A 7. 3-magnitude earthquake recently shook the Ezgeleh district, located about 143kmfrom Kermanshah city (12/11/2017), in the western part of the country. Due to the severity of the earthquakes and the infrastructure of the nearby cities and villages, a largenumber of VICTIMS needed medical treatment. Since earthquakes are natural DISASTER, the state of unpreparedness of the health care systems against natural DISASTERs is unusual. Therefore, the aim of this paper was to assess this critical situation and better prepare for subsequent earthquakes.

Aims Mourning and grief are common experiences that can be stressful events with adverse physical, social, and psychological consequences. This study aimed to design and develop Inter-Organizational Psychosocial Support for the family and survivors of the deceased Covid-19. Participants & Methods This qualitative study was conducted in 2021. After a review of literature, several focus group discussions and rounds of Delphi were carried out with 35 experts, who were selected purposively. The interventions were presented to the target group as a pilot for six months. Findings Inter-organizational Interventions are presented in 5 main stages. Initial social worker assessment, mental assessment by mental health experts, complete a checklist and send it to the expert in charge of social work at the university, providing social and economic interventions by social workers in cooperation with support organizations and finally followup, termination, and documentation. Conclusion The results of this study can be used as inter-organizational interventions to facilitate the realization of social equality and justice especially for vulnerable people.

Objective: Providing effective and correct care to patients requires clinical competence. One of the important components in clinical competence is spiritual intelligence the purpose of the study was to consider the correlation between clinical competence and spiritual intelligence in students who are children of VICTIMS of war of Hamadan University of Medical Sciences in 2019. Method: The cross-sectional study was carried out on 145 Martyrs' and War Veterans' Students of medical, nursing, midwifery, and paramedical schools. Sampling was done through census of students of operating room, anesthesia, medicine, nursing, midwifery, laboratory science, and radiology. The data collection tools were Kazdin et al’ s (1986) Spiritual Intelligence questionnaire and Liu et al’ s (2009) Clinical Competency Assessment questionnaire. Data were analyzed by SPSS 23 software. Results: The results of data analysis showed a direct, positive, and significant linear relationship between spiritual intelligence and clinical competence of all students (P < 0. 05). According to the students' self-report, the highest mean score of clinical competency of the students was related to medical students with a mean score of 37 and the lowest to the laboratory students with a mean score of 30 (P =0. 012). In addition, the results showed that the highest mean score of spiritual intelligence belonged to nursing students with a score of 48 (good spiritual intelligence) and the lowest to radiology students with a score of 39 (moderate spiritual intelligence) (P =0. 019). Conclusion: We found that there is a direct and positive correlation between spiritual intelligence and clinical competence, so it seems that promoting spiritual intelligence may be associated with an increase in clinical competence.

Introduction: Many of those who survive following an earthquake die in the next phase due to preventable and treatable medical conditions such as hyperkalemia. The present study aimed to evaluate the trend of potassium changes in crush syndrome patients of Bam earthquake. Methods: In this retrospective cross-sectional study, using the database of Bam earthquake VICTIMS, which were developed by Iranian Society of Nephrology following Bam earthquake, Iran, 2003, the 20-day trend of potassium changes in > 15 years old crush syndrome patients was evaluated. Results:135 crush syndrome patients with the mean age of 29.9 § 9.91 years were evaluated (56.3% male). Mean potassium concentration during the first 3 days of admission was 5.6 § 1.3 mEq/L. On the day of admission, 43.1% (95% CI: 34.0 - 52.2) had normal potassium concentration, 3.4% (95% CI: 0.1 - 6.8) had hypokalemia, and 53.4% (44.3 - 62.6) had hyperkalemia. During 20-day follow-up, 62.3% (95% CI: 66.7-71.9) of the patients had normal potassium. While, 11.5% (95% CI: 9.7-13.3) had hypokalemia and 19.2% (95% CI: 17.0-21.5) had hyperkalemia. As the days of hospitalization increased, prevalence of hyperkalemia decreased while hypokalemia increased. On the 17th day 21.2% (95% CI: 2.2-39.9) had hypokalemia and 10.5% (95% CI: 0.1 -24.7) had hyperkalemia. Conclusion: Findings of the present study showed that following urine alkalinization and fluid resuscitation, the prevalence of hyperkalemia reduced, but hypokalemia developed. It seems that the correction of serum potassium level should be accompanied by precise monitoring of intake and output of the patient and prescription of reasonable amount of intravenous fluid.

Introduction: Electrolyte imbalances are very common among crushed earthquake VICTIMS but there is not enough data regarding their trend of changes. The present study was designed to evaluate the trend of changes in sodium, calcium, and phosphorus ions among crush syndrome patients. Methods: In this retrospective cross-sectional study, using the database of Bam earthquake VICTIMS, which was developed by Iranian Society of Nephrology following Bam earthquake, Iran, 2003, the 10-day trend of sodium, calcium, and phosphorus ions changes in > 15 years old crush syndrome patients was evaluated. Results: 118 patients with the mean age of 25.6 ± 6.9 yearswere studied (57.3 male). On the first day of admission, 52.5% (95% CI: 42.7 - 62.3) of the patients had hyponatremia, which reached 43.9% (95% CI: 28.5 - 59.3) on day 10. 100.0% of patients were hypocalcemic on admission and serum calcium level did not change dramatically during the 10 days of hospitalization. The prevalence of hyperphosphatemia on the first day was 90.5% (95% CI: 81.5 - 99.5) and on the 10th day of hospitalization 66.7% (95% CI: 48.5 - 84.8) of the patients were still affected. Conclusion: The results of the present study shows the 52.5%prevalence of hyponatremia, 100% hypocalcemia, and 90.5% hyperphosphatemia among crush syndrome patients of Bam earthquake VICTIMS on the first day of admission. Evaluation of 10-day trend shows a slow decreasing pattern of these imbalances as after 10 days, 43.9% still remain hyponatremic, 92.3% hypocalcemic, and 66.7% hypophosphatemic.