Aims: The current study aimed to study the scorpion ecology and fauna of Masjed-Soleyman County, southwestern Iran to manage scorpion sting-related problems during 2016–2017. Materials and Methods: Scorpions were collected from different localities of Masjed-Soleyman using rock-rolling, digging the ground, Ultra Violet flashlight, pouring water in holes, and ordinary flashlight methods. The collected scorpions were placed to 70% alcohol. Morphological studies were completed under a stereomicroscope. The scorpion species were identified using diagnostic valid key for the Iranian scorpions. Results: Out of the 318 collected scorpions, 10 species from three families, buthidae (71.1%), scorpionidae (2.2%), and hemiscorpiidae (26.7%) were identified. The most abundant species were Androctonus crassicauda (32.4%), Hemiscorpius lepturus (26.7%), and Mesobuthus phillipsii (21.4%). The females were the dominant sex, i.e., 1.7:1 (F/M) sex ratio. The highest number of scorpions were caught in August (27.7%). The highest abundant of scorpions were collected in summer (65.7%). Furthermore, the majority of specimens were hunted through of ultraviolet flashlight (44.4%). The most abundant scorpions were caught in animal husbandry (23.6%). Conclusion: Because treatment of the patients who received stings should be managed according to the kind of their venom and the scorpion species, it is important for planning treatment and prevention according to the species composition of scorpions of each region.

Aim: Mechanical ventilation is widely used in the intensive care units (ICUs). Nurses need to learn how to use this device. This study aimed to develop a ventilator training application software (VTApp) on the smartphones and to study its effect on the knowledge and skills of nurses working in the ICUs. Materials and Methods: This quasi-experimental study was carried out on fifty nurses working in ICUs of Shahid Beheshti Hospital in Kashan, Iran. First, the VTApp was designed and developed based on the results of the needs assessment on the Android platform. Participants were asked to install the VTApp on their smartphones and use it regularly. The scores of ICU nurses' knowledge and skills, before and after the intervention, were compared using the Wilcoxon test at a significant level of P < 0.05. Results: The usability assessment of the VTApp showed that it was at a desirable level according to the IT experts' opinions (mean score was 75.3 out of 100). Based on the results of the study, the mean scores of nurses' knowledge and skills in the preintervention stage were 12.22 ± 3.34 and 21.36 ± 6.31, respectively. These mean scores increased to 16.5 ± 2.8 and 28.38 ± 6.21 after intervention, which was significant for both variables (P < 0.0001). Conclusions: The use of the smartphone's VTApp increased the knowledge and skills of nurses in ICUs. Further studies are recommended.

Aims: This study has internationally tested and refined a framework for institutionalizing and practicing health impact assessment (HIA). HIA is conducted differently in different contexts and recently HIA experts suggest that broader context, in which HIAs are carried out is linked to technical aspects of the HIA. Materials and Methods: A survey internationally attained viewpoints of academics and practitioners (n = 38) on the identified parameters of the framework including factors influencing HIA. Structural equation modeling (SEM) through SmartPLS was used to test for relations between the factors. Finally, the model was modified to reach an appropriate fit. Results: The framework emphasizes HIA Context, HIA Capacities including Institutional, Technical and Participation capacities, HIA Content, and HIA Outcomes as key factors in implementation and practice of HIA. This framework reflects the broad range of factors that influence HIA. All broad factors were perceived as significant influences on the practice of HIAs. Some fit measures, i.e., the standardized root mean square residual appear to be in the acceptable range. Conclusion: We have demonstrated the utility of SEM for developing and testing a framework to do HIA in different country contexts.

Aims: Given the dearth of research about middle-aged people's ability to seek online health information in developing countries, this study was conducted to develop the Online Health Information-Seeking Skill Scale (OHI-SSS) and evaluate its psychometric properties. Materials and Methods: This is a methodological study in which a scale was developed within three factors and was validated by face validity, content validity, and structural validity methods. Four hundred and twenty middle-aged individuals completed the questionnaires. Internal consistency and test–retest were used to evaluate the reliability of the scale. Finding: The initial scale, consisting of 38 items on a 5-point Likert scale, was reduced to a 26-item scale following face and content validity measurement. The exploratory factor analysis extracted three subscales in OHIO-SSS that includes “information reception,” “provide and exchange information, and “identification and trust.” Internal consistency of the scale was confirmed by Cronbach's alpha coefficient (0.93). Cronbach's alpha coefficient for subscales was 0.87, 0.795, and 0.74, respectively. Reliability analysis with test–retest revealed an acceptable estimate for the total score (intraclass correlation coefficient = 0.92). Conclusion: The 20-item OHI-SSS has acceptable validity and reliability. Therefore, it can be employed as an appropriate instrument for the evaluation of middle-aged people's skills in seeking online health information.

Aim: This study was conducted to identify gaps in the user interface design of Iran's Electronic Death Registration System (National Registry) using the heuristic method. Materials and Methods: Five independent evaluators assessed the user interface using the heuristic evaluation. Problems were reassessed in the presence of all evaluators, and similar cases were merged, and a single list of unique problems was eventually prepared. By re-evaluating the system, the evaluators determined and categorized the severity of the problem in five domains, including no problem (zero point), a cosmetic problem (1 point), a minor problem (2 points), a major problem (3 points), and a catastrophic problem (4 points). The data were then analyzed in an excel sheet using descriptive statistics. Findings: Forty-two unique problems were identified. The “recognition rather than recall” principle with ten problems (23.8% of all cases) had the most frequent problem, while the “help and documentation” principle with one problem (2.4% of all cases) had the least frequency but the highest mean severity (4). Conclusion: The results of the heuristic evaluation of the electronic death registration system indicated that a large portion of the problems in this system was classified under the minor category, which primarily indicates the good usability of this system. However, this system suffers from several usability problems. Therefore, it could be concluded that considering the national-level use of this system, it has problems that could be resolved through meeting system design principles and standards.

Aims: Management of water resources, especially groundwater in arid and semiarid regions, is of particular importance. Various natural and human factors in recent decades have created critical conditions for these resources. Therefore, this study was conducted to investigate changes in groundwater levels over the past 28 years. Materials and Methods: To conduct this research, statistics related to 64 piezometer wells were studied during the years 1990–2018, and the effect of rainfall and extraction from groundwater resources was interpreted and analyzed. Results: The results of the study showed that according to the hydrograph of 64 piezometer wells in Kashan plain, the groundwater level has a downward trend and has decreased by 15.29 m during 28 years. The annual drop was 0.54 m. An increasing peak of water table was also observed. Moreover, the water level has decreased slightly in some years and has not decreased in some years. Conclusion: The study shows that uncontrolled harvesting in the long run has had a more significant impact than rainfall on groundwater resources. Moreover, water abstraction has occurred on average in the southern and southeastern parts of the plain, which can be due to the concentration of agricultural lands in this area. To reduce this trend, strong management strategies should be adopted and appropriate to the situation.

Aims: In middle age, women's psychological capital decreases. Happiness is one of the possible solutions to this problem. This study was designed to investigate the effect of happiness on the psychological capital of middle-aged women. Materials and Methods: The present study is a clinical trial study in which 60 middle-aged women participated through continuous sampling. The samples were divided into control and intervention groups by block randomization. The experimental group received group happiness training for 8 sessions of 90 min over 4 weeks. The control group did not receive any intervention. Psychological capital scores were measured at the beginning, end, and 4 weeks after the end of the study. The psychological capital questionnaire of McGee et al. and the background data questionnaire was used to collect information. Data were analyzed using SPSS software version 16. Results: The mean score of psychological capital at the beginning of the study in the two groups of intervention (100.615 ± 6.616) and control (104.9 ± 5.921) was not statistically significant. At the end of the intervention in the experimental group (146.154 ± 9.362) and the control group (109.700 ± 6.869) and 4 weeks after the intervention of the experimental group (129.423 ± 9.153) and the control group (110.700 ± 6.670), a statistically significant difference was observed (P < 0.0001). The difference between the scores of the two groups at the end and 4 weeks after the intervention in all dimensions of psychological capital (self-efficacy, hope, optimism, and resilience) was statistically significant. Conclusions: Health-care professionals can use group happiness training to increase the psychological capital of middle-aged women.

Aims: Climate change and environmental factors are two factors affecting the ecosystem and life cycle of vector insects. In this study, the effects of climatic elements and environmental factors on cutaneous leishmaniasis in Kashan were studied. Materials and Methods: This study has adopted an analytical-descriptive method. Climatic data were compared with 3949 cases of cutaneous leishmaniasis from 2007 to 2019 using SPSS 22 software and Pearson correlation. Furthermore, the prevalence of cutaneous leishmaniasis cases in Kashan city was displayed on the land use maps, land cover map, rainfall map, thermal classification map, and digital elevation model and then was investigated. Results: Pearson correlation analysis showed a negative correlation between cutaneous leishmaniasis cases and spring temperature while a positive correlation with total rainfall and winter rainfall was observed. Investigating the spatial distribution of cases of cutaneous leishmaniasis in Kashan city was observed that the frequency of this disease was higher near Kashan desert belt from Abuzeidabad to Abshirin, the landfill areas, around the agricultural fields, the main roads, and the outskirts of the city. Conclusion: The frequency of cutaneous leishmaniasis has a significant negative correlation with reduction of temperature in spring to the desired level for the activity of sandflies. Rainfall has also caused a significant increase of this disease. Autumn has the most cases and spring the least ones. In the spatial distribution of the disease, a clear relationship with the desert areas, where the disease reservoir mice were living, and the agricultural fields, where sandflies reproduced and had activity, was observed.

Aims: The aim of this study was to determine the mortality risk factors of hospitalized moderate-to-severe coronavirus disease 2019 (COVID-19) patients in Tehran. Materials and Methods: We retrospectively evaluated the baseline characteristics and clinical and paraclinical parameters of 223 deceased and discharged patients who were hospitalized in Firoozabadi General Hospital between March 1 and April 1, 2020. Results: According to our multiple logistic regression model, advanced age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02–1.09; P < 0.01), reduced oxygen saturation (OR, 0.92; 95% CI, 0.87–0.96; P < 0.01), and hypertension (OR, 2.59; 95% CI, 1.04–6.46; P = 0.04) can be perceived as independent risk factors for mortality. Conclusion: Our results suggest that patients with older age, lower oxygen saturation, and hypertension are predisposed to an increased risk of mortality. Thus, to lower the COVID-19 mortality rates, patients with these characteristics should be the primary targets for early treatment, vaccination, or monitoring strategies.

Aims: The aim of this study was to monitor mosquito activity with emphasis on Aedes species in Kashan County. Materials and Methods: This investigation was carried out in Kashan County, from April to late September 2019. The location coordinates of the sampling sites were marked and registered with Global Positioning System deviceand mapped using Arc Map 10.5 software. In this study, mosquitos' larvae were collected from 120 standard ovitraps, which had been placed in 15 locations in Kashan, Qamsar, and Niasar. Cyndon dactylon at 50% concentration was used as an oviposition attractant (250 ml/trap). Ovitraps were visited regularly to check for eggs or larvae. The mosquito's larvae were identified using a systematic key. Results: A total of 535 mosquitos' larvae were collected from ovitraps and were identified under two genera Culex and Culiseta. The collected species were Culex pipiens Linnaeus, 1758 (72.4%), Culex theileri Theobald, 1903 (18.3%), Culex torrentium Martini, 1925 (0.2%) and Culiseta longiareolata (Macquart, 1838) (9.1%). This is the first report of present Cx. torrentium Martini, 1925 in Kashan County. Culex pipiens Linnaeus, 1758 was found at 13 locations from 15. In this study, there were 4.46 larvae per ovitrap. Conclusions: Although no samples of Aedes mosquitoes were captured in this preliminary study, further investigations using different methods of mosquito collection should be done to accurately comment on the current fauna of Kashan Aedes.

Aim: Physiotherapists are well-positioned to promote physically active lifestyles as primary health-care providers, but their function and practice in this regard among patients and students have yet to be thoroughly examined. The aim of this study was to determine the knowledge and practice of promoting physical activity by both clinical and academic physiotherapists among patients and students. Materials and Methods: A cross-sectional study was conducted from Jan to March 2020 in different tertiary care hospitals of Karachi and University of Karachi using nonprobability convenience sampling technique. A total of 100 sample data were collected. Questionnaire was based on knowledge, perception, promotion, and barriers of recommended physical activity. Findings: A total number of 100 participants enrolled in the study; academician (n = 19), clinician physiotherapist (n = 48) and both (n = 33). Total 84.2% of academic physiotherapists, 66% clinical therapists, and 69.7% of both were aware of physical activity guidelines for adults. Brief counseling sessions were preferred as highly feasible by 36.8% of academic therapists and 35.4% by clinical physiotherapists. Clinician physiotherapists were found to be feeling more confident in suggesting specific physical activity programs among others (P = 0.02). Conclusion: It was concluded that academic therapists, clinical therapists who worked at both sites had knowledge of standard physical therapist guidelines whereas clinical and both categories physical therapists were found to be promoting physical activity the most.

Aims: Drug abuse is one of the major problems threatening human health. The presence of heavy metals (e.g., lead and thallium) in illicit drugs has raised concerns. This study was designed and performed to indicate the status of thallium in the urine of opioid users with symptoms similar to thallotoxicosis and compare them with the control group. Materials and Methods: This case–control study was conducted in Kashan with the participation of 200 people (including 100 people in the opioid user group and 100 people in the control group). Then, electrothermal atomic absorption spectrometry was used to determine the concentrations of urinary thallium. Findings: In the opioid group, the median (interquartile range) urinary thallium concentrations was 72/29 ± 49/33 μg/l, whereas in the control group, it was 5/57 ± 3/015 μg/l. There was a significant difference in the concentrations of urinary thallium between the opioid group and the control group. Furthermore, the prevalence of thallotoxicosis-related clinical symptoms was significantly higher in the opioid group with high urinary thallium concentrations compared with the control group (weakness, fatigue, paresthesia, ataxia, vertigo, memory deficits, tremor, aggressiveness, tinnitus, sweating, rashes, dry skin, constipation, nausea, vomiting, abdominal pain, and diarrhea). Conclusions: The results of the present study indicated that the levels of urinary thallium in patients using illicit opioids are significantly higher, which can be due to contamination of drugs with thallium.

Aims: Stroke affects the quality of life by affecting daily activities. This study aimed at determining the factors predicting quality of life in patients with stroke referring to Shahid Beheshti Hospital in Kashan. Materials and Methods: In this cross-sectional study, sampling was done by census method during 2019 and in the first 6 months of 2020, and 188 patients with stroke referring to Shahid Beheshti Hospital in Kashan who had at least 2 months after stroke were evaluated. Data collection tools were questionnaire of Stroke Impact Scale-16 and possible factors associated with stroke. Data were analyzed using SPSS software version 16 using the tests of Mann–Whitney, Kruskal–Wallis, independent t-test, Pearson's correlation coefficient (Spearman), and multivariate linear regression analysis. Findings: The mean quality of life was 50.92 ± 24.97. In univariate analysis, the quality of life was significantly associated with gender, marital status, education level, type of stroke, use of rehabilitation services, spouse's education level, occupation, number of children, regular exercise, history of hypertension, and previous history of stroke. Based on the results of multivariate analysis, 62.4% of variance was explained by four factors of the required number of rehabilitation sessions, history of previous stroke, level of education, and severity of stroke (F = 11.597, R² = 0.624, and P < 0.001). The most important factor was the number of rehabilitation sessions required. Conclusion: To improve the stroke patients' quality of life, healthcare professionals should pay attention to the predictive role of low education level, more need for rehabilitation, severity, and history of stroke in their programs and procedures.

Aims: Given the wide cultural diversity of patients in the current world, nurses need to have great cultural competence. This study aimed to explore the concept of cultural competence in Iranian nurses. Materials and Methods: This qualitative study was conducted in 2017–2018 using Graneheim and Lundman's approach to qualitative content analysis. A purposeful sample of eighteen clinical nurses was recruited with maximum variation from hospitals of Isfahan and Ahvaz, Iran. Data were collected through eighteen semistructured interviews and simultaneously analyzed through directed content analysis. Findings: Data analysis resulted in the formation of thirteen subcategories which were respectively grouped into the four categories of cultural cognition (cultural awareness, cultural knowledge, and cultural insight), cultural care intention (cultural encounter, cultural desire, and cultural eagerness), cultural flexibility (cultural attitude, cultural sensitivity, and resolving cultural conflicts), and cultural care skills (communication skills, cultural evaluation skills, behavioral skills, and skills to get feedback about cultural care). Conclusion: Iran has many ethnic and religious groups which have a variety of subcultures, so Iranian nurses need to be sensitive about cultural diversity in health-care settings and have the cultural competence to facilitate the delivery of quality culturally competent care to the patients of different cultures.

Aim: Cattle is one of the main sources of food supply chain for humans in most countries. The present study aimed to identify the infection rates for Toxoplasma gondii, Neospora caninum, and Sarcocystis spp. by polymerase chain reaction (PCR) method in native slaughtered cattle in Kashan, central Iran. Materials and Methods: Totally, 159 diaphragm, esophagus, and muscle samples (53 samples of each) were collected from native beef cattle from Kashan slaughterhouse, central Iran. The genomic DNA was extracted, and PCR method was used separately for detection of N. caninum, Sarcocystis, and T. gondii species using specific primers. Finding: Sarcocystis was found in 84.9% of muscles, 83% of esophagus, and 84.9% of diaphragm samples. Mixed infection (Sarcocystis cruzi–Sarcocystis hominis) was the most common infection, followed by S. cruzi and S. hominis. Sarcocystis hirsuta was not detected in any samples. T. gondii was detected only in three (5.7%) out of the 53 muscle tissues samples of cattle. N. caninum was found in 18.9% of muscles, 24.5% of esophagus, and 28.3% of diaphragm samples. One of the cattle had coinfection to Neospora, Toxoplasma, and Sarcocystis in muscles simultaneously. There was no statistically significant difference between infection rates and age as well as sex in each organ. Conclusion: This study revealed a low prevalence rate of T. gondii, but a high prevalence of infection to N. caninum and S. cruzi or mixed infection of S. cruzi with S. hominis among slaughtered cattle. Prevention measures such as keeping away dogs from cattle grazing are recommended.

Aims: This study has examined exposure to electromagnetic fields (EMFs) and its effect on the general health of computer users. Materials and Methods: This cross-sectional study was performed by participating 73 employees. A calibrated galactooligosaccharide meter model HI-3603 was used to measure EMF and a general health questionnaire examined their health status. Statistical Analysis Used: For analyzing data, the t-test and Chi-square test were applied. Results: The electric field intensities in desktop monitors and laptops were 0.26–1.2 and 0.28–0.87 volts/m, respectively, which is higher than the standard levels. The results from the public health questionnaire revealed that 39% of computer users had some problems in general health status. A significant difference was observed between the general health of the two groups (P < 0.001). Conclusions: The role of using electronic equipment for communication and daily activities became more prominent. Therefore, it is clear that with the widespread use of this equipment, all members of society will be exposed to some kind of EMF. Therefore, people who work with computers due to their job will use this equipment to do things during other nonworking hours. As a result of this increase in the time of using electronic equipment, their health will be at risk.