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Comparison between Emergency Severity Index and Heart Failure Triage Scale in heart failure patients: A randomized clinical trial

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World Journal of Emergency Medicine 2019年第4期10卷 215-221页

作者： Ahmad Pouyamehr Amir Mirhaghi Mohammad Davood Sharifi Ali Eshraghi Nursing and midwifery Care Research Center Mashhad University of Medical SciencesMashhadIran department of Medical-Surgical Nursing School of Nursing and MidwiferyMashhad University of Medical SciencesMashhadIran department of Emergency Medicine Faculty of MedicineMashhad University of Medical SciencesMashhadIran department of Cardiology Faculty of MedicineMashhad University of Medical SciencesMashhadIran

BACKGROUND:It is not clear whether Emergency Severity Index(ESI)is valid to triage heart failure(HF)patients and if HF patients benefi t more from a customized triage scale or not.The aim of study is to compare the effect of Heart Failure Triage Scale(HFTS)and ESI on mistriage among patients with HF who present to the emergency department(ED).METHODS:A randomized clinical trial was conducted from April to June 2017.HF patients with dyspnea were randomly assigned to HFTS or ESI groups.Triage level,used resources and time to electrocardiogram(ECG)were compared between both groups among HF patients who were admitted to coronary care unit(CCU),cardiac unit(CU)and discharged patients from the ED.Content validity was examined using Kappa designating agreement on relevance(K*).Reliability of both scale was evaluated using inter-observer agreement(Kappa).RESULTS:Seventy-three and 74 HF patients were assigned to HFTS and ESI groups respectively.Time to ECG in HFTS group was signifi cantly shorter than that of ESI group(2.05 vs.16.82 minutes).Triage level between HFTS and ESI groups was signifi cantly different among patients admitted to CCU(1.0 vs.2.8),cardiac unit(2.26 vs.3.06)and discharged patients from the ED(3.53 vs.2.86).Used resources in HFTS group was significantly different among triage levels(H=25.89;df=3;P<0.001).CONCLUSION:HFTS is associated with less mistriage than ESI for triaging HF patients.It is recommended to make use of HFTS to triage HF patients in the ED.

关键词： Dyspnea Heart failure Triage Emergency severity index

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Auto-refraction versus subjective refraction in different phakic and pseudophakic conditions:the Tehran Geriatric Eye Study(TGES)

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International Journal of Ophthalmology(English edition) 2023年第8期16卷 1309-1316页

作者： Hassan Hashemi Amir Asharlous Alireza Jamali Abolghasem Mortazavi Alireza Hashemi Mehdi Khabazkhoob Noor Research Center for Ophthalmic Epidemiology Noor Eye HospitalTehran ***Iran Noor Ophthalmology Research Center Noor Eye HospitalTehran ***Iran Rehabilitation Research Center Department of OptometrySchool of Rehabilitation SciencesIran University of Medical SciencesTehran ***Iran department of Neurosurgery Sina HospitalTehran University of Medical SciencesTehran ***Iran department of Basic Sciences School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehran ***Iran

AIM:To compare the subjective refraction data with non-cycloplegic auto-refraction findings in the geriatric population above 60 years of age according to the different crystalline lens conditions.METHODS:This report is a part of the Tehran Geriatric Eye Study(TGES)that was conducted from January 2019 to January 2020 on elderly population 60 years of age and above in Tehran.The samples were selected by multistage stratified random cluster sampling.Of 3791 individual invitees,3310(response rate:87.3%)participated in this study.All study participants underwent non-cycloplegic autorefraction(auto-refractometer/keratometer Nidek ARK-510)and subjective refraction.RESULTS:Regarding the sphere,eyes with mixed cataract had the worst limits of agreement(LoA:-1.24 to 0.87)and the best agreement was related to the pseudophakic eyes(LoA:-0.83 to 0.54).The highest(0.27±0.31 D)and lowest(0.21±0.27 D)differences between the two methods regarding the cylinder power were observed in eyes with cortical cataract and normal eyes,respectively.The worst LoA between the two methods in measuring the cylinder power was related to the eyes with mixed cataract(LoA:-0.44 to 0.96).Regarding the J0(horizontal/vertical components of astigmatism),the mean values of J0 obtained by auto-refraction were tended more toward against the rule direction in all crystalline lens conditions,and the two methods had the greatest difference in cortical cataract cases(0.05±0.17 D).Regarding the J45(oblique components of astigmatism),the lowest(0±0.11 D)and highest(-0.01±0.12 D)differences were observed in normal eyes and eyes with cortical cataract,respectively.CONCLUSION:The auto-refractometer/keratometer Nidek ARK-510 results in the elderly with different phakic and pseudophakic conditions do not correspond well with subjective refraction findings.This discrepancy in spherical findings is more pronounced in individuals with mixed cataract than in other cases.

关键词： refraction subjective geriatric noncycloplegic autorefraction

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The prevalence of red-green color vision deficiency and its related factors in an elderly population above 60 years of age

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International Journal of Ophthalmology(English edition) 2023年第9期16卷 1535-1541页

作者： Hassan Hashemi Aida Shahidi Alireza Hashemi Alireza Jamali Abolghasem Mortazavi Mehdi Khabazkhoob Noor Research Center for Ophthalmic Epidemiology Noor Eye HospitalTehran ***Iran Noor Ophthalmology Research Center Noor Eye HospitalTehran ***Iran Rehabilitation Research Center Department of OptometrySchool of Rehabilitation SciencesIran University of Medical SciencesTehran ***Iran department of Neurosurgery Sina HospitalTehran University of Medical SciencesTehran ***Iran department of Basic Sciences School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehran ***Iran

AIM:To determine the prevalence of red-green(RG)color vision deficiency(CVD)in an elderly population and its related factors.METHODS:This report is a part of the Tehran Geriatric Eye Study:a cross-sectional population-based study that was conducted on the elderly population(≥60y)of Tehran,Iran using multi-stage stratified random cluster sampling.All study participants underwent complete ocular examination,including the measurement of uncorrected and bestcorrected visual acuity,objective and subjective refraction,and slit-lamp biomicroscopy.The color vision was tested using Ishihara plates with the near optical correction in place.RESULTS:Of the 3791 invitees,3310 participated in the study.The data of 2164 individuals were analyzed after applying the exclusion criteria.The prevalence of R-G CVD was 3.73%(95%CI:2.37%–5.09%)in the whole sample;the prevalence of protanomaly,protanopia,and deuteranopia was 1.51%,1.76%,and 0.45%,respectively.The prevalence of R-G CVD was significantly higher in males than in females.The prevalence of RG CVD increased with advancing age from 2.91%in the age group 60–64y to 5.8%in the age group≥80y(P=0.070).According to the multiple logistic regression model,male sex,and glaucoma were significantly related to RG CVD.Older age and hypertension also had a marginally significant relationship with RG CVD.CONCLUSION:Changes in color vision occur in the elderly due to the aging process and some physiological and pathological factors.Since the change in visual perception may affect the person’s performance,this aspect of the visual system’s function should also be taken into consideration in the examinations of the elderly.

关键词： color vision population-base study protanomaly protanopia deuteranopia elderly

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Moving beyond medical facility walls:opportunities,challenges and attitudes of midwives towards planned homebirth

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History & Philosophy of Medicine 2023年第3期5卷 1-7页

作者： Thuraya Ibrahim Ahmad Fallatah Grace M.Lindsay Roa F.Altaweli BSN MMIDSenior Specialist in MidwiferyMinistry of HealthJeddah city 22427Saudi Arabia Professor in Medical Surgical Nursing Umm AlQura UniversityTaif 21944Saudi Arabia midwifery Consultant Director of Midwifery DepartmentMinistry of HealthRiyadh 12211Saudi Arabia.

Background/Aims:The Saudi Vision 2030 program has introduced midwifery-led maternity care in Saudi Arabia,which includes facilitating planned home births.This study aimed to investigate Saudi midwives’attitudes to planned home birth and the opportunities and challenges associated with its implementation.Methods:The study used a descriptive cross-sectional quantitative study design,including all hospitals of the Saudi Ministry of Health and primary healthcare centers in Saudi Arabia.Data were collected concurrently from 301 midwives through the provider attitude toward planned home birth questionnaire.Descriptive analysis and inferential statistical analyses were used for quantitative data.Results:The midwives had a neutral attitude to planned home birth.There were significant differences in attitude according to age,education and health region.Seven major themes emerged:midwives as care providers,health institutions,academic institutions,national policy,women’s health,the socioeconomic and physical environment and maternal and neonatal health outcomes.Conclusion:Saudi midwives are likely to have a favorable attitude to planned home births if the Ministry of Health and Ministry of Education decision-makers eliminate the associated challenges and promote opportunities for providers,organizations and the population.

关键词： maternity services midwife planned homebirth,Saudi Arabia

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Adherence to iron and folic acid supplementation and associated factors amongmothers receiving antenatal care in Lira district, Uganda

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Nursing Communications 2023年第21期7卷 1-9页

作者： Usaama Ssewankambo Rebecca Nakaziba department of midwifery Faculty of Nursing&MidwiferyLira UniversityP.O Box 1035 LiraUganda department of Pharmacology&Therapeutics Faculty of MedicineLira UniversityP.O Box 1035 LiraUganda

Background:Prenatal iron and folic acid supplementation is an economical strategy for reducing iron and folic acid deficiency anemia among expectant mothers in resource-limited countries like Uganda.This study aimed to assess the level of compliance with iron and folic acid supplementation(IFAS)and identify associated factors among mothers receiving prenatal services in Lira district,Uganda.Methods:A cross-sectional study was conducted at the antenatal clinic of Lira Regional Referral Hospital,involving 252 pregnant mothers.Adherence levels to IFAS were evaluated using a visual analogue scale,and associated factors were collected through an interviewer-administered questionnaire.The data were analyzed using SPSS software,and the results were presented in tables.Results:Only 46%of the mothers attending the antenatal clinic adhered to IFAS during the 30 days preceding the study.Participants who had good knowledge of IFAS before recruitment(odds ratio(OR)1.49,95%confidence interval(CI)1.12–1.97),utilized reminder techniques(OR 1.05,95%CI 1.02–1.09),and received support from their partners or relatives(OR 1.56,95%CI 1.07–2.29)were more likely to have good adherence.The main reasons for missing IFAS were forgetfulness and fear of taking too many tablets.Conclusions:There was a low adherence rate to IFAS among mothers attending antenatal clinics in Lira district.Further investigations are recommended to identify barriers to adherence,and comprehensive health education programs should be provided to pregnant mothers.

关键词： adherence iron and folic acid supplements pregnant mothers Uganda

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Effect of Stimulating the BL67 Point on Fetal Correction from Breech to Cephalic Presentation and Natural Delivery after the 36 Weeks of Pregnancy: A Randomized Clinical Trial

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Reproductive and Developmental Medicine 2020年第2期4卷 103-108页

作者： Khatereh Sourani Abolfazl Mohammadbeigi Nasim Khademi Azadeh Asgarian Imaneh Khaki Zohreh Ahmadi department of midwifery and Nursing Student Research CommitteeQom University of Medical SciencesQomIran Neuroscience Research Center Faculty of HealthQom University of Medical SciencesQomIran department of midwifery Nursing and Midwifery Sciences Development Research CenterNajaf Abad BranchIslamic Azad UniversityNajaf AbadIran department of midwifery and Nursing Health ManagementIzadi HospitalQom University of Medical SciencesQomIran department of midwifery and Nursing Faculty of NursingQom University of Medical SciencesQomIran department of Health Education Student research committeeFaculty of HealthQom University of Medical SciencesQomIran

Objective:Various techniques are proposed for changing fetal presentation.We aimed to assess the effect of BL67 point stimulation on correcting breech presentation and natural delivery in women at 36-38 gestational weeks.Methods:A parallel single blinded randomized clinical trial was conducted on 72 eligible pregnant women with breech presentation at the 36 weeks of pregnancy.The subjects were divided into two groups-intervention(n=36)and control groups(n=36)by block randomization method.The intervention group stimulated the BL67 point by self-administration for 20 min once a day for 2 weeks.Finally,the appearance of cephalic presentation and rate of vaginal delivery was compared between the groups(n1=n2=32)using the Chi-square test and multivariate logistic regression.Results:The correction of breech to cephalic presentation occurred in 53.1% of patients in the intervention group.The adjusted relative risk(RR)for fetal correction from breech to cephalic was 1.80(RR=1.80,95%confidence interval[CI],1.13-5.17).It was shown that the stimulation of the BL67 point increased the correction of breech to cephalic presentation.In addition,the rate of vaginal delivery increased by>4-fold(RR=4.16,95%CI,2.54-6.82)by correction to cephalic presentation.Moreover,65.6%of mothers in intervention group and 90.6%in the control group underwent cesarean section.Conclusions:The stimulation of the BL67 point is a safe,inexpensive,and effective method that can be self-administered at home for fetal correction from breech to cephalic presentation in women with breech presentations during 36-38 gestational weeks.This promotes uncomplicated natural childbirth.

关键词： Breech Cesarean Section Cephalic Childbirth Delivery

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Efficacy of the herbal formula of Foeniculum vulgare and Rosa damascena on elderly patients with functional constipation:A double-blind randomized controlled trial

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Journal of Integrative Medicine 2022年第3期20卷 230-236页

作者： Maryam Azimi Hanieh Niayesh Mahboobeh Raeiszadeh Sedigheh Khodabandeh-shahraki Gastroenterology and Hepatology Research Center Kerman University of Medical SciencesKerman ***Iran department of Traditional Medicine School of Persian MedicineKerman University of Medical SciencesKerman ***Iran Student Research Committee Afzalipour Faculty of MedicineKerman University of Medical SciencesKerman ***Iran Herbal and Traditional Medicines Research Center Kerman University of Medical SciencesKerman ***Iran department of Community Health Nursing Razi Faculty of Nursing and MidwiferyKerman University of Medical SciencesKerman ***Iran

Background:Constipation is a common chronic bowel disorder with an incidence of more than 50%in the elderly population.Complementary and alternative medicine is a cost-effective and satisfactory treatment for constipation used widely by the elderly.Objective:This study evaluates the efficacy of an herbal formula made from Foeniculum vulgare Mill.and Rosa damascena for the treatment of constipation in an elderly population and consequent changes to their quality of life.Design,setting,participants and intervention:This double-blind randomized active controlled clinical trial,with parallel group allocation ratio of 1:1,was conducted in a referral clinic in Afzalipour Hospital,affiliated to Kerman University of Medical Sciences in Kerman,Southeastern Iran.Individuals over 60 years of age,diagnosed with functional constipation(based on the RomeⅣcriteria),were included in this study.Participants received a sachet of 10 g F.vulgare and R.damascena(herbal formula group)or polyethylene glycol 4000(PEG 4000 group)with a glass of warm water two times a day for 4 weeks and were followed up for 4 additional weeks.Main outcome measures:Constipation severity,stool consistency,and the quality of life were used as the primary outcomes.Drug side effects were used as a secondary outcome.The outcomes were assessed using the Constipation Assessment Scale,the Bristol Stool Form Scale,and the Patient Assessment of Constipation Quality of Life questionnaire.Results:A total of 25 participants in each group completed the four-week treatment cycle and the eightweek follow-up.At the end of the four-week treatment cycle,all clinical outcomes had significant improvements in both groups(P<0.05).The analysis of constipation severity(P<0.001),stool consistency(P<0.001),and the quality of life(P<0.001)showed significant improvements with fewer side effects(mild diarrhea)and a longer duration of symptom relief in the herbal formula group compared to the PEG 4000 group.Conclusion:Although both interventions significantly improved the treatment out

关键词： Elderly Constipation Foeniculum vulgare Mill. Rosa damascena Persian medicine Randomized controlled trial

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Reproductive outcomes of water pipe smoking:A scoping review

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亚太生殖杂志:英文版 2023年第5期12卷 211-219页

作者： Sahar Rostami Farzane Fereidouni Arezoo Maleki-Hajiagha Mohadese Motaharinejad Somayye Majidi Fardin Amidi department of Anatomy School of MedicineTehran University of Medical SciencesTehranIran Student Research Committee School of Nursing and MidwiferyShahrood University of Medical SciencesShahroodIran department of Economics Applied Statisticsand International BusinessNew Mexico State UniversityLas CrucesNMUnited States

Objective:To present an overview of the adverse effects of water pipe smoking on various aspects of reproduction and perinatal complications,covering all the most relevant studies,from descriptive findings to clinical trials.Methods:We reviewed the literature and included full publications in English provided by international biomedical databases,including PubMed,Science Direct,EBSCO,Scopus,and Google Scholar,and Cochrane Library over the last 38 years(May 1985 to June 2023).Search terms(Water pipe,Narghile,Shisha,Dokha,etc.,and Reproduction,Fertility,etc.)were adopted from Medical Subheading(MeSH)and Boolean operators were utilized to improve sensitivity.Results:133 Papers were identified in the initial search,of which 29 were excluded due to duplication.Eliminating search overlap and irrelevant records by reviewing titles and abstracts reduced 42 papers.62 Full-publication articles met the inclusion criteria.We summarized the effects of waterpipe smoke exposure on reproductive health based on three main categories:male and female fertility,fetal and neonatal outcomes,and pregnancy complications.Conclusions:Water pipe smoking has potential adverse effects on different aspects of human reproductive health,including semen parameters,male and female fertility,and fetal and neonatal health,and contributes to many maternal complications and morbidities.

关键词： Water-pipe smoking Tobacco Fertility Reproduction Pregnancy

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Progressive exhaustion:A qualitative study on the experiences of Iranian family caregivers regarding patients undergoing hemodialysis

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International Journal of Nursing Sciences 2018年第2期5卷 193-200页

作者： Shahriar Salehitali Fazlollah Ahmadi Ali Hasanpour Dehkordi Kobra Noorian Malek Fereidooni-Moghadam Kouroush Zarea Nursing department Faculty of Nursing&MidwiferyShahrekord University of Medical SciencesShahrekordIran Nursing department Faculty of Medical SciencesTarbiat Modares UniversityTehranIran Nursing and midwifery Care Research Center Faculty of Nursing and MidwiferyIsfahan University of Medical SciencesIsfahanIran Nursing Care Research Center in Chronic Diseases Ahvaz Jundishapur University of Medical SciencesAhvazIran

Objective:The aim of this study was to explore the burden of care for patients undergoing hemodialysis from the experiences of family caregivers.Methods:In this qualitative study,a content analysis approach was used for data collection and analysis.Participants were 16 family caregivers selected through purposive sampling from four medical education centers affiliated with Ahvaz Jundishapur University of Medical Sciences,Iran.Semi-structured interviews were held to collect data.Results:Four categories were developed as follows:‘care challenges’,‘psychological vulnerabilities’,‘the chronic nature of care’and“care in the shade”.The categories led to the development of the main theme of‘progressive exhaustion’experienced by the family caregivers during the provision of care to patients undergoing hemodialysis.Conclusion:Family caregivers have a significant role in the process of patient care,and this role leads them to progressive exhaustion;therefore,the overall health of the caregivers should be taken into account and more attention should be paid to their quality of life,social welfare,and satisfaction level.

关键词： Family caregivers Hemodialysis Progressive exhaustion Qualitative study

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Agreements’profile of Scheimpflug-based optical biometer with gold standard partial coherence interferometry

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International Journal of Ophthalmology(English edition) 2023年第12期16卷 2095-2104页

作者： Sara Sardari Akbar Fotouhi Ebrahim Jafarzadehpur Mehdi Khabazkhoob Research and Technology Deputy Tehran University of Medical SciencesTehran ***Iran Noor Ophthalmology Research Center Noor Eye HospitalTehran ***Iran department of Epidemiology and Biostatistics School of Public HealthTehran University of Medical SciencesTehran ***Iran Noor Research Center for Ophthalmic Epidemiology Noor Eye HospitalTehran ***Iran department of Basic Sciences School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehran ***Iran

AIM:To determine the agreement of ocular biometric indices including axial length,keratometric readings,anterior chamber depth,and horizontal corneal diameter between the Pentacam AXL and IOL Master 500.METHODS:The study was a large cross-sectional population-based study(Tehran Geriatric Eye Study)conducted from Jan 2019 to Jan 2020.A total of 160 clusters were randomly selected proportional to size(each cluster contained 20 individuals)from 22 strata of Tehran city.All people aged 60y and above were invited to participate in the study.For all participants,preliminary ocular examinations were performed including the measurement of uncorrected and best-corrected visual acuity,objective and subjective refraction,anterior and posterior segment examinations.All participants underwent an ocular biometry using the Pentacam AXL and IOL Master 500.RESULTS:The 95%limits of agreement(LoA)between the two devices were-0.13 to 0.19,-0.15 to 0.17,and-0.13 to 0.19 in normal,pseudophakic,and cataractous eyes,respectively.With increasing the axial length,the difference between the two devices significantly increased in all three groups of normal,pseudophakic,and cataractous eyes(P<0.001).The 95% LoAs between the two devices regarding the mean keratometry shows that the best LoAs were seen in cataractous(-0.33 to 0.81)and followed by normal eyes(-0.36 to 0.86)and the pseudophakic eyes(-0.48 to 0.90)had the widest LoA.The 95% LoAs for horizontal corneal diameter measurements were-0.08 to 0.86,-0.03 to 0.83,and-0.07 to 0.87 in normal,pseudophakic,and cataractous eyes,respectively.The 95% LoAs of anterior chamber depth measurements between the two devices was-0.39 to 0.19 and-0.37 to 0.13 in normal eyes and cataractous,respectively.CONCLUSION:The Pentacam AXL has excellent agreement with the gold standard,IOL Master 500 in measuring axial length.In eyes with cataracts,the difference between the two devices is more scattered.With the increasing of axial length,the difference between the two devices increased,which should be considered

关键词： ocular biometry optical biometer Pentacam AXL

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