Water-related limits to growth for agriculture in Iran

Globally, agriculture is the primary water consumption sector. This study used water footprint (WF) as a bottom-up tool and satellite imagery as a top-down tool to estimate the internal water use (WU) in the agricultural sector in an innovative way to show the effects of water-intensive use in agriculture in an arid country. The WF of Iran has been quantified for 19 main crops and for related agricultural products exported from Iran to partner countries. Using a bottom-up approach, Iran's total yearly agriculture net water consumption is estimated to be 42.43 billion cubic meters (BCM) per year. Out of 42.43 BCM total net internal water use, only 1.61 BCM is virtual-water export related to these 19 products, and the remaining 40.82 BCM is for internal use. Our results using satellite imagery show that in case of using all possible lands for agriculture, it would require 77.4 BCM. However, not all these lands are within human reach, and the maximum available water is way lower than this amount. Using satellite imagery, the total evaporation from agricultural lands shows 55.27 BCM for 2020, which agrees with national reports during 2005–2014. This study shows that agricultural water consumption tends to use internal water resources at a maximum level for export and national use, significantly impacting renewable and non-renewable water resource availability, especially in groundwater

Assessment of the I-PASS program on nursing shift handover in CCU and ICU wards: The use of a new approach in the nursing profession

Background: Shift handover is one of the critical tasks and major challenges among health care providers in hospitals. Most serious errors are caused by communication problems related to shift handover. Thus, it is essential to implement effective programs to overcome shift handover challenges in hospitals. This study aimed to evaluate the effects of the I-PASS (illness severity, patient summary, action list, situation awareness and contingency planning, and synthesis by receiver) program on nursing shift handover in hospital wards in southeastern Iran. Methods: This study used a quasi-experimental design with a before-and-after method (without a control group) and was conducted in Pasteur Hospital in Bam City from January to March 2021. Sampling was performed using the census method. Participants included 47 nurses who work in critical care unit (CCU) and intensive care unit (ICU) wards. All nurses received shift-handover training based on the I-PASS program for 4 weeks (45-minute sessions weekly). The standardized I-PASS assessment tool was used in this study. Data were analyzed using SPSS version 25, along with the chi-square test, independent t test, and paired t test. P values less than 0.05 were considered statistically significant. Results: Among the participants, 89.4% were female, and 68.1% worked in the ICU ward. The mean age of the nurses was 33.25 ± 5.00 years old, and the mean year of their work experience was 8.08 ± 5.27 years. There was a significant difference in the mean scores of nursing shift handover before and after the intervention in the CCU ward from 1.88 ± 0.32 to 3.62 ± 0.98 (P = 0.018) and in the ICU ward from 2.37 ± 0.84 to 2.93 ± 0.35 (P = 0.013). Also, the mean scores of the CCU ward were higher than those of the ICU ward after the intervention (P = 0.01). Conclusion: The I-PASS program can overcome many challenges in nursing shift handover and workflow. Therefore, this method can be a suitable alternative to the common methods of shift handover and patient delivery in hospital wards

Incidence and Correlates of Maternal Near Miss in Southeast Iran

This prospective study aimed to estimate the incidence and associated factors of severe maternal morbidity in southeast Iran. During a 9-month period in 2013, all women referring to eight hospitals for termination of pregnancy as well as women admitted during 42 days after the termination of pregnancy were enrolled into the study. Maternal near miss conditions were defined based on Say et al.’s recommendations. Five hundred and one cases of maternal near miss and 19,908 live births occurred in the study period, yielding a maternal near miss ratio of 25.2 per 1000 live births. This rate was 7.5 and 105 per 1000 in private and tertiary care settings, respectively. The rate of maternal death in near miss cases was 0.40% with a case:fatality ratio of 250 : 1. The most prevalent causes of near miss were severe preeclampsia (27.3%), ectopic pregnancy (18.4%), and abruptio placentae (16.2%). Higher age, higher education, and being primiparous were associated with a higher risk of near miss. Considering the high rate of maternal near miss in referral hospitals, maternal near miss surveillance system should be set up in these hospitals to identify cases of severe maternal morbidity as soon as possible