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Since the (Covid-19) pandemic outbreak, questioning regarding climate and incident of Covid-19 infection rates has been debated, while there is no clear research evidence until now in Iran. This study has focused on investigating the association between Covid-19 cases and demographic –meteorological factors in arid and semi-arid zones of Iran (from March 1, 2020, to January 31, 2022) by analyzing with Via Poisson and negative binomial regression. As a result, the incidence rate of both Covid-19 hospitalization and mortality cases reached peaks in the summer followed by the autumn. Interestingly, Covid-19 hospitalization cases are associated with humidity, temperature, and wind factors seasonally and monthly, but mortality cases are just associated with wind. In conclusion, the result demonstrated that demographicand meteorological factorsare positively and negatively associated with Covid-19 cases. Therefore, identifying the environmental factors contributing to the excess Covid-19 can help to prevent future pandemic waves in Iranian arid and semi-arid zone. [ABSTRACT FROM AUTHOR]

While taking advantage of the educational benefits of smartphones, students also apply this device in inappropriate ways that cause certain disciplinary and educational problems. This study examines the effect of self-management training on smartphone dependence among male high school students. Methods: In this quasi-experimental study, data were collected using the Cell Phone Addiction Scale (Koo, 2009), which was completed by the trial and control groups before and after the educational intervention. After assessing their normal distribution, the data were analysed using the Chi-square test, the independent and paired t -tests, Mann–Whitney's U -test, and the Wilcoxon test at a significance level of p <.05. Results: The results showed significant post-intervention reductions in the mean score of smartphone dependence (35.10) and its three domains, including withdrawal/tolerance (14.80), life dysfunction (8.70), and compulsion/persistence (11.60), in the trial group compared to the controls (44.80, 16.2, 12.10, and 16.50) and also in the mean score of certain applications of smartphones (p <.05). Discussion and conclusions: Despite the existing limitations, the results confirmed the efficacy of self-management training in reducing smartphone dependence in the students. The implementation of this programme is recommended for reducing dependence and promoting the proper use of this device. [ABSTRACT FROM AUTHOR]

Background: Marital satisfaction is vital for the continuation of married life, and one of the factors negatively affecting this satisfaction is women’s employment in stressful positions, especially in families where the division of domestic tasks is traditionally based on gender. This study was conducted to determine the effect of a family-centered program to manage domestic roles on marital satisfaction in female nurses. Methods: This quasi-experimental study was conducted with a pre-test-post-test design with a control group and a two-month follow-up. The study population consisted of married female nurses working in two hospitals in Zabol City, Iran. Based on the determined sample size, this study was conducted on 50 female nurses and their husbands, who were randomly divided into the trial (25 couples) and control (25 couples) groups. Data were collected using Carlson’s work-family conflict scale (WFCS) and the enrich marital satisfaction questionnaire (1998). The trial group received a family-centered educational-supportive program to empower them in performing domestic roles and was compared to the control group after a two-month follow-up. Data were analyzed in SPSS software version 20 using the chi-square and independent tests for parametric data and Mann- Whitney’s U test for nonparametric data, at the significance level of P<0.05. Results: The mean score of marital satisfaction was significantly higher in the trial group compared to the control group after the intervention (P<0.05). Conclusion: The educational-supportive program for family management based on familycentered care decreased work-family conflict (WFC) in female nurses and led to improvements in marital satisfaction. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine pregnant women’s knowledge about COVID-19 and their anxiety and fear of the unknown. Methods: This online cross-sectional study was conducted in March and April 2020 on Iranian pregnant women visiting comprehensive healthcare centers affiliated with the Gonabad University of Medical Sciences. Participants were selected using a stratified random sampling strategy among pregnant women who agreed to participate, had a Telegram or WhatsApp account or phone number, and had no history of pregnancy complications. A demographic questionnaire, Spielberger’s state-trait anxiety inventory, fearing the unknown questionnaire, and an uncertainty scale was used to collect data. Data were analyzed using simple and multiple linear regression models using SPSS software, version 16. Results: A total of 190 pregnant women were included in the analysis. The Mean±SD for knowledge of COVID-19 was 8.82±1.72. The knowledge of 71.1% of participants was moderate. The Mean±SD for fearing the unknown was 36.2±9.1. The Mean±SD for the state anxiety about COVID-19 incidence in pregnant women was 47.6±10.2. The results showed that 65.3% of the participants had a moderate level of anxiety. Multiple regression analysis showed an increase of 0.16 (P=0.029) in the fearing the unknown score for each week of increase in the gestational age. Similarly, the anxiety increased by 0.56 (P<0.001) for each unit of increase in fearing the unknown. Moreover, the results showed that the anxiety of people using Telegram or WhatsApp was 3.44 units more than others (P<0.018) Conclusion: The findings showed that the pregnant women’s knowledge was moderate at the time of research. However, with increasing gestational age, fear of the unknown, and sources of knowledge were associated with anxiety. This points to the essentiality of increasing supportive programs and it is required to screen pregnant women to prevent the adverse effects of anxiety. [ABSTRACT FROM AUTHOR]

Maternal care and family functioning are major factors in controlling childhood disorders. The present study aimed to compare the quality of maternal care and family functioning in single-parent versus biparental families with preschool children. The present cross-sectional study was conducted on 213 single-mother (divorced or widowed) and biparental families with 3- to 6-year-old children in Gonabad County. The data were collected using the maternal care quality questionnaire and the family assessment device (FAD). The mean maternal care quality scores in the single-parent and biparental groups were 116.36 (Standard deviation (SD) = 19.33) and 130.53(SD = 5.70), respectively. The total family functioning scores in the single-parent and biparental groups were 2.70 (SD = 0.18) and 3.02 (SD = 0.11), respectively. Statistically significant differences were observed in the quality of maternal care and family functioning and their respective subscales between single-parent and biparental families (ps < 0.001). The quality of maternal care and family functioning in single-mother group was significantly lower than the biparental group. [ABSTRACT FROM AUTHOR]

Lifestyle is different in arid and semi-arid zones. However, where people are born and live have a lasting influence on their social and environmental exposure. This review focuses on the, various dimensions of environmental health imbalance inequality especially in significant environmental sources such as (ie, air, water, soil) among provinces that creates a big health gap in the center, East and the Southeast of Iran. Thus, the population of the arid and semi-arid zones of Iran is facing respiratory, cardiovascular, cancer and infection diseases linked to environmental problems such as chemical and microbial pollution due to air pollution and unsafe water sources, respectively. The prevalence of certain types of cancer such as skin, stomach, bladder, prostate and colorectal cancer together with some respiratory and cardiovascular diseases in arid and semiarid zones such as Kerman, Yazd, etc., has been reported in comparison with other provinces frequently. These impacts have effects on multiple levels of health security in those zones. Based on these concerns, we propose key questions that should guide research in the context of the socio environmental science to support science-based management actions in Iran and other similar semi-arid areas worldwide. [ABSTRACT FROM AUTHOR]

Objective: Coronavirus Disease 2019 (COVID-19) is a respiratory disease and a major global health-related issue. Knowledge, attitude and behaviours associated with this disease are being developed. Infected animals and consumption of contaminated foods are probably the main sources of this viral infection. Adhering to a healthy diet is effective in preventing patient affliction and recovery. Thus, the present research aims to determine the nutritional knowledge, attitude and behaviours associated with COVID-19 among Residents of Gonabad, Iran.Design: The present online cross-sectional survey was conducted in March 2020 on 389 people selected through convenient sampling method. The data collection instrument was a questionnaire developed by the present researchers comprising four sections: demographic information, knowledge, attitude and nutritional behaviour. The collected data were analysed statistically in SPSS.Setting: Gonabad city in Khorasan Razavi in the Northeast of Iran.Participants: All people at or above 18 years of age.Results: The present results revealed that the mean age of the participants was 37·3 ± 11·3 years. The mean scores for knowledge, attitude and nutritional behaviour were, respectively, 9·7 ± 1·4, 14·3 ± 3·5 and 29·6 ± 4·2. The mean scores for nutritional knowledge and attitude showed no statistically significant correlation with age, education, occupation, marital status and economic status. However, the mean nutritional behaviour score was significantly higher among women than men (P = 0·004).Conclusions: Participants' nutritional attitude and behaviour regarding COVID-19, at its early stage in Iran, were average and above average. The public education provided with this regard can have affected this result. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of a supportive educational intervention based on the Orem self-care model on women with type 2 diabetes and diabetic peripheral neuropathy. Design: A randomized controlled trial. Setting: Hospital outpatient diabetes clinic. Subjects: Adult women with type 2 diabetes and mild-to-moderate diabetic peripheral neuropathy. Out of 410 patients, 120 diabetic patients were recruited and randomly assigned to trial group (N = 60) and control group (N = 60). Intervention: The trial group received a designed intervention consist of one-month supportive educational program with three months of follow-up (totally four months), based on self-care requisites according to the Orem self-care regarding diabetic peripheral neuropathy. The control group only received a routine care program in the diabetes clinic. Main measurements: The main outcomes were symptoms and severity of diabetic neuropathy. Further outcomes were fasting blood sugar and glycosylated hemoglobin. Results: By the end of the intervention, the number of participants reduced from 60 to 58 in the trial group and to 57 in the control group (totally 115). The intervention significantly decreased mean score of diabetic neuropathy symptoms (trial group: 3.26 vs. control group: 9.57, P = 0.001), severity (trial group: 5.86 vs. control group: 9.02, P = 0.001), fasting blood sugar (trial group: 151 vs. control group: 204, P = 0.001), and glycosylated hemoglobin (trial group: 7.85 vs. control group: 8.62, P = 0.004). Conclusion: Delivering a supportive-educational intervention based on the Orem self-care model on outpatient diabetes clinic can decrease the symptoms and severity of diabetic peripheral neuropathy. Trial registration: It was registered in the Iranian Registry of Clinical Trials (IRCT2015021521095N1). [ABSTRACT FROM AUTHOR]

Ability for effective communication is one of the most essential skills for health system staff, especially nurses, as parts of their roles takes place only through effective communication with clients. The purpose of this study was to determine the effect of education on effectiveness of nurses' professional communication related to clients' health. The participants in this study were 50 nurses who were selected by convenience sampling method. Data collection tool was the questionnaire consisting of two parts; the first part contains 8 questions about personal information and work nurses and the second part contains Sussman and Krivonos's Identify communication questionnaire. The intervention included effective communication traning workshop for nurses. 70 percent of participants were female. The mean age and work experience of participants respectively were 30.58±5.68 years and 10.42±6.42 years. the mean of samples' communication score increased after intervention in three subgroups including, subordinates 11.62, superiors 8.87 and colleagues 6.04, which these changes were significant in the three subgroups. the results show the effect of education on nurses' professional communication related to clients' health. [ABSTRACT FROM AUTHOR]

There are some evidences for the decrease of sleep quality among diabetic patients. Because of negative impact of blood glucose on sleep disorders, we aimed at investigating The prevalence of sleep disorders in patients with type 2 diabetes and its related factors. This cross-sectional study was carried out on 507 patients with type 2 diabetes. For data collection valid and reliable questionnaire and the Pittsburgh sleep quality questionnaire were used. The data were analyzed by software SPS-20 and descriptive statistics. The prevalence of sleep disorders in this study was 50.7%. 65% of participants were women, and mean (standard deviation) age of patients were 57.37 (12.15). Sleep disorder score significantly higher in women than men, and the marital status, education, occupation, daily glibenclamide, a significant relationship was observed in other diseases, and improve sleep program.In this study the prevalence of sleep disorders in patients with diabetes was high. So it seems necessary to notice more to improve sleep disorders in diabetic patients and revise their care program. [ABSTRACT FROM AUTHOR]

With the rising population of the elderly worldwide, especially in developing countries, old age and its accompanied conditions make mental and physical healthcare provision a critical issue of the 21st century.This cross-sectional study was carried out to determine the epidemiological pattern of loneliness and its related factors in elderly women (age ⩾ 60 years) who were covered by the health centers of Gonabad, Iran. After estimating the sample size, 500 eligible subjects were selected through proportional stratified sampling. Data were collected by a questionnaire containing demographic characteristics and the University of California, Los Angeles, Loneliness Scale. The collected data were analyzed using descriptive statistical tests, one-way analysis of variance (ANOVA), and chi-square tests in SPSS 20.0. The prevalence of moderate and intense loneliness was 50.4% and 39.4%, respectively. There were significant relationships between the levels of loneliness and marital status ,education , and family status.The results of this study highlight the necessity of attending to the feeling of loneliness experienced by the elderly people, identifying the situations and events that intensify this feeling, and establishing interventional programs to resolve the problem. [ABSTRACT FROM AUTHOR]

Neonatal jaundice is considered as the most common reason for newborns' admissions and methods to prevention this condition are therefore important. This randomized sham-controlled trial aimed to evaluate whether foot reflexology could affect levels of cutaneous bilirubin and reduce neonatal jaundice. In this single-blind trial, sixty eligible neonates were randomly assigned to one of three groups. Neonates in the foot reflexology group received genuine foot reflexology, while neonates in the sham reflexology group received sham reflexology. These treatments were administered in four 30-min sessions on the first day of life.. The neonates in the control group only received routine neonatal care services. Cutaneous bilirubin level, dermal icterus, and need for phototherapy were assessed at baseline, the first, third and fifth day post-baseline measurements. Data were analyzed by chi-square, analysis of variance, and post hoc tests. Despite the increase of cutaneous bilirubin levels after birth in three groups, it was significantly lower in the foot reflexology group than other two groups on the first and third days but not on the fifth day (P < 0.001, P = 0.003, and P = 0.07, respectively). Dermal icterus did not differ between the three groups at any of the measurement time points (P > 0.05). A significant reduction was observed in the need for phototherapy in the foot reflexology group compared with the sham reflexology and control groups (P = 0.04). Foot reflexology seems to be a potentially beneficial complement for preventing or reducing jaundice without any serious side effects. Nevertheless, larger well powered randomized controlled trials (RCTs) are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Objectives: Melasma is a common acquired hyperpigmentation disorder. The treatment of melasma with conventional drugs causes complications in patients. This study was conducted to compare the effect of the topical use of Petroselinum crispum (parsley) with that of 4% hydroquinone cream on reduction of the severity of epidermal melasma. Materials and Methods: This double blind randomized clinical trial was performed in 2014-2015 in Iran The melasma area and severity index (MASI) were used to determine the severity of melasma. 27 patients in the control group received 4% hydroquinone cream (Eldopaque/Eldoqin), and 27 patients in the case group received Petroselinum crispum brewed every night for 8 weeks. The data were analyzed using independent t-test and paired t-test in the SPSS software (version 20). Results: Mean age of the participants was 32 years (range: 19-55 years). Mean severity of melasma decreased from 6.66 to 4.92 (p=0.002) in the case group receiving parsley, and from 6.68 to 5.06 (p=0.000) in the control group receiving hydroquinone. The decrease in severity was statistically significant in both groups (p<0.05). There was no significant difference between the two groups in terms of the severity of melasma after the intervention (p=0.858). Conclusion: A similar positive response was found to both treatments with hydroquinone and parsley. Although further studies are needed in this regard, it seems that the topical use of parsley may merit the attention of nurses and other medical professionals as a costeffective therapeutic method that causes fewer complications and improves the self-image of patients. [ABSTRACT FROM AUTHOR]

Objectives: Breast congestion is a common problem affecting 40% of mothers after delivery and has adverse effects on proper breastfeeding. This study aimed to identify the effects of the local use of Hollyhock leaves compress with cold and hot compress on breast congestion in breastfeeding women. Materials and Methods: This clinical trial was conducted on 40 women in Abolfazl Hospital of Kashmar, Iran Subjects were randomly divided into two groups of control and intervention. Severity of congestion was evaluated by determining the total scores for symptoms such as redness, tension and pain. Intervention in the control group included hot compress before breastfeeding and cold compress after breastfeeding. In the intervention group, in addition to hot and cold compress, Hollyhock leaves compress was used. Data analysis was performed using generalized estimating equation (GEE) in SPSS. Results: In this study, both groups were homogeneous in terms of age, time of the onset of congestion, education status, occupation and type of delivery. Severity of congestion was on a downward trend during intervention in both groups, while the effects of intervention group on the total score of breast congestion was statistically significant (p<0.001). In addition, average breast congestion score of control subjects was 4.103, which was higher than the score in the intervention group. Also, time had a significant effect on the congestion score (p<0.001); in other words, congestion score saw a reduction with time. Conclusion: According to the results of this study, hot and cold compress alone and along with Hollyhock leaves had significant effects on breast congestion, while using Hollyhock leaves compress resulted in the rapid improvement of breast congestion. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) outbreak is a global health problem. It is necessary to provide evidence on its unprecedented psychological effects to develop effective psychological interventions. The current study aims to determine the anxiety severity level, coping strategies, and influencing factors in response to the COVID-19 pandemic among people aged 15 years and above in Gonabad, Iran. Methods: We conducted a cross-sectional survey via online questionnaires between February and March 2020. We evaluated the anxiety severity levels and coping strategies using the Corona Disease Anxiety Scale (CDAS) and Coping Inventory for Stressful Situations--Short Form (CISS-SF), respectively. Multinomial and ordinal logistic regression models were used to identify the predictors of coping strategies and anxiety. Results: Totally, 500 people completed the questionnaires (response rate: 73%). Of them, 53.4% (95% confidence interval [CI]: 48.9%- 57.8%) suffered moderate to severe levels of anxiety. More than half of the respondents (52.0%; 95% CI: 47.5%-56.4%) utilized emotional-based or avoidant coping strategies. People with no academic education (odds ratio [OR]: 2.16; 95% CI: 1.41-3.31) and without physical exercise (OR: 2.04; 95% CI: 1.22-3.33) preferred emotional-based coping instead of problem-based coping strategy. Female gender (OR: 1.60, 95%, CI: 1.13-2.28), underlying medical conditions (OR: 2.52, 95% CI: 1.65-3.87), and emotional-based coping (OR: 4.06, 95% CI: 2.76-5.99) were associated with higher severity levels of anxiety. Conclusion: The severity of anxiety during the COVID-19 pandemic was significant among participants. Further attention is needed to enhance the mental health of the vulnerable population during the COVID-19 pandemic. Our findings also identified some factors related to the severity level of anxiety related to COVID-19 that could help formulate better psychological interventions. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of laryngeal mask airway, endotracheal tube and oropharyngeal airway for airway management in prehospital emergency care., Methods: The study sample of this randomized clinical trial was 54 patients needing pre-hospital airway management. All cases of intubation (ETI); after two failed attempts (37 patients), were randomly assigned to the oropharyngeal airway (OPA), and the laryngeal mask airway (LMA) groups. Patients' hemodynamic, SaO2 and airway management parameters, were compared in three groups. The study data were analyzed by the Chi-square and one-way ANOVA, Bonferroni post-hoc, using SPSS, v. 18.0., Results: The results demonstrated that before and after the study, there was no significant difference among the study groups in terms of hemodynamic variables (P > 0.05) expect SaO2 (P < 0.001). The results also revealed that in the ETI group (n=17), the number of attempts and the time spent on inserting the airway device was significantly more than other two groups (P < 0.05)., Conclusion: Laryngeal mask airway is as effective as oropharyngial airway for pre-hospital airway management by paramedics.

Background: Despite the benefits of the objective structured assessment of technical skills (OSATS) and it appropriateness for evaluating clinical abilities of nursing students , few studies are available on the application of this method in nursing education., Objectives: The purpose of this study was to compare the effect of using OSATS and traditional methods on the students' learning. We also aimed to signify students' views about these two methods and their views about the scores they received in these methods in a medical emergency course., Patients and Methods: A quasi-experimental study was performed on 45 first semester students in nursing and medical emergencies passing a course on fundamentals of practice. The students were selected by a census method and evaluated by both the OSATS and traditional methods. Data collection was performed using checklists prepared based on the 'text book of nursing procedures checklists' published by Iranian nursing organization and a questionnaire containing learning rate and students' estimation of their received scores. Descriptive statistics as well as paired t-test and independent samples t-test were used in data analysis., Results: The mean of students' score in OSATS was significantly higher than their mean score in traditional method (P = 0.01). Moreover, the mean of self-evaluation score after the traditional method was relatively the same as the score the students received in the exam. However, the mean of self-evaluation score after the OSATS was relatively lower than the scores the students received in the OSATS exam. Most students believed that OSATS can evaluate a wide range of students' knowledge and skills compared to traditional method., Conclusions: Results of this study indicated the better effect of OSATS on learning and its relative superiority in precise assessment of clinical skills compared with the traditional evaluation method. Therefore, we recommend using this method in evaluation of students in practical courses.

Background: Cardiovascular diseases are the leading causes of death around the world. The coronary artery disease (CAD) is one of the most common diseases in this category, which can be the trigger to various psychosocial complications. We believe that inadequate attention has been paid to this issue., Objectives: The purpose of the present study was to explore the psychosocial complications of CAD from the Iranian patients' perspective., Patients and Methods: A qualitative design based on the content analysis approach was used to collect the data and analyze the perspective of 18 Iranian patients suffered from CAD, chosen by a purposeful sampling strategy. Semi-structured interviews were held in order to collect the data. Sampling was continued until the data saturation. The data were analyzed using qualitative content analysis approach by MAXQUDA 2010 software., Results: This study revealed the theme of the patients' challenges with CAD. This theme consisted of: "primary challenges," including doubting early diagnosis and treatment, and feeling being different from others; "psychological issues," including preoccupation, fear of death and surgical intervention, recurrence stress , anxiety and depression; "problems of life," including financial problems, work-related problems, and family-related problems; and "sociocultural issues," including change in perspective of people towards the patient, and cultural issues., Conclusions: Although the management of physical problems in patients with CAD is important, psychosocial effects of this disease is more important. Thus, health care personnel should pay ample attention to identify and resolve psychosocial problems of these patients. Results of this study can be used to empower these patients.

Background: Self-esteem is one of the basic needs for all individuals especially in adolescence. The aim of this study was to determine associations between adolescents' self-esteem and perceived maternal parenting styles as well as its dimensions in terms of family type., Methods: In this analytic cross-sectional study, 356 high school students (250 two-parent nuclear family and 106 single-parent family) participated and filled out the Coppersmith self-esteem and the Robinson and colleagues (2001) perceived parenting styles questionnaires. Data were analyzed by SPSS software, version 18. To assess the relationship between participants' self-esteem and parenting styles and dimensions, Mantel-Haenszel Chi-square test was used to adjust the effect of potential confounder variables. P≤0.05 was considered statistically significant., Results: From a total of 370 questionnaires, 356 questionnaires were completed. The mean±SD of the participants' self-esteem score was 38.49±6.55. Mean±SD of self-esteem score among the two-parent and single-parent students was 39.06±6.36 and 37.42±7.28, respectively (P=0.034). Dominant parenting style in both families was authoritative style. There were significant associations between the respondents' self-esteem and their perceived parenting styles, after matching sex, family income, level of education, and parents job (P<0.005)., Conclusion: The results of this research can be used in educational interventions to modify the dimensions of parenting styles and improve self-esteem. Therefore, considering the relationship between child-rearing style and adolescent self-esteem, assessing other relating factors with adolescent self-esteem especially in single-parent family, such as father absence stigma, is suggested.

Background: Few studies, especially in Iran, have assessed the status of family participation in the care of the hospitalized patients., Objectives: This study was conducted to assess why family members partake in caregiving of their patients in hospitals, the type of care that family provide, and the outcomes of the participation in the opinions of nurses and family members., Patients and Methods: In this comparative-descriptive study, data was collected by a two- version researcher-developed questionnaire, from 253 family members of patients by quota sampling method and 83 nurses by census sampling method from wards which had licensed for entering the families. Each questionnaire has three sections: the care needs of the patients which family participated to provide, the reasons to take part, and the outcomes of this collaborative care. The data was analyzed using descriptive statistics and also chi-squared test through SPSS software version 11.5., Results: The patients received more unskilled and non- professional nursing care from their family members. Most of the nurses and families believed that family participation is both voluntary and compulsory. The shortage of personnel in different categories of nursing and speeding up the patient-related affairs were the most important outcome of the participation, from the nurses' viewpoint was speeding up the patient-related affairs and from the side of the family members, it was the patients' feeling of satisfaction from the presence of one of their relatives beside them., Conclusions: Co understanding, skillfulness and competence of families and nurses in collaboration with each other were not good enough.Few studies, especially in Iran, have assessed the status of family participation in the care of the hospitalized patients.