later the recordings were transcribed and simultaneously the categorizing and coding of the interviews were performed.&nbsp;Results: In the first stage, searching through the available resources for the present study identified 12 published references through which 10 indicators to develop a Hazmat team were ultimately extracted. In the second stage, a total of 10 interviews were conducted and data saturation occurred. Based on the results of the content analysis for the main indicators of designing and developing teams, 8 categories and 19 sub-categories were developed.&nbsp;Conclusions: By interviewing and localizing the 10 main indicators that were achieved in the first stage, we finally reached the 8 indicators including: Training hazmat team’s members, required equipment for team, response plan, medical surveillance program, hazmat team structure, incident command system, hazmat team qualification of different levels, certification and maintenance of the certificate

Age and the Length of Hospital Stay in Patients With Sepsis at the ICU Admission can Prolong the Duration of Endotracheal Intubation

Background: Endotracheal intubation (EI) associated with mechanical ventilation (MV) is frequently performed in critically ill patients admitted to intensive care unit (ICU) with sepsis. Objectives: This study aimed to assess the impact of important factors on the duration of tracheal intubation in patients with sepsis at the ICU admission. Methods: Adult patients admitted to the mixed medical–surgical ICUs with sepsis at the ICU admission who needs prolonged mechanical ventilation (PMV) (≥ 21 days) were included in this retrospective secondary analysis study. The primary outcome was ICU mortality. Baseline demographic and clinical characteristics of all patients were assessed as risk factors associated with the duration of MV by univariate and multivariate Binary logistic regression. Results: Eighty-five patients required more than 21 days of MV. Out of the 85 patients, 52 (61.2%) patients were intubated within 30 to 34.50 days and 33 (38.8%) patients had intubation within 34.51 to 65 days, and categorized as PMV and very prolonged MV groups, respectively. Two parameters were significantly associated with very prolonged MV which are as follows: older age 1.229 (95% CI: 1.002-1.507, P = 0.048) and long hospital stay (LOS) 2.996 (95% CI: 1.676-5.356, P < 0.001). No significant survival difference was observed between the two groups of study. (33.3% vs. 25%, P = 0.406). Conclusion: Our observations showed that the older age and LOS as pre-ICU stay in patients with positive sepsis at the ICU admission can prolong the duration of intubation. In addition, no significant survival difference was observed between patients with PMV and very prolonged MV

Development and validation of the tool for the evaluation of the behavioral factors affecting the prevalence of musculoskeletal disorders in Iranian students

Background: This study was conducted with the aim of developing a standard and valid questionnaire to evaluate the behavioral factors affecting musculoskeletal disorders among adolescent students based on the educational and ecological diagnosis phase of the PRECEDE model. Methods: Based on the PRECEDE model and by using available resources and a panel of experts, a reservoir of items was proposed. The content validity of the questions was measured using content validity ratio (CVR) and content validity index (CVI). 400 Iranian first-year female high school students completed the questionnaire. The construct validity was assessed using confirmatory factor analysis (CFA). The reliability of the questionnaire was evaluated using Cronbach's alpha coefficient. Results: The age range of study students was 13.69 ± 0.86 years. The final developed questionnaire included 25 items in three dimensions: knowledge (9 items), attitude (10 items) and enabling factors (6 items). The mean scores of CVI and CVR were 0.97 and 0.92, respectively. The results of CFA confirmed the three-factor structure of the questionnaire. The Cronbach’s alpha coefficients of the dimensions of knowledge, attitude and enabling factors were 0.65, 0.80 and 0.71, respectively. Conclusion: The present questionnaire had appropriate psychometric properties and could be used as a valid tool in evaluating the factors affecting the development of musculoskeletal disorders among adolescent students

Evaluation of the Effects of Melatonin Supplementation on Coagulation in Patients with Haemorrhagic Stroke; A Randomized, Double-Blind, Controlled Trial

Introduction: Considering that hemorrhagic stroke patients are at higher risk for bleeding, administration of higher doses of melatonin with a controversial coagulation profile is a serious concern.&nbsp;Objective: This study aimed to investigate the possible effects of high doses of melatonin on bleeding parameters and blood hemostasis in hemorrhagic stroke patients.&nbsp;Methods: This study is a randomized, double-blind, prospective, controlled trial. Confirmed hemorrhagic stroke patients were divided into two groups. Participants were randomly assigned into the melatonin group (30 mg daily via gastric tube gavage for 5 consecutive days) or the control group. Each patient was monitored for 5 days, and 2 blood samples were taken and the effect of the intervention on coagulation factors and blood hemostasis were investigated.&nbsp;Result: In total, 30 patients were randomly assigned to melatonin (n=15) or control groups (n=15). there was no significant difference between the two groups in demographic and clinical characteristics. There was a significant decline in prothrombin time (PT) and fibrinogen levels in the melatonin group (p=0.011 &amp; p&lt;0.001, respectively). P-values for VII and VWB factors showed a significant increment in these two factors in the melatonin group after the intervention (p=0.035 &amp; p=0.002, respectively). No significant changes in serum levels of D-dimer factor, APACHE II, and GCS scores were evident in the two groups after the intervention (p&gt;0.05).&nbsp;Conclusion: Considering the favorable changes in coagulation parameters observed in this study, it could be concluded that melatonin can have both procoagulant and antithrombin properties

Impact of United States political sanctions on international collaborations and research in Iran

International research collaborations improve individual, institutional and governmental capacities to respond to health crises and inequalities but may be greatly affected by political environments. Iran ranks highly in tertiary education, productivity growth, knowledge impact and successful patent applications. In many countries, economic hardship has correlated with increased international research collaborations. Some have hypothesised that financial constraint drives scholars to seek outside collaborations for cost and risk sharing, and to access funding, materials and patient populations otherwise unavailable. This paper explores the history and importance of US political sanctions on the health of Iran’s academic sector. Although Iran’s international research collaborations increased during periods of increased sanctions, the Pearson correlation coefficient between gross domestic product and international research collaborations was not significant (r=0.183, p=0.417). This indicates that other factors are at least in part responsible. Additionally, we found Iran’s quantitative (eg, publication number) and qualitative (eg, visibility indices) publishing metrics to be discordant (two-tailed Mann–Kendall trend; p<0.0002 for both). Reasons for this are multifactorial, including increased indexing of Iranian journals, willingness of lower visibility journals to handle manuscripts with Iranian authors, widespread linkage of career advancement to science visibility indices, and others. During periods of increased sanctions, Iranian scholars were increasingly denied opportunities to publish scientific findings, attend scientific meetings, access to essential medical and laboratory supplies and information resources. We conclude that academic boycotts violate researchers’ freedom and curtail progress. Free exchange of ideas irrespective of creed is needed to optimize global scientific progress

Prioritization of Factors Affecting Time Management among Health Managers

Introduction: In today's world, having principle and targeted management is one of the progress and development factors of any organization. Effective use of time for each manager is the most important base for managing current affairs and controlling daily activities. The present study aimed to investigate and analyze the relationship between factors affecting time management among the senior, middle and first-line managers of the hospitals in Kermanshah in 2015. Methods: This was a cross-sectional and descriptive-analytical study conducted in 2015 in ten hospitals of Kermanshah. The study population consisted of all senior, middle and first-line managers of the studied hospitals (N=240) which were selected using census method. The required data were collected using a researcher-made pair-wise comparison questionnaire. The collected data were analyzed using the DEMATEL technique through Matlab8.1.0.604 software. Results: The results showed that, from the studied managers’ viewpoints, the variables of goal setting and prioritization of objectives and activities were certainly affecting variables and located in the cause group. Also, the variables of planning, delegation, communication management, and meetings management were affected variables and located in the effect group. Furthermore, in the hierarchy of affecting and affected variables influencing time management, goal setting and meetings management with the coordinates (1.23, 1.23) and (1.06, -1.05) were identified as the highest and lowest priorities and were considered as the most affecting and most affected variables, respectively. Conclusion: The results of the present study showed that among the studied variables influencing time management, goal setting was the highest priority and most affecting variable, and meetings management was the lowest priority and the most affected variable. It is recommended to increase the hospital managers’ knowledge about time management and the need for accurate goal setting through providing management and time management courses, and requiring them to develop a time management plan in order to improve their time management

The Effect of Dimensions of Illness Perceptions on the Variation of Quality of Life in Patients With Coronary Artery Disease

According to previous studies in patients with Coronary artery disease (CAD), it is important to consider both medical conditions and psychological factors such as illness perceptions to explain differences in Health-Related Quality of Life (HRQoL). Patient’s illness perception is formed based on Patient’s beliefs and perceived information about their conditions, presumably influencing the individual’s mental health and how the patients deal with the medical conditions. The objective of this study was to analyze the relationship between illness perception and quality of life in patients with CAD. In this cross-sectional study, 99 CAD patients filled out questionnaires, including the brief illness perception questionnaire, the Health-related quality of life scale (SF36). The data were analyzed using multiple linear regression.When corrected for confounders, identity (β=−0.47) was  associated with Physical Component (PCS). Identity  and age explained 53% of the variation in PCS (R2=0.53). Personal control (β=0.20), identity (β=−0.23) and Emotional response (β=−0.25)  were associated with Mental Component (MCS). They explained 47% of the variation in the Mental Component (R2=0.47) domain. This study showed that there is a relationship between illness perception and quality of life in patients with CAD. Better HRQoL was found in patients who have a better understanding of the disease, experience better personal control, and have less of a physical and mental response. Results from this study provide starting points for the development of interventions focusing on illness perceptions to support CAD patients in their disease management and to improve HRQoL

Assessing safety culture in a gas refinery complex: Development of a tool using a sociotechnical work systems approach.

Forty years of research into safety culture indicates that an appropriate assessment in a safety-critical context will include items that are common safety factors and also items that are specific to the particular industry and community. To develop a new survey tool, suitable for use in the gas refinery industry, a sociotechnical work systems approach was used, to capture all aspects of that work system context. The program was carried out in three parts at a gas refinery complex in the Persian Gulf. First, 18 semi-directed interviews of experienced employees were conducted. Using a confirmatory framework, the rich qualitative data were summarized into structural codes and 12 themes. Second, 15 safety specialists served as an expert panel on proposed items that emerged from the qualitative interviews. Their comments and assessment of content validity led to a 59-item questionnaire, in which the 12 themes were aligned to 12 safety culture factors and five macroergonomic subsystems of the sociotechnical work systems approach used. In the third part, the psychometric properties of the questionnaire were examined using a sample of 276 employees, supervisors and managers. The results of CFA indicated that a 56-item assessment tool was valid and reliable. Good-of-fitness indices had acceptable values and measurement model was confirmed (CMIN/DF =1.55; GFI=0.94; AGFI=0.91; CFI=0.89; RMSEA= 0.05). The sociotechnical work system approach provided a suitable route to developing the safety assessment tool that recognizes aspects of the gas refinery industry, such as work schedule type, cultural environment, and being away from family support