BACKGROUND: Today, as many as 1.5 million Americans use ventilators once in a year. Response to mechanical ventilation ALARMs remains to be one of the most challenging tasks facing physicians, nurses or other medical personnel in the ICU. In the present study we aimed to compare the response times to “VOCAL ALARMs” and “visual or audible ones”.METHODS: In the present study we developed a system to evaluate the “VOCAL ALARM” and improve the medical ventilator“Benet 7200 ALARMs” with it. Ventilator generates the ALARMs when patient has any problem. The time of Activation and Deactivation is recorded. The survey was done in central ICU for six days, 3 days with VOCAL ALARM, and 3days with“Beep” ALARMs and detected ALARM events then recorded seventy-two hours of data for each type of ALARMs. All of events information saved in the memory and SPSS was used to determine difference between two types of ALARMs.RESULTS: On the average, the duration of the ventilator ALARMs activation were 33±21 seconds for VOCAL ALARMs and 60±46 for audible “Beep” ALARMs. The response times for VOCAL ALARMs were significantly lower (P=0.001).CONCLUSIONS: The response times for normal “Beep” ALARMs were longer than VOCAL ALARMs.

Aims: Ventilators designed to generate the ALARMs when patient have any problem. However, these ALARMs can blend in with other accustomed sounds of the intensive care unit. This study was to improve medical ventilator ALARMs in ICU by comparing VOCAL and beep ALARMs regarding to nurses and physicians opinion.Methods: Studied "VOCAL ALARM" designed in Persian language and put on "Bennet 7200" ventilator. In critical conditions, VOCAL ALARM system using a software microprocessor broadcasted recognized ALARMs in speech, respectively. 40 questionnaires from nurses, physicians and assistants collected and data analyzed with SPSS 11 software.Results: 22 (54.5%) of attitudes were unsatisfied with this belief that death is more occuring with VOCAL ALARMed ventilator. Response duration for normal beep ALARMed ventilators was longer than VOCAL ALARMs.Conclusion: The VOCAL ALARMs improve patient safety by alerting all medical staff in the ICU of all critical ventilator events. Using VOCAL ALARM system reduces the response duration to ALARMs of the ventilator events.

Fire ALARM systems are essentially installed in specific firefighting equipment and serve as one of important ALARM equipments which senses fire early. The main goal of the study is to find methods for improving the structure of fire ALARM needs. This study is about false ALARMs of fire indicating equipment in fire ALARM systems. It is found that false ALARMs false ALARMs by fire ALARM systems are constantly occurring and fire safety manager is neglecting his duty of work by turning ALARM bell stop switch on even during usual times. To prevent this, the ALARM bell stop switch should be changed into an automatically resettable manual operation type so that it can automatically reset to its original state even though fire safety manager turns the switch on. As a result, aid in correcting fire safety managers' wrongful practices by making the ALARM bell ring whenever an actual fire occurs, and ultimately reduce false ALARMs by eliminating fundamental causes when false ALARMs occur.

Background & Aim: Patient monitoring in cardiac intensive care unit (CICU) is considered to be non-invasive and safe, but it can cause unintentional catastrophic consequences due to the ALARM fatigue. The aim of the study was to determine the status of monitoring system ALARMs and nurses’ ALARM fatigue. Methods & Materials: This descriptive, cross-sectional study was carried out in cardiac intensive care units of a hospital in Fars province from January to March 2019. The ALARM status of 24 monitoring devices was observed for 100 hours in 100 patients under the physiological monitoring. Patients under monitoring were included in the study using a continuous and convenience sampling. Also, 62 nurses working in five CICUs of this hospital completed the ALARM fatigue questionnaire (through census). The data obtained from the observation and the questionnaires were analyzed by the SPSS software version 16 using descriptive statistics. Results: The auditory ALARMs of monitoring devices were turned off and only visual ALARMs could be recorded. In the visual ALARMs recorded during 100 hours, 131 ALARMs (53. 47%) were technical, followed by the false, nuisance, and ultimately real or actual ALARMs with rates of 40 (16. 33%), 38 (15. 51%) and 36 (14. 69%), respectively. The mean (and standard deviation) score of ALARM fatigue among nurses was 21. 04 (7. 52), and the ALARM fatigue score for %50 of nurses was higher than the average score. Conclusion: Turning off the auditory ALARMs can lead to serious risks to patients. Also, a high proportion of technical, nuisance, and false ALARMs can cause ALARM fatigue in nurses. Adopting solutions in accordance with standard guidelines and checking physiological monitoring devices in hospitals are necessary in order to reduce false, nuisance, and technical ALARMs. Failure to pay attention to these issues leads to the ALARM fatigue among nurses, which itself results in numerous consequences such as compromising the patients’ safety.

Introduction: ALARM fatigue occurs when there is a high number of ALARMs and their sensitivity leads to complications and endangers patient safety. Effective management of these ALARMs is crucial in the neonatal intensive care unit (NICU) due to the delicate conditions of newborns. Therefore, this study aims to investigate ALARM fatigue and gain insights into nurses' perspectives on ALARM management in NICUs. Methods: This descriptive study was conducted in the year 1400 and included 96 nurses working in neonatal intensive care units affiliated with Tehran University of Medical Sciences. Convenience sampling was used to select participants. The researchers collected data using a demographic information questionnaire, a clinical ALARMs survey, and a nurses' ALARM fatigue questionnaire. Subsequently, the data were analyzed using SPSS software. Results: The nurses' ALARM fatigue score was found to be 19.65±6.35, indicating a moderate level of ALARM fatigue. Furthermore, the findings revealed a statistically significant positive correlation between the number of working hours per month and ALARM fatigue (P=0.017). As the number of working hours increased, nurses experienced more fatigue due to ALARMs. The results also showed that 44 nurses (45.8%) reported no improvement in the clinical ALARM system in the past two years. Additionally, 46 individuals (47.9%) stated that the institute had not implemented new technological solutions to ensure ALARM safety. Among the participants, 25 nurses (26%) reported unfortunate incidents caused by issues with clinical ALARMs in the past two years. Conclusion: Intervention is necessary to reduce the frequency of disturbing ALARMs and improve incident management. This can be achieved by implementing advanced monitoring systems and addressing inappropriate ALARM handling. Potential solutions include adjusting nurses' working hours on a monthly basis, providing training to enhance their knowledge, and combining training with technology-based interventions to reduce ALARM fatigue and enhance patient safety.

There are various methods of treatment for primary nocturnal enuresis. The conditioning therapy by enuresis-ALARM is the most effective therapy for primary nocturnal enuresis. There are, however , a few studies in our society about its effect and side effects. In this study, sixty children with primary nocturnal enuresis were included in a randomly controlled trial. All had light sleep and no organic disease according to history and physical examination . The children were allocated to two match groups. In the first group, 30 children, each used enuresis-ALARM and in the second group 30 children were considered as control without any treatment. After a short period (1-2 Week), 4 children (belonging to the first group) refused to take the treatment by enuresis-ALARM (13.3%). All of them were under 10 yr of age. 26 children used enuresis-ALARM for 2-3 months. At the end of the treatment , 23 children developed improvement (Complete and relative) but in the control group, 4 children developed spontaneous improvement (P = 0). In the first group , 13 children had complete improvement (50%) and 10 children had relative improvement (38.5%), However, in the second group 1 child had spontaneously complete improvement (3.3%) and 3 children had relative improvement (10%). Two months after cessation of treatment, 3 children from the first group developed relapse (11.5%). One of them responded quickly to a second course of ALARM-training. There was not any relapse in the control group. The main problem in this method of treatment was the breakdown of the enuresis-ALARM.

Background: Voice production is a complex mechanism, and the primary tool of the population of professional voice users requires special care. Hence, one area of learning provided by speech and language pathologists to this population is VOCAL hygiene. The current study was conducted to investigate the effectiveness of VOCAL hygiene education on actors’,knowledge. Methods: In this semi-experimental study of one-group clinical trials, 50 actors (29 males and 21 females aged 18-50 years) were selected based on available sampling. Participants were asked to complete the “, assessment of actors’,VOCAL knowledge”,questionnaire. During 4 sessions lasting 60 minutes each, the participating actors were trained on the VOCAL hygiene package. One week after the last training session, participants were again asked to complete the questionnaire. Data was analyzed using SPSS software version 21, and indicators of descriptive statistics were analyzed. Results: The mean score of voice abuse and non-abusive behaviors, which was 23. 34 before training with the VOCAL hygiene package increased to 28. 56 after education, a statistically significant change (P<0. 001). The level of knowledge of participants on the mechanism of phonation increased after education from an average score of 10. 12 to an average score of 11. 21 (P<0. 001). The mean score of knowledge of larynx pathology after education rose from 16. 58 to 21. 44, a significant change (P<0. 001). Conclusion: The provided VOCAL hygiene educational package increased the actors’,knowledge of the mechanism of phonation, voice abuse and non-abusive behaviors, and the functional and structural disorders of the voice.

The bacterial resistance to antibiotics have become a worldwide health concern. Tetracycline has not been excluded, its low price and broad-spectrum antimicrobial agent activity have led to high consumption in the aspects of health care and food hygiene. Escherichia coli is an indicator of bacterial species in food, human, and livestock health, which has led to a good model for studying antibiotic resistance. The purpose of this study was to evaluate the E. coli strains tetracycline resistance status in food, human and animal populations of Iran up to 2018. The discussion about food is important as a common area of human, animal populations and environment and also as one of the resistant strain transmission factors. A survey of the study’ s results showed that the average resistance to Tetracycline in poultry with Colibacillosis 86/74 percent, human isolates 64/11 percent and food isolates are 60/9 percent. Regarding this level of resistance, it is recommended that the distribution and consumption of tetracycline in Iran should be discontinue for a period of time in order to reduce the population of resistant strains by other antibiotics and methods. The molecular epidemiology and affecting factors of resistance creation should be evaluating.