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Background: Emergency departments (ED) are characterized by highly dynamic environments. This study aimed to identify determinants of resilience and mental stress among ED nurses., Methods: A cross-sectional, analytical design was employed to assess 316 emergency nurses in Kermanshah hospitals using a convenience sampling method. The Connor-Davidson Resilience Scale and the Perceived Stress Scale measured resilience and mental stress, respectively. Data were analyzed using independent t-tests, ANOVA, chi-square tests, and Pearson's correlation in SPSS version 25., Results: The average mental stress score was 26.9, and the average resilience score was 64, indicating moderate levels. Significant relationships were found between employment status, emergency responsibility, economic status, and resilience (P < 0.01). Additionally, place of residence, number of children, education, shift work, social network presence, employment status, emergency responsibility, and economic status were significantly related to psychological stress (P < 0.01). Pearson's correlation showed an inverse relationship between resilience and mental stress (r = -0.123, P = 0.029). Age was inversely related to mental stress (r = -0.408, P < 0.001), while overtime hours per month were directly related to resilience (r = 0.135, P = 0.016) and inversely related to mental stress (r = -0.482, P = 0.029)., Conclusion: The research highlights the importance of considering demographic variables in managing nurses' resilience and mental pressure, emphasizing the need for hospital officials to focus on work shifts, employment status, and economic conditions., Competing Interests: Declarations. Ethics approval and consent to participate: In accordance with the Declaration of Helsinki and principles of ethical research, this study was approved by the Ethics Committee of Kermanshah University of Medical Sciences (Ethics code: IR.KUMS.REC.1401.080). Participants were assured of the confidentiality of their data. They were also informed of their right to withdraw from the study at any time. Informed consent was obtained from all individual participants included in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Aim: The present study was conducted to determine the effect of the superficial heat-cold application on the sleep quality of patients with restless leg syndrome., Design: This study was a systematic review and meta-analysis., Methods: In the present study, the electronic databases Scopus, ProQuest, Web of Science, PubMed, SID and Google Scholar were searched from their inception to September 2023. The quality of included studies was evaluated through the Cochrane Collaboration's Risk of Bias Tool, and finally, a meta-analysis was conducted by calculating standardised mean differences (SMDs)., Results: The meta-analysis results revealed that superficial heat-cold application improved sleep quality in patients with RLS (SMD = 0.685, 95% CI: 0.421-0.950). The meta-regression results showed that as the temperature increased, the intervention was more effective in improving sleep quality (β = 0.0182, 95% CI: 0.0096-0.0268, p < 0.05). Moreover, the effectiveness of the intervention in improving the sleep quality of patients with RLS reduced significantly as the duration of intervention in each session (β = -0.031, 95% CI: -0.059 to -0.001, p < 0.05) as well as participants' age increased (β = -0.013, 95% CI: -0.024 to -0.001, p = 0.0259)., Patient or Public Contribution: This research showed that superficial heat-cold application had the capability to improve the sleep quality of patients with restless leg syndrome. In addition, in this study, settings were suggested according to which the maximum effectiveness of the intervention could be achieved., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Background: The clinical readiness of newly graduated nurses is crucial in meeting the growing demand for health services. Consequently, it is essential to develop a scale that accurately evaluates the clinical readiness of these novice nurses., Aim: This study aimed to translate and psychometrically evaluate the Persian version of the Nursing Practice Readiness Scale (NPRS) for new graduate nurses., Methods: This methodological and cross-sectional study was conducted on new graduate nurses from June to November 2023 in Kermanshah City, Iran. The translation of the scale was performed using the forward-backward translation method. Construct validity was assessed using Exploratory Factor Analysis (EFA) with a sample of 180 participants and Confirmatory Factor Analysis (CFA) with a sample of 318 participants, both employing the convenience sampling method. The internal consistency of the tool was measured using Cronbach's alpha coefficient. Additionally, the tool's reliability was evaluated using the intraclass correlation coefficient (ICC). The analyses were conducted using SPSS version 27 and LISREL version 8 software., Results: The results of EFA and CFA confirmed the tool's structure, comprising five factors and 35 items. The CFA results showed a well-fitting model (CFI = 0.96, NNFI = 0.96, GFI = 0.893, RMSEA = 0.062, SRMR = 0.049). Pearson's correlation coefficient indicated a significant relationship between the items, subscales, and the main scale. Additionally, the Cronbach's alpha coefficient of the tool was 0.932, and the intraclass correlation coefficient (ICC) was 0.891(0.724-0.957)., Conclusion: The Persian version of the Nursing Practice Readiness Scale (NPRS) is a valid and reliable tool, comprising 35 items and five factors. This scale can be effectively used to evaluate the clinical readiness of newly graduated nurses within the Iranian community., (© 2024. The Author(s).)

Background: Internet addiction is a common disorder in nursing students, and this calls for a deeper investigation into this phenomenon and its dimensions. The aim of this study was to explain the internet addiction model based on academic performance, academic experience, and clinical self-efficacy in nursing students., Materials and Methods: This study is a correlational and path analysis study that was conducted on 340 nursing students. Data collection tools included Yang's internet addiction questionnaire and self-efficacy in clinical performance scale. In this study, the academic grade point average was the measure of academic performance and the academic term was the measure of academic performance. Data were analyzed using SPSS-16 and AMOS-22 software, descriptive and analytical statistics, and structural equations., Results: There was a significant negative correlation between clinical self-efficacy ( r = -0.950, P ≤ 0.01), academic experience ( r = -0.872, P ≤ 0.01), and academic performance ( r = -0.654, P ≤ 0.01) with internet addiction. A negative and significant relationship was found between the internet addiction and variables of clinical self-efficacy (total effect = -0.743, P < 0.001). Model fit indices were good and acceptable., Conclusions: There was a negative and significant relationship between the variables of clinical self-efficacy, academic experience and academic performance, and the internet addiction. Meanwhile, the academic experience had a negative and significant effect on the internet addiction. This finding highlights the need to implement advisory and psychological interventions to reduce internet addiction, especially in students with less academic experiences., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

Background: Restless legs syndrome (RLS) is a sensorimotor disorder leading to disturbance of resting, discomfort, stress, and impaired daytime activity in the sufferers. The present systematic review and meta-analysis was conducted to determine the effect of temperature therapy on the severity of RLS. Methods: The electronic databases of Google Scholar, ProQuest, Scopus, PubMed, Web of Science, and State Inpatient Databases (SID) were searched from inception to August 2022. The Cochrane Collaboration's Risk of Bias Tool was used to check the quality of included studies. Meta-analysis was performed by calculating standardized mean differences (SMDs), using random effects model, and running Comprehensive Meta-Analysis (CMA) software version 2. Results: The included studies (n=6) comprised 177 participants, whose mean age was 49.85 years old. The results of the meta-analysis showed temperature therapy could reduce the severity of RLS (SMD=-1.520, 95% CI: -2.122 to -0.918). Regarding the source of heterogeneity, meta-regression results indicated the efficacy of the intervention in reducing the severity of RLS enhanced significantly by increasing the duration of the intervention in each session (β=-0.039, 95% CI -0.076 to -0.002, P <0.001). The results also showed increasing the duration (β=-0.039, 95% CI -0.076 to -0.002, P<0.001) and the temperature of the intervention in each session (β=-0.016, 95% CI -0.028 to -0.003, P <0.05) significantly enhanced the efficacy of the intervention in reducing the severity of RLS. The results also indicated that, among patients with underlying clinical conditions, the effectiveness of temperature therapy was higher in hemodialysis patients (β=-2.006, 95% CI -2.736 to -1.276, P <0.05). Conclusion: The present study findings suggested temperature therapy could mildly reduce the severity of RLS symptoms. It was also found that the highest efficacy of this intervention could be achieved when the higher temperature was used in fewer treatment sessions in hemodialysis patients. Based on our findings, this intervention can be included in the care plan of patients with RLS considering the settings described to achieve the highest efficacy., Competing Interests: Disclosures: The authors declare that they have no competing interests and that this research did not receive any specific grant from funding agencies. The datasets used during the current study are available from the corresponding author upon reasonable request., (Copyright © 2023 Marshfield Clinic Health System.)

Background and Aims: Experiencing nausea leads to decreased self-esteem and social isolation in hemodialysis patients and affects all aspects of their quality of life. Nausea and vomiting make hemodialysis unpleasant for patients leading to premature termination of hemodialysis. Therefore, based on this necessity, the present study was conducted to determine the effect of hemodialysis with cool dialysate on nausea in hemodialysis patients., Methods: In this clinical trial, 60 eligible patients receiving hemodialysis were randomly assigned to the control (30 participants) and intervention (30 participants) groups. In the control group, the patients received standard hemodialysis (37°C) for three sessions. Simultaneously, patients in the intervention group received hemodialysis with a cold solution (of 36°C) for three sessions. The patients' nausea and shivering rates were measured using the visual analog scale and the shivering standard assessment scale, respectively. Both groups were evaluated before and after 1 week of intervention. The study did not include blinding. The trial has been registered in the Iranian Registry of Clinical Trials (IRCT) with the number IRCT20200530047597N1. The present study was financially supported by Kermanshah University of Medical Sciences, Kermanshah, Iran (no. 990220). Data were analyzed using SPSS-25 software., Findings: The independent t test showed no statistically significant difference between the two control and experimental groups regarding the nausea rate in the three evaluation times ( p  < 0.05). Nevertheless, nausea severity decreased significantly after the intervention in the two groups. However, the rate of nausea in the intervention group with cold solution decreased more compared to the control group. Moreover, no patient in the intervention group experienced shivering during hemodialysis with a cool dialysate., Conclusion: According to the results of this study, it can be stated that the use of cold hemodialysis to control nausea in patients undergoing hemodialysis requires further studies and can be recommended as a nonpharmacological treatment to manage the treatment costs in case of efficiency., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Objectives: This study was conducted with the aim of determining the validity and reliability of the Persian version of "General Medication Adherence Scale (GMAS)" in chronic patients in Iran., Methodology: The study was conducted among patients with chronic diseases in five hospitals of Iran. In this study, after cultural validation, using the steps of Content, Response Reaction, and Internal structure evaluations, the research sample was increased to 150 individuals for exploratory factor analysis (EFA) and 313 chronic patients for confirmatory factor analysis (CFA) to confirm the construct validity. Cronbach's alpha coefficient was used to assess internal consistency, and test-retest method was used to evaluate the reliability of the tool., Findings: The results of EFA and CFA confirmed the tool with three factors and 11 items. The R 2 index in the above model was estimated at 0.99, indicating that 99% of the variation in medication adherence scores in research units was explained by GMAS with 11 items. The main indices of the model in factor analysis were all above 0.9, indicating a good fit for the model., Discussion: Overall, the study results showed that the Persian version of GMAS has acceptable and practical characteristics for evaluating medication adherence, and it can be used as a valid tool in various related fields., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The instruments used to measure presenteeism are all flawed and only incompletely measure the concept of presenteeism in employees of the general population. As a result, the concept of presenteeism is not measured, and in most of these instruments, the population for which the instrument has been developed differs from the nursing population. The present research was conducted to design and validate the instrument for evaluating presenteeism in nursing., Methods: The present study was part of an exploratory sequential mixed study. In this study, the instrument for measuring the level of presenteeism among nurses was developed and validated based on the results of the qualitative stage. To this end, the instrument's psychometric properties were investigated using face, content, and construct validity, as well as reliability through internal consistency and stability., Results: In this study, an instrument containing 17 items and three dimensions (imperfect cognitive presence, imperfect emotional presence, and imperfect movement presence) with favorable validation characteristics was developed. Therefore, the instrument was able to explain 56.375% of the total variance. Furthermore, Cronbach's alpha and McDonald's omega coefficients were 0.881 and 0.815, respectively. The intra-cluster correlation coefficient (ICC) was also reported as 0.972 for the entire instrument, with a 95% confidence interval of 0.941 to 0.987., Conclusion: Based this study, it was possible to measure the level of nurses' presenteeism through an instrument with favorable psychometric properties. This study helps health managers lay the groundwork for designing a system for measuring presenteeism among Iranian nurses using the developed instrument., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Introduction: Sleep disorders in hemodialysis patients are of high prevalence affecting the lives of these patients., Objective: The present study was conducted to investigate the effect of family-centered and peer-centered education on the sleep quality of hemodialysis patients., Methods: In this controlled clinical trial, 90 patients were randomly assigned to three groups (control, family-centered, and peer-centered). All three groups completed Pittsburgh Sleep Quality Index before the intervention. The intervention included five training sessions conducted by the researcher according to the patients' needs to improve their sleep quality. Routine ward interventions were performed for the control group. At the end of the study, the Pittsburgh Sleep Quality Index was completed by all three groups once again. Data were collected and analyzed using SPSS version 24 software and statistical tests., Results: No significant difference was found between the two intervention and control groups regarding demographic variables and variables related to sleep quality before the intervention ( p  < .05). However, based on the results of the Wilcoxon test, there was a statistically significant difference between the mean rank of sleep quality in the intervention and control groups after the intervention ( p -value = .008), indicating that sleep hygiene education was effective in the two intervention groups., Conclusion: According to the findings, the mean rank of sleep quality in the two intervention groups was significant after the training, indicating the effectiveness of family-centered and peer-centered education. Accordingly, medical healthcare managers, policymakers, and planners, including nurses, are recommended to employ these convenient, safe, and cost-free training methods and provide better sleep quality and more comfort to patients by spending a short period of time for training., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Introduction: To date, no definitive results have been reported on the effect of omega-3 fatty acids on premenstrual syndrome (PMS). Therefore, this systematic review and meta-analysis aimed to determine the effect of omega-3 fatty acids on PMS., Methods: In this systematic review and meta-analysis, the databases were searched. In this regard, randomized clinical trials investigating the effect of omega-3 fatty acids on PMS were included. The quality of the studies was assessed using the Cochrane Collaboration's Risk of Bias tool. Meta-analysis was done based on random effects model and calculation of standardized mean difference (SMDs)., Results: The results of meta-analysis showed that omega-3 fatty acids were efficient in reducing the severity of PMS in women (SMD = -0.968, 95% confidence interval [CI]: -1.471 to -0.464). In addition, the results showed that the studies were heterogeneous (I 2  = 89.11%, p <0.001). Based on meta-regression analysis, aging (β = -0.150, 95% CI -0.202 to -0.098, p <0.001) and increasing the duration of intervention (β = -0.579, 95% CI -0.781 to -0.378, p <0.001) had a significant effect on the severity of PMS. We also found that omega-3 fatty acids could significantly reduce the somatic (SMD = -0.800, 95% CI: -1.126 to -0.474) and psychological (SMD = -0.373, 95% CI: -0.686 to -0.061) symptoms of PMS., Conclusion: Omega-3 fatty acids could reduce the severity of PMS. However, we should caution in the conclusion in affirming the beneficial effects of n-3 PUFAs on PMS, since the heterogeneity is evident in the analysis. The efficacy of the treatment was enhanced by increase of the treatment duration., (© 2022 Japan Society of Obstetrics and Gynecology.)

Background: Primary dysmenorrhea is one of the most common complaints in women. To date, no definitive results have been reported on the effect of omega-3 polyunsaturated fatty acids (n-3 PUFAs) on primary dysmenorrhea. Therefore, this study aimed to determine the effect of n-3 PUFAs on primary dysmenorrhea using a systematic review and meta-analysis., Methods: This study is a systematic review and meta-analysis in which the electronic databases of PubMed, Scopus, Web of Science, ProQuest, Google Scholar, and SID were searched. In this regard, randomized controlled trials (RCTs) conducted to investigate the effect of n-3 PUFAs on primary dysmenorrhea were included. The quality of the studies was assessed using the Cochrane Collaboration's Risk of Bias Tool. Meta-analysis was performed based on the random-effects model using CMA software version 2., Results: The results of the meta-analysis showed that n-3 PUFAs reduce the severity of primary dysmenorrhea in women (SMD = -1.075, 95% CI: -1.871 to -0.279); meta-regression showed that the daily intake of n-3 PUFAs (β = 0.005, 95% CI 0.003 to 0.008, p < 0.001) and age of women (β = 0.256, 95% CI -0.157 to -0.354, p < 0.001) had a significant effect on the severity of primary dysmenorrhea., Conclusion: The present study showed that n-3 PUFAs could have a mild effect on the severity of primary dysmenorrhea in women. Furthermore, the highest effectiveness of treatment was seen at low doses of n-3 PUFAs, and with increasing daily intake, the effectiveness of treatment with n-3 PUFAs decreased. Another finding indicated that with the increasing age of women, n-3 PUFAs showed lesser effectiveness in reducing the severity of primary dysmenorrhea. The results of the present study provide valuable evidence to primary healthcare providers and health policymakers in the treatment of primary dysmenorrhea., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aim: This study aimed to investigate the effects of competency-based education on the clinical performance of health care providers., Background: Having in mind the importance of developing an intervention to enhance the clinical performance of health care providers, the researchers carried out the present study to investigate the effect of competency-based education on the clinical performance of health care providers., Methods: This was a systematic review and meta-analysis carried out by searching six international electronic databases including PubMed, Ovid, Cochrane Library, Web of Science, ProQuest, Scopus and Google Scholar, as well as two national electronic databases including IranMedex and SID. The studies relevant to the research aims were included in the study. To assess the quality of the studies, the Cochrane Collaboration's Risk of Bias Tool was used., Results: Based on the random effects model, competency-based education could enhance the clinical performance of the health care providers in the intervention group compared with that of the control group (standardized mean difference [SMD] = -2.717, 95% CI: -3.722 to -1.712). However, more recent studies have shown that competency-based education has little effect on clinical performance (β = -.255, 95% CI: -0.319 to -0.192, P < .001)., Conclusion: Competency-based education can enhance the clinical performance of health care providers. However, there is increasing concern over the attenuation of the positive effect of competency-based education on the clinical performance of health care providers, which deserves further studies., (© 2021 John Wiley & Sons Australia, Ltd.)

Background: Presenteeism describes the state in which staff who lack the conditions for being present at work and need rest and leave for various reasons (such as illness, low spirits, fatigue, etc.) are present at the workplace. Due to the lack of knowledge about the antecedents of presenteeism in nurses and the context-based nature of this concept, the present study was conducted to explain the reasons for presenteeism in nurses., Methods: This qualitative study was performed using the qualitative content analysis method. The study population consisted of 17 nurses working in different wards of hospitals. In this regard, data were collected from February to June 2020 using individual, face-to-face, in-depth, semi-structured interviews and were analyzed using qualitative content analysis., Results: The nurse without a nurse was a category introduced as an antecedent of presenteeism. In this respect, nurses experienced limited power, injustice, compulsory presence, inadequate structural facilities, damaged professional identity, manager-nurse disconnect, insufficient knowledge, physical and mental health complications, job stress, job burnout, multitasking, and impaired communication., Conclusion: The nurse, who has been responsible for caring, supporting, advising, advocating, and educating the patient, has now been left without a nurse. In other words, not nursing the nurse has given rise to the emergence of presenteeism. It is recommended that the results of this study be used in making health policies. The results of this study can make nurses' voices heard by health leaders and managers. A voice that has never been heard as it deserves., (© 2021. The Author(s).)

Purpose: To explore the concept of presenteeism in nursing., Method: A three-phase concept analysis using a hybrid model was used. In the theoretical phase (first phase), a literature review was conducted using PubMed, Web of Science, Proquest, EBSCO, Scopus, OVID, Cochrane Library, PsycINFO, Google Scholar, SID, and Iranmedex. In the fieldwork phase (second phase), semistructured interviews with 17 nurses were used. In the final analytical phase (third phase), the results of the previous phases were combined., Findings: In the final definition, presenteeism can be considered as a kind of fall from balance, in whose nature lies the non-actualization of capacities. If the imbalance of presence is due to the body, we are faced with the non-actualization of movement capacity, and regarding the imbalance caused by the soul, cognitive and emotional actualization is challenged., Conclusion: Exploration of the concept of presenteeism in the nursing is the basis for identifying this concept in a profession that deals with health as the most valuable human property., Implications for Nursing Practice: The identified attributes of presenteeism provide a deep insight for nurse managers into the nature of presenteeism. Nurse managers cannot deal with a destructive phenomenon without exploring and identifying its exact meaning., (© 2020 NANDA International, Inc.)

Objective: To determine the effectiveness and safety of essential oil from Citrus aurantium on anxiety in patients undergoing coronary angiography., Methods: A single-blind, randomized controlled trial was conducted in 80 patients experiencing coronary angiography in Imam Ali Hospital in Kermanshah, Iran from April to November in 2016. All patients were randomly divided into intervention and control groups by a random number table, 40 cases in each group. The patients in the intervention group inhaled Citrus aurantium essential oil for 15-20 min about 60 min before angiography. Following the same procedure, distilled water was used instead of Citrus aurantium in the control group. Spielbergers State-Trait Anxiety Inventory (STAI) was filled in and vital signs including systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory and pulse rate were recorded before and 20 min after the intervention. Adverse reactions after intervention were observed., Results: In the intervention group, the mean scores of STAI, SBP, DBP, respiratory and pulse rate were 53.30 ± 10.13, 134.82 ± 11.75 mm Hg, 84.49 ± 6.99 mm Hg, 17.87 ± 1.73 times/min, and 76.48 ± 12.55 beats/min at baseline and significantly decreased to 42.37 ± 10.15, 124.49 ± 10.48 mm Hg, 79.23 ± 6.62 mm Hg, 14.54 ± 1.43 times/min, and 70.03 ± 13.66 beats/min respectively 20 min after intervention (all P<0.05); however, in the control group, neither anxiety scores nor vital signs changed significantly (P>0.05). All subjects reported no adverse reactions., Conclusion: Inhalation of the essential oil from Citrus aurantium was effective in reducing anxiety and stress levels in patients undergoing coronary angiography., Trial Registration: IRCT2016040816797N2 (retrospectively registered on 21 April 2016, https://en.irct.ir/trial/15600 ).

Background: Premenstrual syndrome (PMS) refers to a set of somatic and psychological symptoms that occur cyclically in the luteal phase of a menstrual cycle. There is no report of final result of reflexology on PMS. Therefore, the present study aimed to determine the effect of reflexology on PMS through a systematic review and meta-analysis study., Method: The present study was a systematic review and meta-analysis that was conducted by searching in 8 electronic databases including PubMed, EMBASE, Cochrane Library, Web of Science, ProQuest, Scopus, Google Scholar, and SID until December 28, 2018. In this regard, interventional studies, which examined the impact of reflexology on women with premenstrual syndrome, were included. These studies were published during 1993 to 2018. The Cochrane Collaboration's Risk of Bias Tool was used to assess the quality of studies. Meta-analysis was performed by the help of CMA 2 software., Results: Nine out of 407 studies finally remained after screening, and quantitative and quantitative analyses were performed on them. The total number of research samples was 475. The mean treatment time with reflexology was 40.55 min per session that was performed in 6 to 10 sessions of treatment in 66.67% of studies. According to the meta-analysis and based on the random effects model, the reflexology could decrease the severity of PMS in the intervention group compared to the control group (SMD = - 2.717, 95% CI: - 3.722 to - 1.712). Meta-regression results indicated that the duration of intervention sessions (β = - 0.1124, 95% CI - 0.142 to - 0.084, p  < 0.001) had a significant impact on the severity of PMS. Reflexology could also significantly affect somatic (SMD = - 1.142, 95% CI: - 1.481 to - 0.803) and psychological (SMD = - 1.380, 95% CI: - 2.082 to - 0.677) symptoms arising from PMS., Conclusion: In general, results of the present study indicated that the reflexology could relieve PMS symptoms, so that overall scores, somatic and psychological symptoms of PMS decreased by applying the reflexology intervention. Furthermore, an increase in the length of reflexology time in each session increased its efficiency. Reflexology can be used as an effective intervention in a patient care program by nurses and its efficiency can be enhanced by increasing intervention time in each reflexology treatment session., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s). 2019.)

Objective: Malathion is the most organophosphates which capable to produce free radicals and induce disturbance on some of male reproductive parameter. Resveratrol is an herbal polyphenol and it has been beneficial antioxidant effects during short-term administration. This study was designed to evaluate the effects of Resveratrol against damage induced by Malathion to the reproductive parameter of male rats. Materials and methods: In this experimental study, 48 male rats were randomly assigned to 8 groups: normal control (saline) and Malathion control (250 mg/kg) groups; Resveratrol groups (2, 8, 20 mg/kg) and Malathion + Resveratrol (2, 8, 20 mg/kg). Treatments were administered intraperitoneally and gavage daily for 65 days. The sperm parameters, testis malondialdehyde (MDA), total antioxidant capacity (TAC), testosterone level and germinal layer height were evaluated and statistically analyzed. Results: The results displayed that the values of all parameters except MDA level (which increased) reduced significantly in the Malathion control group compared to the normal control group (p < 0.001). The Resveratrol and Resveratrol + Malathion treatments at all doses increased significantly all parameters except MDA level (which decreased) compared to the Malathion control group (p < 0.001). No significant modifications were observed in all Resveratrol groups compared to the normal control group (p > 0.05). Conclusion: Resveratrol attenuates toxic effect of Malathion on some of male reproductive parameters., (Copyright © Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences.)

Background: Pregnancy is associated with negative psychological symptoms (NPS) and multidimensional pain. Therefore, the present study was conducted to determine the effect of the combination of Benson's relaxation technique (BRT) and brief psychoeducational intervention (BPI) on multidimensional pain and NPS of pregnant women., Materials and Methods: The present randomized clinical trial was conducted on pregnant women referred to Imam Reza and Motazedi Hospitals in Kermanshah, Iran. In this regard, 60 pregnant women were randomly allocated to intervention ( n = 30) and control ( n = 30) groups. The groups attended BRT and BPI educational sessions for 4 weeks, but the control group received no intervention. Subsequently, both groups completed Depression Anxiety Stress Scale-21 and multidimensional pain inventory., Results: The mean NPS (stress, anxiety, and depression) was significantly decreased in the intervention group ( P < 0.001), while no statistically significant differences were observed in the control group ( P > 0.05). The independent t -test revealed a significant difference between the mean scores of intervention and control groups ( P < 0.001). The mean multidimensional pain was significantly decreased in mothers after the completion of educational sessions ( P < 0.001), and the independent t -test results indicated a significant difference between the scores of the intervention and control groups ( P < 0.001)., Conclusion: The results of this study suggested that the combination of BRT and BPI can lead to a reduction in the NPS and multidimensional pain in the pregnant women. This intervention is recommended to be considered as part of a healthcare program in pregnant mothers., Competing Interests: There are no conflicts of interest.

Background: Normal delivery is a natural and physiological process with numerous benefits for mother and baby. Giving birth by Caesarean Section (CS) should be limited to the cases in which normal delivery is not possible. The purpose of the study was to determine the attitudes of pregnant women towards Normal Delivery and factors driving the use of Caesarian Section in Kermanshah, Iran., Methods: This analytical-descriptive study was conducted on 410 pregnant women referred to the PHC centers in Kermanshah in western Iran. They had been selected through a multi-stage sampling method, including clustering, randomized, and proportional sampling, from among all eligible women. Data was collected using a questionnaire standardized by previous studies. The level of 0.05 was considered significance association, whenever applied., Results: The mean and standard deviation for participant age was 27.65 ± 5.37 years. The median score for participant attitude was 60.7 ± 9.5 (range from 22 to 85). Generally, 21.5% had a negative attitude toward normal delivery and preferred CS. Participant attitude was negatively correlated with a pregnant woman's age, lower age, and a more positive attitude towards vaginal childbirth. The attitude of women with a history of normal delivery was 63 ± 9 and for those with a history of CS was 56.7 ± 9.3, significantly different., Conclusion: Most women had a positive attitude towards normal delivery, particularly those who had experienced normal delivery in their previous childbirth. Although only a quarter of the participants had a negative attitude toward normal delivery, this figure still was of utmost significance, therefore educational interventions, specifically encouraging women with history of normal delivery to consult their peers, are recommended., Competing Interests: This study was approved by the Ethics Committee of Kermanshah University of Medical Sciences, Kermanshah, Iran.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Background: Oxidative stress is strongly associated with development of diabetes mellitus. F. vulgaris , contains antioxidant ingredients. This study was designed in order to evaluate the effect of F. vulgaris on the damaged liver in diabetic rats., Methods: In this study, hydroalcoholic extract of F. vulgaris was prepared. Sixty four male rats were divided into 8 groups ( n  = 8), including saline (normal control), streptozotocin (STZ) (diabetic control) (60 mg/kg), F. vulgaris (50, 100, 150 mg/kg), and STZ plus F. vulgaris (50, 100, 150 mg/kg) were administered through oral gavage on treated group once a day for 28 consecutive days. Serum nitrite oxide (NO) level, Ferric reducing/antioxidant power (FRAP), Malondialdehyde (MDA), liver weight, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), diameter of hepatocytes and central hepatic vein have been examined. Statistical analysis was performed using one-way analysis of variance and the post hoc test., Result: The outcomes showed that administrating streptozotocin enhanced liver MDA, nitrite oxide, the mean diameter of central hepatic vein and hepatocyte, liver enzymes significantly and reduced liver weight compared to saline group ( P  < 0.05). Though, administrating F. vulgaris and F. vulgaris plus STZ enhanced liver weight and tissue FRAP level significantly and reduced liver enzymes, NO levels, liver MDA, the mean diameter of hepatocyte and central hepatic vein in entire doses were equal to STZ group ( P  < 0.05)., Conclusion: It seems that, were equal F. vulgaris might recover liver injuries in diabetic rats., Competing Interests: Competing interestsThe authors declare that they have no competing interest.

Objective: Falcaria Vulgaris (F.Vulgaris) is a multipurpose herb in traditional medicine, containing essential amino acids, vitamins and numerous nutrients. The aim of this study was to determine the effects of F.Vulgaris on the on the milk production parameters in rats. Materials and methods: In this experimental study, 32 wistar female rats were equally divided into 4 groups; group1, control group and group2-4, experimental groups by various doses of F.Vulgaris (20, 50, 100 mg/kg) injected interaperitoneally once a day for 21 consecutive days. The milk production parameters including, diameter and number of alveoli, prolactin hormone level and receptor prolactin (PRLR) gene expression in mammillary gland tissue were measured and compared. Results: The results indicated that F.Vulgaris significantly increased diameter and number of alveoli, prolactin hormone level and PRLR gene expression compared to control group (p < 0.05). Conclusion: F.Vulgaris extract has positive effects on the milk production parameters in mammary glands.

Objective: Mothers with low birth weight infants experience more stress, which results in reduced breastfeeding self-efficacy and exclusive breastfeeding; In this regard, stress Inoculation Training (SIT) is one of the effective ways for inoculation against stress and psychological distress; Therefore, this study aimed to investigate the effect of SIT on breastfeeding self-efficacy and perceived stress of mothers with low birth weight infants. Materials and methods: This clinical trial study was conducted from October to December 2017 on 100 mothers with low birth weight infants; the infants had been hospitalized in the neonatal intensive care unit (NICU) in Kermanshah, Iran. The eligible mothers were randomly divided into two groups, i.e., intervention (n = 50) and control (n = 50) groups. Results: The mean score of breastfeeding self-efficacy, before SIT (33.82 ± 8.92) compared to after SIT (42.02 ± 8.83), significantly increased (p < 0.001), though no statistically significant difference was reported in the control group (p > 0.05). The mean score of perceived stress was significantly reduced after SIT (26.29 ± 6.49) compared to values before SIT (31.25 ± 5.82) (p < 0.001). Conclusion: The present study showed that on the one hand, SIT can effectively increase the breastfeeding self-efficacy in mothers with low birth weight infants; on the other hand, it can reduce their perceived stress. Therefore, the need for holding in-service training courses is felt in order to train the caregiving personnel, especially nurses, in applying the SIT technique.

Introduction: Restless legs syndrome (RLS) is a common disorder in hemodialysis patients. The present study was conducted to determine the effect of near-infrared (NIR) light therapy given to acupoints on the severity of RLS in patients undergoing hemodialysis., Methods: This single-blind, randomized controlled trial was performed on 60 hemodialysis patients with RLS. Participants who met the inclusion criteria were randomly assigned to an intervention group (n = 30) or a control group (n = 30). Data were collected using the International Restless Legs Syndrome Rating Scale (IRLSRS) and demographic information questionnaire. The intervention group received 12 sessions of NIR light therapy (940 nm) to acupoints in the legs and feet during hemodialysis three times a week, while the control group received sham treatment. Data were analyzed using SPSS version 22 software., Results: The results indicated that there were statistically and clinically significant differences between the intervention and control groups at the end of the intervention sessions ( P < 0.001, mean difference [MD] = 3.8). However, after the treatment was discontinued, the difference was not clinically significant (MD = 2.4). In the within-group compression, the mean RLS scores of the intervention group decreased significantly during the intervention sessions (MD = 3.2, P < 0.001); however, after the treatment was discontinued, the difference was not clinically significant (MD = 1.67)., Conclusion: The present study showed that the application of NIR light to acupoints in the legs and feet was as an effective treatment for attenuating the symptoms of RLS in hemodialysis patients., (© 2018 Marshfield Clinic.)

Background: Despite the emergence and development of evidence-based practice (EBP) in recent years, its adoption continues to be limited. This study used Rogers's diffusion of innovation theory to identify the factors that advance EBP adoption, determine the process by which such adoption occurs, and develop an EBP adoption model. Methods: This descriptive correlational study with model testing design conducted in 2015.Data were collected from 482 individuals (322 nurses and 160 nursing students) applying a demographic information questionnaire, a standard scale for the perception EBP attributes, an EBP scale, and an individual innovation inventory. The relationships between variables we reexamined by path analysis. Results: The results showed that EBP adoption had a significant positive relationship with individual innovation (r = 0.578, P < 0.001), knowledge (r = 0.657, P < 0.001), attitude (r = 0.623,P < 0.001), and age (r = 0.357, P < 0.001). The findings of path analysis indicated that the goodness of fit indices such as goodness of fit index (GFI) = 0.999, comparative fit index (CFI)= 0.999, root mean square error of approximation (RMSEA) = 0.036 were in the ideal ranges.Knowledge (total effect=0.309, P < 0.001), attitude (total effect = 0.372, P = 0.002), and work experience (total effect=0.321, P = 0.003) had the highest coefficient in the model. Conclusion: The results suggested that EBP adoption was influenced by various factors, such as individual innovation, attitude, knowledge, and the perception of EBP attributes. Among these factors, attitude had the greatest effect on EBP adoption. The findings can serve as a guide for the identification of factors that effectively influence EBP adoption. They can also be used as bases for the design of training programs intended to enhance the adoption of EBP.

Objectives: IL-12 as an anti-tumor cytokine and IL-33 a novel identified cytokine with both pro- or anti-tumor activities, play important roles in response against tumor cells. Our aim was to evaluate the IL-12 and IL-33 levels and single nucleotide polymorphisms (SNP) in their genes in patients with breast cancer., Materials and Methods: Blood samples were collected from 100 patients with breast cancer, and 100 healthy women were controls. The serum IL-12 and IL-33 levels were measured by ELISA. The SNP rs3212227 (in IL-12 gene) and rs1929992 (in IL-33 gene) were determined using PCR-RFLP., Results: The IL-12 levels similarly expressed in patients and controls. IL-12 levels in patients at stage I were significantly lower than in the healthy group (P<0.05). IL-33 levels and the IL-33/IL-12 ratio were significantly higher in patients than the control group (P<0.001). The IL-33 levels and IL-33/IL-12 ratio in stage IV patients were significantly higher than other stages and controls (P<0.0001 and P<0.001, respectively). There were no significant differences in the frequencies of genotypes in rs3212227 and rs1929992 between patients and the control group. No significant differences were observed between subjects with various genotypes at rs3212227 and rs1929992 with respect to related cytokine levels., Conclusion: These results indicate that the diminished IL-12 production may contribute to the tumor establishment. The higher IL-33 levels and IL-33/IL-12 ratio in patients also indicate an imbalance in Th1/Th2 responses that may contribute to tumor development. Thus, correcting the imbalance of Th1/Th2 could be an important strategy for cancer immunotherapy.

After proposing the idea of antiproton cancer treatment in 1984 many experiments were launched to investigate different aspects of physical and radiobiological properties of antiproton, which came from its annihilation reactions. One of these experiments has been done at the European Organization for Nuclear Research known as CERN using the antiproton decelerator. The ultimate goal of this experiment was to assess the dosimetric and radiobiological properties of beams of antiprotons in order to estimate the suitability of antiprotons for radiotherapy. One difficulty on this way was the unavailability of antiproton beam in CERN for a long time, so the verification of Monte Carlo codes to simulate antiproton depth dose could be useful. Among available simulation codes, Geant4 provides acceptable flexibility and extensibility, which progressively lead to the development of novel Geant4 applications in research domains, especially modeling the biological effects of ionizing radiation at the sub-cellular scale. In this study, the depth dose corresponding to CERN antiproton beam energy by Geant4 recruiting all the standard physics lists currently available and benchmarked for other use cases were calculated. Overall, none of the standard physics lists was able to draw the antiproton percentage depth dose. Although, with some models our results were promising, the Bragg peak level remained as the point of concern for our study. It is concluded that the Bertini model with high precision neutron tracking (QGSP&#95;BERT&#95;HP) is the best to match the experimental data though it is also the slowest model to simulate events among the physics lists.

Geant4 is an open source simulation toolkit based on C++, which its advantages progressively lead to applications in research domains especially modeling the biological effects of ionizing radiation at the sub-cellular scale. However, it was shown that Geant4 does not give a reasonable result in the prediction of antiproton dose especially in Bragg peak. One of the reasons could be lack of reliable physic model to predict the final states of annihilation products like pions. Considering the fact that most of the antiproton deposited dose is resulted from high-LET nuclear fragments following pion interaction in surrounding nucleons, we reproduced depth dose curves of most probable energy range of pions and neutron particle using Geant4. We consider this work one of the steps to understand the origin of the error and finally verification of Geant4 for antiproton tracking. Geant4 toolkit version 9.4.6.p01 and Fluka version 2006.3 were used to reproduce the depth dose curves of 220 MeV pions (both negative and positive) and 70 MeV neutrons. The geometry applied in the simulations consist a 20 × 20 × 20 cm(3) water tank, similar to that used in CERN for antiproton relative dose measurements. Different physic lists including Quark-Gluon String Precompound (QGSP)&#95;Binary Cascade (BIC)&#95;HP, the recommended setting for hadron therapy, were used. In the case of pions, Geant4 resulted in at least 5% dose discrepancy between different physic lists at depth close to the entrance point. Even up to 15% discrepancy was found in some cases like QBBC compared to QGSP&#95;BIC&#95;HP. A significant difference was observed in dose profiles of different Geant4 physic list at small depths for a beam of pions. In the case of neutrons, large dose discrepancy was observed when LHEP or LHEP&#95;EMV lists were applied. The magnitude of this dose discrepancy could be even 50% greater than the dose calculated by LHEP (or LHEP&#95;EMV) at larger depths. We found that effect different Geant4 physic list in reproducing depth dose profile of the beam of pions was not negligible. Because the discrepancies were pronounced in smaller depth and also regarding the contribution of pions in deposited dose of a beam of antiproton, further investigation on choosing most suitable and accurate physic list for this purpose should be done. Furthermore, this study showed careful attention must be paid to choose the appropriate Geant4 physic list for neutron tracking depending to the applications criteria. We failed to find any agreement between results from Geant4 and Fluka to reproduce depth dose profile of pion with the energy range used in this study.

Background: Cardiovascular health promotion in children has the potential to reduce the risk of atherosclerosis in both the individual child and the population at large. It thus seems eminently reasonable to initiate healthful lifestyle training in childhood to promote improved cardiovascular health in adult life., Aims: To test the hypothesis that a year long, classroom-based education for the third and fourth graders could change their knowledge scores about healthy heart., Settings and Design: A randomized, controlled trial in elementary schools of Bushehr/Iran., Methods and Materials: A total of 14 elementary schools, categorized by socioeconomic types and male and female setting were selected and randomized into control or intervention groups. Subjects were 1128 third and fourth graders, aged 9 to 10 years (49.1% boys and 50.9% girls). Over a course of 8 weeks, health educators and sport teachers of the elementary schools presented two hours sessions per week on heart function, nutrition, and exercise for healthy heart and living tobacco free for the intervention group. The education program was based on HeartPower! Program, an American Heart Association program., Statistical Analysis: Mann-Whitney U test and Wilcoxon matched-pairs signed rank test and Bonferroni correction for the two pair wise comparisons were used., Results: Total heart knowledge at posttest was 25% correct higher in the intervention than in the control group (p< 0.001). Difference in means of total healthy heart knowledge scores between control and intervention group increased from 1.43 points in baseline to 4.02 points in posttest (p< 0.001)., Conclusion: It can be concluded that the classroom-based cardiovascular health promotion had a significant effect on the heart healthy knowledge. Therefore, schools provide an excellent setting for introducing comprehensive healthy heart education and promotion of cardiovascular health to the general population.