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Background Depression is one of the most common psychological disorders that can affect a person’s mood and change his/her perception of the self and environment. Melilotus officinalis L. plant contains effective substances and antioxidant compounds. Objective The present study aims to investigate the antidepressant effects of alcoholic extract of Melilotus officinalis L. in male rats. Methods In this experimental research, 42 male rats were divided into six groups of 7 including control (normal saline), negative control (reserpine), positive control (reserpine+fluoxetine) and three reserpine groups treated by intraperitoneal injection of 100, 200, 400 mg/kg doses of alcoholic extract of Melilotus officinalis L. Behavioral tests including forced swim test (FST) and tail suspension test (TST) were used to evaluate depression, and the antioxidant capacity and malondialdehyde level were also measured. The data were analyzed in SPSS software, version 20 using one-way analysis of variance. The significance level was set at P<0.05. Results The 200 mg/kg and 400 mg/kg doses of alcoholic extract significantly reduced the duration of immobility in the FST compared to the negative control. In the TST, the doses of 200 and 400 mg/kg showed a significant increase compared to the negative control. The doses of 200 and 400 mg/kg significantly increased the antioxidant capacity of the brain compared to the negative control. The doses of 200 and 400 mg/kg significantly reduced the antioxidant capacity of the brain compared to the negative control. Conclusion The alcoholic extract of Melilotus officinalis L has antidepressant effects similar to fluoxetine probably due to its antioxidant compounds. [ABSTRACT FROM AUTHOR]

Background Herb shops are important for preparing medicinal plants. Improper packaging can lead to contamination of these plants by various types of microorganisms, fungi and yeasts. Objective This study aims to investigate the prevalence of microbial and fungal contamination in four plants from the Lamiaceae family in herb shops in Rasht, Iran. Methods In this study, 15 samples from mint, rosemary, and wild mint plants, and 16 samples from lemon balm were collected. The samples were diluted and incubated for one hour, then transferred onto Tryptic soy agar culture medium for bacterial enumeration. The sabouraud dextrose agar culture medium was used to count total mold and yeast, while McConkey Broth culture medium was used for specific identification of Escherichia coli. Data analysis was conducted in SPSS software, version 16. For comparing the bacterial and fungal contamination levels in the plant samples with the Pharmacopeial quality standard values, the non-parametric Wilcoxon signed rank test was used. Results Out of 61 plant samples, 59 (73.7%) were contaminated with bacteria, and 60 samples (86.6%) were contaminated with fungi. The number of samples contaminated with Escherichia coli was 27 (44.2%). The mean counts of bacteria and fungi in the plant samples were 3.39×105 and 6.3×105, respectively. Conclusion The microbial contamination in most of the plant samples examined in this study is significantly higher than the permissible limit. It is necessary for health authorities to implement stricter policies for monitoring the quality of natural products in herb shops of Rasht, Iran. [ABSTRACT FROM AUTHOR]

Background Nasal septal abscess, which is the collection of purulent materials between the cartilaginous or bony septum and the mucoperichondrium or mucoperiosteum, often occurs after septal hematoma caused by trauma. Other common factors include surgery, foreign bodies, and sinusitis. In addition to the risk of nasal deformity, septal abscess can cause life-threatening complications such as osteomyelitis, orbital or intracerebral abscess. Objective This study aims to investigate the frequency of nasal septal abscess and its related factors in patients in north of Iran. Methods In this descriptive cross-sectional study on the patients referred to a hospital in north of Iran in 2022. Their demographic and disease-related information were recorded and the risk factors were finally identified. Results In this study, 37 patients had septal abscess. The most common risk factor identified was a history of septoplasty or septorhinoplasty (35.1%), followed by diabetes mellitus (21.6%). Surprisingly, one of the factors in these patients was cauterization for epistaxis treatment (n=6). All patients were treated with broad-spectrum antibiotics and surgical drainage. In five patients, abscess resulted in saddle nose deformity. Positive culture results were reported in five samples. Conclusion Early identification of nasal septal abscess and its risk factors can help control the disease and prevent its serious complications. [ABSTRACT FROM AUTHOR]

Background It is necessary to provide safe care for patients with acute and life-threatening conditions by nurses working in the emergency departments (EDs). These nurses need higher levels of independent performance. Therefore, the competency to provide safe care and having professional nursing autonomy in novice nurses working in the EDs are very important. Objective The purpose of this study was to determine the relationship between professional nursing autonomy and safe nursing care in newly graduated nurses working in the EDs. Methods In this analytical cross-sectional study, the study population consists of all newly graduated nurses working in EDs of hospitals in Guilan, Iran. They all were included in the study using a census sampling method. The tools for collecting information were a demographic form, the assessment of safe nursing care questionnaire, and the professional nursing autonomy scale. Descriptive and inferential statistics (independent t-test, Spearman or Pearson correlation test, and linear regression analysis) were used to analyze the collected data. Results There was a significant relationship between professional nursing autonomy and safe nursing care; for every one unit increase in professional autonomy, the chance of providing safe nursing care increases by 0.133 (P=0.009). Conclusion The significant relationship of professional nursing autonomy with safe nursing care among the EDS nurses shows that if nurses have a greater control over their performance, decision-making ability, and autonomy to act based on patient safety, they can provide better quality care to patients. Therefore, empowering nurses by providing conditions to perform based on professional autonomy, can ultimately lead to better results for the patients and cause overall safety in the EDs. [ABSTRACT FROM AUTHOR]

Background Temporomandibular disorders (TMDs) are a group of conditions that cause dysfunction in the jaw joint, masticatory muscle pain and mouth opening limitations, and affects patients’ ability to eat, practice oral health, and perform other activities of daily living. The etiology of TMDs is not well-known. These disorders have a higher prevalence in women and younger people. Although the benefits of lowlevel laser therapy (LLLT) in treating TMD have been reported, the results vary from study to study. Objective The purpose of this study is to investigate the effectiveness of LLLT in the treatment of TMDs Methods In this narrative review study, a search was conducted in Google Scholar, PubMed, and Scopus databases for randomized clinical trials, case-control studies, and systematic reviews published from 1976 to 2023 using the keywords (Mesh terms) temporomandibular disorder, low-level laser therapy, LLLT, and myofascial pain. Results Of 271 found articles, only 8 were included in the study, of which 6 confirmed that the LLLT was effective in the treatment of TMDs. One article concluded that superluminous devices are more effective than LLLT and one article concluded that LLLT is not effective in treating TMDs. Conclusion The LLLT is effective in the treatment of TMDs and its related disorders, such as masticatory muscle disorder, temporal joint pain, and difficulty in jaw opening. The nuber of studies are limited and definite conclusions cannot be drawn. Therefore, further studies are needed in this field. [ABSTRACT FROM AUTHOR]

Background The human immunodeficiency virus (HIV) infection is important because it can cause stigma and psychological, family, and social problems in affected people. Objective This study aims to investigate the effect of schema therapy on adaptive and maladaptive strategies of cognitive-emotion regulation in people with HIV. Methods This is an interventional study with a pretest-posttest design. Thirty people with HIV were selected by a convenience sampling method and randomly divided into two groups of intervention and control. Garnefski et al.’s cognitive-emotion regulation questionnaire - short form (CERQ-SF) was used to collect data. The intervention group received 10 two-hour sessions of group treatment based on Young’s schema therapy model. The data analysis was performed in SPSS software, version 26 using descriptive statistics (frequency, percentage, mean, standard deviation) and analysis of covariance (ANCOVA). The significance level was set at 0.05. Results The results ANCOVA showed that group schema therapy affected the use of adaptive strategies (acceptance, positive refocusing, refocusing on planning, positive reappraisal, and putting into perspective) and maladaptive strategies (self-blame and catastrophizing), (P<0.001). However, it had no significant effect on other-blame (P=0.033) and rumination (P=0.102). Conclusion Schema therapy can increase the use of adaptive strategies and reduce the use of maladaptive strategies (self-blame and catastrophizing) of cognitive-emotion regulation in people with HIV. [ABSTRACT FROM AUTHOR]

Background Research theses can have a significant impact on the development of applied sciences, especially when their results are published. Objective This study aims to determine publication rate of papers extracted from the medical residency and master’s degree theses of Guilan University of Medical Sciences (GUMS) during 2008-2018. Methods This is a descriptive cross-sectional study. The data were collected from the medical residency and master’s degree theses of GUMS from 2008 to 2018. Then, they were searched in international and national databases according to the title, keywords, and names of supervisors, advisors, and students. Results Of 774 theses, 449 (58 %) papers had been extracted and published in journals indexed by ISI/ PubMed (41.2%), Scopus (11.8%), BIOSIS, Chemical Abstract, and Embase (0.44%) and others (46.56%). Most of them (98.66%) were original research. Moreover, in 383(85.3%) of the theses, there was no statistician or data advisor. The median time from defending theses to the publication of a paper from them was two years. Conclusion The publication of papers extracted from the theses of GUMS has increased, and more than 50% of them have been published in journals indexed by ISI, PubMed, and Scopus. However, the factors associated with the publication of papers need to be surveyed. [ABSTRACT FROM AUTHOR]

Background Cleft lip and cleft palate are the most common congenital anomalies in the head and neck region, which are affected by environmental and genetic factors. These anomalies can cause serious problems such as physical deformity, nutritional problems, respiratory problems, and problems in social interactions for affected people. Objective The current study aims to investigate the prevalence of lip and palate clefts and the related factors in infants born from 2014 to 2019 in Karaj, Iran. Methods This descriptive-analytical study was conducted on the data of 91,563 babes born from 2014 to 2019 in Kamali, Imam Ali, Maryam, and Ghaem hospitals in Karaj, Iran. The data were collected and analyzed in SPSS software, version 24. Results Of 91,563 cases, 46 were identified with various types of clefts. The overall prevalence was 0.5 per 1000 live births; 26.08 had cleft lip, 52.17% had cleft palate, and 21.73% had cleft lip and palate (P=0.024). Also, 56.52% of babies were male (P=0.37), 76.08% had mothers aged 20-30 years with a mean age of 24.4 years, 58.69% had first-time pregnancy mothers, 13.03% had parents with cousin marriage (P<0.001), and 37% had mothers with blood type A (P=0.11). Conclusion The prevalence of lip and palate clefts in babies born in Karaj is lower than the global prevalence and the prevalence in other cities of Iran. [ABSTRACT FROM AUTHOR]

Background & Aims Despite the significant impact of immunosuppressive drugs on controlling and treating certain diseases, their continued use can predispose patients to infectious diseases such as COVID-19, leading to anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms. This study aims to determine the levels of anxiety, depression, and PTSD symptoms in patients treated with immunosuppressive drug during the COVID-19 pandemic. Materials & Methods This descriptive cross-sectional study was conducted on 330 individuals treated with immunosuppressive drug such as those with autoimmune diseases, cancer, and transplant recipients in Firoozgar and Rasoul-e-Akram hospitals in Tehran, Iran, from July to December 2022. They were selected using a continuous sampling method. The instruments were a demographic/disease related questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Impact of Event Scale-Revised (IES-R). Data analysis was done in SPSS software, version 16 using descriptive (frequency, percentage, mean, standard deviation) and inferential (Independent t-test, analysis of variance, and Pearson’s correlation test) statistics. Results In this study, the mean age of participants was 51.35±12.95 years, and 148 (44.8%) were female. The majority of the patients had normal levels of anxiety and depression (91.2% and 92.1%, respectively). The mean total IES-R score was 27.71 out of 88. The anxiety and depression scores did not have a significant relationship with any demographic, disease-related, and COVID-related characteristics of the study participants, but a significant correlation between income level and total score of IES-R was observed (P=0.043). Conclusion The individuals receiving immunosuppressive drugs in this study, despite being susceptible to COVID-19, had normal levels of anxiety and depression and obtained lower than average score in the IES-R. This finding can reduce the concerns about the mental health of these patients. Further studies using other questionnaires or a qualitative study on the experiences of these patients during the COVID-19 pandemic are recommended. [ABSTRACT FROM AUTHOR]

Background & Aims Evidence has shown that the inability to regulate and understand emotions causes various behavioral problems in children with autism spectrum disorder (ASD). This study aims to investigate the effect of an emotion labeling (EL)-based training on the behavioral disorders of children with ASD. Materials & Methods This is a quasi-experimental single-subject study ABA method. Five boys with high functioning autism were purposefully included in the study after one week of sampling in 2022. For each child, the Let’s Face It software was used individually to recognize basic emotion expressions (6 types) in three sessions followed by teaching EL at 8 sessions for 4 weeks, two sessions per week. The data collection tool was a demographic form and the test of behavioral disorders of children with ASD. The collected data at five phases were analyzed in SPSS software, using descriptive statistics, and Friedman’s test. Results According to the result of Friedman test, there was a significant difference between the first and third phases (P=0.037) and the third and fourth phases (P=0.019) of behavioral disorders measurement. The EL training significantly reduced the behavioral disorders of patients (P=0.030). Conclusion It seems that the EL-based training can reduce the behavioral disorders of children with ASD. [ABSTRACT FROM AUTHOR]

Background & Aims During the COVID-19 pandemic, vaccination is necessary for pregnant or lactating women which can prevent them from infection to severe case of disease. The present study aims to determine the factors related to the acceptance of COVID-19 vaccination among pregnant or lactating women in Zahedan, Iran using the health belief model (HBM). Materials & Methods This is a cross-sectional study. Participants were 260 pregnant or lactating women referred to comprehensive health service centers in Zahedan city in 2022. Sampling method was done as a convenience sampling method. Data collection was done using a demographic form and a HBM-based questionnaire. The reliability of the questionnaire was confirmed based on Cronbach’s alpha value of 0.7. Moreover, the content validity index value was 0.81 and the content validity ratio was 0.77. The data were analyzed using non-parametric Wilcoxon test, Mann-Whitney U test, Spearman correlation test, and regression analysis in SPSS software, version 22. Results The results of the regression analysis showed that the demographic variables explained 12.6% of the variance in vaccine acceptance behavior, where only the effect of age and educational level was significant, (P<0.05). The BM constructs along with age and educational level predicted 26.3% of the variance in vaccine acceptance behavior, where only age, self-efficacy and perceived benefits had a significant effect (P<0.05). Overall, the mentioned variables predicted 38.9% of the variance in vaccine acceptance behavior. Conclusion The factors of young age, high educational level, and the HBM constructs of self-efficacy and perceived benefits can predict the COVID-19 vaccine acceptance behavior of pregnant or lactating women in the South East of Iran. These findings can help policymakers and health care providers to use this model in designing program for improving vaccination acceptance of these high-risk groups. [ABSTRACT FROM AUTHOR]

Background & Aims Due to the effects of COVID-9, health care workers, including nurses, faced many psychological challenges, including death anxiety. This study aims to determine the death anxiety level of nurses working in the intensive care units (ICUs) for COVID-19 patients in hospitals affiliated to Tehran University of Medical Sciences in 2020. Materials & Methods This is a descriptive cross-sectional study that was conducted on 179 nurses working in the ICUs for COVID-19 patients in two hospitals located in Tehran and Qom cities. Continuous sampling method was used for their selection. Data collection was done using a demographic form and Templer's 15-item death anxiety scale. Results The mean death anxiety score of nurses was 8.74±2.007 out of 15, which is higher than the median score (i.e., 7.5). The results of one-way analysis of variance showed that the death anxiety score was significantly different between nurses only in terms of age (P=0.000). Tukey's post hoc test showed that the mean DAS score in nurses aged 30-39 was lower than in nurses aged ≥40 years and <30 years. There was no statistically significant difference in death anxiety between nurses in terms of other demographic factors (P>0.05). Conclusion The nurses working in ICUs experienced a high level of death anxiety during the COVID-19 in Iran. It is necessary that the policy makers and educational, medical or hospital managers develop educational and interventional programs including online in-service programs or educational booklets to help nurses overcome the COVID-19-related conditions [ABSTRACT FROM AUTHOR]

Background & Aims Chronic obstructive pulmonary disease (COPD) is a debilitating respiratory disease and one of the main causes of death and disability in the world. Respiratory support treatments are among the methods for the recovery of these patients. The present study aims to assess the effect of breathing exercises and chest physiotherapy on the fatigue of patients with COPD. Materials & Methods This is a quasi-experimental study on 45 patients COPD who were selected by convenience sampling method and randomly assigned to two experimental groups of breathing exercises (n=15) and chest physiotherapy (n=15) and one control group (n=15). Before and 6 weeks after the intervention, Krupp’s Fatigue Severity Scale was completed by the patient. Data analysis was done using paired t-test, one-way analysis of variance and chi-square in SPSS software, version 26. Results The mean scores of fatigue severity were significantly different in all groups between pretest and post-test phases (P<0.001). The fatigue severity in the intervention groups was reduced, while it increased in the control group, after intervention. There was no significant difference in fatigue severity among the three groups at baseline, but the difference was significant after the intervention (P<0.001). Conclusion Considering the reduction in fatigue severity after two supportive treatments, it is recommended that breathing exercises and chest physiotherapy should be used along with drug treatments for patients with COPD to improve their respiratory conditions. [ABSTRACT FROM AUTHOR]

Background & Aims Suicide and suicidal thoughts among adolescents have become a worrying psychosocial problem. This study aims to evaluate suicidal ideation among adolescents from the west of Tehran, Iran. Materials & Methods In this descriptive cross-sectional study, 256 boys and girls were selected from second-grade high schools in the west of Tehran by a convenience sampling method in 2022. The data collection tools were a sociodemographic form and the Beck scale for suicidal ideation (BSSI), which were completed using a self-report method. The collected data were analyzed in SPSS software, version 16 using descriptive and inferential statistics (independent t-test, analysis of variance). Results The mean age of the participants was 17.33±0.67 years. The mean score of BSSI was 3.19±5.66 out of 5. Among the sociodemographic factors, suicidal ideation had a statistically significant relationship only with the grade point average (P=0.004). Conclusion It is recommended to design and implement programs to educate and provide psychiatric services to high school students in Iran to reduce their suicidal ideation. [ABSTRACT FROM AUTHOR]

Background In the treatment process of hospitalized patients with COVID-19, one of the threatening complications is pulmonary complications such as barotrauma. Objective This study aims to investigate the prevalence of barotrauma in COVID-19 patients admitted to intensive care units (ICU) of two hospitals in Rasht, Iran. Methods This retrospective study was conducted on COVID-19 patients admitted to the ICUs of Razi and Poursina hospitals in Rasht in 2020. Their files were studied, and their demographic/clinical data and pulmonary complications were extracted using a checklist by an anesthesia resident. Results Out of 140 patients, 81(57.9%) received non-invasive mechanical ventilation and 59(42.1%) had invasive ventilation. Barotrauma was observed in 9 cases (6.4%), 8(88.9%) in the form of pneumothorax and one (11.1%) in the form of both pneumothorax and subcutaneous emphysema. The results showed that the incidence of barotrauma was significantly higher among patients who received invasive mechanical ventilation (P=0.003). No significant difference was observed among patients received noninvasive ventilation (P>0.05). Conclusion The prevalence of barotrauma among COVID-19 patients in the study hospitals is low, which indicates the proper performance of the attending physicians and compliance with the standard guidelines. [ABSTRACT FROM AUTHOR]

Background The COVID-19 pandemic caused changes in daily life and disrupted hospital performance and the provision of medical services, especially in the organ transplant departments. Objective This study aims to compare the frequency of organ donation and transplantation before and after the COVID-19 outbreak in the transplant centers of northern Iran. Methods This cross-sectional study was conducted on 75 donors with brain death from 2018 to 2021 in Rasht. Demographic data, underlying diseases, history of smoking and drug use, causes of brain death, type of donated organ, number of donated organs per patient, type of transplanted organ, and the location of transplantation (in or out of the province) were recorded. Then, these factors were compared between two time periods: Before the pandemic (from July 2018 to February 2020) and during the pandemic (from February 2020 to August 2021). The recorded data was analyzed in SPSS software, version 21. The significance level was set at 0.05. Results The mean age of donors during the pandemic was significantly higher than that of patients before the pandemic (P<0.001). The most common cause of brain death in donors before the pandemic was trauma; after the pandemic, cerebrovascular causes were more common (P=0.01). The frequency of organ donation and the mean number of donated organs per donor during the pandemic were significantly lower than before the pandemic (P<0.001). Conclusion The COVID-19 pandemic has significant impact on the process of organ donation and transplantation in northern Iran. [ABSTRACT FROM AUTHOR]

Background One of the applications of honey is in wound healing. A stapler normally connects the skin graft to the underlying bed. Due to its high cost and lack of production in Iran, and causing physical damage to the tissue, an alternative method is needed. Objective This study aims to compare the effects of using medical honey and staplers for skin graft fixation in patients with burn wounds in the north of Iran. Methods In this clinical trial, 80 patients with deep second-degree and third-degree burns less than 40% of total body surface area were included and were randomly divided into two groups of honey (n=40) and stapler (n=40). Demographic information and the percentage of burns were extracted from patients’ medical files. The graft rejection, number of hospitalization days, grafted skin displacement, graft contracture, pain severity, existence of edema or hematoma, itching severity, and infection after grafting were investigated and recorded. Results Of 80 patients, 34 were male (42.5%) and 46 were female (57.5%). The mean age of the patients was 39.29±15.42 years. A significant difference was observed in the mean number of hospitalization days after grafting (P<0.001), incidence of infection, hematoma, edema, and severity of pain and itching (P<0.001), which were lower in the honey group. The graft contracture rate was lower in the stapler group (P<0.001). Graft rejection was not observed in any groups. Conclusion The use of medical honey for skin graft fixation reduces the duration of hospitalization and adverse effects such as pain, itching, edema, hematoma, and infection compared to staplers. This method is as efficient as the routine treatment. [ABSTRACT FROM AUTHOR]

Background Today, the consumption of nutritional supplements is increasing dramatically in the world. Objective This study aims to survey the knowledge and attitudes of people in Rasht, Iran, towards nutritional supplements and determine their consumption rate. Methods This descriptive-analytical study with a cross-sectional design was conducted over 6 months on 1220 people referred to pharmacies in Rasht city. They completed a self-report questionnaire surveying demographic data, knowledge, and attitude towards nutritional supplements. Results The majority of people had poor knowledge (mean score: 5.14±2.36 out of 9). The knowledge scores were significantly different in terms of educational level, occupation, use/non-use of supplements, number of used supplements, and the reason for taking drug supplements, such that people with a master’s degree or higher, healthcare providers, and supplement users had higher scores. The attitude score was 16.14±4.64 (out of 40), and 76.33% had a negative attitude towards nutritional supplements. The knowledge score had a significant negative relationship with the attitude score. Conclusion Given the poor knowledge of people in Rasht city and their negative attitude towards nutritional supplements, it is recommended to develop public education programs to improve their knowledge of nutritional supplements. [ABSTRACT FROM AUTHOR]

Background Infertility is a major crisis for couples, causing anxiety in them. Infertile couples experience more psychological, marital, family, and social problems. Objective This study aims to compare psychological well-being, moral foundations, and sense of humor between fertile and infertile couples in Rasht, Iran. Methods In this causal-comparative study, 212 couples (106 infertile and 106 fertile) referred to AlZahra Hospital in Rasht in 2022 participated. Ryff’s psychological well-being scale, moral foundations questionnaire, and multidimensional sense of humor scale were used to collect data. For data analysis, the analysis of covariance was used in SPSS software, version 28. Results There was a significant difference between infertile and fertile couples regarding self-acceptance, positive relations with others, autonomy, and personal growth dimensions of psychological well-being and its total score, and also in the sanctity/purity dimension of moral foundations and the humor creativity and uses of humor for social purposes dimension of sense of humor. Conclusion Fertile couples in Rasht have significantly higher scores in some dimensions of psychological well-being, moral foundations, and sense of humor than infertile couples. [ABSTRACT FROM AUTHOR]

Background & Aims Tracheostomy is often performed for people hospitalized in intensive care units (ICUs), but it can cause larynx damage and discomfort in the patient. Given that the final outcome and possible complications of tracheostomy are directly related to the quality of nursing care, this study aims to evaluate the effect of tracheostomy care training on the performance of nurses working in the ICUs of selected hospitals affiliated to Iran University of Medical Sciences. Materials & Methods This quasi-experimental study was conducted on 64 nurses working in the ICUs of Rasul Akram and Firouzgar hospitals in 2021. The data collection tools were a demographic form and the tracheostomy patient care evaluation questionnaire of Atashzadeh et al. (2015). data analysis was performed in SPSS software, version 16 using descriptive and inferential statistics (paired t-test, and analysis of variance). P<0.05 was considered statistically significant. Results The mean age of nurses was 31.49±6.02 years. Most of them were female (70.3%) with a bachelor's degree (90.6%). Their mean overall work experience was 6.74±5.13 years, and their average work experience in the ICU was 4.92±4.66 years. Most of the nurses (43.8%) had permanent employment. Most of the nurses had rotating shift (89.1%), and had not completed the course of tracheostomy care (93.8%). The results of the paired t-test showed a statistically significant difference in the mean performance score of nurses before training (45.85±8.87) and after training (93.3±42.33) (P<0.001). Conclusion Considering that the performance of nurses in caring for patients with tracheostomy in the ICUs of selected hospitals is not satisfactory, educating nurses and providing sufficient facilities based on guidelines and opinions of experts are recommended to improve the quality of services to these patients by nurses in the hospitals. [ABSTRACT FROM AUTHOR]

Background & Aims The ethical challenges of pediatric nurses in the work environment is inevitable. One of these challenges for nurses is related to euthanasia, which is affected by extensive legal, religious, and cultural issues. This study aims to determine the relationship between ethical reasoning and attitudes towards euthanasia in nurses working in children’s hospitals. Materials & Methods This descriptive-analytical study was conducted on 194 pediatric nurses working in two children’s hospitals affiliated to Tehran University of Medical Sciences. Data were collected electronically and in person using three questionnaires, including a demographic form, the nursing dilemma test (NDT), and the euthanasia attitude survey (EAS). The collected data were analyzed in SPSS software, version 26. Results The mean score of ethical reasoning was 42.92±10.33, and the mean score of EAS was 2.65±0.12. The ethical reasoning score had no significant correlation with age, work experience, sex, marital status, education level, and history of participation in nursing ethics courses, except for the department, which was significantly related to ethical reasoning. The EAS score had no significant correlation with any of the demographic variables, except for the department. The Pearson correlation test results indicated a significant negative correlation between ethical reasoning and attitudes toward euthanasia (r=-0.60, P<0.001). Conclusion The ethical reasoning of pediatric nurses in the study hospitals is at a moderate level, and they have a negative attitude toward euthanasia. The nurses with higher ethical reasoning have a more negative attitude toward euthanasia. Nurses from special care units and emergency departments have lower ethical reasoning but a more positive attitude toward euthanasia. Participation in nursing ethics workshops has no significant relationship with ethical reasoning scores and attitudes toward euthanasia. Based on the findings of this study, it is recommended that comprehensive educational programs should be held to strengthen the ethical reasoning of pediatric nurses and enhance their perception of euthanasia. [ABSTRACT FROM AUTHOR]

Background & Aims One of the goals of providing training to the anesthesia care team is to train staff with theoretical and functional abilities to deal with clinical challenges. However, there is a gap between the existing and desired performance levels of personnel in anesthesia procedures. This study aims to assess the competence of anesthesia personnel in Kashan, Iran, and find its related factors. Materials & Methods This descriptive-analytical study was conducted on 95 anesthesia personnel of hospitals in Kashan, Iran, in 2023, who were selected using a census method. The data collection tools were a demographic form and the Anesthesia Nursing Competence Scale. Data were analyzed in SPSS v.22 software using descriptive statistics (frequency, mean, standard deviation), Mann-Whitney U test, Kruskal-Wallis test, Spearman’s correlation test, Point-Biserial correlation test, and regression analysis. Results The mean age of the participants was 34.57±10.1 years. The overall competence level of anesthesia personnel was at a high level (84.84±53.11). Their competence had a significant relationship with their sex and marital status (P<0.05). Conclusion The competencee of anesthesia personnel in Kashan is at a high level in all fields, except for the patient’s risk care. It is recommended to empower personnel in this area to prevent adverse events and improve the quality of medical services. [ABSTRACT FROM AUTHOR]

Background & Aims Caring for a patient undergoing hemodialysis is a stressful experience that causes a heavy care burden. With the outbreak of COVID-19, family caregivers of these patients had increased worry about the risk of infection in the dialysis centers. This fear can make their care burden heavier. This study aims to investigate the impact of coping skills training on the care burden experienced by family caregivers of patients undergoing hemodialysis. Materials & Methods This quasi-experimental study was conducted in 2020 on 60 family caregivers of patients undergoing hemodialysis at the Comprehensive Treatment Center for Special Diseases in Birjand, Iran. Participants were randomly assigned to intervention and control groups. The intervention group received coping skills training in six sessions. All participants completed the Zarit burden interview before, immediately after, and one month after the intervention. The data were analyzed in SPSSsoftware, version 19. Results The two groups were homogeneous regarding demographic information (P>0.05). Both groups had a moderate to severe care burden before the intervention. A significant difference was reported in the care burden score of the intervention group after training (P<0.001). Conclusion Coping skills training can reduce the care burden of the family caregivers of patients undergoing hemodialysis. Therefore, coping skills training can be used by nursing managers to reduce the care burden of family caregivers of patients with hemodialysis. [ABSTRACT FROM AUTHOR]

Background & Aims One of the concerns of nurses and physicians is the adherence to treatment in patients with heart diseases. In Iran, there are no accurate statistics on the treatment adherence of patients with coronary artery stents, and the risk of cardiovascular diseases (CVDs) in these patients has not been investigated. Therefore, this study aims to determine the relationship between treatment adherence and the risk of CVDs in patients with coronary artery stents. Materials & Methods This descriptive cross-sectional study was conducted from June to August 2021 in Shahid Madani Hospital in Tabriz, Iran. Participants were 200 patients who underwent coronary angioplasty in the past year and had coronary artery stents. They were selected by a simple random sampling method. To collect data, a demographic form, the treatment adherence questionnaire, and the Framingham risk score (FRS) were used. The collected data were analyzed in SPSS software, version 22 using descriptive statistics, Pearson correlation test, t-test, and one-way analysis of variance. Results The mean age of the patients was 61.6±10.62 years. Most of them were male (60.5%) and married (68%). The overall mean score of treatment adherence was 41.50±8.48, indicating moderate adherence. Patients had poor adherence in domains of dietary regimen and regular physical activity such that most of them used high-fat food (87%) and had the least amount of physical activity per week (92.4%), but they used prescribed medicines on time (70.3%). Based on the FRS, men were twice as likely to have CVDs as women. There was a significant association between treatment adherence and the risk of CVDs, such that the risk of CVDs in the next 10 years among patients decreased with increasing their adherence to treatment (r=-0.25, P<0.001). Conclusion Given that there is a significant relationship between treatment adherence and the risk of CVDs in patients with coronary artery stents, and considering that these patients have poor adherence to a low-fat diet and regular physical activity, it is recommended that nurses in their patient education programs emphasize adherence to having a low-fat diet and regular physical activity and identify the barriers to achieving it, so that, by increasing patients’ adherence to treatment, the risk of CVDs in the next 10 years can be reduced in these patients. [ABSTRACT FROM AUTHOR]

Background & Aims Aging is associated with decreased physical and psychological functions. This study aims to investigate the ability to perform basic and instrumental activities of daily living (ADL) in elderly women with osteoporosis in Tehran, Iran. Materials & Methods This is a cross-sectional study conducted on 130 elderly women over 60 years of age referred to selected hospitals affiliated to Iran University of Medical Sciences in 2019-2020, who were selected by a consecutive sampling method. The data collection tools were a demographic form, the Barthel index for ADL, and the Lawton-Brody Instrumental ADL scale. The data was statistically analyzed in SPSS software, version 20. Results The mean age of the women was 67.5±5.7 years. None of them had dependency for performing ADLs such as eating. The highest dependence was for urination (54.62%). Regarding instrumental ADLs, the highest inability was related to shopping (60.77%), and the lowest inability was related to managing one's own medication use (0.77%). The scores of basic and instrumental ADLs were significantly related to age and educational level (P<0.001). Conclusion More governmental, family and social support is needed for elderly women with osteoporosis (with older age and educational level) who have lower ability to perform their basic and instrumental ADLs. [ABSTRACT FROM AUTHOR]

Background & Aims During the COVID-19 pandemic, nurses working in psychiatric departments were also involved, which affected their mental health. The present study aims to determine the effect of psychological immunization on perceived stress and anxiety caused by COVID-19 in nurses working in the psychiatry department of a hospital in Zahedan, Iran. Materials & Methods This is a quasi-experimental study that was conducted from February to June 2022. Participants were 50 nurses from the psychiatry department of Baharan Hospital in Zahedan city who were selected by a census method, and were assigned to intervention and control groups. Data collection tools included a demographic form, the perceived stress scale, and the corona disease anxiety scale. The psychological immunization was provided in two four-hour workshops. Data analysis was done in SPSS software, version 16 using mean, standard deviation and chi-square test, independent t-test, paired t-test, and Fisher’s exact test. P<0.05 was considered statistically significant. Results Most of the nurses had an infection with COVID-19 and were vaccinated. The mean and score of anxiety decreased from 11.96±10.05 to 8.12±6.92 in the intervention group (P=0.004) and decreased from 11.84±10.26 to 8.40±6.51 in the control group (P=0.07). The mean score of perceived stress changed from 27.45±5.56 to 27.20±4.20 after intervention in the intervention group (P=0.8) and from 27.48±4.71 to 28.32±4.87 in the control group (P=0.43). Conclusion The psychological immunization program has no significant effect on anxiety and stress caused by COVID-19 in nurses of psychiatric departments in Zahedan, Iran. It is recommended that psychiatric hospital managers should pay attention to the psychological problems of nurses at the beginning of the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: One of the biggest environmental challenges of the 21st century is the phenomenon of climate change and global warming, which can cause numerous health problems. One significant health issue associated with climate change is the increase in the prevalence of heat stress, particularly in occupational encounters in hot outdoor environments. So this study aimed to predict and model temperature and humidity indices in the coming decades in a dry climate. Methods: This study obtained daily atmospheric parameters, including minimum temperature, maximum temperature, and relative humidity of Kerman station, representing a dry climate, for a period of 30 years (1965 to 2005) from the meteorological organization. Modeling of these parameters and calculation of the Temperature and Humidity Index (THI) were performed using the atmospheric general circulation model HadGEM2-ES and the CORDEX dynamic microscaler model. Three different radiative forcing scenarios, including optimistic (RCP 2.6), intermediate (RCP 4.5), and pessimistic (RCP 8.5), were considered for the coming decades (three 30-year periods from 2011 to 2099). The Ethics Committe of Iran University of Medical Sciences (IUMS) approved the present study (Code: IR.IUMS.REC.1400.020). Results: The results of the study showed an increasing trend for minimum and maximum temperature parameters in all three time periods using the three scenarios considered. Moreover, the increase in temperature in the decades of 2099-2071 was more pronounced compared to the previous decades. The results also demonstrated an increasing trend in the THI index based on all three scenarios. The average results obtained using these scenarios showed an increase of 2.11, 2.53, and 3.3 degrees Celsius, respectively, in this index until the end of the last century compared to the base decades. Conclusions: Overall, the increase in temperature and the investigated THI index in the studied station, based on all three scenarios, will lead to changes in thermal comfort. Higher levels of thermal discomfort will not only occur in hot months and seasons but also in other seasons. Therefore, proper planning should be implemented to address the adverse effects of climate change on people's health. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents are one of the most vulnerable groups against risky behaviors. Therefore, this research was conducted with the aim of determining the relationship between attachment styles and rumination of anger in high-risk behaviors of adolescents by analyzing the mediating role of difficulty in emotion regulation. Methods: The method of the current research is descriptive-analytical of the correlation-path analysis type. The statistical population of this research was all the students of the first secondary level in the marginal areas of Kermanshah city in the academic year of 2011-2014 and the sample included 530 people who They were selected by multi-stage cluster sampling method. To collect data, Iranian youth risk-taking questionnaire, Hazen and Shiver attachment scale, Sakodolski, Glob and Cromwell anger rumination scale, and Gertz and Roemer scale of difficulty in regulating emotions were used. The data obtained from the questionnaires were analyzed using the path analysis model and the statistical software Smart PLS version 3.3 and SPSS version 25. This study with ID IR.IAU.KSH.REC.1402. 014 has been approved by the Research Ethics Committee of Kermanshah Islamic Azad University. Results: The path of attachment style to risky behaviors (β = 0.81 and t = 2.32), the path of anger rumination to risky behaviors (β = 0.45 and t = 2.32), the path of attachment style to risky behaviors with mediation Emotion regulation difficulty (β = 0.61 and t = 3.28), rumination to risky behaviors with the mediation of emotion regulation difficulty (β = 0.21 and t = 3.55), it was found that all values at the error level are less than 0.05 are significant. Conclusions: Through the mediation of difficulty in emotion regulation, there is a positive and significant relationship between attachment styles and rumination of anger in high-risk behaviors of adolescent girls. These results emphasize the difficult role of brahmin in regulating emotions in high-risk behaviors of adolescent girls. [ABSTRACT FROM AUTHOR]

Introduction: Methamphetamine increases the release of dopamine from nerve terminals. Binding of dopamine to dopamine receptors increases the phosphorylation of cyclic adenosine monophosphate responsive element (CREB) protein and changes the transcription of downstream genes.The purpose of this study is to investigate the effect of methamphetamine induction followed by aerobic training and Berberine on dopamine receptor 4 and CREB gene expression in the heart tissue of methamphetamine-addicted female rats during the withdrawal period. Methods: 30 rats were randomly divided into 5 control groups, methamphetamine, methamphetamine + aerobic training, methamphetamine + Berberine, methamphetamine + aerobic training + Berberine. Intraperitoneal injection of 10 mg/kg of methamphetamine was performed for 5 days, and during the withdrawal period, aerobic training was performed for 4 weeks and simultaneously the consumption of berberine 100 mg/kg as a solution in drinking water was considered. Real Time PCR method was used to measure gene expression. Independent T-test, Kruskal-Wallis test and SPSS24 software were used at the level of 0.05 to analyze the data. The code of ethics in the research was received with number IR.IAU.SHAHROOD.REC.1402.015. Results: The results showed that methamphetamine use caused a non-significant increase (97%) in CREB expression and a non-significant decrease (52%) in dopamine 4 receptor compared to the control group (P>0.05). The implementation of interventions during the withdrawal period, such as Berberine consumption and the combination of berberine with aerobic training, produced non-significant increasing and decreasing effects on dopamine 4 receptor gene expression and CREB in the heart of methamphetamine-addicted rats, respectively (P > 0.05). Conclusions: Short-term induction of methamphetamine did not cause significant changes in the expression of dopamine 4 receptor and CREB genes in the heart. Therefore, these genes could not undergo a significant change as a result of interventions such as Berberine and exercise. More studies are needed to investigate exact genetic changes in heart tissue. [ABSTRACT FROM AUTHOR]

Introduction: The scorpion of Androctonus crassicauda belongs to the Buthidae family, it has a strong and deadly venom for humans, and every year there are cases of death due to the sting of this scorpion. The purpose of this study is the biological evaluation of the venom of this scorpion, the production of monovalent antivenom against it, and the evaluation of the effectiveness of the produced antivenom. Methods: The A. crassicauda scorpions were collected from different cities of Khuzestan province and milked by electric shock. In this research, the amount of venom protein, lethal dose 50 (LD50), immune response of horses, purification of antibodies, effectiveness of antivenom (ED50), degree of neutralization of venom with antivenom and the effect of monovalan antivenom in neutralizing the activity of hyaluronidase enzyme were evaluated. This research has been approved by the Ethics Committee of the Razi Vaccine and Serum Research Institute with code IR.RVSRI.REC.1401.017. Results: The amount of protein and LD50 of the venom from studied scorpion were calculated to be 78 mg/ml and 11.27 µg per mouse, respectively. The results of measuring the antibody titer at different times of venom injection showed the increase in the immune response of horses against the venom. The value of ED50 was around 9 LD50 and 92.22 µg per mouse. According to the results, scorpion venom has hyaluronidase enzyme activity, and 10 µL of the produced pure antivenom was able to neutralize 100% of the venom's hyaluronidase activity. Conclusions: In this project, extracted venom and produced antivenom showed their effectiveness. The produced antivenom was able to neutralize the venom in mice and prevented the death of the envenomed mice [ABSTRACT FROM AUTHOR]

Background Technology-based interventions, such as electrical brain stimulation may be effective in the cognitive and personality processes of substance abusers, including nicotine dependents. Objective We conducted this study to investigate the effectiveness of transcranial alternating current stimulation (tACS) using alpha frequency on inhibitory control and impulsivity in nicotine-dependent individuals. Methods We used a pre-test/post-test/follow-up quasi-experimental design with control and sham groups. We selected 30 eligible nicotine addicts from Mashhad using the available sampling method and randomly divided the subjects into three groups. We applied the intervention in eight sessions for 20 minutes in the dorsolateral prefrontal cortex for the first group, fake interventions for the second group, and no intervention for the third group. The Fagerström questionnaire, Barrett impulsivity questionnaire, and go-no-go task were used to collect data. After eight sessions, people’s inhibitory control and impulsivity were evaluated and analyzed using multivariate analysis of covariance (MANCOVA). Also, after two months, we evaluated inhibitory control data with repeated-measures analysis of variance. Results The effectiveness of alpha-tACS intervention on short- and long-term inhibitory control was significantly different in the experimental group compared to other groups (P=0.001). There was no significant difference between these three groups in impulsivity (P=0.700). Conclusion Alpha-tACS intervention effectively increases inhibitory control in nicotine-dependent individuals but does not explicitly affect their impulsivity. [ABSTRACT FROM AUTHOR]

Background Treatment measures for ankle sprains include care recommendations, symptomatic therapy, joint immobilization using bandages and plasters, and reconstructive surgery. Objective The purpose of this study is to compare the therapeutic effect of bandages and plastering in the treatment of ankle sprain. Methods This study was a randomized clinical trial that was conducted on 78 patients who were referred to the Poursina Hospital emergency room with ankle sprains. Patients who needed treatment after being diagnosed with ankle sprain were included in the study. The patients who met the inclusion criteria were divided into two groups A (plaster) and B (bandage) by a simple random method, and 3, 6, and 12 weeks after the start of the treatment, they were examined for the level of pain. Results The results showed that the amount of pain based on the visual analogue scale (VAS) after three and six weeks in the bandage group was lower than in the plaster group and this difference was statistically significant (P<0.001). Ankle-hindfoot scale (AHS) after 3, 6, and 12 weeks had the same average in the two studied groups. The duration of activity restriction in the plaster group was significantly lower than in the bandage group. The treatment results were evaluated in terms of complete recovery, time to return to work and activity, and pain level. Conclusion Plastering treatment reduces the days of activity limitation and patients return to work and daily activities faster. However, plastering has limitations, such as more cost and limiting the movements of the limbs. For a logical conclusion, there is a need for more studies considering all aspects of applying bandage and plastering methods in ankle sprain. [ABSTRACT FROM AUTHOR]

Background The proper diagnosis and treatment of neonatal sepsis is done depends on the understanding of its causative organisms. Objective The present study aimed to investigate the types of microorganisms in definitive neonatal sepsis. Methods Neonatal sepsis is a serious infectious disease with high mortality. And its diagnosed by blood culture. It includes early (appearance of clinical symptoms from birth to the third-seventh day) and late (from the third day to the twenty-eighth day) types with specific and sometimes common clinical symptoms. This cross-sectional study was performed on 266 neonates hospitalized with definitive sepsis in Ghaem Hospital in Mashhad from 2010 to 2020 using available sampling method. Infants suspected of bacterial infection who had positive blood cultures were included in the study. Type of bacterial organism, time of sepsis, main causes of death and need for mechanical ventilation were evaluated. Results Eighty eight neonates had early sepsis and 197 neonates had late sepsis. The bacterial organism of early sepsis was gram negative as 70.1% and in late sepsis was gram negative as 77.1%. The most common causes of early sepsis were Klebsiella pneumonia 21 cases (23.9%), Staphylococcus epidermis 16 cases (18.2%) and 10 cases (11.4%) E. coli . And the most common causes of late sepsis were K. pneumonia 35 cases (25.4%), Enterobacter aeroginosa 25(18.1%), S. epidermis 12(8.7%) and E. coli 11(8%). Conclusion K. pneumonia, S. epidermis and E. coli were three most common organisms in early neonatal sepsis and K. pneumonia, S. epidermis and Enterobacter were the most common organisms in late neonatal sepsis. [ABSTRACT FROM AUTHOR]

Background Emotional intelligence as the ability to understand emotions in self and others, is recognized as underlying success in various aspects. Objective This study aimed to investigate the relationship between emotional intelligence and sleep quality in female high school students. Methods This cross-sectional study was conducted on 284 female high school students in Rasht in 2019- 2020, selected by cluster sampling. Demographic, the Bar-On emotional intelligence, and the Pittsburgh sleep quality index (PSQI) questionnaires were completed online by the participants. Data were analyzed by IBM SPSS statistics software, version 22 using Spearman’s correlation coefficient and multiple logistic regression analysis. Results The Mean age of participants was 13.94±0.95 years, and the mean previous grade point average (GPA) of participants was 19.61±0.89. The Mean total score of students’ emotional intelligence and sleep quality were 334.95±42.82 and 4.71±3.20, respectively. There was a significant negative correlation between the total score of emotional intelligence and sleep quality (r=-0.427 and P<0.001). Also, 31% of the subjects had poor sleep quality (95% CI, 25.7%-36.6%), and the multiple logistic regression showed an inverse relationship between poor sleep quality and emotional intelligence score (OR=0.98, P<0.001). There was no association between demographic variables and sleep quality (P>0.05). Conclusion About a third of female students had poor sleep quality. There was a significant relationship between sleep quality and emotional intelligence. Therefore, poor sleep quality was associated with lower emotional intelligence. [ABSTRACT FROM AUTHOR]

Background and Aim Food and sports supplements are used by athletes all over the world, and correct and optimal consumption improves performance and prevents sports injuries. In this regard, creatine and ginseng supplements can be effective on physiological indicators and sports performance. Therefore, considering that no research has been done on the use of these supplements on blood indicators on fencers. The present study compares the effect of creatine and ginseng supplements on blood ammonia, HDL, LDL and homocysteine indices of the male players of the Iranian Epe fencing team. Methods & MaterialsIn the present study, 14 male players of the Epe national fencing team were divided into two creatine supplement groups (7 people) and ginseng supplement group (7 people). Subjects in two groups performed their normal exercises with the team during the research, and on the day before the measurement, after a specific activity in a sitting position, blood was taken from the arm vein of the subjects by a specialist. The statistical significance difference was determined at the level of P ≥ 0.05 and ANCOVA test was used to determine the differences between groups and the data was analyzed by SPSS software, version 25. Ethical Considerations This article was approved by the Ethics Committee of Islamic Azad University, Shahrood Branch (Code: IR.IAU.SHAHROOD.REC.1400.073). Results The results showed that after six weeks, there is a significant difference between the creatine and ginseng groups in the blood indices of ammonia, LDL, HDL and homocysteine (P≥0.05). so that the average of creatine supplement group in ammonia, LDL, HDL and homocysteine index in terms of mg/ dL respectively (2.56±0.83, 1.16±0.33, 7.45±0.48, 8.89±0.18) and Gensing group (2.05±0.29, 1.46±0.78, 8.11±0.27, 7.63±0.45). Conclusion The results showed that there is a significant difference in the average of blood ammonia, HDL, LDL and hemocytin between the creatine supplement group and the ginseng supplement group. Therefore, the role of ginseng supplement in reducing blood ammonia and homocysteine and in increasing HDL was more than that of creatine supplement, and the role of creatine supplement in reducing LDL was more than that of ginseng supplement. So it can be concluded that the role of ginseng supplement in the changes of blood ammonia, homocysteine and HDL is more than the role of creatine supplement. [ABSTRACT FROM AUTHOR]

Background and Aim It is suggested that hearing impaired children with hearing aids and cochlear implant, showed poor pragmatic abilities. Pragmatic is the most related language component to social interaction. Further, it has effect on personality development and self-esteem. The main aim of the present study is investigating the relationship between pragmatic abilities and self-esteem in hearing impaired children. Methods & Materialssixty hearing impaired children with hearing aids or cochlear implant were included into this study according to inclusion and exclusion criteria. Then parents or other caregivers were asked to fulfill children’s communication checklist (CCC) and self-esteem questionnaire. The participants were divided into three groups based on hearing impairment severity, including: severe, moderate and mild. The relationship between pragmatic ability and self-esteem was examined in three groups and without considering categorization, by Pearson correlation coefficient, significant level was 0.05. Ethical Considerations This project was approved by the Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1399.150). Results The results illustrated that there is significant relationship between pragmatic abilities and selfesteem in all hearing impairment children without considering categorization (P<0.05). By considering categorization, significant relationship was showed in self-esteem and pragmatic abilities in moderate and mild groups (P<0.05). Conclusion According to our analysis, pragmatic abilities and self-esteem are related. This relationship is more obvious in low severity impairment. [ABSTRACT FROM AUTHOR]

Background and Aim Oral and dental health plays an important role in people's general health and is affected by various factors such as knowledge and attitude of a person regarding oral and dental health. Improving people's Knowledge and attitude in this regard will lead to more attention towards oral and dental health. therefore, the present study was conducted to determine the rate of tooth decay and its relationship with knowledge, attitude and performance in high school students in the Islamabad-eGharb city. Methods & Materials This study was a cross-sectional study conducted among 348 high school students in Islamabad-e-Gharb. Which were selected through sampling in two stages, cluster and random. Data were collected using clinical examination and standard questionnaire and analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Sheffe post hoc test and Spearman's correlation coefficient at a significance level of less than 0.05 using SPSS software, version 22. Ethical Considerations This study was approved by the Ethics Committee of the Kermanshah University of Medical Sciences (Code: IR.KUMS.REC.1397.548). Results The Mean Decay-Missing-Filled Teeth (DMFT) index 6.07±3.47 and Mean teeth decayed were 5.31± 2.90 respectively and 96.3 percent of the students had dental carries. Both DMFT index (r=-0.124, P=0.021) and teeth decay (r=-131, P=0.015) had a significant relationship with students' performance regarding oral and dental health. There was no significant difference between DMFT index and the number of teeth decayed with students' knowledge and attitude regarding oral and dental health (P<0.05). No significant relationship were found between either DMFT index (P=0.749) and teeth decay (P=0.614) with gender. Conclusion In this study, DMFT index and teeth decay were relatively high and this shows the need to design educational interventions in adolescents to prevent teeth decay. [ABSTRACT FROM AUTHOR]

Background & Aims Healthcare providers are responsible for providing services to mothers and infants during disasters. The purpose of this study is to determine their educational needs for maternal and newborn care during disasters in Iran. Materials & Methods This is a cross-sectional study that was conducted in 2017 on 208 healthcare providers (nurses, practical nurses, and midwives) from nine armed forces hospitals in Tehran, Iran who were selected by a census method. The data collection tool was a researcher-made questionnaire with acceptable face validity, content validity, and structure, with a Cronbach’s alpha of 0.94. The data were analyzed using descriptive and inferential statistics in SPSS software, version 16. Results The mean score on the educational needs assessment scale was higher in the fields of sexual violence management (4.30±0.01) and information management (4.28±0.01), indicating the high need for education in these areas. The lowest scores were in the fields of postpartum care in newborns (2.19±0.96) and responsiveness (2.98±0.89). In total, the educational needs of healthcare providers were high (3.3±0.43). Conclusion The readiness of healthcare providers in Iran to provide maternal and newborn care during disasters is low and needs more attention. Therefore, it is recommended to compile and revise university educational programs and implement continuous education programs based on the results of this study in the proposed areas (especially sexual violence management and information management) in a regular, periodic, and continuous manner. [ABSTRACT FROM AUTHOR]

Background & Aims safe nursing care is the use of knowledge and skills by nurses to provide quality patient care and it is considered one of the health goals in intensive care units. The feeling of being supported by the hospital play a key role in achieving this goal; it can lead to job satisfaction, good job performance, and patient satisfaction. This study aims to determine the relationship between perceived organizational support and safe nursing care in nurses working in the intensive care units (ICUs) of public hospitals in Tabriz, Iran. Materials & Methods This is a descriptive-correlational study with a cross-sectional design that was conducted on 200 nurses working in the ICUs of hospitals affiliated to Tabriz University of Medical Sciences in 2021-2022, who were selected using a quota sampling method. Eisenberger et al.’s perceived organizational support scale and Rashvand et al.’s safe nursing care questionaire were used to collect data. Data analysis was done in SPSS v.16 software using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, analysis of variance, and Pearson correlation test). Results The mean score of perceived organizational support was 23.20±9.57, which was lower than the cutoff point. Safe nursing care was at a favorable level with a mean score of 322.89±34.1. The perceived organizational support had no statistically significant correlation with safe nursing care and its dimensions. Conclusion Despite the unfavorable perceived organizational support of ICU nurses in Tabriz, their safe nursing care is favorable. There is no statistically significant relationship between their perceived organizational support and safe nursing care. This finding is probably due to the prevailing rules and professional beliefs in the work of nurses, which has caused the care provided to be safe despite the perception of low organizational support. [ABSTRACT FROM AUTHOR]

Background & Aims Breast cancer (BC) is one of the important challenges of the health system due to its impact on marital relationships. This study aims to compare sexual function and sexual distress of women with and without BC. Materials & Methods In this case-control study, 75 women with BC and 75 healthy women from Zanjan, Iran participated. Data were collected using a demographic form, the female sexual distress scale-revised (FSDS-R), and the female sexual function index (FSFI). Data analysis was done in SPSS software, version 20 using the Mann-Whitney test and multivariate analysis of covariance. Results The mean age of patients was 36.49±6.53 years and the mean age of controls was 36±0.72 years. There was no statistically significant difference between the two groups in terms of some demographic variables such as age, educational level of women and their husbands, occupation of women and their husbands, place of residence, and number of children (P>0.05). The mean score of FSFI in all subscales in the patient group was lower than in the control group. This difference was statistically significant only in the dimension of desire (P=0.003). regarding the sexual distress variable, the mean FSDS-R score of healthy women was lower than that of women with breast cancer, but this difference was not statistically significant (P>0.05). Conclusion The difference between women with and without breast cancer is significant only in the desire domain of sexual function. There is no statistically significant difference between the two groups in sexual distress and in other domains of sexual function. The sexual problems of women with BC require consideration and support, and provding counseling in terms of sexual function. [ABSTRACT FROM AUTHOR]

Background & Aims Admitting a child to a pediatric intensive care unit (PICU) brings various physical, psychological and social consequences for parents. Supporting parental self-efficacy is a step to ensure successful implementation of pediatric care. Therefore, it is necessary to provide appropriate interventions to reduce anxiety and stress and improve self-efficacy of parents. Although mobile-based education has been used for patients in many studies, its use for family caregivers of children admitted to PICU is limited. This study aims to assess the effect of a mobile-based educational program on the anxiety and self-efficacy of mothers with children admitted to PICUs in Iran. Materials & Methods In this quasi-experimental study, participants were 60 mothers of children admitted to the PICUs of hospitals in Shahrekord, Iran from April to August 2022. They were selected using a convenience sampling method and were divided into two intervention and control groups. The intervention group received a mobile-based educational program for four days, one session per day, each for 60 minutes. For the control group, routine education was given by the ward nurses. Data were collected by Spielberger’s state-trait anxiety inventory and Schwarzer & Jerusalem’s general self-efficacy scale. Data were analyzed using descriptive and inferential statistics. Results The mean self-efficacy score in the intervention group increased significantly compared to the pre-intervention score (from 19.60±4.01 to 21.87±5.13; P<0.001), but no significant difference was observed in the control group (from 18.53±4.23 to 19.30±5.40; P=0.393). In the intervention group, the mean anxiety score decreased significantly compared to the pre-intervention score (from 47.33±5.52 to 43.63±5.27; P=0.001) but no significant difference was observed in the control group (from 48.30±6.88 to 46.43±9.02; P=0.131). There was no significant difference between the two groups in anxiety and self-efficacy scores before and after the intervention (P>0.05). Conclusion Nurses can reduce anxiety and increase the self-efficacy of mothers of children admitted to PICUs by using other measures along with virtual education, which requires more research in this field. [ABSTRACT FROM AUTHOR]

Background & Aims The present study aims to determine the fear of COVID-19 in the elderly newly diagnosed with cancer referred to selected hospitals affiliated to Alborz University of Medical Sciences. Materials & Methods In this longitudinal study, 174 elderly people newly diagnosed with cancer referred to the selected hospitals participated, who were selected using a continus sampling method. To collect data, a demographic form, the Abbreviated Mental Test, and the 7-item fear of COVID-19 scale were used before diagnosis, one month after, and two months after. The data were analyzed in SPSS software, version 22. Results Fear of COVID-19 level at the time of cancer diagnosis was moderate (mean score: 17.69±4.74). In the second stage (one month after the diagnosis), the mean score was 14.26±4.09. In the third stage (two months after diagnosis), the mean score was 11.81±4.13. Fear of COVID-19 at the time of cancer diagnosis was significantly different based on marital status (P=0.049), underlying diseases (P=0.014), and perception of health (P=0.004). Conclusion Fear of COVID-19 can disrupt the process of treatment and chemotherapy in elderly patients with cancer. It is recommended to develop interventions to improve the mental health of the elderly with cancer during the pandemic. [ABSTRACT FROM AUTHOR]

Background & Aims One of the challenges in accurate and macro planning for the future is the uncertainty involved in estimating the future and rapid changes in various health-related fields. A powerful tool that can predict future competitive environments is the scenario planning tool. The current research aims to provide scenarios for the future of nursing education in Iran. Materials & Methods This exploratory research was conducted in 2022. In the first stage, the drivers and trends of nursing education were identified using meta-synthesis, interviews, and the Delphi method. Then, the influence and uncertainty of the identified trends were rated using the opinions of a panel of experts. In the next step, using influence/uncertainty diagrams, the key factors for writing the scenario were identified. Scenarios were then designed by Scenario Wizard software, version 4.11, and strategies were presented. Results The experts agreed on 6 drivers and 31 trends. With five key uncertainties, the scenarios were designed with three optimistic, realistic, and pessimistic assumptions. According to the size of the matrix and its dimensions (15×15), four problem-oriented, ethics-oriented, maintaining the status quo, and limited educational system scenarios were designed. The validity of the scenarios was examined according to feasibility, internal consistency, usefulness, and differentiability. Conclusion Each of the four designed scenarios has the potential to be realized, but their occurrence depends on the current plans. The use of future planning methods, such as the scenario planning tool, can be used as a warning system for awareness of opportunities and threats in Iran's health system before a crisis. [ABSTRACT FROM AUTHOR]

Background and Aim Crisis management is an important field of management, especially in the field of health. This study aims to investigate the factors affecting the development of disaster management mechanisms in hospitals of Arak, Iran. Methods & Materials In this regard, 240 questionnaires were distributed among hospital and nursing managers in Arak. The questionnaire had acceptable reliability with Cronbach’ alpha value of 0.897. Ethical Considerations This study was approved by the ethics committee of Arak University of Medical Sciences (code: 1274.1401.REC.ARAKMU.IR). Results Then, by using structural equation modeling in LISREL software, the designed model was analyzed. Finally, by using statistical tests, the research hypotheses were examined. Conclusion The results showed the significant effect of three factors of “lack of stability in business environment”, “risk taking”, and “organizational culture” on the development of the mechanism of crisis management. [ABSTRACT FROM AUTHOR]

Background and Aim Old age is a critical period in life. Due to advances in technologies and improvement in healthy conditions, the number of aged population is increasing. Hence, it is necessary to pay attention to their life satisfaction and attitudes towards aging. The present study aims to assess the effectiveness of a psychological empowerment program on life satisfaction and attitude towards aging in older women living in Tehran, Iran. Methods & Materials The study population consists of all women aged 60-70 years referred to a charity foundation in Tehran, Iran in 2020. Of these, 24 women were selected by a convenience sampling method. They were randomly assigned to the intervention (n=12) and control (n=12) groups. Using a pre-test/post-test design, the elderly first completed the life satisfaction index-Z and the attitude towards aging questionnaire. Then, the experimental group received the psychological empowerment program at 8 sessions. After the intervention, the questionnaires were completed again by both groups. Multivariate analysis of covariance was used to analyze the collected data in SPSS software, version 19. Ethical Considerations This study was approved by the Research Ethics Committee of Islamic Azad University of Arak Branch (Code: IR.IAU.ARAK.REC.1400.027). Results There was a significant difference in life satisfaction (F=9.673, P=0.006) and attitudes towards aging (F=8.385, P=0.009) between the two groups. The psychological empowerment program significantly improved life satisfaction and attitudes towards aging in older women. Conclusion The psychological empowerment program is effective in improving life satisfaction and attitude towards aging in older women living in Tehran. It can be used by experts in the fields of counseling, geriatrics, psychology, and health. [ABSTRACT FROM AUTHOR]

Background and Aim This study aims to investigate the effect of nurses’ autonomy on the quality of patient care based on Kramer and Schmalenberg’s model Methods & Materials This is a causal-comparative study. Participants were 101 nurses of Imam Khomeini Hospital in Arak, Iran from the intensive care unit and internal medicine, surgery, pediatrics, gynecology, orthopedics, and emergency departments. The data collection tools were Moghimi and Ramazan’s patent care quality questionnaire and an autonomy assessment questionnaire based on Kramer and Schmalenberg’s autonomy model. The data were analyzed in SPSS software. Ethical Considerations This study was approved by the ethics committee of Islamic Azad University of Arak Branch (Code: IR.IAU.ARAK.REC.1397.66). Results The mean autonomy score of nurses was 3.16 ±0.35, indicating a desirable level. Nurses of all departments had limited autonomy. In the internal department, nurses had unsanctioned autonomy, while in the surgical department, they had autonomous nursing care action. The regression models were significant for all departments except for the internal department. With an increase of one unit in limited autonomy in the intensive care unit, autonomous nursing care in the surgical department, and limited autonomy in pediatrics, gynecology, orthopedics, and emergency departments among the nurses, the quality of care can be increased by 0.253, 0.187, 0.522, 0.205, 0.466 and 0.129, respectively. Conclusion Nurses’ autonomy can increase the quality of patient care. The nursing managers need to empower nurses and provide an environment for them to apply their knowledge in practicing autonomy. [ABSTRACT FROM AUTHOR]

Background & Aims Nurses are the largest group of healthcare providers, especially during the COVID-19 pandemic. Patients with COVID-19 are in dire need of spiritual care due to being alone in quarantine, away from their families. The present study aims to assess the spiritual care competence of nurses in the special care units for COVID-19 in teaching hospitals in Arak, Iran Materials & Methods This is a descriptive cross-sectional study. Participants were 142 nurses working in the special care units for COVID-19 in hospitals affiliated to Arak University of Medical Sciences in 2022, who were selected by a census method. The data collection tool was the spiritual care competence scale. The data were analyzed in SPSS software, version 16. Results The mean total score of spiritual care competence was 100.71±14.45, which was higher than the median score of 81. The spiritual care competence had a significant relationship with marital status (P=0.044), willingness to work overtime (P<0.001), age (P=0.011), total work experience (P=0.03), and work experience in the special care unit (P=0.025), such that spiritual care competence was higher in older married nurses with a willingness to work overtime and a higher work experience. Conclusion The spiritual care competence of nurses in the study hospitals is at a favorable level. The results of this study can help future studies in improving the quality of nursing care and the competence of nurses in spiritual care. [ABSTRACT FROM AUTHOR]

Background & Aims Infant hospitalization in the neonatal intensive care unit (NICU) causes loss or delay in mother-infant attachment. On the other hand, quarantine and social distancing during the COVID-19 epidemic had psychological consequences, such as increased fear of infection. This study aims to determine the relationship between mother-infant attachment and fear of COVID-19 in mothers with neonates admitted to the NICUs of selected hospitals in Tehran, Iran, during the COVID-19 pandemic. Materials & Methods In this descriptive-correlational study, participants were 195 mothers with neonates admitted to the NICUs of selected teaching hospitals affiliated to Iran University of Medical Sciences in 2021. Data collection tools were a demographic form, the fear of COVID-19 scale (FCoV-19S), and Avant’s mother-infant attachment behaviors questionnaire, which were completed by the researcher. Data were analyzed in SPSS software using independent t-test, Kruskal-Wallis test, Mann-Whitney U test, and ANOVA. Results The mean score of FCoV-19S was 19.04±5.40, and the mean score of mother-infant attachment was 70.12±50.65. No significant relationship was observed between the fear of COVID-19 and motherinfant attachment (P>0.05). Fear of COVID-19 had a significant relationship with the interest in the baby’s gender (P=0.001) and the mother’s education level (P=0.041). Mother-infant attachment had a significant relationship with interest in the baby’s gender (P=0.01) and infant hospitalization due to jaundice (P=0.049). Conclusion Mother-infant attachment of the mothers in this study is low, and their fear of COVID-19 is almost high. There is no significant correlation between the fear of COVID-19 and mother-infant attachment. It is necessary to pay attention to effective factors in promoting emotional attachment between mothers and neonates hospitalized in the NICUs. It is also recommended that the medical staff and nurses pay attention to this group of mothers during pandemics such as COVID-19 and use some techniques to reduce their fear of infection. [ABSTRACT FROM AUTHOR]

Background & Aims The present study aims to compare the effects of emotion regulation training and mindfulness-based cognitive therapy (MBCT) on the resilience and self-compassion of women with irritable bowel syndrome (IBS). Materials & Methods This is a quasi-experimental study with a pre-test/post-test/follow-up design. The study population consists of 300 women with IBS who visited the clinics of internal medicine physicians in Ilam, Iran, in 2018-2019. The sample size was determined 20 for each group based on the Fleiss method. Therefore, 60 were selected by a simple cluster sampling method and based on the entry criteria. They were divided into three groups of emotion regulation (n=20), MBCT (n=20), and control (n=20). After the interventions, the post-test and follow-up assessments were conducted for the groups. The instruments were the Connor-Davidson resilience scale and the self-compassion scale of Neff (2003). For data analysis, SPSS software, version 23 and repeated measures analysis of variance were used. Results Both emotion regulation training and MBCT had a significant effect on the resilience and self-compassion of women (P=0.001), where MBCT had a greater effect compared to emotional regulation training. Conclusion The MBCT can be used as an effective method to increase resilience and self-compassion of women with IBS. [ABSTRACT FROM AUTHOR]

Background & Aims Due to having multiple tasks in ensuring the health of patients, primary healthcare workers are under many stresses that may lead to job burnout. The present study aims to determine the relationship between occupational stress and job burnout of primary healthcare workers. Materials & Methods This descriptive, correlational study was conducted in 2019 on 128 primary healthcare workers in Saveh and Zarandieh cities, who were selected by a census method. Data was collected by a demographic form, the Maslach Burnout Inventory (MBI), and Spielberger’s job stress survey (JSS). Descriptive statistics were used to describe the data, and independent t-test, analysis of variance, and Pearson correlation test were used to analyze data in SPSS software, version 18. Results The mean score of JSS was 140.7±48.6, which was lower the median score (150). The mean frequency score was 23.43±8.3 for the MBI dimension of emotional exhaustion, 17±4.78 for depersonalization, and 14.43±6.74 for personal accomplishment. Occupational stress had a positive and significant relationship with the frequency of emotional exhaustion (r=0.59, P<0.001) and depersonalization (r=0.22, P<0.001), and a negative and significant relationship with the frequency of personal accomplishment (r=-0.47, P<0.001). This indicates that with the increase of occupational stress, the frequency of job burnout in two dimensions of emotional exhaustion and depersonalization increases, while the frequency of personal accomplishment decreases. Conclusion Primary healthcare workers in the study region have moderate occupational stress and a high level of job burnout in the areas of depersonalization and personal accomplishment. Considering the high level of job burnout and its relationship with occupational stress in these healthcare workers, and the fact that these factors can have a negative impact on the quality of healthcare services, it is necessary to carry out necessary interventions to reduce and manage occupational stress and job burnout of primary healthcare workers. [ABSTRACT FROM AUTHOR]